New modelling prepared for the Ontario government predicts that COVID-19 cases will continue to drop as long as strict restrictions stay in place, even if more schools reopen and faster-spreading variants of the coronavirus gain a stronger foothold in the province.
The province’s COVID-19 science advisory and modelling consensus tables unveiled the fresh projections on the same day the province announced that elementary students in four more regions, including the cities of Ottawa and London, would return to in-person learning on Monday.
However, neither Chief Medical Officer of Health David Williams, nor Adalsteinn (Steini) Brown, co-chair of the province’s COVID-19 science advisory table, would say what criteria should be used to decide when other shuttered schools might reopen.
Schools in Toronto, Peel Region, York Region, Hamilton and Windsor-Essex are scheduled to reopen on Feb. 10. The provincial government hasn’t made clear when schools might reopen in other regions where closings remain in effect.
“We’re trying to open our schools safely, even with the presence of high community transmission, with checks and balances,” Dr. Williams said. “We’re looking at all possibilities because it is a fine balance.”
The modelling Dr. Brown presented on Thursday was much rosier than his previous report on Jan. 12, unveiled on the eve of a provincewide stay-at-home order.
At the time, case counts and hospital admissions were soaring. The modelling group projected on Jan. 12 that, if public behaviour didn’t change, the province could see anywhere from 10,000 to 40,000 new infections a day and 1,000 COVID-19 patients in intensive-care units by mid-February.
Instead, the stay-at-home order seemed to help: New Infections fell from a seven-day average of 3,555 cases a day on Jan. 11, a historic high, to an average of 2,128 cases a day as of Thursday. The new forecast expects that trajectory to continue, with new infections dropping to between 500 and 1,000 a day by the end of February if the current public-health measures stay in effect, and even if schools reopen.
The modelling projects that anywhere between 150 and 300 COVID-19 patients will be in Ontario ICUs by the end of February, down from 358 on Thursday, according to provincial data.
Dr. Brown, the dean of the University of Toronto’s Dalla Lana School of Public Health, said the projections assume the more transmissible variants of the coronavirus will have largely supplanted the existing version by March.
“I think I’d be urging that in any place where we have concern that cases may take off to maintain the public-health measures,” Dr. Brown said. “By doing that, you may be able to get kids back to school.”
Unlike in Ontario, the vast majority of Quebec students returned to in-person learning after the holidays.
The daily tally of new cases in Quebec has gradually decreased from its peak during the first week of January, when Quebec imposed an 8 p.m. to 5 a.m. curfew. The seven-day rolling average of new cases in Quebec now stands at 1,437.
Lindy Samson, chief of staff at CHEO (formerly the Children’s Hospital of Eastern Ontario), said she was pleased to hear that schools in Ottawa would reopen Monday. “The impact of not being able to do in-school learning, for many, many children and their families, is huge,” she said. “We don’t even understand what the real mid- and long-term impacts are. So [reopening schools] is the right thing to do.”
Dr. Samson stressed that the provincial government must step up efforts to curb transmission in schools, including by improving ventilation and increasing testing.
Kali Barrett, a critical care physician with the University Health Network in Toronto and a member of the province’s modelling collaborative, echoed the importance of stringent infection-control measures in classrooms. “I agree with many in infectious diseases and public health that schools should be last to close and first to open,” she said.
Still, Dr. Barrett said the situation in the province’s intensive-care units remains extremely serious.
She said it is “incredibly alarming” that more than 50 per cent of hospitals had no or only one or two ICU beds available as of this week. “We are still fighting a war in the hospitals and we can’t let our guard down yet.”
Zain Chagla, a professor of medicine at McMaster University in Hamilton and an infectious-disease physician, said he is concerned about how the fast-moving variants will hit vulnerable neighbourhoods. The modelling showed that communities with the highest proportion of essential workers continue to have the highest number of cases.
“I think all of us can guess where [the variant known as] B.1.1.7 is going to start showing up: It’s going to be on essential workers and people who can’t physically distance at work and live in multigenerational families,” Dr. Chagla said.
With a report from Tu Thanh Ha.
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