By Sue Tiffin
Local Journalism Initiative Reporter

A day after Ontario saw the highest number of people with COVID-19 related critical illness admitted to intensive care units [ICUs] of the pandemic, and a day before the Easter holiday began, the provincial government announced on April 1 they were pulling their so-called “emergency brake,” calling for a four-week shutdown in the province beginning April 3, though critics questioned if it was enough to prevent a further healthcare crisis.

“We are facing a very serious situation and drastic measures are required the contain the rapid spread of the virus, especially the new variants of concern,” said Premier Doug Ford in a statement released on the afternoon of April 1. “I know pulling the emergency brake will be difficult on many people across the province, but we must try and prevent more people from getting infected and overwhelming our hospitals. Our vaccine rollout is steadily increasing, and I encourage everyone who is eligible to get vaccinated. That is our best protection against this deadly virus.”

Modelling released by the provincial government’s COVID-19 scientific advisors in the morning prior to the shutdown announcement showed a surge of both COVID-19 case numbers and hospitalizations as variants of concern spread rapidly in the third wave of the pandemic in Ontario.

Ontario reported 2,557 new COVID-19 cases on that same day, while in Haliburton County, one new COVID-19 case – the only local case currently confirmed – was reported.

Earlier in the week, Ford said, “don’t make plans for Easter,” in hinting about Thursday’s announcement and more restrictions, and during the announcement, told people to not gather with people outside of their immediate household.

“Friends, right now we’re into a third wave of COVID-19,” said Ford in the April 1 announcement. “The variants of concern are spreading rapidly. This is a new pandemic. We’re now fighting a new enemy.”

The shutdown announcement means the colour-coded zones of COVID-19 Response Framework are paused. The ’emergency brake’ zone is listed above the grey zone in that framework.

As of 12:01 on Saturday, April 3, all 34 public health regions in the province will move into shutdown for four weeks.

Restrictions include:

• Prohibiting indoor organized public events and social gatherings and limiting the capacity for outdoor organized public events or social gatherings to a 5-person maximum, except for gatherings with members of the same household (the people you live with) or gatherings of members of one household and one other person from another household who lives alone.
• Limits on in-person shopping in all retail settings, including a 50 per cent capacity limit for supermarkets, grocery stores, convenience stores, indoor farmers’ markets, other stores that primarily sell food and pharmacies, and 25 per cent for all other retail including big box stores, along with other public health and workplace safety measures;
• No personal care services;
• No indoor and outdoor dining. Take-out, delivery and drive-thru options are allowed.
• Prohibiting the use of facilities for indoor or outdoor sports and recreational fitness (e.g., gyms) with very limited exceptions;
• The closure of day camps;
• Limiting capacity at weddings, funerals, and religious services, rites or ceremonies to 15 per cent occupancy per room indoors, and to the number of individuals that can maintain two metres of physical distance outdoors. This does not include social gatherings associated with these services such as receptions, which are not permitted indoors and are limited to five people outdoors.
• Short-term rentals – cabins and cottages – are only to be provided to individuals in need of housing.

Additionally, Ontarians are asked to limit their trips out for necessities – food, medication, medical appointments, exercise, and supporting vulnerable community members. Indoor gatherings are not allowed outside of those people you live with, and outdoor gatherings are limited to five people with physical distancing maintained, according to the Haliburton, Kawartha, Pine Ridge District health unit.

The restrictions are similar to those already in place in Toronto and Peel regions.

“The announcement from the provincial government regarding the province-wide emergency break measures is disheartening for local businesses,” said Angelica Ingram, Haliburton BIA. “Our BIA members have gone to great lengths to incorporate policies and measures that result in a safe shopping/dining/service experience. Many of these emergency measures (like the ones announced today) primarily hurt small, independent businesses and don’t take into account the number of COVID 19 cases in the region. Moving forward, the BIA hopes the government begins to consider the health and resiliency of the local economy when making provincial decisions and that there is a light at the end of this long tunnel.”

Ingram added “it is encouraging to see some businesses can remain open with capacity limits in place. It is unfortunate that certain sectors of the economy, mainly dining establishments and personal care services, are constantly being asked to close their doors without much notice. This is resulting in business owners making tough decisions for their business and job losses in our community.”

Brick-and-mortar schools will remain open after Easter weekend for four days from Tuesday to Friday next week before the spring break – which was postponed from March to reduce spread of the virus – though 1,240 of 4,828 schools- almost 26 per cent – reported currently having at least one case of COVID-19 as of April 1.

