Update on COVID-19 Projections

Science Advisory and Modelling Consensus Tables

June 10, 2021

Key Findings

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• Cases, percent positivity, and hospitalizations have all dropped sharply thanks to the commitment of Ontarians.

• Cases should continue to decline for the next 10 days. As vaccination continues, it will be important to monitor carefully for new variants and continue assessing for signs of breakthrough and serious infection.

• The Delta variant is more transmissible and may be more dangerous. It will likely be the dominant form of the virus this summer. It is critical to control the spread of this variant.

• To avoid a fourth wave, we need to continue to ensure first and second doses in high-risk communities, continue tailoring vaccine clinics to community needs, and ensure strong testing and case and contact tracing.

Data source: CCM

Data note: Data for the most recent day have been censored to account for reporting delays 3

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50

100

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May 24 June 6

Average weekly cases on:

Cases have decreased sharply in almost all Public Health Units

% positivity has declined sharply since the last briefingDec 26

Province-wide lockdown14-days for N. Ontario

28-days for S. Ontario

Jan 18First dosevaccinationIn LTC inprioritized PHUs

Apr 3Province-wide

emergency brake

Apr 17Enhanced public healthmeasures and enforcement

Porcupine, 9.5%

Peel, 6.3%Hamilton, 6.1%Waterloo, 5.5%

Toronto, 4.0%Ontario, 3.2%

0

2

4

6

8

10

12

14

16

18

Au

g 1

Au

g 1

5

Au

g 2

9

Sep

12

Sep

26

Oct

10

Oct

24

No

v 7

No

v 2

1

Dec

5

Dec

19

Jan

2

Jan

16

Jan

30

Feb

13

Feb

27

Mar

13

Mar

27

Ap

r 1

0

Ap

r 2

4

May

8

May

22

Jun

5

Specimen Date

(7-d

ay a

vg.)

% p

osi

tivi

ty o

f d

aily

tes

tin

g ep

iso

des

Data source:Ontario Laboratory Information System (OLIS), data up to June 44

Porcupine, 442

Timiskaming, 107

Ontario, 172

0

100

200

300

400

500

600

700

Au

g 1

Au

g 1

5

Au

g 2

9

Sep

12

Sep

26

Oct

10

Oct

24

No

v 7

No

v 2

1

Dec

5

Dec

19

Jan

2

Jan

16

Jan

30

Feb

13

Feb

27

Mar

13

Mar

27

Ap

r 1

0

Ap

r 2

4

May

8

May

22

Jun

5

Specimen Date

(7-d

ay a

vg.)

Test

ing

epis

od

es p

er 1

00

,00

0

Data source:Ontario Laboratory Information System (OLIS), data up to June 4

Testing has declined. Continued strong monitoring will be critical for control of the pandemic.

5

Data Sources: MOH COVID Inpatient Census and Critical Care Information System

COVID-19 hospitalizations and ICU occupancy have dropped

0

500

1000

1500

2000

2500

Patients in Inpatient Beds with COVID19

Patients in ICU with COVID-Related CriticalIllness

6

Data Source: Wait Times Information System

Most urgent surgeries

Semi urgent surgeries

Least urgent …

HO

LID

AYS

-100%

-50%

0%

50%

100%

150%

2020 2021

Ch

ange

vs

Pre

vio

us

Year

† (%

)Continuing control of the pandemic will be key to reducing the access-to-care deficit

Apr 2020 May Jun Jul Aug Sep Oct Nov. Dec Jan. 2021 Feb Mar Apr May

7

-

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

5,000

01

/01

01

/08

01

/15

01

/22

01

/29

02

/05

02

/12

02

/19

02

/26

03

/05

03

/12

03

/19

03

/26

04

/02

04

/09

04

/16

04

/23

04

/30

05

/07

05

/14

05

/21

05

/28

06

/04

06

/11

06

/18

06

/25

07

/02

07

/09

07

/16

07

/23

07

/30

08

/06

08

/13

Dai

ly C

ase

s

ON - Daily ON - 7-Day Average High, 142k/day High, 180k/day

Medium, 142k/day Medium, 180k/day Low, 142k/day Low, 180k/day

Ontarians’ commitment to public health measures means we are doing much better since the last briefing

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Figure shows predictions based on 4 models.

