Epidemiologists warn drastic action needed to stop the spread: 4 charts that currently summarize COVID-19 in Ontario

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If sensitive areas of Ontario cannot bring COVID-19 under control, more stringent mandatory measures may be needed to slow the spread and bring the virus under control, epidemiologists warn.

It’s a blunt message that came on a day when Toronto reported a record 538 new infections, four deaths and 176 hospitalizations, including 42 people in intensive care – numbers that Eileen de Villa, the city’s medical officer of health, gave Monday described as “alarming”.

“In my opinion, the reimbursement of allowances was insufficient to slow the spread in these areas,” said Raywat Deonandan, epidemiologist at the University of Ottawa. “At the very least, focused orientation is warranted in some areas. People need to reduce their daily exposures, if not voluntarily, perhaps on a mandatory basis.

Colin Furness, an infection control epidemiologist at the University of Toronto, echoed Deonandan’s comments and suggested that a lockdown is the only tool Ontario would have left if hospitals came close to being overwhelmed.

“Mortality rises when health care is overwhelmed and then it continues to get worse,” Furness said. “If other measures don’t work, that’s the only thing left… a lockdown is a failure. “

In Ontario hot spots – Toronto, Peel, York and Ottawa – cases continue to rise, with new cases in those areas accounting for 68% of all new cases in the province on Monday.

Over the past week, daily new cases in Ontario have remained above 1,200 per day; the seven-day moving average is now 1,465 new cases per day.

What follows is Star’s weekly graphical roundup of key metrics in our battle with COVID-19 and what we can expect in the coming weeks, along with some expert commentary.

COVID-19 hotspots in Ontario

Toronto leads with the highest seven-day moving average for the four hot spots with 479.9 new cases per day.

Laura Rosella, associate professor of epidemiology at the Dalla Lana School of Public Health, told The Star that new restrictions, increased testing and community support are needed to bring the spread under control.

“It’s too high to hope that it will… settle down,” she said, noting that even though there isn’t much left to close, all venues with mixed populations should be closed or very restricted.

“I think we’re probably at a level where we need to think about everything that is considered non-essential, whether or not it should stay open and how it can stay open safely. Community transmission is just too high. “

In Peel, which reported 303 new cases on Monday, the seven-day moving daily average rose to 407.6, from 313.6 last week. In Ottawa, 51 new cases have been reported and in York Region, 138 new cases of the virus have been detected. The seven-day moving daily average in these regions is 53 and 151.6 new cases per day, respectively.

Nonetheless, Furness said he believes compliance with measures such as masking remains high. “I think most people are actually compliant or trying to be compliant,” Furness said.

“When I get on the subway, when I look around, most of the people are actually there” with masks and practicing physical distance. That said, where cases continue to rise, “the genius is really out of the bottle,” he said. “It’s over there in the community, and it will go where we expect it to go.”

Cases requiring hospitalization continue to increase

Hospitalizations are on the rise in the province, with 500 people hospitalized Monday across the province. Of these, 125 are in intensive care.

Despite the increase in hospitalizations, Deonandan said hospitals were still able to accept patients and surgeries had yet to be canceled – a move that would show a overwhelmed health system.

“Usually there is room at the hostel,” Deonandan said. However, the demand for nursing staff is high. “In some places the nurses feel overwhelmed. Our problem, as far as I know, is staffing, not space. “

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While new beds can be put in quickly, the number of health workers available is limited, he said. “Critical care nurses in particular are in demand, as every COVID patient so admitted requires hundreds of hours of dedicated care.

Rosella said the province was on track to see hospitals forced to cancel elective procedures. Unlike the first wave, when elective and planned care was largely suspended, hospitals are generally busier with non-COVID cases, she said.

“I would say we should be concerned about the level of hospitalizations,” Rosella said. “I think we’re at a point where we’re hitting the numbers we’ve almost seen in terms of total hospitalizations in the first wave when things are really bad.

While some hospitals are already full, many remain able to accommodate patients, she said.

“Some hospitals, they’re really at the point where they’re overwhelmed and other hospitals… maybe not quite feeling it yet,” she explained. “And so we have a lot more variability this wave.”

Deaths on the rise

Deaths have increased steadily since mid-October. Deonandan said he expects the average daily death toll to exceed 20 per day in the next week or so.

The current death toll is nowhere near the peak the province experienced in early May during the first wave. On Monday, 10 new deaths were reported in Ontario. On Sunday, there were 29 new deaths. The seven-day moving average of daily deaths in Ontario is 16.1 Monday.

“One way to look at this is that some of the people infected during the Thanksgiving socialization surge will be entering the hospital system in mid-December, potentially showing a peak in deaths by the end of the year. This reflects the national trend, ”Deonandan said.

In the first wave, the death rate was “really tragic,” Rosella said. This time around, if we are able to protect vulnerable populations and prevent so much of the spread in older groups, the death rate could be lower, she said.

“At this point, however, we are still seeing outbreaks of long-term care and older family members infected. So I’m not optimistic that the death rate is going to be drastically different. “

Looking west

Manitoba continues to experience accelerated spread and a 13% test positivity rate. In Ontario, that number is 4%.

“Alberta is not reporting that number because of exceeding its testing regime,” Deonandan said. “So most of the signs point to Ontario being in a better position.

He said Ontario’s ability to absorb cases is better, while the length of hospital stays has decreased since the spring and has opened up more space. “But the increasing number of cases (in Ontario) is consuming that buffer that the reduced length of stay has given us,” Deonandan said.

“I suspect that we are probably quite indifferent to learning from our data,” said Furness. “Ontario is treating this as a political issue. COVID is a political problem and it is leading to some truly terrible results. “

Jenna Moon is a breaking reporter for The Star and is based in Toronto. Follow her on Twitter: @_jennamoon



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