Dr. Theresa Tam, Canada’s chief public health officer, continues to recommend people stay two metres apart from others to curb COVID-19 as the economy reopens and countries like Britain relax their distancing rule.
On Tuesday, British Prime Minister Boris Johnson announced pubs, restaurants and hotels could reopen in England from July 4 with relaxed distancing from two metres to “one metre plus,” as long as there is mitigation, such as wearing face coverings or using protective screens.
Britain’s hospitality industry pushed for the rule change. Johnson said local flare ups are expected, just as other countries experienced after loosening restrictions, and that his government will not hesitate to re-apply the brakes nationally if needed.
Switzerland reduced its distancing recommendation from two metres to 1.5 metres this week. China and France already use the 1-metre rule for physical distancing. Germany and Australia have adopted 1.5 metres. The U.S. Centers for Disease Control and Prevention recommends six feet, or 1.8 metres.
But Canada is sticking to its two-metre guidance.
Epidemics can be reignited anywhere, anytime, Tam said.
“With COVID-19 around us, we can’t have a reopening that doesn’t include all of us working together to keep our guard up and keep the curve down,” Tam said at a briefing in Ottawa.
“Now that spaces are reopening, we need to avoid or strictly limit our time in settings and situations that increase our risk of exposure to the virus, like close spaces with poor ventilation, crowded places with large numbers of people gathered and close contacts where you can’t keep the two metres apart from others.”
Dr. Isaac Bogoch, an infectious disease physician at Toronto General Hospital, said transmission has declined “to an impressive extent,” and lockdowns can’t remain in place forever. But he also warned against complacency.
“My concern is people will just get a little bit too relaxed,” he said. “We can hit a patio, we can get a haircut, we can hit the beach. Should we? I honestly think we should. I just think we should do so carefully.”
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Overcoming a Catch-22
Dr. Derek Chu of McMaster University co-authored a review and meta-analysis in Lancet earlier this month of studies looking at how physical distancing, face masks, and eye protection affect the spread of COVID-19 and two other coronavirus infections, SARS and MERS.
The dozens of observational studies included were mostly conducted in health-care settings across 16 countries.
“The main benefit of physical distancing measures is to prevent onward transmission and, thereby, reduce the adverse outcomes of SARS-CoV-2 infection,” the reviewers wrote. “Hence, the results of our current review support the implementation of a policy of physical distancing of at least one metre and, if feasible, two metres or more.”
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The review was funded by the World Health Organization, which has advised people to “keep a distance of at least one metre from each other” as part of its COVID-19 advice for months.
Chu, a clinician scientist at McMaster, said the review was based on the best observations available, but people will not perfectly recall distances. Unlike laboratory studies measuring how far aerosols and droplets transmit, the meta-analysis focused on what transmission actually happened at zero to two metres.
“The Catch-22 is the available information is less than ideal. So what to do?”
There won’t be certainty in the evidence, he said.
“What is actually most effective for individuals is not necessarily always what’s better for individuals.”
Factors such as acceptability, feasibility, and resources all come into play in considering the evidence and setting policy, Chu said.
Other considerations include how long you’re in close proximity, the number of people and whether people speak softly or shout.
Across the country, 66 per cent of respondents to a poll conducted by Leger and the Association for Canadian Studies said two metres should remain the safe distance kept between people.
The web survey was conducted from June 19 to June 21 with 1,521 Canadian adults.