COVID-19 pandemic in Ontario

Notice of school closure at a YCDSB high school in Markham. Note the stated reopening date in what was initially expected to be a brief lockdown.

On March 12, 2020, the provincial government announced that publicly funded schools would be closed for an additional two weeks after March Break until April 5.[41] On March 24. Premier Ford announced that the reopening of schools would be delayed indefinitely past the original April 6 target.[42]

On March 31, Premier Ford announced that in-person classes would remain suspended through at least May 4; in tandem, Minister of Education Stephen Lecce announced the second phase of its "Learn from Home" program, which would involve "teacher-led" instruction delivered via distance education.[43]

On April 14, Premier Ford delayed the reopening of public schools once again,[44] on April 26 it was announced that there were plans to resume in-person classes on May 31.[45] On May 19, Premier Ford announced that all public schools would remain closed through the end of the semester, with plans to pursue in-person classes when the next school year begins in September.[46]

For the next school year, Lecce presented three scenarios: full online learning, a hybrid of online and in-class learning, and a return to full-time in class learning.[47] On July 30, it was announced that that elementary schools would return to class full-time, while high schools in 24 districts with higher enrollment would use a hybrid model, alternating daily between in-person and online instruction to reduce class sizes, with physical classes conducted in cohorts of 15 students each. Students in grade 4 and higher would be required to wear a face mask, parents would have the option to opt out of in-person classes in favour of online classes, and high school students with special needs would be able to attend in-person daily if they are not capable of using remote learning.[48] The province allocated $309 million in funding to cover the costs of additional cleaning supplies, protective equipment, and staffing.[49]

The plan faced criticism from parents, educators, and health care professionals, noting that some schools had insufficient ventilation and that there was no reduction in elementary school class sizes—with only 1 metre of distancing specified between desks. Lecce stated that the distance of desks was in conjunction with the use of masks. The hashtag "#UnsafeSeptember" was used on Twitter to publicize concerns regarding the back-to-school plan.[49] A poll conducted by Maru/Blue in mid-August suggested 38% of parents surveyed were not going to send their children back to school, and a majority believed they stood with teachers and that there should be a staggered start to the school year.[50][51][52]

On August 26, details were issued regarding how positive cases will be handled. In the event of a positive case, the entire cohort will be dismissed and required to self-isolate for 14 days. Students may return to class if they have not developed symptoms during the 14-day period. However, they will not be required to receive a test. Schools may be shut down entirely if the local health unit determines that "potential widespread transmission" is occurring.[53] The same day, the federal government announced a $2 billion funding toward schools in Canada, of which Ontario will receive $763 million with the first tranche of $381 million arriving in the fall.[53]

The Toronto District School Board, Canada's largest, debated and later decided to delay the reopening of schools until September 15, one week later than the initial September 8 date.[54][55] A survey by the board suggested 70% of students would be returning to in class school and 30% of students would be opting for learning from home.[56]

On September 8, the first day of public school for many parts of the province, at least COVID-19 cases reported in Ottawa-area Catholic schools and teachers in a Mississauga Catholic school refusing work until proper personal protective equipment was provided.[57][56]

On September 11, the Ontario government released a website to track COVID-19 infections in public schools and daycares.[58]

By the end of the second week of school reopening, the government has reported 72 cases of COVID-19 in 60 schools and one school closure in Pembroke in Renfrew County in Eastern Ontario.[59]

The last day of class for public schools in 2020 was December 18, the province closed the fall semester with 7,292 cases reported in public schools. Before the winter break, there more than 20 schools closed in addition to all public schools in the Windsor-Essex region.[60]

Due to the province-wide shutdown beginning December 26, all public schools in the Northern section of the province will participate in online learning until returning to in-person class on January 11, 2021, while schools in the South will return to in-person class on January 25, 2021.[61][62][63] On January 12, this was later amended, and schools in Toronto, Windsor-Essex, Hamilton, Peel and York region will not return until February 10, 2021.[64] On February 3, it was announced all regions except for Toronto, York and Peel will return to in-class learning on February 8. Toronto, York and Peel will return to class on February 16 (the day following Family Day).[65]

