update on covid-19 projections
TRANSCRIPT
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
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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
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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
vg.)
Test
ing
episo
des p
er 1
00,0
00
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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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
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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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