Community transmission of COVID-19 may have peaked but new modelling from Ontario’s science table is warning that hospital occupancy is “likely to continue to rise for some time” and could approach the levels experienced during the height of the fifth wave of the pandemic this past winter.

The group of scientists and epidemiologists advising the Ford government on its pandemic response have released new projections, which suggest that the number of Ontarians hospitalized with COVID-19 could surpass 3,000 by May in the most likely scenario.

The scientists say that in a more pessimistic scenario it is possible that more than 4,000 people will be hospitalized with COVID-19 by May, approaching the peak reached in mid-January when 4,183 people with COVID-19 were hospitalized.

The table is also projecting that the number of COVID patients taking up ICU beds will rise but it says that the ultimate peak will likely be lower than during the Omicron-fueled fifth wave of the pandemic.

The most likely scenario would see about 500 patients in intensive care with COVID by May, according to the table. The worst case scenario, meanwhile, would see more than 600 people in the ICU with COVID-19 by May. In January, the number of people in the ICU peaked at 626.

“We really have a lot of uncertainty here and we're not completely sure how this will play out,” Dr. Peter Jüni, the scientific director of the table, told CP24 on Thursday afternoon. “We are relatively confident that the hospital and ICU occupancy should be likely be lower this time than last time and that helps. But there's a caveat. The caveat is you have again a lot of healthcare workers knocked out (by infection), about the same level as last time during the Omicron wave and that will increase the strain for the healthcare system.”'

Hospitalizations modelling

The latest projections paint a much more alarming picture than modelling released by the table last month, which estimated that there would be about 800 COVID patients in hospital by May as well as another 300 in the ICU.

That, however, was before Ontario lifted the mask mandate in most settings, along with a number of other public health restrictions.

It also pre-dated the more infectious BA.2 subvariant becoming dominant in Ontario, which the science table now estimates occurred sometime around March 10.

In a presentation accompanying the latest figures, the science table said that masking in indoor areas “will substantially reduce the risk of getting and spreading COVID-19” and noted that the “community benefits from masking are most pronounced when adopted widely in public spaces, schools and workplaces.”

While the table did not explicitly call for the return of an outright mask mandate, Jüni did tell CP24 that he would like to see masks required in schools given the rise in transmission.

“I would personally think most of my colleagues or all of my colleagues at the science table would probably welcome a mask mandate in school indeed,” Jüni said. “Why? We are still in a really challenging situation. We have probably about five per cent of the population right now infected by COVID and this is, of course, also reflected in schools. It probably wouldn't hurt to go beyond strong recommendations there. But I know that there are also political considerations and that is beyond my role.”

Hospitalizations up more than 23 per cent week-over-week

Over the last week the number of people in Ontario hospitals with COVID-19 has risen by 23.6 per cent and now stands at 1,392, which is the highest that number has been since mid-February.

The good news is that the pace of the increase, at least so far, is not as pronounced as it was in January when hospitals were forced to cancel elective surgeries and procedures for about three weeks.

“I am cautiously optimistic that the impact on our health system will be much less than the first (Omicron) wave, our numbers are well below what's been modeled at present,” Chief Medical Officer of Health Dr. Kieran Moore told CP24 on Thursday afternoon, calling the latest projections “good news.”

Moore said that the slower rate of increase in hospitalizations compared to during the height of the Omicron wave this past winter, suggests to him that Ontario is “building a wall of immunity” through vaccination and recent infections.

He said that while the next couple of weeks could be tough for hospitals from a “staffing vantage point,” he does believe that they will have the resources to manage the increase in patients presenting with COVID-19.

“We're seeing somewhat of a disconnect. We're not seeing a rapid acceleration in the use of intensive care. I think it's because Ontarians have been so good at coming forward and getting vaccinated,” he said.

The science table estimated that between 4.5 and six million Ontarians have contracted COVID-19 since Dec. 1, accounting for at least one-third of the province’s population.

It said that the sheer number of infections will likely have some long term impact on the healthcare system, with conservative estimates suggesting that 10 per cent of unvaccinated individuals who contract the virus ultimately develop long COVID.

“This will likely have an important impact on the economy, the health care system and society for years to come,” the table warns.