We were going to write about the good, the bad and the ugly of COVID-19 right now. Turns out, it’s all ugly
The pace at which Ontario is vaccinating against COVID-19 isn’t fast enough to prevent the need for restrictive public health measures in the coming weeks as variants drive new cases of the virus ever higher, infectious disease experts warn.
The province’s COVID-19 Science Advisory Table estimates that as much as 55 per cent of all cases in the province are variants of concern (VOCs).
And, on Thursday, Ontario reported 2,380 new cases, the first time the province’s daily case count has gone above 2,000 since Jan. 30. (The province provided the caveat that the count is higher by about 280 cases due to a catch-up in data in its monitoring system, but even accounting for that, the case count is above 2,000).
“Every infection we see out there needs to be handled as if it’s a variant of concern,” said Dr. Peter Juni, an epidemiologist and scientific director of the science advisory table.
Juni noted that he believes the province will have to enact restrictions, at least in the Golden Horseshoe area, to keep the spread of variants under control.
The science advisory table estimates the effective reproduction number of variants of concern is 1.26, meaning for every infectious person, 1.26 people will become infected on average.
“The epidemic curve is being driven entirely and exclusively by the new variants,” Juni said.
“(As) we’ve never had them under control, and because we’re not far enough along with our vaccinations, we need public health interventions that are really more effective than even those we saw during the January lockdown with stay-at-home orders.”
A Star analysis of Public Health Ontario data shows that the number of mutations indicating the presence of VOCs in positive COVID-19 tests has grown 140 per cent in the last two weeks, from 6,513 on Mar. 10 to 15,657 on Mar. 24.
Toronto, Durham and York are leading the GTA in weekly-per-cent positivity for mutations or VOCs on a rolling, seven-day average.
Toronto is highest, with mutations, or VOCs, being detected in 66.9 per cent of positive COVID-19 tests. Next is Durham, at 66.1 per cent, followed by York at 61.5 per cent.
Speaking to reporters this week, Toronto’s medical officer of health, Dr. Eileen de Villa, said she is concerned with what she is hearing from those providing care in ICUs and critical care units.
“We have seen what has happened to other health care systems around the world when they get overwhelmed with large volumes of COVID-19 patients. This is exactly what we have been seeking to avoid to the greatest extent possible here and that’s why we’ve undertaken the kind of COVID-19 response you’ve seen us engage in over the past year and a bit now,” de Villa said.
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Hospitalizations due to COVID-19 have been on the rise since the beginning of March, and sit at 894, of which 332 are in the ICU, with 212 patients in the ICU and on a ventilator.
Contrary to many of his public health contemporaries, Dr. Karim Kurji, York’s medical officer of health, says lockdowns are “definitely not the way to go.”
In an interview with the Star, Kurji said the region is not finding outbreaks at restaurants, stores or malls, but rather in places that do not respond to the province’s colour-coded framework, such as manufacturing plants, homes and households gatherings where close contact transmission can occur.
“When you have a gathering in a private home, you’re going to increase the likelihood of infections spreading. These things are not going to be controlled by us being in the grey zone or whatever,” he said.
The best way to cut down on the spread of variants, he said, is an aggressive vaccination strategy that not only targets older residents but also younger populations in areas of high concentrations of new cases. Kurji pointed out that 70 per cent of new cases are occurring in people between the ages of 20 and 64.
While it is expected that increased vaccinations will eventually begin to curb hospitalizations, not enough people are getting the jab fast enough to avoid what could be an “ugly April” when it comes to case numbers, said Colin Furness, an infection control epidemiologist at the University of Toronto.
“The variants of concern are substantially more contagious and I think what’s worrisome is that they’ve been growing in areas even where we’ve had strict lockdowns,” said Furness, who noted that the increase in the proportion of VOCs, combined with reopening many areas of the economy, including the allowance of indoor dining in red and orange zones, “makes it all but for sure that we’re going to have some pretty severe (public health) intervention.”
“If we picked carefully and judiciously, we wouldn’t have to lock everything down.
“But we don’t have a good track record of doing that.”
Meantime, the race to administer at least one dose to every Ontarian by June 20 is on. On Wednesday, the province administered 79,446 doses, a record. More than 304,000 Ontario residents have been fully vaccinated, while about 1.4 million people have had one dose.
But those who have received one dose represent just 9.85 per cent of the province’s population.
There’s still a long way to go until 75 per cent of the population gets at least one dose by the first day of summer.
Kenyon Wallace is a Toronto-based investigative reporter for the Star. Follow him on Twitter: @KenyonWallace or reach him via email: firstname.lastname@example.org
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