Editor:

Open letter to the Right Honourable Justin Trudeau, P.C., M.P., Prime Minister of Canada, Honourable Dwight Ball, Premier of Newfoundland and Labrador, Honourable Caroline Cochrane, Premier of the Northwest Territories, Honourable Doug Ford, Premier of Ontario, Honourable Blaine Higgs, Premier of New Brunswick, Honourable John Horgan, Premier of British Columbia, Honourable Jason Kenney, Premier of Alberta, Honourable Dennis King, Premier of Prince Edward Island, Honourable François Legault, Premier of Québec, Honourable Stephen McNeil, Premier of Nova Scotia, Honourable Scott Moe, Premier of Saskatchewan, Honourable Brian Pallister, Premier of Manitoba, Honourable Joe Savikataaq, Premier of Nunavut, Honourable Sandy Silver, Premier of Yukon

RE: Dealing with COVID-19: A Balanced Response

The undersigned represent current and past leaders in public health, health care systems and academia. We are writing to you to with our regarding a balanced approach to dealing with COVID-19. We strongly believe that population health and equity are important considerations that must be applied to future decisions regarding pandemic management.

The current approach to dealing with COVID-19 carries significant risks to overall population health and threatens to increase inequities across the country. Aiming to prevent or contain every case of COVID-19 is simply no longer sustainable at this stage in the pandemic. We need to accept that COVID-19 will be with us for some time and to find ways to deal with it.

The current and proposed measures for reopening will continue to disproportionately impact lower income groups, Black and other racialized groups, recent immigrants to Canada, Indigenous peoples and other populations. And it risks significantly harming our children, particularly the very young, by affecting their development, with life-long consequences in terms of education, skills development, income and overall health.

Canada must work to minimize the impact of COVID-19 by using measures that are practical, effective and compatible with our values and sense of social justice. We need to focus on preventing deaths and serious illness by protecting the vulnerable while enabling society to function and thrive.

Elimination of COVID-19 is not a practical objective for Canada until we have a vaccine. While there is hope for a vaccine to be developed soon, we must be realistic about the time it will actually take to develop and evaluate it and then deliver an immunization campaign covering the entire population. We cannot sustain universal control measures indefinitely.

We need to accept that there will be cases and outbreaks of COVID-19. We need localized control measures that are risk-based. We should consistently reassess quarantine and isolation periods, recommendations for physical distancing and non-medical masks, and travel restrictions based on current best evidence and levels of risk.

At the same time we must improve infection prevention and control in long-term care and congregate living settings. We should provide support for people living in the community who need to or choose to isolate when the disease is active, as well as those who have been adversely affected by COVID-19, or the consequences of the public health measures.

Canadians have developed a fear of COVID-19. Going forward, they have to be supported in understanding their true level of risk, and learning how to deal with this disease, while getting on with their lives – back to work, back to school, and back to healthy lives and vibrant, active communities across this country.

We acknowledge the heroic work that has been done in recent months by many across all levels of government and the public and private sector, and the sacrifices that Canadians have made to get to this stage. As we look forward, Canada must balance its response to COVID-19.

Sincerely yours,

Robert Bell - Former Deputy Minister of Health, Province of Ontario, Former President and CEO, University Health Network, Toronto

David Butler-Jones - Canada’s first Chief Public Health Officer and former Deputy Minister for the Public Health Agency of Canada

Jean Clinton - Clinical Professor, Psychiatry and Behavioural Neurosciences, McMaster University

Tom Closson - Former President and CEO, University Health Network, Toronto Former President and CEO, Capital Health Region, British Columbia

Janet Davidson - Former Deputy Minister, Alberta Health, Former CEO, Trillium Health Centre

Martha Fulford - MA, MD, FRCPC, Infectious Diseases Specialist Associate Professor, McMaster University

Vivek Goel - Professor, Dalla Lana School of Public Health, University of Toronto,Former President, Public Health Ontario

Joel Kettner - Former Chief Public Health Officer, Province of Manitoba

Onye Nnorom - President, Black Physicians’ Association of Ontario,Associate Program Director, Public Health and Preventive Medicine Residency Program

Dalla Lana - School of Public Health, University of Toronto

Brian Postl -Dean, Rady Faculty of Health Sciences and Vice- Provost, Health Sciences, University of Manitoba, Former President, Winnipeg Regional Health Authority

Neil Rau - Infectious Disease Specialist and Medical Microbiologist,Assistant Professor, University of Toronto

Richard Reznick, Professor of Surgery and Dean Emeritus, Faculty of Health Sciences, Queen’s University

Susan Richardson - Professor Emerita, University of Toronto, Richard Schabas, Former Chief Medical Officer of Health, Province of Ontario, Former Chief of Medical Staff, York Central Hospital

Gregory Taylor - Former Chief Public Health Officer of Canada

David Walker - Former Dean of Health Sciences, Queens University Chair, Ontario’s Expert Panel on SARS, 2003

Catharine Whiteside - Executive Director, Diabetes Action Canada - CIHR SPOR Network, Emerita Professor and Former Dean of Medicine, University of Toronto

Trevor Young - Professor of Psychiatry, Dean, Faculty of Medicine and Vice Provost, Relations with Health Care Institutions University of Toronto