Data as of February 8, 2021

On May 14, 2020, it was announced that Stage 1 of Ontario's lifting of restrictions would take begin May 20, focusing primarily on "workplaces that are well-positioned to follow public health advice to maintain physical distancing, implement workplace safety guidance and limit gatherings". Certain outdoor recreation activities that are part of Stage 1 were allowed to resume on May 16, for the Victoria Day long weekend.[67]

On June 8, it was announced that Stage 2 would be implemented across most of the province, excluding 10 Southern Ontario health regions primarily in the Greater Toronto and Hamilton Area and along the Canada–United States border (such as Windsor-Essex County) due to a large number of active cases.[68] In addition, Ford announced that the cap on gathering sizes would be increased to 10 province-wide regardless of phase, and that there would be a moratorium on evictions through the end of August of small businesses which are eligible for the Canada Emergency Commercial Rent Assistance program.[69][68] On June 15, the Durham, Halton, Haldimand-Norfolk, Hamilton, Lambton, Niagara, and York health regions were allowed to enter Stage 2.[70]

On June 22, it was announced that Peel and Toronto would be allowed to enter Stage 2 on June 24. Windsor-Essex was still excluded from Stage 2 due to outbreaks involving the agriculture industry.[71] On June 24, it was announced that most of Windsor-Essex would be allowed to enter Stage 2 on June 25, excluding Kingsville and Leamington.[72]

On July 3, Premier Ford stated that he did not have a specific timetable for Stage 3; "You see what's happening [in the United States] when you move too quickly, you see what's happening south of the border. We don't want that happening up here."[73]

By August 12, after a region-by-region roll-out, all regions in Ontario had entered Stage 3.[30] On September 8, in response to growing case numbers, the provincial government announced a moratorium on further lifting of restrictions (such as expansion of "social circles" and gatherings) for at least four weeks, besides those already ongoing (such as schools, and reopening of selected casinos on September 26).[74]

On November 3, 2020, Premier Ford stated that future modifications of restrictions during the second wave will be performed regionally using a colour-coded "response framework". The framework went into place on November 7.[78][79][80]

On November 11, it was reported by the Toronto Star that the Ford government had allegedly ignored recommendations by Public Health Ontario regarding the metrics used for the advisory system — which were four times narrower than what was actually implemented by the government.[81]

Two days later, Premier Ford announced that the thresholds for each level would be decreased: for example, the criteria for the "Control" (Red) level was reduced from a weekly incidence rate of 100 or more per-capita, to 40 or more. Regions included in each tier were adjusted to match the new thresholds effective November 16. Ford stated that the original criteria was based on earlier models that had anticipated only 950–1,250 new cases per day by the time it was implemented and that he would not have used them if case numbers had reached the point they had on November 10.[82]

Due to the present declaration of emergency, the COVID-19 Response Framework is currently paused.[83] As announced on February 8, 2021, certain batches of regions will gradually leave the stay-at-home order and re-enter the framework on February 10, February 16 and February 22 respectively.[84]

On December 21, 2020, Premier Ford announced that in order to "save lives and prevent our hospitals from being overwhelmed in the coming weeks", a "strict" Provincewide Shutdown would begin in all health regions (regardless of their current status on the COVID-19 Response Framework) at 12:01 a.m. ET on December 26, 2020 (Boxing Day). This measure will last for 28 days.[86][87] It was originally to last only 14 days in the northern regions of the province (north of Sudbury), but on January 7, 2021 it was announced that the Provincewide Shutdown will be extended in these regions to the same length as in Southern Ontario.[88]

Indoor social gatherings that involve people from outside of one's immediate household are prohibited. Outdoor gatherings are limited to 10 people with social distancing. All non-essential businesses, retail outlets (which include all businesses deemed non-essential under lockdown, as well as hardware stores and pet shops), cultural amenities, sports and recreation facilities (unless "being used by high-performance athletes and specified professional leagues"), and personal care services must close to the public. Essential retail businesses are subject to capacity limits stricter than those used under lockdown (50% for supermarkets and pharmacies, 25% for liquor stores and allowable big-box stores that sell groceries). Bars and restaurants are prohibited from offering dine-in service. All drive-in or drive-through events are prohibited, excluding drive-in religious services.[88][86]

