Is Niagara ready to reopen its economy?
Medical officer of health says it isn’t, noting Region only meets two of three key Public Health Ontario criteria
According to recently published guidelines by Public Health Ontario, Niagara is not yet ready to open its economy, and the region’s top public health official warns moving forward too soon will set the community up for failure.
In a Feb. 11 evidence brief that looked at reopening in light of the new, more infectious variants of the novel coronavirus, Public Health Ontario (PHO) laid out three key criteria it advises should be met before lifting COVID-19 restrictions.
Niagara had only met one of them as of Tuesday.
The provincial government is expected to make an announcement regarding Niagara’s colour-coded restriction zone status on Friday. Currently, Niagara is in the grey lockdown zone, which
keeps many businesses closed, including restaurants for indoor dining and gyms.
Niagara acting medical officer of health Dr. Musfata Hirji is not recommending the region proceed into the less restrictive red zone yet, citing several pandemic metrics, including the PHO measures.
Reopening too soon, he said, could trigger a renewed rise in infections and, ultimately, a third full lockdown.
“If you look at the fall, we had different regions in different colour-coded zones and that really did not work,” Hirji said Tuesday. “So we know, experientially, that going back to that system will result in the same outcome, which means this would not be a successful reopening.”
Hirji said he wants to see Niagara establish conditions that will allow for a sustained reopening that can avoid future lockdown entirely. But the region isn’t there yet.
Hirji said no one metric should be used to determine if a region is ready to open, particularly given the presence of the viral variants in Ontario, but pointed to PHO’S new guidelines as a good place to start.
A Feb. 11 brief titled “Using COVID-19 Data to Inform Reopening Decision-making in the Context of Variants of Concern,” recommends thresholds for the local reproductive rate of the virus, cases per 100,000 people and health-care capacity as measurable ways to determine if a slow and cautious reopening is possible.
The reproductive number
The reproductive number is a calculation that estimates the number of people an infected person can make sick. A value below 1.0 indicates a declining infection rate, while anything at or above that level is a mark of an increasing rate.
The brief said because the viral variant are 50 to 70 per cent more infectious, before a region opens its reproductive rate should be at or below 0.6 to 0.7 for two consecutive weeks. Last week, Niagara’s reproductive number fell to 0.6, but by Tuesday had risen increased to 0.9. Niagara has not sustained a value of less than 0.7 for 14 days in 2021.
Hirji said the local infection rate is still declining, but that decline is “more shallow” than it initially was coming out of January, which saw a record number of local cases and deaths.
There are six probable variant cases under investigation in Niagara, but Hirji said lab results needed to confirm them are not in yet.
He said if the infection rate is not pushed down and the variants are introduced locally, case numbers could spike.
Cases per population
The brief said the figure should be less than 10 cases per 100,000 people in a region. By Tuesday, Niagara’s rate was 18.2, down significantly from a week ago.
The current rate is also a vast improvement from where it was in January when Niagara had one of the highest rates per population in the province, mirroring rates in other Ontario COVID-19 hot zones.
However, with a rate still well above the threshold PHO is recommending, Hirji said more time is needed to bring it down to a more manageable level.
Health-care capacity
Where Niagara may be fairing better is with its health-care capacity. The PHO brief said intensive
care unit bed occupancy for both COVID-19 and NONCOVID-19 cases should be in decline before reopening. According to public health data, local ICU capacity is improving as the number of COVID-19 cases in hospitals decline.
There are 14 people with COVID-19 in Niagara Health hospitals.
Hirji said public health contact tracing capacity is only starting to improve as a result of the downward trend in infections over the past few weeks.
“I think Niagara might meet that measure,” Hirji said of the PHO brief.
There are other metrics that concern Hirji, including a relatively high number of outbreaks, continuing deaths — albeit at a slower rate — and the fact there are not enough vaccine doses available to take a significant bite out of the infection rate.
Hirji said he concurs with a
Monday statement by the Association of Local Public Health Agencies that said “we believe that the timing of loosening the restrictions and the degree to which they have been relaxed in many areas underestimates the imminent and considerable threat posed by the (variants). Experience in other jurisdictions has demonstrated that decisive and early action prevents later prolonged shutdowns, which in turn contributes to faster economic recovery.”
Other major Ontario healthcare groups, including the Registered Nurses Association, the Ontario Medical Association and the Ontario Hospital Association, have also released statements saying it is too early to ease pandemic restrictions in the province.