‘Circuit breaker’ measures needed to prevent Omicron from overwhelming ICUs, science table says

Ontario’s COVID-19 science table on Thursday called for immediate and stringent public health measures to combat a growing surge of the Omicron variant that could see ICU admissions reach “unsustainable levels” early next year.

The group’s latest modelling suggests that without “circuit breaker” restrictions to reduce social contacts by about 50 per cent, booster shots alone will likely not be enough to stop daily cases reaching between 6,000 and more than 10,000 per day by the end of 2021.

Such measures, coupled with a sustained booster shot campaign of about 250,000 to 350,000 daily, could keep new cases below 5,000 per day in the same time frame, the table said. The most new infections ever recorded in Ontario during the pandemic were 4,812 on April 16, during the peak of the third wave.

“It’s not a lockdown, it’s not a stay-at-home order. But it does involve a reduction in contacts,” said Adalsteinn Brown, co-chair of the advisory group, who presented the latest forecasts at a news conference in Toronto.

The measures could include things like further capacity restrictions for indoor settings, and better enforcement of masking rules, Brown said.

“It’s not new things that we haven’t seen before, it’s those core public health measures,” he continued. “Every day that you wait, you have a greater spread and a bigger challenge ahead of you.”

Those changes would buy time for the province to bolster its booster coverage, Brown said.

Without further additional measures, admissions of COVID patients to critical care could, in an absolutely worst case scenario, reach 600 by the new year, the modelling suggests.

The province has said about 600 ICU beds are available, with nearly 500 more available for surge capacity if needed, but experts have said surgeries will start to be affected once roughly 300 COVID-19 patients are in critical care.

As of yesterday evening, there were 328 people with COVID in hospital, up from 309 at the same time last week. Similarly, there were 165 patients being treated for COVID-related illnesses in ICUs, up from 155 last Thursday.

“This will likely be the hardest wave of the pandemic. There is still some uncertainty but there is an undeniable urgency,” Brown said. “Waiting to take action means waiting until it is too late to take action.”

Province offers no indication of renewed restrictions

In a statement in response to the briefing, the Ministry of Health offered no indication that any further public health restrictions are coming, beyond a 50 per cent reduction in capacity for venues that hold more than 1,000 people, which was announced Wednesday.

Asked specifically whether that move would be enough, Brown said it would of course help, but falls short of the kind of “circuit breaker” that is needed.

“They’re not enough to really curb the rapid growth of the variant,” he said.

In its statement, the province said the modelling “affirms” that the best defence against Omicron is dramatically ramping up access to booster shots. It was announced this week that as of Monday, anyone 18 and older who had their second dose more than three months ago will be able to book a booster appointment.

Public health units collectively administered another 119,286 boosters yesterday. A total of 1,441,100 Ontarians have now had a third dose.

The statement pointed out that up to two million rapid tests will be available for free at pop-up testing sites in high-traffic settings including malls, retail settings, holiday markets, public libraries and transit hubs over the holidays, as well as at select LCBO locations.

You can find a list here of pop-up sites confirmed so far. Each person is limited to one pack that contains five tests.

Uncertainty over severity of Omicron cases

In its modelling update, the science table drew a skeptical eye toward the conclusion that Omicron results in less severe health outcomes for those infected by it.

The latest data suggests that admissions to hospital and ICUs in the South African province of Gauteng — which has been particularly hard hit by Omicron — are on the rise.

Similarly, a rapid rise in Omicron cases has led to a steeper increase in hospitalizations and ICU admissions than any previous wave in South Africa more broadly, the table said.

The population of South Africa is also, on average, younger than that of Ontario. The median age in South Africa is 27, while in Ontario it is 41. Further, it is estimated that roughly 90 per cent of South Africans have previously been infected with a COVID variant, imparting a degree of resistance to severe illness, compared to just 10 per cent of Ontarians.

Early data from Denmark, the table said, shows that the overall percentage of Omicron cases that required hospitalization is no lower when compared to earlier strains. In fact, the rate is even somewhat higher.

Brown conceded there remains a lot of uncertainty about the ultimate severity of Omicron cases, but also pointed out that the sheer number of cases expected means that Ontario hospitals will be strained even if average outcomes are not as bad as with delta or other variants.

“It is a very, very transmissible disease that grows very quickly,” he said. “”Though uncertainty exists, waiting for more information will eliminate the opportunity for action.”

He went on to recommend that regardless of any further government-imposed restrictions, Ontarians should get a booster as soon as they can, wear the highest-quality mask they can find and avoid crowded indoor spaces.

“Its an airborne disease — I think that’s clear,” Brown said.

7% test positivity rate

Meanwhile, Ontario reported 2,421 new cases of COVID-19 on Thursday, the most on a single day in seven months and an 88 per cent increase over the same time last week.

Today’s additional cases push the seven-day average to 1,676, a 59 per cent jump from last Thursday.

The science table’s most recent estimate has the number of new Omicron-linked cases in Ontario on pace to double every two days or so.

Omicron is infecting between four and eight times more people than Delta, according to Dr. Kieran Moore, Ontario’s chief medical officer of health, and has already become the dominant strain in the province.

Public Health Ontario reported a seven per cent positivity rate from 54,724 tests on Thursday. That’s the highest level since May 18, when a rate of 7.6 per cent was reported on just 22,915 total tests.

While cases and positivity rates are spiking in much of the province, the number of COVID patients in hospitals and intensive care has continued to hold relatively steady, though there are signs that the burden is slowly increasing.

The Ministry of Health also reported the deaths of nine more people with COVID, pushing the official toll to 10,102.

CBC