6-week stay-at-home order, strict new measures needed to control 3rd COVID-19 wave in Ontario, experts say

·6 min read
Adalsteinn Brown, co-chair of the province’s science advisory table, says given the current rate of growth in COVID-19 cases in Ontario, it would take very strict public health measures and as many as 300,000 vaccinations a day to significantly flatten the curve by the end of June. (Frank Gunn/The Canadian Press - image credit)
Adalsteinn Brown, co-chair of the province’s science advisory table, says given the current rate of growth in COVID-19 cases in Ontario, it would take very strict public health measures and as many as 300,000 vaccinations a day to significantly flatten the curve by the end of June. (Frank Gunn/The Canadian Press - image credit)

Ontario needs at least a six-week stay-at-home order with an average of 100,000 vaccinations per day to get the third wave of COVID-19 now gripping the province under control, a panel of experts said Friday.

"Without stronger system-level measures and immediate support for essential workers and high-risk communities, high case rates will persist through the summer," Ontario's COVID-19 science advisory table said in its latest update, echoing recommendations it has been making for months.

This latest update came on the same day as new provincial restrictions were introduced extending the stay-at-home order by two weeks, promising more vaccines for harder-hit neighbourhoods, and limiting inter-provincial travel.

Adalsteinn Brown, co-chair of the group of experts that advises the government on its pandemic response, presented the table's latest modelling at a news conference this afternoon. He was joined by Dr. David Williams, Ontario's chief medical officer of health.

You can read the full presentation at the bottom of this story.

On course for 10,000 cases per day by May

Cases of the illness are rising in most of the province's 34 public health units, and the province-wide test positivity rate has climbed to 7.9 per cent. That figure is higher than 10 per cent in Toronto, Peel and York regions.

Charting out Ontario's current trajectory — with what Brown describes as "moderate" public health restrictions in place for four weeks, along with approximately 100,000 vaccines administered per day — Ontario could see more than 10,000 new cases per day by late May, and 15,000 by late June.

The pace of vaccinations is simply not enough on its own to contain increasing transmissions of the virus, he continued.

In fact, even with stricter public health measures in place and about 300,000 vaccinations administered per day, it could take until the end of June to see cases counts drastically reduced.

"It really requires everyone to pull together," Brown said.

He did note that things could have been worse, saying that without the measures that are currently in place, Ontario could have been on track to see more than 30,000 new infections per day by the end of May.

Growth in ICU numbers 'baked in' for 2 weeks

Hospitalizations and ICU levels are also at all-pandemic highs, "compromising care" for all Ontarians and causing the backlog of surgeries and procedures to grow, said Brown.

"Notice that our hospitals can no longer function normally. They are bursting at the seams, we are setting up field hospitals," he said, alluding to a field hospital in the parking lot at Sunnybrook Hospital in Toronto.

"Our children's hospitals are admitting adults. This has never happened in Ontario before. It's never happened in Canada before."

Many intensive care units in particularly hard-hit areas of the province were never able to fully recover from the second wave of the pandemic that peaked in January, Brown added. They are now approaching a breaking point.

Health-care workers move through the intensive care unit (ICU) at Scarborough Health Network’s Centenary Hospital, in north-east Toronto, on Apr. 8, 2021. The number of COVID-19 patients in Ontario ICUs reached an all-time high this week.
Health-care workers move through the intensive care unit (ICU) at Scarborough Health Network’s Centenary Hospital, in north-east Toronto, on Apr. 8, 2021. The number of COVID-19 patients in Ontario ICUs reached an all-time high this week. (Evan Mitsui/CBC)

Under any scenario, ICU admissions are expected to top 800 in the coming weeks. With only the current measures in place, admissions will still likely exceed 1,000, Brown said. Continued impacts for critical care units are now "baked in" for at least two weeks given growth in overall cases.

The "longer and stronger" public health measures remain in place, Brown said, the more it will drive down admissions to intensive care.

Dr. Kali Barrett of the University Health Network, reacting immediately after the province's presentation, called the numbers that were unveiled "catastrophic."

"The health-care system is now buckling down and going to the trenches to fight the battle of our lifetime," she said.

Where Ontario went wrong after Christmas

Part of the problem, Brown explained, is that Ontario began easing public health measures during the brief lull between the second and third waves of the pandemic. During this time, the prevalence of variants of concern — which are more transmissible and increase the risk of both hospitalization and death — exploded.

The science table reported as early as late January that if the spread of variants was not brought under control, Ontario was facing a potential "disaster" scenario. Revised projections published in March built on those concerns, forecasting up to 8,000 cases per day by the end of April if action was not taken.

"This is what we were expecting moving forward if we relaxed public health measures" coming off the second wave, Brown said.

Ford and his government imposed a month-long stay-at-home order on April 8, one week after moving the whole province into a "shutdown."

Another key issue is mobility. The current stay-at-home order has reduced how much people are moving around, based on cell phone data, but not nearly as much as the order that kicked in Boxing Day 2020.

What restrictions would help?

Brown offered several key recommendations for curbing the ongoing third wave, many of them measures the science table has repeatedly called for without corresponding action from the government.

Among them is a paid sick leave program for essential workers that offers easier, quicker access to money than the federal option currently in place. Ford and his cabinet have thus far refused to offer such a program.

Other recommendations to the province include:

  • "Double down" on vaccinations in the highest-risk communities.

  • Limit what businesses are allowed to stay open and enforce the rules.

  • Limit mobility into Ontario and within Ontario.

  • Make essential workplaces safer

The province did say Friday it would limit travel, reduce the capacity of essential stores to 25 per cent, and promised to give 25 per cent more vaccines to hot-spot areas. You can read more about those restrictions here.

When asked Friday why the province would not consider closing some non-essential warehouses, manufacturing, and other large workplaces, Premier Doug Ford responded that shutting down one manufacturing workplace would affect Ontario's supply chain and prevent the province from making the products it needs.

Both Brown and Dr. David Williams also made appeals to individual Ontarians — though they were notably different in tone.

"I know we're tired, I know we're demoralized, and I know some of us are heartbroken," said Brown, before asking people to stick to the basics of not seeing others indoors, mask-wearing and distancing, and getting a vaccine as soon as you are eligible.

"There's been a sense among the public that this pandemic really is not such a big deal," said Williams during his turn to speak. "You really have to take this seriously now."