update on covid-19 projections … · 2021-06-10 · 19 patients in icus by mid-july and begin to...
TRANSCRIPT
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
0
50
100
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Wee
kly
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cas
es p
er 1
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,00
0 r
esid
ents
Porc
up
ine
Thu
nd
er B
ay
Peel
Ham
ilto
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Bra
nt
Du
rham
Wat
erlo
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Toro
nto
Nia
gara
York
Wel
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ffer
in-G
uel
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Mid
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coe
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sko
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bto
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Pete
rbo
rou
gh
Sou
thw
este
rn
Ren
frew
Ch
ath
am-K
ent
East
ern
Gre
y B
ruce
Sud
bu
ry
No
rth
Bay
Par
ry S
ou
nd
KFL
A
Has
tin
gs &
PEC
No
rth
wes
tern
Alg
om
a
Tim
iska
min
g
Leed
s G
ren
ville
Lan
ark
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
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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.
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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
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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
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/18
02
/25
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/04
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/11
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/18
03
/25
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/01
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/08
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/15
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/22
04
/29
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/06
05
/13
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/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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