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Toronto is in the fourth wave of COVID-19, experts say, as daily infection numbers soar
Aug. 11, 2021

Toronto is in the early days of a fourth wave of COVID-19 certain to worsen this autumn, experts say after an almost fivefold jump in daily new infections over one month.

The question now is how to ensure the city’s high vaccination rate prevents hospitalizations and deaths from surging along with infections, especially among the legions of unvaccinated young schoolchildren headed back to classrooms.

Defences include continued mask rules and, if necessary, shutting schools and businesses to halt outbreaks, said Toronto infectious diseases expert Dr. Anna Banerji. But she said the best defence is vaccine mandates -- a measure the Ontario government is so far rejecting.

Students should be required to show proof of COVID-19 vaccination, Banerji said, as should workers in health care, long-term care and maybe just people going to theatres and other crowded places with an elevated risk of virus spread.

Fully vaccinated people are much less likely to get COVID-19 and, if they are infected, less likely to get seriously ill. The virulent Delta variant, fuelling new pandemic waves in Australia, Britain and the U.S., is primarily hospitalizing unvaccinated people, including schoolchildren, amid post-lockdown mingling.

In Toronto, Banerji said, “between the border reopening, loosening public health restrictions and kids going back to school -- all of that is going to increase the number of COVID cases, mostly in the unvaccinated population including when school starts.

“I’d rather have vaccine mandates than mandates to close -- I think everyone is fed up with that. There should be leadership and responsibility from the provincial government,” to issue proof of vaccination and set rules for its use, she said.

“If somebody chooses not to get vaccinated and wants to do everything from home, that’s their option. For the rest of us, we want to keep everyone safe.”

Health Minister Christine Elliott on Tuesday again rejected calls from groups, including nursing home operators, for mandatory vaccinations for health-care workers, saying people can print their own vaccination records and suggesting “smart cards” would be somehow more prone to fraud.

Also Tuesday, Seneca College announced all staff and students must be vaccinated to attend the Toronto campus. Quebec, meanwhile, announced details of its coming vaccine passport, limiting who can go to crowded sites including festivals, bars, restaurants and gyms in an attempt to prevent a fourth wave of COVID-19.

Experts note that vaccinated people can be infected with COVID-19 and, with no or minor symptoms, infect unvaccinated people at much greater risk. Another concern is kids under 12, who currently can’t be vaccinated, getting sick at school and then infecting unvaccinated adults at home and triggering community spread.

While most infected kids won’t get seriously ill, the sheer number of them heading back to school raises the risk of some being hospitalized and even dying, warns Dr. David Fisman, a University of Toronto epidemiologist.

“I think if you look south of the border -- schools open in the southern states in August -- and see what’s happening there, and look at what was happening in the U.K. a few weeks ago, it’s entirely reasonable to expect fairly explosive COVID growth in kids here this fall,” he said. “Masks and cohorts will help, but Delta is a pretty big challenge.”

Infection levels have risen in Toronto since mid-July when restrictions on businesses and gatherings eased. Toronto Public Health on Monday reported a daily average of 105 new cases, up from 22 on July 10.

New hospitalization and death numbers, however, remain near pandemic lows.

Asked if Toronto is in a fourth wave, Toronto Public Health said in a statement the exponential growth in spread suggests “another distinct rise and peak in the future” -- but “we would only be able to know if a fourth wave has occurred with certainty only after we reach the peak and start our decline.”

Omar Khan, a U of T professor of biomedical engineering, said he hopes virus “flare-ups” in this wave will be spread throughout Ontario rather than overwhelming the health-care capacity of any particular region.

Key, he said, will be tracking who goes into intensive care with COVID-19 and quickly adjusting if many of them are school kids.

“The coming weeks are going to be very telling,” Khan said. “Online learning is a very real possibility if you see too many hospitalizations of children under 12.”