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Flowers sit on a bench in front of Orchard Villa long-term care home in Pickering, Ont. on April 27, 2020.

Frank Gunn/The Canadian Press

Canadian seniors are suffering the most from COVID-19, with 79 per cent of all deaths in the country now connected to long-term care and seniors’ homes.

Numbers released on Tuesday show a steep jump from two weeks ago, when almost half of all coronavirus deaths were linked to the homes. The numbers also show the death rate for the disease at 5.5 per cent, more than double the 2.2 per cent on April 9.

The numbers were released by Canada’s Chief Public Health Officer Dr. Theresa Tam and her deputy, Dr. Howard Njoo, along with updated short- and long-term projections for the pandemic. By May 5, the models show that the total number of coronavirus-related deaths in Canada could rise to between 3,277 and 3,883, with a 95-per-cent probability.

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"As the epidemic comes under control and the growth of cases slows, the severe outcomes and deaths continue to accrue as COVID-19 takes a heavy toll among highly susceptible populations,” Dr. Tam said at a press conference.

Although national models underestimated the number of deaths from COVID-19 because they didn’t anticipate the harm in seniors’ residences, Dr. Theresa Tam says new calculations on the spread of the illness are encouraging. The Canadian Press

Quebec, Ontario and Nova Scotia are particularly challenged by outbreaks in long-term care where deaths in single facilities have reached double digits. The updated models confirm the well-documented problems in seniors homes and raise more questions about the lack of transparency around the federal models and their underlying assumptions, according to experts who spoke with The Globe and Mail.

Despite the bleak figures, Dr. Tam said the overall picture in Canada is improving and the spread of the disease is slowing significantly. In late March, the number of confirmed cases was doubling every three days. That has slowed to every 16 days.

So far, the federal officials believe Canada is staying within the most optimistic scenario where no more than 10 per cent of people become infected in the first wave of the pandemic. However, if the first wave of the disease has a low infection rate, continuing physical distancing measures will be all the more important, as few people will have immunity.

short-term epidemic tRajectories

Federal forecasts indicate that deaths in Canada due

to COVID-19 as well as cumulative case counts will

rise in the coming week, but that their rates of

increase are likely to start levelling off compared to

their persistent upward slope in April.

Deaths

3,883

4,000

Cumulative deaths

by April 24

3,000

Prediction to May 5

3,277

Lower 95% prediction limit

Upper 95% prediction limit

2,000

1,000

Prediction

0

11

15

19

23

27

31

4

8

12

16

20

24

28

2

March

April

May

Cases

66,835

70,000

Cumulative reported cases

by April 24

50,000

Prediction to May 5

53,196

Lower 95% prediction limit

Upper 95% prediction limit

30,000

10,000

Prediction

0

11

15

23

27

31

4

8

12

16

20

24

28

2

19

March

April

May

ivan semeniuk and JOHN SOPINSKI/THE GLOBE

AND MAIL SOURCE: public health agency

of canada

short-term epidemic tRajectories

Federal forecasts indicate that deaths in Canada due to

COVID-19 as well as cumulative case counts will rise in

the coming week, but that their rates of increase are

likely to start levelling off compared to their persistent

upward slope in April.

Deaths

3,883

4,000

Cumulative deaths

by April 24

3,000

3,277

Prediction to May 5

Lower 95% prediction limit

2,000

Upper 95% prediction limit

1,000

Prediction

0

11

15

19

23

27

31

4

8

12

16

20

24

28

2

March

April

May

Cases

66,835

70,000

Cumulative reported cases

by April 24

Prediction to May 5

50,000

53,196

Lower 95% prediction limit

Upper 95% prediction limit

30,000

10,000

Prediction

0

11

15

23

27

31

4

8

12

16

20

24

28

2

19

March

April

May

ivan semeniuk and JOHN SOPINSKI/THE GLOBE AND MAIL

SOURCE: public health agency of canada

short-term epidemic tRajectories

Federal forecasts indicate that deaths in Canada due to COVID-19 as well as cumulative case

counts will rise in the coming week, but that their rates of increase are likely to start level

ling off compared to their persistent upward slope in April.

Deaths

3,883

4,000

Cumulative deaths

by April 24

3,000

3,277

Prediction to May 5

Lower 95% prediction limit

2,000

Upper 95% prediction limit

1,000

Prediction

0

11

15

19

23

27

31

4

8

12

16

20

24

28

2

March

April

May

Cases

66,835

70,000

Cumulative reported cases

by April 24

Prediction to May 5

50,000

53,196

Lower 95% prediction limit

Upper 95% prediction limit

30,000

10,000

Prediction

0

11

15

23

27

31

4

8

12

16

20

24

28

2

19

March

April

May

ivan semeniuk and JOHN SOPINSKI/THE GLOBE AND MAIL

SOURCE: public health agency of canada

Until there is a treatment or vaccine, life won’t go back to normal, Dr. Tam said. What’s clear, she said, is Canadians will be living with the virus for a “significant number of months” and mass gatherings are off the table for the foreseeable future.

She said public health officials need to continue efforts to contain outbreaks in facilities where physical distancing isn’t possible, including in long-term care, shelters, prisons and food-processing plants.

Zulfiqar Bhutta, a professor of epidemiology and co-director of the Centre for Global Child Health at the Hospital for Sick Children in Toronto, said the newly released figures show the agency is getting a better handle on the specifics of COVID-19 mortality in Canada, and that the previous fatality rate did not correctly capture the full impact of the disease in long-term care facilities.

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Despite the much higher death rate in April, the federal health agency didn’t update its death projections for the entire pandemic. Instead, Ottawa is still basing its pandemic planning on a 1.2-per-cent death rate, which is what is predicted by Imperial College London. Dr. Tam said officials were keeping it at that rate because Canada is still only in the first wave, and the death rate will continue to change.

At the press conference, she also sidestepped questions about why the agency has not been more forthcoming about the methods and assumptions that underpin its projections.

Dr. Bhutta said the lack of openness makes it difficult to compare and understand why the federal numbers diverge at times from that of some other modelling groups. For example, predictions for Canada generated by the University of Washington’s Institute for Health Metrics and Evaluation skew somewhat higher, projecting 3,820 deaths (2,730 to 6,814 with a 95-per-cent probability) in the same time frame.

Access to a complete breakdown of the federal numbers would also help academic researchers and the public better understand how the disease is likely to play out in different regions, and how age, ethnicity and economic status could affect the overall picture.

“It would be so much easier if they just put the model out there and put the assumptions that have gone into the model up for public discussion,” Dr. Bhutta said.

He added that the use of a 1.2-per-cent fatality rate for longer-term modelling is likely too low, given what is currently known about how COVID-19 is unfolding in Canada.

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Caroline Colijn, a disease modeller at Simon Fraser University who has been working with the BC Centre for Disease Control on its modelling, said the long-term projections would be more meaningful if they were anchored by better data.

In particular, she said, testing a random sample of about 5,000 individuals for COVID-19 would provide a much-needed snapshot of the true state of the pandemic in Canada. Such a data set would also improve the usefulness of models in guiding the emergence from lockdown.

“That’s what we need to know,” Dr. Colijn said. “We need estimates of disease prevalence by age. The best time would have been four weeks ago. The second best time is right now.”

Since scientists aren't sure whether people who have recovered from COVID-19 are immune to getting sick with it again, Dr. Theresa Tam says we'll need to adjust our work and social lives to a world where the virus circulates but can be contained and suppressed. The Canadian Press

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