Burst your social bubble and limit contact only to those in your household: Toronto's top doctor

Toronto's top doctor is warning that it's time to burst your social bubble and limit your interactions with anyone outside your immediate household or essential supports.

Bubbles were initially an effective method of curbing the spread of COVID-19, the city's medical officer of health Dr. Eileen de Villa said at a news conference on Monday. But since then, she said, "times have changed."

"In Toronto, we have to acknowledge that the extent of the infection spread and the nature of city life means that the concept of the bubble or the social circle no longer reflect the circumstances in which we live," she said Monday. 

The idea of a social bubble was first introduced to Ontarians in early June, when people were given the go-ahead to build circles of up to 10 people that could include family and friends. Interactions involving people outside of that group required physical distancing and wearing masks when that wasn't possible. 

Ontario Premier Doug Ford declined to comment on Toronto's move when asked by reporters, deferring to Dr. David Williams, Ontario's Chief Medical Officer of Health.

Williams said the province stands by the bubble idea, but warned people have become too casual about maintaining their circles. "You have to maintain the integrity of that," he told reporters, especially in "hot zones" like Toronto.

De Villa took a harder line, suggesting the changed circumstances in Toronto — namely the reopening of schools — have rendered those bubbles ineffective and much harder to implement. 

Not only that, but health officials say the bubbles have contributed to a recent surge in cases across the city. 

COVID-19 spread through people, not places 

What's more important now, de Villa said, is for people to think carefully before making the decision to go anywhere and to limit all interactions with anyone outside their immediate household and essential supports — even those who were previously in their bubble. 

"Where you go in the city is less important than what you do when you are there," she said. 

"Truly, the most important thing to know is that you get COVID-19 from people, not from places. And in a big city like ours, people are everywhere.

Board of Health Chair Joe Cressy agrees. 

"We must accept that we are now in a very different place than we were back in August," he said in a statement Monday. 

"The 10-person social bubble is over. The time has come to take stronger action, together." 

Their comments come as Toronto reported 381 new cases on Monday, while Ontario saw a record-breaking total of 700 new cases recorded in a single day. 

Toronto again led the way in terms of cases across the province on Tuesday, with 251 of Ontario's 554 recorded cases. 

Outbreaks in the city have been linked to a number of restaurants, as well as two Toronto schools. 

De Villa isn't the only one to push for an end to social circles. Amid the return to school, experts warned earlier this month that the approach comes with risks. 

De Villa calls for enhanced regulations in new report 

In place of social bubbles, de Villa is calling for stricter regulations across the city. 

She issued a new report Monday that recommends extending current mandatory masking, physical distancing, and bar and restaurant bylaws, along with scaling up measures to combat COVID-19. You can read more of her recommendations here.

Mayor John Tory said he "fully supports" de Villa's recommendations, saying they will protect the health of the city. 

"We are asking Toronto residents to recognize the alarm bell is ringing and to take action now in their own lives that will help stop the spread of COVID-19 and flatten the curve again," he said in a statement issued Monday. 

Tory said the city is taking action to address the recommendations, which will be considered by city council this week. 

Is another lockdown coming? 

Cressy also said enhanced restrictions are necessary if Toronto hopes to avoid another lockdown. 

"There is no longer any ambiguity: COVID-19 cases are rising rapidly, and we must act now in order to stop transmission, preserve our health-care system and prevent another city-wide lockdown," he said. 

Cressy added that the city is at a "tipping point," and the action taken now will impact the trajectory of Toronto's COVID-19 curve. 

"If we want to keep schools open, ensure access to public services and protect the capacity of our health-care system we can't afford to continue with the status quo." 

Meanwhile, despite a group of doctors and medical experts calling for a return to Stage 2, Ontario Premier Doug Ford has not announced any new public health measures, but has said nothing is off the table to address the increase.

Speaking to reporters, Ford said Ontario is indeed embarking on its second wave, which will be "more complicated, more complex — it'll be worse" than the first.