• Partial reopening June 14

• Vaccinating 140k-180k/day

• Delta VOC considered• Different levels of

disease spread after Step 1 opening

Predictions informed by modeling from Fields Institute, McMasterU, PHO, YorkUData (Observed Cases): covid-19.ontario.ca

Range from last briefing

-

100

200

300

400

500

600

700

800

900

1,000

12

/31

01

/07

01

/14

01

/21

01

/28

02

/04

02

/11

02

/18

02

/25

03

/04

03

/11

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/18

03

/25

04

/01

04

/08

04

/15

04

/22

04

/29

05

/06

05

/13

05

/20

05

/27

06

/03

06

/10

06

/17

06

/24

07

/01

07

/08

07

/15

ICU Occupancy

ON - Daily ON - 7-Day Average Predicted High, 142k/day High, 180k/day

Medium, 142k/day Medium, 180k/day Low, 142k/day Low, 180k/day

If we continue to control COVID-19, we can drop below 200 COVID-19 patients in ICUs by mid-July and begin to resume normal hospital operations

9Predictions: COVID-19 ModCollab. Data (Observed ICU Occupancy): CCSO

Range from last briefing

The 2nd vaccine dose is more than 2x as effective against the Delta variant – it is key to get 2nd doses in arms

Delta variant (B.1.617.2)• About 50% more transmissible

than Alpha (B.1.1.7)• Will likely be the dominant

variant in the early summer• Risk of hospitalization may be

increased• 1st dose of vaccine less effective

against symptomatic disease but it may protect against severe disease

Source: SARS-CoV-2 variants of concern and variants under investigation in England Technical briefing 14

Source: Estimated from Bernal et al, BMJ 2021; Bernal et al, medRxiv 2021 10

Continuing a strategy based on age and community risk will help control the spread and impact of the Delta variant

Protect all regions with 1st doses, avoid ‘pockets’ with low coverage

• Minimize risk of introduction and propagation of Delta-variant

• Continue core public health functions of case and contact tracing, testing

Protect regions at high-risk of Delta with increased 1st and 2nd dose coverage

• Control surges in Delta-high-risk areas

• Minimize risk of spillover into other areas

• Continue core public health functions of case and contact tracing, testing

Benefits of continuing a focus on high-risk communities• Compared to a pure age-based allocation, continuing a high-risk community strategy

reduces the overall case count by 39% (both with 2nd dose eligibility at 6 weeks)• Much of the reduction in cases are in lower-risk communities; benefitting all communitiesTechnical Note: Modelling based on 2nd dose coverage of 45% in high-risk regions and 25% in all other regions by the end of June, 70% 1st dose coverage for all regions

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Data SourcesMOF 2020 Population ProjectionsCOVAX analytical file, extracted 8:00pm June 6 2021, CPAD, MOHCOVAX Skedulo, extracted 6:00pm June 6 2021

Vaccination coverage continues to increase

-

500,000

1,000,000

1,500,000

2,000,000

2,500,000

80+ 70 to 79 60 to 69 50 to 59 40 to 49 30 to 39 18 to 29 12 to 17

Population remaining

Has made an appointmentfor first dose*

Number of individualswith at least one dose

Provincial progress (Age 18 or older) 72.8% 27.2%

* Note that this is just Pending Appointments. Anyone who has made an appointment and received a vaccine will be counted under “Individuals with at least one dose”. Data for Appointments reflect 21 PHUs that are captured through the provincial booking system. Appointments made through other systems (e.g., local PHU booking systems, pharmacies, primary care) are not included. ^ Age is based on year of birth.

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The high-risk community strategy has helpedFigure excludes long-term care vaccination – at least 1 dose as of June 7, 2021

13Source: ICES

Key Findings

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• Cases, percent positivity, and hospitalizations have all dropped sharply thanks to the commitment of Ontarians.

