On a day when new restrictions were imposed on Toronto and the Region of Peel in an attempt to rule over record daily COVID-19 cases in recent weeks, a hospice doctor specializing in long-term care said he was “Terrified” by the growth in nursing home cases as winter approaches.
“We know coronaviruses are seasonal viruses,” said Dr. Amit Arya, executive director of the Canadian Society of Hospice Palliative Care Physicians and Clinical Assistant Professor in the Department of Family Medicine at McMaster University.
“We’ve had months over the summer to prepare for this, to respond especially in long term care where the biggest impact of the first wave has been. As cases and mortality start to accelerate in long-term care, it is absolutely devastating to see and hear about it, ”he said.
“Winter is just beginning. We are not at the same point as in the first wave.
Of the 2,150 residents of Ontario long-term care facilities who have died from the virus since the start of the pandemic, 305 have died since August 1 (Ontario as a whole has reported 711 deaths from COVID-19 since then.)
Meanwhile, local Ontario public health units reported 1,451 new cases of the virus as of Monday afternoon. Most of these cases were from Peel Region (406), Toronto (331) and York Region (169), accounting for 62% of new cases in the province.
Here we present the weekly roundup of Star’s key metrics in our battle against COVID-19, including an overview of the situation in other provinces, as well as expert commentary.
Peel and Toronto continue to increase cases in Ontario
Together, Peel and Toronto accounted for about half of the new cases in the province reported Monday afternoon.
Dionne Aleman, a professor at the University of Toronto and expert in pandemic modeling, said Peel’s case numbers were “really, really surprising given that Toronto has a much larger population.” The region has 1.5 million people, about half that of Toronto.
Aleman says it’s difficult to determine why Peel is such a hot spot, but that it could be due to a number of factors, including an addiction to public transit – which could mean greater exposure to the virus – multigenerational life situations or even a setting workplace.
“They might not have the luxury of being able to work from home as much as people who live in cities,” Aleman said. “I’m really not sure these current measures will really be enough to mitigate this.”
During the first lockdown, when only essential services were open, the province experienced summer days when the total number of new cases was less than 100.
“The lockdown we had at the start of the summer was extremely effective,” said Aleman.
But she doubts it will see such solid results.
Stores still offer curbside pickup, which means employees in those settings get to work, perhaps by public transit, while people who work in offices can get to work as well.
Toronto’s St. Lawrence Market is open, as is the Hudson’s Bay store on Queen Street, as well as other department stores that sell basic necessities.
Aleman added that she hoped the new restrictions on the movement of people “will signal a lot of people to be much more careful and to reconsider their attention and caution during the summer.” “
The summer months also meant the kids weren’t in school. Aleman said if the number were too high, the province could close schools, although the decision would be difficult.
“Children’s development, their socialization and their ability to learn at home are very concerned,” Aleman said. “There is nothing to sniff. You don’t want to just rule it out. And if our ultimate goal is to keep schools open for our children, then we need to be much more hypervigilant and restrained everywhere else.
She says given the current trajectory of the virus, the government’s projection that we could reach 5,000 or 6,000 new cases per day by December is realistic.
Growth of long-term care homes
Ontario’s long-term care homes continue to fight to stop the second wave of COVID-19 from breaking through their walls.
Arya, the palliative care doctor, noted that due to the lack of staff in long-term care facilities, staff members are unable to create bubbles in the facilities.
“It becomes impossible to do the job well because the sheer volume of medically complex (residents) is so high, and then you have too many contacts,” he said, adding that the ideal case would be for groups of Health workers have the capacity to work in the same unit, care for the same people, and guarantee employees a living wage, sick leave and the ability to work in one home.
There were 528 infections from active residents in Ontario long-term care homes as of November 22, up from a second wave high of 721 on November 13. As of August 1, there were only 10 cases of COVID-19 among residents of Long-Term Care in Ontario. Staff cases now stand at 467, down from the second wave high of 541 on November 17.
