Five Questions with … Colin Furness ’90

Trinity graduate and 9T0 Year Rep. Professor Colin Furness, teaches information and knowledge use in organizations at U of T’s Faculty of Information. An infection control epidemiologist by training, he spent several years in industry, leading innovation work in the measurement of indoor and outdoor spread of disease, and hand hygiene behaviour.  A frequent commentator on COVID-19, Colin answers some of our most pressing questions about where we are heading during this unprecedented time.

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Trinity Magazine: What do you see as the trajectory of COVID-19?

Colin Furness: COVID-19 is a very successful virus. It has a high attack rate, and it is adept at crossing between species. However, what makes COVID-19 unusual and worrisome is its ability to spread asymptomatically – many people become infected and contagious, but without feeling ill. For most countries, the initial trajectory seems the same: the virus had been spreading exponentially for weeks before being detected. Nobody’s pandemic planning anticipated this might happen: COVID-19 outsmarted us all. Canada’s pandemic experience has been markedly variable, from rapid elimination in New Brunswick, to severe suffering in the Montreal region. Generally, the sooner the response and the lower the number of early cases, the better the outcome has been. In Ontario, community spread simmers in the Greater Toronto region. It has been slowly diminishing, but with loosening restrictions, it will likely ebb and flow, and I doubt it will go away until we have a vaccine. Even then, COVID-19 may well become like influenza – a recurring, mutating menace, where immunity is temporary and annual vaccination is needed. Ontario has avoided a public health catastrophe, but various forms of physical distancing, and all the pain it entails, may be with us for quite some time to come.

 

TM: Have we seen the peak of this pandemic or do you anticipate a second wave?

CF: In Ontario, there was a peak roughly between April 14 and April 23 of this year. But we can’t talk meaningfully about a second wave while the first one is still rolling. The tail of this first wave is much longer than it needed to be, because Ontario’s strategy was early but not disciplined.  “Essential business” includes specialty cheesecake shops; there has been no night curfew and limited enforcement of physical distancing rules; we had no coherent strategy to prevent spread through vulnerable populations in congregate settings; our testing strategy continues to stumble and fail many of those at greatest risk. With a strictly disciplined approach, the first wave would have ended by now. Despite its flaws, our strategy is working, but very slowly; if we are collectively vigilant, if we continue physical distancing despite current loosening of restrictions, and with the benefit of a really hot, humid summer, the wave could end by the fall. However, additional small outbreaks are inevitable, mostly because of travel: new cases will walk, drive, and fly into Ontario, particularly from the US. Whether small outbreaks precipitate successive waves of community spread will depend heavily on whether Ontario is able to substantially expand its ability to do testing and contact tracing.

 

TM: Beyond hand washing and social distancing, what do you see as the most important thing to stop the spread of COVID-19?

CF: Testing is foundational to stopping the spread of COVID-19. But this isn’t just about the number of tests. We need to change our testing strategy. The standard approach to testing is to treat it as a scarce resource, where sufficiently serious symptoms need to be present before a test is approved. We need to move beyond waiting for severely ill people to arrive at the hospital. We need to proactively go and test people who look and feel healthy, but who have high occupational risk of infection: grocery store clerks, transit operators, frontline health and allied healthcare workers, our homeless population, crowded factory workers, and the list goes on. And they need to be tested repeatedly and regularly. That is a tall order: we would need many hundreds of additional public health workers to carry out this work, and maybe an order of magnitude more testing capacity than Ontario currently boasts. We have only done proactive testing in long-term care homes thus far, so we have barely begun. We have a truly urgent need to aggressively grow testing capacity, and to deploy it aggressively based on risk, not symptoms.

 

TM: If you had one piece of advice for your fellow alumni in regards to keeping safe during this pandemic what would it be?

CF: One word: mindfulness. We need to be mindful of where we go, how close to others we get, and what we touch. That means not just reconstructing our lives to limit physical interaction, which we have been doing at great cost, but working out how to do so in a sustainable way. We need to be mindful about mental health. Getting outside – while being careful to avoid crowds – is an excellent way to safely take care of ourselves.

 

What has been the most inspiring and uplifting thing you have seen over the last few weeks?

CF: This is the first time in my life that I have seen public health elevated to the pinnacle of everyone’s thoughts and actions. It is not just COVID-19 we are defeating right now, we are also beating back influenza and a whole host of contagious disease. Might the moratorium on shaking hands become permanent? That alone would save untold suffering and needless death long into the future. And I never would have imagined that a few months ago. We are now talking openly about protecting the health of people in long-term care homes, shelters, prisons, and our homeless population. That’s something else I never thought I’d see. When I wonder at how we might improve population health out of this pandemic, well, I feel awe.

 

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Colin Furness: In the News

May 2020 (to May 14)

Alum and Faculty of Information & Dalla Lana School of Public Health Prof. Colin Furness, an infection-control epidemiologist, discusses the pandemic:

 

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