Update on COVID-19 Projections - Science Advisory and Modelling Consensus Tables February 11, 2021 - Ontario COVID-19 Science ...
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Update on COVID-19 Projections
Science Advisory and Modelling Consensus Tables
February 11, 2021
Key Findings
• Public health measures are paying off in declining mobility, cases, positivity,
and hospitalizations.
• Focussing vaccination on long-term care homes is paying off with declining
daily deaths.
• ICU occupancy is flat and the access to care deficit continues to grow.
• The B.1.1.7 Variant of Concern is spreading. Cases will likely grow again in
late February with ICU admissions increasing afterwards.
• Aggressive vaccination and sticking with stay-at-home order will help avoid
a third wave and a third lockdown.
• Some key mental health indicators are unchanged. However, important
measures such as emergency department admissions, opioid deaths and
care for eating disorders are worsening.
2
Declines in mobility have helped reduce cases
British Columbia
Manitoba
Alberta
Quebec
Ontario
3
4 4
5 5
Cases and percent positivity declined across age groups.
6Cumulative COVID-19 vaccine dose administrations
(426,834 doses to Feb 10, 2021)
Vaccine dose administrations
Current status
Cumulative COVID-19 Vaccinations
Since December 15, 2020, 426,834 450
426,834
Thousands
vaccine dose administrations have 400
been reported in COVax.
350
These administrations include Pfizer
300
and Moderna vaccines.
Doses Administered
250
92% of vaccine administrations have
200
been since Jan 1, 2021.
150
100
50
0
01-Feb
03-Feb
05-Feb
07-Feb
09-Feb
15-Dec
17-Dec
19-Dec
21-Dec
23-Dec
25-Dec
27-Dec
29-Dec
31-Dec
02-Jan
04-Jan
06-Jan
08-Jan
10-Jan
12-Jan
14-Jan
16-Jan
18-Jan
20-Jan
22-Jan
24-Jan
26-Jan
28-Jan
30-Jan
2020 2021 Source: COVAX
Data Source: COVax. Data to Jan 22nd extracted from COVax Dose Admin by Day Report. Jan
23rd-Feb 7th: COVax daily reports (Health Data Branch, MOH). Includes Pfizer and Moderna
vaccines. Excludes records where status is not known.
7The majority of deaths arise from long-term care.
Analysis: COVID-19 ModCollab. 8
Data: CCM+Long-term care key indicators improved.
COVID-19 cases and deaths for LTC residents and staff
Current status 2000
213 LTC homes have COVID-19 1800 Daily Active Cases Residents
outbreaks (34% of all homes) 1600
Daily Active Cases Staff
with 90 outbreaks involving 1400
Cumulative deaths since Sept 1
resident cases. 1200
25 of 34 PHUs have at least 1 1000
home in outbreak. 800
600
Since January 900 LTC
1st
400
residents and 3 staff have
died of COVID-19. Wave 2 200
deaths (1,821) now roughly 0
Sep Sep Oct Oct Nov Nov Dec Dec Jan 15- 01-
equal to Wave 1 (1,848). 1 15 1 15 1 15 1 15 1 Jan Feb
Data Source: Ministry of Long Term Care Tracker, Feb 8th extraction based on data reported up to 3:30
pm Feb 7th, 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 9
health units (i.e. iPHIS database) due to lags in reporting time.Hospitalizations dropped and ICU occupancy stabilized.
2,000
1,900
1,800
1,700
Confirmed COVID-19 Acute Inpatients (excluding ICU)
1,600 Confirmed COVID-19 ICU Patients
1,500
1,400
1,300
1,200
1,100
1,000
900
800
700
600
500
400
300
200
100
0
10
Data Sources: Daily Bed Census Summary COVID-19 Report + Critical Care Information System. Extracted via MOH SAS VA February 9, 2021. Does not include patients in alternative health facilities (AHFs)The highly transmissible B.1.1.7 variant will soon
dominate.
• Variants are likely between 5% and
10% of cases now.
• To prevent an increase in total
cases Re for B.1.1.7 needs to be
below 0.7.
• Current Re is between 0.8 and 0.9,
it has only approached 0.7 once.
• Public Health Measures appear to
be effective against all variants.
• First cases of B.1.351 (detected in
South Africa) and P.1 (detected in
Brazil) detected in Ontario.
11
Predictions: QueensUTo control growth with variants, we must push R to 0.7
Toronto Forecast OV R = 0.7
1800
1600
1400
1200
Daily Counted Cases
Observed Cases
1000 Old Variant (Estimated)
New Variant (Estimated)
800 Forecast OV R = 0.7
600 OV Forecast (R = 0.7)
NV Forecast (R = 0.98)
400
200
0
15-Dec-20 04-Jan-21 24-Jan-21 13-Feb-21 05-Mar-21 25-Mar-21 14-Apr-21 Predictions: DLSPH
12At R=0.9 (just above current) variant triggers exponential
growth
Toronto Forecast OV R = 0.9
1800
1600
1400
1200
Daily Counted Cases
Observed Cases
1000 Old Variant (Estimated)
New Variant (Estimated)
800
Forecast OV R = 0.9
600 OV Forecast (R = 0.9)
NV Forecast (R = 1.26)
400
200
0
15-Dec-20 04-Jan-21 24-Jan-21 13-Feb-21 05-Mar-21 25-Mar-21 14-Apr-21 13
Predictions: DLSPHIf public health measures are lifted, cases could rise
dramatically depending on spread of B.1.1.7.
