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Health care workers attend to an ICU patient sick with COVID-19 at Brampton Civic Hospital in Ontario on May 25, 2021.Fred Lum/the Globe and Mail

Ontario’s COVID-19 cases are rising in most public health units, with hospitalizations and intensive-care occupancy rates remaining stable but ICU admissions likely to increase, according to new modelling.

On Friday, the province’s COVID-19 science and modelling advisory tables released data showing that between Oct. 26 and Nov. 8, all but eight of the province’s 34 public health units saw an increase in cases. The sharpest rise occurred in the Sudbury public health unit, which reimposed local restrictions such as capacity limits this week.

The models also state that those with lower incomes, essential workers and minority groups are at highest risk of COVID-19-related mortality, citing “different exposures” and access to testing.

The data show vaccinations continue to be highly effective in combatting COVID-19, with unvaccinated people 11 times more likely to be hospitalized and having a 26-fold higher risk of being in the ICU compared with the fully vaccinated.

With case counts rising, “the immediate future is uncertain,” because the current surge is very recent, the document said. Colder weather causing people to spend more time indoors, the lifting of capacity limits in most venues across the province and indoor gatherings are cited as the sources of recent transmission.

ICU OCCUPANCY

PROJECTIONS

FOR ONTARIO

Oct. 25: Capacity limits lift in most venues requiring proof of vaccination

600

Observed ICU occupancy

Seven-day average

500

Possible

More likely

400

Less likely

300

200

100

0

July

Aug.

Sept.

Oct.

June

2021

Nov.

Dec.

THE GLOBE AND MAIL, SOURCE: ONTARIO COVID-19

SCIENCE ADVISORY TABLE

 

ICU OCCUPANCY

PROJECTIONS

FOR ONTARIO

Oct. 25: Capacity limits lift in most venues requiring proof of vaccination

600

Observed ICU occupancy

Seven-day average

500

Possible

More likely

400

Less likely

300

200

100

0

July

Aug.

Sept.

Oct.

June

2021

Nov.

Dec.

THE GLOBE AND MAIL, SOURCE: ONTARIO COVID-19

SCIENCE ADVISORY TABLE

 

Oct. 25: Capacity limits lift in most venues requiring proof of vaccination

ICU OCCUPANCY PROJECTIONS FOR ONTARIO

600

Observed ICU occupancy

Possible

500

Seven-day average

More likely

Less likely

400

300

200

100

0

July

Aug.

Sept.

Oct.

June

2021

Nov.

Dec.

THE GLOBE AND MAIL, SOURCE: ONTARIO COVID-19 SCIENCE ADVISORY TABLE

 

Hospitalizations and intensive-care occupancy have fallen significantly from a peak in the spring, but the projections warn they are likely to rise again. On Friday, 207 people were hospitalized with COVID-19, with 130 people in ICU – 121 of whom are not fully vaccinated or have an unknown vaccination status. Modelling shows that ICU numbers could climb to between 200 and 250 people by the end of December or early January.

While previous projections from October showed cases declining, Ontario Chief Medical Officer Kieran Moore said this week that the province is seeing an increase in key indicators. These include the effective reproductive number, which represents how many cases result from one infection; the per cent of tests that are positive; and weekly case rates, which are up 30 per cent. The spread is happening mostly in the 20-to-39 age group in social settings indoors, Dr. Moore said.

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The province reported 598 new cases of COVID-19 on Friday. Ontario continues to have one of the lowest case rates in the country.

The government announced this week that Ontario is pausing further reopening for at least 28 days and delaying lifting capacity limits in higher-risk settings such as nightclubs, wedding receptions with dancing, and strip clubs and sex clubs. Other settings, such as sports venues, restaurants and bars, remain at full capacity.

In the latest brief, the science table says “a deliberate pause on reopening is the right decision at this time. Policies that support wearing masks properly indoors and getting fully vaccinated will be helpful.”

Andrew Morris, an infectious disease physician at Toronto’s Mount Sinai Hospital and University Health Network and a member of the COVID-19 Science Advisory Table, said he expects Ontario will have to do more to slow the spread of the virus.

“My personal feeling … is that this is not going to be enough, and that they absolutely are going to need to do more than just a pause in reopening, or expect to see a rise in cases like we see in other jurisdictions,” he said.

“The uncertainty is whether all the favourable conditions that we have in Ontario will attenuate the rise.”

Dr. Morris said Ontario could improve how it communicates with the public about the importance of public health measures, as well as better enforce current restrictions, such as checking vaccine certificates and proper indoor masking. He said there is also a need to improve ventilation in more public spaces as people move inside.

Ontario has implemented a vaccine-passport system, but the government has announced that it plans to gradually lift proof-of-vaccination requirements beginning Jan. 17, “in the absence of concerning trends in public health.” Remaining public health measures, such as masking in indoor public spaces, will be lifted beginning on March 28, the government announced previously.

Alexandra Hilkene, a spokeswoman for Health Minister Christine Elliott, said that Friday’s modelling “supports Ontario’s cautious and gradual plan for reopening,” including the decision to pause the lifting of capacity limits next week.

“There’s no question that the months ahead will require continued vigilance, and the modelling rightly points out that some jurisdictions are struggling as they continue to face the fourth wave of COVID-19,” she said. “That’s why Ontario continues to take a different approach by maintaining strong public health measures such as indoor masking and proof of vaccination requirements to access higher-risk settings.”

Also on Friday, the province announced that it has extended the deadline for long-term care workers to get fully vaccinated against COVID-19.

The latest figures show 98 per cent of staff in long-term care homes have now received at least one dose, and 95 per cent are fully vaccinated. However, data from 57 homes is still not available because of a technical issue, the Ministry said.

Staff, support workers, student placements and volunteers now have until Nov. 15 to provide proof of one dose, and until Dec. 13 to provide proof of two doses, in order to enter long-term care homes in the province.

The previous deadline for full vaccination was Nov. 15, but the province said it was pushed back based on recent advice from the National Advisory Committee on Immunization, which now recommends eight weeks between doses.

Editor’s note: A previous version of this story said Nov. 12 modelling data showed unvaccinated people were 17 times more likely to be hospitalized and had a 23-fold higher risk of being sent to the ICU compared to the fully vaccinated. This information was based on Oct. 22 modelling. The Nov. 12 data show unvaccinated people are 11 times more likely to be hospitalized and have a 26-fold higher risk of being in the ICU compared to the fully vaccinated. This version has been corrected.


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