Update on COVID-19 ProjectionsScience Advisory and Modelling Consensus Tables

April 16, 2021

Key Findings

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• COVID-19 cases, hospitalizations and ICU occupancy are at their highest levels since March 2020 and variant cases continue to rise sharply.

• ICU occupancy is compromising care for all patients.• Ontarians can help themselves and others by limiting mobility to truly

necessary trips and always wearing a mask and keeping 6 feet distantwhen in contact with anyone outside their household.

• Although improving, vaccination is not reaching people at high-risk fast enough to overcome the level of serious illness in our communities and our hospitals.

• Without stronger system-level measures and immediate support for essential workers and high-risk communities, high case rates will persist through the summer.

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Data source: CCMData note: Data for the most recent day have been censored to account for reporting delays

Cases are rapidly increasing in most Public Health UnitsMarch 29 April 11

3

Dec 26Province-wide lockdown

14-days for N. Ontario28-days for S. Ontario

Jan 18First dosevaccinationcomplete inprioritized PHUs

Apr 3Province-wide

emergency brakePeel, 15.0%

Toronto, 11.3%York, 10.4%

Durham, 9.0%Ontario, 7.9%

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2

4

6

8

10

12

14

16Au

g 1

Aug

15

Aug

29

Sep

12

Sep

26

Oct

10

Oct

24

Nov

7

Nov

21

Dec

5

Dec

19

Jan

2

Jan

16

Jan

30

Feb

13

Feb

27

Mar

13

Mar

27

Apr 1

0

Specimen Date

(7-d

ay a

vg.)

% p

ositi

vity

of d

aily

test

ing

episo

des

Data source: Ontario Laboratory Information System (OLIS), data up to April 9

Test positivity rates are increasing across Ontario

4

Hastings & PEC, 473

Windsor-Essex, 145

Ontario, 320

100

200

300

400

500

600

700

Aug

1

Aug

15

Aug

29

Sep

12

Sep

26

Oct

10

Oct

24

Nov

7

Nov

21

Dec

5

Dec

19

Jan

2

Jan

16

Jan

30

Feb

13

Feb

27

Mar

13

Mar

27

Apr 1

0

Specimen Date

(7-d

ay a

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Test

ing

episo

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er 1

00,0

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Data source: Ontario Laboratory Information System (OLIS), data up to April 9

Ontario testing rates are flat – the increase in cases is becausethere are more cases, not more tests being done

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The number of variant cases continues to rise and variants now dominate, but even the original strain is rising.

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200

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800

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1400

1600

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2000

01-Sep 08-Sep 15-Sep 22-Sep 29-Sep 06-Oct 13-Oct 20-Oct 27-Oct 03-Nov 10-Nov 17-Nov 24-Nov 01-Dec 08-Dec 15-Dec 22-Dec 29-Dec 05-Jan 12-Jan 19-Jan 26-Jan 02-Feb 09-Feb 16-Feb 23-Feb 02-Mar 09-Mar 16-Mar 23-Mar 30-Mar 06-Apr

Patients in Inpatient Beds with COVID19

Patients in ICU with COVID-Related Critical Illness

Data Sources: MOH COVID Inpatient Census and Critical Care Information System

A record number of Ontarians are in hospital due to COVID-19

Last 2 weeks:67% growth in

hospitalizations51% growth in ICU

occupancy

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A 6 week stay-at-home order with a vaccination rate of at least 100K doses per day is the only way to flatten the curve.

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Figure summarizes predictions across 4 models with many scenarios.Stay-at-home order assumptions:• 4 or 6 weeks starting Apr 8• Weak to strong effect on

transmissionVaccine assumptions:• 60% effective in preventing

infection• 100,000 doses/day• Administered at random

Predictions informed by modeling from COVID-19 ModCollab, Fields Institute, McMasterU, PHO, YorkUData (Observed Cases): covid-19.ontario.ca

Under every scenario, more vaccines mean a faster resolution in the long-run

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5,000

10,000

15,000

20,000

25,000

30,000

35,000

01-01 01-08 01-15 01-22 01-29 02-05 02-12 02-19 02-26 03-05 03-12 03-19 03-26 04-02 04-09 04-16 04-23 04-30 05-07 05-14 05-21 05-28 06-04 06-11 06-18 06-25

Daily Cases

ON - Daily ON - 7-Day Average

Weak PH Measures 4 wks + 100k doses/day Moderate PH Measures 6 wks + 100k doses/day

Strong PH Measures 6 wks + 100k doses/day Weak PH Measures 4 wks + 300k doses/day

Moderate PH Measures 6 wks + 300k doses/day Strong PH Measures 6 wks + 300k doses/day

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As predicted, ICU occupancy is rising dramatically. System-level public health measures will help blunt some of the impact.