Daily Cases
20,000
18,000
16,000
14,000
12,000
10,000
8,000
6,000
4,000
2,000
-
01-01
01-03
01-05
01-07
01-09
01-11
01-13
01-15
01-17
01-19
01-21
01-23
01-25
01-27
01-29
01-31
02-02
02-04
02-06
02-08
02-10
02-12
02-14
02-16
02-18
02-20
02-22
02-24
02-26
02-28
03-02
03-04
03-06
03-08
03-10
03-12
03-14
03-16
03-18
03-20
03-22
03-24
03-26
03-28
03-30
ON - Daily ON - 7-Day Mean ON 5%↓ Low Medium High
Predictions informed by modeling from COVID-19 ModCollab, McMasterU, QueensU, YorkU;
recent decrease in new daily cases 14
Data (Observed Cases): covid-19.ontario.caThe majority of ICU admissions arise outside of long-term
care homes.
Analysis: COVID-19 ModCollab. 15
Data: CCM+ICU Occupancy will follow changes in case rates by two weeks.
Growth could start as early as the second week in March.
ICU Occupancy
700
600
500
400
300
200
100
0
01-01
01-03
01-05
01-07
01-09
01-11
01-13
01-15
01-17
01-19
01-21
01-23
01-25
01-27
01-29
01-31
02-02
02-04
02-06
02-08
02-10
02-12
02-14
02-16
02-18
02-20
02-22
02-24
02-26
02-28
03-02
03-04
03-06
03-08
03-10
03-12
03-14
03-16
03-18
03-20
03-22
03-24
03-26
03-28
03-30
ON Observed ON Predicted Low High Medium Capacity Threshold
Predictions: COVID-19 ModCollab. 16
Data (Observed ICU Occupancy): CCSOThe impact of the Pandemic has been inequitable and
will continue to be inequitable
Analysis: COVID Heterogeneity Research Group 17
Data: ICESMental health medication dispensing has been stable
Individuals dispensed benzodiazepines (per 1,000 population) [ICES data]
WHO pandemic
declaration
Analysis: ODPRN 18
Data: ICES data is updated quarterly, with up to a 3 month reporting lagEmergency department visits for mental health and
addictions care have declined
30%
WHO pandemic
Mental Health-related ED visits Substance Use-related ED visits
declaration
20%
10%
6%
0%
-2%
Percent
-10%
-15%
-20%
-17%
-30%
-38%
-40%
-43%
-50%
2020-02-23 2020-03-23 2020-04-23 2020-05-23 2020-06-23 2020-07-23 2020-08-23 2020-09-23 2020-10-23 2020-11-23 2020-12-23 2021-01-23
Analysis: OH MHA Centre of Excellence 19
Data: Electronic Canadian Triage and Acuity Scale (eCTAS)Overdose deaths have continued to climb
WHO pandemic
declaration
Notes:
Data provided by the office of the Chief Coroner of Ontario (OCC); Suspect drug-related deaths are identified based on preliminary information reported by the investigating
coroners to the office of the Chief Coroner of Ontario. It takes several months for these investigations to be completed and acute drug toxicity deaths to be confirmed; Opioid-
related deaths includes confirmed and probable, and are considered preliminary; Once investigations are complete, acute opioid toxicity is typically deemed to be at least one of Analysis: ODPRN 20
the substances directly contributing to about 65%-80% of suspected-drug related deaths (depending on the time period) Data: Chief Coroner of OntarioEating disorder visits and admissions have increased.
Hospitalizations and emergency department visits* for eating disorders among children and adolescents (3
to 17 years) in Ontario by 4-week average, Jan 2017 to Sept 2020
Emergency department visits Hospitalizations
3.5
3
Crude rate per 100,000 population
2.5
2
1.5
1
0.5
0
Apr-17
Jan-17
Mar-17
Oct-17
Apr-18
Jul-17
Oct-18
Aug-17
Jan-18
Mar-18
Apr-19
Oct-19
Jun-17
Jul-18
Aug-18
Jan-19
Mar-19
Apr-20
Jun-18
Jul-19
Aug-19
Jan-20
Mar-20
May-17
Jun-19
Jul-20
Aug-20
Jun-20
Feb-17
Sep-17
Dec-17
May-18
Nov-17
Feb-18
Sep-18
Dec-18
May-19
Nov-18
Feb-19
Sep-19
Dec-19
May-20
Nov-19
Feb-20
Sep-20
4-week average
Analysis: OH MHA Centre of Excellence 21
Data: ICES)Key Findings
• Public health measures are paying off in declining mobility, cases, positivity,
and hospitalizations.
• Focussing vaccination on long-term care homes is paying off with declining
daily deaths.
• ICU occupancy is flat and the access to care deficit continues to grow.
• The B.1.1.7 Variant of Concern is spreading. Cases will likely grow again in
late February with ICU admissions increasing afterwards.
• Aggressive vaccination and sticking with stay-at-home order will help avoid
a third wave and a third lockdown.
• Some key mental health indicators are unchanged. However, important
measures such as emergency department admissions, opioid deaths and
care for eating disorders are worsening.
22Contributors
• 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
• DLSPH: Ashleigh Tuite, David Fisman
• Fields Institute: Kumar Murty
• QueensU: Troy Day
• 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)
• ODPRN: Tara Gomes
• PHO: Sarah Buchan, Kevin Brown
23Content 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
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