Sorry to burst your COVID-19 ‘social bubble’ but even small gatherings are getting riskier

Sorry to burst your COVID-19 ‘social bubble’ but even small gatherings are getting riskier

For months, Canadians have been bubbling up with other friends and family to socialize safely during the pandemic.

But with COVID-19 case counts rising in many communities, kids back in schools and more people returning to work, many public health experts agree that what worked as a safe approach in the early days of the lockdown now comes with more risk.

“I honestly think with the return to school right now, most people’s bubbles have burst,” says epidemiologist Ashleigh Tuite. “You’re talking about large numbers of connections.”

In Ontario, “social circles” allow you to see up to 10 people without the usual pandemic precautions in place as long as all of those family members, friends or neighbours make a pact to socialize only with each other, while in Alberta, the cap for your “cohort” is your household plus up to 15 other people.

In B.C., the guidelines for a “bubble” are a little looser. Officials say the members of your immediate household can be “carefully expanded” to include outsiders, with the goal of limiting the number as much as possible — since these are people you’re allowed to kiss, hug, chat with and dine with, without masks or distancing.

It’s a concept being adopted in several countries around the world. And while it works well in principle, experts warn it may be harder to maintain at this point in the pandemic.

Bubble makes sense in ‘theory’

“As a theory, the bubble makes a lot of sense,” said Dr. Dominik Mertz, an associate professor in the division of infectious diseases at Hamilton’s McMaster University. “But there’s a lot of confusion from people over what it is.”

He also added it can be tough to do safely, particularly if the bubble involves multiple households “who all have different risks.”

Say you have two four-person households socializing without the usual pandemic precautions. On paper, it follows the Ontario and B.C. guidelines.

But what if one person is back at work, leaving them exposed to dozens of colleagues? Or either family’s children are in school, where physical distancing and mask wearing might be a challenge?

A small sphere of contacts can quickly expand to include everyone that each family member comes in contact with, which means the bubbling approach really isn’t “useful” anymore, according to Tuite, an assistant professor at the University of Toronto’s Dalla Lana School of Public Health.

‘It’s not going to work for all people’

Raywat Deonandan, an epidemiologist and associate professor at the University of Ottawa, agreed it’s not a “perfect model” at this point in the pandemic.

“It would’ve worked better back when things were fully locked down,” he said, adding there’s still merit in bubbling with a few close friends or family if everyone is cautious.

“I don’t want to remove any tools from the table,” he said. “If bubbling is working for some people, keep on doing it. But it’s not going to work for all people.”

For instance, a supply teacher, with a social network of students and staff in various classrooms or even buildings, can’t realistically have a social bubble without any precautions, Deonandan said, while someone working from home might be able to do it more safely.

WATCH | ‘Exponential’ growth in new cases in parts of Canada, says infectious disease specialist:

Parts of Canada are seeing ‘exponential’ growth in COVID-19 cases, and we could be headed toward a thousand new cases per day, says infectious disease specialist Dr. Michael Gardam. 0:58

Fo many people, losing their bubble could mean a long, lonely winter, made worse by mental health struggles or living alone.

“We know there are benefits to having that human contact,” said Dr. Nitin Mohan, a physician epidemiologist and assistant professor at Western University in London, Ont. 

But when dropping temperatures push people indoors, where transmission risk is higher, and families start making plans to gather over the upcoming stretch of holidays, it could make adhering to the bubble principles even tougher. 

Bubble burst? Isolate for a while 

Mertz says Canadians should already be planning for upcoming gatherings like Thanksgiving.

If outside-the-bubble family members want to celebrate together, find ways to do it safely, he says, by meeting outdoors and staying apart as much as possible. Otherwise, you’re blending several household bubbles together and upping the risk for everyone.

And if you do throw caution to the wind for a turkey feast, there’s another approach: Isolate yourself as much as possible for two weeks after the gathering. 

“That would give us downtime, so in case someone got infected, you are not spreading it from that gathering into each individual bubble,” Mertz said.

The various experts who spoke with CBC News acknowledged the challenges in sticking to even the safest bubbling plan, with peer pressure, slip-ups, and our innate desire for human connection all potential obstacles.

For that reason, Dr. Andrew Morris, an infectious disease specialist with the Sinai Health System and University Health Network in Toronto, stresses the onus shouldn’t just be on individuals to reduce transmission.

From a system-wide perspective, he says, provincial governments need to ensure every piece of the pandemic plan is adequately resourced: testing capacity, contact tracing, personal protective equipment and hospital staff.

“If you can’t test people who are symptomatic, then you can’t contact trace … and you can’t identify people who are about to become symptomatic and are unknowingly and unwittingly spreading the disease,” he said.

Ontario gathering sizes reduced

Ontario officials say they’re working to increase testing capacity amid hours-long lineups in multiple cities, including Ottawa and Toronto.

The province is also lowering the maximum size limit for private gatherings — things like backyard barbecues or dinner parties, with precautions in place among people in different social circles — in some regions.

The new limits will be 10 people indoors and 25 people outdoors, with hefty fines of $10,000 or more for organizers who flout the rules.

Deonandan calls that the “single best policy intervention” for controlling the spread of COVID-19, given the growing body of research showing large gatherings can be hot spots for virus transmission.

“Mask wearing, that’s important. Distancing, that’s important, too,” he said. “But time and time again we see explosions of cases in otherwise controlled areas … driven by these super-spreading events.”

Even smaller gatherings can fuel the virus’s spread, like infections after a family outing documented in Toronto, and a 10-person cottage trip — which would still meet the province’s new rules — that led to 40 new cases in Ottawa.

It’s not clear if anyone involved in those gatherings was bubbling together, and Mertz stresses in all situations, the same safety precautions apply.

“Whether you continue with the bubble concept or not, it comes down to the less people gathering, the more time you can spend outside, the more you can spread out — the lower the risk.”

Ontario rolls back gathering limits in some areas as 293 new COVID-19 cases reported

Ontario rolls back gathering limits in some areas as 293 new COVID-19 cases reported

Ontario health officials are holding a news conference at 3 p.m. ET. You can watch it live in the player above.