• Cases should continue to decline for the next 10 days. As vaccination continues, it will be important to monitor carefully for new variants and continue assessing for signs of breakthrough and serious infection.

• The Delta variant is more transmissible and may be more dangerous. It will likely be the dominant form of the virus this summer. It is critical to control the spread of this variant.

• To avoid a fourth wave, we need to continue to ensure first and second doses in high-risk communities, continue tailoring vaccine clinics to community needs, and ensure strong testing and case and contact tracing.

Contributors

• COVID Vaccination Strategy Modeling Group: Sharmistha Mishra, Jesse Knight, Huiting Ma, Kevin Brown, Amir Ghasemi, Kamil Malikov, Michael Paterson, Hannah Chung, Andrew Calzavera, Kinwah Fung, Kristy Yiu, Sarah Buchan, Sarah Wilson, Leigh Hobbs, Linwei Wang, Stefan Baral, Rafal Kustra, Gary Moloney, Nathan Stall, Jeff Kwong, Peter Jüni & Beate Sander

• COVID-19 Modeling Collaborative: Kali Barrett, Stephen Mac, David Naimark, Aysegul Erman, Yasin Khan, Raphael Ximenes, Sharmistha Mishra, Beate Sander

• Fields Institute: Taha Jaffar, Kumar Murty

• ICES: Jeff Kwong, Hannah Chung, Kinwah Fung, Michael Paterson, Susan Bronskill, Laura Rosella, Astrid Guttmann, Charles Victor, Michael Schull, and Marian Vermeulen

• McMasterU: Irena Papst, Michael Li, Ben Bolker, Jonathan Dushoff, David Earn

• YorkU: Jianhong Wu, Yanyu Xiao, Zack McCarthy

• MOHLTC: Michael Hillmer, Kamil Malikov, Qing Huang, Jagadish Rangrej, Nam Bains, Jennifer Bridge

• OH: Erik Hellsten, Stephen Petersen, Anna Lambrinos, Chris Lau, Access to Care Team

• PHO: Kevin Brown

• Science Advisory Table: Peter Juni, Antonina Maltsev, Bruno da Costa

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Content provided by Modelling Consensus and Scientific Advisory Table members and secretariat

Beate Sander,* Peter Juni, Brian Schwartz,* Kumar Murty,* Upton Allen, Vanessa Allen, Kali Barrett, Nicholas Bodmer, Isaac Bogoch, Kevin Brown, Sarah Buchan, Yoojin Choi, Troy Day, Laura Desveaux, David Earn, Gerald Evans, David Fisman, Jennifer Gibson, Anna Greenberg, Anne Hayes,* Michael Hillmer, Jessica Hopkins, Jeff Kwong, Fiona Kouyoumdjian, Audrey Laporte, John Lavis, Gerald Lebovic, Brian Lewis, Linda Mah, Kamil Malikov, Antonina Maltsev, Doug Manuel, Roisin McElroy, Allison McGeer, David McKeown, John McLaughlin, Sharmistha Mishra, Justin Morgenstern, Andrew Morris, Samira Mubareka, Laveena Munshi, Christopher Mushquash, Ayodele Odutayo, ShahlaOskooei, Menaka Pai, Samir Patel, Anna Perkhun, Bill Praamsma, Justin Presseau, Fahad Razak, Rob Reid,* Paula Rochon, Laura Rosella, Michael Schull, Arjumand Siddiqi, Chris Simpson, Arthur Slutsky, Janet Smylie, Nathan Stall, Robert Steiner, Ashleigh Tuite, Jennifer Walker, Tania Watts, Ashini Weerasinghe, Scott Weese, Xiaolin Wei, Jianhong Wu, Diana Yan, Emre Yurga

* Chairs of Scientific Advisory, Evidence Synthesis, and Modelling Consensus Tables

For table membership and profiles, please visit the About and Partners pages on the Science Advisory Table website.

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