COVID-19: Modelling Update

Advice from the Science Advisory and Modelling Consensus Tables

October 29, 2020

Purpose

• Share latest trends in Ontario epidemiology, health system indicators

• Provide an update on progress in controlling pandemic

2

Current projections show slower growth, similar to Michigan

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Number of Cases per Day (aligned at 300 cases/day for 7-day average)

ON 2nd wave - Reported Date ON 2nd wave predicted - increase to 1,200 ON 2nd wave predicted - increase to 1,000

ON 2nd wave predicted - decrease to 800 ON 2nd wave - 7-day average ON 1st Wave

Michigan Victoria adj.

3

Positivity rates continue to increase in older age groups with significant health and health system consequences

4Data Source: Ontario Laboratory Information System (OLIS), MOH – extracted from SAS VA October 25.Note: Includes all data submitted to OLIS up to October 24, 2020. The last six days are considered interim data (week 42) and subject to change

Weekly % positivity = total number of positive tests within the week (based on reported date)/COVID tests within the week

Week ending Oct 24

"

5Data Sources: Daily Bed Census Summary COVID-19 Report + Critical Care Information System. Extracted via MOH SAS VA Oct. 27

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50

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150

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300

350

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

Confirmed COVID19 Acute Inpatients (excluding ICU)

Confirmed COVID19 ICU Patients

Over last 3 weeks (October 5-October 26) there has been a 56% increase in confirmed COVID bed occupancy

Growth in hospitalizations is slowing, but spillover risk persists

Slower growth means that risk to ICUs is lower

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Predicted ICU Occupancy

ON - 1,200 ON - 1,000 ON - 8,000

Ontario ICU occupancy predicted to exceed lower threshold of 150 beds within 30 days in only the worst case scenario.

6

Cases in LTC continue to increase with cumulative mortality up substantially (85 deaths since August 15)

Current status (Oct 27)

• 87 homes currently in outbreak, 677 active confirmed cases in these homes

• 396 residents, 281 staff active cases

• 1,934 cumulative resident deaths, 8 cumulative staff deaths

• 21 of the 87 homes in outbreak are based on 1 staff case

• Oct 26 showed the highest daily count of deaths since Aug 1 (11 deaths), with 27 deaths in the past 7 days.

Oct 26:11 resident

deaths

0 staff deaths

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100

150

200

250

300

350

400

Aug 1 Aug 15 01-Sep 15-Sep 01-Oct 15-Oct

COVID-19 cases and deaths for LTC residents and staff

Daily Active Cases Residents Daily Active Cases Staff

Daily Deaths, Residents Daily Deaths, Staff

Active cases are the number of people who have tested positive for COVID-19covid 19. This number does not include cases that have been changed to resolved or deaths. 7

Peel 83.1

Toronto 72.0

Eastern 53.2

York 54.7

Ottawa 47.4

Durham 38.3

Halton 30.7

All other PHUs 12.8

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90

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

7-d

ay a

vera

ge n

ew c

ases

pe

r 1

00

,00

0 r

esi

de

nts

Date case reported to PHU

Substantial variation in new cases per 100,000 population by PHUSept. 17

In-person classes started for all major

school boards

8Data Source: Case and Contact Management System (CCM), extracted Oct 27

Oct. 9Modified

Stage 2 begins in Toronto,

Ottawa, Peel

Oct. 16Modified

Stage 2 begins in

York

Sept. 19Limits on social gathering sizes

Sept. 25Restrictions on bars and restaurants

9Data Source: Ontario Laboratory Information System (OLIS), extracted via MOH SAS VA Oct 27

Peel 6.5%

Toronto 4.8%

Eastern 2.1%

York 4.5%

Ottawa 3.1%

Durham 2.3%

Halton 2.5%

All other PHUs 1.0%

0%

1%

2%

3%

4%

5%

6%

7%

01-Aug 08-Aug 15-Aug 22-Aug 29-Aug 05-Sep 12-Sep 19-Sep 26-Sep 03-Oct 10-Oct 17-Oct

% p

osi

tivi

ty o

f d

aily

te

stin

g ep

iso

des

-7

day

mo

vin

g av

era

ge

Date test performed

Substantial variation in percent positivity by PHU

Peel 77.4%

Toronto 85.9%

Eastern 62.5%

York 88.4%

Ottawa 73.0%

Durham 81.5%

Halton 61.8%

Ontario 78.7%

0%

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60%

70%

80%

90%

100%

01-Aug 08-Aug 15-Aug 22-Aug 29-Aug 05-Sep 12-Sep 19-Sep 26-Sep 03-Oct 10-Oct 17-Oct

