Over the last week, provincial and local health officials have said COVID-19 cases are in the peak period, which appears to be good news. But what exactly does it mean?
While cases seem to be in the peak period for Ontario and Toronto, it doesn’t mean we’re on the home stretch yet. However, it shows a more positive trend in cases.
On April 9, Canada’s Chief Public Health Officer Dr. Theresa Tam said that it was too early to call if Canada was in the peak of cases, but did predict the first wave of cases would last until the summer.
At this time, all three, Canada, Ontario and Toronto’s trajectories are lower than other countries like the US, Spain and Italy, which have seen exponential growth for cases and deaths.
Reaching the peak in the pandemic
On Monday, Ontario health officials said being in the peak means that the number of new cases has begun to level off rather than continuing to exponentially incline.
While a peak means a levelling off, there can still be daily spikes in cases.
“Peaks are not a single day,” Steini Brown, dean of the Dalla Lana School of Public Health at the University of Toronto, said during a press conference on April 20. “They’re not a nice single sort of spike. They can be a little bit bumpy, they can be prolonged for a period of time, particularly given public health interventions.”
Brown said pandemic curves are usually symmetrical in nature, meaning an increase of cases is followed by the plateau or peak, with a decline in cases to follow.
Toronto’s Medical Officer of Health Dr. Eileen de Villa repeated the same sentiments.
On Tuesday, de Villa said the peak is not one day or single number and that numbers can vary in the peak.
Toronto will only know it’s hit the peak once it has passed.
“We must see it level and then go down to know we’ve hit our peak,” de Villa said.
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Ontario and Toronto’s general population are in the peak
The positive news is that Ontario and Toronto are both in the peak stage amongst the general population.
Health officials emphasized that the general population and congregate settings like long-term care homes, retirement homes and hospitals must be measures separately, as congregate settings are still seeing an exponential rise in case.
According to Brown, Ontario will now see 20,000 or less total cases by the end of April, compared to the 80,000 originally projected — the province is now trending toward a best case scenario rather than a worst case scenario.
“The province has avoided a significant surge in cases. Total cumulative cases are forecast to be substantially lower than worst case or even moderate case scenarios projected by previous models,” the province said.
The enhanced public health measures, including staying home and physically distancing from each other, are working to contain the spread of the virus and flatten the curve.
Previously, the health officials said Ontario would hit its peak in May, but that given the enhanced measures, the peak came sooner than expected.
Earlier this week, de Villa said that based on data models, the curve of “pandemic activity” shows the city is in its peak period and hospitalizations have not seen the “dramatic surge we feared,” and that there has been less hospitalizations each day.
Congregate settings tell a different story
However, the data for long-term care homes tells a different story.
Ontario health officials said outbreaks in long-term care and congregate settings continue to be a “major concern” and actions are underway to protect vulnerable people in these settings.
“The new province-wide modelling data are encouraging, but we know that long-term care homes and other congregate settings will track on a different path,” Dr. Merrilee Fullerton, Minister of Long-Term Care said on Monday. “We will continue to take aggressive action to support our most vulnerable residents and their caregivers.”
To date, there are 125 outbreaks reported in long-term care homes across the province with 295 reported deaths.
Toronto is also seeing a similar situation.
In the city, deaths have been significantly attributed to long-term care homes, with 131 deaths reported out of the 190 total deaths reported in Toronto, as of April 21.
When can physical distancing measures be lifted?
While the news for the general population should seen with “cautious optimism” de Villa said, physical distancing measures must still be adhered to.
De Villa said that the measures in place will need to kept in place for “more time,” a sentiment that was shared by Mayor John Tory.
“I share in her cautious optimism, your efforts are helping to flatten the curve. Thank you to every resident who is doing their part to slow the spread of the virus,” Tory said on Monday.
“The message is clear we’ve come a long way. We will win as long as we stay the course, and we are staying the course.”
Christine Elliott, Deputy Premier and Minister of Health also acknowledged that the numbers show public health efforts are working but told residents to continue staying at home as much as possible and practise physical distancing.
On Monday, Premier Doug Ford said that the province will begin talks to “gradually” and “safely” reopen the economy, based on new data projections.
He said the Jobs and Recovery Committee will start discussing, in a measured way, the reopening of the province in slow stages and create a framework to have “strict criteria” in place for when the economy can reopen.