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People relax on Lake Ontario overlooking the City of Toronto at Jack Darling Park in Mississauga, Ont., on June 17, 2020.

Nathan Denette/The Canadian Press

Ontario and Quebec, long the twin epicentres of Canada’s COVID-19 crisis, are finally seeing a sustained decrease in the number of new coronavirus infections reported daily – a reversal of fortune that has happened despite both provinces easing restrictions designed to suppress the virus.

In Quebec, where more coronavirus infections and deaths have been recorded than in the rest of Canada combined, there has been a sharp drop in new infections over the past two weeks. The province reported just 120 new cases on Thursday, down significantly from the end of May, when Quebec was still logging an average of between 500 and 600 new infections daily.

New cases have even taken a nosedive in Montreal, the Canadian city hit hardest by the coronavirus.

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The decrease in Ontario has been more gradual but no less significant. Ontario reported 173 new cases of COVID-19 on Thursday, the fifth straight day of new case counts below 200. The province last saw such low numbers in March, before the coronavirus pandemic took off. Most of the new cases were in Toronto and Peel Region, which includes the cities of Mississauga and Brampton.

“It’s a bit unexpected, certainly,” said Matthew Miller, a viral immunologist at the Michael G. DeGroote Institute for Infectious Diseases Research at McMaster University in Hamilton. “I think that most people would probably have said that, as we began measures to reopen, the best we could have hoped for is for cases to remain stabilized.”

There is no single explanation for the decline in new cases, according to epidemiologists and infectious-disease experts, who say that Canadians shouldn’t use the positive trends as an excuse to let their guards down. On Thursday, the country surpassed the grim milestone of 100,000 cases confirmed since the coronavirus was first detected here in January.

Some experts chalk up the recent drop in new infections to a reduction in the number of outbreaks at seniors homes in Quebec, others to more testing and tracing in Ontario and still others to the low-risk nature of some of the outdoor activities that were allowed to resume first, such as golf, tennis and curbside pickup at stores.

The drop in new infections in Quebec is especially perplexing because the figures began trending downward a few weeks after the province kicked off a reopening plan that was faster and more ambitious than that of any other province.

Schools and daycares outside of greater Montreal welcomed students back on May 11, Quebec provincial parks began reopening on May 20 and outdoor gatherings of up to 10 people were permitted across the province beginning May 22.

Ontario, by contrast, has kept schools closed and began allowing groups of 10 to gather just last Friday.

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Seven-day rolling average of new

COVID-19 cases

ONTARIO

Greater Toronto Area

Rest of Ontario

1

2

3

600

500

400

300

200

100

0

March

April

May

June

May 11

Retail businesses with street entrances reopen for pick-up and delivery

1

2

May 19

Retail businesses outside of malls reopen with physical distancing measures and customer limits; Indoor and outdoor non-team sports, like tennis and horse racing, can be played; Services, including housecleaning, maintenance and vet appointments, can resume

May 29

Testing policy is enhanced, including for more people without symptoms

3

QUEBEC

Montreal & Laval

Rest of Quebec

 

1

2

3

600

500

400

300

200

100

0

March

April

May

June

May 11

Schools and daycares reopen outside the Montreal region

1

May 22

Outdoor gatherings allowed to include up to 10 people; Provincial parks started reopening two days prior

2

3

June 1

Daycares reopen in the Montreal region and malls reopen outside

THE GLOBE AND MAIL, SOURCE:

PROVINCIAL GOVERNMENTS

Seven-day rolling average of new COVID-19 cases

ONTARIO

Greater Toronto Area

Rest of Ontario

1

2

3

600

500

400

300

200

100

0

March

April

May

June

May 11

Retail businesses with street entrances reopen for pick-up and delivery

1

May 19

Retail businesses outside of malls reopen with physical distancing measures and customer limits; Indoor and outdoor non-team sports, like tennis and horse racing, can be played; Services, including housecleaning, maintenance and vet appointments, can resume

2

May 29

Testing policy is enhanced, including for more people without symptoms

3

QUEBEC

Montreal & Laval

Rest of Quebec

 

1

2

3

600

500

400

300

200

100

0

March

April

May

June

May 11

Schools and daycares reopen outside the Montreal region

1

2

May 22

Outdoor gatherings allowed to include up to 10 people; Provincial parks started reopening two days prior

June 1

Daycares reopen in the Montreal region and malls reopen outside

3

THE GLOBE AND MAIL, SOURCE: PROVINCIAL GOVERNMENTS

Seven-day rolling average of new COVID-19 cases

ONTARIO

Greater Toronto Area

Rest of Ontario

1

2

3

600

500

400

300

200

100

0

March

April

May

June

1

May 11

Retail businesses with street entrances reopen for pick-up and delivery

May 19

Retail businesses outside of malls reopen with physical distancing measures and customer limits; Indoor and outdoor non-team sports, like tennis and horse racing, can be played; Services, including housecleaning, maintenance and vet appointments, can resume

2

May 29

Testing policy is enhanced, including for more people without symptoms

3

QUEBEC

Montreal & Laval

Rest of Quebec

 

1

2

3

600

500

400

300

200

100

0

March

April

May

June

1

May 11

Schools and daycares reopen outside the Montreal region

May 22

Daycares reopen in the Montreal region and malls reopen outside

2

June 1

Daycares reopen in the Montreal region and malls reopen outside

3

THE GLOBE AND MAIL, SOURCE: PROVINCIAL GOVERNMENTS

David Kaiser, a physician with Montreal’s public-health department, attributed the overall drop in new infections in the city to better control of outbreaks in institutions, including the seniors facilities where the vast majority of Quebec’s more than 5,300 coronavirus victims lived before they died.