Ontario is rolling back gathering limits in some areas of the province, and also implementing new fines for people who host and attend large gatherings during the pandemic, Premier Doug Ford announced Thursday.

This comes as the province reported 293 new cases of COVID-19. Infections in Ontario have been on an upswing since mid-August.

Ford said that starting Friday in Toronto, Ottawa and Peel region, gatherings are now limited to 25 people outdoors and 10 indoors. Those new caps don’t extend to places like restaurants, movie theatres, banquet halls, gyms and convention centres.

Ford said that the new gathering limits don’t apply to those areas, as well as to schools, because they have “really strict protocols in place.”

“We’re comparing apples and oranges here,” Ford said. Instead, the new measures are meant to discourage things like parties.

Toronto Public Health has previously cited weddings, restaurants, and family trips as sources of virus transmission.

Dr. David Williams, chief medical officer for Ontario, said at a news conference Thursday that the province has seen workplace infections, as well as cases in bars and restaurants — but he also noted that the majority of those cases were “staff-to-staff transmission.”

People at any gathering must also maintain distancing measures with people outside their social bubble, Ford noted. 

“This is to send a message to the reckless, careless people who want to hold these parties,” he said.

The premier said the province is also instituting a minimum fine of $10,000 for the organizers of illegal social gatherings, as well as a $750 fine for people who show up to them.

“We will throw the book at you if you break the rules,” Ford said. 

“They must be a few fries short of a happy meal, these people.”

Ford also said the province is freezing residential rent increases in 2021 and extending Ontario’s current ban on commercial evictions.

Most cases found in people under 40

According to provincial data, there were 35,134 tests completed Wednesday in Ontario, which is the most since the end of July. There is also a backlog of 37,624 tests currently under investigation.

In a tweet, Health Minister Christine Elliott said 85 new cases were found in Toronto, with 63 discovered in Peel and 39 in Ottawa.

Elliott said that 70 per cent of the new cases were found in people under 40.

WATCH: Premier Doug Ford explains the province’s new gathering limits

Ontario Premier Doug Ford unveiled a series of new measures to stop the spread of COVID-19, including restrictions on social gatherings in three regions and significant fines for violating the new rules. 4:41

“With a slight increase in hospitalizations to 53, ICU admissions and vented patients remain stable,” Elliott said.

Twenty-one patients are currently in intensive care, with 12 on a ventilator.

The province also counted an additional three deaths Thursday, bringing Ontario’s total to 2,825. A CBC analysis of local public health units, which is more up to date than the provincial figures, had the real total at 2,864 deaths as of Wednesday evening.

The province also marked 179 cases as resolved on Thursday.

Virus cases concentrated in urban areas

A CBC analysis shows that Ontario’s active cases — the bulk of which have been reported since Sept. 1 — are concentrated in the province’s most densely populated urban areas. Ottawa and the five public health units in the Greater Toronto Area account for 84 per cent of the current cases.

Of the more than 2,300 currently active cases in Ontario:

  • The suspected method of exposure for 54 per cent of cases is either unknown, missing or labelled as “no epidemiological link,” which means the novel coronavirus is being spread in the community.
  • More than one-third of active cases are among people in their 20s, even though that age group makes up only 14 per cent of the province’s population. 
  • More than half of active cases are in just two public health units — Toronto and Peel Region.

As cases trend upwards, the Ontario NDP says it plans to force a vote Thursday afternoon in the legislature on a motion to cap class sizes at 15 students.

“Parents are growing increasingly worried about their little ones’ safety,” NDP Leader Andrea Horwath said in a statement.

“COVID-19 cases keep going up, and more new infections are being reported every day among the students and staff who are back in school, with one school already being forced to shut down because of COVID-19 cases.”

COVID cases have been reported at multiple schools in the province in recent days, largely clustered in and around the Greater Toronto Area.

Williams said Thursday there have been 62 COVID-19 cases found so far in Ontario schools, with 20 cases identified in students and 22 in staff, with 20 not yet identified.

Williams said when the number of people heading back to schools is considered, it is “still reassuring” that the number of infections isn’t higher.

Horwath said the province’s plan still wasn’t good enough.

“Doug Ford is penny-pinching on the backs of students, jamming kids into full-size classes to avoid having to hire more teachers and education workers,” Horwath said. 

“Parents, kids, teachers, education workers, school boards and public health experts recommend smaller class sizes. Today, with the province on the brink of a second wave, I’m calling on the legislature to change course, and finally cap all class sizes at 15.”

Ontario’s Progressive Conservative government has a majority, so for the motion to pass a number of MPPs would have to vote against their own government’s back-to-school plan. 

What we know about Ontario’s September surge in COVID-19 infections

What we know about Ontario’s September surge in COVID-19 infections

Public health officials can’t trace how roughly half of Ontario’s latest COVID-19 cases got infected, even as Premier Doug Ford prepares fresh measures to try to slow the pace of spread.   

To gain insights into the September surge of COVID-19 in Canada’s largest province, CBC News has analyzed Ontario’s data on active cases — those who have most recently tested positive for the virus and are either hospitalized or still considered to be infectious. 

This gives a clearer picture of current trends that can’t always be spotted in the province’s daily release of COVID-19 numbers.     

Of the more than 2,300 currently active cases in Ontario:

  • The suspected method of exposure for 54 per cent of cases is either unknown, missing or labelled as “no epidemiological link,” which means the novel coronavirus is being spread in the community.
  • More than one-third of active cases are among people in their 20s, even though that age group makes up only 14 per cent of the province’s population.  
  • More than half of active cases are in just two public health units — Toronto and Peel Region. 

The data suggests that many Ontarians are currently contracting COVID-19 through unmemorable interactions with others in the course of their daily lives. Experts are worried that failing to track the source of so many new infections will hamper efforts to rein in the spread of the virus. 

