Why this lockdown might not work, plus the growing battle within Ontario’s long-term care homes: 5 Graphs Showing the Status of the Pandemic

On a day when new restrictions have been introduced for Toronto and the Peel region in recent weeks in an attempt to reign in record-breaking daily COVID-19 cases, a palliative care physician specializing in long-term care says he is “terrified. “from the growing numbers of cases in nursing homes as winter approaches.

“We know coronaviruses are seasonal viruses,” said Dr. Amit Arya, director general of the Canadian Society of Palliative Care Physicians and assistant clinical professor in McMaster University’s family medicine department.

“In the summer we had months to prepare for this, to respond primarily to long-term care, where the biggest impact of the first wave was. As cases and mortality begin to accelerate in long-term care, it’s absolutely devastating to see and hear, ”he said.

“Winter is just beginning. We are not at the same point as the first wave “.

Of the 2,150 residents of Ontario long-term care facilities who have died from the virus since the start of the pandemic, 305 have died since August 1 (Ontario as a whole reported 711 overall deaths from COVID- 19 since).

Meanwhile, Ontario local public health units reported 1,451 new cases of the virus on Monday afternoon. Most of these cases originated in the Peel region (406), Toronto (331) and the York region (169), accounting for 62% of the province’s new cases.

Here we present Star’s weekly roundup of key indicators in our battle against COVID-19, including a look at how other provinces are doing, plus expert commentary.

Peel and Toronto continue to raise cases in Ontario

Together, Peel and Toronto accounted for about half of the new cases reported in the province on Monday afternoon.

Dionne Aleman, a University of Toronto professor and expert in pandemic models, said Peel’s case numbers were “really very surprising considering Toronto has a much larger population.” The region has 1.5 million residents, about half that of Toronto.

Aleman says it’s difficult to determine why Peel is such a hot spot, but that it could be due to a number of factors, including dependence on public transport – which could mean more exposure to the virus – multi-generational or even life situations. workplace settings.

“They may not have the luxury of being able to work from home as much as the people living in the city,” said Aleman. “I’m not really sure these current measures will really be enough to dampen it.”

During the first block, when only essential services were open, the province had summer days when the total number of new cases was less than 100.

“The block we had at the beginning of the summer was extremely effective,” said Aleman.

But he doubts this will see such strong results.

Stores still offer curbside pickup, meaning employees in these facilities get to work, perhaps by public transportation, while people who work in offices can also go to work.

Toronto’s St. Lawrence Market is open, as is the Hudson’s Bay store on Queen St., as are other large stores selling basic necessities.

Aleman added that he hopes the new restrictions on people’s movements “will cause many people to be much more careful and return to how careful and cautious they have been over the summer.”

The summer months also meant that the children did not go to school. Aleman said that if the numbers get too high, the province could close schools, although the decision would be difficult.

“There is a lot of concern for children’s development, socialization and their ability to learn at home,” said Aleman. “There is nothing to smell. You don’t want to just wave it. And if our ultimate goal is to keep schools open for our children, then we just need to be much more hyper-vigilant and limited everywhere. “

He says that given the current trajectory of the virus, the government’s projection that we could reach 5,000 or 6,000 new cases per day by December is realistic.

Growth in long-term care homes

Ontario’s long-term care homes continue to struggle to stop the second wave of COVID-19 from breaking through their walls.

Arya, the palliative care physician, noted that due to staff shortages in long-term care facilities, staff members are unable to create bubbles in the facilities.

“It becomes impossible to do the job well because the huge volume of medical (resident) complexes is so high, and therefore you have too many contacts,” he said, adding that the ideal case would be for health care groups to have the capacity to work in the same unit, looking after the same people and guaranteeing employees a decent wage, sick leave and the ability to work in one home.

There were 528 active resident infections in Ontario long-term care homes as of November 22, down from a second-wave high of 721 on November 13. As of August 1, there were only 10 COVID-19 cases among Ontario Long-Term Care residents. Personnel cases now stand at 467, down from a second wave high of 541 on November 17.

