Not to be overly cynical about things, but I think it’s fair to say that Doug Ford finally has the pandemic where he wants it in Ontario. This latest wave is very different from prior ones — indeed, it might be time to stop thinking about “waves” at all. In the first, second, and third waves of COVID-19, the Greater Toronto Area, and specifically Toronto and Peel Region, led the province in the severity of their outbreaks. That’s not the case now.
As of Tuesday morning’s report, the places that are seeing the highest rates are not Toronto or any of the regions immediately adjacent to Toronto. The closest is Haldimand-Norfolk, or perhaps Simcoe-Muskoka. But the cities that make up about half of Ontario’s population — from Durham in the east, swinging through Toronto, Peel, Halton, and Hamilton — all have fewer new daily cases and fewer active cases than the provincial average.
Meanwhile, things are bad in Sudbury and Algoma, especially; those areas are seeing more than 100 active cases per 100,000; provincewide, the number is about 30 (Toronto has just over 24 per 100,000, and Peel, 15.) Unsurprisingly, then, the local medical officers of health in Algoma and Sudbury have reimposed such public-health measures as capacity limits in bars and sporting venues to try to contain the spread of the virus.
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This is what I mean when I say that Ford has the pandemic where he wants it: local outbreaks might be severe, but so long as things are relatively under control in the province’s biggest population centres, the risk to the hospital system should be manageable. Outbreaks in the northeast should be taken seriously, and if the province can do more to help there, it should, but it’s hard to see them generating the volume of ICU cases necessary to threaten the overall health-care system.
For a government that never has less than one eye on its approaching re-election bid, this isn’t great — nothing is, in a pandemic — but it’s manageable and shouldn’t involve the need for the deeply unpopular lockdowns of previous waves. Better still, in the next month or so, some concrete measures should tamp down the rate of viral spread even further.
First, we’ll see Health Canada approve the use of Pfizer vaccines for the five-11 cohort. The largest remaining common group of unvaccinated people regularly in a congregate setting — schoolchildren, in other words — will start to be protected. (If that doesn’t happen very soon, there’s a real risk that parents of young children will march on Ottawa with fire and sword.) It’s now mathematically impossible for young kids to be fully vaccinated — 14 days after a second dose coming 21 days after the first — before the start of Christmas break, but every bit helps.
In terms of keeping ICU beds clear, third doses will have the largest impact, and they’re going to start rolling out in larger numbers in coming weeks. The province’s current rule is that people are eligible for third doses 168 days (six 28-day “months”) after their second, so, at the moment, relatively few people even within the 70-plus cohort are eligible: 168 days ago, only about 6 per cent of Ontarians over 70 had received their second doses. But those numbers are going to start climbing quickly. By December 6, half of the 70-plus cohort will be eligible; a week after that, half of the 60-plus cohort will be — but only if the government expands the eligibility criteria. Currently only those 70-plus, those who had two shots of the Astra Zeneca vaccine, and Indigenous people are generally eligible.
There’s probably an argument for speeding this up, at least a little. If people could, for example, get a third dose at five months instead of six (140 days instead of 168), 60 per cent of the 50-59 cohort and even larger shares of older cohorts would be eligible by December 1. Since these are the age groups most likely to need the improved immune response of a third dose and most in danger of a COVID-19 infection turning into a COVID-19 ICU case, the option of offering them improved protection before the heart of the holiday season (which is also the flu season, alas) is worth discussing.
But vaccines for school-age kids will help suppress the spread of COVID-19 in schools. And third doses will reduce the likelihood that the elderly will end up in the hospital. There are solid, science-based reasons to believe that this winter won’t be a repeat of last year’s winter of our discontent. There are still good reasons for caution — ask folks in Sudbury or Algoma about that — but, as things stand now, there are relatively few reasons to panic. If you’re the government of Ontario, a winter where the lid is mostly kept on the pandemic and nobody needs to worry about school shutdowns in the spring — and where the outbreaks that do happen can be handled by local public-health officers, not via grim press conferences by the premier — will be very welcome indeed. For the rest of us, it’s just the promise of a slightly more normal holiday.