Epidemiologists Warn Drastic Action Is Needed to Stop Spread: 4 Graphs Summarizing COVID-19 in Ontario Right Now

If hot regions of Ontario fail to keep COVID-19 under control, stronger mandatory measures may be needed to slow the spread and manage the virus, epidemiologists warn.

It’s a strong message that came the day Toronto reported a record 538 new infections, four deaths, and 176 hospitalizations, including 42 people in intensive care – the numbers Eileen de Villa, the city health officer, on Monday reported. defined as “alarming”.

“In my opinion, the withdrawal of benefits was not enough to slow the spread in these regions,” said Raywat Deonandan, an epidemiologist at the University of Ottawa. “At the very least, targeted guidance is guaranteed in some regions. People have to reduce their daily exposures, if not voluntarily, perhaps on a mandatory basis. “

Colin Furness, an infection control epidemiologist at the University of Toronto, echoed Deonandan’s comments and suggested that a lockdown is the only tool Ontario would leave if hospitals came close to being. overwhelmed.

“Mortality goes up as healthcare is overwhelmed and then continues to worsen,” Furness said. “If other measures don’t work, that’s the only thing left … a blockade is a failure.”

In Ontario hotspots – Toronto, Peel, York and Ottawa – cases continue to rise, with new cases in these regions accounting for 68 percent of all new cases in the province on Monday.

Over the past week, new daily cases in Ontario have remained above 1,200 per day; the seven-day moving average is now 1,465 new cases per day.

What follows is Star’s weekly summary in the form of a chart of the key indicators in our battle with COVID-19 and what we can expect in the coming weeks, along with expert comments.

Ontario’s COVID-19 hot spots

Toronto leads with the highest seven-day moving average for the four hotspots with 479.9 new cases per day.

Laura Rosella, an associate professor of epidemiology at the Dalla Lana School of Public Health, told the Star that more restrictions, more testing, and community support are needed to achieve controlled dissemination.

“It’s too high to hope that … it will settle down,” he said, noting that while there isn’t much left to close, all places with mixed populations should be closed or highly restricted.

“I think we’re probably at a level where we have to think about everything that is considered non-essential, and whether or not it should stay open and how it can stay open safely. Community broadcast is just too high.”

In Peel, which reported 303 new cases on Monday, the seven-day moving average rose to 407.6, up from 313.6 last week. 51 new cases have been reported in Ottawa and 138 new cases of the virus have been detected in the York region. The seven-day moving average in these regions is 53 and 151.6 new cases per day, respectively.

However, Furness said he believes compliance with measures such as masking remains high. “I think most people are actually complying or trying to be compliant,” Furness said.

“When I get on the subway, when I look around, most of the people are actually out there” with masks and practicing physical distance. That said, where cases continue to rise, “the genius is really out of the bottle,” he said. “It’s available in the community and will go where we expect it to go.”

Cases requiring hospitalization continue to rise

Hospitalizations are growing in the province, with 500 people hospitalized since Monday throughout the province. Of these, 125 are in intensive care.

Despite the increase in hospitalizations, Deonandan said hospitals are still able to accept patients and surgeries have not yet been canceled, a metric that would show an overwhelmed healthcare system.

“In general, ‘there is room in the inn,'” Deonandan said. However, the demand for nurses is high. “In some places, nurses feel overwhelmed. Our problem, as far as I can see, is the staff, not the space. ”

While the new beds can be brought in quickly, there is a limit to the number of health workers available, he said. “ICU nurses in particular are in demand, as each COVID patient so hospitalized requires hundreds of hours of dedicated care.”

Rosella said the province is on track to see hospitals forced to cancel elective procedures. Unlike the first wave, when elective and planned care were largely on hold, hospitals are generally busier with non-COVID cases, he said.

“I would say we should be worried about hospitalizations,” Rosella said. “I think we are at a point where we are reaching the numbers that we have almost seen in terms of total admissions in the first wave when things are very bad.”

While some hospitals are already full, many remain unable to accommodate patients, he said.

“Some hospitals are really at the point where they are overwhelmed and other hospitals … maybe they aren’t feeling it yet,” he explained. “And so we have a lot more variability in this wave.”

Deaths on the rise

Deaths have steadily increased since mid-October. Deonandan said he expects the average daily death toll to exceed 20 per day by about next week.

Current death numbers are nowhere near the peak the province saw in early May during the first wave. On Monday, 10 new deaths were reported in Ontario. There were 29 new deaths on Sunday. The seven-day moving average for daily deaths in Ontario is 16.1 as of Monday.

“One way to see this is that some of the people infected during the Thanksgiving socialization spurt will enter the hospital system in mid-December, potentially showing a spike in deaths at the end of the year. It mirrors the nationwide trend, ”Deonandan said.

In the first wave, the death rate was “really tragic,” Rosella said. This time around, if we can protect vulnerable populations and prevent them from spreading to older age groups, the death rate could be lower, he said.

“At this point, however, we are still seeing long-term care outbreaks and elderly family members infected. So I’m not optimistic that the death rate will be significantly different. “

Looking to the West

Manitoba continues to experience an accelerated diffusion and a 13% positive test rate. In Ontario, that number is four percent.

“Alberta is not reporting that figure due to their testing regime being overwhelmed,” Deonandan said. “So most of the signs indicate that Ontario is in a better position.”

He said Ontario’s ability to absorb cases is better, while the length of hospital stays has decreased since spring and has opened up more space. “But the rise in cases (in Ontario) is consuming that buffer that the shortened length of stay has given us,” Deonandan said.

“I suspect we probably remain very disinterested in learning from our data,” in Ontario, Furness said. “Ontario treats it as a political problem. COVID is a political problem and this leads to truly terrible results. ”

Jenna Moon is a breaking news reporter for The Star and is based in Toronto. Follow her on Twitter: @_jennamoon