The first signs are that parts of Canada may begin to flatten the curve, as the feared surge of COVID-19 patients overwhelming hospitals has so far failed to materialize.
But infectious disease experts warn that it is still possible for Canada to experience a significant spike in cases. Some regions, especially Ontario and Quebec, are struggling to contain outbreaks in long-term care homes and other facilities, and experts say too quick a release of physical distance could exacerbate the situation .
“I think the fact that we have been able to avoid a disaster at this point highlights the fact that we must maintain the policy of physical distance,” said Michael Warner, medical director of intensive care at Michael Garron Hospital in Toronto. “In terms of the survival mechanism, we must continue to do so.”
For weeks, public health officials highlighted the start of April as a pivotal moment in Canada’s battle against COVID-19, saying that new cases, hospital patients and deaths would help point in which direction. the country’s epidemics are heading.
As of mid-month, data from several provinces show that policies of physical distancing combined with increased COVID-19 testing and increased hospital capacity are preventing the spread from becoming uncontrollable. Experts say that reducing the growth of new cases – smoothing the curve – would prevent the pandemic from overwhelming the healthcare system.
Alberta, for example, which has more than 500 ventilators, said it hospitalized 47 patients on Saturday following COVID-19. Of these, 13 patients are in the intensive care unit. Since the start of the COVID-19 outbreak, only 33 patients in Alberta have been admitted to intensive care because of the disease.
Officials in British Columbia on Saturday reported that 63 people were in the ICU with COVID-19, down from 72 Monday when 72 were in the ICU. Last week, Minister of Health Adrian Dix said the province’s intensive care occupancy rate was 53%.
Even in Ontario, which has had low screening rates and widespread outbreaks in long-term care homes and other facilities, hospitals are not overloaded with COVID-19 cases. Critical Care Services Ontario reports show that almost 80% of the province’s ventilators are not in use. Ontario reported having 738 patients in hospital as a result of COVID-19 on Sunday. Of these, 261 were in the intensive care unit and 196 were on respirators.
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In Quebec, there were 217 people in intensive care with COVID-19 on Sunday. Officials say the province has about 1,000 intensive care beds and 3,000 ventilators.
“This is the first week that you start to see tangible evidence of a flattening of the curve and that there may be an end to it in terms of the first wave,” said Jim Kellner, pediatrician and disease specialist infectious at the University. from Calgary.
Lynora Saxinger, an infectious disease specialist at the University of Alberta in Edmonton, said there is a marked divergence in the trajectory of COVID-19 outbreaks in western and central Canada.
“Canadian data should be looked at almost the same way we look at data from different countries,” said Dr. Saxinger. “I think the epidemic … in Quebec and Ontario is really the kind of driver of the total number of Canadians.”
In these provinces, the number of new cases, hospitalizations and deaths continues to be higher than in other parts of the country. Ontario reported outbreaks of COVID-19 in 86 long-term care homes on Sunday, which have so far resulted in at least 1,153 cases and 115 deaths.
Quebec is also facing hundreds of outbreaks in long-term care homes. This weekend, health authorities, police and a coroner opened an investigation into the deaths of 31 residents in a retirement home for the elderly in Montreal.
Dr. Kellner said that if trends continue, provinces that have successfully controlled their outbreaks may want to think about how and when to reduce physical remoteness. But in other parts of the country, including Ontario and Quebec, these conversations could be more distant, he said.
Hospitals that have canceled surgeries and taken other measures to reduce the number of patients in preparation for a COVID-19 flare will also need to start thinking about how to move forward, said Dr. Saxinger .
“If our push turns out to be more of a steady stream or a net, we also need to adapt and determine how we are going to do the rest of health care,” she said. “If we tell everyone to stay home with their chronic health conditions at some point, it becomes a problem. “
With a report by Ian Bailey in Vancouver
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