As Ontario enters its second week of lockdown, COVID-19 cases in the province continue to climb and five more health units fall into an increased risk category – with greater restrictions – in a bid to reduce infections.
“Obviously, we need patience, which is difficult because we always see an unacceptable number of new cases per day,” said Dr. Isaac Bogoch, infectious disease specialist at the Toronto General Hospital Research Institute and the ‘University of Toronto.
“But we weren’t expecting to see significant changes for about 10-14 days. It is a little too early to assess whether this is successful or not. “
As of Monday evening, local Ontario public health units reported a total of 1,832 confirmed or probable cases of COVID-19 and 13 deaths. This brought the seven-day moving average to a new high of 1,657 cases per day.
Bogoch said he believes more needs to be done to address factors underlying the infection in the community that may not be affected by the lockdown policy.
“There are a lot of sectors of the economy that are still open and people could be at risk in those areas. On top of that, there may be people at risk in these areas who go to intergenerational homes and infect other people, ”he said. “There may still be people who organize private meetings and meet in their homes. It is therefore other factors of the epidemic in Ontario that are more difficult to combat.
Here, we take stock of Ontario’s battle against COVID-19 with expert commentary and take a look at some European countries to see how they stack up against Canada.
Toronto and Peel remain under lock and key
Peel public health officials have targeted some of the underlying drivers of the pandemic, including non-cooperative businesses that have had cases or outbreaks.
On November 16, a section 22 order went into effect in the region, fining employers and operators $ 5,000 per day who failed to take the necessary steps to prevent or stop the spread of the disease. COVID-19.
Peel’s medical officer of health Dr Lawrence Loh said that while many companies are cooperative, some do not “participate in our investigations or take action to protect their workers”, such as asking an infected employee to stay on. the house, he said, adding that he had seen a higher level of compliance since the order was issued.
Cases continue to rise in the region, but more slowly, said Loh, which he says is a combination of the positive results of the Section 22 order and the lockdown, combined with more cases as a result. two-week Diwali and Bandi Chhor Divas festivities. since.
Like Bogoch, he believes we could see the results of the lockdown by the end of this week.
“That’s what I’m hoping for at least, that we’ll see a plateau and then hopefully it starts to go down,” Loh said.
Toronto reported 643 cases on Monday, a new high for daily cases, which have fluctuated over the past week, up from 331 last Monday.
Dr Eileen de Villa, the city’s medical officer of health, told a press conference on Monday that “the infections that we are seeing lately have occurred a week or even two weeks ago,” a reminder that the town is still in its early stages from the current lockdown.
“The high number of cases is largely under our own control. The same goes for our countdown, ”said de Villa. “I know there is a real awareness of what we can do individually to play our part, as I know a lot of people do. And I am convinced that we will achieve good results if we do just that.
Deaths in Toronto and Peel have recently accelerated.
Since the start of October, 421 people have died in Toronto from COVID, up from 22 deaths in the previous two months.
“We know death is a lagging indicator,” Bogoch said, “and I certainly wouldn’t be surprised if they climbed again. It takes time.
“But when we start to see between 1,500 and 1,700 new cases a day… some of these people are going to be hospitalized, some of these people are going to need intensive care and some of these people are going to die of the disease.
“Unfortunately, we have to take an approach that we listen to because we are going to see these numbers increase. “
Five Ontario Regions Tighten Restrictions
Windsor-Essex County has 424 active cases, ranking it 10th in the province for active cases. The health unit was moved to the red category, or control, by the province on Monday, meaning social gatherings inside will be limited to five and restaurants can seat a maximum of 10 people inside. , although weddings and funerals can continue at 30% of the venue’s capacity or 100 people outside.
The region has a population of 428,556, about 50,000 less than the Niagara region, and more than double the active cases, according to an analysis by Star’s Andrew Bailey.
At a press conference on Friday, the area’s medical officer of health asked residents to keep a travel diary to help public health trace contacts should it become necessary.
“Have a plan,” said Dr Wajid Ahmed, the region’s medical officer of health. “Don’t wait for public health to tell you to isolate yourself and do all of this.”
