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No one's talking about winter yet. When it comes to COVID-19, here's why we should

You might be reading this while sitting on your front porch or lounging at the beach. Perhaps you're on a park bench or taking a pit stop on a summer road trip.

Wherever you are in Canada, chances are you don't have sub-zero temperatures on your mind just yet. But amid the COVID-19 pandemic, winter could bring a whole host of new challenges — and experts say now is the time to prepare.

"No one's talking about winter," said Laura Rosella, an associate professor of epidemiology at the University of Toronto's Dalla Lana School of Public Health.

"I think, frankly, everyone's just overwhelmed with the next big change, which is back to school, and we almost can't think that far — but it's probably what we should be doing."

For months, we've been told to stay apart to stop the spread, but chilly temperatures will force people to cram indoors. We've been able to run for fun and bike to work, but snow-covered streets will bring workouts into gyms and more commuters onto transit networks. 

Classrooms will fill up, more restaurants and offices will open, all while patios and parks empty out. Layer in the regular cold and flu season and the mental health impacts of darker days and isolation, and it's easy to picture the Great White North being a great big mess.

Summer, in comparison, is easy.

"It's actually really nice that people are able to socialize and see family and see their friends outside in a safe way," Rosella said.

More Canadians could be crowding onto public transit or carpooling during the winter months to get to work and school. (Evan Mitsui/CBC)

"So I think it's going to be very hard when people are going to have to make the decision about maybe not entering those social situations, because it is much higher risk in an indoor environment."

Dr. Andrew Morris, an infectious disease specialist with the Sinai Health System and University Health Network in Toronto, said the winter months also mean added risks going to and from work and school — whether that's people forced to carpool together, take a school bus or crowd onto transit.

"I anticipate that we will start to see transmissions occurring not as much necessarily in the workplace but going to and from the workplace," he said.

So how can Canadians mitigate the risks when the temperature starts dropping, forcing people increasingly inside?

Housing, filtration both key, experts say

Experts say solutions need to come from all levels — policy-makers, business owners and individuals — and should tackle both the essential trips people need to make and the inevitable social gatherings Canadians crave.

There's definitely cause for concern when it comes to the design of buildings where people will be spending more of their time, said Linsey Marr, an expert in the transmission of viruses by aerosol at Virginia Tech, in Blacksburg, Va.

That's because it's harder to open windows for better airflow in many offices and schools once temperatures drop and heating systems are turned on.

"And I think to prepare, the filtration will be important," she said.

Winter weather can make getting around more difficult, sending more people indoors, like this January 2020 snowfall in Vancouver. (Ben Nelms/CBC)

Dr. Andrew Boozary, an assistant professor at U of T's Dalla Lana School of Public Health, said political leaders also need to ensure that people struggling to physically distance from others at home or work have proper supports — whether that's offering housing to those crowded into shelters or ensuring essential workers have paid sick leave to take time off when needed.

Hotel rooms for people to recover from COVID-19, for instance, can be helpful for those who can't isolate at home or in the shelter system, but Boozary said that's merely a stopgap.

"All levels of government are going to need a generational response on housing," he said. 

Socialize outdoors 'as much as possible'

There's also growing concern over the recreational aspect of winter life and the hurdles Canadians face socializing when temperatures drop.

"We need to be changing all aspects of our life, and we need to get back to really encouraging more outdoor life and outdoor recreation," Morris said.

Both business owners and policy-makers should be looking at winter gathering options, creating event spaces that maintain air flow while offering a bit of shelter and outdoor heating, he said — "the kinds of things to encourage socialization outside as much as possible."

WATCH | Epidemiologist focuses on managing risks for children returning to school:

Dr. Christopher Labos says there is little value in testing every child for the coronavirus before school starts and he speaks to concerns about keeping kids apart in the classroom. 5:43

Rosella stressed the need to create incentives for people to go outside, whether that's building more outdoor skating rinks or creating snowshoeing paths, even in dense city environments. 

"These are the types of things that people that actually live in very cool climates all year round do all the time," she said.

These strategies for keeping people safe inside and out are, of course, layered on top of the well-worn public health messaging that's been in place for months: Wear a mask, stay apart from others and wash your hands regularly.

None of those recommendations have changed, and they're perhaps even more crucial now that people are set to spend more time gathered indoors for work and play — and as the regular cold and flu season approaches.

Flu season means added 'challenge' ahead

During a news conference this month, Canada's chief public health officer, Dr. Theresa Tam, stressed the months ahead will be a "period of challenge" given the combination of COVID-19 and influenza.

But some public health officials, Tam included, are optimistic that widespread, continued uptake of their advice might even ward off those seasonal illnesses.

'We need to be changing all aspects of our life, and we need to get back to really encouraging more outdoor life and outdoor recreation,' says Toronto infectious disease expert Dr. Andrew Morris. (Ben Nelms/CBC)

"From what we have seen in other countries, public health measures such as physical distancing can also be effective against the flu, but we'll likely be able to see more evidence of this once the flu season is over in the southern hemisphere," Dr. Vinita Dubey, Toronto's associate medical officer of health, said in a statement.

Morris said facing this complex set of challenges requires coming to terms with one key fact: While the seasons may be changing, the virus behind COVID-19 isn't going anywhere.

That means Canadians need to figure out new ways to handle the cold winter months and mitigate spread.

"We're not getting back to normal any time soon," he said.

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source https://www.cbc.ca/news/canada/toronto/winter-covid-19-indoors-transmission-1.5681175?cmp=rss

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