Cases are expected to rise with most restrictions lifted and the increase of BA.2, but we’re not expected to hit the peak numbers of January.
As Ontario gets rid of masking requirements for most indoor settings on Monday, European countries that have already dropped public health restrictions are offering a glimpse of how the province may fare in the next several weeks, say doctors and scientists.
Perhaps unsurprisingly, several nations in western Europe with comparable vaccination rates to Ontario are experiencing rising daily case counts as society returns to some semblance of pre-pandemic normalcy, especially with the arrival of the more transmissible BA.2 subvariant of Omicron.
It’s not unreasonable, then, to assume that Ontario will also see an uptick in daily cases as we drop our public health measures, combined with the spread of BA.2 and an influx of March break travellers returning to Canada, experts say.
Already, the Ontario-wide COVID-19 wastewater signal is on the rise after dipping in January and February, according to the Ontario COVID-19 Science Advisory Table’s most recent analysis. Wastewater surveillance is now the province’s best early indicator in the tracking of the spread of the virus in the absence of widespread polymerase chain reaction (PCR) testing.
“I think it’s caused by rapidly lifting mask mandates, gathering limits and other public health measures, which resulted in an increase of high-risk contacts; waning immunity; and BA.2 might also contribute but likely to a lesser extent,” said Peter Jüni, scientific director of Ontario’s COVID-19 Science Advisory Table, of the “dramatic U-turns” in COVID cases in countries such as Austria, Switzerland and Finland.
Parts of Asia, including Hong Kong and mainland China, are also grappling with COVID surges. But it’s harder to make comparisons as Hong Kong has a much lower vaccination rate among older people than Ontario. There is also some evidence that three doses of the Chinese Sinovac vaccine are less effective against Omicron than three mRNA shots.
Last week, Ontario dropped mandatory vaccinate-or-test policies for staff in hospitals, long-term-care homes and schools. Along with removing masking requirements on March 21 (mandates will remain in certain settings, such as public transit and long-term care until April 27), in-school screening and cohorting will also end.
A Thursday update by the science table showed that COVID transmission, hospital admission and ICU admission will likely increase in the next few weeks but is not expected to grow to levels seen at the height of the Omicron peak in January — provided changes in the population’s behaviour aren’t too drastic. An individual’s risk of getting the virus will depend on the number of close contacts one has, vaccination status and the spread of BA.2, the science table said.
Meanwhile, many countries in western Europe are “winding down their pandemic responses,” and the public is behaving as if the threat is over, said Ahmed Al-Jaishi, an epidemiologist based in London, Ont. But it’s hard to “disentangle” this from BA.2, which could have taken hold in the population just as mandates around masks and vaccination were dropped.
There is a “high likelihood” Ontario will see increases as well in cases, hospitalizations and deaths over the next few weeks.
“We’ve seen even in the past that we’ve been in a cycle, said Omar Khan, a professor of Biomedical Engineering and Immunology at the University of Toronto, “and when we look at places like Europe, that can often suggest what will happen here next.”
Here’s a look at five European countries with similar vaccination rates and median population age to Ontario.
Denmark
The small Scandinavian nation lifted almost all public health restrictions in early February, one of the first countries in Europe to take this step despite the dominance of BA.2.
The Danes officially no longer consider COVID-19 a “socially critical disease,” but the Copenhagen-based newspaper Berlingske reported Tuesday that more than 1,000 people in the country have died of the virus since New Year’s Day. Cases are falling, after a peak in mid- February, but community transmission remains high.
About 81 per cent of the population is fully vaccinated, and 61 per cent have third doses, according to the Danish Health Authority, with very high vaccination rates for seniors.
Dr. Amit Arya, palliative care lead at Kensington Health in Toronto, warned that Ontario does “not have the same hospital capacity as Denmark,” so we should be careful about comparisons, he said.
“We know we have a huge shortage of health workers across the province, especially when we speak about nursing,” Arya said. “That itself is dangerous.”
Finland
Daily new cases per million people in Finland are still lower than in Denmark, but they are on the rise, according to Our World in Data, which aggregates global COVID data. The country also has a relatively high vaccination rate with just over 80 per cent of the population having received one dose, and 76 per cent with a second dose, according to data compiled by Reuters. But according to the Helsinki Times, third-dose uptake, at 61 per cent of adults, is lower than in nearby Nordic countries.
Many restrictions have already been dropped. The paper reported Wednesday that some experts there are doubting whether now is the time to go ahead with a plan to scrap masks.
According to Reuters, there’s now an average of over 10,000 cases reported in Finland each day. The seven-day average for new deaths is also on the rise, at 44 as of March 16.
Germany
In February, German officials announced a plan to gradually wind down most COVID public health restrictions by the end of the month.
Meanwhile, daily new cases per million people are rising, according to Our World in Data. About 76.5 per cent of people have one dose of a vaccine and 75.8 have been fully vaccinated, according to Reuters’ global vaccine tracker.
More than 200,000 cases are reported each day, on average, Reuters says. The Guardian reported Wednesday that the country has hit a record new daily COVID infection rate, just as mask mandates in many places are set to end on the weekend.
Austria
This small landlocked country of about nine million lifted most of its public health measures on March 5, with the exception of masks on public transit and in establishments deemed “essential,” such as supermarkets, banks and pharmacies. Since then, Austria has seen daily COVID cases skyrocket to the highest they have ever been since the start of the pandemic. On Wednesday, the country reported 58,500 new cases, a new single-day record, according to Reuters’ global vaccine tracker.
“Austria’s jumping up, it’s really coming up and its testing volume has dropped a little, too,” said Khan. “So that’s something to think about.”
Hospitalizations due to COVID are also up in Austria to almost the level during the peak of the BA.1 Omicron wave in early December 2021. ICU numbers, however, have not increased with the growth in daily case counts, likely due to the variant’s milder symptoms.
Ontario has the advantage in that 82.1 per cent of our population is fully vaccinated (two doses), compared to just over 74 per cent of Austria’s population.
Switzerland
Similarly, Ontario’s full vaccination rate is much higher than that of Switzerland, where about 71 per cent of the people have received at least one dose, and only 69.9 per cent of the population is fully vaccinated.
This could partly explain why the country is reporting another surge — more than 21,500 daily cases on average over the past seven days — similar to levels seen at the beginning of February, Reuters reported. COVID deaths have also risen over the last two weeks.
It was in the middle of last month that the Swiss government announced it was lifting most restrictions, saying that despite high daily case numbers, hospitalizations were not increasing.
“That was really a sign to the population saying the pandemic is kind of over,” said Kaspar Staub, an epidemiologist at the University of Zurich. “Cases came down for a couple of weeks in February. But we were not able to bring down the BA.1 Omicron wave entirely.
“The government of Switzerland made a bet that we would make it to the milder season when cases go down anyway and that’s what everyone is expecting.”
But now, “cases are skyrocketing again,” added Staub, noting the official number is likely an undercount of the true numbers due to reduced testing.
Read the projection pdf here.
565289392-Update-on-COVID-19-Projections-2022-03-17-EnglishArticle From: The Star
Author: May Warren, Kenyon Wallace