% o

f te

stin

g ep

iso

des

wit

h r

esu

lts

rele

ased

wit

hin

2 d

ays

of

test

-7

day

mo

vin

g av

erag

e

Date test result released

Sept. 24Testing guidance update

Data Source: Ontario Laboratory Information System (OLIS), extracted via MOH SAS VA Oct 27

10

Substantial variation in % 2-day test turnaround by PHU

11Data Source: Case and Contact Management System (CCM), extracted Oct 27

Peel 16.9%

Toronto 65.0%

Eastern 4.5%

York 15.5%

Ottawa 48.8%

Durham 27.5%

Halton 8.4%

All other PHUs 20.3%

0%

10%

20%

30%

40%

50%

60%

70%

80%

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

% o

f n

ew c

ases

wit

h n

o k

no

wn

ep

idim

iolo

gica

l lin

k -

last

7 d

ays

Date case reported to PHU

Interim data subject to

change

Substantial variation in % of cases with no epidemiological link by PHU

Changes in outbreak location suggest impact from shifts to modified Stage 2 (1 of 2)

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Other Health Units Ottawa, Peel, Toronto, York Health Units

Mar Apr May Jun Jul Aug Sep Oct Mar Apr May Jun Jul Aug Sep Oct

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1.00

Outbreak start month

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port

ion

of

rep

ort

ed

outb

reaks

LTC or retirement home

Hospital

Group home, shelter, or correctional facility

Workplace

School or daycare

Other or unknown setting

Changes in outbreak location suggest impact from shifts to modified Stage 2 (2 of 2)

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Other Health Units Ottawa, Peel, Toronto, York Health Units

Mar Apr May Jun Jul Aug Sep Oct Mar Apr May Jun Jul Aug Sep Oct

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25

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Outbreak start month

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mb

er

of re

po

rted o

utb

rea

ks

LTC or retirement home

Hospital

Group home, shelter, or correctional facility

Workplace

School or daycare

Other or unknown setting

Data Source: Case and Contact Management System (CCM), extracted Oct 25

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LTC & Retirement Homes, 36,

18%

Schools & Daycare, 45,

22%

Congregate Settings, 20,

10%Industrial

Settings, 9, 4%

Healthcare, 21, 10%

Other, 23, 12%

Restaurants, Bars & Clubs,

27, 14%

Grocery, Retail &

Service, 8, 4%

Gyms & Sports, 6, 3%

Events, Ceremonies & Religious Services, 5,

3%

Toronto

LTC & Retirement

Homes, 1, 1%

Schools & Daycare, 17,

20%

Congregate Settings, 7,

8%

Industrial Settings, 19,

22%

Healthcare, 0, 0%

Other, 15, 18%

Restaurants, Bars & Clubs,

3, 3%

Grocery, Retail &

Service, 16, 19%

Gyms & Sports, 3, 4%

Events, Ceremonies & Religious Services, 4,

5%

Peel

LTC & Retirement Homes, 63,

33%

Schools & Daycare, 74,

39%

Congregate Settings, 13, 7%

Industrial Settings, 0,

0%

Healthcare, 12, 6%

Other, 11, 6%

Restaurants, Bars & Clubs,

3, 2%

Grocery, Retail &

Service, 2, 1%

Gyms & Sports, 9, 5% Events,

Ceremonies & Religious Services, 2,

1%

Ottawa

LTC & Retirement Homes, 22,

17%

Schools & Daycare, 13,

10%

Congregate Settings, 9,

7%

Industrial Settings, 24,

19%

Healthcare, 4, 3%

Other, 28, 22%

Restaurants, Bars & Clubs,

10, 8%

Grocery, Retail &

Service, 14, 11%

Gyms & Sports, 3, 2%

Events, Ceremonies & Religious Services, 1,

1%

York

Substantial variation in source of outbreak by PHU since August 1, reported October 24

Access to care continues well below 2019 volumes

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Key Findings: pandemic spread continues according to several indicators but is slowing• Most indicators show slowing growth in COVID-19 cases, trajectory appears to be

moving away from worst case but cases are continuing to climb

• Levelling up public health capacity to respond to the disease is necessary to respond to and control disease spread

• Continuing to respond on a PHU by PHU basis to account for regional variations will be important

• Health system able to respond to pandemic at current levels of growth but pandemic trajectory can change quickly

• Long-term consequences of COVID-19 pandemic continue:• Case growth and spillover into older age groups will increase mortality due to COVID-19• Potential for long-term health system burden from COVID-19 “long-haulers”• Access to necessary care continues below 2019 levels• Mental health and long-term consequences of economic impacts deserve further study

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