Politics, economics & public health collide in Peel’s new COVID messaging 

“Trust and transparency” are the key to fighting this pandemic. So said U.S. Congressman Raja Krishnamoorthi in the face of President Donald Trump’s pathological distortion of the truth, which has put millions of lives at risk. 

Clear and concise information is, perhaps, the most crucial antidote against the spread of COVID-19. It allows officials to update residents on what should be done to keep them safe.

But, unfortunately, just like Americans, Peel residents have not always enjoyed life-saving public health information that is free of confusion. 

Ahead of Thanksgiving, Premier Doug Ford’s messaging on gatherings perplexed many. After he said gatherings should not exceed 10 people, it became unclear who those 10 people could be. Eventually, at the eleventh hour, the Province told residents to limit gatherings to immediate household members only. 

Premier Doug Ford and other political leaders have not always provided clear messaging during the pandemic. 

Later, politics at Queen’s Park appeared to mix uncomfortably with public health guidance. A letter from mayors and MPPs in Halton Region convinced Ford and Dr. David Williams, Ontario’s chief medical officer, to change their minds and back away from moving the region to a modified Stage 2. 

Political leaders, heavily influenced by the business community, have stepped into the spotlight on decision making, despite repeated claims across the country by leaders that, in Canada, scientists and medical experts would dictate our pandemic response. Much of the decision making power appears back in the hands of politicians, not the experts. 

When Peel Region entered a modified Stage 2 on October 10, local leaders, reminded by loud advocates of the devastating impact the move would have on businesses, expressed their displeasure. Both Brampton Mayor Patrick Brown and Mississauga Mayor Bonnie Crombie publicly advocated for restrictions to ease, saying businesses would struggle with the shutdown. 

Crombie has been far more transparent and has admitted that her role as the city’s CEO demands she consider what constituents are telling her.

“My job as mayor is to try to balance public health priorities with economic realities,” Crombie told The Pointer in an email Thursday. “Many businesses in our community are on the verge of collapsing, with many small-business owners struggling to provide for their families. This is why I advocated for a safe path forward for all our small businesses.”

In recent weeks, Crombie has drawn on two key arguments. She has said restaurants, bars and gyms are not a significant cause of COVID-19 cases in Peel, while advocating for a restaurant model similar to school settings. She has suggested restaurants with reported cases should be closed or cleaned similar to the protocols in place at schools. 

Mayors Patrick Brown and Bonnie Crombie

Last week, one in four schools at Peel’s two major boards had at least one active case of COVID-19, suggesting they may not be an ideal example to copy. Education also plays a significant role in child development and is the building block of our entire economy; critics would argue restaurants and bars, though a central part of our entertainment culture and its spillover economy, do not represent the same fundamental role in society. A variety of schools have also seen outbreaks declared, with one Catholic school conducting emergency testing.

“We know that the safety protocols that are in place in schools have been effective at limiting the transmission of COVID between an infected individual and the larger group in that setting,” Crombie told The Pointer. “I am hopeful that the new Provincial guidelines in place for restaurants, bars and gyms will likewise reduce the risk of any individual infected with COVID transmitting the virus to others in those settings.”

For several weeks, Crombie and Brown maintained that no COVID-19 cases had been linked to bars or restaurants. While the Mississauga mayor has since acknowledged the possibility, Brown has clung to his line in order to justify calls from some in his city to reopen even while Brampton remains the worst hit city in the province.

Provincial modeling released in late October shows, between August 1 and October 24, 3 percent of outbreaks that occurred in Peel came from restaurants, bars, and clubs, which Dr. Lawrence Loh, the region’s chief medical officer, attributes to “staff socializing after hours”. A further 4 percent are linked to gyms. 

Some 20 percent of transmission is attributed to the “community” and these infection sources are largely unknown. After being pressed by The Pointer Loh admitted that restaurants could be a source of unknown community transmission. With the release of the new data and Dr. Loh’s clarification, Crombie has acknowledged that low viral spread has occurred at restaurants. 

Brown has not addressed the data and did not respond to questions sent by The Pointer. Despite his city having an infection rate more than twice as bad as Mississauga and a test positivity rate well above twice as high, he continues to deny that reopening restaurants could make Brampton’s current COVID crisis even worse. 

Crombie admitted in her Thursday response to The Pointer some cases have been linked to restaurant and gym settings, saying residents should be aware of the risks. “While I believe that the new Provincial framework has provided us with a safe path forward for our small businesses, I also believe that it is important for our community to understand the inherent risks of dining indoors as well as working out indoors,” she said. “It is important that they know transmission can occur in these settings.”

