With Ontario now seeing an estimated 30,000 to 35,000 new daily infections — roughly double the number of daily cases on March 1 when the province dropped vaccine passports — it’s clear Ontario has entered its sixth wave of the COVID-19 pandemic, experts say.
Those numbers are according to the latest wastewater signal estimates from the COVID-19 Science Advisory Table, which also reports that most public health units are once again experiencing exponential growth of infections.
“Basically, we’re in either a resurgence, a sixth wave, or as I like to say, the ‘throw-caution-to-the-wind’ wave,” said Dr. Peter Jüni, epidemiologist and scientific director of the science table.
“Many people are behaving as if the pandemic is almost over. And this means that it is mainly our own behaviour that is driving this wave,” he added, noting that the new highly transmissible subvariant of Omicron, BA.2, is only partly responsible for the increase in cases.
“The new variant is not the main culprit. It’s us. It’s people just dropping their guards and increasing their high-risk contacts, such as gathering with others indoors without masks.”
According to the wastewater estimates, Ontario case rates are now on a similar trajectory to where they were in mid-December when the Omicron wave was beginning to build.
The estimates suggest daily infections are already higher now than any time before the Omicron wave. The table’s estimate peaked at about 130,000 daily cases in early January.
Because the province no longer conducts widespread polymerase chain reaction (PCR) testing, the number of reported cases each day picks up only a fraction of the true number of COVID infections in Ontario. Wastewater surveillance, which measures the level of SARS-CoV-2, the virus that causes COVID, in water carrying fecal matter flushed down our toilets is now the best indicator of case levels in the population.
The wastewater readings have been steadily increasing over the past three weeks, during which time the province lifted capacity limits for most indoor public settings, eliminated the vaccine passport program and scrapped mask mandates at places like schools, gyms, bars and restaurants.
“This is a pretty earnest, authentic signal that says, ‘yeah, we’re really heading into the storm.’ — and we’re not only heading into the storm, we’re doing it under full power,” said Colin Furness, an infection control epidemiologist at the University of Toronto. “If the goal were to create a wave as large as possible, then we have made all the right decisions.”
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He said he is not surprised we are entering another wave given that the province decided to drop mask mandates “at the very worst possible time” and decreased the self-quarantine period to five days when many people remain infectious beyond that time.
“We know factually that that will accomplish one thing: it will put infectious people back in places where they can infect others.”
The wastewater analysis is not the only signal that Ontario is in another wave.
Although Ontario is processing a fraction of the PCR tests it was handling late last year, the province has continued to conduct targeted testing in vulnerable settings. And the tests that are being done have been coming back positive increasingly more often, with average PCR test positivity up to about 14 per cent from a low of around nine per cent in late-February.
The growth is also showing up as a rise in reported outbreaks in these vulnerable settings, with 140 seniors’ homes reporting active outbreaks as of Wednesday, up from a low of 85 on March 15.
One clear signal that a new wave is well underway has little to do with PCR testing or wastewater — it’s the fact more people are already showing up sick in hospital, up to nearly 800 COVID-19 hospitalizations this week from around 600 just 10 days ago.
In the past, hospital trends have tended to lag behind changes in general infection rates, reflecting the time it takes for patients to get sick enough to seek care — an increasing hospital burden is a sign the new wave may have been building for some time.
Furness noted that due to the virus’s increased transmissibility, people prone to poor health outcomes and who, up until now had managed to stay safe, are in a risky situation.
“If you are really high risk,” he said, “the pandemic is not over for you.”
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
Ed Tubb is an assignment editor and a contributor focused on crime and justice for the Star. He is based in Toronto. Follow him on Twitter: @edtubb
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