Update on COVID-19 ProjectionsScience Advisory and Modelling Consensus Tables
February 11, 2021
Key Findings
2
• Public health measures are paying off in declining mobility, cases, positivity, and hospitalizations.
• Focussing vaccination on long-term care homes is paying off with declining daily deaths.
• ICU occupancy is flat and the access to care deficit continues to grow. • The B.1.1.7 Variant of Concern is spreading. Cases will likely grow again in
late February with ICU admissions increasing afterwards. • Aggressive vaccination and sticking with stay-at-home order will help avoid
a third wave and a third lockdown.• Some key mental health indicators are unchanged. However, important
measures such as emergency department admissions, opioid deaths and care for eating disorders are worsening.
Declines in mobility have helped reduce cases
3
Ontario
Quebec
AlbertaManitoba
British Columbia
4 4
5 5
Cases and percent positivity declined across age groups.
6
7
Vaccine dose administrations
Data Source: COVax. Data to Jan 22nd extracted from COVax Dose Admin by Day Report. Jan 23rd-Feb 7th: COVax daily reports (Health Data Branch, MOH). Includes Pfizer and Modernavaccines. Excludes records where status is not known.
Current status
Since December 15, 2020, 426,834 vaccine dose administrations have been reported in COVax.
These administrations include Pfizer and Moderna vaccines.
92% of vaccine administrations have been since Jan 1, 2021.
7
Cumulative COVID-19 vaccine dose administrations (426,834 doses to Feb 10, 2021)
0
50
100
150
200
250
300
350
400
450
15-D
ec
17-D
ec
19-D
ec
21-D
ec
23-D
ec
25-D
ec
27-D
ec
29-D
ec
31-D
ec
02-Ja
n
04-Ja
n
06-Ja
n
08-Ja
n
10-Ja
n
12-Ja
n
14-Ja
n
16-Ja
n
18-Ja
n
20-Ja
n
22-Ja
n
24-Ja
n
26-Ja
n
28-Ja
n
30-Ja
n
01-F
eb
03-F
eb
05-F
eb
07-F
eb
09-F
eb
Dose
s Adm
inis
tere
dTh
ousa
nds
Cumulative COVID-19 Vaccinations
2020 2021 Source: COVAX
426,834
The majority of deaths arise from long-term care.
8Analysis: COVID-19 ModCollab. Data: CCM+
Data Source: Ministry of Long Term Care Tracker, Feb 8th extraction based on data reported up to 3:30 pm Feb 7th, 2021. Data are self-reported by the long-term care homes to the Ministry of Long-Term Care. Daily case and death figures may not immediately match the numbers posted by the local public health units (i.e. iPHIS database) due to lags in reporting time.
Current status
213 LTC homes have COVID-19 outbreaks (34% of all homes) with 90 outbreaks involving resident cases.
25 of 34 PHUs have at least 1 home in outbreak.
Since January 1st 900 LTC residents and 3 staff have died of COVID-19. Wave 2 deaths (1,821) now roughly equal to Wave 1 (1,848).
9
0
200
400
600
800
1000
1200
1400
1600
1800
2000
Sep1
Sep15
Oct1
Oct15
Nov1
Nov15
Dec1
Dec15
Jan1
15-Jan
01-Feb
COVID-19 cases and deaths for LTC residents and staff
Daily Active Cases Residents
Daily Active Cases Staff
Cumulative deaths since Sept 1
Long-term care key indicators improved.
10Data Sources: Daily Bed Census Summary COVID-19 Report + Critical Care Information System. Extracted via MOH SAS VA February 9, 2021. Does not include patients in alternative health facilities (AHFs)
0
100
200
300
400
500
600
700
800
900
1,000
1,100
1,200
1,300
1,400
1,500
1,600
1,700
1,800
1,900
2,000
Confirmed COVID-19 Acute Inpatients (excluding ICU)Confirmed COVID-19 ICU Patients
Hospitalizations dropped and ICU occupancy stabilized.
The highly transmissible B.1.1.7 variant will soon dominate.
• Variants are likely between 5% and 10% of cases now.
• To prevent an increase in total cases Re for B.1.1.7 needs to be below 0.7.
• Current Re is between 0.8 and 0.9, it has only approached 0.7 once.
• Public Health Measures appear to be effective against all variants.
• First cases of B.1.351 (detected in South Africa) and P.1 (detected in Brazil) detected in Ontario.
