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Ontario is in 'twice the red' level, needs a 'hard lockdown' to flatten COVID-19 case growth, modelling reveals

Elisabetta Bianchini
·5-min read
COVID-19 in Canada
COVID-19 in Canada

For more on today’s top stories and the spread of the novel coronavirus across the country, please refer to our live updates below throughout the day, as well as our COVID-19 news hub.

Ontario’s latest COVID-19 modelling data still shows that the province is in a “precarious” position and a “hard lockdown” is needed.

“We do need to have measures that will reduce people’s interaction with other people that don’t live in their household,” Dr. Barbara Yaffe, Ontario’s associate chief medical officer of health said.

“The earlier work starts to reduce the contacts between people and support people who need to isolate at home, the lower the case numbers will be,” Dr. Adalsteinn Brown, co-chair of Ontario’s COVID-19 science advisory table added.

Ontario's COVID-19 science advisory table
Ontario's COVID-19 science advisory table

The data released on Monday shows that Ontario’s case levels are twice the “red” level, also known as the “control” level, referring to the zone in the province’s COVID-19 response framework just before lockdown.

All public health units are at or above the “restrict” or “orange” threshold, seeing more than 25 cases per 100,000 people.

The five zones of public health measures for COVID-19 in Ontario. Currently, with an average of over 2,000 cases a day, most impacted regions in the province have doubled the case-number for "Control" level, thereby pushing the province into "Grey", or "Lockdown".
The five zones of public health measures for COVID-19 in Ontario. Currently, with an average of over 2,000 cases a day, most impacted regions in the province have doubled the case-number for "Control" level, thereby pushing the province into "Grey", or "Lockdown".

If Ontario continues with case growth between one to three per cent , the province will see between 3,000 and 5,000 cases a day by the fourth week of January. The case growth increases to seven per cent, Ontario will see more than 30,000 cases a day by the end of January.

“We’re in a place still with very, very strong growth potential,” Dr. Brown said.

Ontario's COVID-19 science advisory table
Ontario's COVID-19 science advisory table
Ontario's COVID-19 science advisory table
Ontario's COVID-19 science advisory table

Dr. Brown highlighted that although Ontario is seeing “a little bit” of a flattening in test positivity, overall it is much higher with an increase of about 30 per cent to 50 per cent since the beginning of last month.

Ontario's COVID-19 science advisory table
Ontario's COVID-19 science advisory table

“We are in a very, very challenging situation in terms of control of the disease,” Dr. Brown said.

Ontario's COVID-19 science advisory table
Ontario's COVID-19 science advisory table

There is also significant regional variation in the number of public health units that are able to get test results back to people in two days.

“Getting test results back to people quickly is critical to the control of the disease, it’s critical to helping people isolate, it’s critical to case and contact tracing,” Dr. Brown said.

Ontario's COVID-19 science advisory table
Ontario's COVID-19 science advisory table

The increase in hospitalizations has decreased from the last time modelling data was presented, earlier this month, from about 92 per cent to about 69 per cent. The increase in the number of ICU patients with COVID-19 has also decreased from about 166 per cent to about 83 per cent.

“This pattern of growth at a substantial level continues, as it has pretty much since we began these briefings,” Dr. Brown said.

Ontario's COVID-19 science advisory table
Ontario's COVID-19 science advisory table

Under any of the modelling projections, ICU occupancy will still be above 300 beds by the end of December, even under a zero per cent growth scenario. In a seven per cent growth situation, there will be about 1,500 ICU beds occupied with COVID-19 patient by mid-January.

Ontario's COVID-19 science advisory table
Ontario's COVID-19 science advisory table

“With lower case numbers we can maintain safe ICU care for COVID-19 and non- COVID-19 patients who require it,” the key findings from the modelling data reads.

Ontario's COVID-19 science advisory table
Ontario's COVID-19 science advisory table

ICU occupancy in the province is not spread out by a small amount across Ontario, Dr. Brown identified that it is “clustered” in regions with the most COVID-19 spread.

Ontario's COVID-19 science advisory table
Ontario's COVID-19 science advisory table

Dr. Brown also stressed that the biggest predictor of an outbreak in a long-term care home is spread in the communities around these facilities.

Ontario's COVID-19 science advisory table
Ontario's COVID-19 science advisory table

“These communities, from where people who work in long-term care homes come, are the same communities that face the long-standing structural barriers around access to suitable housing, the need to work in essential frontline work...and multigenerational housing, that lead to higher spread,” he said.

Ontario's COVID-19 science advisory table
Ontario's COVID-19 science advisory table

If case rates continue, Ontario will most likely see an estimate of about 50 deaths a day by mid-February.

Ontario's COVID-19 science advisory table
Ontario's COVID-19 science advisory table

When looking at international jurisdictions, they have all seen growth until some form of more stringent or “lockdown” measures were implemented.

“There’s been no self-correction in the disease in any of the jurisdictions,” Dr. Brown said. “You will likely see continued case growth and a [greater] risk of that accelerated case growth.”

Ontario's COVID-19 science advisory table
Ontario's COVID-19 science advisory table

Dr. Brown stressed a “hard lockdown with very, very clear communication” and strong enforcement is needed. He added that there is a need for support to people during any lockdown period.

“Based on what we saw in Australia and France, cases will continue to grow...for a period of time, then the decline in contact between people will start to take over and case numbers will come down,” Dr. Brown said.

Ontario's COVID-19 science advisory table
Ontario's COVID-19 science advisory table

A lockdown for the duration of about four weeks could bring case numbers down under 2,000 per day, while a six-week lockdown would bring case numbers down under 1,000 cases a day.

“If there’s a lot of social interaction around the holiday time...you actually will still get to a place where the total case number exceed 5,000 before you start to come down and it will take about 50 per cent longer to get the numbers under 1,000 cases per day,” Dr. Brown said.

Ontario's COVID-19 science advisory table
Ontario's COVID-19 science advisory table

Changes in mobility will take a time to result in a reduction in the number of cases but Dr. Brown stressed that stringency is important.

The earlier any lockdowns begin, the more case numbers will be able to be reduced.

Check out our COVID-19 in Canada topic page for latest news, tips, health updates, cases and more.