Why is downtown Toronto the new focus for COVID-19? Lack of evidence, ‘private and social gatherings’ between potential drivers

As the Omicron variant takes hold in Toronto, the very pattern of infections in the city has changed, and the hotspot for positive cases is now concentrated in the dense city center.

While in previous waves, the virus swept through the northwest corner of Toronto, and just a few weeks ago, hot spots began to appear in new areas like Old East York and Mimico, now the worst-hit part of the city has become the oceanfront neighborhood. with an infection rate of 625 cases per 100,000 inhabitants during the last three weeks, excluding cases in nursing homes and long-term care.

Other nearby areas, such as Trinity-Bellwoods and Niagara, have experienced similarly high rates.

The precise reason for the concentration in the city center is unclear, and epidemiologists suggest theories about the uneven access of evidence to the impacts of post-infection immunity; while Toronto Public Health and Toronto Board of Health Chairman Joe Cressy point to social gatherings as a possible driver for the increase.

“The same trend that we saw at the beginning of the second wave is what we are seeing right now. Transmission is largely driven through meetings, as opposed to during blackout periods, when it is primarily done through work, ”Cressy said.

“The downtown communities are the youngest neighborhoods in the city and we have a lot of young people who are gathering.”

While Toronto Public Health says the exact reasons for neighborhood rate fluctuations may not always be discernible, listing influencing factors, such as school outbreaks, in an email to the Star, He said he saw gatherings during the Christmas season as a factor in the increase in cases, and also noted a shift from transmission in the workplace to contact in more “private and social gatherings.”

The agency did not specify any age cohorts, while suggesting other “possible explanations,” such as neighborhoods that have a higher concentration of children who were only recently eligible for vaccines, or the increased transmissibility of the new Omicron variant. .

Isaac Bogoch, an infectious disease expert at the University of Toronto, said he couldn’t say for sure why cases were concentrating in the city center in the past three weeks.

“Obviously, there are theories here,” he said, while cautioning that any suggestion came with a “huge grain of salt.” One of those theories, he said, was that with increasing demand, access to the PCR tests necessary to officially register a positive case could be uneven across the city.

He and fellow epidemiologist Susan Bondy also suggested that there may be higher rates of immunity in previously devastated communities, from those who contracted and recovered from COVID-19, as well as vaccination efforts targeting the worst affected neighborhoods.

Throughout the fourth wave, city ​​data shows that the percentage of cases from 18-29 year olds overall (23.8 percent, as of Tuesday) has been similar to the second and third waves, and higher than the first wave.

That age cohort has seen the sharpest increase in its rate lately, from 17.8 percent the week of November 28 to 21.8 percent the week of December 5.

But Andrew Boozary, executive director of social medicine at University Health Network, cautions against “shaming and blaming” certain populations when their cases rise.

“I don’t think we can have the knee-jerk reflex to say, ‘This is about young people coming out downtown.’ There may be elements of that. But we allow nightclubs to be open, ”he said, suggesting that younger people can also work front-line jobs or live in tighter homes. (A few days ago, the province introduced new restrictions that force bars and restaurants to close their doors at 11 p.m. and lowered their capacity limits.)

Across Ontario, the most recent data shows a record number of outbreaks in recreational facilities such as bars, nightclubs, venues and gyms. In Toronto, customers who visited establishments such as Cineplex on Yonge-Dundas Square, Bar Raval and Lopan Bar on College Street, and the History concert hall on Queen Street East during specific hours you have been asked to control themselves for symptoms.

As the cases have recovered again, some establishments in the center have made the decision to temporarily close their doors during the holidays. The Calii Love restaurant has recently halted operations at two of its Toronto stores due to positive cases among staff.

In analyzing the spread, Boozary, like Bogoch, questioned the role of test access. If someone couldn’t get tested, or was only able to access a quick test that didn’t register on the larger cast counts, he said it was more difficult to paint a complete picture of where the virus was spreading.

Still, for some inner-city youth, the increase in cases has been palpable.

Kyle Noble, 28, says he now feels like playing “Russian roulette” to avoid infection, as more and more people he meets at the center have tested positive.

You were recently notified about a possible exposure at your gym. When his throat began to scratch, he immediately searched for proof.

After spending hours scouring pharmacies and testing centers, Noble found an appointment on the other side of town, which is scheduled for Wednesday. The experience made him wonder how many cases in the city center can still go unnoticed.

“It makes me lose a lot of faith in how far we’ve come,” he said.


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