Ahmed said that in the past three weeks an average of 40 cases are identified every day and put a strain on public health.
There are also numerous outbreaks in the region, including seven in workplaces and one in a hospital which Ahmed said he did not lightly report due to the pressure it would place on the community.
“The bottom line is we’re getting worse,” Ahmed said. “We certainly don’t want the whole public health system to collapse. Or the acute care system collapses.
“We don’t have three or four hospitals in the region that can support this reorientation of patients. It was not an easy decision to declare an epidemic in the hospital. We recognize this will have a huge impact on patient admissions and transfers. “
The province has also downgraded four other health regions, moving Haldimand-Norfolk to orange, or the restricted category, which means intermediate measures such as limiting private social gatherings indoors to 10 people and 50 for organized events. indoors.
Hastings and Prince Edward Counties Public Health, Lambton Public Health, and the Northwestern Health Unit have moved to the yellow or protection category.
Norway leads the way
In Europe, leaders are desperately trying to reduce daily COVID-19 infections with a series of restrictions before the Christmas holidays. And in at least one European country – Norway – there are signs that infection control measures may have started to bear fruit.
In early November, the country introduced its toughest rules yet in an effort to curb the spread. These included limiting private gatherings in public spaces and places rented to 20 people; deny entry to travelers from high-risk countries unless they show proof of a negative COVID-19 test taken within the last 72 hours; a recommendation that people stay at home as much as possible; and a ban on the serving of alcohol in restaurants and bars after midnight. In the capital, Oslo, places where people congregate, such as cinemas, theaters and swimming pools, have been closed, while the service of alcohol in any establishment at any time was banned.
“There is light at the end of the tunnel. We have to hold on, ”Norwegian Prime Minister Erna Solberg said last week.
Three weeks ago, Norway and Canada had almost the same number of new confirmed cases per day per million (about 107 cases on a seven-day moving average). As of November 29, the trends in the two countries have diverged considerably, with Norway falling to about 58 new daily confirmed cases per million and Canada to about 144 new daily cases per million.
The European Center for Disease Prevention and Control reports that Norway currently has a 14-day cumulative number of COVID-19 cases per 100,000 out of 141.2, the third lowest in Europe (Iceland and Finland, respectively, have the lowest of these measurements).
One of the reasons for Norway’s relatively good fortune to date is its relationship between citizens and government, said Dr Colin Furness, infection control epidemiologist at the University of Toronto.
“It is a socialist country,” he said. “They take very high taxes and in return they receive a lot of government services. So there is a lot of orientation towards the collective right here. Show me a population that denounces the payment of taxes and I will show you a population that promotes iniquity and every man for himself. Which population will do better when you need collective action? “
He added that the decision to halt alcohol sales was smart. “If you think culturally, what they’re really saying is that restaurants aren’t the place to be. At home, this is the place to be, and this is where the alcohol is.
England’s month-long lockdown will end on Wednesday, but new restrictions will immediately come into place. The country will be divided into three “tiers” depending on the severity of the risk of infection. Most of the country will be in levels 2 and 3, or “high” and “very high.”
“They certainly didn’t come out of the woods,” Furness said. “Public Health England has done an extremely bad job and the government trying to run the show has done a worse job. It’s a real mess.
London, for its part, will skip Level 3 and move into Level 2, meaning bars and restaurants will be able to reopen, as well as gyms, shops and personal care services. Regions in level 3 will have their bars, pubs, cafes and restaurants remain closed, as well as indoor entertainment venues, such as cinemas. Officials are also telling people living in level 3 areas not to travel outside of their region.
The major cities that will remain at level 3 are Greater Manchester, Bristol and Birmingham.
The UK currently has the third highest number of cumulative 14-day cases in Europe, at 372, just behind Spain and France. The UK also has the third highest number of cases since the start of the pandemic (1,617,327), behind Spain (1,628,208) and France (2,218,483), according to the European Center for Prevention and disease control.
“The countries that have done quite well, Iceland, Taiwan, New Zealand, are islands. They can literally go up the drawbridges and say that we are not going to welcome people and that we are not going to travel for a while. The UK could have done it, but it didn’t.
With files from Ed Tubb