Effective Saturday April 3rd at 12:01 am, the provincial government will implement the “emergency break” for the entire province. All 34 public health regions will move into shutdown for a period of at least four weeks.
Measures under the emergency break include, but are not limited to:
- Prohibiting indoor organized public events and social gatherings and limiting the capacity for outdoor organized public events or social gatherings to a 5-person maximum, except for gatherings with members of the same household (the people you live with) or gatherings of members of one household and one other person from another household who lives alone.
- Restricting in-person shopping in all retail settings, including a 50 per cent capacity limit for supermarkets, grocery stores, convenience stores, indoor farmers’ markets, other stores that primarily sell food and pharmacies, and 25 per cent for all other retail including big box stores, along with other public health and workplace safety measures;
- Prohibiting personal care services;
- Prohibiting indoor and outdoor dining. Restaurants, bars and other food or drink establishments will be permitted to operate by take-out, drive-through, and delivery only;
- Prohibiting the use of facilities for indoor or outdoor sports and recreational fitness (e.g., gyms) with very limited exceptions;
- Requiring day camps to close; and,
- Limiting capacity at weddings, funerals, and religious services, rites or ceremonies to 15 per cent occupancy per room indoors, and to the number of individuals that can maintain two metres of physical distance outdoors. This does not include social gatherings associated with these services such as receptions, which are not permitted indoors and are limited to five people outdoors.
All Ontarians are asked to limit trips outside the home to necessities such as food, medication, medical appointments, supporting vulnerable community members, or exercising outdoors with members of their household. Employers in all industries should make every effort to allow employees to work from home. Premier Ford stated Ontario has the toughest restrictions in North America right now.
ICU/Hospital Capacity
There have never been more patients in ICUs in Ontario than there are now. The provincial government is dedicating an additional 70 beds at the Toronto Congress Centre for alternate care patients. This will help free-up beds for COVID-19 patients in hospitals.
Vaccines
350 additional pharmacies will offer vaccines across the province on Saturday, bringing the total to over 700 pharmacy locations. The province is ready to ramp up to 1500 locations when more vaccines arrive. Premier Ford stated that the millions of vaccines needed by the province are only weeks away, but the province needs more time to get cases under control before they arrive.
Schools
The provincial government is closely monitoring the situation in the province’s schools. Keeping schools open is a top priority, but the provincial government will not hesitate to act to protect kids and their families.
Outbreaks/Restriction in Peel Region and Toronto
Dr. Williams stated that outbreaks are occurring in small businesses such as gyms, and restaurants. Dr. Williams stated that these outbreaks have not occurred in Toronto and Peel Region because small businesses have been closed in these areas, but that doesn’t mean these outbreaks wont happen if these businesses were to reopen. Dr. Williams stated that the lockdown has worked in Toronto and Peel Region, and the local medical officers of health would agree with that.
Premier Ford stated the provincial government will continue to focus on Peel Region, York Region, and Toronto, and more specifically the high-risk areas within these regions.
Easter
Premier Ford stated that indoor religious services will be allowed to remain open this weekend at 15% capacity. Premier Ford stated that all Ontarians need to avoid social gatherings this weekend.
COVID-19 Provincial Modelling – April 1st
Key Findings
- The third wave is here and is being driven by the Variants of Concern (VOC).
- Younger Ontarians are ending up in hospitals. The risk of ICU admission is 2x higher and the risk of death is 1.5x higher with the B.1.1.7 variant.
- COVID-19 is already threatening the health system’s ability to deal with regular ICU admissions.
- Vaccination is not reaching the highest risk communities, delaying its impact as an effective strategy
- School disruptions have a significant and inequitable impact on students, parents, and society. Further school disruptions should be minimized.
- Stay-at-Home orders will control the surge of cases, protect access to care, and increase the chance of the summer Ontarians want.
Cases
Cases are increasing in most Public Health Units, and remain above the Control or Red-Level of the Ontario Framework. Most new cases are due to the VOCs, primarily the B.1.1.7 variant.
Testing Positivity
Testing percent-positivity has increased (8.6% in Peel Region). Testing rates remain the same, so the growth in cases is not a result of more testing.
Variants of Concern (VOC)
VOCs have more severe consequences and are more fatal. VOCs have a 2x higher risk of resulting in ICU admissions, and a 1.5x higher risk of resulting in death. The risk of being put on a ventilator is now 3x higher. There is a 2.5x greater risk of transmission of the virus before symptoms show, reinforcing the need to follow public health measures so people do not spread the virus when they don’t know they have it.
COVID-19 is now having a great impact on younger and healthier people, including hospitalizations and deaths.
Hospitalizations and ICU
There has been a 41.7% increase in hospitalizations over the past two weeks. While hospitalization rates after the second wave dropped, rates of ICU occupancy never really came down. 46% of ICU patients are currently between the ages of 0 – 59. During the peak of the second wave, 30% of ICU patients were between the ages of 0 – 59. This reflects the changing nature of the VOC. Entire families are now showing up in ICUs at the same time.
Case Projections
The provincial health table has provided modelling for four scenarios with the corresponding daily case rates by the end of April:
- No intervention = just under 12,000 cases
- Vaccinations = 6,000 cases
- Vaccinations and a two-week stay-at-home order – 2,000 cases, before creeping back up
- Vaccinations and a four-week stay-at-home order – under 2,000 cases
ICU Projections
The provincial health table has provided modelling for three scenarios with the corresponding ICU bed occupancy rates by the end of April.
- Vaccinations = 1000
- Vaccinations and a two-week stay-at-home order = 800
- Vaccinations and a for-week stay-at-home order = just under 800
It should be noted that it takes longer to reduce ICU cases. The four-week stay-at-home order would significantly reduce ICU occupancy over a longer period of time, but it is harder to forecast beyond the end of April. Dr. Brown stated that if ICU occupancy rates reach 800 it will result in “a place where clinicians will have to make hard decisions you never want them to make…their will be lives lost”.
Surgery Backlog
The cumulative pandemic-related surgery backlog is 245,367. At some point these procedures will need to be performed. These are not only optional surgeries, but all types of surgeries.
Communities at Risk
Case rates are highest in communities where more essential workers live, and there are substantially higher growth rates in these communities. It will be important to consider how we support and vaccinate these communities.
Vaccinations are not reaching the highest risk populations. Older age groups are being vaccinated more which is good to see, but we are not vaccinating more in the most at-risk communities. Getting vaccines to where they are needed most is a complex endeavour, but it is an important target to pursue.
School Disruptions
School disruptions will have a significant impact on students, families, and society. With school disruptions, there will be a significant loss in learning. Schools should be the last to close and first to open during any public health measure decisions.
Studies have demonstrated that schooling impacts will result in long-term economic and social issues:
- 3% drop in lifetime earnings for these cohorts
- Lost GDP for Canada estimated at $1.6 trillion
- Loneliness and social isolation
- Loss of structure affecting physical activity, sleep, and mental health
- Decreased ability to detect neglect or abuse
All negative impacts are highly inequitable with greater learning loss for students at a greater disadvantage.