COVID-19 is a highly contagious and fatal respiratory disease that is having negative implications on different aspects of society. The transmission rate of COVID-19 is higher in an indoor setting, where airflow and physical space between individuals can be limited. From a public health perspective, cautious approaches to indoor public spaces are recommended to limit the potential outbreak. These approaches include: limiting the number of individuals within a closed entity, maintaining physical distancing, ensuring individuals are wearing masks and routine hand washing. The potential economic burden of COVID-19 is also substantial, and there is a need for reopening the province and restarting the economy while minimizing the risk of potential COVID-19 outbreak.
What does Stage 3 mean?
In summary, Stage 3 means that nearly all business and public spaces can reopen, with public health restrictions in place. For example, a restaurant will be allowed to provide indoor services for customers with the safety measure detailed by the Province. Some high-risk venues such as private karaoke rooms will remain closed until further notice. Meanwhile, in terms of gathering limits, indoor social gatherings will expand to a maximum of 50 people compared to 10 people in Stage 2. For outdoor settings, the upper limit will increase to a maximum of 100 people. Note that both gathering limits are subject to physical distancing protocols as individuals from different social circles need to strictly comply with social distancing rules to minimize the potential transmission. Additionally, for indoor activities like religious services, wedding ceremonies or funeral services, the room could fill up to 30% of its original capacity, meaning up to 15 people can share the same room if the room capacity is 50. Currently, Ontario is gradually reopening the business and economy on a regional basis because each region may have different progress in the fight against COVID-19. On Monday (July 13th), the Provincial Government announced that most municipalities in Ontario would move to Stage 3 on July 17th. Nonetheless, the Greater Toronto Area and a few other populated regions are not on the list .
Why is the Greater Toronto Area (GTA) not on the list?
Stage 3 does not mean that COVID-19 is over, and it is necessary to continue following public health advice and safety protocols. While there is a decline in the incidence of COVID-19 in most areas of Ontario, it does not diminish the fact that the GTA is the most populous metropolitan area in Ontario and Canada. It includes the City of Toronto and the regional municipalities of Durham, Halton, Peel, and York and has a total population of approximately 6 million . In their study on population densities and spread of COVID-19, researchers from Sweden summarized that a high population density could accelerate the spread of COVID-19 because it indirectly increased the number of potential contacts and time-period of exposure . Meanwhile, from a practical perspective, maintaining social distance is difficult when the population density is high unless one individual can block all the social behaviours.
The Government of Ontario defined that “everyone living in the same household is a social circle” , and up to ten members in the same social circle do not need to comply with social distancing rules. It is important to note that the upper limits of gatherings could add more barriers to conducting precise contact tracing because COVID-19 is a more contagious disease compared to SARS and MERS . Therefore, one potential recommendation is that the ten people rule should still apply to situations where there is a need for additional support for childcare, elder care and other emergency personal situations, whereas it should be approached with more caution for other forms of social activities.
 Government of Ontario (2020). Reopening Ontario in stages. Retrieved from: https://www.ontario.ca/page/reopening-ontario-stages#section-3
CityPopulation.de (2020). Canada: Ontario. Retrieved from: https://www.citypopulation.de/en/canada/ontario/admin/
 Rocklöv, J., & Sjödin, H. (2020). High population densities catalyse the spread of COVID-19. Journal of travel medicine, 27(3), taaa038. https://doi.org/10.1093/jtm/taaa038
 Schröder I. (2020). COVID-19: A Risk Assessment Perspective. Journal of Chemical Health & Safety, acs.chas.0c00035. https://doi.org/10.1021/acs.chas.0c00035