COVID-19 has now killed 2,000 Torontonians — a grim milestone reached Thursday — as experts warn the death toll is poised to accelerate through the winter.
From the start of the pandemic, it took fewer than 100 days for Toronto to record 1,000 deaths on June 18. It’s taken more than six months since then to reach 2,000 deaths.
But the second wave that has infected more young people is now pushing health care capacity to the brink and there is no sign we are anywhere near the peak.
It is also increasingly stalking long-term-care homes where residents, who comprised most of the first wave’s victims, are at dramatically higher risk of death. The spectre of 3,000 Toronto lives lost to COVID-19 is very real, experts warn.
As health officials race to ramp up vaccinations, Ontario on Thursday recorded 3,519 COVID-19 cases with 89 deaths — the province’s deadliest day since the start of the pandemic.
“We’re in a really bad place in terms of our province right now,” said Dr. Nathan Stall, a health researcher and Mount Sinai Hospital geriatrician.
“I think most tragically we’re probably going to end up with a higher death toll in the second wave than we did in the first wave, given the recent severe acceleration of epidemiological trends.
“It’s extraordinarily alarming what’s happened in the past couple of weeks.”
Vaccinations and any new restrictions such as school closures won’t stop a surging death toll in January and February because those deaths are, as one expert put it, “baked in.”
The time lag between virus infection, symptoms, hospitalization, intensive care and death means many people who will die between now and March are already sick and, based on health research projections, doomed — they just don’t know it yet.
Stall rhymed off indicators that suggest the death toll for Toronto, and the rest of Ontario, could surge before the vaccine rollout begins to have any impact.
Ontario’s new COVID-19 hospitalizations and intensive-care admissions are at all-time highs, triggering postponement of non-virus treatments for cancer and other potentially deadly ailments.
The number of Ontario long-term-care homes in outbreak has blown past the first-wave high, although not overall LTC infections. The 47 deaths of LTC home residents reported Wednesday was the highest one-day total since May 26.
“It’s going to be a couple of months before we see actually see vaccinations affect our data,” Stall said. “Community spread is out of control and that has knock-on impacts. We are in worse shape now than ever before. This is going to be a very hard few months.”
Toronto and the world “will be in a better place” by summertime, Stall added.
But, he said, “I think there’s a real possibility we’ll hit 3,000 deaths” in Toronto before the end of the pandemic.
Where Toronto’s first wave hit frighteningly quickly, the second wave has built relatively slowly over several months.
It took just 88 days from Toronto’s first confirmed COVID-19 death on March 22 to its 1,000th on Jun 18; it’s taken another 203 days to hit 2,000.
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But the pace at which deaths are being reported each day in the city is rising. At the city’s current seven-day average of 12 deaths a day, Toronto is on pace to report its 3,000th death in less than three months.
Throughout the pandemic, the oldest COVID-19 patients have been by far the most vulnerable to the disease — especially those in long-term-care homes. About 70 per cent of Toronto’s reported deaths are among patients over the age of 80.
The city’s second wave has been less deadly so far in part because fewer of these older, more vulnerable patients are being infected than at the height of the spring wave.
According to Toronto Public Health, the worst week of the first wave saw 566 reported infections among patients over 80. The most recent weekly number is less than half that — at around 200 cases among patients over 80.
In addition to the demographics of who got infected, improved hospital treatments have helped make the second wave less deadly, said Dr. Amol Verma, a physician and scientist at St. Michael’s Hospital.
Despite the vaccine rollout, Verma shares Stall’s concerns about Toronto’s winter.
“COVID is still not under control — we’re in the thick of it and there’s a real chance things will get much worse in the next one to two months,” Verma said, calling LTC homes “a match in a dry haystack.”
“All it takes is for one or two large LTC facilities to have major outbreaks and suddenly our death rate could look worse than in the first wave,” said Verma.
“We’re in a very unstable situation right now and I’m definitely worried.”
Asked if he thinks Toronto could hit 3,000 COVID-19 deaths, Verma paused and said: “I sure hope not.”
On Thursday, the city announced 941 new infections and 29 new deaths, bringing the total to 2,017. In a statement Mayor John Tory mourned the “grim milestone,” while public health chief Dr. Eileen de Villa urged residents to prevent future deaths by staying home as much as possible.
Coun. Joe Cressy, chair of Toronto’s public health board, said: “The reality is that the worst months of this pandemic may still be ahead of us. But there’s still hope” if governments work to protect people and individuals stop risky behaviours.
There are other ways to reduce Toronto’s death toll, Stall said.
They include ramping up vaccinations for all LTC residents across Ontario. Currently the Ontario government has a Jan. 21 deadline for LTC residents in virus hot zones, including Toronto, despite deadly outbreaks in other regions.
Ontario could also save lives by ensuring supports, such as guaranteed sick pay, for people who are being infected in workplaces, he said. Many of those workers live in Toronto’s northeast and northwest corners.
“We are still failing to protect vulnerable populations — older adults in congregate settings like long-term-care homes and people who are marginally housed or lower socio-economic status,” Stall said.
“The same themes are persistent.”
With files from Ed Tubb
David Rider is the Star’s City Hall bureau chief and a reporter covering city hall and municipal politics. Follow him on Twitter: @dmrider
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