“If we don’t understand how and where people are getting infected, it’s very hard to control this disease,” said Ashleigh Tuite, epidemiologist at the University of Toronto’s Dalla Lana School of Public Health. “It suggests that our contact tracing is not up to the level that we wanted it to be.” 

Measures to reduce the spread of COVID-19 need to be based on good data about the types of locations and activities that are driving the increase in infections, said Tuite in an interview Wednesday. “If we have a large number of cases who are getting infected and we can’t trace where they’re getting their infection, it’s really hard to respond to that.”   

Provincial and local officials are poised to announce stricter prevention measures in Ontario’s most-affected regions, such as lowering the maximum size of social gatherings and stiffer fines for people who break public health rules. 

Currently all of the province’s public health units are under Stage 3 of looser pandemic restrictions. Stage 3 allows gatherings of as many as 50 people indoors and 100 people outdoors, with the requirement that physical distancing of two metres be maintained between people not in the same social circle.

CBC’s analysis shows that Ontario’s active cases — the bulk of which have been reported since Sept. 1 — are concentrated in the province’s most densely populated urban areas. Ottawa and the five public health units in the Greater Toronto Area account for 84 per cent of the current cases.

Premier Doug Ford is promising to lower the limits on social gatherings in a bid to stem Ontario’s recent increase in COVID-19 cases, particularly in Toronto, Ottawa and the Region of Peel. (Carlos Osorio/The Canadian Press)

“If we act quickly and strongly in those regions that are seeing increased cases, we might be able to avoid wider-spread restrictions,” said Tuite.

There are just six active cases in all of northern Ontario, home to nearly 800,000 people. 

The vast geographic differences in the infection rate make it unlikely that the Ford government will impose any across-the-board rollbacks of Ontario’s reopening plan.

Ford has in recent days spoken with mayors and public health officials in Toronto, Ottawa and the Peel Region cities of Mississauga and Brampton about tighter restrictions. “When we’re all agreeing on policies and guidelines to be put in place, we act quickly and we’re going to act quickly on this,” Ford told a news conference Wednesday. 

As the pandemic has worn on, there’s been a noticeable rise in cases among younger adults, and the current Ontario data shows a dramatic surge among people in their 20s. They now make up 34 per cent of Ontario’s active cases.

That means someone in their 20s is more than twice as likely to have a fresh case of COVID-19 than you’d expect based on the size of that population.

Nearly two-thirds of all active cases in the province are among people younger than 40, a demographic that represents roughly half the population.

“You hear anecdotally, it’s because people in that age bracket are less scared and they’re not taking the precautions that other age groups are taking,” said Tuite. “Another explanation is that a lot of people in that age demographic need to be out to work. They’re the people who are working in restaurants. They’re the people who are working in bars.” 

New information from Toronto Public Health suggests staff are currently far more likely than customers to contract COVID-19 in retail and food-service environments. 

Younger people make up bulk of cases

Long lines at testing centres, like this one pictured in Toronto on Sept. 16, 2020, mirror a spike in cases of COVID-19 provincial health officials link to people under 40 not following public health guidelines at social gatherings. (Evan Mitsui/CBC)

The flip side of the demographic data suggests there’s been some recent success in preventing the spread of the disease to the most vulnerable age group, Ontario’s oldest citizens, but there are concerns that may not continue as the pace of spread accelerates. 

Another factor in Ontario’s September surge that worries the epidemiologists is the rising percentage of Ontario’s daily tests that are positive for COVID-19.

“When you start having higher positivity, it suggests that we’re probably missing a fair number of cases,” explained Tuite.

Research by Tuite and her colleague David Fisman shows the positive test rate among people in their 20s has shot up in the past few weeks and is currently running above four per cent, roughly four times higher than the general population. 

The World Health Organization recommends governments impose tighter public health restrictions if they are seeing a positivity rate of five per cent. 

Ontario reports 315 new COVID-19 cases, will lower limits on gatherings in some regions

Ontario reports 315 new COVID-19 cases, will lower limits on gatherings in some regions

Ontario will lower the limits on social gatherings in a bid to stem a recent increase in COVID-19 cases, but isn’t yet saying when the new health guidelines will be available. 

The current limit on social gatherings is 50 people indoors and 100 outdoors.

As for the specifics around the measure, Ontario Premier Doug Ford said he will be discussing the issue with his cabinet and will be talking with local mayors and medical officers before going ahead with the plan.

“I’ll always follow the guidelines of health and science,” said Ford.

“There’s going to be some severe, severe fines” for those who choose not to follow the guidelines, he said, noting that details could come as soon as Thursday. “They will be the highest in the country.”

Provincial health officials have attributed the spike in cases largely to people not following public health guidelines at social gatherings.

Ford has promised to take action in the regions where most of the cases have emerged — Toronto, Peel, and Ottawa.

He has also not ruled out further lockdowns in those areas if virus case numbers aren’t brought under control.

Ontario reported another 315 new cases of COVID-19 on Wednesday — more than half of which are in people under 40.

In a series of tweets, Health Minister Christine Elliott said 64 per cent of Wednesday’s cases were in that age bracket.

Of the province’s 34 health units, 25 reported five or fewer cases, and 12 regions saw no new cases at all.

The majority of the cases are now concentrated in five different health units.

Toronto, Ottawa and Peel continue to record the highest number of daily case counts with 77, 61, and 54 cases respectively. York Region also reported 37 cases today, while Durham Region reported 24.

At a news conference Wednesday, Ford announced the launch of a new interactive screening tool for students, parents, and staff to help gauge whether to attend school each day.

Ford was also asked Wednesday about a photo making the rounds on social media showing him and other elected officials at MPP Stan Cho’s wedding under a marquee tent, with some of the attendees not wearing masks.

The premier maintained everyone present had their temperature taken and was wearing masks, and that the photo in question was taken when people stood to welcome the bride and groom. 

Long lines at testing centres

With the numbers continuing to trend upward, lines outside testing centres have grown longer in recent days.

At St. Joseph’s Health Centre in Toronto, some were waiting nearly three hours to get a test.

