The number of COVID-19 patients in intensive care in Ontario is projected to reach nearly 800 by the end of April even with the continuation of vaccinations and the implementation of two or four weeks of stay-at-home orders, according to the latest modelling update.
Ontario’s COVID-19 Science Table released new modelling on the province’s response to the COVID-19 pandemic Thursday morning.
According to modellers, highly-contagious variants of concern are driving the third wave of the pandemic which is causing a spike in daily cases and hospitalizations.
“As the new variants spread, you will see that COVID is killing faster and younger. It's spreading far more quickly than it was before. And we cannot vaccinate quickly enough to break this third wave, this is the challenge of the new variants,” Dr. Adalsteinn (Steini) Brown, co-chair of the Ontario COVID-19 Science Advisory Table, said Thursday morning.
If the government were to implement a month-long provincewide stay-at-home order starting Apr. 5, while continuing vaccination efforts, ICU occupancy is still slated to hit nearly 800 daily by Apr. 30, modellers said.
If there were no vaccines administered and no further measures than ICU patients could rise to nearly 1,000 daily.
In these modelling scenarios, officials assume that all vaccines are administered at a constant rate and have at least 70 per cent effectiveness.
The stay-at-home order refers to the provincewide measure implemented by the government after the holiday season to encourage people to stay home unless they needed to leave for essential reasons, including going to work, medical purposed, buying groceries and exercise.
Brown said as ICU occupancy nears 800 it will be difficult for hospitals to provide adequate care for all patients and that triaging may be a possibility.
“Eight hundred is a place where we are not able to provide all the care as well as we want to people,” he said.
“I don't mean to use strong language but that is a place where clinicians need to make hard decisions that we’d never want them to have to make, where you will see loss of life and where you will see the sorts of challenges that we've seen in Northern Italy, that we've seen in New York, that we've seen in other jurisdictions where the hospitals are filled up.”
On Thursday, the province hit a new record-high in COVID-19 ICU occupancy with 430 patients, according to Ontario Hospital Association President and CEO Anthony Dale who tweeted the latest numbers from Critical Care Services Ontario.
Over the past two weeks, overall COVID-19 hospitalizations rose by 41.7 per cent, according to officials.
Modellers noted that with the rise in variants of concern, more younger Ontarians are ending up in hospital. Fourty-six per cent of people ages zero to 59 were in ICUs across the province between Mar. 15 to 21 compared to only 30 per cent between Dec. 14 to 20.
ICU admission for younger people is also two times higher and the risk of death is 1.5 times higher with the dominant B.1.1.7 variant.
As of Thursday, Ontario has identified 2,116 lab-confirmed cases of variants of concern, and another 22,371 cases that are awaiting whole genome sequencing to confirm their lineage.
“The largest increase we're seeing is in the B.1.1.7, the so-called one that was identified first in the U.K., and that we see an increase of 34 per cent in that number just over the past week,” Dr. David Williams, Ontario’s Chief Medical Officer of Health said.
With a rise in case counts and hospitalizations, modellers also noted that the pandemic-related surgical deficit continues to spike, hitting 245,367 cases in backlog as of Mar. 25. These are all cases that have been delayed, cancelled and postponed throughout the pandemic, which was declared last March.
The science table also released somewhat promising estimates on the trend of daily case counts over the next month.
According to the modellers, four weeks of stay-at-home orders and keeping up with vaccinations could help keep daily case counts between 1,000 and 1,500 by the end of April, whereas only two weeks of stay-at-home orders would increase daily infections to about 2,000 daily.
If no further public health measures were implemented and the province only relied on vaccines, daily case counts could climb to 6,000 by the end of April. Furthermore, if the province halted vaccinations this month, nearly 12,000 COVID-19 cases could be logged by the end of April.
In the past seven days, Ontario logged more than 2,000 new COVID-19 cases daily. On Thursday, the seven-day rolling average hit 2,341, up from 1,794 one week ago.
Today’s modelling update comes as CTV News has learned that the Ford government is expected to announce today a month-long provincewide shutdown to begin on Saturday to curb the rise of cases and hospitalizations.
The shutdown will force all restaurants across the province to close for in-person dining, along with gyms and personal care services. Essential stores are expected to remain open at 50 per cent capacity and non-essential retail at 25 per cent capacity.
As vaccinations are ramping up, with a record 89,973 doses administered on Mar. 30 alone, the modellers noted that vaccines are not reaching the highest risk communities, delaying its impact in driving down case counts.
From Feb. 3 to Mar. 18, residents in Toronto and Peel Region who are among the top third of communities, by the proportion of people living in those communities, who are essential workers saw a 51 per cent growth in infection with the variants of concern.
Brown said vaccination efforts need to be reorganized to target more of these workers faster to help decrease transmission across the province.
“Moving vaccination clinics in the communities, running them longer, a variety of techniques that although they can be challenging and hard, and require constant local adaption, can actually increase the payoff from the amount of vaccination we're doing.”
School interruptions will have significant impact on students
Modellers also noted how school interruptions and closures due to the pandemic could have long-term economic impacts on students.
They discussed research based on international studies of students who have been out of school between one to three months in the Netherlands, Britain, England, California and Ohio.
Researchers estimate that a loss of in-person learning could result in a roughly three per cent drop in lifetime earnings for these cohorts and an estimated GDP loss of $1.6 trillion for Canada.
In addition, researchers say school closures could result in non-pandemic related health risks, including loneliness and social isolation, loss of structure affecting physical activity, sleep and mental health and decreased ability to detect neglect or abuse.
Although COVID-19 cases are rising in communities, Brown said schools should be the last service to close because of its damaging effects.
“We know that if schools stay open we will see more infection, but we also know that the impact on children of these interruptions in schooling is really hard and damaging. So it's a challenging trade off.”
