As vaccinations lag, while COVID-19 case-counts climb, Ontario faces stumbling blocks on the path back to normal

Infectious disease experts are skeptical Ontario will be able to relax COVID-19 restrictions in the next seven to 10 days, a time frame suggested earlier this week by the province’s chief medical officer. They point to rising daily case counts and the fact that several public health units are far from meeting thresholds to exit Step 3 of the reopening process.

While more than 72 per cent of Ontarians 12 and older are now fully vaccinated, that is still below the 75 per cent overall double-vaccination threshold the province says must be met to proceed out of Step 3. In addition, 12 of the province’s 34 public health units still have not fully vaccinated 70 per cent of their eligible populations, another benchmark that must be met to continue to reopen.

To make matters worse, the province’s COVID-19 Science Advisory Table reported Thursday that 28 public health units are seeing exponential growth in new daily cases. That’s up from 21 since the beginning of August.

“Unless something close to a miracle happens, additional reopening in the next 10 days will result in major challenges. It’s mission impossible from an epidemiological perspective,” said Dr. Peter Juni, the science table’s scientific director.

“We’re already in exponential growth of new cases and if we added anything else to the reopening we’ve done already, we would be at even greater risk of future explosive growth. This is especially important now when facing the next big step, which is a safe school reopening.”

The virus’s doubling time is now eight days, down from 10 earlier this week, according to the science table. And at 1.62, the effective reproduction number is the highest it has been all year. (This means every 100 COVID-19 cases causes an average of 162 new infections.)

New daily COVID-19 cases in Ontario are still substantially lower compared to where they were at the peak of the last wave, but the current average of 439 cases per day is more than double what it was a week ago.

And while daily case counts are still relatively low, any increase in cases will inevitably be followed by hospital and ICU admissions, lagging indicators which can take several weeks to show up. Dr. Kieran Moore, Ontario’s chief medical officer of health, signalled earlier this week that these two metrics will be the key indicators in the coming weeks to judge the effectiveness of the province’s response.

“Does it make sense to head at all down that path toward relaxation, given what we’re doing right now is already allowing case counts to grow?,” asked Ashleigh Tuite, an infectious disease epidemiologist at the Dalla Lana School of Public Health.

“For me, the answer is: ‘No.’

“If anything, it feels a bit strange that we’re not reacting to the cases we’re seeing now.”

Bill Campbell, a spokesperson for the Ministry of Health, told the Star Thursday that, while the province has reached the milestone of 80 per cent of Ontarians aged 12 and older having received a first dose of vaccine, “we are not yet at the point where we can safely move out of the ‘Road map to Reopen,’ and additional time is still required to monitor existing data, including any initial impacts of moving to Step 3.

“We will continue to monitor data to determine when it is safe to exit the road map and lift the majority of public health and workplace safety measures currently in place,” said Campbell.

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All of this comes just as Canada reopens its border for fully vaccinated adults (and unvaccinated children) with the United States, even as Delta variant cases skyrocket in that country.

“There are going to be kids visiting their cousins, who are potentially going to infect their relatives, just before school starts. To me, that’s very worrisome,” said Dr. Anna Banerji, an infectious disease specialist at the University of Toronto’s Temerty Faculty of Medicine.

The province recently announced additional funding for as many as 20,000 new HEPA filters in schools, high-efficiency particulate air filtration systems to enhance the cleaning of air.

Banerji says public health officials should act to vaccinate students.

“If there is a kid that’s exposed in a classroom, all these unvaccinated kids have to go home for the incubation period,” Banerji said.

“Everyone who’s going to be 12 this year should be vaccinated immediately.”

Ontarians in the 12-17 and 18-29 age groups continue to have the lowest rates of full vaccination, at 54.1 and 59.2 per cent, respectively.

On a regional basis, some public health units are struggling more than others to get shots in arms. Twelve units have yet to fully vaccinate 70 per cent of the population 12 and older, according to the latest publicly available provincial data.

Hamilton, for example, has yet to crack the 70-per-cent threshold, with 68.5 per cent of individuals over the age of 12 fully vaccinated.

Hamilton Public Health Services spokesperson Jacqueline Durlov said in an email that the health system is making a big push to increase vaccination rates across the city, including continuing to place clinics in areas where residents have been disproportionately affected by the virus and where there has been a lower uptake of vaccination.

Within this approach, public health is working with several community organizations and community ambassadors “to reach priority and hard-to-reach populations, to ensure we can help bridge gaps in vaccine information, remove barriers to access, increase vaccine confidence, and ultimately increase uptake in areas of the city or amongst populations that are particularly vulnerable,” she said.

At the upper end of vaccination rates, Ottawa Public Health has vaccinated some 75 per cent of its eligible population over 12. This has partly been the result of a coalition of settlement agencies coming together with Ottawa Public Health and family health teams to strategize on the best ways to engage communities that would otherwise feel uncomfortable walking into mass clinics or places without language or cultural “sensitivities,” said Andrea Gardner, associate executive director of Jewish Family Services of Ottawa and co-chair of the Ottawa Local Immigration Partnership, in a media conference this week.

“So, hosting clinics, having staff there who knew the client base that was coming in, doing the door-to-door that the Ottawa health team was doing …,” Gardner said. “It was really just being where our client base was and working with them …. We still have much more to do, but it was definitely a start.”

Kenyon Wallace is a Toronto-based investigative reporter for the Star. Follow him on Twitter: @KenyonWallace or reach him via email: kwallace@thestar.ca

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