The spread of COVID-19 within the community appears to have peaked even as its spread within long-term care homes and other congregate settings continues to intensify, officials say.
Ontario has released updated modeling on the spread of COVID-19 which indicates that the province is “trending better than the best case scenario” that was detailed in modeling released by epidemiologists with Public Health Ontario back on April 3.
Officials are now projecting that there will be 20,000 cases of COVID-19 during the first wave of the pandemic, down from both the 80,000 cases that were projected as a “best case scenario” earlier this month and the up to 300,000 cases that the province could have seen under a “worst case scenario.”
The modelling also says that the spread of the virus within the community “seems to have peaked and is coming under control,” though it notes that we are still seeing the “accelerating upswing of the curve” in long-term care homes and other congregate settings, such as homeless shelters.
Officials had previously said that Ontario wasn’t likely to see the peak of the pandemic until sometime in May.
“We have to continue at this point to implement the enhanced public health measures to stop the spread of COVID-19 and flatten the curve,” Ontario’s Associate Chief Medical Officer of Health Dr. Barbara Yaffe said at a press conference held to release the new projections. “We are probably at the peak but the peak is not just at one point in time, the peak can last a bit and we don’t want it to go up again.”
Epidemiologists had previously said that there would be 1,600 deaths by April 30.
The province, however, has so far only reported 584 deaths and no longer appears to be on track to hit that grim milestone.
Hospitalizations are also not where epidemiologists thought they would be by this point. The modeling released earlier this month said that by yesterday there would be 1,200 people in intensive care beds as a “best case scenario,” potentially overwhelming the healthcare system. Instead there were 247 people with the virus in ICU units, down from as many as 264 last week.
“The public health interventions, both large and small, have actually accelerated the peak until now for the community transmission of COVID-19 and peak is important because epidemics follow what is called Farr’s Law, which means they essentially have a symmetrical shape and we are now hoping to see a reduction in cases as we go along,” Adalsteinn (Steini) Brown, Dean of the Dalla Lana School of Public Health at the University of Toronto, said at the press conference. “Peaks are not a single day, peaks are not sort of a nice single spike, they can be a bit bumpy and go on for a period of time but we are in that peak period right now.”
Province may be able to reopen healthcare system
The province had previously projected that the pandemic would result in 3,000 to 15,000 deaths in Ontario over the next two years, though the modelling released on Monday does not make any further projections about mortalities.
Brown said the reason for that is that two separate “disease processes” have emerged with community transmission trending downwards while the spread of the virus within long-term care homes and other congregates settings speeding up.
“The ramp up in cases in long-term care homes and the mortality that follows with that obviously makes it hard to predict a number of actual deaths, “ he said, noting that there are currently outbreaks at 127 different long-term care homes.
The modelling released on Monday says that there are currently 687 available ICU beds in the province in addition to those already filled by COVID-19 patients. The modelling also says that the province also has the ability to quickly add another 1,497 ventilator-equipped beds for COVID-19 patients if the situation starts to deteriorate.
Matthew Anderson, who is the head of Ontario Health, said that we are “now tracking to the best case scenario.”
He said that given the more optimistic picture painted by the new modelling, the province can now “start to take a look at how we can bring back the rest of the healthcare system” in particular the elective procedures that were put on hold in anticipation of a surge in cases.
He said that the province could also use some of the capacity available in its acute care system to support the long-term care system.
“The modeling we were looking at was not unreasonable. Where we are today is thanks to everybody in Ontario who worked together to ensure we could get community spread down, obviously with the acknowledgement that we are not done and have more to do, especially in long-term care,” he said.
Virus remains a ‘clear and present danger,’ Ford says
During a news conference at Queen’s Park on Monday, Premier Doug Ford said that the new modeling shows that there is “some light at the end of the tunnel” but he said that “we are not out of the woods yet.”
“The numbers clearly show that the steps we have taken as a province are working and they are working because of you, they are working because we have all come together and we are throwing everything we have at it but we can’t let our guard down now,” he said. “This virus remains a clear and present danger. My friends we still have far to go but thanks to our collective efforts we are in a better position today.”
Health Minister Christine Elliott also commented on the updated modeling on Monday, noting that it shows “early but unmistakable signs that our collective efforts to stop the spread of COVID-19 are working.”
“The province has avoided a significant surge in cases. The rate of growth day over day has stabilized with the outbreak of this virus having likely peaked in the community and we are trending towards a best case scenario rather than a worst case scenario,” she said.
In addition to the provincial modelling that was released today, officials in Toronto are also expected to release their own figures.
In an interview with CP24 on Monday morning, Mayor John Tory said that those projections will "more or less in parrallel" with the provincial data. He said that they will indicate that “we have made some progress” but “by no means” will they signal that it is time to reopen the city.
“We are still a long way from where we need to be,” he said. “I know people don’t want to hear that but at the same time I think it is necessary that we focus on the fact that we have a lot of work left to do in terms of the physical distancing so that we can be sure we can ride this thing out.”