All publicly-funded schools will remain closed to in-person classes (resuming remotely after the holiday break) until January 11, 2021 in Northern Ontario, and January 25, 2021 in Southern Ontario.[63] Elementary schools were originally slated to reopen in Southern Ontario on January 11, but on January 7 it was announced that this would be delayed.[63]

On January 12, 2021, citing models forecasting that Ontario's health care system will be "overwhelmed" with cases and mortality exceeding those of the first wave unless actions are taken,[89] Premier Ford declared a second provincial state of emergency and announced stricter province-wide measures, to take effect on January 14 at 12:01 a.m. ET and last through at least February 11. These measures upgrade the Provincewide Shutdown to a stay-at-home order; all Ontario residents must remain at their homes unless conducting an activity deemed essential. These include shopping at grocery stores or pharmacies, receiving health care, exercise, or conducing essential work that cannot be performed remotely (all employees must work from home if they have the capability of doing so).[90][89] The province states that what is considered "essential work" is based on "[the] best judgement and common sense of employers".[91] All other restrictions enacted under Provincewide Shutdown remain in force, and the Ontario COVID-19 Response Framework is officially considered "paused" due to the Declaration of Emergency.[91][83]

Certain businesses, such as liquor stores, hardware stores, and stores offering delivery or curbside pickup services, must close from 8 p.m. to 7 a.m. nightly. Non-essential construction activity will also be suspended. Outdoor gatherings are limited to five people, and guidance now recommends masks be worn outside (in addition to the existing indoor mandate) if social distancing is not possible.[90][89] The closure of schools in Hamilton, Peel, Toronto, Windsor-Essex, and York will be further-extended to February 10.[90]

The Ontario Provincial Police (OPP), municipal police departments, bylaw officers, and provincial workspace inspectors, will have the authority to issue tickets to enforce the stay-at-home order and mask mandate,[90] however they will not have the authority to stop drivers or pedestrians for questioning.[92] Premier Ford stated plans for a compliance "blitz" of retail store inspections beginning the weekend of January 15.[93][90] Results of the inspection "blitz" revealed 36 of 110 stores visited in violation of COVID-19 measures, or 70% compliance rate.[94] The measures have faced criticism for disproportionately favouring big box retailers, by not restricting the times of day in which they may offer curbside pickup or delivery services, or preventing them from selling non-essential goods. It also does not include funding to cover paid sick days for essential and low-wage workers.[90]

As per an announcement on February 8, 2021, the stay-at-home order will be lifted in each region re-entering the colour-coded response framework, which will happen in batches, on February 10, February 16 and February 22, respectively.[95]

Data as of 8 p.m. February 7, 2021

A plan for widespread inoculation is currently laid out in three phases.

• General (retired) Rick Hillier, former Chief of Defence Staff for the Canadian Forces (chair)
• Mario Di Tommaso, Deputy Solicitor General, Community Safety, Commissioner of Emergency Management (vice-chair)
• Helen Angus, Deputy Minister of Health (vice-chair)
• Ontario Regional Chief RoseAnne Archibald of Taykwa Tagamou Nation
• Dr. Isaac Bogoch, infectious diseases consultant and internist, Toronto General Hospital
• Dr. Dirk Huyer, Ontario's Chief Coroner
• Angela Mondou, President and CEO, Technation
• Mark Saunders, former Toronto Police Chief
• Dr. Maxwell Smith, bioethicist and assistant professor, University of Western Ontario
• Dr. Homer Tien, trauma surgeon and President and CEO, Ornge
• Dr. Regis Vaillancourt, Director of Pharmacy, Children's Hospital of Eastern Ontario

• Linda Hasenfratz, CEO, Linamar, resigned due to her travel outside of the country in December, 2020[116]