WATCH | Man waits 2 hours for COVID-19 test so he can accompany wife on hospital visit:

James Koziak arrived at the St. Joseph’s Health Centre at 6:45 a.m for a test and still had to wait two hours. 0:35

It took James Koziak two hours to be tested, and he was one of the lucky ones. 

Koziak’s wife is in a long-term care facility. He’s been tested six times before, but arrived early at 6:45 a.m. to beat the crowd so he could produce a negative test in order to accompany her on an upcoming hospital visit.

“I came here yesterday afternoon, saw the bloody lineup and I knew I had to be here really early.

“I just cannot believe in Canada that someone would have to go through this,” he said, his voice breaking.  

At his news conference Thursday, Ford insisted “we weren’t caught off guard” with the recent increase in demand for COVID-19 tests, saying the province is aiming for a new daily testing target of 50,000 per day.

The province is currently processing around 25,000 to 30,000 tests per day, the health minister said.

The premier said the province is “working out a few details with the private sector” to make testing available at various retailers including pharmacies. Ford said there will be “a couple thousand” such sites, specifically to test people without symptoms. Those with symptoms should still go to traditional testing centres. 

“It’s going to be very, very soon,” Ford said. “I can’t give you exact date … but we’re ready, they’re ready and we’re just going to ramp up the testing like you’ve never seen before.”

Ontario cases rising since mid-August

Cases have been on an upswing since mid-August, with numbers topping 200 a day since Sept. 12. Wednesday’s update brings the province’s total to 45,383 cases of the virus since the outbreak first began in late January. 

Ontario also recorded an additional two deaths, bringing the province’s official toll to 2,822. A more up to date death toll, according to data collected by CBC News from the province’s local health units, stands at 2,862. 

Hospitalization numbers remain relatively similar to Tuesday’s with 44 patients currently admitted for the novel coronavirus.

Twenty of those patients are being treated in intensive care and 12 are on a ventilator. In total, the province currently has 2,316 active, confirmed cases of COVID-19. 

Almost 29,000 tests for the virus were processed on Tuesday in Ontario’s network of labs. 

Ontario reports 315 new COVID-19 cases, lowers limits on gatherings in some regions

Ontario reports 315 new COVID-19 cases, lowers limits on gatherings in some regions

Ontario will lower the limits on social gatherings in a bid to stem a recent increase in COVID-19 cases, but isn’t yet saying when the new health guidelines will be available. 

The current limit on social gatherings is 50 people indoors and 100 outdoors.

As for the specifics around the measure, Ford said he will be discussing the issue with his cabinet and will be talking with local mayors and medical officers before going ahead with the plan.

“I’ll always follow the guidelines of health and science,” said Ford.

“There’s going to be severe, severe fines” for those who choose not to follow the guidelines, he said, noting that details could come as soon as Thursday.

Provincial health officials have attributed the spike in cases largely to people not following public health guidelines at social gatherings.

Ford has promised to take action in the regions where most of the cases have emerged — Toronto, Peel, and Ottawa.

He has also not ruled out further lockdowns in those areas if virus case numbers aren’t brought under control.

Ontario reported another 315 new cases of COVID-19 on Wednesday — more than half of which are in people under 40.

In a series of tweets, Health Minister Christine Elliott said 64 per cent of Wednesday’s cases were in that age bracket.

Of the province’s 34 health units, 25 reported five or fewer cases, and 12 regions saw no new cases at all.

The majority of the cases are now concentrated in five different health units.

Toronto, Ottawa and Peel continue to record the highest number of daily case counts with 77, 61, and 54 cases respectively. York Region also reported 37 cases today, while Durham Region reported 24.

At a news conference Wednesday, Ford announced the launch of a new interactive screening tool for students, parents, and staff to help gauge whether to attend school each day.

Ford was also asked Wednesday about a photo making the rounds on social media showing him and other elected officials at MPP Stan Cho’s wedding under a marquee tent, with some of the attendees not wearing masks.

The premier maintained everyone present had their temperature taken and was wearing masks, and that the photo in question was taken when people stood to welcome the bride and groom. 

Long lines at testing centres

With the numbers continuing to trend upward, lines outside testing centres have grown longer in recent days.

At St. Joseph’s Health Centre in Toronto, some were waiting nearly three hours to get a test.

WATCH | Man waits 2 hours for COVID-19 test so he can accompany wife on hospital visit:

James Koziak arrived at the St. Joseph’s Health Centre at 6:45 a.m for a test and still had to wait two hours. 0:35

It took James Koziak two hours to be tested, and he was one of the lucky ones. 

Koziak’s wife is in a long-term care facility. He’s been tested six times before, but arrived early at 6:45 a.m. to beat the crowd so he could produce a negative test in order to accompany her on an upcoming hospital visit.

“I came here yesterday afternoon, saw the bloody lineup and I knew I had to be here really early.

“I just cannot believe in Canada that someone would have to go through this,” he said, his voice breaking.  

At his news conference Thursday, Ford insisted “we weren’t caught off guard” with the recent increase in demand for COVID-19 tests, saying the province is aiming for a new daily testing target of 50,000 per day.

The province is currently processing around 25,000 to 30,000 tests per day, the health minister said.

The premier said the province is “working out a few details with the private sector” to make testing available at various retailers including pharmacies. Ford said there will be “a couple thousand” such sites, specifically to test people without symptoms. Those with symptoms should still go to traditional testing centres. 

“It’s going to be very, very soon,” Ford said. “I can’t give you exact date … but we’re ready, they’re ready and we’re just going to ramp up the testing like you’ve never seen before.”

Ontario cases rising since mid-August

Cases have been on an upswing since mid-August, with numbers topping 200 a day since Sept. 12. Wednesday’s update brings the province’s total to 45,383 cases of the virus since the outbreak first began in late January. 

Ontario also recorded an additional two deaths, bringing the province’s official toll to 2,822. A more up to date death toll, according to data collected by CBC News from the province’s local health units, stands at 2,862. 

Hospitalization numbers remain relatively similar to Tuesday’s with 44 patients currently admitted for the novel coronavirus.