11Predictions: QueensU
To control growth with variants, we must push R to 0.7
120
200
400
600
800
1000
1200
1400
1600
1800
15-Dec-20 04-Jan-21 24-Jan-21 13-Feb-21 05-Mar-21 25-Mar-21 14-Apr-21
Daily
Cou
nted
Cas
es
Toronto Forecast OV R = 0.7
Observed Cases
Old Variant (Estimated)
New Variant (Estimated)
Forecast OV R = 0.7
OV Forecast (R = 0.7)
NV Forecast (R = 0.98)
Predictions: DLSPH
At R=0.9 (just above current) variant triggers exponential growth
130
200
400
600
800
1000
1200
1400
1600
1800
15-Dec-20 04-Jan-21 24-Jan-21 13-Feb-21 05-Mar-21 25-Mar-21 14-Apr-21
Daily
Cou
nted
Cas
es
Toronto Forecast OV R = 0.9
Observed Cases
Old Variant (Estimated)
New Variant (Estimated)
Forecast OV R = 0.9
OV Forecast (R = 0.9)
NV Forecast (R = 1.26)
Predictions: DLSPH
If public health measures are lifted, cases could rise dramatically depending on spread of B.1.1.7.
14Predictions informed by modeling from COVID-19 ModCollab, McMasterU, QueensU, YorkU;
recent decrease in new daily casesData (Observed Cases): covid-19.ontario.ca
-
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
20,000
01-0
1
01-0
3
01-0
5
01-0
7
01-0
9
01-1
1
01-1
3
01-1
5
01-1
7
01-1
9
01-2
1
01-2
3
01-2
5
01-2
7
01-2
9
01-3
1
02-0
2
02-0
4
02-0
6
02-0
8
02-1
0
02-1
2
02-1
4
02-1
6
02-1
8
02-2
0
02-2
2
02-2
4
02-2
6
02-2
8
03-0
2
03-0
4
03-0
6
03-0
8
03-1
0
03-1
2
03-1
4
03-1
6
03-1
8
03-2
0
03-2
2
03-2
4
03-2
6
03-2
8
03-3
0
Daily Cases
ON - Daily ON - 7-Day Mean ON 5%↓ Low Medium High
The majority of ICU admissions arise outside of long-term care homes.
15Analysis: COVID-19 ModCollab. Data: CCM+
ICU Occupancy will follow changes in case rates by two weeks. Growth could start as early as the second week in March.
16Predictions: COVID-19 ModCollab. Data (Observed ICU Occupancy): CCSO
0
100
200
300
400
500
600
700
01-0
1
01-0
3
01-0
5
01-0
7
01-0
9
01-1
1
01-1
3
01-1
5
01-1
7
01-1
9
01-2
1
01-2
3
01-2
5
01-2
7
01-2
9
01-3
1
02-0
2
02-0
4
02-0
6
02-0
8
02-1
0
02-1
2
02-1
4
02-1
6
02-1
8
02-2
0
02-2
2
02-2
4
02-2
6
02-2
8
03-0
2
03-0
4
03-0
6
03-0
8
03-1
0
03-1
2
03-1
4
03-1
6
03-1
8
03-2
0
03-2
2
03-2
4
03-2
6
03-2
8
03-3
0
ICU Occupancy
ON Observed ON Predicted Low High Medium Capacity Threshold
The impact of the Pandemic has been inequitable and will continue to be inequitable
Analysis: COVID Heterogeneity Research GroupData: ICES
17
Mental health medication dispensing has been stable
Analysis: ODPRNData: ICES data is updated quarterly, with up to a 3 month reporting lag
Individuals dispensed benzodiazepines (per 1,000 population) [ICES data]
WHO pandemic declaration
18
Emergency department visits for mental health and addictions care have declined
-43%
-2%
-15%
-38%
6%
-17%
-50%
-40%
-30%
-20%
-10%
0%
10%
20%
30%
2020-02-23 2020-03-23 2020-04-23 2020-05-23 2020-06-23 2020-07-23 2020-08-23 2020-09-23 2020-10-23 2020-11-23 2020-12-23 2021-01-23
Perc
ent
Mental Health-related ED visits Substance Use-related ED visitsWHO pandemic
declaration
Analysis: OH MHA Centre of ExcellenceData: Electronic Canadian Triage and Acuity Scale (eCTAS)
19
Overdose deaths have continued to climb
Notes: Data provided by the office of the Chief Coroner of Ontario (OCC); Suspect drug-related deaths are identified based on preliminary information reported by the investigating coroners to the office of the Chief Coroner of Ontario. It takes several months for these investigations to be completed and acute drug toxicity deaths to be confirmed; Opioid-related deaths includes confirmed and probable, and are considered preliminary; Once investigations are complete, acute opioid toxicity is typically deemed to be at least one of the substances directly contributing to about 65%-80% of suspected-drug related deaths (depending on the time period)
WHO pandemic declaration
Analysis: ODPRNData: Chief Coroner of Ontario
20
Eating disorder visits and admissions have increased.