On April 15, CBC reported that the Ontario Ministry of Long-Term Care had conducted resident quality inspections (RQI) at only nine out of 626 long-term care homes in the province in 2019,[120] down from a bare majority in 2018 and larger proportions from 2015 to 2017.[120] RQIs are proactive, unannounced and more comprehensive than the other main category of care home inspections in the province, complaint and critical incident inspections, where facilities know of the impending scrutiny in advance;[120] the 2018 Long Term Care Homes Public Inquiry noted that "focusing only on specific complaints or critical incidents could lead to missing systemic issues."[120] As of 15 April 2020, 114 care facilities in Ontario had experienced COVID-19 outbreaks, and those that had multiple COVID-19 deaths last had their RQI in 2018 or earlier.[120]

On April 7, Ontario reported that there are 51 long-term care homes in the province that are experiencing COVID-19 outbreaks, and by April 10, it had surged to 69 LTC homes in Ontario.[118][119] Some LTC workers pointed to a lack of personal protective equipment as a cause of the outbreaks.[118] By April 21, 121 outbreaks have been reported in long-term care homes.[121]

On April 8, the Ontario Ministry of Health released directives to ramp up coronavirus testing and infection control. Also, new residents entering a home must be isolated for 14 days and tested within that period. The directives also require that all long-term care home staff and essential visitors for gravely ill residents wear surgical masks, "whether the home is in outbreak or not." LTC homes are expected to take "all reasonable steps" to follow the new long-term care rules. Prior to this directive, LTC staff were not required to wear masks or other PPE, and testing levels were considered low for at-risk seniors and LTC staff.[119][122]

On April 28, Chief Public Health Officer Theresa Tam stated that as many of 79 percent of Canada's COVID-19 fatalities occurred in long-term care homes, with Ontario and Quebec accounting for most of the cases.[123]

As part of Operation Laser, assistance from the Canadian Armed Forces at five Toronto-area nursing homes, beginning in April, led to a report by the Brigadier General in charge documenting extreme conditions and abuse.[124] The Ontario Ombudsman announced the launch an investigation into long-term care facilities on June 1.[125]

During the second wave of the pandemic, LTC homes began to experience outbreaks again. Tendercare Living Centre in Scarborough for example has experienced 43 deaths related to COVID-19. On December 25, 2020, North York General Hospital took over control of the home.[126]

Data as of February 8, 2021

Updated as of February 4, 2021.[130]

Updated as of Dec 31, 2020.[131][132]

Access to testing is set by Public Health Ontario who publishes a guidance document that defines the conditions for an individual to be tested.[137] Conditions have included close contact with a test-confirmed case, recent travel, admission to hospital for serious symptoms, healthcare worker, longterm care home resident, etc. The set of conditions has been updated repeatedly from January to April 2020, at times reducing access and at other times increasing access to testing.[138] Starting in March, the public health units across the province have opened over 70 assessment centres, which members of the public can visit if directed by a health professional. These range from mobile units, to walk-up locations, to drive-through locations. This diverts potentially infected people from hospitals and doctors' offices. If warranted, the centre will collect a swab from a visitor for testing. Swabs are also collected at hospitals and by public health officials, for example, at long-term care facilities.[139]

Since many cases are not tested, the number of test-confirmed cases, which are the infection numbers reported by the Ontario government, should not be misconstrued as the actual number of infections, which have been estimated to be substantially higher.[140] Unlike some countries, the number of suspected or probable infections is not reported by the Ontario government.[141][142]

In an effort to reduce a burden on provincial assessment centres amid a continued surge in cases, Ford announced on September 23 announced that it would expand testing of asymptomatic people by-appointment into pharmacies across the province, beginning with 60 locations by September 25. He also announced plans to deploy saliva-based rapid testing at three hospitals in Toronto.[143] Accordingly, the province announced on September 24 that it would discourage asymptomatic patients from receiving tests at assessment centres.[144]

The COVID-19 testing rates in Ontario from March to May 2020. Points are data and lines are a 4-day moving average. Source: data.ontario.ca

In late March and April, Ontario was performing the lowest number of tests per capita of all the provinces.[145][146] As of early May 2020, among the larger provinces, Ontario is second to Alberta and ahead of British Columbia and Quebec in daily tests per capita.[147]

In mid-April, polling firms Forum Research and Mainstreet Research released results of a pair of surveys about COVID-19 symptom prevalence and testing.[148][149] Four to five thousand Ontario households were randomly selected. Of them, 2% of households contained someone who had been tested by April 12, increasing to 5% on April 19, whereas the incidence of COVID-19 symptoms in a household decreased from one in five to one in seven households. The second survey indicated that one-third of Ontarians report an underlying condition that might aggravate a COVID-19 infection.

