Third wave of pandemic hits seniors the hardest, figures show
Infections rise among youth, but older adults still account for vast majority of deaths
While COVID-19 has spread fastest among unvaccinated people under 30 years of age during Ontario’s third wave, that growth has taken attention away from another, more deadly trend: the pandemic is still hitting Ontario seniors the hardest.
Despite a vaccination program initially targeting people in their 60s, 70s and 80s, these older demographics continue to suffer the worst outcomes more often.
Since March 1, the majority of new cases have been among those in their 30s or younger, but people in this age group are far less likely to die of the virus than older demographics. The younger cohort has accounted for nearly 60 per cent of new infections in the past six weeks, but less than two per cent of deaths. Conversely, people 60 and older have made up about 15 per cent of new cases in the past six weeks, but those cases are responsible for nearly 90 per cent of deaths.
“Any death is horrible, but the fact is there has been a lot of attention around a few young people dying when at the same time, on a daily basis, there are at least a dozen older people dying. But for some reason, they have not been making the news,” said Dr. Samir Sinha, director of geriatrics at the Sinai Health System and the University Health Network.
“The majority of people who are ending up in hospital are older adults and older adults still remain the ones who are most at risk of getting sick and dying of COVID.”
Older Ontarians aren’t just suffering more deaths; they also make up the vast majority of hospitalizations.
In the past 14 days, adults 60 and over accounted for 61 per cent of COVID-19 hospitalizations, while those age 39 and younger made up 13 per cent.
As of Tuesday, Ontario was reporting 1,646 people in hospital with COVID-19, just shy of an all-time record. Meanwhile, the totals of 619 patients in the ICU, with 408 on ventilators, are both well above the worst figures Ontario saw in Wave 2.
Why are cases, hospitalizations and deaths still high among Ontarians over 60? Experts say there are a combination of factors.
First, even though the provincial government’s vaccine rollout plan targeted older Ontarians during its first phase, recent vaccination data shows we still have a long way to go before most older residents are vaccinated. As of March 29, about 67 per cent of Ontarians 80 years of age and older had received at least one dose of the COVID-19 vaccine, according to data from the non-profit ICES, formerly the Institute for Clinical Evaluative Sciences. In the 70-79 age group, only about 25 per cent of people had received at least one dose, while roughly 16 per cent of those between 60 and 69 were vaccinated.
“The vaccination proportion in the 60s and 70s isn’t adequate to make any real difference. In other words, the pool of fully susceptible people is still very large,” said Colin Furness, an infection control epidemiologist at the University of Toronto. “You need to get a lot higher than that.”
Meanwhile, vaccinations have helped lower deaths among even-older Ontarians over the age of 90.
In Wave 2, that cohort was responsible for 30 per cent of reported deaths, many in longterm care. In Wave 3, following a vaccine rollout that focused on nursing homes, that number is below 15 per cent.
While vaccination rates among those in their 60s and 70s are still relatively low in Ontario, they are even lower in GTA areas with high concentrations of essential workers, an inequality that allows the virus to spread among vulnerable populations, said Dr. Amit Arya, a GTA palliative care physician.
Last week, ICES published statistics showing that neighbourhoods in Toronto and Peel hardest hit by COVID-19 were among those with the lowest rates of vaccination. For example, in Toronto’s Jane and Finch neighbourhood, where many essential workers live in multi-generational households, just 5.5 per cent of residents had at least one dose of the vaccine as of March 29, the lowest rate in the city.
“Through this pandemic, a large part of the suffering I’ve seen has been in long-term care and congregate care settings. But other than that, almost everyone I’ve seen has been someone who’s an essential worker or a family member of an essential worker,” said Arya, who has worked in Peel Region, where many of the province’s hot spots are located.
“Many of the people that I see live in these extended-family type of settings, like a multigenerational household, and what we have seen with the variants, of course, it’s not just one or two people getting sick, but it’s everybody in the house getting COVID.”
Premier Doug Ford announced last week the province will begin to offer vaccines to people 18 years of age and older in Toronto and Peel hot spots, with mobile teams fanning out in an effort to reach people in residential complexes and workplaces.
Arya added that as vaccines are distributed in these regions, the province needs to ensure that not only essential workers receive the vaccine, but also their family members and other vulnerable residents, such as homebound seniors.
“If you’re homebound, you’re weak, and your children are working paycheque to paycheque and are extremely busy, and there’s mixed messaging that is often not language-specific, it’s very easy to miss your appointment or not get an appointment for a vaccine through no fault of your own,” he said.
Dr. Nathan Stall, a geriatrician at Mount Sinai Hospital in Toronto, noted that with the spread of variants of concern, “you’re more likely to end up in hospital in ICU and you’re more likely to die if you’re a younger person. That is true, but the same is also true for older people and to a much greater extent.”
“There’s this prevailing narrative that this pandemic is only impacting younger people now and that the tragedies that are happening are only among the young,” he added. “The point is that we should focus on both of the tragedies and focus on protecting all vulnerable people in the province.”
“Many of the people that I see live in ... a multi-generational household, and what we have seen with the variants, it’s not just one or two people getting sick, but it’s everybody in the house getting COVID.”
DR. AMIT ARYA
PALLIATIVE CARE PHYSICIAN