Ontario’s recommendation that children in the COVID-19 hot spots of Toronto, Ottawa, and Peel and York regions not go trick-or-treating on Halloween is drawing ire from some in the medical community who say the advice is confusing and cruel.

The new advice, issued by the province’s top doctor on Monday, is supported by the regions’ local medical officers of health. But it is also being criticized by some infectious-disease experts who say the province has lost perspective and could have offered up creative ways to make the activity safe for children.

Premier Doug Ford said on Monday his government wasn’t “cancelling Halloween,” but rather recommending safer alternatives in the four regions where community spread is highest and where new restrictions have been placed on indoor dining, gyms and team sports.

“We all know that this isn’t going to be a regular Halloween, and the steps we take now will determine what the holiday season looks like this year,” Mr. Ford said.

“We just can’t have hundreds of kids showing up at your door if you live in a hot spot, especially in apartment buildings.”

Ontario Medical Officer of Health David Williams said children in hot spot areas can have “candy hunts” with people they live with, carve pumpkins and watch movies, or participate in “virtual activities” online. The province also recommended that children in other areas of the province wear face coverings while trick-or-treating and only do it outside with those from their household, and for people to use tongs or other devices to hand out treats.

Medical experts contacted by The Globe and Mail said they were confused by the province’s reasoning, especially when trick-or-treating can take place outdoors with face coverings and physical distancing. The recommendation also came on the same day Ontario announced it would be allowing indoor dance classes to resume in the hot spot regions.

Andrew Morris, an infectious-diseases physician at Sinai Health and the University Health Network, both in Toronto, said he disagreed with the recommendation and is worried it will harm the credibility of provincial and municipal public-health leaders.

“We’ve been telling everyone – I know I have – that if you want to have a low-risk activity, what you do is you have people socially distanced, outside, wearing masks, preferably not in crowded conditions,” he said.

With some modifications, outdoor trick-or-treating checks all those boxes, Dr. Morris said. Cancelling such a low-risk activity “won’t make sense to kids,” he added. “It doesn’t make sense to adults. It certainly doesn’t make sense to me. I’m really so disappointed.”

Andrew Boozary, the University Health Network’s executive director of health and social policy, predicted Ontario’s recommendation against trick-or-treating in hot zones “will cause an uproar” among people already frustrated by inconsistent messages about how to reduce the risk of catching the coronavirus.

“We want to support public-health officials,” Dr. Boozary said. “But when we start to see so much conflicting messaging and ideas around what’s actually safe, we can really start to lose people.”

Susy Hota, medical director of infection prevention and control at the University Health Network, said the recommendation could end up backfiring.

“Sometimes when you don’t permit something that just forces the activity underground somehow,” Dr. Hota said. “Suddenly you’ve got little gatherings of parties that got a little bit bigger than you’d like because it’s hard to exclude this friend and their parents and their sibling.”

Cancelling trick-or-treating will likely only add to many peoples’ frustrations and growing sense of COVID-19 fatigue, said Zain Chagla, an infectious-diseases physician at St. Joseph Healthcare Hamilton.

“People from these regions … are probably already feeling a bit under the gun and a bit more cooped up,” he said. “Getting through these next few months, however long it takes, we really can’t keep going at it from a ‘You can’t do x’ or ‘You can’t do y’ attitude.”

Toronto Medical Officer of Health Eileen de Villa said that she and other municipal public-health leaders in the Greater Toronto Area supported Dr. Williams’ advice against trick-or-treating because the activity was simply too risky, particularly if it took place indoors.

“Trick-or-treating is often outdoors, but it’s not always outdoors. Not everybody has that circumstance in their daily lives,” Dr. de Villa said. The challenge with traditional trick-or-treating, she added, is that it risks bringing too many people together in a way that might encourage them to relax and forget the rules.

Asked if city bylaw officers intend to fine or ticket anyone for trick-or-treating, Toronto Mayor John Tory said that while he hoped not, enforcement decisions would be left to law enforcement officials. Brad Ross, the city’s chief communications officer, later clarified that the recommendation against tricking-or-treating is only advice. There is no bylaw prohibiting it, meaning people can’t be ticketed for ignoring the recommendation.

Denise Figueiredo, who works in human resources and lives in Toronto, said she is considering allowing her children, who are 9 and 6, to do some trick-or-treating.

“If it’s super busy I’m not going to send my kids out. If it’s not super busy then we may do a few houses on the street,” she said.

She said the family plans to hand out candy through a chute to maintain physical distancing.

The Globe and Mail, October 19, 2020