Update on COVID-19 Projections

Science Advisory and Modelling Consensus Tables

February 25, 2021
Key Findings

• Declines in cases, hospitalization and ICU occupancy are slowing. Public health
measures have decreased transmission and slowed spread of variants of concern.
• Variants of concern such as B.1.1.7 continue to spread across Ontario. Cases,
hospitalizations, and ICU admissions will likely soon increase.
• Evidence-based approaches to key public health measures, such as focusing
vaccination where it has the biggest impact on deaths and hospitalizations, are
key to controlling the impact of the pandemic.
• The next few weeks are critical to understanding the impact of the variants. There
is a period of remaining risk before the pandemic likely recedes in the summer.
• We can keep the gains we have made by watching spread very closely and by
loosening public health measures only carefully. We must be nimble in applying
public health measures to extinguish flare ups quickly.

2
 Total new cases per 100,000 per week across Public Health Units
360
Province-wide lockdown First dose vaccination
Completed in
Weekly new cases per 100,000 residents

prioritized PHUs
320

280

240
(7-day avg.)

200

160

120
Northwestern, 105 weekly cases
Thunder Bay, 105 weekly cases
80 Peel, 84 weekly cases
Toronto, 71 weekly cases
York, 67 weekly cases
CONTROL (cases ≥ 40) Ontario, 49 weekly cases
40
RESTRICT (cases ≥ 25)
PROTECT (cases ≥ 10)
0
Aug 15
Aug 22
Aug 29

Oct 10
Oct 17
Aug 1
Aug 8

Oct 24
Oct 31
Oct 3

Nov 14
Nov 21
Nov 28
Nov 7

Feb 13
Feb 20
Jan 16
Jan 23
Jan 30
Feb 6
Jan 2
Jan 9
Sep 12
Sep 19
Sep 26

Dec 12
Dec 19
Dec 26
Sep 5

Dec 5
3
Data source: Case and Contact Management System (CCM), data up to February 22
 Testing episodes per 100K across Public Health Units
650

600

550
Testing episodes per 100,000

500

450 Porcupine, 448

Thunder Bay, 444
400
(7-day avg.)

350

300

250 Ontario, 247

200
Ottawa, 175
150 Halton, 169

100

50

0
Aug 15
Aug 22
Aug 29

Oct 10
Oct 17
Aug 1
Aug 8

Oct 24
Oct 31
Oct 3

Nov 14
Nov 21
Nov 28
Nov 7

Feb 13
Feb 20
Jan 16
Jan 23
Jan 30
Feb 6
Jan 2
Jan 9
Sep 12
Sep 19
Sep 26

Dec 12
Dec 19
Dec 26
Sep 5

Dec 5 4
Data source: Ontario Laboratory Information System (OLIS), data up to February 22
 COVID-19 testing % positivity across Public Health Units
14 First dose vaccination
Province-wide lockdown completed in
prioritized PHUs
% positivity of daily testing episodes

12

10
(7-day avg.)

8
Peel, 7.1%
6
Toronto, 5.6%
York, 5.3%
Thunder Bay, 4.6%
4
Northwestern, 3.1%
CONTROL (positivity ≥ 2.5%) Ontario, 3.1%
2
RESTRICT (positivity ≥ 1.3%)
PROTECT (positivity ≥ 0.5%)
0
Aug 15
Aug 22
Aug 29

Oct 10
Oct 17
Aug 1
Aug 8

Oct 24
Oct 31
Oct 3

Nov 14
Nov 21
Nov 28
Nov 7

Feb 13
Feb 20
Jan 16
Jan 23
Jan 30
Feb 6
Jan 2
Jan 9
Sep 12
Sep 19
Sep 26

Dec 12
Dec 19
Dec 26
Sep 5

Dec 5
5
Data source: Ontario Laboratory Information System (OLIS), data up to February 22
Case and death rates in long-term care homes continue to
improve (20 resident deaths in the last 7 days)

