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COVID-19: Advisors project 3,000 cases, 400 in hospital in January even without variant

New science table projections note that the variant's impacts could be 'substantial'

TORONTO — Ontario's pandemic advisers predict the province's hospitals may be strained by mid-January, with close to 400 COVID-19 patients in intensive care and possibly 3,000 new infections reported daily, even without accounting for the new Omicron variant.

The new projections from the COVID-19 Science Advisory Table issued Tuesday note that the variant's impacts could be "substantial," though its characteristics aren't yet known. The group called for increased vaccination and public health measures to reduce transmission as cases rise across the province.

Dr. Allison McGeer, a member of the science table, said the predicted trends are the result of exponential case growth that began in October and accelerated as cases multiplied.

"It will start to get worse more quickly," she said in an interview, as Ontario reported 928 new COVID-19 cases and nine virus deaths Tuesday.

The projections don't factor in the possibility of increased socialization over the holiday season. McGeer said that makes the scenario predicting 3,000 daily cases the most "realistic" outcome based on the current situation.

That scenario, which also said 400 COVID-19 patients could be in intensive care, was based on the assumption that residents maintain their current behaviour and 30 per cent of children aged five to 11 are vaccinated by the end of December.

Another scenario with maintained current behaviour and 50 per cent of young children vaccinated predicted 1,750 daily cases by mid-January and 300 patients in intensive care.

A third scenario with a 15 per cent decrease in transmission through more public health measures pegs the mid-January daily case count at just over 1,000 and 250 patients in intensive care.

To get to that level of decreased transmission, McGeer said everyone would need to reduce their contacts from social gatherings, work, transit and recreation. That could mean cutting back on holiday parties or reintroducing capacity limits on some high-risk settings like restaurants and gyms.

Some health units have already taken such measures in response to rising cases, which McGeer said can be effective.

But she also pointed out that cases are rising in most public health units and a provincewide approach could avoid repeating scenarios from earlier in the pandemic when people travelled between regions that had different degrees of public health measures to gain access to certain settings.

The science table said intensive care occupancy will also increase over the next month, "likely exceeding" 250 patients by the end of this month without accounting for the Omicron variant, of which at least 21 cases had been confirmed as of Tuesday morning.

The provincial government said Tuesday that Ontario can "safely admit" approximately 300 critically ill COVID-19 patients without risking urgent surgery capacity, with capacity to add more spaces.

McGeer said the government's 300 figure is reasonable for ICU occupancy, but said the province's ongoing health-care worker shortage is going to be the biggest challenge.

"The government is right to be confident that we can tolerate higher ICU occupancy than we could at the beginning of the pandemic and still get by. That's not making me feel any better about what the situation might be in hospitals in January," she said, adding that influenza cases have been late to hit Ontario this season and may add to hospital strain in the new year.

There were 165 people in intensive care with COVID-19 related critical illness as of Tuesday including 95 people on ventilators and one patient from Saskatchewan.

The science table projections came amid calls for the Progressive Conservative government to decide whether to keep proof-of-vaccination requirements in place for certain venues after Jan. 17 – a tentative date the government had set to begin lifting those rules.

Health Minister Christine Elliott said the province is waiting for "final data" on the Omicron variant and advice from top medical advisors before deciding to pause that plan.

"We expect within the next week or so, we should have more information," she said. "I want people to know that we're going to take the same cautious approach that we always have."

Also on Tuesday, the government said it would maintain a pause on lifting capacity rules in certain settings, including nightclubs, event spaces with dancing, strip clubs and sex clubs.

The province reported 80 per cent of residents aged five and older as fully vaccinated against COVID-19 and 84 per cent with at least one shot. Twenty-two per cent of children aged five to 11 had received their first vaccine doses as of Tuesday.

This report by The Canadian Press was first published Dec. 7, 2021.

Holly McKenzie-Sutter, The Canadian Press