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Rising COVID-19 hospitalizations will strain system, even without omicron: Ontario science table

Medical student Morgyn McKerlie draws outs COVID-19 vaccine at a drive-through vaccine clinic at St. Lawrence College in Kingston, Ont., on Dec. 4, 2021. (Lars Hagberg/The Canadian Press - image credit)
Medical student Morgyn McKerlie draws outs COVID-19 vaccine at a drive-through vaccine clinic at St. Lawrence College in Kingston, Ont., on Dec. 4, 2021. (Lars Hagberg/The Canadian Press - image credit)

Ontario could see between 250 and 400 COVID-19 patients requiring intensive care in January, putting more strain on an already burdened health system, the province's science advisory table says.

The latest modelling report from the group, released on Tuesday, said that cases are rising in most public health units, and recommends continued public health measures and increasing the speed of the campaign to vaccinate children aged five to 11 against the virus.

The projected climb in cases and admissions to ICUs does not account for the presence of the omicron variant, which injects multiple layers of uncertainty into the latest modelling and could mean the forecasts are overly conservative, the group said.

"COVID will almost certainly rise through (January) even before omicron hits us in full force. Case numbers count, because too many Ontarians remain un/under vaccinated and will end up in hospital," the expert group said in a Twitter thread expanding on its report.

"We can't predict omicron precisely, but it will almost certainly hit us hard and fast."

At a news conference Tuesday afternoon, Medical Officer of Health Dr. Kieran Moore said that the modelling is "disconcerting." He also noted that unvaccinated people are driving the majority of hospitalizations and are most often the ones requiring intensive care.

"It's absolutely preventable what is happening in our acute care sector," he said.

"I am concerned about the coming months and the potential effect on our health-care system."

WATCH | Medical officer of health discusses new modelling:

Test positivity rates are climbing

Testing levels for the illness across Ontario have remained flat in recent months, while the overall test positivity rate continues to climb, suggesting a real rise in cases of COVID-19, according to the science table.

Just how much cases will climb is largely dependent on the pace of vaccinations, the group said. In a worst-case scenario — which includes no further public health restrictions, and about 30 per cent of five-to-11 year olds fully vaccinated by year's end — daily cases could rise to nearly 3,000 by mid-January.

If vaccination coverage of that demographic rises to 50 per cent by the end of December, daily cases will likely top out in the range of 1,500 to 1,800 by mid-January, the group projected.

In a hypothetical scenario in which further public health restrictions are re-introduced — leading to a 15 per cent drop in overall transmission of the virus — and 30 per cent of five-to-11 year olds are fully immunized by the end of the year, cases could flatten out around 1,100 per day by some point in January.

As of Monday, roughly 22 per cent of eligible five-to-11 year olds had received a first dose of vaccine.

WATCH | No way to further loosen restrictions in face of omicron variant, science advisor says:

While overall admissions to hospital and ICUs have remained steady in recent weeks, further increases in cases will inevitably lead to more Ontarians requiring critical care, the group said.

Hospitals are dealing with severe burnout among staff and ongoing high demand for urgent non-COVID-related care, and could therefore struggle to deal with a surge of COVID-19 patients, the table said.

Ontario can 'safely admit' 300 COVID-19 patients to ICUs: government

In a news release, the Ontario government said that investments to increase hospital capacity mean the health-care system could "safely admit approximately 300 patients with COVID-related critical illness into ICUs without putting at risk urgent surgeries.

"This would allow the province's hospital system to effectively manage the intake of ICU patients projected as the most likely scenario by expert modellers in the coming months. Ontario can quickly surge up capacity further if necessary," the government said.

In the same news release, the government said it is once again holding off on lifting capacity limits in remaining higher-risk settings where proof of vaccination is required while officials monitor health-care indicators and study the omicron variant.

Those settings include food or drink establishments with dancing like nightclubs, and wedding receptions in meeting and event spaces where there is dancing, as well as strip clubs, sex clubs and bathhouses.

"We must remain cautious in the face of the virus," Moore said.

"There's no doubt that the months ahead will require continued vigilance."

Omicron may be more transmissible than delta: science table

The confirmed presence of the omicron variant further complicates the situation in Ontario, the science table said. Early data suggests it is more transmissible than delta, and that people who have already been infected with the virus are at risk of reinfection — meaning omicron could be resistant to immunity.

That said, the early data also suggests that vaccination provides significant protection from developing severe COVID-19 symptoms from omicron.

Submitted by Region of Waterloo Public Health
Submitted by Region of Waterloo Public Health

At least 13 omicron cases have been detected so far in the province, and the London-area health unit investigating a potential cluster of 30 cases.

Toronto Public Health officials also said late Monday they are investigating the city's first school-based case of the variant, at Precious Blood Catholic School.

928 new COVID-19 cases reported Tuesday

Meanwhile, Ontario reported 928 new cases of COVID-19 on Tuesday.

Ontario's seven-day average of daily new cases is up to 975, a level not seen since the decline of the third wave in early June, and nearly a 23 per cent increase of last Tuesday.

Today's case count is a 35 per cent jump from the same time last week.

Officials have said a rise in cases this fall and winter was expected, as the weather gets colder and more activities move indoors.

Some local public health units have recently imposed stricter rules in response. Chatham-Kent Public Health was the latest to announce tighter restrictions, set to take effect Friday. The changes include lower capacity limits for indoor gatherings, with the exception of weddings, funerals and religious services. Those events must, however, ensure that capacity is limited to a number that allows for physical distancing.

Ontario: New daily cases of COVID-19

As of Monday, there were 340 people hospitalized with COVID-19, the most since Sept. 16. Of those, 165 were being treated in intensive care units, down from 168 the day before.

According to Critical Care Services Ontario, 13 more adults were admitted to ICUs yesterday and the seven-day average of COVID-19 patients in ICUs stands at 156.

The Ministry of Health also reported the deaths of nine more people with the illness, pushing the official toll to 10,036.

Here are some other key pandemic indicators and figures from the ministry's daily provincial update:

School-related outbreaks: There are currently 237 active outbreaks of COVID-19 tied to schools in the province, according to Public Health Ontario, with 219 of those in elementary schools, a new pandemic high. The previous high for elementary school-related outbreaks came on April 14, when there were 214.

Tests completed in the previous 24 hours: 26,136, with a 3.8 per cent positivity rate.

Active cases: 8,479.

Vaccinations: Nearly 81 per cent of all eligible Ontarians have had two doses.