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Public-health officials, infectious disease experts and provincial data show that B.C.'s and Alberta’s efforts to flatten the curve may be starting to pay off. By contrast, Ontario and Quebec – a patient seen here being wheeled to the emergency unit of the Verdun Hospital in Montreal on April 6, 2020 – appear to be in an uphill battle.

Paul Chiasson/The Canadian Press

Two distinct narratives are emerging in Canada’s battle to contain COVID-19, with hard-hit Western provinces showing signs of progress in containing the spread while Ontario and Quebec are struggling to get growing outbreaks under control.

The country is in the midst of a critical period, during which officials are closely watching the number of new COVID-19 cases, hospitalizations and deaths to determine whether bans on gatherings and the shutdown of schools, restaurants, playgrounds and stores are enough to slow the spread of the virus, or if stricter measures are needed. As of Monday, there were more than 16,500 confirmed cases of COVID-19 in Canada and 322 deaths, more than double the figures from a week ago.

Public-health officials, infectious disease experts and provincial data show that B.C.'s and Alberta’s efforts to flatten the curve may be starting to pay off. By contrast, Ontario and Quebec appear to be in an uphill battle.

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The number of confirmed cases in B.C. was 1,266 on Monday, compared with 970 one week ago. Alberta reported 1,348 cases on Monday, up from 690 a week ago.

The changes in Ontario and Quebec are more dramatic. On Monday, Ontario reported 4,347 cases, more than 2.5 times the number of confirmed cases from a week earlier. In Quebec, there were 8,580 cases on Monday, a significant rise from 3,430 one week earlier.

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Experts say Quebec’s jump in cases is due to a combination of factors, including an earlier March break that occurred before any social-distancing policies were enacted, broader testing and the inclusion of presumptive cases in the provincial total.

Theresa Tam, Canada’s Chief Public Health Officer, said it’s difficult to say why the situations in B.C. and Alberta are so distinct from Ontario and Quebec. Dr. Tam said it could be that Western provinces started to experience outbreaks before central provinces, but regardless, she and other health officials will be watching the situation closely.

“It’s always very difficult to make any pronunciation on this,” Dr. Tam said during a conference call with reporters on Sunday. “It is a day-by-day look.”

Given the variables in testing for COVID-19 in each province, infectious disease experts say they are looking to rates of hospitalization and admission into intensive-care units as a more reliable indicator of where the curve is headed.

As of Monday, B.C. had 140 patients hospitalized, with 72 of them in ICU. By comparison, one week ago, there were 106 patients hospitalized in the province with COVID-19 and of those, 60 were in ICU.

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B.C.'s provincial health officer says timing, luck and good planning appear to be factors in the lower rate of COVID-19 infection compared with Quebec and Ontario. Dr. Bonnie Henry says March Break came later in B.C. than Quebec and Ontario, and health officials in those provinces reported people returning from holiday with the virus. The Canadian Press

In Alberta, 40 patients were hospitalized with COVID-19 as of Monday, with 16 of those in ICU. A week earlier, there were 28 people hospitalized, with 11 in ICU.

The rates of increase are much higher in Ontario and Quebec. On Monday, Ontario reported having 589 patients hospitalized, more than double the number from six days earlier, last Tuesday, when there were 291 patients hospitalized. (Barbara Yaffe, Ontario’s Associate Chief Medical Officer of Health, did not provide the number hospitalized last Monday.) And there were 216 patients in ICU on Monday, compared with 100 a week earlier.

In Quebec, there were 533 people hospitalized and 164 in ICU as of Monday, more than double the totals from a week earlier. Last Monday, there were 235 hospitalized, with 78 in ICU.

cumulative daily covid-19

cases in canada

As of April 6

8,000

Que.

Ont.

6,000

B.C.

Alta.

Atlantic

4,000

Sask.

Man.

Territories

2,000

Repatriated

0

March 1

March 15

April 1

Report date

cumulative daily covid-19 cases in canada

As of April 6

8,000

Que.

Ont.

6,000

B.C.

Alta.

Atlantic

4,000

Sask.

Man.

Territories

2,000

Repatriated

0

March 1

March 15

April 1

Report date

THE GLOBE AND MAIL, SOURCE:

Dalla Lana School of Public Health

cumulative daily covid-19 cases in canada

As of April 6

8,000

Que.

Ont.

6,000

B.C.

Alta.

Atlantic

4,000

Sask.

Man.

Territories

2,000

Repatriated

0

March 1

March 15

April 1

Report date

THE GLOBE AND MAIL, SOURCE: Dalla Lana School of Public Health

“It’s concerning watching this progress,” said Isaac Bogoch, an infectious diseases physician at Toronto General Hospital. “We don’t know what lies ahead. ... We do know that if we do continue along this trajectory, we’re going to be in trouble in terms of hospital and ICU capacity.”

On Monday, Quebec Premier François Legault highlighted the fact hospitalizations only increased by eight on Monday compared with Sunday, suggesting this could be a sign of a positive trend.

But in Ontario, infectious disease experts say there are serious problems that continue to threaten the province’s ability to contain COVID-19.

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Ontario has the lowest testing rate of any province, with only 517 out of every 100,000 people being tested as of Monday. By comparison, Alberta does 1,469 tests for every 100,000 people, while Quebec does 1,157 and B.C. does 949.

David Fisman, an epidemiologist at the University of Toronto’s Dalla Lana School of Public Health, said Ontario’s testing rates mean provincial officials don’t know the true scope of the outbreak, which makes the disease harder to contain.

“Getting tested for COVID is basically a luxury item in Ontario,” said Dr. Fisman, who is also an attending physician at Toronto Western Hospital. “We’re still flying blind here in terms of the epidemic in Ontario."

The number of ICU admissions in Ontario appears to have slowed somewhat in recent days, Dr. Fisman said. But outbreaks at long-term-care homes, hospitals and other institutions remain a major problem in the province.

Ontario had reported 46 COVID-19 outbreaks at long-term-care homes and 10 at hospitals as of Monday. Spread of COVID-19 at Quebec long-term-care homes is also a huge problem, with nearly a quarter of the province’s care facilities experiencing an outbreak.

Dr. Fisman, who is following the situation in Ontario closely, said the growth in outbreaks at long-term-care homes and other institutions is an urgent problem that needs a clearer response from the province.

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“That’s clearly been an area of vulnerability,” he said. “I haven’t seen any strategic plan from the province.”

A spokeswoman for Ontario Health Minister Christine Elliott said nursing homes and other institutions are expected to have their own pandemic plans, but that the province has been providing them with guidance throughout the outbreak.

With a report from Les Perreaux

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