Epidemiologists are warning that if Ontario’s hotspots cannot control COVID-19, stronger mandatory measures may be needed to slow the spread and deal with the virus.
It’s a stark message that came on the day Toronto reported 538 new infections, four deaths and 176 hospitalizations, including 42 people in intensive care – Ellen De Villa, the city’s medical officer for health, described Monday as “alarming.” .
“In my opinion, the reversal of allocations was not sufficient to slow the spread in these areas,” said Rewat Dionandan, an epidemiologist at the University of Ottawa. “At the very least, targeted targeting is justified in some areas. People should reduce their daily exposure, if not voluntarily, then perhaps on a mandatory basis.”
Colin Furness, an epidemiologist in infection control at the University of Toronto, echoed Dionandan’s comments and indicated that the lockdown was the only tool that would have remained in Ontario if hospitals had come close to being indulged.
“Mortality rises dramatically when health care sinks and then continues to decline,” said Furness. “If other measures don’t work, that’s the only thing left … the shutdown is failure.”
In hotspots in Ontario – Toronto, Belle, York and Ottawa – cases continue to rise, with new cases in these regions accounting for 68 percent of all new cases in the province on Monday.
During the past week, Ontario’s daily new cases remained above 1,200 per day; The average rollover for seven days is now 1,465 new cases per day.
What follows is the Star’s weekly report in the form of an outline of the key indicators in our battle with COVID-19 and what we may expect in the coming weeks, along with expert comments.
COVID-19 hotspots in Ontario
Toronto leads the way with the highest average seven-day circulation for the four hot spots at 479.9 new cases per day.
Laura Rosella, an assistant professor of epidemiology at the Dalla Lana School of Public Health, told the Starr newspaper that more restrictions are needed and more testing and community support is needed to control the spread of the disease.
“It is expected that a kind of hope that … will stabilize,” she said, noting that although there is not much to close it, any places with mixed populations should be closed or severely restricted.
“I think we’re probably at a level where we need to think about anything that’s considered unnecessary, whether or not it needs to stay open and how it can stay open safely. Community transmission is very high.”
In Bell, which reported 303 new cases on Monday, the seven-day daily average traded rose to 407.6, from 313.6 last week. In Ottawa, 51 new cases were reported, and in the York area, 138 new cases of the virus were discovered. The average daily circulation for seven days in those regions is 53 and 151.6 new cases per day, respectively.
However, Furness said he believes compliance with measures such as masking remains high. “I think most people are actually complying or trying to comply,” said Furness.
“When I go on the subway, when I look around, most of the people are actually there” wearing masks and practicing physical distance. However, as cases continue to rise, “the genie is really out of the bottle,” he said. “It’s in the community, and it’s going to go where we expect it to go.”
Cases requiring hospitalization continue to rise
The number of hospitalizations is increasing in the province, with 500 people in hospitals as of Monday across the province. Of those, 125 are in intensive care.
Despite the high number of hospitalizations, Deunandan said hospitals were still able to admit patients, and surgeries had yet to be canceled – a measure that would show an overcrowded healthcare system.
“In general, there is room in the hostel,” Deunandan said. However, the demand for nursing staff is high. “In some places, the nursing staff is overwhelmed. Our problem, as far as I can see, is staffing, not space.”
He said that while a new family can be brought in quickly, there is a limit to the number of health care workers available. “There is a demand for ICU nurses in particular, because every patient with the emerging coronavirus requires hundreds of hours of personalized care.”
Rosella said the county is on its way to seeing hospitals being forced to cancel elective measures. In contrast to the first wave, when elective and planned care was largely suspended, hospitals were generally more preoccupied with cases without COVID.
“I would say we should be concerned about the level of treatment in the hospital,” Rosella said. “I think we got to the point where we got to the numbers that we could almost see in terms of the total number of hospitalizations in the first wave when things got really bad.”
She said that while some hospitals are already full, many are still able to accommodate patients.
She explained: “Some hospitals have already reached the stage of exhaustion, and others … you may not feel that yet.” “So we have a lot of diversity in this wave.”
Deaths are on the rise
The number of deaths has increased steadily since mid-October. Deunandan said he expected the average daily death toll to exceed 20 deaths per day for approximately the next week.
The current death numbers are nowhere near the peak the county saw in early May during the first wave. On Monday, 10 new deaths were reported in Ontario. On Sunday, there were 29 new deaths. The average seven-day average daily death toll in Ontario is 16.1 as of Monday.
“One way to look at this is that some people infected during the Thanksgiving socialization spurt will enter the hospital system in mid-December, which may show a rise in deaths at the end of the year.” Deunandan said it reverses the trend nationwide.
Rosella said the death rate in the first wave was “really tragic.” This time, she said, if we can protect vulnerable populations and avoid significant prevalence in older age groups, the death rate could be lower.
“At this point, though, we are still seeing long-term outbreaks of care and infecting older family members. So I am not optimistic that the mortality rate will be significantly different.”
Manitoba continues to suffer from a rapid spread and a positive test rate of 13 percent. In Ontario, that number is four percent.
“Alberta did not report this number because its testing system was overwhelmed by it,” Dionandan said. “So most of the evidence indicates that Ontario is in a better position.”
He said Ontario’s capacity to absorb cases is better, while hospital stays have decreased since spring and more space has opened up. “But the increasing cases (in Ontario) are consuming the range that the short stay allowed us,” Deunandan said.
“I think we might still be totally disinterested in learning from our data,” Furness said in Ontario. Ontario treats this as a political problem. COVID is a political problem and this is leading to some really horrific consequences. ”
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