Ontario moves school online for at least 2 weeks, closes indoor dining and gyms
Ontario Premier Doug Ford, expecting a “tsunami of new cases in the days and weeks ahead” in the province, announced a number of changes on Monday, including a pause on non-urgent medical procedures and a return to virtual learning for at least the next two weeks for elementary and secondary students.
“The math isn’t on our side,” Ford said on a day when Ontario’s seven-day case average climbed to more than 14,000 even as limitations on COVID-19 testing access mean the number of actual infections is likely higher.
As part of the modified step two of the province’s reopening plan, Chief Medical Officer of Health Dr. Kieran Moore reinstated a directive ordering hospitals to pause all non-urgent surgeries and procedures in order to preserve critical care capacity.
That measure had been taken during earlier waves in the pandemic, contributing to a large backlog of procedures the health system had been working to clear in recent months.
The chief executive officer of Ontario Health, which oversees the province’s health system, said the directive would affect between 8,000 and 10,000 procedures a week.
“It was a tough decision, a big cost, but something that is necessary given what we’re seeing in the numbers,” Matt Anderson said.
But that particular decision didn’t sit well with some Ontario physicians, who have noted — as documented by CBC News in recent weeks — that many serious illnesses and diseases are going untreated and surgeries considerably delayed. Critics are likely aware that while Omicron’s transmission rate is prohibitive, there were about 900 patients in ICUs and about 2,400 with COVID-19 hospitalized during third-wave peaks in early 2021.
Moore said the “most important metric” right now is the hospitalization rate, with between 1,200 and 1,500 additional beds designated to provide care to patients with Omicron in anticipation of a rise in admissions.
The number of people with COVID-19 in ICUs across the province rose to 248 on Monday from 224 on Sunday. In total, there are 1,232 people hospitalized with COVID-19, although Health Minister Christine Elliott noted that not all hospitals report on weekends.
Dr. Lisa Salamon, emergency room physician at Scarborough Health Network (SHN) in Toronto, told CBC News on Monday that the large number of cases in mid-December wasn’t particularly translating into hospitalizations, a contrast to late 2020.
But, she said, “we’re just seeing it over the last one to two weeks, a gradual climb and now it’s rising exponentially so I think we’re really going to have to brace ourselves in the hospital.”
Salamon predicted another storm for Ontario’s health-care system to weather over the next “two to four weeks.”
Ontario also announced changes to indoor capacity levels for a number of businesses, as well as an expanded rebate program for businesses affected by the new slate of closures and child-care breaks for front-line workers with school-aged children. For a more thorough list of the changes, click here.
Ford praised Ontario residents for responding well to the accelerated booster shot campaign. Moore expressed hope that, as hinted at in other countries, Omicron’s wrath will be more short-lived than previous variants given the stricter mitigation efforts and generally high rates of vaccination.
From The National
Medical workers are growing nervous as COVID-19-related hospitalizations rise, signalling a building Omicron wave. 3:12
Why some provinces are shortening isolation periods for vaccinated people who get COVID-19
Alberta residents who’ve received at least two doses of vaccine who test positive for COVID-19 will only need to isolate for five days, effective Monday.
Health Minister Jason Copping announced the change last week, down from the standard 10-day isolation period, in the face of the rapidly spreading Omicron variant. Copping said it was based on evidence that fully immunized people have shorter infectious periods.
“We believe this step will help balance the need for continuity in the workforce, the well-being of Albertans and our need to continue to reduce the spread of the Omicron variant,” he said.
Alberta is among a number of provinces that have announced shorter isolation periods, a list that also includes British Columbia, Manitoba, New Brunswick, Ontario and New Brunswick.
At Friday’s announcement in Alberta, provincial Chief Medical Officer of Health Dr. Deena Hinshaw said the move is “based on the evidence that those who are fully immunized shed virus for a shorter amount of time if they have a breakthrough infection.”