21
0
0.5
1
1.5
2
2.5
3
3.5Ja
n-17
Feb-
17M
ar-1
7Ap
r-17
May
-17
Jun-
17Ju
l-17
Aug-
17Se
p-17
Oct
-17
Nov
-17
Dec-
17Ja
n-18
Feb-
18M
ar-1
8Ap
r-18
May
-18
Jun-
18Ju
l-18
Aug-
18Se
p-18
Oct
-18
Nov
-18
Dec-
18Ja
n-19
Feb-
19M
ar-1
9Ap
r-19
May
-19
Jun-
19Ju
l-19
Aug-
19Se
p-19
Oct
-19
Nov
-19
Dec-
19Ja
n-20
Feb-
20M
ar-2
0Ap
r-20
May
-20
Jun-
20Ju
l-20
Aug-
20Se
p-20
Crud
e ra
te p
er 1
00,0
00 p
opul
atio
n
4-week average
Hospitalizations and emergency department visits* for eating disorders among children and adolescents (3 to 17 years) in Ontario by 4-week average, Jan 2017 to Sept 2020
Emergency department visits Hospitalizations
Analysis: OH MHA Centre of ExcellenceData: ICES)
Key Findings
22
• Public health measures are paying off in declining mobility, cases, positivity, and hospitalizations.
• Focussing vaccination on long-term care homes is paying off with declining daily deaths.
• ICU occupancy is flat and the access to care deficit continues to grow. • The B.1.1.7 Variant of Concern is spreading. Cases will likely grow again in
late February with ICU admissions increasing afterwards. • Aggressive vaccination and sticking with stay-at-home order will help avoid
a third wave and a third lockdown.• Some key mental health indicators are unchanged. However, important
measures such as emergency department admissions, opioid deaths and care for eating disorders are worsening.
Contributors
• COVID Heterogeneity Research Group: Rafal Kustra, Huiting Ma, Siyi Wang, Gary Moloney, Kristy Yiu, Beate Sander, Jeff Kwong, Stefan Baral, Sharmistha Mishra
• COVID-19 Modeling Collaborative: Kali Barrett, Stephen Mac, David Naimark, Aysegul Erman, Yasin Khan, Raphael Ximenes, Sharmistha Mishra, Beate Sander
• DLSPH: Ashleigh Tuite, David Fisman• Fields Institute: Kumar Murty• QueensU: Troy Day• McMasterU: Michael Li, Irena Papst, Ben Bolker, Jonathan Dushoff, David Earn• YorkU: Jianhong Wu, Francesca Scarabel, Bushra Majeed • MOHLTC: Michael Hillmer, Kamil Malenvov, Qing Huang, Jagadish Rangrej, Nam Bains, Jennifer Bridge• OH: Erik Hellsten, Stephen Petersen, Anna Lambrinos, Chris Lau, Access to Care Team, Michelle Rossi, Paul
Kurdyak (also DLSPH and CAMH)• ODPRN: Tara Gomes• PHO: Sarah Buchan, Kevin Brown
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Content provided by Modelling Consensus and Scientific Advisory Table members and secretariatBeate Sander,* Peter Juni, Brian Schwartz,* Kumar Murty,* Upton Allen, Vanessa Allen, Nicholas Bodmer, Isaac Bogoch, Kevin Brown, Sarah Buchan, Yoojin Choi, Troy Day, David Earn, Gerald Evans, David Fisman, Jennifer Gibson, Anna Greenberg, Anne Hayes, Michael Hillmer, Jessica Hopkins, Jeff Kwong, Audrey Laporte, John Lavis, Gerald Lebovic, Brian Lewis, Linda Mah, Kamil Malikov, Antonina Maltsev, Doug Manuel, Allison McGeer, David McKeown, John McLaughlin, Sharmistha Mishra, Justin Morgenstern, Samira Mubareka, Laveena Munshi, Christopher Mushquash, Ayodele Odutayo, Shahla Oskooei, Samir Patel, Bill Praamsma, Justin Presseau, Fahad Razak, Rob Reid, Paula Rochon, Laura Rosella, Arjumand Siddiqi, Chris Simpson, Arthur Slutsky, Janet Smylie, Nathan Stall, Ashleigh Tuite, Jennifer Walker, Tania Watts, Ashini Weerasinghe, Scott Weese, Xiaolin Wei, Jianhong Wu, Diana Yan, Emre Yurga
* Chairs of Scientific Advisory or Modelling Consensus Tables
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