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The entrance sign to the Mount Sinai Hospital in Toronto. Uncertainty caused by the new Omicron variant of COVID-19 has cast doubt on Ontario’s previously announced plan to lift its vaccine certificate system by Jan. 17.Evan Buhler/The Canadian Press

Ontario’s science advisers are warning of a potential swell in intensive-care patients next month, as COVID-19 cases increase across the province, even without factoring in any surge caused by the new Omicron variant.

But Ontario and other provinces with Omicron cases within their boundaries as the holiday season approaches have so far announced few new public-health restrictions to contain the virus’s spread. Ontario Health Minister Christine Elliott said the province hopes to have more data on Omicron within a week before making any moves.

The uncertainty caused by the new variant has cast doubt on Ontario’s previously announced plan to lift its vaccine certificate system by Jan. 17. But neither Ms. Elliott nor the province’s Chief Medical Officer of Health, Kieran Moore, would declare for certain on Tuesday that the date would be scrapped, saying the province needs to review data over the holidays before making a decision.

The worst-case scenario outlined in projections released by Ontario’s COVID-19 Science Table on Tuesday suggest Ontario could see 3,000 new cases a day and 400 people in its hospital intensive-care units by mid-January – numbers that could be even higher given the variant, which reports suggest could be more contagious than the dominant Delta strain.

In a best-case scenario that assumes an increase in children’s vaccinations and a decrease in personal contacts, the province’s daily new infections would peak around 1,000, not far from current levels.

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The science table’s projections show that while hospitalizations and ICU admissions are stable for now, as cases continue to rise the province’s ICU occupancy will likely increase to 250 people by the end of December.

The modelling shows that ICUs could see as many as 400 COVID-19 patients by mid-January, a level that could force the province’s hospitals to once again cancel surgeries and redirect staff to care for those suffering with the virus.

COVID-19 CASE AND ICU OCCUPANCY

PROJECTIONS FOR ONTARIO

Current behaviour (e.g., no change in contacts) and 30% of five-to-11-year-olds vaccinated by end of December

Current behaviour (e.g., no change in contacts) and 50% of five-to-11-year-olds vaccinated by end of December

15% decrease in transmission through additional public health measures (e.g., decrease in contacts) and 30% of five-to-11-year-olds vaccinated by end of December

Cases

3,000

Daily

2,500

Seven-day average

2,000

1,500

1,000

500

0

Sept. 2021

Oct.

Nov.

Dec.

Jan. 2022

ICU occupancy

500

Daily

400

Seven-day average

300

200

100

0

Sept. 2021

Oct.

Nov.

Dec.

Jan. 2022

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

COVID-19 CASE AND ICU OCCUPANCY

PROJECTIONS FOR ONTARIO

Current behaviour (e.g., no change in contacts) and 30% of five-to-11-year-olds vaccinated by end of December

Current behaviour (e.g., no change in contacts) and 50% of five-to-11-year-olds vaccinated by end of December

15% decrease in transmission through additional public health measures (e.g., decrease in contacts) and 30% of five-to-11-year-olds vaccinated by end of December

Cases

3,000

Daily

2,500

Seven-day average

2,000

1,500

1,000

500

0

Sept. 2021

Oct.

Nov.

Dec.

Jan. 2022

ICU occupancy

500

Daily

400

Seven-day average

300

200

100

0

Sept. 2021

Oct.

Nov.

Dec.

Jan. 2022

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

COVID-19 CASE AND ICU OCCUPANCY PROJECTIONS FOR ONTARIO

Current behaviour (e.g., no change in contacts) and 30% of five-to-11-year-olds vaccinated by end of December

Current behaviour (e.g., no change in contacts) and 50% of five-to-11-year-olds vaccinated by end of December

15% decrease in transmission through additional public health measures (e.g., decrease in contacts) and 30% of five-to-11-year-olds vaccinated by end of December

Cases

3,000

Daily

2,500

Seven-day average

2,000

1,500

1,000

500

0

Sept. 2021

Oct.

Nov.

Dec.

Jan. 2022

ICU occupancy

500

Daily

400

Seven-day average

300

200

100

0

Sept. 2021

Oct.

Nov.

Dec.

Jan. 2022

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

But the effect of the new variant remains unknown. In South African data, vaccination appears to protect against serious illness from Omicron and most hospitalizations are in the unvaccinated, the modelling says.

Ms. Elliott said Tuesday the province has anticipated a surge and is prepared to handle up to 300 COVID-19 patients in its ICUs without resorting to cancelling other surgeries.

Dr. Moore called the modelling “disconcerting,” and urged anyone who has not been vaccinated to get their shots. He said the vast majority of ICU patients in the province are unvaccinated.

“We know these vaccines are safe, they are effective, they will decrease the severity of infection in Ontarians. And it’s absolutely preventable what is happening in our acute-care sector,” he said.

Anthony Dale, president and chief executive officer of the Ontario Hospital Association, said in a tweet on Tuesday that, “It is hard to put into words the anger and disappointment within the hospital sector at the prospect of having to provide care for another large wave of critically ill COVID patients when the vast majority will be unvaccinated. What a colossal waste.”

Ontario reported 928 new cases on Tuesday. The province’s hospitals are caring for 340 people with the virus and 165 in intensive care – 146 of whom are not fully vaccinated or have an unknown vaccination status.

Other provinces, including Prince Edward Island, also raised concerns on Tuesday about the number of recent cases of COVID-19.

British Columbia’s Provincial Health Officer, Bonnie Henry, said the province has so far recorded five cases of the Omicron variant, three of whom were fully vaccinated. All have been mild and were associated with travel to countries in Africa such as Nigeria and Egypt, as well as Iran. She said that number is expected to grow.

Alberta was up to 11 cases of the Omicron as of Tuesday, with more expected, including household contacts who were exposed to the variant and tested positive for COVID-19 but are awaiting more detailed results. At least two of those contacts attended schools, where officials have notified families who may be at risk and are distributing rapid test kits.

Deena Hinshaw, Alberta’s Chief Medical Officer of Health, said it’s too early to say whether the province will need to shift its approach.

Meanwhile, Quebec announced Tuesday that residents will be able to have private gatherings of up to 20 fully vaccinated people starting Dec. 23, up from 10, as the province expanded access to third doses of COVID-19 vaccines to health care workers, people with chronic illnesses, pregnant women and people in their 60s.

Ontario’s new modelling says a combination of increased vaccination for children 5 to 11, as well as decreased contacts and increasing public-health measures, can help slow the spread of the virus. The report did not specify which health measures should be increased. The province recently announced expanded boosters for those 50 and over, as well as people with high-risk medical conditions, starting on Dec. 13.

The science table says to avoid the worst outcomes, child vaccinations must be accelerated to at least 30 per cent by the end of December. After just two weeks, 22 per cent of Ontario children 5 to 11 have their first shot.

Ontario’s Dr. Moore also said the regional health units getting hit harder by COVID-19, such as Sudbury, Algoma and Windsor-Essex, are working with his team to put in their own stricter health rules to contain the spread in their areas. “We’re really having to try to put fires out where they come up,” he said.

The Ontario government made two other announcements Tuesday as it eyed rising cases and the Omicron variant. It paused indefinitely the lifting of capacity limits in higher-risk settings such as nightclubs, wedding receptions with dancing, and strip clubs and sex clubs. The government also said it would extend its three-day provincial sick day program, which was set to expire at the end of December, until July 31.

With reports from James Keller in Calgary and The Canadian Press

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