‘We should not sell out our lives for short-term economic gain’: Pandemic expert says despite ‘glimmer of hope’ in COVID-19 battle, too soon to return to normal

Ontario may be creeping toward a turning point in the battle against COVID-19.

Some numbers suggest the pace of new COVID-19 cases is slowing and the so-called curve is close to flattening. The number of coronavirus patients in intensive care has stabilized over the last few days after weeks of steady increases.

At long last, as Premier Doug Ford said during a news conference Monday, there's a "glimmer of hope."

Still, the road ahead is long and the urge to push for a return to normal may be strong. The expert advice: Stick to what seems to be working.

The Star spoke with Dionne M. Aleman, an associate professor at the University of Toronto specializing in pandemic planning and medical applications of operations research, about the steps forward.

Q: As a vocal minority of people start to rail against the government to "open up" the province, what would be the risks of doing so too soon? Would there be economic benefits that would offset the effects on health?

A: "The risks of opening up the province now are huge. As much as we have been physically distancing ourselves and borders and businesses have been restricted, COVID-19 is still spreading rapidly through Ontario (several days of around 450 new infections per day just a few days ago).

The curve is only just now starting to seem like it might be flattening. Imagine how much worse the situation would be if the province were "opened up." Thousands of people are still infected, and if we start relaxing the restrictions put in place to slow disease spread, the disease will just take off again - worse than before because so many more people are infected and contagious compared to a month ago - and we will be forced into longer and potentially more stringent restrictions to safeguard public health.

The tradeoff of economic benefit over public health is a false dichotomy: the economy will greatly suffer if hundreds of thousands of Canadians die, as predicted by the Public Health Agency of Canada if no restrictions are in place. Protecting public health now, while posing short-term risk to the economy, will allow the economy to bounce back in the long term. We should not sell out our lives for short-term economic gain."

Q: Is it feasible or advisable for the government to set up "on-off cycles," in which the province opens up the province for a time, shuts it down once infections reach a threshold, and then resume the cycle once the health system recovers?

A: "It is hard to say whether on-off cycles would be advisable.

Some businesses might be able to function with some sense of normalcy despite sudden closures and reopenings, but others won't. From my own personal experience with my family's business, which was sold several years ago, opening and closing at sporadic, unpredictable intervals would have wreaked havoc on our ability to function.

Managing employees, inventory levels, purchases from international manufacturers with several weeks shipping lead times, customs quotas and tariffs, etc., would be a nightmare if the business had to close suddenly for a few weeks or more. I imagine businesses with perishable inventory, like restaurants, may also struggle to manage the financial impact of lost inventory that would come with sudden closures."

Q: Do you think there's a risk in having the province shut down for too long?

A: "It is hard to say what being closed for 'too long' would do to the economy's ability to bounce back. In the long term, the economy will always come back; the question is just how long will it take. How many lives are you willing to sacrifice to speed up the economy's return, given that it will return to pre-COVID-19 levels eventually anyway?

Ultimately, we will never be able to definitely know if we overreacted and kept restrictions in place for too long, and I doubt anyone has looked back on the pandemics that have happened from 1918 until now and regretted overreacting.

But, if we underreact and loosen restrictions too soon, that under-reaction will be measured in deaths and lifelong health complications for tens of thousands of Canadians, as well as a long-term negative impact to the economy."

Q: At present, is the risk growing for Ontarians - or is it being minimized? Are infection rates really going down? Are day-by-day percentage change rates deceptive?

A: "Daily infection numbers are deceptive. Fluctuations up or down can be just noise and not indicative of a trend one way or other. Further, the daily numbers are retroactively updated as patients test positive for COVID-19, and their infection is counted at the date of symptom onset. So, any numbers less than a week old or so may be revised upward.

Still, we can be cautiously optimistic that the last few days show a potential start to the curve flattening, which means risk is decreasing. But, it is important to remember that risk is decreasing because the actions we are taking now are working, so we need to continue with those actions and not let up."

This interview has been edited for clarity and length.