Update on COVID-19 Projections

Science Advisory and Modelling Consensus Tables

April 16, 2021
Key Findings

• 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 distant
when 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.
2
 Weekly new cases per 100,000 residents

100
150
200
250
300

50

Data source: CCM

Peel
Toronto
York
Durham
Middlesex-London
Ottawa
Niagara
Hamilton
Wellington-Dufferin-Guelph
Halton
Brant
Eastern
Simcoe Muskoka
Haldimand-Norfolk
Hastings & PEC
Waterloo
Windsor-Essex
Haliburton KPR
Southwestern
March 29

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

KFLA
Northwestern
Grey Bruce
Porcupine
Renfrew
April 11

Huron Perth
Algoma
North Bay Parry Sound

Sudbury
Lambton
Cases are rapidly increasing in most Public Health Units

Leeds Grenville Lanark

Thunder Bay
Chatham-Kent
Timiskaming
3
 Test positivity rates are increasing across Ontario
Dec 26 Jan 18 Apr 3
16 Province-wide lockdown First dose Province-wide
14-days for N. Ontario vaccination emergency brake
28-days for S. Ontario complete in Peel, 15.0%
% positivity of daily testing episodes

14
prioritized PHUs

12
Toronto, 11.3%
10 York, 10.4%
(7-day avg.)

Durham, 9.0%
8
Ontario, 7.9%
6

0
Aug 15

Aug 29

Oct 10

Oct 24

Nov 21

Apr 10
Mar 13

Mar 27
Dec 19
Sep 12

Sep 26

Feb 13

Feb 27
Jan 16

Jan 30
Aug 1

Nov 7

Dec 5

Jan 2
Specimen Date 4
Data source: Ontario Laboratory Information System (OLIS), data up to April 9
Ontario testing rates are flat – the increase in cases is because
there are more cases, not more tests being done
700

600
Testing episodes per 100,000

500 Hastings & PEC, 473

(7-day avg.)

400

300
Ontario, 320

200

Windsor-Essex, 145
100
Aug 1

Aug 15

Aug 29

Oct 10

Oct 24

Apr 10
Nov 21

Feb 13

Feb 27
Jan 2

Jan 16

Jan 30
Nov 7

Mar 13

Mar 27
Sep 12

Sep 26

Dec 5

Dec 19
5
Data source: Ontario Laboratory Information System (OLIS), data up to April 9 Specimen Date
The number of variant cases continues to rise and variants
now dominate, but even the original strain is rising.

6
 A record number of Ontarians are in hospital due to COVID-19
2000

1800

Patients in Inpatient Beds with COVID19

1600

Patients in ICU with COVID-Related Critical Illness Last 2 weeks:

1400 67% growth in
hospitalizations
51% growth in ICU
1200
occupancy

1000

800

600

400

200

0
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
7
Data Sources: MOH COVID Inpatient Census and Critical Care Information System
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.
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
transmission
Vaccine 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, YorkU 8
Data (Observed Cases): covid-19.ontario.ca
Under every scenario, more vaccines mean a faster resolution
in the long-run
Daily Cases
35,000

30,000

25,000

20,000

15,000

10,000

5,000

-
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

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

9
As predicted, ICU occupancy is rising dramatically. System-level
public health measures will help blunt some of the impact.

Predictions: COVID-19 ModCollab. 10

Data (Observed ICU Occupancy): CCSO
Mobility has declined slightly but not enough to bring current
growth under control.

Predictions: COVID-19 SAT. 11

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.

Predictions: COVID-19 SAT. 12

Data Google and Apple Mobility data
 The access to care deficit is building which will be felt by
250,000 Ontarians well past the pandemic Cumulative backlog:
248,109 cases

200,000

150,000

100,000

50,000

13
Data Source: Wait Times Information System. Backlog estimated based on comparison of 2020/21 with 2019/20 surgical volumes
First dose vaccine coverage expanding but remains incomplete
More than 3m doses administered

Data Sources
MOF Population Projections
COVAX analytical file, extracted, 8:00 pm Apr 12 2021, CPAD, MOH
COVAX Skedulo, extracted 6:00pm Apr 12 2021 14
Vaccination by risk is improving but remains a key to controlling spread
Figure 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

Potential impact at 60 days: % of cumulative cases

averted, compared to no vaccination moving forward
70
% cumulative cases averted

60
50 Number
vaccines
40
30 per case
averted
59 34
20
10
0
Age 16-59 (60 days) Age 60+ (60 days) Total population (60
days)
Population

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

Analysis: COVID Heterogeneity Research Group, COVID-19 ModCollab, PHO. 16

Data: CCM
Key Findings

• 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 distant
when 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.
17
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 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, 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 Tables

For table membership and profiles, please visit the About and Partners pages on the Science
Advisory Table website.

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