While 31 of the province’s 34 public health units are set to be in phase 3 reopening by the end of the week, epidemiologists are calling for caution now that two western provinces – which are further ahead in their plans to reopen – have more COVID-19 cases per capita than Ontario.
Alberta was recognized for its aggressive reopening stages, which included gymnasiums, cinemas and swimming pools. It now has 19.3 active cases per 100,000 population, almost double that of Ontario, which currently stands at 10.11 per 100,000 population.
Saskatchewan, which allowed restaurants, gyms and stores to reopen in June and recently moved to open museums, cinemas and casinos, has a per capita active case rate of 11.54 per 100,000 people .
Todd Coleman, epidemiologist and assistant professor of health sciences at Wilfrid Laurier University, said this isn’t the first time we’ve seen scenarios where increasing cases coincide with easing restrictions.
“We’ve seen a number of other countries where they’ve started to ease restrictions, and it’s only going back up,” Coleman said. “This is a very easy infection to transmit, and we have to make sure that everything is really locked in terms of the public health response.”
By the end of this week, seven other regions of Ontario will move to Stage 3 of the reopening: Durham, Halton, Hamilton, Niagara, Haldimand-Norfolk, Sarnia-Lambton and York. This will only leave three regions in Stage 2: Toronto, Peel and Windsor-Essex. Facilities authorized to reopen in Stage 3 include restaurants, convention centers, casinos, gymnasiums and outdoor playgrounds.
“Continuous dissemination of messages is important,” said Dr. James Kellner, professor of microbiology, immunology and infectious diseases at the University of Calgary. “People are tired of COVID. Everyone wants this to go away. Finding a way to send a positive message without harassing people, encouraging people to be careful – it’s easier to say, but harder to do.
To give us an idea of the situation in Ontario and some other provinces, we asked experts to give us their opinions on several data points.
Case of Greater Toronto versus the rest of Ontario
Although the number of new cases outside the GTA remains lower than in the GTA, a worrying trend has emerged in recent days: the seven-day moving average of new COVID-19 cases outside the GTA increased from 33 on July 7 to 51.4 on July 19. Likewise, in the GTA, the seven-day moving average of new cases fell from 76.9 on July 12 to 97.1 on July 19.
This is a “worrying” trend, says Raywat Deonandan, associate professor and epidemiologist at the University of Ottawa.
“Two weeks ago things started to open up more and people started spending more time with family and friends,” Deonandan said, adding that an increase in the number of cases means we cannot let our guard down.
“I think we have to keep our foot on the pedal, so to speak. We cannot slow down our desire to make things secure. “
He added that the company should now focus on finding ways to open schools safely in the fall.
“Opening up parts of our economy that are luxury goods, like bars, in my opinion is a disservice to the ultimate goal of school openings, especially if it translates into things like (increase in new cases )”, did he declare.
What about Toronto, Peel and Windsor-Essex?
Premier Doug Ford asked residents of Toronto, Peel and Windsor-Essex for patience on Monday when he announced the additional regions that will enter Stage 3 later this week.
“For other regions that went into step 2 later in the process, please be patient. We will get there very soon, ”said the Prime Minister. We know as a province that we cannot relax. We cannot give this virus an absolute thumbs up. ”
In the three days leading up to Monday, Toronto recorded 107 new cases of COVID-19, according to the city’s medical officer of health, Dr Eileen de Villa, who acknowledged on Monday that some may be disappointed that Toronto has yet to move on to step 3..
She noted that cities that were a few weeks ahead of Toronto in their outbreaks and have since reopened “are now seeing an increase in COVID-19 activity linked to the reopening of restaurants and bars. In some cases, cities that previously had very low or no COVID-19 activity are now seeing an increase in cases related to these parameters. “
Peel reported 22 new cases on Saturday, 38 on Sunday and 29 on Monday. Its public health unit said several household members tested positive for the virus, a trend in recent weeks where the virus is spreading through all families.
“Regarding the introduction of the virus into households, we have seen residents who may contract the infection at work and then spread to members of their household,” the health unit said. “The infected person can carry it without knowing it to their place of work, thus initiating chains of transmission.”
The median age of those infected is 37, unchanged over the past few weeks.
