New modelling from Ontario’s science table suggests that hospitalizations are likely to “rebound” and remain at a “prolonged peak” following the lifting of some public health restrictions this week.
The latest projections, released on Tuesday morning, use three different scenarios based on varying levels of immunity acquired through infection to chart the path ahead.
virus will start to rise in mid-February and eventually approach 6,000 sometime in March, exceeding the number of beds available.
In a moderate community immunity scenario in which there is about 2.5 million Ontarians with a recent COVID-19 infection, hospitalizations will still rise but at a more gradual pace. Scientists say that in that scenario the number of people hospitalized with COVID-19 would continue to hover around 3,000 until mid-February and then rise to approximately 4,500 in March, exceeding the pandemic high set just last month.
The science table says that only under “the most favourable assumption” would hospitalizations actually continue to decrease in the weeks and months ahead as restrictions are lifted.
That scenario, which would see the number of people in hospital decline to around 2,000, is based on a “high community immunity” assumption in which approximately three million people have a recent infection to provide them with increased immunity.
The science table is also projecting that the number of people in the ICU with COVID-19 by March will range from around 400 in a best case scenario to approximately 900 in a worst case scenario, which would equal the third wave peak last spring.
But it warns that there is “considerable uncertainty” to those numbers amid data suggesting that Omicron is resulting in a lower proportion of patients ending up in intensive care.
“I think it's important to understand that it's very difficult right now for us to estimate how many people were basically infected since December,”Dr. Peter Jüni, who is the head of the science table, told CP24 on Tuesday morning. “If indeed we have only about two million people who were infected during the last two months that means will start to see a rebound of our hospital occupancy patients in hospital beds with COVID that could be considerable and actually have a higher peak than what we experienced so far. I personally believe that that is the worst case scenario and hopefully we won't be there. But we do need to tread carefully and to look at early indicators during the next few weeks to figure out what's forthcoming later.”
Up to 4 million Ontarians may have been infected since December
In a presentation accompanying the new projections, the science table said that wastewater surveillance conducted in all 34 public health units does point to a peak in community transmission on Jan. 11 with “plausible range” of infections in the last 60 days of 1.5 million to four million.
But Juni told CP24 that three million Ontarians with a recent COVID-19 infection is the more “realistic best case scenario.”
He said that right now it is likely that about one out of 10 infections are actually showing up in the statistics, pointing to true daily case counts that still likely exceed 30,000.
The modelling, however, does note a consistent decline in positivity rates, both overall and in selected groups targeted for testing, such as hospital patients.
“It will now really depend on the next few weeks for us to see where we are. The most important part really is that we need to be able to have enough time to distinguish between a scenario that is potentially best case and then we say ‘OK, we can do a next step of reopening’ or a scenario that doesn't look that exciting and it could be that mid-March or end March we reach a peak which is higher regarding hospital occupancy or ICU occupancy,” Juni said. “We want to avoid that. Therefor it has to be careful moving forward. Otherwise we could see again just too many people in our hospitals.”
Scientists say relaxation of public health measures will result in increased spread
Bars and restaurants were permitted to reopen at 50 per cent capacity for indoor dining on Monday, as part of the Ford government’s latest reopening plan.
A wide swath of other businesses that had been shuttered since Jan. 5 were also allowed to reopen at a reduced capacity, including gyms and cinemas.
Speaking with reporters at a press conference on Tuesday, Premier Doug Ford said that his goal is to move forward with the reopening “in a very cautious way to make sure we don't have to have long lockdowns” again.
The science table, however, warmed in its presentation that relaxing public health measures will “will increase the spread of COVID-19” with the size of the resurgence depends on “vaccination, the spread of Omicron, and changes in behaviour.”
“We're ready to move forward but we have to do it cautiously. We can't just jump into it and just open everything up tomorrow,” Ford said. “We have to be very, very cautious. We have a strong plan and the great news is that we're opening up. We're opening up on February 21, and then March 14. But again, make no mistake about it, the hospitals are in better shape but we still see a little bit of absenteeism, we're still seeing pressure, we're still getting surgeries back up and going. So we're going to be cautious moving forward.”
In a statement released on Tuesday morning, a spokesperson for Minister of Health Christine Elliott said that while the coming weeks “will continue to be difficult” the government is confident in its ability to “ensure capacity” in the healthcare system.
The spokesperson also noted that “Ontario is currently trending between the projected best and moderate-case scenario for hospitalizations” and continues to have “sufficient capacity” to meet demand.
“We do have capacity in our hospitals and the science advisory table has basically indicated that it appears that the peak of Omicron has passed,” Elliott told reporters during Tuesday morning’s press conference. “That doesn't mean we're entirely in the clear of course. We still do have high levels in both our hospitalizations and intensive care units. However, that is starting to decline.”
The last time the science table released modelling on Dec. 16 it warned that “ICU occupancy could reach unsustainable levels in early January” without “prompt intervention,” including public health measures that would help to reduce contacts by at least 50 per cent.
Since then the spread of the Omicron variant has driven an exponential growth in cases and hospitalizations but there are signs that the worst is over.
On Monday the Ministry of Health reported that there were 2,983 people hospitalized with COVID-19 across the province, down nearly 30 per cent from mid-January.
Outbreaks in the handful of settings with access to widespread PCR testing, including long-term care homes, also appear to be on the decline after reaching record highs last month.