Twenty of those patients are being treated in intensive care and 12 are on a ventilator. In total, the province currently has 2,316 active, confirmed cases of COVID-19. 

Almost 29,000 tests for the virus were processed on Tuesday in Ontario’s network of labs. 

It’s easy to point the finger at parties — but younger Canadians spread COVID-19 in all kinds of settings

It’s easy to point the finger at parties — but younger Canadians spread COVID-19 in all kinds of settings

The virus behind COVID-19 has a knack for slithering through society undetected. 

Not everyone gets a fever, and not everyone gets a cough. Instead, the range of symptoms can pop up in various parts of someone’s body, like a nagging headache or upset stomach, mimicking a whole host of other ailments. Many people don’t feel sick enough to worry, if they ever get symptoms at all.

So when someone young and healthy does test positive for SARS-CoV-2 — as hundreds of Canadians now do every day — the question often is: Where’d they catch it? 

In Ontario, Premier Doug Ford often points the finger at crowded parties. “We can’t have these big parties,” he said earlier this month. “We can’t have the big weddings.”

There are multiple recent reports of cases tied to bustling indoor spaces — from strip clubs to wedding events — that build on months of research showing the combination of crowds, close contact and closed settings for virus transmission is like kindling for a fire.

But younger Canadians may also be fuelling the spread of COVID-19 in far more mundane ways, with potentially dire consequences. 

Emerging details from public health officials suggest a variety of social gatherings are helping SARS-CoV-2 find new hosts — and in Ontario, a majority of those virus carriers are under 40.

They’re getting infected at cottages, family gatherings, dinner parties — all kinds of indoor settings, and not always the ones with large, headline-making crowds.

“The vast majority of transmission is with close contact with someone who’s infected, typically for a prolonged period of time in an indoor environment,” said Dr. Isaac Bogoch, a Toronto-based infectious disease specialist.

Risks in indoor settings

The notion that indoor settings are riskier is nothing new. For months, case studies from around the world have highlighted danger zones: cruise ships, a call centrea choir practice.

But the specifics of where real people are getting real infections in Ontario has been hazier, beyond now-obvious hot spots like long-term care homes and other institutional settings.

In recent weeks, a clearer picture began emerging. 

On one end of the spectrum, there are the big, risky gatherings called out by Ford: A series of wedding events in Markham led to more than 20 cases, for example, while infected staff at two Toronto strip clubs sparked multiple confirmed cases and hundreds of possible exposures.

In London, Ont., at least nine university students have tested positive for the virus so far, and public health officials suggested they socialized in the city’s jam-packed downtown bar scene.

WATCH | How to navigate daily challenges amid the COVID-19 pandemic:

Living life during a pandemic can be confusing. But experts say you can navigate how to approach different settings and activities once you know the risks. 1:11

Then there’s the other end of the spectrum: smaller groups of friends and family meeting up indoors.

In Windsor, public health officials recently carried out contact tracing and tracked more than 30 recent cases back to one family’s social life — including parties and dinners with friends at home and a card game in a storage unit, the region’s local newspaper reported.

Toronto’s medical officer of health, Dr. Eileen de Villa, on Monday outlined several similar settings that led to recent infections, including one family gathering and another family’s trip where time was spent with someone who wound up having COVID-19.

“Personal gatherings are the main driver of cases,” Dr. Mustafa Hirji, acting medical officer of health for Niagara Region, noted in a tweet the same day.

LISTEN | Helping Canadians under 40 stay safe from COVID-19:

With COVID-19 on the rise among those under 40 in Ontario, science communicator Samantha Yammine warns that playing the blame game won’t help bring down the numbers among the young. 8:53

One striking case study from Ottawa involved a 10-person cottage trip. It’s a gathering size allowed by the province, as long as there’s physical distancing in place, but according to the city’s medical officer of health, Dr. Vera Etches, the trip wound up being a cautionary tale.

“There was one person who developed cold-like symptoms while at the cottage party and then tested positive on their return home. Subsequently, seven of those friends tested positive for COVID-19,” Etches recently told Ottawa’s city council. 

“Within nine days, one person with symptoms became 40 confirmed people who tested positive.”

After leaving the cottage, some members of the group had visited work and retail locations, including two child-care centres that wound up shuttered to prevent further spread — and several people ended up hospitalized.

The chain of virus transmission from a cottage gathering into the community, identified by Ottawa public health officials. Within nine days, one person with symptoms led to 40 confirmed cases. (CBC News/Ottawa Public Health)

‘It leaves lasting damage’

That’s the ripple effect of young adults getting infected: They can pass it on to more vulnerable people, including the elderly and those in long-term care, who are more likely to wind up seriously ill or worse.

Those younger Canadians themselves could also fare poorly, even if death is a rare outcome.

According to a random sample of hospital outpatients from the U.S. Centers for Disease Control and Prevention, 20 per cent of previously healthy adults between 18 and 34 weren’t back to their usual health 14 to 21 days after testing positive, while thousands of others around the world say their symptoms are lasting far longer.

For Forbes, COVID-19 started with chest pain, but she never had a fever or cough, which are the usual symptoms. Instead, she wound up having various gastrointestinal issues and shortness of breath. (Evan Mitsui/CBC News)

Nada Forbes, a 37-year-old mother of two living in Oakville, Ont., has been suffering with lingering symptoms for six months after testing positive for the virus following a trip to Egypt in March.

The illness started with chest pain, but Forbes never had a fever or cough, which are the usual symptoms. Instead, she wound up having various gastrointestinal issues and shortness of breath.

“You can get a moderate case, or a mild case, that goes on and on and on, and leaves lasting damage and leaves you with these lingering problems — when you started as a healthy person without any pre-existing conditions,” she warned.

Don’t ‘shame and blame’

Months into the pandemic, health experts now say it’s crucial the younger demographic is better informed about how to avoid spreading the virus, without any finger-pointing.

“Harm reduction is not about shame and blame,” said Samantha Yammine, a Toronto-based neuroscientist and science communicator.

