COVID-19 variants on track to trigger exponential growth of cases: Ontario science table

COVID-19 variants of concern are already spreading rapidly in the province and are on track to spur an exponential growth of cases in the coming weeks, according to the province's science advisers.

Dr. Adalsteinn (Steini) Brown, co-chair of the Ontario COVID-19 Science Advisory Table, presented new data Thursday on the COVID-19 variants.

Afterward, he agreed with a reporter who said his presentation appeared to be "predicting a disaster."

Brown presented what he described as two stories. The first was that since the province began a provincewide shutdown and stay-at-home order, cases have been declining in Ontario. The reproduction rate — the number of other people each person infects — has hovered between 0.8 and 0.9, Brown said.

But that progress is threatened by the new variants, which have been spreading rapidly in the meantime, he said.

The modelling Brown presented shows that if the status quo remains the same, Ontario's downward trajectory will reverse in late February or early March. The number of daily new cases will begin to climb because the COVID-19 variants are much more transmissible. So far, the variants — the one discovered in the U.K. in particular — are believed to be between 5 per cent and 10 per cent of new cases now but are on track to become dominant over the old variant within weeks.

In order to avoid another surge in cases, Ontario would need to lower the contacts between people and bring the reproduction rate of the old variant down to 0.7, Brown said, a level Ontario has only briefly approached since the provincewide lockdown began in December. If the reproduction number hovers around 0.9 — just higher than its current rate — Ontario will experience exponential growth.

Brown presented charts that illustrate the difference in the spread of COVID-19 variants in Toronto if the old-variant R hovers at 0.9 — slightly higher than the rate today — versus 0.7 — a level lower than Ontario has been able to maintain under the current restrictions.

And Ontario has already begun loosening public health restrictions, rather than tightening them.

Ontario is in the process of lifting the stay-at-home order in stages across the province and transferring individual public health regions back to the provincial framework, with three in eastern Ontario with low COVID-19 rates having been transferred into the Green tier, with the most lax restrictions. An announcement concerning which levels most of the rest of the province — excluding Toronto, Peel and York — will enter is expected Friday.

However, Ontario Chief Medical Officer of Health Dr. David Williams said the transition to the framework isn't throwing the doors wide open, even though the restrictions under the framework are more permissive than those in place across most of the province today. Even in the most strict grey-lockdown level, retail stores will be allowed to open.

"While we're going back into the framework, this is not an opening up," said Williams, adding that people need to be more careful with their personal conduct. He expressed confidence that the province can keep the variants under control with the current plan and when asked if there were plans for any increased measures, offered none.

Brown appeared to disagree with Williams' assessment when questioned by TVO reporter John Michael McGrath.

McGrath said that the way he understood the presentation, cases could rise dramatically as Ontario loosens public health restrictions as planned.

"Am I missing something here, or is the presentation actually predicting a disaster?" McGrath asked.

"No, I don't think you're missing anything," replied Brown. "The cases will likely rise given the variants of concern. The need to keep that R down is really, really critical, but there are a number of things that need to be weighed in making these decisions."

To strongly paraphrase @jm_mcgrath excellent question, “why is the govt doing exactly what this data modelling says don’t do?”

Indeed. #onpoli pic.twitter.com/iSBfQhtKrD

— rose dsouza (@thewaywardrose) February 11, 2021

Williams later tempered that.

"I wouldn't say it's a prediction of disaster," he said. "It tells you that by doing A, B, or C, you could end up with consequences and by staying the course, there still is a good scenario there, that's why we do the modelling."

He said the situation is being monitored very carefully and the province needs to find a fine balance with people suffering under the lockdown.

Meanwhile, schools are also reopening in phases. Brown said that schools tend to amplify the transmission happening in their local community, so keeping schools open — "a very important goal" — means the spread in the community must be kept down.

Overall, Brown urged an extension of the stay-at-home order and an aggressive vaccination campaign.

Brown also said that the vaccination campaign in long-term care has worked and has saved lives. But he also noted it has had no impact on the province's stubbornly high intensive care occupancy rates, as long-term care residents are rarely sent to ICUs for care. While long-term care deaths are declining significantly, the total in the second wave will exceed that of the first, he said.

In a statement after the modelling presentation, NDP Leader Andrea Horwath urged Ford to reconsider loosening public health restrictions.

“It’s clear that Ontario is on the brink. We are at a crossroads. We can save ourselves by continuing public health measures for a little while longer, or we can re-open too soon and allow the variant to take hold and run rampant,” said Horwath.

“There is still time to make a better choice, and save Ontario from another devastating round of illnesses, deaths, closures and lockdowns. I’m urging Doug Ford not to re-open so fast.”