Third COVID-19 wave will likely be Toronto’s worst yet, says city’s top doctor

Thestar.com
April 13, 2021
Francine Kopun and Jennifer Pagliaro

The third wave of COVID-19 will likely be the worst the city has seen, Toronto’s top doctor has warned.

The city is on track to hit 2,500 new COVID-19 cases a day by the end of the month if transmission continues at the current rate, medical officer of health Dr. Eileen de Villa told the Board of Health in an update on Monday morning.

During the second wave, the highest daily number was 1,642 new COVID-19 cases. Even if transmission can be cut by 10 per cent, by mid-May, hospitalizations will reach the peak levels of the second wave.

“Right now what we can anticipate is that this third wave is likely going to be the worst that we have seen thus far over the course of the pandemic,” de Villa told the board.

Asked at the COVID-19 briefing at city hall later in the day how the third wave got so bad, despite the experience gained fighting the first two waves of the epidemic, de Villa said she isn’t sure.

“I think that’s a question that we may have to reflect on for some time,” she said.

“I think the other thing, of course, that we have to keep in mind is that the variants, they’re a different virus. It is a different set of circumstances that we’re dealing with here.”

Later in the day, the province announced schools will remain closed after the April break, and students will continue with virtual classes instead, a move Mayor John Tory said he supports.

Tory added that the city will work with the province to continue to provide and support emergency child care options for the families of front-line workers.

Toronto’s seven-day moving average was at 931 new cases per day on Monday morning; the test positivity rate was at 8.4 per cent. The goal is a test positivity rate of less than three per cent.

The reproductive rate is at 1.07, far above the goal of below one new case for every new infection. The acute bed occupancy rate was reported at 92 per cent, as of Monday morning, when the goal is under 90 per cent occupancy.

A local expert says vaccines don’t offer an immediate rescue.

“Vaccinations won’t help blunt things in April. It will help precipitate a decline in May,” said Dr. Colin Furness, an infection control epidemiologist.

The goal of vaccinations is to create an immune community, where COVID has nowhere to go, and that takes time, said Furness. “We’ll get there, but not until we have had a real catastrophe.”

He said a hard lockdown, including curfews or mass rapid testing to ferret out cases, could work, but he said testing has not been widely used for that purpose yet and he doesn’t think the government will change tactics now.

“Our current situation is extremely dire. We lack the political will to interrupt this wave. I am expecting refrigerator trucks outside hospitals. We have seen that elsewhere and we have put ourselves on the same path,” said Furness.

However, fellow epidemiologist Dr. David Fisman said that while such a scenario is possible, it’s unlikely.

“If you look at how rapidly infections declined in January, you can see that this disease (even with variants) is eminently controllable.

“Also, people react to information from non-government sources. I suspect movement would decline just based on news headlines right now. People are scared and that results in behaviour change.”

A third epidemiologist, Dr. Andrew Morris, said this third wave could have been avoided had the government undertaken more serious measures earlier on.

“Our government has played a dangerous game of chicken with our lives against all scientific advice, and this is where we’re at,” he said, in his most recent newsletter, which he has been issuing weekly since the pandemic began.

A letter from the College of Physicians and Surgeons of Ontario, issued last week, warns doctors may soon be faced with deciding which patients will be offered critical-care resources that are in short supply, under a triage protocol developed by the province.

According to the World Health Organization, nearly three million people worldwide have died of COVID-19, including 23,315 people in Canada.