Yammine said for many young adults, avoiding risk can be difficult. She recently surveyed her roughly 70,000 Instagram followers about their COVID-19 experiences, and hundreds of respondents cited various challenges — from living with roommates or in a multi-generational home, to working in sectors where safety measures aren’t always followed. 

“Why did we ever open up indoor dining and have a setting where people would be talking loudly, with people in large groups, without wearing masks?” Yammine said.

Toronto-based neuroscientist and science communicator Samantha Yammine says there’s a need to ’empower people to make decisions that are more safe but allow them to live their lives.’ (Michael Barker)

The province is holding off on the next phase of reopenings, but there’s no word yet if officials will start scaling back limits on the size of gatherings or implementing any lockdowns to curb rising case counts.

In the meantime, Bogoch said that for young adults trying to safely navigate daily choices, it’s all about layering in protection to lower the risk as much as possible, such as increasing ventilation and wearing masks as much as possible.

“You want to get together for this wedding, for your friend’s birthday, for some other ceremony, but let’s make smart choices,” he said. “So can you do it outside? Can you spread apart? Can you have fewer numbers?”

Yammine said the aim can’t be zero risk, since that’s an impossible goal.

“If we focus on what we can do versus what we can’t do, we can empower people to make decisions that are more safe but allow them to live their lives,” she said. “Because this isn’t going away any time soon.”

Young Canadians spreading COVID-19 in all kinds of ways

Young Canadians spreading COVID-19 in all kinds of ways

The virus behind COVID-19 has a knack for slithering through society undetected. 

Not everyone gets a fever, and not everyone gets a cough. Instead, the range of symptoms can pop up in various parts of someone’s body, like a nagging headache or upset stomach, mimicking a whole host of other ailments. Many people don’t feel sick enough to worry, if they ever get symptoms at all.

So when someone young and healthy does test positive for SARS-CoV-2 — as hundreds of Canadians now do every day — the question often is: Where’d they catch it? 

In Ontario, Premier Doug Ford often points the finger at crowded parties. “We can’t have these big parties,” he said earlier this month. “We can’t have the big weddings.”

There are multiple recent reports of cases tied to bustling indoor spaces — from strip clubs to wedding events — that build on months of research showing the combination of crowds, close contact and closed settings for virus transmission is like kindling for a fire.

But younger Canadians may also be fuelling the spread of COVID-19 in far more mundane ways, with potentially dire consequences. 

Emerging details from public health officials suggest a variety of social gatherings are helping SARS-CoV-2 find new hosts — and in Ontario, a majority of those virus carriers are under 40.

They’re getting infected at cottages, family gatherings, dinner parties — all kinds of indoor settings, and not always the ones with large, headline-making crowds.

“The vast majority of transmission is with close contact with someone who’s infected, typically for a prolonged period of time in an indoor environment,” said Dr. Isaac Bogoch, a Toronto-based infectious disease specialist.

Risks in indoor settings

The notion that indoor settings are riskier is nothing new. For months, case studies from around the world have highlighted danger zones: cruise ships, a call centrea choir practice.

But the specifics of where real people are getting real infections in Ontario has been hazier, beyond now-obvious hot spots like long-term care homes and other institutional settings.

In recent weeks, a clearer picture began emerging. 

On one end of the spectrum, there are the big, risky gatherings called out by Ford: A series of wedding events in Markham led to more than 20 cases, for example, while infected staff at two Toronto strip clubs sparked multiple confirmed cases and hundreds of possible exposures.

In London, Ont., at least nine university students have tested positive for the virus so far, and public health officials suggested they socialized in the city’s jam-packed downtown bar scene.

WATCH | How to navigate daily challenges amid the COVID-19 pandemic:

Living life during a pandemic can be confusing. But experts say you can navigate how to approach different settings and activities once you know the risks. 1:11

Then there’s the other end of the spectrum: smaller groups of friends and family meeting up indoors.

In Windsor, public health officials recently carried out contact tracing and tracked more than 30 recent cases back to one family’s social life — including parties and dinners with friends at home and a card game in a storage unit, the region’s local newspaper reported.

Toronto’s medical officer of health, Dr. Eileen de Villa, on Monday outlined several similar settings that led to recent infections, including one family gathering and another family’s trip where time was spent with someone who wound up having COVID-19.

“Personal gatherings are the main driver of cases,” Dr. Mustafa Hirji, acting medical officer of health for Niagara Region, noted in a tweet the same day.

LISTEN | Helping Canadians under 40 stay safe from COVID-19:

With COVID-19 on the rise among those under 40 in Ontario, science communicator Samantha Yammine warns that playing the blame game won’t help bring down the numbers among the young. 8:53

One striking case study from Ottawa involved a 10-person cottage trip. It’s a gathering size allowed by the province, as long as there’s physical distancing in place, but according to the city’s medical officer of health, Dr. Vera Etches, the trip wound up being a cautionary tale.

“There was one person who developed cold-like symptoms while at the cottage party and then tested positive on their return home. Subsequently, seven of those friends tested positive for COVID-19,” Etches recently told Ottawa’s city council. 

“Within nine days, one person with symptoms became 40 confirmed people who tested positive.”

After leaving the cottage, some members of the group had visited work and retail locations, including two child-care centres that wound up shuttered to prevent further spread — and several people ended up hospitalized.

The chain of virus transmission from a cottage gathering into the community, identified by Ottawa public health officials. Within nine days, one person with symptoms led to 40 confirmed cases. (CBC News/Ottawa Public Health)

‘It leaves lasting damage’

That’s the ripple effect of young adults getting infected: They can pass it on to more vulnerable people, including the elderly and those in long-term care, who are more likely to wind up seriously ill or worse.

Those younger Canadians themselves could also fare poorly, even if death is a rare outcome.

According to a random sample of hospital outpatients from the U.S. Centers for Disease Control and Prevention, 20 per cent of previously healthy adults between 18 and 34 weren’t back to their usual health 14 to 21 days after testing positive, while thousands of others around the world say their symptoms are lasting far longer.

