“We can’t vaccinate our way out of the third wave”: Why Peel public health chief Lawrence Loh is shutting down workplaces with outbreaks

Yesterday, Lawrence Loh, Peel’s medical officer of health, implemented an order requiring all businesses with five or more cases of Covid-19 in the previous two weeks to close for 10 days; hours later, Toronto followed suit. Loh’s order came amid widespread criticism that the provincial government’s workplace restrictions are too lax; some observers are calling the decision a “mutiny.” Peel is one of the hardest-hit regions in the province, with a positivity rate of 22 per cent. We spoke with Loh about why business closures are an important step toward protecting Peel residents during the third wave.

You announced an updated Section 22 order on Monday, which comes into effect later this week. Why now?
It’s very dire. During this third wave, we’re not seeing any sort of plateau in daily case counts, even two to three weeks after some of the stricter provincial measures have come into play. And we know that the new variants have very much changed the game. In Peel, we’ve had an essential workplace challenge throughout all three waves of the pandemic, which has kept our case numbers higher than the provincial average. Now, in the third wave, we’re seeing way more workplace outbreaks, with more widespread transmission. So we thought we need to start treating workplaces like schools: if you’ve got a few cases, close things down and keep people safe while you’re investigating, because otherwise there’s no way to get ahead of this virus.

Eileen de Villa implemented the same measures in Toronto a few hours after you did in Peel.
It was actually a coordinated effort. I understand that my counterpart in Toronto has a slightly larger machine to move, so that was the reason for the disjointed announcements.

Tell me a bit about moving that machine. What kinds of signoff from Queen’s Park do you need for measures like this?
I had spoken with David Williams the night before, on behalf of Peel Region, letting him know that this was percolating. Ultimately, I derive my mandate from our board of health. There are provisions within the provincial Health Protection Promotion Act that allow us to take immediate action in the face of a communicable disease threat, which is what Section 22 covers. Because Section 22 is directed at individuals or classes of individuals, it can be appealed.

So a workplace could appeal the new order?
Correct.

You’ve recommended that employers provide paid sick leave for employees if a workplace is shut down under the new Section 22 orders. But on the provincial level, paid sick leave is not required—so if a bunch of folks are required to stay home from work, are they just not getting paid?
That’s a great question. I’ll start by saying that we know that paid sick leave is essential to saving lives and controlling the spread of the virus. When we did our analysis in January 2021, we identified that almost 25 per cent of people in Peel who’d tested positive for Covid-19 reported going to work after their symptom onset date. So you realize that’s a monumental number of cases that could have been avoided if people could confidently stay home without worrying about losing their houses. Fortunately, what we’ve seen in terms of closures is that most employers are willing to take care of their employees. So we’re really relying on employers to understand the situation we’re in, and that there’s a need for them to be good corporate citizens.

Is it within your power to mandate paid leave under Section 22?
Section 22 covers taking immediate action against communicable disease threats. The legal opinion I’ve received is that paid sick leave would not be seen as an immediate measure against communicable disease. We could always hire a lawyer to argue it one way or another, but ultimately, businesses would challenge it. Similarly, there is a recognition of jurisdiction: the regulation of labour is ultimately up to the province.

How do you feel the province is doing right now?
I consider myself part of the system that’s responding to Covid in Ontario, so I try to drive home the point that context matters. We were never going to be New Zealand. It’s been frustrating for some, especially public health specialists like myself, that some of these closures and changes didn’t happen quickly enough. And being from a region that’s particularly hard-hit, it’s like, yeah, Kingston looks great right now, but maybe Kingston would look very different if it had Pearson Airport and a whole bunch of warehouses and distribution centres.

I mean, I don’t envy the premier. The province is diverse, and he’s trying to balance so many different interests. But you cannot bargain with this virus. With any other national disaster, we would shut things down. We wouldn’t be arguing about indoor dining in the middle of a hurricane. But because this is unprecedented, and because there is such a significant economic impact, the reality that you can’t bargain with the virus has been muddied. I think it always stretches the limitations of human rationality, to understand that sometimes it’s better to just rip the Band-Aid off, rather than drag it out and find yourself in a worse position than if you had addressed things with a clearer direction initially. It’s been interesting to watch the interplay between clear science and human nature unfold. And to a degree, I wish it had unfolded slightly differently.

The vaccine rollout is unfolding now in Peel. How’s that going?
I’m really excited about it. We’re really starting to see the airplane take off now. We know that there’s continuing supply chain volatility at the federal level, but we have 11 vaccination clinics, and we’re doing about 12,500 doses a day, or about 100,000 doses a week. Our goal is to get to 1.2 million residents vaccinated, because then we think we’ll really start to see some changes in transmission. I will say: we can’t vaccinate our way out of the third wave. We need to use other measures, like the workplace closures. Our goal is to keep things closed while we continue to vaccinate, so that those two strategies eventually cross over, and hopefully, we soon enter a post-pandemic future.

I am also hopeful that we soon enter a post-pandemic future.
Trust me: no one wants that more than I do.