10Predictions: COVID-19 ModCollab. Data (Observed ICU Occupancy): CCSO

Mobility has declined slightly but not enough to bring current growth under control.

11Predictions: COVID-19 SAT. Data Google and Apple Mobility data

Mobility has declined slightly across settings. Further reducing mobility and always wearing a mask and distancing is how Ontarians help reduce cases.

12Predictions: COVID-19 SAT. Data Google and Apple Mobility data

0

50,000

100,000

150,000

200,000

250,000

Data Source: Wait Times Information System. Backlog estimated based on comparison of 2020/21 with 2019/20 surgical volumes

The access to care deficit is building which will be felt by Ontarians well past the pandemic Cumulative backlog:

248,109 cases

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0

First dose vaccine coverage expanding but remains incompleteMore than 3m doses administered

Data SourcesMOF Population ProjectionsCOVAX analytical file, extracted, 8:00 pm Apr 12 2021, CPAD, MOHCOVAX Skedulo, extracted 6:00pm Apr 12 2021 14

Vaccination by risk is improving but remains a key to controlling spreadFigure excludes long-term care vaccination – at least 1 dose as of April 12, 2021

Source: ICES 15

What happens if we vaccinate 3 million adults over the next 30 days?100,000 vaccinations per day, top 20% highest incidence neighbourhoods

010203040506070

Age 16-59 (60 days) Age 60+ (60 days) Total population (60days)

% c

umul

ativ

e ca

ses

aver

ted

Population

Potential impact at 60 days: % of cumulative cases averted, compared to no vaccination moving forward

Age-based, per-capita Enhanced to high-incidence FSAs

Number vaccines per case averted

59 34

Analysis: COVID Heterogeneity Research Group, COVID-19 ModCollab, PHO. Data: CCM

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Key Findings

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• COVID-19 cases, hospitalizations and ICU occupancy are at their highest levels since March 2020 and variant cases continue to rise sharply.

• ICU occupancy is compromising care for all patients.• Ontarians can help themselves and others by limiting mobility to truly

necessary trips and always wearing a mask and keeping 6 feet distantwhen in contact with anyone outside their household.

• Although improving, vaccination is not reaching people at high-risk fast enough to overcome the level of serious illness in our communities and our hospitals.

• Without stronger system-level measures and immediate support for essential workers and high-risk communities, high case rates will persist through the summer.

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

• Fields Institute: Taha Jaffar, Kumar Murty• ICES: Jeff Kwong, Hannah Chung, Kinwah Fung, Michael Paterson, Susan Bronskill, Laura Rosella,

Astrid Guttmann, Charles Victor, and Michael Schull, Marian Vermeulen• McMasterU: Michael Li, Irena Papst, Ben Bolker, Jonathan Dushoff, David Earn• YorkU: Jianhong Wu, Francesca Scarabel, Bushra Majeed • MOHLTC: Michael Hillmer, Kamil Malikov, Qing Huang, Jagadish Rangrej, Nam Bains, Jennifer

Bridge• OH: Erik Hellsten, Stephen Petersen, Anna Lambrinos, Chris Lau, Access to Care Team• PHO: Kevin Brown• Science Advisory Table: Peter Juni

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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, Laura Desveaux, David Earn, Gerald Evans, David Fisman, Jennifer Gibson, Anna Greenberg, Anne Hayes,* Michael Hillmer, Jessica Hopkins, Jeff Kwong, Fiona Kouyoumdjian, Audrey Laporte, John Lavis, Gerald Lebovic, Brian Lewis, Linda Mah, Kamil Malikov, Antonina Maltsev, Doug Manuel, Roisin McElroy, Allison McGeer, David McKeown, John McLaughlin, Sharmistha Mishra, Justin Morgenstern, Andrew Morris, Samira Mubareka, Laveena Munshi, Christopher Mushquash, Ayodele Odutayo, Shahla Oskooei, Menaka Pai, Samir Patel, Anna Perkhun, Bill Praamsma, Justin Presseau, Fahad Razak, Rob Reid,* Paula Rochon, Laura Rosella, Michael Schull, Arjumand Siddiqi, Chris Simpson, Arthur Slutsky, Janet Smylie, Nathan Stall, Robert Steiner, Ashleigh Tuite, Jennifer Walker, Tania Watts, Ashini Weerasinghe, Scott Weese, Xiaolin Wei, Jianhong Wu, Diana Yan, Emre Yurga

* Chairs of Scientific Advisory, Evidence Synthesis, and Modelling Consensus TablesFor table membership and profiles, please visit the About and Partners pages on the Science Advisory Table website.

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