An interesting scenario is unfolding right now in Ontario. Our daily COVID-19 cases have bumped upward considerably in recent days. They’re down a bit Monday, but that’s been a pattern throughout the pandemic — the weekend seems to temporarily knock down the COVID-19 case counts, which then rise a bit later in the week. The “rise” may not actually reflect a rise at all but simply a catching-up in terms of illness and tests from the week before. This is why seven-day averages are your best friend in trying to understand what’s happening. Those averages are rising now.
I described this above as an interesting scenario, which may seem an odd way to characterize it, but it really is an interesting challenge for policymakers. Ontario’s case rates have been stable or declining for months. I’ve made a habit of knocking wood every time I point this out, but even as Alberta and Saskatchewan have struggled with brutal fourth waves, there hasn’t been much to see in Ontario. We’ve reopened schools, travelled for Thanksgiving, begun returning to large indoors events — Go Leafs Go! — and all the rest, and the numbers stayed good. This really did suggest that our vaccination level might have been getting high enough to really present broad-based societal benefits.
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The individual benefits of vaccination are clear; our exit from COVID-19, though, won’t be at the individual level but at the provincial one: when there aren’t enough people left who can get seriously ill from COVID-19 such that they threaten the health-care system, the pandemic will be over (over here, at any rate). The virus will continue to circulate, and people will still become sick and die, but the society-wrenching event of the pandemic will be behind us. And though I am reluctant to get ahead of things and jinx the whole endeavour, our recent numbers have looked fantastic.
Is the vaccine level high enough that, combined with masks, we can hold COVID-19 at bay? Or have we, yet again, declared victory prematurely? Will COVID-19 once again humble all those who dared to hope and plan?
Damned if I know. I’m not shocked to see the case numbers way up. We’re just about a week removed from Halloween, which fell on a weekend this year. I am a boring father in his increasingly late 30s, so my own social life is pretty tame. But as I was out and about on errands on the Halloween weekend, and then as I saw my entire neighbourhood descend into pleasant chaos as hordes of kids rampaged through to make up for the time and candy lost to the pandemic last Halloween, it occurred to me that we would probably see a bump in the numbers right around now. People were everywhere, going from house to house to trick-or-treat or to join parties. I said to my wife as we escorted our barbarians from door to door that Halloween was probably going to a superspreader of more than just little bags of Doritos. Obviously, people travelled and gathered indoors with family around Thanksgiving, but there was nothing on the chaotic scale of what I saw on Halloween. Barely a week later, yeah, the cases are up. The fact that the new cases are also lopsidedly clustered among the young is no surprise, also for this reason.
So what do we do?
For now, for my money, we wait. This might be a temporary Halloween-related blip that’ll smooth itself out as it runs into the wall of vaccine. By the time next weekend rolls around, maybe we’ll be back to looking great. If so, awesome. Carry on as you were.
If this is a real surge, though, and we are looking at the beginning of something more worrying, our response undoubtedly would and should look different. The third wave that proved so disruptive in Ontario came at a very different time. Though you can quibble about the precise start date of the third wave, no one can deny that, when it kicked off in February and March 2021, Ontario’s vaccination rate was in the single digits, and even then, mostly for single doses. The number of Ontarians who’d received a shot was in the low-to-mid six figures. We were throwing every available dose at the most vulnerable people, including health-care-sector workers and residents in long-term-care facilities. Despite the scale of the third wave, the strategy did seem to succeed in keeping deaths down to a less appalling level than we had previously seen. But enough people still got sick that our hospitals were pushed right to the brink of catastrophe.
Today in Ontario, we have very high vaccination levels, they continue to slowly move upward, and we are hopeful that vaccines will become available for children over the age of five sometime in the next few weeks (which would mean protection for the last large remaining segment of the population). Boosters are about to roll out to vulnerable groups. The number of COVID-19 patients in our hospitals and intensive-care units is currently manageable. Indeed, Ontario has been able to absorb patients from Saskatchewan, helping prevent the much smaller province’s system from collapsing the way we feared ours would last spring
These are all points in our favour. A massive case surge now would obviously result in more serious illnesses, hospitalizations and, tragically, deaths. But it would not look the same as the last one and would warrant a different kind of response
There’s also the political dimension. Though he had to be dragged to it kicking and screaming, insisting he would not roll out a vaccine passport, Premier Doug Ford eventually did indeed roll out a vaccine passport. Future lockdowns would not necessarily need to be entirely broad-based. We could, if we chose, try to tailor them in a more specific way, with different rules for the vaccinated and unvaccinated, reflecting the different risk profile.
If we’re being honest, no one around Ford has any real political desire to lock anything down ever again. I’m not sure there’s much willingness among the public, either, to be frank — not with vaccine levels as high as they are. We are likely heading into the management stage of COVID-19, even if that management stage is more, uh, dynamic than we might have hoped.
We’ll know more in a week or so. By then, we should know whether the numbers are still rising, and we might begin to see whether the more important metric — hospital capacity — is also heading in the wrong direction. If we are looking at a fourth wave building here (a big if, still), then Ford and those around him are going to need to make some decisions, and quickly. They haven’t excelled as this thus far, and this time, they’d need to react to a very different kind of crisis … if only to buy time for children to become eligible for vaccination.
The next week or so will be interesting. There’s no cause for alarm. But pay attention.