Current status COVID-19 cases and deaths for LTC residents and staff
2000
129 LTC homes have COVID-19 1800 Daily Active Cases Residents
outbreaks (20% of all homes);
1600
46 involve residents (Feb 21). Daily Active Cases Staff
1400
Outbreaks still occurring across 1200
Cumulative deaths since Sept 1

most Public Health Units. 1000

Second wave mortality (1,886 800

deaths) has now surpassed the 600

first wave (1,848 deaths). 400

Daily death rates have dropped 200

sharply. 0
Sep Sep Oct Oct Nov Nov Dec Dec Jan 15- 01- 14-
1 15 1 15 1 15 1 15 1 Jan Feb Feb

Data Source: Ministry of Long Term Care Tracker, Feb 21st extraction based on data reported up to 3:30
pm Feb 22, 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 6
health units (i.e. iPHIS database) due to lags in reporting time.
Focused LTC vaccination, together with lockdowns, have
rapidly reduced infections and deaths in LTC

7
A key to disease control, mobility has been flat but new
variants will start to increase case numbers

8
Variants of Concern (VOC) continue to spread quickly in
Ontario (likely 40% of cases in second week of March)

9
Data: PHO
Weekly growth in Variants of Concern in Ontario matches
other countries.
100%

90%
% VOC by week (Countries aligned at VOC > 10%)
80%

70%

60%

50%

40%

30%

20%

10%

0%
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Ontario Germany Netherlands Denmark Switzerland UK

Data: PHO (Ontario), Robert Koch Institute (RKI), Rijksinstituut voor Volksgezondheid en Milieu (RIVM), 10
Danish Covid-19 Consortium, SARS-CoV-2 Variants of Concern in Switzerland, Public Health England
 -
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
1-1-21
1-3-21
1-5-21
1-7-21
1-9-21
1-11-21
1-13-21
1-15-21

ON - Daily
1-17-21
1-19-21
1-21-21
1-23-21
1-25-21
1-27-21
variants of concern.

1-29-21
1-31-21
2-2-21
2-4-21

ON - 7-Day Mean
2-6-21
2-8-21
2-10-21
2-12-21
2-14-21
Daily Cases

2-16-21
2-18-21
ON 5%↓

2-20-21
2-22-21
2-24-21
2-26-21
High

2-28-21
3-2-21
3-4-21
3-6-21
3-8-21
3-10-21
3-12-21
Medium

3-14-21
3-16-21
3-18-21
3-20-21
3-22-21
Low

3-24-21
3-26-21
3-28-21
3-30-21
Future case growth depends heavily on our control of the

Data (Observed Cases): covid-19.ontario.ca

Predictions informed by modeling from COVID-19 ModCollab, McMasterU, PHO, YorkU
11
 COVID-19 hospitalization and ICU occupancy decreases
1800
have started to level off.
1600
Patients in Inpatient Beds with COVID19…
1400
Patients in ICU with COVID-Related Critical Illness

1200

1000

800

600

400

200

0
01-Aug 08-Aug 15-Aug 22-Aug 29-Aug 05-Sep 12-Sep 19-Sep 26-Sep 03-Oct 10-Oct 17-Oct 24-Oct 31-Oct 07-Nov 14-Nov 21-Nov 28-Nov 05-Dec 12-Dec 19-Dec 26-Dec 02-Jan 09-Jan 16-Jan 23-Jan 30-Jan 06-Feb 13-Feb 20-Feb

Data Sources: MOH COVID Inpatient Census and Critical Care Information System, data up to February 21 12
 0
50
100
150
200
250
300
350
400
450
500
01-01
01-03
01-05
01-07
01-09
01-11
01-13
01-15
01-17

ON Observed
01-19
01-21
01-23
01-25
01-27
01-29
01-31
02-02

ON Predicted
02-04
02-06
02-08
02-10

High
02-12
02-14
02-16
02-18
ICU Occupancy

02-20
02-22
Medium

02-24
02-26
02-28
03-02
Low

03-04
03-06
03-08
ICU occupancy is likely to remain challenged.

