Toronto unveils plan to deal with 2nd wave of COVID-19 that medical officer calls 'inevitable'

City officials unveiled a plan on Monday to deal with a second wave of COVID-19 that Toronto's medical officer of health says is "inevitable" this fall.

Dr. Eileen de Villa told reporters at a virtual news briefing at city hall that there is "no question" that there will be a resurgence of COVID-19, given the experience of other places, the reopening of schools across the city and the fact that most residents do not have immunity to the virus.

"Based on what we've seen in other places, resurgence in Toronto is inevitable," De Villa said.

"Even New Zealand, hailed as one of the leaders in COVID-19 containment, has had to mobilize to fight cases that have popped up."

She said the University of Minnesota's Center for Infectious Disease Research and Policy has described three possible scenarios:

• A series of small waves that will occur through to 2021 and gradually diminish.
• A large wave in the fall or winter followed by smaller waves after that, similar to what occurred in the 1918-1919 influenza pandemic.
• A slow burn of transmission and case occurrence but with no clear wave pattern.

"There is no way to know what will happen," she said.

But Toronto must plan for additional cases as schools reopen, she said.

"We are planning based on certain assumptions. While scientists are working with speed and determination, we still don't expect highly effective treatments in the very near future and we aren't planning on vaccine availability before the spring of 2021 at the earliest. Until then, we have to find way to live with COVID-19 in our city," De Villa said.

Her comments came as officials outlined how the city is preparing for a resurgence of the virus and how it will act to minimize that resurgence.

The city has conducted a review of its response to COVID-19 during the first wave to determine what worked, what proved to be challenging and what would be useful to implement in future.

In a news release on Monday, it said it is getting ready for "several potential scenarios" with measures that will be based on advice from the medical officer of health.

These plans include actions in the following areas:

• Childcare: In the event that licensed child care centres are required to close, the city said it would operate free emergency child care for essential workers again, if the province is willing to fund these centres again.
• Long-Term Care Homes: The city would implement infection prevention and control best practices and lessons learned from the first wave of COVID-19, take action to ensure stability of staffing resources and allow designated essential visitors and caregivers into homes to support residents during outbreaks.
• Parks and Recreation facilities: In the event that recreation facilities and park amenities are required to close, the city said it would move quickly to scale back to critical services. To respond to vulnerable populations and emergency social services, the city would modify facilities to create food distribution sites and expand its shelter system.
• Bylaw enforcement: Municipal Licensing and Standards bylaw enforcement, part of a coordinated enforcement team that consists of nine city divisions and Toronto police, will focus on enforcing provincial orders and city bylaws pertaining to COVID-19.
• Homelessness support: Shelter, Support and Housing Administration will continue to protect people experiencing homelessness and continue to focus on providing permanent housing as the best solution to homelessness. Protective measures, such as physical distancing, will remain in place in shelter facilities.
• Homelessness support and cold weather planning: As the weather becomes colder, plans include maintaining additional winter space and enhanced street outreach services to help people gain access to shelter and housing and to allow them to move indoors from encampments. The city is also exploring a program model to operate a warming centre during extreme cold weather alerts.
• Support for vulnerable residents: Under the city's community coordination plan, the city works with nearly 400 community agencies to coordinate support for vulnerable communities.The city is prepared to step up measures in response to a resurgence.
• TTC: Service levels can adjusted based on demand. The TTC continues to focus on protecting service on high ridership routes. Health and safety measures implemented on the system in response to COVID-19 will continue to be maintained.
• Toronto Public Library: The focus will be on keeping buildings open to serve communities of highest need and pivot between digital and in-person services as needed to respond to surges in demand.

Mayor John Tory says city plans for a resurgence include strengthening case and contact management at public health, creating community outreach rapid response teams to tackle spread of the virus in hard hit neighbourhoods, drafting specific health plans for schools and long-term care homes and maintaining a supply of personal protective equipment.

The rapid response teams, which would be multilingual, would connect directly with people, agencies and organizations working in communities that have seen many cases.

"All of these plans are focused on making sure we minimize the resurgence as much as possible," Tory said in the release.

Toronto reported 40 new cases on Monday. A total of 1,175 people have died of COVID-19 in the city. According to Toronto Public Health, the city has had a cumulative total of 16,044 cases, with 14,498 marked as resolved.