Infectious disease doctor offers advice as Kingston moves into Stage 3

Kingston Frontenac Lennox & Addington (KFL&A) is moving into Stage three of the Provincial Framework for Reopening on Friday, Jul. 17, 2020, giving Kingstonians more choices about where to go and how to behave during the COVID-19 pandemic.

The City confirmed Wednesday, Jul. 15 that parents will be able to take their kids to the playground, after more than three months of closure.

Dr. Gerald Evans, Medical Director of Infection Prevention and Control at Kingston Health Sciences Centre (KHSC), says playgrounds are likely as safe “a place as any” for kids to spend their time, so long as physical distancing is respected. The risk of transmission of COVID-19 on playground surfaces, he said, appears to be low.

“We know that over 90 per cent of COVID-19 cases appear to be transmitted through being in close contact with someone, as you would expect for respiratory droplet transmission,” he said.

“What that’s telling us is, if there are other modes of transmission they’re less than 10 per cent.”

Viral transmission on inanimate surfaces is known as fomite transmission. Other coronaviruses, such as those that cause common colds, exhibit fomite transmission rates closer to 20 or 30 per cent, he said. The diligent disinfecting efforts by individuals and businesses since the start of the pandemic may explain COVID-19’s low fomite rate, he said. Disinfectant wipes and sprays have been scarce on store shelves since the pandemic reached North America, in March.

“It’s possible that because there’s such a lot of attention being paid to disinfecting surfaces, maybe that’s why fomite transmission is less,” he said. “If that’s the case, then cleaning surfaces is important.”

Many studies conducted on the lifespan of COVID-19 on surfaces take place in sterile laboratory conditions, he said, that may not necessarily represent the real world.

“In an outside environment, particularly one with the ultraviolet light that comes from sunlight, the fact is that the virus is going to live on those surfaces a lot less easily than it’s going to live on an internal surface indoors, in a laboratory,” he said. “UV light clearly has an effect on all different types of viruses and does tend to inactivate it.”

“A number of my colleagues and I have been really asking why playgrounds have been closed for so long,” Dr. Evans said. “Now that we’re opening bars and restaurants, that becomes an even bigger question.”

As authorities plan reopening, he said they need to ask what types of activities are likely to result in increased transmission.

“Playgrounds are not,” he said. “Even if I was in Toronto right now, I would be happy with playgrounds.”

Being indoors at restaurants and bars, by contrast, people will need to use extra caution, he explained.

“If you’re looking for an environment that this virus would love, that would be a bar,” Dr. Evans said. “They’re indoor spaces. We know indoor spaces are much more likely to result in transmission than outdoor spaces.”

Behaviours and activities in bar settings also have an impact, he said. “If you’re in a restaurant or a bar, you’re there to eat or drink and so wearing your mask all the time is not going to happen,” he added, “So there are mask issues.”

He noted that alcohol also tends to lower people inhibitions. “Inhibitions are really important when you’re looking at somebody who needs to follow rules, needs to make sure they’re six feet away from people, needs to wash their hands and such. Alcohol is going to impair your judgement in that setting.”

He suggests restaurants and bars make extra efforts to disinfect high touch surfaces, especially in the bathrooms, such as toilet handles, door knobs and sinks. “It’s a closed space, and if someone is actively infected they could be leaving virus behind on all those high-touch surfaces,” he said.

The provincial government asks everyone continue to maintain two metres of physical distancing, practice diligent handwashing, and use alochol-based hand sanitizers when soap is unavailable as we move into Stage 3. The KFL&A region is also still under a Mandatory Face Covering order, that requires people to wear face masks or coverings in all indoor, public settings.