#COVID in Canada: Here’s how our battle to prevent a second wave is going

Note: Data in the charts last updated on Sept. 16 at 9 a.m. EDT. (Some provinces include their weekend numbers in Monday’s data announcement.)

As the number of COVID-19 cases surged in Ontario,  Anthony Dale, CEO of the Ontario Hospital Association, sounded the alarm: “If current trends continue to accelerate, economic restrictions may tighten once more, and the school year for our children will be in jeopardy.”

The next day, the provincial government reported that COVID-19 hospitalizations jumped from 39 to 47, a 20 per cent increase. The numbers are well below those in the spring, when more than 1,000 beds were occupied by COVID-19 patients, but the exponential trend may foreshadow a dark autumn season for the pandemic.

The number of cases are increasing even faster than hospitalizations in Ontario. For the week ending on Sept. 14, the number of COVID-19 cases in the province jumped 58 per cent. For the previous week, that increase was 24 per cent while the week before that saw just a six per cent increase. The numbers have pushed Ontario’s rate of new cases to 15.6 per million population, its highest level since June 15.

“Everything about staying open and trying to live our lives as best we can while the pandemic is here is predicated on controlling community spread, and we’re just, we’re seeing it slip away, I’m afraid, unless we’re far more diligent as individuals,” Dale of the Ontario Hospital Association told the Globe and Mail. While the Ontario government has put on hold any further relaxation in public health rules, health experts are calling for immediate rollbacks. “The longer we wait to do something differently in Ontario, the more impactful that ‘something’ will need to be,” stated Dr. Irfan Dhalla, vice-president at St. Michael’s Hospital in Toronto, adding that measures may include limiting non-urgent health care and closing schools. Dr. David Fisman, an epidemiology professor at the University of Toronto, concurs with the need to be proactive, equating the spread of COVID-19 in a population to that of cancer in a body: “Treat localized disease or chase your tail on widespread metastases.”

Ontario isn’t alone in erasing its summer gains. In recent weeks, Quebec’s numbers have turned south. On Aug. 30, the province’s rate of new cases surpassed the national average. As of Sept. 14, it is 25.9 per million population, the province’s highest level since June 9.

Ontarians and Quebeckers wondering what may be coming next, need only to look at the cautionary tale that is British Columbia. By adopting tough public health measures, the Western province had escaped the worst of the spring crisis that hit Ontario and Quebec hard. For months, B.C. held its rate of new cases below three new daily cases per million population, keeping the COVID-19 fire reduced to low embers.

But when the province relaxed its rules, many residents lowered their guards. They doffed masks and ignored physical distancing rules as they enjoyed the summer in bars and backyard gatherings, and B.C.’s COVID-19 fire roared back to life. “The location may be different, but the risks in these uncontrolled environments are similar—being indoors, in close face-to-face contact with a number of people for an extended period of time, and in many cases, with alcohol,” explained Dr. Bonnie Henry, the provincial health officer, on Sept. 8. On that day, B.C.’s rate of new cases was a provincial record 20.7 per million population.

“Exposure events in these higher-risk, uncontrolled locations that have been a major source of transmission since the start of our Phase 3 reopening,” Henry explained, as she announced rollbacks of previous reopening measures. Nightclubs and banquet halls were immediately closed, while liquor sales in bars and restaurants had to end by 10 p.m. As well, the volume levels on sound systems had to be dialled down to that of normal conversation so people didn’t need to shout or move closer to hear.

The situation in neighbouring Alberta is just as serious. On Monday, Sept. 14, Alberta announced that 418 new cases had been added to its tally for Saturday, Sunday and Monday (like B.C., it doesn’t update its COVID-19 data on weekends). Those new cases sent its per capita rate skyrocketing from 32.2 daily cases per million on the previous Friday to 44, its highest since May 3.

 
Young people account for most of Canada’s recent cases of COVID-19. Their fearlessness means many don’t worry about the well-known health threat of COVID-19. Yet, new research published in the JAMA Network shows they should take the new coronavirus seriously. Analysis of more than 3,200 Americans, age 18-34, admitted to hospital, showed that more than 20 per cent ended up in intensive care while nearly three per cent died of the disease.

Even those who experience few major COVID-19 symptoms can still develop serious problems. Doctors now believe that as many as 10-15 per cent of those infected suffer from heart inflammation, Dr. Mitchell Elkind, president of the American Heart Association, told Buzzfeed News, a rate much higher than caused by other viruses, including the seasonal flu. “This is a serious, deadly disease that does more than just kill people, but leaves others with potential long-term consequences they may have to live with for a long time,” said Elkind. “This is all just one more reason to wear a mask, wash your hands, take care of your neighbours.”

The quick spread of COVID-19 can be seen in its “R value,” or reproduction number, which indicates how easily COVID-19 is spreading. As of Sept. 14, eight of the 10 provinces have R values of more than 1, meaning that each infected person is infecting more than one other person, according to data crunched by Ryan Imgrund, a hospital biostatistician in London, Ont. For example, Saskatchewan has an R value of 1.64, meaning each 100 infected people are passing COVID-19 to 164 others.

The quickness with which COVID-19 can spread through communities can be seen in Quebec school statistics. Since students returned to classes, nearly 300 schools have reported at least one case of COVID-19 as of Monday, Sept. 15, according to official notifications collected by Covid école Québec.

A familiar pattern has developed as jurisdictions deal with the virus. There is a surge in cases; then, some of the newly infected end up needing hospitalization; finally, some of the seriously ill die of the new disease. As Canada reduced its caseload during the summer, the number of deaths fell. On Friday, the Public Health Agency of Canada reported no new deaths from COVID-19, the first time that’s happened since March 15, when the nation was in the midst of locking down. The news went viral, especially in the United States, which recorded 1,094 deaths that same day.

Now, after several weeks of increasing numbers of new cases, hospitalizations are growing in COVID-19 hotspots. Experts say it’s only a matter of time before the death toll starts rising.