03-10
03-12
03-14
03-16
03-18
03-20
03-22
Capacity Threshold

03-24
03-26
03-28
03-30
Data (Observed ICU Occupancy): CCSO
Predictions: COVID-19 ModCollab.
13
More Ontarians are getting vaccinated, focusing coverage on
areas where impact is greatest will be important.
Individuals whohave
Individuals that have received
recieved first dose
at least 1 dose Individualsthat
Individuals who have
have been
been fullyfully vaccinated
vaccinated (2 doses)
400000

350000

300000
Cumulative # of Doses

250000

200000

150000

100000

50000

0
2020-12-15
2020-12-16
2020-12-17
2020-12-18
2020-12-19
2020-12-20
2020-12-21
2020-12-22
2020-12-23
2020-12-24
2020-12-25
2020-12-26
2020-12-27
2020-12-28
2020-12-29
2020-12-30
2020-12-31
2021-01-01
2021-01-02
2021-01-03
2021-01-04
2021-01-05
2021-01-06
2021-01-07
2021-01-08
2021-01-09
2021-01-10
2021-01-11
2021-01-12
2021-01-13
2021-01-14
2021-01-15
2021-01-16
2021-01-17
2021-01-18
2021-01-19
2021-01-20
2021-01-21
2021-01-22
2021-01-23
2021-01-24
2021-01-25
2021-01-26
2021-01-27
2021-01-28
2021-01-29
2021-01-30
2021-01-31
2021-02-01
2021-02-02
2021-02-03
2021-02-04
2021-02-05
2021-02-06
2021-02-07
2021-02-08
2021-02-09
2021-02-10
2021-02-11
2021-02-12
2021-02-13
2021-02-14
2021-02-15
2021-02-16
2021-02-17
2021-02-18
2021-02-19
2021-02-20
2021-02-21
2021-02-22
• Reporting in COVax began on December 15, 2020. At this time, only first doses were administered.
• Starting the first week of January 2021, second doses began being administered.
Source: COVax-ON data February 23, 2021 - 10:10 AM
- Data for Time Given between 12/15/2020 to 02/22/2021
- Dose 1 Administered was determined based on the first Time Given for each client. 14
- Dose 2 Administered was determined based on the last Time Given for each client where there is more than 1 dose administered
The next few months are key to maintaining our gains
and a declining pandemic in the summer
• A combination of vaccination and public health measures should help reduce
transmission
• Strong public health measures brought cases down and slowed spread of new variants of concern
• Vaccination in long-term care has helped bring down deaths and cases
• Vaccination of older age groups and high-risk communities will drive hospitalizations and deaths
down further
• A changing environment for COVID-19 will help decrease transmission
• Warmer weather will increase time outdoors and decrease time in crowded or closed-in places
• Increasing vaccination should confer immunity more reliably and safer than historical models
(1918 Influenza pandemic) that had to rely on the spread of infection alone
• The major challenge becomes how to protect the health system over the next few
months and closely monitor the spread of all types of cases while accelerating
vaccination
• We should expect flares in communities and settings where risk factors make people
vulnerable
15
Key Findings

• Declines in cases, hospitalization and ICU occupancy are slowing. Public health
measures have decreased transmission and slowed spread of variants of concern.
• Variants of concern such as B.1.1.7 continue to spread across Ontario. Cases,
hospitalizations, and ICU admissions will likely soon increase.
• Evidence-based approaches to key public health measures, such as focusing
vaccination where it has the biggest impact on deaths and hospitalizations, are
key to controlling the impact of the pandemic.
• The next few weeks are critical to understanding the impact of the variants. There
is a period of remaining risk before the pandemic likely recedes in the summer.
• We can keep the gains we have made by watching spread very closely and by
loosening public health measures only carefully. We must be nimble in applying
public health measures to extinguish flare ups quickly.

16
Contributors

• COVID-19 Modeling Collaborative: Kali Barrett, Stephen Mac, David

Naimark, Aysegul Erman, Yasin Khan, Raphael Ximenes, Sharmistha Mishra,
Beate Sander
• Fields Institute: Kumar Murty
• 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)
• PHO: Sarah Buchan, Kevin Brown, Vanessa Allen

17
Content provided by Modelling Consensus and Scientific
Advisory Table members and secretariat
Beate 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

18