What to expect in 2021: More COVID-19, more deaths

OPINION: Given the events of last year, making predictions about this one is an act of hubris. But it’s fair to say that Ontario will face at least three major pandemic-related challenges
By John Michael McGrath - Published on Jan 05, 2021
Education Minister Stephen Lecce (left), pictured here with Premier Doug Ford in July 2020, sent a letter to parents saying elementary-school students will return to in-class instruction on January 11. (Nathan Denette/CP)



If, on January 1, 2020, you’d been asked to predict what would happen in the ensuing 365 days, you might have gotten some big things right — if you predicted Joe Biden would win the United States election, collect your winnings. But unless you have truly paranormal gifts of prediction, getting the truly big stuff about last year right would have been all but impossible. Could anyone, on New Year’s Day one year ago, have predicted the global reach of COVID-19? The scale of anti-police protests across the U.S. over the summer? Or, closer to home, the WE scandal that destroyed a major Canadian charity, taking a finance minister along with it? The year ahead could hold just as many surprises, making prediction an act of hubris.

But just because we can’t know everything doesn’t mean we don’t know anything, and plenty about what will unfold in 2021 is going to unfold from things that have already happened — or are happening right now.

For starters, more people will continue to get sick from COVID-19. This is so obvious at this point that it barely needs to be said, but it’s worth elaborating on since it’s going to be the single biggest factor driving events in Ontario for at least the next six months. More people were sick from COVID-19 on a single day at the beginning of 2021 (24,778 active cases on January 3) than were infected in all of October 2020 (24,459). And October was already well into Ontario’s second wave. Even if cases start declining immediately after this column is published — a lovely thought, truly — we’re still looking at many days with 1,000-plus new cases and at weeks with scores of new deaths. And it’s not obvious, as I write this, that cases are going to start declining at all, much less declining quickly.

This reality is going to consume the government’s attention on at least three fronts. The most immediate involves a decision Premier Doug Ford and Education Minister Stephen Lecce need to make by the end of this week: whether elementary-school students will return to in-class instruction on January 11, as currently planned. The minister reiterated that plan in a January 2 letter to parents — which will make him look foolish if the government has to reverse course by Friday.

But COVID-19 didn’t take the Christmas break off: an additional 3,315 school-aged children have been infected just since the government announced the extended Christmas break on December 21, according to Ministry of Health data. Spread over Ontario’s millions of students, that’s not a huge figure, but there’s little to suggest that it’s slowing down — so if the rate of infection was sufficient to justify the closure in the first place, how will it be safe to reopen?

The next problem the government needs to solve is COVID-19 in long-term-care homes. The premier’s promise to create an “iron ring” around residents and staff in LTC is sounding increasingly hollow: more than 1,000 residents have died since September 1, and more than 500 of those in December alone. As necessary, hospitals have taken over the management of LTCs, but the same pandemic that’s killing the frail elderly is filling up hospital intensive-care units to levels not seen even during the first wave, raising the very serious question of how far hospital resources can be stretched before they snap.

Long-term-care residents are, mercifully, near the front of the line for vaccinations, so there’s reason to hope that their deaths will start to decline relatively early in the new year.

But the vaccination rollout is the third pandemic-related factor the government needs to manage, and so far it’s off to a rocky start. After taking time off during the Christmas holiday (a decision for which task-force chair Rick Hillier has taken responsibility), Ontario has so far been vaccinating between 4,000 and 5,000 people a day, which everyone regards as inadequate. Whether those numbers can rise quickly enough to choke off the increasing deaths from outside the long-term-care system is an open question.

On December 9 — the day Health Canada approved the Pfizer-BioNTech vaccine — 3,871 people had died of COVID-19 in this province. On January 4, the number was 4,679, and it will continue to grow. One of the grim milestones I’m watching for in 2021: whether more Ontarians will die from COVID-19 after the vaccine was certified than did before. For us to avoid that grim arithmetic, the province’s case counts need to start falling, and its vaccinations need to start rising, quickly.

There will, of course, be more to provincial politics this year. We’ll get the report from the LTC commission the government created last year (the commission has accused the government of “significant delays” in providing information and asked for an extension of its April 30 deadline; the government has refused). The Supreme Court of Canada will make its decision known in the carbon-tax reference brought by Ontario and Saskatchewan. There’s always the possibility of a federal election this year, given the minority Parliament in Ottawa, and that could upend provincial politics in interesting ways. But everything that happens in the foreseeable future — perhaps everything that happens in 2021 — will happen in the shadow of the pandemic.

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