Fancy a government-sanctioned hug, Ontarians?
The provincial government loosened pandemic guidelines on Friday, which now allows for people to see those outside their households without social distancing.
Chief medical officer of health Dr. David Williams endorsed social “circles” of 10 for these expanding networks, meaning people can come into close contact with up to nine others, provided they all follow some guidelines.
This comes on the heels of what provincial health minister Christine Elliott called a “promising trend” in COVID-19 cases, as they’ve dipped below 200 active infections for the first time since March.
The government released five rules circles should follow: Start with your current circle (a.k.a., your immediate household), add more if under 10, make sure everyone agrees to be in the circle, continue physical distancing from all others, and “be true to your circle” — being in multiple circles is a no-go.
“Not only will social circles help to improve people’s mental health and reduce social isolation, they will support rapid case and contact tracing by limiting the number of close contacts, in the event of a case of COVID-19 in that circle,” Williams said in a statement.
What’s the difference between a bubble, a circle, and a gathering?
New Brunswick and Newfoundland adopted the “double bubble” approach weeks ago, which permits all members of two households to engage in close contact. In Nova Scotia, the double-bubble system only allows two households of the same immediate family to get together.
Watch: when you’re allowed to double bubble, hugs immediately follow. Story continues below.
People in Ontario’s social circles can come from multiple households, but are currently capped at 10 people and the circle must be exclusive.
Social gatherings are groups of people who meet up in person while respecting physical distancing. Any configuration is fine, with people at gatherings able to swap in and out. As of Friday, Ontario increased gatherings in one place to 10 people.
For bubbles, circles, and gatherings, all members should be healthy and have had no contact with anyone displaying COVID-19 symptoms.
Going in circles about circles
Some online expressed confusion and forecasted misinterpretation, as well widespread “cheating,” due to the new rules announced at a news conference on public health updates, fielded by Williams, Elliott, and Ontario premier Doug Ford.
Like many, infectious diseases physician Dr. Zain Chagla reacted to the new rules with some head-scratching.
“I understand the reasoning behind it, in trying to limit transmission, while still allowing people to reduce isolation,” Chagla told HuffPost Canada. “But the language and organization behind circles, makes it seems like it might be off-purpose. All of these plans should emphasize principles, rather than make X or Y rule.”
He had hoped Ontario would follow in the footsteps of other province’s social expansion efforts; B.C.’s guidelines for social gatherings was especially good in Chagla’s eyes, as it took the form of a flowchart people could use to assess their own risks.
“People are going to wonder if their home bubble is different from their work bubble, there’s so many factors,” he said. “The whole point of these systems is to make sure the public can make informed decisions, the fact that we’re sitting here wondering kind of goes against the principle.”
What might get lost with being a circle stickler, he worries, is forgetting to assess risks. Not all circles are created equal; households who have been isolating since March merging together are at a lower risk than a circle comprised of several households with people on the front lines every day.
“If you look at individual risk, you get riskier the more interactions you have,” he said. “If there’s 10 people in 10 different workplaces, that’s actually a very risky bubble, whereas two families coming together is fairly benign.”
Given the grey areas Ontarians may be puzzling over as they try to organize their own circle, Chagla shared with HuffPost Canada his interpretation of how people can weigh risks while making their circles as safe as possible:
Is 10 a hard limit?
Most people can’t sort their friends and loved ones easily into tidy groups, making circles of 10 tricky for many large households: Two families with six members each would go over the limit, for example.
“If there’s 10 people in 10 different workplaces, that’s actually a very risky bubble, whereas two families coming together is fairly benign.”
In Chagla’s opinion, most families shouldn’t sweat slightly going over the 10 limit if everybody in the circle is low-risk and no-contact with potential cases.
While somewhat arbitrary and likely based on the amount in a nuclear family unit, it makes more sense to see 10 as a number that helps evaluate what type of people you include in your circle, with the goal being to reduce the number of risky units.
“A gathering of 12 for the family BBQ, you’re probably fine ... 10 or 11 is a risk when you’re having individuals or couples coming together, but two big units coming together, that’s fairly low.”
If I have roommates, do we have to share one circle?
“Yes, unless the roommates don’t interact with each other,” he said. “If they’re sharing an environment, sharing furniture, it’s better from a risk standpoint if they stay as a unit and they move as a single group.”
Can you safely swap people in and out of your circle?
Circles are locked groups, but what happens when a family member requires some extra TLC? Or if a gaggle of friends decides to add a new pal?
“It really depends on the people coming in,” Chagla said.
He suggested asking the incoming circle members questions that assess how risky they are to interact with, such as if they’ve been in contact with confirmed cases.
“Are they also doing low-risk activities? Have they been introduced to high-risk situations and if so, was there a cool-down? You could take two elderly people, injecting them into a group of eight front-line workers probably isn’t ideal.”
Mitigating potential viral transmission might mean like saying no to circle entry requests or kicking out someone who engages in risky behaviour. This may sound harsh on the surface, but gets to the reasoning behind why differing levels of contact are needed.
And, it’s important not to forget that socializing can still happen between circle and non-circle members.
“It’s not necessarily about getting as much interaction as you can ... maybe we should just go outside and hang out in a backyard patio for a few hours instead of watching TV in the basement,” he said. “You can always make those value judgements with a bit of logic.”
Does it matter if circle members live far from each other?
“It’s all about mitigation. In terms of the GTA [Greater Toronto Area], we live in an area of the province with a lot of geographic mobility. My parents living in London, Ont., I would consider them a part of my social circle when they visit to see their grandkids.
“The only caveat is as this pandemic progresses, there’s a lot of regional differences. So especially high-risk folks interacting with low-risk folks in regions with a lot of disease activity, there may be more consideration,” Chagla advised. “If I was living in Brampton [Ont.], which maybe seems like an epicentre now, and my parents were coming, I would be a little wary.”
Is there a “cool-down” period before introducing a COVID-19 recovered person into a circle?
“For very vulnerable people, if they were ill or sub-clinically ill [tested positive but were asymptomatic], that cool-down period should be a couple weeks before a visit, as well as a negative test.
“We know that one in five people who are exposed won’t test positive. If they do their isolation period, it’s safe to jump back in.”
If someone in a circle tests positive, does the circle collapse?
“Everyone goes into isolation if they were in close contact. However, if someone was exposed, but tested negative, they should leave the group for two weeks. Then you could theoretically come back.”
Can social enforcement fines be given to circles socializing, like family picnics in parks?
“There’s no way to tell and it’s hard to enforce the bylaws, unless the numbers are more than 10,” Chagla said. “No one’s registering these circles through formal documents or agreements.”
Also on HuffPost: