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Ontario Health Minister Christine Elliott attends the Ontario-Quebec Summit in Toronto in September.

Chris Young/The Canadian Press

Ontario could hit 6,500 COVID-19 cases a day by mid-December, surpassing the rates of growth in European countries that are now in lockdown, new projections done for the provincial government show.

The situation in Ontario has been worsening rapidly, with deaths in long-term care homes rising, and outbreaks and hospitalizations increasing. Ontario reported a record 1,575 cases on Thursday, with 18 more deaths.

The new models project that within two weeks, the number of COVID-19 patients in Ontario’s intensive care beds will exceed 150 – and hospitals would not have enough beds to carry out all planned surgery. At a growth rate of 5 per cent, which the modellers said could even be viewed as “optimistic,” number of cases would reach 6,500 by mid-December. At a rate of 3 per cent growth figures, they would hit 3,500 by mid-December.

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Does a mask protect me from COVID-19 infection? Understanding the latest public-health guidance

How many coronavirus cases are there in Canada, by province, and worldwide? The latest maps and charts

Quebec, Ontario weigh extending winter break at schools as COVID-19 cases surge

COVID-19 is surging throughout most of Canada, with Quebec saying it may have to shut schools for a month and Manitoba locking down as the virus spreads dangerously out of control. In Alberta, Premier Jason Kenney on Thursday announced modest measures in response to rapidly increasing coronavirus infections in that province. Bars will have to close early and group fitness classes and team sports will be prohibited for two weeks, and people in places with high rates of infection have been advised to stop social gatherings.

Adalsteinn Brown, the dean of the Dalla Lana School of Public Health at the University of Toronto, and co-chair of the science advisory group that prepared the Ontario models, said without any further government action, cases will simply continue to climb, with more people in intensive care and more deaths in long-term care.

He said he believed more restrictions are needed in virus hot zones if the government’s goal is to reduce cases and deaths.

“I do not believe that there is a way that the cases will change without action,” Dr. Brown said.

The new projections also show that a month from now, Ontario’s rate of COVID-19 growth could outstrip even those in France and Britain, which are in lockdowns.

In response to the new modelling, Ontario’s Chief Medical Officer of Health, David Williams, said on Thursday he is asking his public health advisers to look at what would trigger a lockdown, and whether he needs to recommend “urgent actions” to the Health Minister, Premier and cabinet. Ontario Premier Doug Ford told Toronto news station CP24 on Thursday evening that the new projections are “very concerning.” He said public health officials will brief him on Friday and he will decide what to do.

“I promise you I will not hesitate for a second if we have to go further,” he said.

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Andrew Morris, medical director of the antimicrobial stewardship program at Sinai Health System and University Health Network in Toronto, said the lack of any call to action from Dr. Williams in light of the new projections was mystifying.

“It’s unbelievable. I no longer know what to say. It is, honestly, inexplicable,” said Dr. Morris, who argues that an immediate and lengthy lockdown is the only way to get cases back under control.

He said he did not believe the Ford government would act until hospitals are overwhelmed and “they start seeing bodies on the front pages.”

Doctors in the province have expressed concern for several days that a new colour-coded framework for COVID-19 restrictions the province introduced last week was not stringent enough.

COVID-19 Hospitalizations

continue to rise

450

Confirmed COVID-19 acute

inpatients (excluding ICU)

400

Confirmed COVID-19

ICU Patients

350

300

250

200

150

100

50

0

Aug.

1

Aug.

15

Aug.

29

Sept.

12

Sept.

26

Oct.

10

Oct.

24

Nov.

7

Data Sources: Daily Bed Census Summary COVID-19 Report + Critical

Care Information System. Extracted via MOH SAS VA Nov. 10

JOHN SOPINSKI/THE GLOBE AND MAIL

SOURCE: COVID-19 ADVISORY FOR ONTARIO

COVID-19 Hospitalizations

continue to rise

450

Confirmed COVID-19 acute

inpatients (excluding ICU)

400

Confirmed COVID-19

ICU Patients

350

300

250

200

150

100

50

0

Aug.

1

Aug.

15

Aug.

29

Sept.

12

Sept.

26

Oct.

10

Oct.

24

Nov.

7

Data Sources: Daily Bed Census Summary COVID-19 Report + Critical

Care Information System. Extracted via MOH SAS VA Nov. 10

JOHN SOPINSKI/THE GLOBE AND MAIL

SOURCE: COVID-19 ADVISORY FOR ONTARIO

COVID-19 Hospitalizations continue to rise

450

Confirmed COVID-19 acute

inpatients (excluding ICU)

400

Confirmed COVID-19

ICU Patients

350

300

61% increase in hospitalized COVID-19 patients over the past

three weeks

250

200

167% increase over

the past six weeks

150

100

50

0

Aug.

