The latest provincial modelling data shows that lockdown measures have slowed the spread of COVID-19 in Toronto, but case growth has not yet plateaued.
During a data modelling presentation at Queen’s Park on December 10, Adalsteinn Brown, co-chair of Ontario’s COVID-19 science advisory table, said the number of people testing positive province-wide for COVID-19 is flattening.
However, he said data for Toronto shows cases continue to grow dramatically among people with the lowest access to suitable housing or employment outside essential areas, namely people who can’t work from home such as factory and grocery store workers.
Public health restrictions are not impacting these people in Toronto, he said, noting people who live in multi-generational households have higher case growth than those with access to suitable housing. But case infection rates are still increasing among both groups.
“We’re going to need to have a comprehensive approach to supporting these communities if we are going to control the pandemic,” he said. “It requires attention to these long-standing structural factors.”
Mayor John Tory said earlier this week the city is turning decommissioned TTC buses into pop-up testing sites to reach people in lower-income areas with high positivity rates, such as Rexdale.
The city is also increasing bus frequency on busy routes to allow for physical distancing, specifically on 36 Finch West, 35 Jane, 105 Markham, 54 Lawrence East, 41 Keele and 29 Dufferin.
The mayor also said many workers are reluctant to get tested for fear of losing employment or income. This issue has yet to be addressed by the other levels of government, he said.
Brown said data from cellphones reveals that current public health restrictions are having less of an impact on mobility in the Greater Toronto Area than in the spring.
Data from the University of Toronto, St. Michael’s Hospital and AI firm Bluedot show the percentage of mobile devices leaving homes sloping upward.
Brown added this data does not reflect the impact of the most recent lockdown measures, but preliminary analysis of the newer restrictions shows only a one per cent drop in mobility.
“When I’m required to drive on the highways, the traffic load is very similar to a non-COVID season,” Ontario’s Chief Medical Officer of Health Dr. David Williams said. “There is a lot of people on the move. We have to get that down and limit that somehow.”
Williams said 83 per cent of Ontario’s cases are occurring in red and lockdown zones of the provincial COVID-19 response framework, but concerning increases are happening in other regions.
“We’re in a really precarious stage here,” he said. “And we have to really watch this carefully if we are not going to have to close some things further.
“We’re bending the curve a bit,” he added. “The data shows we are slowing the rate of increase, but we have to do better than that. We have to flatten it. We have to show some downward trend.”
Toronto and Peel Region are in lockdown and Durham Region, Halton Region, Hamilton and Waterloo are in the red level of the framework.
York Region and Windsor-Essex will move into lockdown just after midnight on December 14, the province said on Friday.
Williams also said more outbreaks are occurring in hospitals, affecting staffing levels. He also said data shows school kids who test positive for COVID-19 are primarily contracting the virus at home, not in the school environment.
Williams said he would not be surprised to see daily case counts pass the the 2,000 mark over the next few days.
If Ontario continues at the current level of an average of 1.5 per cent daily growth, we should see 2,500 new cases per day with no new restrictions.
Impact of lockdown in Toronto and Peel Region
Williams said it’s hard to comment yet on the precise effects of lockdown measures in Toronto and Peel, which are currently set to expire on December 21.
Top public health officials in both regions say they are seeing an impact through a slowed rate of increase in new cases.
In November, modelling suggested Ontario would hit 3,500 to 6,500 daily cases by this time. As of December 11, the provincial seven-day moving average for new daily cases is just under 1,900.
On Wednesday, Toronto’s Medical Officer of Health Eileen de Villa said daily case counts may be “settling,” but the virus is still spreading “widely.”
Just over two weeks into the lockdown, Toronto’s daily case counts have been above 500 and 600. “These levels of infection clearly indicate that we must be on high alert,” de Villa said.
As of December 9, Toronto’s seven-day moving average was 506. At the same time last week it was 454 and the week before it was 418.
