Ontario has already hit one of its worst-case COVID-19 scenarios

OPINION: Late last month, the province’s public-health modellers identified red lines for taking more aggressive action to contain the virus. We might already have crossed the first
By Matt Gurney - Published on Nov 19, 2020
Ontario is reporting 146 COVID-19 patients in hospital intensive-care units as of November 18. (Jonathan Hayward/CP)

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It’s become almost too easy to note how weird and often conflicted Ontario’s crisis communications during the COVID-19 pandemic have become. I’ve written on that topic here more than once myself. But there was a moment on Wednesday that was so bizarre even by the low standard of the current moment, I couldn’t help but be surprised.

On Wednesday, Education Minister Stephen Lecce released a statement saying that no school shutdown was required. There had been speculation that the government was considering extending the length of the Christmas holiday, but, apparently, the public-health experts have concluded that our COVID-19 policies in the classroom are working sufficiently well. No extended break or shutdown is needed at present, Lecce said.

Fair enough. If that’s what the numbers show, that’s what the numbers show. But it was just a short while later that Lecce’s boss, Premier Doug Ford, came out and read the province the riot act.

“The virus is spreading at an alarming rate in [much of the Greater Toronto Area],” Ford said. “I can’t stress this enough. The situation is extremely, extremely serious.” He added, “We expect new measures to be discussed at cabinet and announced in the coming days. Because, my friends, we need to hunker down.”

What will that mean? Who knows? It’s not even clear that the premier knows yet. This is a democracy, after all, and no decision is made until those responsible have made it. But there is certainly reason to suspect that perhaps some enhanced form of semi-lockdown is imminent for the Toronto area, at least —  and, this time, even the dance studios might have to close.

It’s not exactly that the statements by the two men are incompatible. There is nothing explicitly contradictory about them. It is possible that effective and robust protocols in schools are minimizing the danger that keeping classes open poses to the broader population, even as that broader population suffers the consequences of an uncontrolled second wave. There are obvious and varied reasons to keep schools and daycares open for every possible day. Along with the health-care system and other critical life-sustaining infrastructure, schools — particularly elementary schools — should absolutely be the last things to close. That makes perfect sense.

But just in terms of getting some kind of clear, coherent message out there, it was hard to imagine something less helpful than Lecce giving the province a big thumbs-up at nearly the exact moment the premier was warning he’ll bring the hammer down on us, God help him, if we don’t shape up and improve our act.

The only thing you can do in the face of such incongruous communication and mixed messaging is look beyond what the politicians and public-health bureaucrats are saying and instead focus on the raw numbers. The raw numbers are bad. Late last month, as I noted here on TVO.org, the province’s public-health modellers identified red lines for taking more aggressive action to contain the virus. The red lines they settled on were how many beds in our hospital intensive-care units were occupied by COVID-19 patients. Ontario has run its health-care system so close to the bone for so many years that there is damn little excess capacity at the best of times. When our ICUs have 150-plus COVID-19 patients, we were told, the health-care system’s ability to function normally has been exceeded. At and above 350 ICU patients, the health-care system is in serious, dangerous trouble.

Late last month, public-health modelling had shown that we would hit that first red line within the next 30 days only in the worst-case scenario. A week ago, when things had worsened, the new update was that we’d hit 150 ICU beds by the end of next week. We hit 150 COVID-19 patients in ICU as of this morning.

Or near to it — there is some conflict between the data sources, with Critical Care Ontario saying 150 on the nose, and the government providing the slightly lower figure of 146. Even if the latter, lower figure is the accurate one, that’s still a one-day increase of 19. It’s hard to imagine any scenario in which the 150 figure isn’t reached in a matter of hours, if it hasn’t been already.

Either way, we’ve achieved the worst-case scenario, with a full week to spare. This is, to put it mildly, decidedly suboptimal. And since hospitalizations lag infections by many weeks, as noted in my last column here, it’s already too late to avoid this. Locking down the entire province today, with total and perfect effect, would still leave the health-care system struggling deep into next month. It’s too late to change that. The only question is what’s going to happen going forward.

And, again, we’re back to what I said above. Who knows? The province is obviously, and understandably, reluctant to hammer the economy with another widespread lockdown, which is why we keep seeing increasingly marginal tweaks to existing rules — okay, fine, you can sit in a restaurant, but with one fewer person, and you’d better know him really well! — instead of a more sweeping directive. Lockdowns have real, painful consequences for many, and it makes sense that Ford and his cabinet want to avoid them.

But attacking COVID-19 with half-measures hasn’t worked. At best, it’s held the line, as in Quebec, and, even there, things don’t look great. We are barely a month away from Christmas, when families travel and gather. We’re certainly already into the Christmas shopping season. If we’re going to stabilize our health-care system, Ford will have to have to make some tough decisions. Now.

Or by Friday, at any rate. We’ll see what he has to say. I’ll be watching, but I’ll be keeping one eye on those ICU numbers. As before, that’s the real story.

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