1

Aug.

15

Aug.

29

Sept.

12

Sept.

26

Oct.

10

Oct.

24

Nov.

7

Data Sources: Daily Bed Census Summary COVID-19 Report + Critical Care

Information System. Extracted via MOH SAS VA Nov. 10

JOHN SOPINSKI/THE GLOBE AND MAIL, SOURCE: COVID-19 ADVISORY FOR ONTARIO

Projections of cases

at 5 per cent rate of growth

Number of cases per day (other countries

aligned at 10/100,000)

8,000

Neth.

>100/100,000

threshold

7,000

Ontario

6,000

Britain

5,000

4,000

Germany

3,000

France

Ontario

2nd wave

2,000

1,000

0

Nov.

1

Nov.

10

Nov.

20

Dec.

1

Dec.

10

Projections of cases

at 5 per cent rate of growth

Number of cases per day (other countries

aligned at 10/100,000)

8,000

Neth.

>100/100,000

threshold

7,000

Ontario

6,000

Britain

5,000

4,000

Germany

3,000

France

Ontario

2nd wave

2,000

1,000

0

Nov.

1

Nov.

10

Nov.

20

Dec.

1

Dec.

10

Projections of cases at 5 per cent rate of growth

Number of cases per day (other countries aligned at 10/100,000)

8,000

Neth.

>100/100,000

threshold

7,000

Ontario

6,000

Britain

5,000

4,000

Germany

3,000

France

Ontario

2nd wave

2,000

1,000

0

Nov.

1

Nov.

10

Nov.

20

Nov.

30

Dec.

1

Dec.

10

Earlier on Thursday, Mr. Ford said the system balances economic concerns with health restrictions, and takes into account the mental-health impact of bankrupting businesses.

“It’s easy for people to just say shut everything down, when they are guaranteed a pay cheque every single week,” Mr. Ford said. “The No.1 priority is the health and safety. And right beside that is the economy.”

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On Wednesday, the Toronto Star reported that the province rejected advice from its own public health agency when crafting the framework, leading opposition parties to accuse the government of lying when it said experts had approved the plan.

Shelley Deeks, chief health protection officer at Public Health Ontario, told The Star that the agency advised the Health Ministry on the new framework in September. But she said she only saw the final plan when it was made public. The upper limits in the strictest level before a lockdown, she said, were four times higher than what her agency had recommended. In the framework’s red or “control” level, which comes before a lockdown, Public Health Ontario recommended a threshold of 25 cases per 100,000 people and a lab positivity rate of 2.5 per cent, Dr. Deeks told the Star. The framework set those thresholds at 100 cases per 100,000, and 10 per cent positivity.

Dr. Deeks did not respond to a request for comment from The Globe and Mail, but Public Health Ontario said on Thursday it “stands by the reported comments of Dr. Shelley Deeks.”

The Premier said on Thursday it was “totally inaccurate” to say he lied about having public health advice, stating that the reopening framework his cabinet approved was endorsed by Dr. Williams.

Mr. Ford dismissed Dr. Deeks’s views as “one doctor’s perspective,” even though she is an infectious disease specialist at the principal Ontario government agency dealing with pandemics. He later said he appreciated her expressing her opinion and that she was “working her back off.”

Health Minister Christine Elliott said the government sought advice from numerous experts, including Dr. Williams and local medical officers of health, in crafting the plan. She said Dr. Williams also considered the economic and mental health effects of lockdowns in making his recommendations to cabinet.

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She said Dr. Williams and the government determined the framework. “Ultimately, the government is accountable,” she said.

Earlier on Thursday, Ms. Elliott said the government is not considering changing the thresholds, although her office later said that could change.

The Ontario Medical Association, which represents 43,000 physicians, said the framework is “too lax,” and called on the government to shutter bars and indoor dining in virus hot spots. The Ontario Hospital Association also urged the province to reconsider its framework, warning that hospitals will soon be overwhelmed.

Toronto and nearby Peel Region have already said they are adding their own, stricter restrictions on top of the provincial government’s framework as cases continue to rise.

NDP Andrea Horwath called the new data modelling “horrific” and said Ontario needs to take action before hospitals are overwhelmed. “The government is speeding in the wrong direction, and Ontario has to change course right now, or people will die,” she said.

With a report from James Keller in Calgary

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