Residents on track to defeat disease, experts predict

WATERLOO REGION — Experts agree that outside of ravaged nursing homes, residents are winning the battle against COVID-19.

The latest data shows new cases of the disease are not accelerating. Hospitalizations are down to 26 Thursday after peaking at 36 on April 6. Almost 200 infected people have recovered, helping to flatten active cases.

It looks like victory ahead. But experts warn we can’t ease up because the disease could still rage.

There’s alarm about the deepening toll in a few long-term care and retirement homes. Residents and staff now account for more than half of all local cases. Residents account for three-quarters of 39 deaths.

The Record reached out to four professors at the University of Waterloo for insights into 582 cases recorded in the pandemic since Feb. 27 by the regional public health department. Question: has the disease been beaten or managed or slowed, outside of facilities for the elderly?

“Local residents have been very effective in flattening the curve and this has been achieved by closure of schools and workplaces and all of the physical distancing measures that we have applied,” said Chris Bauch, a mathematician who studies the dynamics of infectious disease.

“Handwashing, avoiding gathering in groups, maintaining your distance at the supermarket — all of these have combined to bring down the infection rate by a very significant amount ...

“This is what has kept the number of hospitalizations and deaths lower than it would have been otherwise.”

Question: are there different pandemics inside and outside of long-term care homes?

“Once (COVID-19) gets into a home, the risk of death is very high because it is such a vulnerable population,” said John Hirdes, a public health professor who studies geriatric care.

“I don’t think we’re in a position yet to say whether having an outbreak in a home is a function of the quality of care in a home. We don’t have the evidence for that.”

Hirdes attributes the spread of disease in nursing homes to factors such as the frailty of residents, unhelpful facility design, inadequate staff training, lack of staff expertise and delays in adopting protective gear.

“With all our focus on equipping hospitals to deal with the pandemic, I think there’s some things that we missed that we could have done to better prepare nursing homes,” he said.

Fixing what’s broken in senior care “will mean an increased cost to taxpayers, but it’s essential.”

Question: should we ease up on restrictions?

“Not quite yet,” said Craig Janes, director of the School of Public Health.

He advises waiting for a sustained reduction in transmission, and until we develop a greater capacity for testing. More testing will help control future outbreaks.

“Travel restrictions likely need to stay in place for longer,” Janes said, pointing to the spread of disease in the U.S.

Reopening could lead to a surge of cases as people move around “which can lead to more hospitalizations, deaths and the health care system being overwhelmed,” said Zahid Butt, a public health professor who studies infectious disease.

“The timelines for easing up on restrictions will depend on how much we are testing and the number of new cases that we see in the community.”

“We will be able to ease some restrictions in the coming months, but we need to phase them out slowly, one at a time,” said Bauch, the mathematician.

“Ideally, we should start by phasing out the restrictions that are having the most economic impacts. But this needs to happen in consultation between provincial and local decision-makers and it needs to be based on evidence.

“We cannot simply rush back to doing the things we did before.”

Question: what are the numbers not telling us, or how should we be cautious about interpreting them?

“There could be more cases out there still that haven’t come into the system yet,” Janes said.

He points to many people who are untested, and notes that some people may not be hospitalized until three weeks after infection.

Butt worries about people who have the disease, but show no symptoms.

“The decrease in hospitalization could be because we may be seeing some slowing down of the virus spread,” he said.

“It could also mean that there may be people infected in the community, but do not have severe symptoms that warrant hospitalization.”