Bars are emerging as COVID-19 hot spots. Can Ontario avoid the dangerous cocktail seen in Florida?

No karaoke rooms, no standing. Keep tables six feet apart, with a maximum of 50 people. Absolutely no dancing (unless you're dancing by yourself for everyone else).

That's the new reality at bars across the province that will be allowed to reopen Friday as part of Ontario's Phase 3 of COVID-19 recovery, outside of the GTA and a handful of other areas.

With surges of cases in several U.S. states and Montreal that public health officials are blaming on 20- and 30-somethings gathering in crowded bars, all eyes are on these high-risk settings, with the hope that a careful approach can avoid the pitfalls of other places. And in Toronto, officials say they're open to considering even more cautious measures.

The virus that causes COVID-19 thrives in crowded bars. It's spread primarily by droplets, which means even if someone doesn't seem sick, they can easily pass it on.

This disease, its signature is that it just loves mass indoor gatherings," said Raywat Deonandan, an epidemiologist and associate professor at the faculty of health sciences at the University of Ottawa.

You're going to be standing near each other, you're going to be breathing near each other, you're going to be spending a lot of time close to strangers, in an environment where the air is not circulating."

And after a few drinks even the most vigilant people start to slip up. It's a recipe for spread."

Nightclubs are not allowed to open under Phase 3 in Ontario. This is also the approach B.C. took, along with social distancing inside bars, and capping numbers, and other measures.

It's good that they'll stay closed for now, said Deonandan. Bars are trickier, but if you prohibit standing, enforce distancing and minimize the number of people inside, then you're on the path to management."

It would make more sense though, he said, to make rules more around capacity and space, instead of just making an arbitrary one-size-fits-all cap. Bars should also collect names and phone numbers of customers to help with contact tracing.

That's something that's now required in Quebec, as of late last week.

Over the weekend authorities in Montreal asked everyone who has visited any bar in the city since July 1 to get tested, as people were infected at least five bars since then across the city and the client registers weren't yet in place to help with tracking cases.

Deonandan is not alone in being concerned. Toronto Mayor John Tory also told reporters Monday that he's very worried about bars," given what's going on in Quebec and south of the border, and the thousands of such establishments in the city. He noted restaurants do not seem to pose the same risks.

The city and Toronto Public Health are studying the province's framework to see what moving into Stage 3 will look like in the city, said Councillor Joe Cressy, who chairs the board of health.

As we look in Toronto to other jurisdictions, whether it's the state of California, or Seoul, Montreal just recently, or even Detroit or Pittsburgh, this trend is being seen in real time," he said in an interview.

This doesn't mean that we cannot or should not reopen bars in indoor settings, but it does mean that we need to be extremely cautious, that we need to have protocols in place to ensure and rigorously enforce physical distancing."

Cressy, while acknowledging he does not want to sound like the dad in Footloose," said we need to avoid being Pittsburgh. That city successfully flattened the curve but then there was a rush on bars when they reopened.

Because there was a sense that the light had switched and they were back to normal," he said. This means talking to young people in ways and on platforms that they respond to, to make sure messages about ongoing risk are clearly communicated.

The answer, then, is not to shame younger people but rather to work with them."

Asked if she would consider even stricter measures in Toronto than what the province is planning, Dr. Eileen de Villa, Toronto's medical officer of health, said the city's unique and complex circumstances" mean she'll consider everything that is reasonable," based on the data, science and what's happening in other places.

I'm keeping my mind quite open," she told reporters.

Dr. Sumon Chakrabarti, an infectious diseases physician at Trillium Health Partners in Mississauga, said it's clear that overlapping risk factors" combine for elevated risks in bars, and new cases are expected.

This is a situation where enforcement makes sense, he said. A bar that disregards regulations can be fined, or lose its liquor licence. This already happened earlier this month with Goldie, a bar on King Street West that lost its licence after allegedly holding a secret indoor party.

But Chakrabarti said a key difference between Ontario and the U.S., is that here cases are trending downward, and in many states they are already out of control again. Many bars south of the border reopened too soon and all at once, Chakrabarti said.

In South Korea, Seoul managed to squash a cluster at a few nightclubs in May, through the classic public health measures of testing, tracing and isolating. Although homophobia against members of the LGBTQ community who frequented the gay bars and clubs involved did complicate contact tracing.

We are going to see cases and that's expected, as long as we can identify them quickly and curb those fires before they become the big ones," said Chakrabarti.

It's all part of the hammer and dance." The first phase, or the hammer, was to get cases down as much as possible using blunt measures like lockdowns.

The dance is now that we're at this low level, a slow crawl of transmission, you're tying to keep it in control by really aggressive contact tracing, tracking and testing," he said.

I do think much of Ontario's ready for it."

The attitudes of most people in Ontario also seem to differ from those in parts of the U.S such as Florida, added Deonandan, where more are refusing to wear masks or take the threat seriously.

We're at the stage of the epidemic now where it's no longer about governments making rules and doctors holding down the fort, or epidemiologists making models. It's entirely in the hands of the citizens to do their part.

And it looks like Ontarians are willing, so I'm very optimistic."

May Warren is a Toronto-based breaking news reporter for the Star. Follow her on Twitter: @maywarren11