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Why are people going out in groups in Ontario? 'Isolation fatigue', mixed messages from leaders to blame, doctor says

As scores of Torontonians descended on Trinity Bellwoods Park a few weeks ago to enjoy the warm spring weather and flout social distancing rules, the images hit a nerve for those on the frontlines.

“It really struck a chord with me and I felt saddened that our efforts as frontline people and just anybody who’s been sacrificing for the past several months have been for not and been undermined,” said Dr. Abdu Sharkawy, an infectious disease specialist at Toronto Western Hospital.

After seeing several images circulate online, Dr. Sharkawy was flabbergasted by the amount of people who were in the park and how reckless they were being by being in public without masks and not physically distancing.

“The first thing that went through my mind was just shock, I had seen images on other warmer days where people were bending the rules, but I think the scale of what I say was like something out of Woodstock, just hordes of people,” he said.

The images were especially disappointing to Dr. Sharkawy who’s been on the frontlines for months fighting against COVID-19, especially as he and fellow healthcare workers put their own wellbeing at risk.

“I think what I really saw was a sense of oblivion as to [what’s going on around the city and inside the walls of hospitals,” he said. “We’re putting ourselves at harm’s risk when we see patients, sacrificing and toiling away, and that was a difficult thing for me to reconcile and digest.”

During the Trinity Bellwoods swarm, the city handed out zero tickets under the physical distancing bylaw, but nine people received tickets for urinating in public. While he was amazed at the turnout, Dr. Sharkawy noted that with the warm weather approaching and other provinces effectively flattening the curve, people are wanting to ease back to normalcy.

“I think the weather brings with it a sense of leisure and signs of hope that we are moving towards a [new] normal again,” he said.

Dr. Abdu Sharkawy discusses why the Trinity Bellwoods fiasco may have occurred.
Dr. Abdu Sharkawy discusses why the Trinity Bellwoods fiasco may have occurred.

As Ontarians enter month three of the pandemic there may be another hurdle of moving towards Phase Two of the province’s reopening plan, as numbers have remained in the 300 to 400 cases daily range. With the positive cases combined with little communication of when things could return to normal on the province’s end, it’s clear the mental strain that restrictions are having on people.

“There’s starting to be isolation fatigue, people are starting to feel like they’ve had enough of being cooped up and are feeling restricted. They can’t see their friends, and it’s only compounded with the deficit in our messaging from the province downwards,” he said.

Leadership failures across the board, Dr. Sharkawy says

While it’s easy to point the finger at park-goers for their behaviour, Dr. Sharkawy feels part of the blame falls on the Ontario government and public health for their handling of the pandemic.

“I think the leadership in much of public health in Ontario has had its share of problems for quite some time, I don’t think those issues have been addressed adequately enough by Premier Ford,” she said.

Dr. Sharkawy points to the West Coast and to the work done by chief medical officer of health for the province of Alberta, Dr. Deena Hinshaw and Provincial Health Officer for British Columbia, Dr. Bonnie Henry who have both been able to flatten the curve in their respective provinces.

“The leadership from the top down is consistent and not surprisingly has translated into a community that follows through and trusts the advice,” he said.

In response to the Trinity Bellwoods situation, Toronto’s medical officer of health, Eileen de Villa said she had consulted with the province’s chief medical officer and associate chief medical health officer and the trio all agreed people who were at the park on the Saturday should self-monitor for symptoms for the next fourteen days. But, earlier in the day, Premier Doug Ford had offered contradictory advice telling Torontonians to take advantage of the assessment centres and go get tested.

“I think it speaks to the principle of clear, consistent messaging which is not contradictory between different levels of leadership and this has been very problematic in Ontario,” said Dr. Sharkawy.

The advice from the province and from its medical health officers is just the latest case of mixed messaging since the beginning of the pandemic, which Dr. Sharkawy admits is having a negative effect.

“There’s consistent issues with lack of communication, consistent issues with lack of urgency on issues of testing or reacting to issues around long-term care homes...it doesn’t appear that they’re being addressed,” he said.

In many respects, Dr. Sharkawy thinks the province has dragged its feet, especially when evidence was available from other jurisdictions. He points to long-term care (LTC) homes in British Columbia and Washington State being hit hard by COVID-19, but the province of Ontario had lengthy delays when addressing similar problems. He also cited the delayed approach to bring extra support staff, while other epidemiologists who spoke to Yahoo News months ago had called on the Ontario government to call in the military, especially in LTCs.

“These are not impressive examples of leadership when you take into account the lessons from other parts of the country and other parts of the world, well before they hit parts of Canada, there was evidence everywhere,” he said.

Since the beginning of the pandemic, freelance journalist, Nora Loreto has kept a list of Canadians who have died in an LTC. Of the 6639 deaths in the country, Loreto’s data shows at least 86.56% of the deaths have occurred in long-term care homes, which makes the province’s slow response that much more damning, according to Dr. Sharkawy.

“The province was clearly late in terms of reacting, in terms of identifying the scope of the problem that existed and in terms of steps they needed to follow to address PPE and staffing issues,” he said.

Learn the lessons, now

It hasn’t all been bad however, as there have been a couple of well thought out ideas, according to Dr. Sharkawy, most notably Mayor John Tory’s CurbTO plan which involved blocking curb lanes to alleviate overcrowding on sidewalks while creating more room for activities.

“Designating spaces for cyclists, for people to walk and run and take their dogs out, that is an example of forward thinking that is helpful and gives people some sort of accommodation and to exercise a little bit of freedom,” said Dr. Sharkawy.

In regards to parks or green spaces, Dr. Sharkawy adds that when larger numbers of people tend to congregate in one area and there needs to be clearly laid out rules or places of demarcation, or it can lead to the masses invoking poor judgement.

“You have a sort of structure that allows you to go out so it’s not a sort of free-for-all, where as being out in an open space without that means you’re left to your own devices and judgement,” he said.

Since the Bellwoods incident, the city of Toronto said they would be introducing piloting physical distancing circles at the park to limit how many people can congregate at one time, similar to what’s being done in New York and California.

SAN FRANCISCO, CA - MAY 21: People utilize social-distancing circles at Dolores Park in San Francisco, Calif., on Thursday, May 21, 2020. The Parks and Recreation Department painted the circles in the northernmost area of the park, but other areas have not been painted. (Jane Tyska/Digital First Media/East Bay Times via Getty Images)
SAN FRANCISCO, CA - MAY 21: People utilize social-distancing circles at Dolores Park in San Francisco, Calif., on Thursday, May 21, 2020. The Parks and Recreation Department painted the circles in the northernmost area of the park, but other areas have not been painted. (Jane Tyska/Digital First Media/East Bay Times via Getty Images)

At the end of it all, Dr. Sharkawy noted a lot of people making negative comments about the park-goers, but he hopes that people understand that if there are not clearly laid out rules and direction from those in power, trying to put the onus on citizens is a tough ask.

“A lot of sentiment that has emerged from the Bellwoods situation is of finger pointing and blame towards the young people of the city of Toronto, and I don’t think that’s fair. It’s also important to remember that not everyone did this with malice,” said Dr. Sharkawy.