Ontario is now seeing an estimated 100,000 new COVID-19 infections a day

Ontario is now seeing an estimated 100,000 new COVID-19 infections per day — the highest number of daily infections since the beginning of the pandemic — prompting experts to warn of increased hospitalizations in the coming weeks and calls for mandatory masking in essential businesses and schools.

New wastewater readings analyzed by the COVID-19 Science Advisory Board estimate that between 90,000 and 110,000 COVID infections are now happening every day in the province, with 30 out of Ontario’s 34 public health units showing exponential growth of new cases.

While the wastewater estimates are based on incomplete data, the science table’s scientific director, Dr. Peter Jüni, says the signal has now overtaken January’s peak with 90 per cent certainty.

“It makes me frown. We never were as high,” he said. “People need to be aware of that. This means that approximately five per cent of the population has an active infection right now as we speak. This number continues to increase.”

The record swell of cases will send a surge of people testing positive for COVID to hospitals, say experts, who warn the increase in hospitalizations combined with staffing shortages from workers off sick with the virus will again stress the health-care system.

“The widespread transmission of this highly infectious variant means it will eventually make its way to the most vulnerable, including the marginalized, elderly, immune-compromised, unvaccinated and those not boosted,” said Dr. Kali Barrett, a critical care physician at the University Health Network and senior research associate with the science table.

“There will be many from these high-risk groups who need hospitalization and some will die. This is a certainty.”

On Wednesday, the province reported 1,074 COVID hospitalizations, representing a 68 per cent increase in the last two weeks. That includes 906 patients in regular wards, surpassing the science table’s most recent moderate-transmission scenario by more than 250.

“We assumed a moderate change in behaviour, meaning a 30 per cent increase in contacts with half of all contacts made without masks if BA.2 became dominant,” Jüni said. “Now that BA.2 has become dominant, that’s not what we’re seeing. The behavior change is much more dramatic and masks are being dropped like T-shirts on a beach.”

Jüni added that determining the severity of increased hospitalizations is complicated by immunity acquired through infection, as well as waning immunity from vaccination.

More than 90 per cent of Ontarians 12 and older are fully vaccinated (two doses of Pfizer or Moderna, or one dose of a single-dose vaccine series).

Over the past two weeks, the number of ICU patients testing positive for COVID has remained relatively stable, and the growth of overall hospitalizations has slowed compared to early January when the province was entering the Omicron wave.

Still, the overall increase in hospitalizations will put additional strain on a system already “experiencing a serious staffing crisis,” Barrett said. “I’m not sure how this significantly depleted workforce is expected to help support health system recovery while simultaneously dealing with a new surge of hospitalizations due to COVID-19.”

According to Public Health Ontario’s most recent weekly epidemiological summary, 890 health-care workers tested positive during the week of March 13-19. That rose to 1,176 — an increase of about 30 per cent — March 20-26.

The last three weeks have also seen a steady rise in the number of reported outbreaks in vulnerable settings — one of the few metrics remaining in Ontario to gauge the pandemic.

As of Wednesday, there were 180 senior homes reporting active outbreaks, up from 144 a week ago, and more than double the 85 homes reporting outbreaks on March 16.

Dr. Isaac Bogoch, an infectious diseases specialist at University Health Network, said there is an expected rise in hospitalizations, but it’s not yet clear how big this wave will get and how significantly it will impact the province.

“What is always true, though, is that this virus disproportionately impacts vulnerable individuals and at-risk communities,” he said, speaking to the Star during a break from seeing patients on the COVID ward at Toronto General Hospital. “And it’s going to do that again this time around.”

In this wave so far, physicians are primarily seeing elderly people and those who are immunocompromised getting severely ill with the virus and requiring hospital care, Bogoch said.

In a Wednesday afternoon tweet, Dr. Kevin Smith, president and CEO of UHN, said the hospital system was caring for 30 COVID inpatients, up from the previous week.

“We are truly seeing a lot more cases of COVID (at UHN) these past few days. So much so that staffing is challenging once again,” Smith tweeted, adding that wearing masks, handwashing, distancing and getting vaccinated help curb the virus’s spread. UHN had 16 patients with COVID on March 30 and just six positive patients at the beginning of that month.

Ontario’s pediatric hospitals are reviewing their capacity plans in anticipation of a rise in the number of children with the virus coming to hospital following March break and the lifting of mask mandates in schools.

Public Health Ontario data show 91 children 19 and under — including 57 under five — were admitted to hospital with COVID from March 22 to April 5. At CHEO (the Children’s Hospital of Eastern Ontario) in Ottawa, last week saw the highest COVID admissions since January and early February, according to a spokesperson.

Dr. Michael Warner, medical director of critical care at Toronto’s Michael Garron Hospital, said the province can take measures to help blunt the impact of the sixth wave. First, he said the government should change the definition of “fully vaccinated” to three doses given the high uptake of two shots but relatively low uptake of third shots. (Only about 50 per cent of eligible Ontarians have received a third shot.)

“The benefit in terms of preventing hospitalizations is massive, especially for older people,” Warner said.

“I think the government and the public health officers have really failed in communicating that this is a three-shot vaccine. They need to change the definition … not for the purpose of reinstating passports or mandates, but for the purpose of being honest about what is actually required to protect you from hospitalization.”

Beginning Thursday, the province will begin administering fourth COVID-19 vaccine doses to Ontarians 60 and older and First Nations, Métis and Inuit over 18 and their household family members.

Warner also said masking mandates should be reinstituted in settings such as grocery stores and pharmacies so that immunocompromised or medically frail people can do essential tasks without fear of contracting COVID. Schools should also reinstate mask requirements, he said, noting that children in many of Toronto’s most vulnerable neighborhoods live in multi-generational homes with grandparents who may not be fully vaccinated.

“Those are the people who end up in hospital,” he said.

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