Meanwhile, the number of homes with active outbreaks as of November 22 was 101, up from 20 on August 1, with a high of 108 reached on November 16. The facility with the most current resident infections is Rockcliffe Care Community, a 204-bed facility in Scarborough, with 53 active cases, followed by the 160-bed Harmony Hill Care Community in East York, with 36 active cases.

Arya noted that even though many residents of such facilities survive COVID-19, “their lives are forever changed by the virus.

“We can imagine how serious it would be for someone who is already elderly and suffering from other diseases. After they get COVID, they may not be counted in the mortality statistics, but they are bedridden, “said Arya, who witnessed the spread of the virus firsthand while working in GTA facilities during the first wave.” People, regardless of whether they survive COVID-19, they have the right to treatment and they have the right not to suffer. “

Newfoundland and Labrador, PEI leave the Atlantic bubble

For the past four and a half months, Canadians from the four provinces of Atlantic Canada have been allowed to travel across those provincial borders without the subsequent need for quarantine in what became known as the Atlantic bubble.

But on Monday everything changed with the announcements of the premieres of both Newfoundland and Labrador and Prince Edward Island.

Newfoundland Premier Andrew Furey said on Monday he made the tough decision to “implement a circuit break” as his province leaves the bubble for two weeks.

Some time later, IEP Premier Dennis King announced that his province would also be leaving. The travel means that visitors from these two provinces, including those from the other Atlantic provinces of New Brunswick and Nova Scotia, will have to self-isolate for 14 days upon arrival. Additionally, travel to and from these provinces will be limited to essential travel for two weeks.

Newfoundland currently has 23 active cases of COVID-19, including two new confirmed cases announced on Monday. IEP reported its first new case of the virus in nearly two weeks on Monday and has had a total of 69 cases since the start of the pandemic.

Terranova closed schools in the area that had the most recent cases for a couple of days to figure out what was going on, Aleman said; students in one class were placed in solitary confinement for two weeks.

“They are really taking very swift and timely action, which will help bring them back to a place where cases are zero,” said Aleman, who compared the situation in these two provinces with an Ontario region like Peel, who has seen hundreds of new cases every day for the past few weeks.

“It becomes virtually impossible to respond quickly to any of these cases,” said Aleman. “As we know, our contact tracing has been suspended more or less in Toronto and Peel because there are too many cases to contact the track. So we can’t know for sure where people get infected. Is it in their workplaces? Is it in schools? Is he in the gym? Is it retail?

“If we don’t know where people are infected, we can’t apply truly targeted restrictions,” Aleman said. “We really just left this block tool to ourselves.”

Alberta opens for business

Cases are on the rise in the western province, but that’s not surprising given that Alberta is practically open for business.

The province had 12,195 active cases as of Sunday, nearly as many as Ontario, despite having a population a third the size of Ontario.

“The numbers are crazy,” said Jim Kellner, a pediatrician with a subspecialist in pediatric infectious diseases and a professor at the University of Calgary. “They really took off. Our new case rates per day are extremely high … Not surprising, but very distressing. “The cumulative cases amount to 46,872.

The province has implemented some restrictions, such as banning indoor fitness classes, shutting down liquor sales after 10pm in restaurants, and banning residents from socializing with people outside their family.

But Kellner said people can still go to the gym – although he said there isn’t much evidence that gyms or restaurants are a problem – and people can congregate in groups of 15 outside the home in restaurants and other venues, as well as in cohorts of up to 50 when it comes to sports or performing arts teams.

Kellner said the province was doing very well in the first part of the pandemic, when it was on top of testing and contact tracing. And the deaths are still lower on a per capita basis than in Quebec and Ontario.

But he said hospitalizations are on the rise and positivity rates are around six percent, much higher than they were from June to October, when the rate was around one percent.

Classroom sizes are also unchanged and ventilation is a problem at school, although students from kindergarten through third grade wear masks. But some schools have had major outbreaks with as many as 40 cases.

He said cases in schools may be a reflection of the spread in the community, but suggested that a longer vacation would be better than doing nothing to control cases in schools. Contact tracing in Alberta also lagged behind, he said.

“Too many contacts are allowed,” Kellner said. “It’s that simple, in the desire to keep the economy open.”