Meanwhile in Ontario, Chief Medical Officer of Health Dr. Kieran Moore last week said available evidence indicates that “90 per cent of your viral risk of transmission is already transpired by five days.” Furthermore, he said, a significant amount of community transmission occurs in a 48-hour period before people realize they have symptoms and likely haven’t been isolating.
Raywat Deonandan, an epidemiologist and associate professor at the University of Ottawa, said the isolation changes are risky because they are based on an average — and they could lead to infectious people mingling with healthy ones.
“Some can be infectious for three days, some for 12 days or longer,” he said. “The concerning part is that we have people who are re-entering society with suspected infection and infectiousness without a negative test to clear them.”
Dr. Christopher Labos, a Montreal cardiologist with a degree in epidemiology, said it’s clear that “the further you get from the start of the infection, the less infectious you are.”
“If you have a critical job like you work in health care or something like that, if after the first five days you are completely fine, you’ve recovered and you’ve been fully vaccinated, it’s probably a reasonable thing to do.”
But, he told CBC News Network in an interview on Monday, “if you have the luxury to self-isolate for a full 10 days, based on how bad the situation is now, probably a good idea to do that.”
Clearly, Omicron’s potential for widespread workforce disruptions is playing a part in the rationale. Moore said at Monday’s Ontario COVID-19 news conference that there could be between a 20 to 30 per cent absenteeism rate in some employment sectors in the province in the coming weeks.
Canada is not an outlier on the isolation requirement change, as the U.S. Centers for Disease Control and Prevention made a similar five-day recommendation just before the new year. On Monday, France also announced a reduction in the isolation requirement for the fully vaccinated, albeit to seven days.
Pandemic’s end likely to be gradual, not uniform
While much of the Western world is grappling with the massive case spikes caused by the Omicron variant, it is conceivable as a new year begins that 2022 will be the third and final year that COVID-19 outbreaks meet the definition of a pandemic.
At some point, the World Health Organization will determine when enough countries have tamped down their COVID-19 cases sufficiently — or at least, hospitalizations and deaths — to declare the pandemic officially over.
Exactly what that threshold will be isn’t clear.
“Certainly COVID will be with us forever,” Dr. Albert Ko, an infectious disease specialist at the Yale School of Public Health, told The Associated Press. “We’re never going to be able to eradicate or eliminate COVID, so we have to identify our goals.”
Dr. Anthony Fauci, the top U.S. infectious disease expert, is looking ahead to a time when controlling the virus “does not disrupt society, that does not disrupt the economy.” To Fauci’s point, it was shown in 2021 that the world is interconnected in that regard, as the Delta variant cases caused manufacturing closures in Southeast Asia that helped lead to supply chain disruptions for many products on the other side of the world.
Deaths from influenza and pneumonia typically number fewer than 10,000 annually in pre-pandemic years, according to federal health statistics, with COVID-19 deaths in Canada more than 30,000 in slightly less than two years, with evidence of neurological, kidney and lung issues for some surviving patients not typically seen in flu cases. In the U.S., COVID-19 has killed more than 800,000 Americans in two years, while flu typically kills between 12,000 and 52,000 a year.
Exactly how much continuing COVID-19 illness and death the world will put up with is largely a societal question, not a scientific one.
“We’re not going to get to a point where it’s 2019 again,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “We’ve got to get people to think about risk tolerance.”
Even when WHO makes a declaration, some parts of the world still will struggle — especially low-income countries that lack enough vaccines or treatments — while others more easily transition to what scientists call an “endemic” state. According to current estimates from Our World In Data, while rich countries like Canada accelerate booster shots campaigns, only 8.5 per cent of citizens in low-income countries have received at least one COVID-19 vaccine dose.
Dr. Peter Singer, special adviser to the World Health Organization director general, recently told CBC News “we have to do better” in 2022 on that front or else risk the development of another virulent variant.
“The next one will be coming unless we vaccinate the world. We didn’t do well on that in 2021, to put it mildly.”
Today’s graphic:
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