Ontario’s hitting the gas when we should be applying brakes
Tuesday, most of Ontario will relax the restrictions that have finally bent the COVID-19 curve. It’s the kind of thing a government would do if it were run by the kind of people who still think Sweden is a model to be emulated. It almost seems designed to create a third wave, and a disaster.
So Tuesday could be the first day of an unfolding debacle, where a government which has never cared much about vulnerable people faces a last chance to actually care about vulnerable people, and the people it serves.
Because right now, we’re worse than too late. More transmissible variants are already popping up all over. Variants are estimated to make up between five and 10 per cent of cases now. In order for this plan to work, the best hope to contain the new, more transmissible variants is the new emergency brake the government has added to a framework that was unable to contain the old COVID-19.
“If the new variant really takes off in late February, early March, then we would need the emergency brake pretty much now, to see the effect two weeks from now,” said Dr. Beate Sander, a scientist and modeller at University Health Networks, a Canadian Research Chair in the economics of infectious diseases, and a member of the province’s independent volunteer science table.
“By the time you consider that it’s going to go the wrong way and start doing something, it’s really, really, really late, and that’s the scary thing with the variant, because it could take off really quite rapidly.”
In other words, we’re not only already late in applying a brake; we’re hitting the gas instead.
New cases tell us what was happening up to two weeks ago. We know the variants that originated in the United Kingdom and perhaps South Africa are projected to be the dominant strains of the disease in Ontario by the end of February, or as late as mid-March. Two weeks, maybe more.
“The best-case scenario is that we use the brake, and we step really carefully, which is a problem because I don’t think we have the tools to see things clearly,” said one source familiar with the province’s decision-making. Indeed, Ontario has finally reached its target capacity for 100,000 tests per day, but it is still a near-completely reactive detection system, rather than a surveillance one.
“The rules of the game that worked for the old virus will not necessarily work for the new ones. The rules of the game changed.”
DR. PETER JUNI
SCIENTIFIC DIRECTOR OF ONTARIO’S INDEPENDENT VOLUNTEER SCIENCE TABLE
And despite the best efforts of many in the public health and medical community, we are still chasing a virus that rolled upwards here from September to January, except it now runs about 40 per cent faster, and seems to increase the risk of hospitalization and death. This reopening plan, combined with reopening schools even in Toronto and Peel and York, is objectively reckless.
The premier surely knows this. Cabinet should know this. Doctors, nurses, hospitals and more public health units than you’ve heard from are all opposed. When the current modelling was presented last Thursday, Dr. Steini Brown, the co-chair of the science table, was asked if we were missing something, as the data showed that reopening would produce a disaster, Brown said, “No, I don’t think you’re missing anything.” The province must have been told.
And still on Tuesday the Ottawa, Haliburton-Kawartha, Eastern Ontario, Huron Perth, Haldimand-Norfolk, Sudbury, Brant County, Porcupine and Lambton health units will not only have no stay-at-home order, and won’t just open schools, but will be allowed to have 50 people indoors in a restaurant, bar, gym, meeting space, casino, performing arts space or a movie theatre, all with at-least theoretical social distancing. Meanwhile, Thunder Bay, Chatham-Kent, Hamilton, Waterloo, Halton, Durham, Windsor-Essex, SimcoeMuskoka — which has seen the variant from the U.K., respectively — Middlesex-London, Wellington-Dufferin Guelph, and Southwestern health units will be in red level, which means instead of 50 people indoors, it will be 10, and no movie theatres or performing arts venues.
And the variants will move, because when different regions are open, people move. They might fly.
So why is Ontario doing this? Maybe it is just a measure of what this government — or enough of it — believes. It’s reminiscent of the November framework, which was mindbogglingly irresponsible towards the health of Ontario’s citizens. Then, the province ignored advice from Public Health Ontario, and changed the thresholds after showing them to medical officers of health numbers. Had the province not backed down, we would have overwhelmed hospitals by Christmas.
That framework was a brief victory for the provincial government’s COVID denialism faction, whoever is in it. So is this. Finally, cases are falling. Finally, we started heading in the right direction.
But apparently that isn’t the important part, so here is what probably happens next. Cases will stop declining, at first. According to Dr. Peter Juni, the scientific director of Ontario’s independent volunteer science table, the B.1.1.7 variant was still doubling every eight days under the restrictions that were otherwise crushing the virus. When the variant hits 10 per cent of total cases, the decline flattens; watch specific regions first. After 30 per cent, the variant starts climbing walls. Britain’s third wave, fuelled by the variant, was worse than the first two.
So then will come the flood, and a government that decided on this foolhardy recklessness will have to find enough wisdom to reinstitute not just the restrictions they are loosening, but to make them stronger to control the variants. Ontario has vaccinated more or less the entire long-term care population, if later than we should have. But the rest of society can overwhelm hospitals just as easily, if they get sick enough.
“The rules of the game that worked for the old virus will not necessarily work for the new ones,” Juni said. “The rules of the game changed.”
Dr. Juni points to Ireland, which added reopening, Christmas, and the variant, and found new cases doubling every three days before strong lockdown measures.
“The point is they had a possibility to lock down to bring it under control again,” Juni. said. “And we do not have a track record that we will be able to do so under the old conditions.
“Our handbrake, once we go into lockdown, will not even be enough to bring the curve to a horizontal flat line, unless we are actually reinforcing the lockdown, and do that much differently than last time. Paid sick leave would be a part of that, reinforcing a clear distinction between essential and non-essential work would be a part of that, a curfew would be a part of that. It can be done much more strictly.
“And if you don’t react (at 30 per cent) you’re too late if you can’t pull a really strong handbrake. It’s Toronto and Peel I really worry about. More vulnerable people, more vulnerable communities, more essential workers in industrial settings, more difficult living situations, lower income, not enough social security. It’s always the same 101.”
This is, as many have begun to say, a second pandemic, with the same people bearing the burden as the first. And the province knows that, now. Which means this province’s leadership might actually be less prepared to truly fight this time around.