Concern and confusion was shared by educators and parents in the past week that the April spring break would possibly be cancelled or postponed again. While one school board told parents the impending provincial shutdown would likely also result in a school closure, and some education unions have suggested switching to online-only classes after Easter, Education Minister Stephen Lecce said “schools are critical for students’ mental health and learning” and that the chief medical officer of health had said schools remain safe.

Locally, two cases of COVID-19 in students at Haliburton Highlands Secondary School have been reported by the Haliburton, Kawartha, Pine Ridge district health unit as being resolved and no other school cases have been reported locally, although asymptomatic testing has not been done on the entire school population in Haliburton County – a weekend event for staff, their students and families to be tested resulted in just 69 people turning up.

A stay-at-home order was not issued during Thursday’s announcement, with Health Minister Christine Elliot noting the last time a stay-at-home order was in place – earlier this year – it had “tremendous ill effect on children and adults,” and said that with the warm weather coming, Ontarians should still be able to be outdoors, although previous stay-at-home orders still permitted people to be outdoors.

As of March 31, there were 421 patients in intensive care units in the province with COVID-related critical illness. On Wednesday, the CCSO reported that almost 60 per cent of hospitals with ICUs have less than five critical care beds left.

The high-water mark for COVID-19 patients in intensive care in Ontario was 420 on Jan. 15, during the province’s second wave of the pandemic.

Health care professionals have been pleading with the government to intervene as critical care centres became overloaded, taking to Twitter to describe the situation they were seeing in their hospitals.

Before the April 1 announcement, a group of more than 150 ICU physicians released an open letter to Premier Ford, Minister Elliot and chief medical officer Dr. David Williams, requesting stricter public health measures.

“Ontario is at a critical point in the pandemic, and we are being led down a very dangerous path by using ICU capacity as a benchmark for tolerance of COVID-19 spread,” reads the letter. “We do not agree with this approach and believe new public health measures are required immediately in order to regain control of the pandemic and save lives.”

Variants of concern are causing those who get infected to have a higher chance of hospitalization, ICU admission, and death, reads the letter, which notes healthcare teams aer seeing younger patients on ventilators – “many are parents of school-aged children” – including “entire families” that end up in ICUs.

“We are caring for people who have contracted COVID-19 at work, or who have followed all the rules and only gone out for groceries,” reads the letter.

While the government has increased bed capacity in hospitals, healthcare workers say there is a need for staff, which would have to be “borrowed from other crucial but non-emergent services.”

“As we are forced to increasingly scale back these services to treat COVID patients, non-COVID care suffers,” said the letter. “The surgical backlog will take years to overcome. Early-stage cancers will be missed.”

“As ICU doctors, we are the last line of defence, and we are ringing the alarm bell,” said the letter. “Please hear it. We implore you to act now.”

On March 26, Anthony Dale, Ontario Hospital Association president and CEO shared a media release warning that Ontario’s critical care system was reaching its “saturation point.”

He said the levels being faced then – 1,871 patients in ICU, 401 of those with COVID-related illness, and 74 COVID-related admissions in the past 48 hours – were “already well beyond the threshold after which hospitals can operate normally,” he wrote. “If the number of ICU admissions continues to increase in the days ahead, as is expected, Ontario’s hospitals will be under extraordinary pressure to try and ensure equitable access to lifesaving critical care.”

He wrote that while “hospitals and their dedicated clinicians” would work to “ensure access to critical care despite these very serious circumstances,” he also noted that “unlike in the pandemic’s first two waves, many regions now have less flexibility to accept patient transfers because of local capacity pressures,” and that “[w]hile Ontario’s critical care transport network has been a very effective partner with hospitals, there are also limits to its capabilities.”

Dale said the B.1.1.7 variant was creating a third wave that was resulting in a “different kind of pandemic,” with younger populations facing more serious health effects and requiring more care. As there is only one critical care system that treats both COVID and non-COVID patients, he said, the result would be likely further disruption to scheduled surgeries. He also said that while the 2021 Ontario Budget includes funding for 3,100 beds, those beds require staffing which is difficult to maintain at this time.

“The health system will face punishing conditions in the weeks to come, and it is vital that each and every Ontarian redouble their efforts to protect themselves, their loved ones, and those who continue to fight the virus on the frontlines,” he said.

For more information visit https://covid-19.ontario.ca/zones-and-restrictions.