So can Toronto expect an extension of the lockdown or added public health restrictions?
“[The daily case count] hasn’t not gone down as much as we’d like to see. So we’re having further discussions on what we might do in there,” said Williams, adding he is asking de Villa for recommendations on next steps.
Complicating matters is the number of people continuing to socialize in private residences. Williams said contact tracers regularly hear that positive cases cannot pinpoint when they may have caught COVID-19.
“We’re hearing again and again: It’s people in their personal, social and home-type exposure risks that are taking place,” he explained, adding the province will look at ideas to prevent spread in those situations.
He said people either aren’t remembering situations where they would have contracted COVID-19 or are socializing with people outside of their households in situations that they believe do not pose a significant transmission risk.
“There seems to be a certain group in the population that have, in a way, abandoned that precautionary approach,” he said.
On December 1, Toronto Public Health reported survey data that showed 35 per cent of positive cases said they had close contact with people outside their household.
Public health officials have strongly urged people to stay home except for essential reasons and not to socialize with people outside their households.
Key takeaways from the modelling data
Here are the key findings from the modelling data presented this week:
- Long-term care and overall mortality will continue to rise and may exceed 25 deaths per day within a month;
- Ontario’s reproduction number – or R – is fluctuating around one. The R number indicates the average number of people infected from a single positive case. Above one means the epidemic is growing. Below one means the epidemic will slowly die out. Currently, case rates are changing quickly and unpredictably;
- Intensive care unit occupancy will remain above 200 beds for the next month and may go higher if public health measures are relaxed. In some cases, ICU occupancy will surpass 300 beds
- Continued case growth is the highest in Peel Region over the past seven days, with 119 to 120 positive cases per 100,000 people. Toronto is close behind with 118 cases per 100,000 people;
- New cases are flattening in long-term care homes but deaths will continue to rise
- Positivity rates are highest in Peel at 11 per cent. Toronto’s positivity rate is six per cent.
- There has been a 91.6 per cent rise in hospitalizations over the past four weeks
- Intensive care admissions are highly concentrated in Peel Region and Toronto
COVID-19 case growth projections
- If Ontario continues to see zero per cent case growth, there will be 2,000 cases per day;
- If case growth is at one per cent, there will be 2,200 to 2,500 new cases per day;
- At three per cent case growth, there will be “well over” 4,000 cases per day;
- If there is fast growth of around five per cent, there will be up to 10,000 new cases per day by early January;
- If there is 9 per cent daily case growth as there was in the first wave in the spring, Ontario will have 15,000 new cases per day.
Tam: Canada is on a “rapid growth trajectory”
On Friday, December 11, federal public health officials presented new modelling data that said the country is on a “rapid-growth trajectory” as the holiday season approaches.
“The resurgence of COVID19 in Canada clearly shows that the current daily case count far exceeded the peak of the first wave,” said Theresa Tam, Canada’s Chief Public Health Officer. “On the average, over 6,500 cases are being reported daily and there’s little indication this upward trajectory will change without further public health measures.”
Officials say trends among Indigenous people are also worrisome. As of December 10, there have been 5,675 cases on First Nations reserves, with 2,100 reserves reporting active infections.
The number of active on-reserve cases has doubled in the past month and is 20 times higher than the peak of the first wave. There have been 49 on-reserve deaths.
Tam said there have been about 100,000 new COVID-19 cases reported across the country in the past three weeks.
She also said Canadians should expect to see 12,000 daily cases by beginning of January with increasing hospitalizations and deaths unless “significant reductions” in contact rates are achieved.
“We have yet to see the kind of sustained decline in daily case counts that would indicate we are bringing the pandemic under control,” said Tam.
There is an average of 2,900 people with COVID-19 in Canadian hospitals, including 565 in intensive care, she added.
The average length of stay in hospital for COVID-19 patients is 17 days and 24 for more serious cases.
Currently, there are over 73,200 active cases in Canada, up from 52,000 three weeks ago.