For Forbes, COVID-19 started with chest pain, but she never had a fever or cough, which are the usual symptoms. Instead, she wound up having various gastrointestinal issues and shortness of breath. (Evan Mitsui/CBC News)

Nada Forbes, a 37-year-old mother of two living in Oakville, Ont., has been suffering with lingering symptoms for six months after testing positive for the virus following a trip to Egypt in March.

The illness started with chest pain, but Forbes never had a fever or cough, which are the usual symptoms. Instead, she wound up having various gastrointestinal issues and shortness of breath.

“You can get a moderate case, or a mild case, that goes on and on and on, and leaves lasting damage and leaves you with these lingering problems — when you started as a healthy person without any pre-existing conditions,” she warned.

Don’t ‘shame and blame’

Months into the pandemic, health experts now say it’s crucial the younger demographic is better informed about how to avoid spreading the virus, without any finger-pointing.

“Harm reduction is not about shame and blame,” said Samantha Yammine, a Toronto-based neuroscientist and science communicator.

Yammine said for many young adults, avoiding risk can be difficult. She recently surveyed her roughly 70,000 Instagram followers about their COVID-19 experiences, and hundreds of respondents cited various challenges — from living with roommates or in a multi-generational home, to working in sectors where safety measures aren’t always followed. 

“Why did we ever open up indoor dining and have a setting where people would be talking loudly, with people in large groups, without wearing masks?” Yammine said.

Toronto-based neuroscientist and science communicator Samantha Yammine says there’s a need to ’empower people to make decisions that are more safe but allow them to live their lives.’ (Michael Barker)

The province is holding off on the next phase of reopenings, but there’s no word yet if officials will start scaling back limits on the size of gatherings or implementing any lockdowns to curb rising case counts.

In the meantime, Bogoch said that for young adults trying to safely navigate daily choices, it’s all about layering in protection to lower the risk as much as possible, such as increasing ventilation and wearing masks as much as possible.

“You want to get together for this wedding, for your friend’s birthday, for some other ceremony, but let’s make smart choices,” he said. “So can you do it outside? Can you spread apart? Can you have fewer numbers?”

Yammine said the aim can’t be zero risk, since that’s an impossible goal.

“If we focus on what we can do versus what we can’t do, we can empower people to make decisions that are more safe but allow them to live their lives,” she said. “Because this isn’t going away any time soon.”

Here’s what happens when there are COVID-19 cases in Ontario schools

Here’s what happens when there are COVID-19 cases in Ontario schools

With two million students, teachers and other education workers heading back to class this month, confirmed cases of COVID-19 will almost undoubtedly appear in the province’s school system. 

The Ministry of Health has laid out detailed guidelines on what’s to happen when staff or students show symptoms of COVID-19, or test positive for the coronavirus. School administration, the school board and the local public health unit all play roles in a response that can — if there’s evidence that infections are spreading — include shutting down schools. 

Here’s the plan in a nutshell. 

When someone shows symptoms at school 

Parents are being told not to send their kids to school if they are showing symptoms of COVID-19. If a student starts showing symptoms during the school day, the principal is to contact the parents immediately to arrange a pickup as soon as possible. In the meantime, the child is to isolate, and staff caring for the child are to wear full personal protective equipment. 

The school principal must ensure the space and materials used by the ill student are cleaned, that staff are informed of the situation, and the rest of the school population is monitored for symptoms.

Students, teachers or education workers who test positive are to self-isolate for at least 14 days and are not to return to school until cleared by their local public health unit or health-care provider. (Christopher Katsarov/The Canadian Press)

  

The parents of the ill student will be encouraged to get their child tested for COVID-19. The student must not return to school while waiting for test results, but can attend virtually if they feel well enough. Even if the test result is negative, the child is still not to return to school until 24 hours after their symptoms have resolved.

While the province doesn’t want schools to bombard public health units with a report on every student with the sniffles, the system will be keeping a close eye on rates of absenteeism. School attendance is to be reported daily to the local public health unit and the Ministry of Education.

When someone tests positive 

If a case of COVID-19 is confirmed among a student or a staff member, the provincial guidelines say the public health unit handling the case will notify the school. The guidelines also say the school is responsible for reporting any confirmed or probable case to the local public health unit and to the Ministry of Education.  

Information is to be posted publicly on the school board’s and school’s website, but the individual is not to be named. 

“Parents, students and staff have an understandable interest in knowing when a COVID-19 positive case has been identified in their school,” the provincial guidelines say.

Those who had close contact with the confirmed case while infectious — whether by being in the same class, on the same school bus or attending the same after-school care program — are to be informed directly.

If a case is confirmed, public health units are to contact the parents of students who were potentially exposed, whether on a bus or in the classroom. (Paul Chiasson/The Canadian Press)

Contacts of a confirmed case

The public health unit determines the risk that various students and staff were exposed to the virus according to their level of contact with the person who tested positive. To allow for tracing, the school is required to provide public health with such information as class lists, attendance records and parental contact details.    

Anyone in the same classroom cohort as the confirmed case will generally be considered to be at high risk of transmission. Parents of those children are to be notified immediately.

Everyone considered at high risk of exposure will be directed to self-isolate, and will be encouraged to get tested for COVID-19. However, even if they test negative, they are still to self-isolate for 14 days from the last contact with the confirmed case. 

Those considered to be at low risk of exposure are to self-monitor for symptoms and can return to school.

If a student or staff member clearly contracted COVID-19 from someone outside the school and was not at the school while contagious, their cohort will not be required to self-isolate.

If there are two or more confirmed cases among students and/or staff in a school within a 14-day period, public health must declare an outbreak. (Evan Mitsui/CBC)

When multiple students or staff test positive  

If there are two or more lab-confirmed COVID-19 cases among students and/or staff in a school within a 14-day period, public health must declare an outbreak, provided that the cases appear to have “an epidemiological link,” such as being in the same class, the same after-school care group, or the same school bus.

The public health unit decides which cohorts in the school should self-isolate by being most at risk from the outbreak.