Meanwhile, the number of outbreaks with active outbreaks as of November 22 was 101, down from 20 on August 1, with a high of 108 reaching on November 16. The facility with the largest number of current resident infections is Rockcliffe Care Community. , a 204-bed facility in Scarborough, with 53 active cases, followed by the 160-bed Harmony Hill Community of Care in East York, with 36 active cases.
Arya noted that although many residents of these facilities survive COVID-19, “their lives are forever changed by the virus.
“We can imagine how bad it would be for someone who is already old and has other illnesses. Once they receive COVID, they may not be counted in the death statistics, but they are bedridden, ”said Arya, who has witnessed the spread of the virus while working in the hospitals. GTA facilities during the first wave. “People, whether or not they survive COVID-19, have the right to care and they have the right to be free from pain.”
Newfoundland and Labrador and Prince Edward Island leave the Atlantic bubble
For the past four and a half months, Canadians from all four of Atlantic Canada’s provinces have been allowed to cross those provincial borders without having to self-quarantine in what has become the Atlantic bubble.
But on Monday, that all changed with the announcements of the premiers of Newfoundland and Labrador and Prince Edward Island.
Newfoundland Premier Andrew Furey said on Monday he had made the difficult decision to “put in place a blackout” as his province left the bubble for two weeks.
A little later, the Premier of Prince Edward Island, Dennis King, announced that his province would also be leaving. The travel means visitors from those two provinces, including those from the rest of the Atlantic provinces, New Brunswick and Nova Scotia, will be required to self-isolate for 14 days upon arrival. In addition, travel to and from these provinces will be limited to essential travel for two weeks.
Newfoundland currently has 23 active cases of COVID-19, including two new confirmed cases announced on Monday. Prince Edward Island reported its first new case of the virus in nearly two weeks on Monday and has recorded a total of 69 cases since the start of the pandemic.
Newfoundland closed schools in the area that had the most recent cases for a few days, in order to understand what was going on, Aleman said; students in one class were placed in segregation for two weeks.
“They’re really taking very quick and quick action, which will help them get back to a place where there’s no case,” said Aleman, who compared the situation in those two provinces with an area in Ontario. like Peel, who has seen hundreds of new cases. cases every day for the past few weeks.
“It becomes virtually impossible to respond quickly to each of these cases,” said Aleman. “As we know, our contact tracing has been more or less suspended in Toronto and Peel because there are just too many cases to contact. So we can’t really know for sure where people are infected. Is it at their workplaces? Is it in schools? Is it at the gym? Is it retail?
“If we don’t know where people are infected, we can’t apply really targeted restrictions,” Aleman said. “We really only left this unique tool of foreclosure.”
Alberta is open for business
Cases are increasing in the Western Province, but this is not surprising given that Alberta is quite open for business.
The province had 12,195 active cases on Sunday, almost as many as Ontario, despite a population one-third the size of Ontario.
“The numbers are insane,” said Jim Kellner, a pediatrician with a subspecialist in pediatric infectious diseases and professor at the University of Calgary. “They really took off. Our rates of new cases per day are extremely high… It’s not surprising, but it is very distressing. Cumulative cases total 46,872.
The province has some restrictions in place, such as banning indoor fitness classes, closing alcohol sales after 10 p.m. in restaurants, and banning residents from socializing with people outside of the city. their home.
But Kellner said people can still go to gyms – although he said there’s not much evidence that gyms or restaurants are a problem – and people can get together in groups. of 15 outside the home in restaurants and other venues, as well as in cohorts of up to 50 when it comes to sports teams or the performing arts.
Kellner said the province was doing extremely well at the start of the pandemic, when it was in addition to testing and contact tracing. And deaths are still lower per capita than Quebec and Ontario.
But he said hospitalizations were on the rise and positivity rates were around 6%, much higher than they were from June to October, when the rate hovered around 1%.
Class sizes are also unchanged, and ventilation is an issue at school, although K-12 students wear masks. But some schools have seen large epidemics with up to 40 cases.
He said cases in schools may reflect the spread of the community, but suggested that a longer vacation period would be better than doing nothing to control cases in schools. Contact tracing in Alberta has also been behind schedule, he said.
“Too many contacts are allowed,” Kellner said. “It’s that simple, in a desire to keep the economy open.”