Since January 2020, Ontario has been increasing its capacity to perform testing based on RT-PCR. Various factors have impeded this increase, including shortages of reagent chemicals for the RT-PCR machines and shortages of validated swabs. To tackle these challenges, labs have adapted. In particular, RT-PCR machines from multiple manufactures have been obtained, each of which takes different sets of chemicals. New suppliers of swabs have been found but each must be tested and validated to perform properly. Returning tests results to individuals is automated with an online portal.[150]

On March 18, The Toronto Star reported that test results announced by the provincial government were several days old, with turnaround times increasing from 24 hours to 4 days, leading the government to "making decisions based on old information".[161] The province was only able to process around 2,000 tests per day by March 19, which caused the backlog.[162] The backlog increased to over 8,000 unprocessed samples on March 24 with patients waiting at least four days for results, partially due to fact that private and university laboratories are not allowed to process samples.[163][164]

More backlogs emerged in September and October amid increased demand for tests and a heightened caseload, reaching 68,000 by the weekend of October 4.[143] On October 5, CBC News reported that COVID-19 tests administered at pharmacies were being sent to Quest Diagnostics laboratories in California for processing by means of the local partner for the scheme, In-Common Laboratories (ICL).[165]

Officials for Public Health Ontario include the following individuals:

• Dr. Vanessa Allen, chief of medical microbiology with Public Health Ontario[133]
• Dr. Peter Donnelly, president and CEO of Public Health Ontario (on leave as of April 9, 2020)[166][167]
• Colleen Geiger, interim president and CEO of Public Health Ontario (as of April 9, 2020)[166][167]
• Dr. David Williams, Ontario's chief medical officer[168]
• Dr. Barbara Yaffe, Ontario's associate chief medical officer of health[168]

In early April, the Ministry of Health brought in a multinational accounting firm KPMG to assist in the organization and optimization of testing capacity in Ontario.[134] Premier Doug Ford said on April 8 that he was losing his patience with Ontario's inadequate testing numbers, showing testing capacity was not being fully utilized.[169] Later that day, the province appointed a former Toronto public health head, Dr. David McKeown to troubleshoot and rethink the province's response to the pandemic. The following day on April 9, amid mounting criticism of the province's testing, the president and CEO of Public Health Ontario Dr. Peter Donnelly temporarily stepped down for medical reasons and was replaced in the interim by Colleen Geiger, Public Health Ontario's chief of strategy, stakeholder relations, information and knowledge.[166][167][170]

Regional public health experts suggested that Ontario's initial incremental response — adding new voluntary measures piece by piece — had been ineffective. Businesses of all sizes remained open, and unnecessary social contacts continued. Describing Ontario's efforts to battle COVID-19 as piecemeal and ineffective, Dr. Shanker Nesathurai, who was one of Ontario's 34 regional medical officers of health, urged his colleagues to band together and use more powerful measures to contain the pandemic than provincial leaders had endorsed by the third week of March. In an email, Dr. Nesathurai, who worked for Haldimand Norfolk Health Unit, wrote on March 19 that Ontario's response had undermined the province's attempt to contain the outbreak, as businesses remain open and travellers ignore advice to self-isolate.[171]

An anti-lockdown protest in front of the Ontario Legislative Building in Queen's Park, Toronto, April 25, 2020

On April 25, there were small protests totalling 200 protesters in front of the Ontario Legislative Building in Queen's Park, Toronto, demanding that Doug Ford end all emergency measures. Some of the protesters consider the coronavirus a hoax. Ford called them "a bunch of yahoos."[172]

On May 2, there was another protest with 100 protesters in front of the Ontario Legislative Building.[173]