“If public health advises that a class, cohort or a school should be closed for a period of time, parents, students and staff will be notified immediately,” say the provincial guidelines. 

The outbreak can be declared over once 14 days have passed with no evidence of school-related transmission, so long as no one who was exposed to the initial outbreak is still awaiting test results. 

Anyone who tests positive for COVID-19 is to remain in isolation for at least 14 days. (Paul Chiasson/The Canadian Press)

When will school closures happen?

As a result of an outbreak, a school may be closed, but not necessarily. There is no firm threshold for a number of cases to trigger a closure. It’s a judgment call, and public health officials make that judgment.

The provincial guidance says closing a school “should be considered if there is evidence of potential widespread transmission.” That could include any number of cases among students and staff “with no known source of acquisition outside of the school.” 

If a school is closed, public health may recommend testing for everyone from the school.  

The school may be reopened even if the outbreak is not fully over. “Cohorts without evidence of transmission can be gradually brought back to school as additional information and test results become available,” say the province’s guidelines.

When can you return to school after testing positive?

Anyone who tests positive for COVID-19 is to remain in isolation for at least 14 days. A student or staff member should not return to school until they are cleared by their local public health unit or health-care provider, the province says. 

What if a parent or sibling tests positive?

Parents who contract COVID-19 are encouraged to tell their children’s school, but it’s not a legal requirement. However, the province advises that everyone living in the household with a person who tests positive should self-isolate, and the children should not come to school, for 14 days. 

Teachers say they’re facing many unknowns as they head back to school

Teachers say they’re facing many unknowns as they head back to school

Doug Garlick packed up his personal belongings Monday in his Pickering, Ont. classroom as he prepared for an uncertain school year amid the COVID-19 pandemic.

For the last few years, the 61-year-old has taught Grade 1 in the Durham District School Board. But this year, because of the danger the novel coronavirus poses to him due to his Crohn’s disease and diabetes, he’s teaching online.

But like so many teachers in Ontario, he still doesn’t know what date classes will begin. He also doesn’t know what grade he’ll be teaching, or even how he’ll be teaching it.

“We’re not sure what platform we’ll be using, what delivery method,” he told CBC News over the phone. “There are many of us that are pretty close to panic at this stage, just not knowing what’s going on.”

Escalating conflict between unions and government

All the uncertainty comes amid an escalating conflict between Ontario Premier Doug Ford’s government and four major teachers’ unions. While Garlick and many other teachers will be holding virtual classes, others are worried about how teaching in classrooms during the pandemic might endanger their health.

The dispute is now headed to the province’s labour board as the unions allege Ontario’s school reopening plan violates its own workplace safety laws.

Parents can’t expect teachers to be ready to start virtual programs this month, Garlick said.

“I cannot realistically know how that’s going to happen because we don’t know what we’re doing yet,” he said.

Garlick, like many teachers in the province, is expected to receive some additional training about online learning this week, but he doesn’t know what it will cover.

After the pandemic forced the province to shut down schools in the spring, Garlick said, his class moved online. But he didn’t teach in real time. Rather, students would visit class website at their leisure.

Grade 1 teacher Doug Garlick packs up in his classroom as schools get ready to reopen. He will be connecting with students virtually during the 2020-2021 school year because of health concerns, but doesn’t yet know what grade he will be teaching. (Submitted by Doug Garlick)

This school year, he said, things may be different.

“I believe they’re trying to put us more toward the live teaching method,” he said. But that presents its own challenges, — especially with a large group of students with mixed abilities, he said.

‘I am confused, scared’

“How do you teach them to read through a computer?” Garlick said.

He created his own solution to overcome the challenges posed by virtual teaching and learning during the pandemic.

Each day, he would drive to the homes of six different students and teach them in person, one on one, in their driveways.

He says he would even assign and collect homework by putting it in plastic Ziploc bags and leave them sealed for a few days before marking to prevent the spread of germs.

But when a relative of one of his students contracted COVID-19, the driveway lessons had to stop.

This school year, his doctor tells him, it’s too risky to even try.

In the meantime, thousands of other Ontario teachers will be teaching students in person. But in-class learning has its challenges too, said Farzana Karmali, who teaches kindergarten French immersion for the Toronto District School Board.

Both students and teachers will be wearing masks to prevent the spread of the virus, among other measures. She questions how she can communicate when much of her face will be hidden.

Farzana Karmali, shown teaching French immersion to kindergarten students in Toronto, fears wearing a mask will get in the way of language learning. ‘How will they see my lips?’ she said. (Submitted by Farzana Karmali)

“How will they learn French? How will they see my lips?” Karmali said.

“I am confused, scared and I don’t know how this is going to work.”

Province prepared to shut schools if necessary

The provincial government says it is “sparing nothing” to keep children safe when schools reopen.

And if all the measures fall short, Ford said Monday he will once again shut them down.

“We’re ready and we’re going to move as soon as the outbreak happens,” he told reporters. “If it really starts taking off, I will not hesitate for a second to close the schools down.”

WATCH | What classes will look like in Canada’s biggest school board:

CBC News gets a look at how two schools in the Toronto District School Board, Canada’s largest, are preparing for teachers and students to safely return to class during the COVID-19 pandemic. The board has been tweaking its plan based on feedback from teachers as opening day draws closer. 2:13

The premier said he couldn’t understand the unions’ perspective.

“We have done absolutely everything … Every idea possible, we’re putting into the classrooms,” he said. “If you compare the report card with all the other provinces, it’s night and day … The teachers’ unions just want to fight. They want to fight with everyone,” Ford said.

Ford said he distinguishes between the unions and actual teachers he’s spoken to whom he says tell him he will “do a great job.”

But Karmali is wondering how she, as an individual teacher, is going to deal with students who start showing symptoms.

 “What am I supposed to do if a child is sick, comes up to me and is very close or is vomiting? ” she asked.

“As a human being, a teacher, it’s my role to be there as the child’s parent. I’m not going to allow the child to throw up and not look after them, for example.

“I know that many parents will feel that going back to school will create a sense of normality for their children, but I don’t know how this is going to be normal.”