TORONTO -- As new COVID-19 cases in Canada follow a downward trend, a national association of physicians is warning Canadians not to let their guard down.

The Canadian Medical Association has released a list of "critical issues" the country needs to address before a potential resurgence of the novel coronavirus, including clear messaging, effective testing and an immense medical backlog.

Whether there will be a dramatic surge akin to a “wave” remains to be seen. Instead, CMA President Sandy Buchman thinks Canada might see “little bumps here and there” like we’re at the top of a ski hill.

“It’s a hill full of moguls. We need to find our way through the moguls, the bumps that are bound to occur,” he told CTVNews.ca over the phone on Wednesday.

Canada will be best equipped to navigate those bumps if the critical issues identified by the CMA are addressed, he said.

COMPLACENCY AND MESSAGING

Canadians must continue to adhere to public health measures, including physical distancing that has proven to help flatten the curve of coronavirus infections across the country. It could be a challenge with COVID-19 “fatigue” settling in as much of the country closes out its 17th week of widespread restrictions. 

“We can’t let up,” said Buchman. “We have to continue to be vigilant about the public health measures. If we’re not doing that we can suffer another lockdown and way more restrictions.”

To ensure public health measures are clear and feasible, the messaging from health authorities should be consistent, said Buchman. But this has been an issue since the pandemic began and it became clear that people were confused by guidance being issues, particularly as it related to face coverings.

“It’s clearer lately with regards to mask wearing,” said Buchman, noting numerous jurisdictions that have started to enforce mandatory face coverings in indoor public spaces.

But messaging around contact tracing, which can help identify and contain new infections, has proven to be a new challenge for public health officials. 

TRACING AND TESTING

In June, Prime Minister Justin Trudeau said that a new voluntary mobile app for contact tracing would be tested in Ontario and arrive for use in July. Last week, the provincial government announced that the app was delayed​, but officials were working with federal partners to release the it “shortly.”

This is the kind of messaging snafu that Buchman said authorities need to iron out before further outbreaks of the virus take hold. 

“It is now July 9. We haven’t heard anything,” he said of the app. “We should be getting clear consistent messaging and why the delay."

In addition to improved contact tracing across the country, the CMA recommends that “proactive strategic testing” be expanded across essential worker groups and other susceptible populations.

FRONT-LINE WORKERS AND MARGINALIZED PEOPLE

While production of personal protective equipment (PPE) has mitigated an earlier crisis, the health and wellness of front-line workers remains a concern. 

“Governments need to do more to recognize the unique risks and financial hardships experienced by our frontline health-care workers,” the CMA said in a news release Thursday.

Canada has also “failed dramatically” in protecting vulnerable groups that have been disproportionately impacted by the COVID-19 pandemic so far, the CMA said, including marginalized populations and residents of long-term care facilities, where most of the Canadian deaths have occurred. 

‘NON-ESSENTIAL’ BACKLOG

Early in the pandemic, surgeries, procedures and consults deemed “non-essential” were cancelled and postponed to maintain physical distancing and to better equip hospitals for an influx of cases. An immense backlog of cases has piled up over recent months that health officials have said could take years to clear. 

“As health services begin to resume, health systems will be left to grapple with a significant spike in already lengthy waiting times,” the CMA wrote in its news release.

Despite the prospect of new outbreaks, Buchman says he’s optimistic as long as Canada begins to attend to the issues the CMA has outlined.

“Let’s do it now,” he said. “Let’s just ensure that we’re on this path and we can get through it.”