Source of COVID-19 outbreaks in Peel between August and October

Health officials have been at pains to point out the Province’s data is just the tip of the iceberg and does not represent the full picture.

A Twitter thread from Ottawa Public Health, which has been particularly effective in its use of social media to communicate, explained the limits. “Important note: outbreaks are part of the picture, but not all,” one of the tweets reads. “Of our nearly 7000 lab-confirmed cases of COVID to date (the real number is much higher as not everyone gets tested), just over 2150 came from confirmed outbreaks (a little over 30%).”

In Peel, the number of new COVID-19 cases outstrips Ottawa daily. The region currently has the highest test positivity rate and per-capita rate of COVID-19 in Ontario. 

In the face of this reality, both Brown and Crombie are projecting a bullish stance: spread in restaurants is limited and the economy is suffering, so it's time to reopen.

Dr. Loh told The Pointer he took the input of all three of Peel’s mayors into account when making decisions. “The mayors have never hesitated to tell me what they want,” Dr. Loh said in an email. “They have also never hesitated to recognize that I am making recommendations and have listened to my advice.”

From Saturday, Peel restaurants will be allowed to start indoor dining, gyms can reopen and smaller public gatherings can resume under the Province’s tiered system. The new measures will put Peel in the restrict (orange) category of the Province’s new framework. A maximum of 50 people will be allowed to dine indoors, with no more than four people at one table. Restaurants will have to close by 10 p.m. and further restrictions on the sale and consumption of alcohol will be implemented. A maximum of 50 people will also be allowed in gyms and users won’t be allowed to exceed a 60-minute stay. Spectators will also not be allowed to attend any sporting events. 

It’s the move Crombie and Brown have been begging for.

Mayors of Peel's two big cities have pushed for the reopening of local restaurants for indoor dining, claiming it is safe to do so as viral spread in these settings has been minimal. 

To balance the relaxing of rules at the height of a second wave that already dwarfs the first in terms of new cases, Dr. Loh has outlined new measures for Peel.

In a Wednesday presentation to Mississauga councillors, he proposed new regulations that effectively doubled down on advice already in place. He suggested a ban on all indoor gatherings beyond immediate household members. He also suggested making sure the four people at a table inside restaurants are not from different households. After describing gyms and restaurants as “high-risk settings, even with precautions in place” at Brampton’s Wednesday press conference, Dr. Loh also suggested to Mississauga councillors capping religious settings to 50 people.  

The measures are being presented as a “counterbalance” to reopenings. It remains unclear how most will be enforced. A ban on having parents around for dinner, a friend over to watch TV or hosting a book club seem impossible to implement without constant enforcement. As The Pointer has previously reported, excessive fines and heavy-handed bylaw enforcement risk residents becoming uncooperative with contact tracers for fear of punishment. 

“My continued discussions with our Regional leadership will hopefully see some measures introduced then [at the November 12 Region of Peel Council meeting],” Dr. Loh said. “In the meantime, I provided my recommendations publicly to counterbalance the opening given the timeline announced by the province.”

Dr. Lawrence Loh, Peel's chief medical officer.

Mississauga councillors, meeting in General Committee Wednesday, were unable to pass an immediate bylaw. So far, they have not convened a special council meeting to enable the creation of tailored rules; Brampton council did not meet this week.

“I do not support the unrestricted opening of bars and restaurants,” Dr. Loh told The Pointer Wednesday, referencing the rules he wants to see put in place. 

He alluded to Provincial decision making as removed from his own process. “I understand, for whatever reason, the Province has decided [restaurants, gyms, bars] are to reopen in my community,” he said. 

Asked by The Pointer if he would push back and demand a delay from the Province, Dr. Loh said it was important for him to work as a “good partner”. The comment suggests Peel will take its marching orders from Queen’s Park, instead of using its unique local situation.

In her email response to questions, Crombie echoed the statement. “It is important to remember that the Province makes the decision as to when businesses are able to reopen,” she wrote. “The Province decides what category Peel Region is in under the new provincial framework and when restaurants, bars and gyms are allowed to reopen.”

In contrast to Peel, Toronto has held back on reopening until November 14 – despite similar pressure on its politicians and health officials from the business community. 

