Ontario staring down possible third wave of COVID-19, but severity remains unclear

Ontario appears to be standing on the edge of a third wave of COVID-19, some experts say — but because of virus variants, vaccinations and the promise of warmer weather on the horizon, it's unclear how severe it could be.

All of those changing variables mean predicting exactly what will happen in the coming weeks is difficult, said epidemiologist Dr. Tim Sly, a professor emeritus at Ryerson University in Toronto.

"It's almost like a dystopian plot in a movie. On the horizon ahead you've got the vaccine cavalry … and on the other horizon you've got the mutants, all lined up, a motley bunch," Sly said.

"It's almost like the third act of a three-act play … it's the crisis now. The future will be determined by this conflict, and it could go either way."

As it stands, there are concerning signs in Ontario. Ottawa's medical officer of health said Friday it seems the city's third wave is coming, pointing to increasing levels of the novel coronavirus found in wastewater.

Provincial case counts also spiked again Monday, with 1,631 new cases reported. That puts the seven-day average for the province at 1,155, which is the highest that number has been since Feb. 13.

The Ministry of Health says Monday's count was higher than expected due to a "data catch up process." At a Monday afternoon news conference, Associate Medical Officer of Health Dr. Barbara Yaffe said the real number is "probably closer to 1,300." 

Ashleigh Tuite, an epidemiologist at the University of Toronto's Dalla Lana School of Public Health, told CBC News case counts in Ontario are not declining, and if growth is sustained, it would suggest the province is once again looking at exponential growth of the virus.

"[But] it's too early to call right now," she said.

A 'significant increase' in COVID-19 variants

At a Monday afternoon news conference, Toronto's Medical Officer of Health Dr. Eileen de Villa reported 636 new cases of the virus. However, she cautioned that "one day of data does not a trend make."

Still, de Villa said, preliminary data from the city now suggests almost 40 per cent of the most recent reported cases in Toronto are screening positive for variants of concern (VOCs), which are thought to spread more easily.

Provincial officials said Monday they are also seeing a "significant increase" of variants in Ontario, with roughly 31 per cent of recent tests coming back as positive for a VOC.

Provincial Medical Officer of Health Dr. David Williams said Monday the province is in a "race against time" with these variants, which have caused cases to surge in other jurisdictions.

"As they are rising, we are getting more vaccines," Williams said.

Thus far, those vaccines have proven effective. Figures from the province show that daily death rates in long-term care homes have dropped sharply in recent weeks, and that sector was first in line for available vaccines.

De Villa said for the week of Feb. 21, there were only two COVID-19 cases found in residents of Toronto's retirement and long-term care homes, which is a significant drop from the first and second waves.

"That is exactly the kind of outcome we hope for following a vaccination campaign," she said.

Stay-at-home orders lift

Meanwhile, stay-at-home orders lifted Monday in three regions of Ontario, including Toronto and Peel — which have consistently seen the province's highest number of infections throughout the pandemic. Both regions now sit in the most-restrictive grey zone of the province's original COVID-19 framework.

Tuite said it is jarring to see restrictions eased when case counts remain high.

"Having said that, to date, both Peel and Toronto have been very cautious in lifting restrictions, and even though stay-at-home orders have been lifted, they're still in grey/lockdown," she said.

"And again, we need to see what happens over the next couple of days to understand if [case growth] is a real trend or an anomaly."

Sly said most epidemiologists are "nervous as hell" about the province opening back up, adding that by mid-May to mid-June, people should have a better idea of what the future holds.

"By then, we'll have a good idea of whether the vaccines are going to win this battle, or whether the [variants] are going to win the battle," he said.

"But it's really too early to say at the moment."