Ontario will see a rise in ICU admissions related to COVID-19 that will once again put its hospitals under significant strain even without taking into account the spread of a new variant that it likely to “drive cases above current projections,” new modelling suggests.

Ontario’s Science Advisory Table has released updated projections which attempt to lay out the possible scenarios the province is facing amid a worsening fourth wave of the pandemic that has already seen case counts double over the span of a month.

The scientists say that “even without Omicron” the number of people in the ICU with COVID-19 is projected to climb to between 250 and 400 by January, putting hospitals that are already struggling with staffing shortages and employee burnout “under strain again.”

They say that in the most likely scenario, which assumes that the percentage of children aged five to 11 that have received one dose of COVID-19 vaccine rises from 22 per cent to 50 per cent by the end of December, case counts will reach about 1,750 a day in early 2022.

But the scientists warn that Omicron will eventually “hit us hard and fast,” meaning that their projections are probably a little too conservative.

They say that if Omicron proves to be even “moderately” more infectious, daily case counts will likely surpass 2,000 in early 2022.

That said, if the new variant is “much more infectious” and “much more” resistant to vaccines, the scientists say that daily case counts could surpass 3,000 in early January, approaching the numbers that Ontario saw during a devastating third wave of the pandemic in April.

“The modeling is predicting a rise in cases which I think we all knew would occur as we head indoors in crowded spaces and close spaces. I am concerned about the coming months and its potential impact on our health-care system but our fate is in our hands,” Chief Medical Officer of Health Dr. Kieran Moore told reporters during a briefing on Tuesday afternoon. “We can wash them, we can use them to put a mask on and we can find the nearest clinic where we can provide safe and effective vaccines. So the modeling is disconcerting but I think we can prevent major impact by adhering to all the basics that we've done in the last several months of this pandemic.”

Ontario has increased hospital capacity

Ontario’s rolling seven-day average of new cases has more than doubled over the last month, going from 478 on Nov. 7 to 975 as of today.

Hospitalizations, considered a lagging indicator, have also begun to climb albeit at a more gradual rate.

As of Monday, there were 340 people in hospital due to COVID-19 across the province, the highest hospital occupancy seen since mid-September. Of those individuals, 165 were in intensive care.

It should be noted that the Ford government has said that investments it has made in new hospital beds and staff have increased the number of individuals with COVID-related critical illness that can be cared for ““without putting at risk urgent surgeries” from about 150 to approximately 300.

That, interestingly, is the number of COVID-19 patients that the science table says will be in intensive care come January in its most likely scenario, which doesn’t take the spread of Omicron into effect.

Speaking with CP24 following the release of the latest projections on Tuesday, the scientific director of the science table Dr. Peter Jüni said there is “tremendous variation” in the viral picture between different public health units and there is therefore no “one size fits all” solution to reducing transmission.

He said that some public health units “may need to follow” the lead of Windsor-Essex which reduced gathering limit sizes amid a rapid rise in cases. Others, he said, can continue to follow existing public health precautions with the caveat that things could change as the Omicron variant spreads.

“The GTA still does relatively well but we just need to be aware that things will change with Omicron coming,” he warned. “So right now what we need to do is we need to do is to get vaccinated our kids five to 11 fast, we need to push third doses as well and in addition we really should decrease on average our contacts a bit.”

Cases rising in 26 public health units

The science table said in its modelling that cases are now rising in 26 of Ontario’s 34 public health units.

Given the situation the province is facing, the scientists are warning that Ontario must increase vaccination rates, particularly among school-aged children, and “continue to use public health measures to reduce transmission now.”

In a message posted to Twitter, Ontario Hospital Association President and CEO Anthony Dale said that it is “hard to put into words the anger and disappointment within the hospital sector at the prospect of having to provide care for another large wave of critically ill COVID patients when the vast majority will be unvaccinated.”

Moore, however, stressed that there is capacity in the health-care system to accommodate an uptick in hospitalizations should it materialize.

“We're monitoring overall ICU capacity for both adults and children on a daily basis. Roughly we're at 74 per cent capacity so that's 1,700 plus beds across Ontario. We also can surge up for 300 or 400 extra beds if necessary but that would potentially mean decreasing some surgeries. So there is capacity across Ontario already built in,” he said. “We are moving into a season when typically surgeries slow down. So ICU capacity should be maintained and we should be able to provide care if necessary if there's a rise in cases but I hope you're hearing my voice that these admissions are preventable. They're preventable by us adhering to our best practices of masking, hand hygiene, distancing and decreasing the number of social contacts you have over this next month.”