The downward trend of new infections in the community has been more “modest,” Dr. Kaiser added.

He also warned that it could be too early to see the true impact of Quebec’s reopening measures. “The story will be told in the next couple of weeks, in the number of cases,” Dr. Kaiser said. “Not necessarily today.”

Another partial explanation could be the fact that the number of people tested in Quebec has fallen recently. Quebec has tested fewer than 8,000 people a day since June 1, according to provincial data, well short of the goal of 14,000 a day set by Horacio Arruda, Quebec’s Director of Public Health.

“I [said] 14,000 per day and we are not obtaining it,” Dr. Arruda told reporters at a Tuesday news conference.

David Buckeridge, an epidemiologist at McGill University, said Quebec is testing primarily people who are sick enough to seek testing, rather than pro-actively testing broader swaths of the population.

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“There are certainly more [infections]. It’s quite clear that the number confirmed by testing is going to be much smaller than the true number,” he said.

As long-term-care home cases drop, Quebec Premier François Legault reminded Quebeckers that the province managed to control its community deaths during the pandemic. He called the province’s community death count – more than 500 so far – a “victory” when compared with the crushing toll of COVID-19 on seniors residences: more than 4,500 deaths.

“Why did we have so few deaths in the community? It’s because Quebeckers followed instructions and saved thousands – if not tens of thousands – of lives,” Mr. Legault said Monday.

Unlike in Quebec, Ontario’s drop in new infections over the past two weeks has happened at a time when the number of tests processed daily is higher than ever, with more than 20,000 tests completed on most days during that stretch.

On June 12, when Ontario reported its third-lowest number of new infections since March – 182 – it completed 28,335 tests, the most in a single day. (Ontario’s figures are based on the number of tests processed, while Quebec’s reflect the number of people tested.)

Barbara Yaffe, Ontario’s associate chief medical officer of health, said the province’s decision near the end of May to make testing available to more people, including those without symptoms of COVID-19, is one of a “whole host of factors,” that help explain why new infections are falling.

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“Part of it is the increased access to testing,” Dr. Yaffe said during a briefing on Monday. “People are going for testing earlier, when the symptoms just begin, so hopefully they’re isolating right away and so there’s less spread.” As the number of cases drops, detailed contact-tracing becomes easier, she added – a virtuous cycle.

It also helps that Ontario is grappling with far fewer nursing and retirement home outbreaks than it was in April and May, Dr. Yaffe said. However, a Globe and Mail analysis of provincial data found that new infections connected to institutional outbreaks in Ontario had already dropped dramatically by the beginning of May, replaced by an increase in new cases confirmed in the community, especially in the Greater Toronto Area and among younger age groups.

The number of COVID-19 deaths in Ontario has been trending downward, as has the number of people treated for the disease in hospital. There were 351 coronavirus patients in Ontario hospitals on Thursday, down from more than 1,000 in the middle of May. The province reported three new deaths on Thursday; Toronto reached 1,000 total.

Amy Greer, an infectious-diseases epidemiologist at the University of Guelph, said one reason the initial reopening seems not to have caused a spike in cases is that many of the activities permitted to resume first in Ontario allowed for physical distancing and took place outdoors, including golf and tennis.

“The reason they were on the list to occur early is because they’re lower-risk in terms of transmission,” Dr. Greer said. “Outdoor venues are much less risky than indoor locations.”

Encouraging people to be safely separated from others while getting outside and enjoying the warm weather is probably helping to curb the virus more than the heat and humidity itself, said Isaac Bogoch, an infectious-diseases physician at Toronto General Hospital.

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Dr. Bogoch said the raging coronavirus epidemics in places such as Brazil, Ecuador, India and Bangladesh make it clear that hot, humid weather doesn’t do much to stop the spread of a new virus through a population with next to no immunity.

“Let’s not falsely attribute this to having more sunlight,” he said of the drop in new infections in central Canada.

With reports from Danielle Webb and Les Perreaux

Fresh modelling from the Public Health Agency of Canada shows that COVID-19 is in decline in Canada, thanks to strict limits on public activities and gatherings, Dr. Theresa Tam says. To keep that going as some things return to normal will take ever-greater efforts to test for and track cases, or else all the progress can be undone. The Canadian Press

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