Toronto, which entered the modified Stage 2 with Peel on October 10, has a lower per-capita rate of cases than Peel. As of November 3, there have been nearly 104 cases for every 10,000 residents in Peel since the start of the pandemic, compared to 101 in Toronto for the same number of residents.

Brampton’s numbers are far worse than Toronto’s, with 149 COVID-19 cases per 10,000 residents since the beginning of the pandemic and a test positivity rate, according to the latest data, of 9.6 percent, more than twice Toronto’s 4.6 percent. 

When asked why he wasn’t following Toronto’s example of restraint even though the city is allowed to reopen indoor dining and gyms Saturday, Loh said he does not have the power to hold Peel back. But, unlike his Toronto counterpart, Dr. Eileen de Villa, he has not handed down such a directive to local politicians, instructing them to put public safety above economic concerns.  

When Provincial officials presented their new system, the Keeping Ontario Safe and Open Framework, it was understood that local medical officers of health could take action under Order 22 of the Province’s Health Protection and Promotion Act if they believe the framework doesn't fit the local context.    

The order states: a medical officer of health may make an order under this section where he or she is of the opinion, upon reasonable and probable grounds,

(a)  that a communicable disease exists or may exist or that there is an immediate risk of an outbreak of a communicable disease in the health unit served by the medical officer of health;

(b)  that the communicable disease presents a risk to the health of persons in the health unit served by the medical officer of health; and

(c)  that the requirements specified in the order are necessary in order to decrease or eliminate the risk to health presented by the communicable disease

Dr. Loh told The Pointer the section would only be used for those “who posed an immediate communicable disease threat,” such as someone who was diagnosed with tuberculosis, an infectious disease that affects the lungs. “The legal advice that I have received to date is that imposing things on a whole community would not meet the test for this definition.” 

It’s not clear why two separate sets of explanations exist, according to Loh, and why the section can only be used in certain cases of infectious diseases and not others. 

On November 4, Peel reported 299 cases, representing 30 percent of the province’s 987 new cases, and almost double the per capita rate of Toronto on the same day.

Brampton’s case numbers have been disproportionately high compared to Mississauga and Caledon for most of the pandemic. On Tuesday, Dr. Loh said he “would absolutely put more restrictions on Brampton if need be under the new framework.” When asked Thursday what could lead to those restrictions being imposed, the question was not directly answered. He instead repeated the current goal of introducing counterbalancing restrictions. 

With the new framework in place, Brampton’s test positivity rate is approaching 10 percent, putting it on the cusp of the control (red) stage. Peel, largely because of Brampton, is in a similar situation. 

While Mississauga has repeatedly made moves to impose its own restrictions, such as its decision in Stage 2 to keep hockey rinks closed for public use, Brampton, despite having a much worse COVID-19 situation, has not done the same. Even Brown took advantage of the hockey rink openings at the end of June – he was caught on video at one arena going to play hockey without a mask and not practicing social distancing.

Dr. Loh, meanwhile, seems to be contradicting himself, making stark warnings about the Province’s decision to allow reopenings in Peel, while refusing to direct the municipalities under his public health authority to enact their own legislated measures, just like Toronto did.

“Regardless of what the province’s new framework is saying, I must be clear: all of our metrics are going in the wrong direction. Peel is seeing the highest rates of case and test positivity in the province,” Dr. Loh said at Brampton’s Wednesday press conference. At Mississauga’s press conference later the same day, he repeated a similar message, saying “now is not the time to let our guard down.”

The strong words are part of a confusing line of messaging from Loh about how bad the situation is in Peel. Just two weeks earlier he claimed the region wasn’t even in a second wave, despite clear evidence that contradicted him, which showed Peel entered a second wave two months ago. Provincial and federal public health officials stated a second wave began in early September.

But after wider scrutiny by the media, Loh has quickly switched his stance. This week he urged residents to pick up the phone if Peel Public Health calls them, citing the overwhelming demand on contact tracers. A spokesperson from the Ministry of Health told The Pointer 14 public health units with lower case counts assisted Peel with investigations; 70 case and contact management staff are also being provided to Peel to help control the surging virus. 

Loh urged residents not to meet with people outside of their own household. Stressing the importance of working together to stop the spread, he asked residents not to attend any social gatherings. 

“We succeeded in slowing spread before...I know we can do it again. But it will take the extra effort and action of everyone pushing together to push COVID-19 back down again.”

Meanwhile, restaurants and gyms in Peel will reopen Saturday.

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Twitter: @isaaccallan 

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