In recent weeks, Ontarians have been presented with duelling snapshots of the pandemic. As I noted in my last column, there are some early signs that our case numbers and hospitalizations may be stabilizing. That would be good news, to put it mildly. On Monday, the province’s latest numbers and data from the City of Toronto both suggested that there are real reasons for cautious hope. Case numbers are down off recent highs, hospitalizations are generally flat (with some daily variation), and mobility data suggests that, after a burst of travel around the Christmas and New Year’s holidays, Ontarians are hunkering down and staying home at levels comparable to the beginning of the first wave.
In an update from Toronto health officials, the province’s largest city indicated that the R(t) for COVID-19 in Toronto — the rate of growth — is just slightly higher than one. That means that the pandemic is still spreading in the city, but only by a very little bit. No spread would be better, and contraction even better than that. But this was at least mildly encouraging.
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And that’s great! Mild encouragement is highly welcome. But the province has also opened our first field hospital and temporary morgues. And even if our numbers are indeed stabilizing, they’re stabilizing too damned high. We are already beyond the health-care system’s red line, and, with new COVID-19 variants emerging, there is a ton of downside risk. To provide some capacity to handle the high number of COVID-19 patients in the Greater Toronto Area, an entire hospital will be set aside to function as a surge facility. This was always part of our pandemic preparedness plan, but it isn’t a sign that things are going particularly well.
Ontarians today are presented with a pandemic-flavoured version of that age-old question: Taken in their totality, do all these emerging trends and indicators add up to a glass that’s half full (cases coming down!) or half empty (morgues and ICUs overflowing!). The answer, of course, is “yes” to both options. This is a moment of great risk, of real hope, of early signs the lockdown is working, and of hospitals already out of beds transferring their sickest patients to other facilities. And it’s anyone’s guess where things will go from here. If we are lucky, the new state of emergency and stay-at-home order will bring things under control. But how many of us, after the past year, are feeling lucky?
As we wait for more data regarding the course of the pandemic, as we wait to find out whether the breaks will go for or against us, there was an interesting development in downtown Toronto. Even as production challenges at Pfizer constrain Canada’s access to desperately needed vaccines, the city is moving ahead with a pilot of a mass-vaccination facility. The Metro Toronto Convention Centre — an absolutely enormous series of buildings in the downtown core that’s normally home to trade conferences, the Auto Show, and, of course, Star Trek conventions — is now home to the province’s first vaccine clinic in a non-medical environment. Thus far, all of Ontario’s delivered vaccines have been provided at hospitals or long-term-care facilities. The convention centre is a way of testing how vaccine can be distributed to the general public, in a non-medical setting, en masse.
It’s not being delivered en masse yet. The facility has a daily capacity of only 250 people, which won’t make much of a dent in a city of roughly 3 million. But the small number is a feature, not a bug. This is a trial facility. It’s about testing the workflows and processes. For those familiar with the centre, it makes sense to put it there — it has multiple entrances and exits and enormous, cavernous spaces. Even huge crowds could be processed into the buildings and held in widely separated areas, with physical distance assured, in a facility of this size. And, if even more space is needed, the SkyDome — Rogers Centre, if you’re being technical — is right next door. It, too, has multiple entrances and exits, massive spaces and, oh, yeah, a retractable roof. In warmer weather, crank it open! (Get the beer and hot-dog concessions operating, too, if at all possible.)
But we won’t see vaccination centres, big or small, popping up all across the province for some time. Right now, we’ve got the one, at the convention centre, which is capable of handling 250 people at a time. There’s no point scaling it up to be any larger, because, frankly, we don’t have the vaccine supply to make it worth the effort. But it’s a worthy enterprise all the same. The various provinces haven’t knocked it out of the park thus far in terms of delivering what vaccines the federal government has provided. (There’s problems at the federal level, too, but the provinces haven’t even maxed out what’s under their own direct control.) Ontario has improved its delivery of vaccines, but it’s still inconsistent and slower than it needs to be. Getting mass-vaccination sites figured out now, in expectation of mass shipments of vaccine to come later, makes good sense.
The important thing about the convention-centre facility, of course, is that it’s scalable. And once the concept is proven, it can be transferred to other locations. What starts in an empty convention centre in downtown Toronto could be transplanted to a hockey rink, church basement, or community centre in a town near you. It may take longer than you’d like. But help is coming, and by the time it gets to you — thanks to pilot projects such as this one — it will hopefully be running like clockwork.