Doug Ford said we need to learn to ‘live with’ COVID. What does that look like, anyway?

For nearly two years, Canadians have faced rolling restrictions on public life due to the ongoing threat of COVID-19. As the Omicron wave begins to wane in the province, politicians and doctors alike are beginning to envision a world where we move beyond emergency measures and live alongside the virus.

Ontario Premier Doug Ford said Friday that the province needs to learn to “live with” COVID-19. That thought was echoed the same day by Toronto’s medical officer of health Dr. Eileen de Villa, who said a mix of vaccinations, masking, distancing and ventilation will help lessen the risk of severe flare-ups of the virus as Toronto moves away from a “COVID-zero” approach to handling the pandemic. As of Monday, some restrictions placed on indoor dining, gyms and movie theaters have been lifted, though they will only be able to operate at 50 per cent of their regular capacity.

Meanwhile, a study released Monday has shown just how far the virus spread in Canada as a result of the highly-contagious Omicron variant: One in every five households has seen at least one case of COVID since the beginning of December. The same study found that more than half of respondents support an end to restrictions.

But what does “living with” COVID-19 look like? As Dr. Nelson Lee, interim director of the Dalla Lana Institute for Pandemics, told the Star, it’s not so much about living with the virus as it is about overcoming it.

Evidence has already shown that vaccination efforts reduced the spread of the virus, but more steps are needed to keep transmission low. Here are the measures three doctors have suggested we take to try to move past the emergency stage of the pandemic.

First, you need to have a plan

A proactive plan is a key part of responding to future waves, said Dr. Kashif Pirzada, a Toronto-based emergency physician. “You have to have an effective plan ready to go when cases start picking up again,” he said, adding ongoing monitoring of COVID-19 levels through measures such as wastewater testing will give a clear picture of when an action plan might need to be implemented. If numbers spike, the plan should be implemented automatically, Pirzada said.

Plans could include a move back to masking if mask mandates have been removed, he suggested, or a temporary stop of concession sales at entertainment venues. Pirzada foresees these measures as needing just a couple of weeks to slow a wave. “If you do it proactively, you can head the crisis off,” he added.

Improve ventilation in high-risk settings

With an airborne disease such as COVID-19, quality ventilation is a necessity. Lee said that improving the ventilation of shared spaces is an important aspect of infection control. Pirzada agreed, noting precautions like HEPA filters and carbon dioxide monitoring can help encourage clean air. The virus “struggles to spread” in well-ventilated settings, Pirzada said.

Upgrading ventilation in congregate settings like schools is a huge undertaking, said Dr. Lisa Iannattone, an assistant professor of dermatology with the University of Montreal.

“We can not do them all in a weekend, but you have to start somewhere,” she said of the need to upgrade air quality in congregate settings. Evaluating the worst-hit areas to see which need the most urgent attention is a good place to start, Iannattone added.

Your mask is sticking around for a while

Ventilation is just one piece of the puzzle in order to keep transmission down, the doctors agreed. While they do offer protection, surgical masks are not enough to slow the spread of Omicron, Iannattone said, adding respirator masks such as N95 or KN95 masks are much better. “That should be the mask that everyone is using,” she said, adding that because the masks are much more expensive than their surgical or cloth counterparts, equitable distribution must be considered.

Pirzada agreed, adding that countries like Japan which have embraced high-quality masks as a default have been able to handle the Omicron variant. Lee said that masks are an element that will allow us to return to businesses, schools and meet with friends or relatives. “It’s going to be a longer while,” he said of the need for masking.

Widespread testing is a must

All three doctors agreed that widespread testing will be required to prepare for future surges of the virus. Deploying rapid tests across the country to individuals, rather than asking the public to line up for just a couple of tests, would help to “break a lot of transmission chains quickly,” Pirzada said.

Though not as sensitive as their PCR counterparts, frequent rapid testing is a way to monitor for cases, Iannattone said. Having enough tests to monitor yourself on a near-daily basis, she said, would offer a way to catch positive cases and move people into isolation. “We’ll be able to contact trace, to isolate (close contacts) and get case numbers down to manageable levels again,” she said.

But with PCR tests still the most effective way to catch a positive case of COVID-19, Lee argued that access to these tests needs to be widespread. Increased availability of PCR testing is important long term, he said, so that people can access treatment options such as Paxlovid, a new antiviral COVID treatment that has recently arrived in Ontario.

Jenna Moon is a breaking news reporter for the Star and is based in Toronto. Follow her on Twitter: @_jennamoon