And in Windsor-Essex, 18 new cases were reported on Monday, seven of them in the agri-farming industry and one in the manufacturing sector.
Deonandan said the likelihood of being exposed to COVID-19 is likely to be higher in these areas, which helps explain why they are not yet at stage 3.
“There is also something to say about the types of neighborhoods, economic situations and jobs that people in these regions may have,” he added. “This disease has a way of revealing the truth of inequalities in our society. Look at how this is revealed and how certain ethnicities are more susceptible to contracting the disease. It has nothing to do with biological susceptibility and everything to do with social susceptibility. I suspect we see a bit of it here.
Alberta has seen a gradual increase in the number of cases since the province’s “permissive” Phase 2 reopened in mid-June, says Jim Kellner, infectious disease expert and professor at the Cumming School of Medicine. University of Calgary.
The province saw a single-digit rise in cases in early June, but last week Alberta reported 120 new cases on Thursday and 105 more on Friday.
“We haven’t seen numbers like this since May,” Kellner said. “Most striking is the age distribution.”
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Overall, 36% of cases in Alberta were in the 20 to 39 age group, but last week he said that number had risen to 44%. In Canada, it’s 27%.
“A lot of the more permissive recommendations and guidelines have been particularly adopted by the younger population, especially at social gatherings,” Kellner said.
During Phase 2, Alberta opened businesses including massage parlors, cinemas, gymnasiums, swimming pools and bingo halls.
But the biggest change has been the size of the gatherings, Kellner says, including “household cohorts” – as the province calls them – of up to 15 people and outdoor gatherings of up to 200 at events such. as weddings, festivals or sporting events, as long as social distancing has been maintained.
The province also allowed certain groups such as sports teams and performers to form cohorts of up to 50 people, with the idea that social distancing would be maintained, but acknowledging that this would not always happen, says Kellner.
“And I’m sure maintaining the social distance, going to restaurants and to outdoor and indoor gatherings, has been a challenge,” he said.
The province offers universal testing and testing for 7,000 to 9,000 people per day. Results for symptomatic people are received within 24 hours, while those who are not symptomatic see results in about four days. Alberta also has robust contract tracking.
The government divided the province into 42 regions, based on population; an area goes on a “watch” if active cases exceed 10 or if the number of cases exceeds 50 per 100,000, says Kellner. The government has not said what restrictions it will reimpose if the number of cases becomes too high, he said.
“The only way we could tolerate such a high number,” he said, referring to the population-based number of cases, “is to have good testing and good contract traceability.”
In the past 10 days, Saskatchewan has also seen an increase in the number of cases, which have reached as high as 50 in the past few days, a high number for a province that has only 943 cases to date.
“It’s a concern,” said Nazeem Muhajarine, epidemiologist and professor of community health and epidemiology at the College of Medicine at the University of Saskatchewan. “It tells us that we have to be vigilant and that the virus is here.”
The province has not been as open with data as Alberta or Ontario, and Muhajarine said this makes it difficult to know where the outbreaks are occurring and in which age groups.
But since last week Saskatchewan has introduced universal testing and it says there is aggressive contract tracing when cases are identified.
As in many other jurisdictions, Muhajarine said the fall and reopening of schools was still a big concern. The province organized a small expert think tank to examine emerging data around the world to find best practices in places where schools have reopened.
Cases remained low in British Columbia and Manitoba.
Around the world
Brazil now has 2,098,389 cases of the virus, just behind the United States, but the actual number could be much higher due to a lack of testing, according to media reports.
The epidemic began in the northwest of the country, where it affected indigenous communities, before spreading to major cities such as Rio de Janeiro on the coast and near São Paulo, the country’s financial center, where a number of makeshift hospitals have been built.
Nearly 80,000 people have died in Brazil, compared to more than 140,000 in the United States, which has more than 3.8 million cases.
South Africa is now the fifth country most affected by COVID-19, after India and Russia, with 364,328 cases, after being ranked eighth less than a week ago. Almost 23,000 new cases have been identified in the past two days.
The World Health Organization said on Monday that cases rose by about 30% last week, according to media reports.
Large increases are also occurring in Madagascar, Namibia and Botswana, although numbers there are lower than in South Africa, and WHO experts fear this may be the start of an acceleration in disease in Africa.