A month ago, Dr. Adalsteinn Brown, co-chair of Ontario's COVID-19 Science Advisory Table sat with the province’s chief medical officer Dr. David Williams where they unveiled modelling data to indicate a third wave would likely hit the province with the more infectious variants of COVID-19 playing a significant role.
Rather than continue to hold their lockdown restrictions in place, to the shock of many, including those at the Science Table, Doug Ford’s government went the opposite way and scaled back restrictions. For Dr. Gerald Evans, Chair and Medical Director of Infection Prevention & Control at Kingston Health Sciences Centre and member of the Science Table, the lifting of restrictions is yet another indication of the government playing the “hope game” with the pandemic.
“We haven't made very many errors in predicting what was gonna happen, but I think that's the nature of politicians. I think there's a lot of wishful thinking that they have. We've been pretty right more than we’re wrong,” said Dr. Evans.
While Ontario’s case numbers are down from the height of the second wave, they’re steadily rising from below 1,000 per day to hitting 1,747 on March 14. The numbers are going in the opposite direction of when they reduced restrictions, but this was predicted at that time.
In the worst-case scenario, the modelling suggested that by April, cases in the province could hit or exceed 8,000. Whether it’s the B.1.1.7 emerging from Britain, or a myriad of others from Brazil, South Africa and other countries, variants which were significantly more transmissible were expected to overtake the current strain. Recent data released by Ontario's Science Table shows that is exactly what is occurring as the variants make up 49 per cent of cases as of March 15. The Ontario Hospital Association has quantified the latest data and declared the most recent outbreak to be the starting point of the third wave.
Dr. Evans said he was “cautiously worried” given the repealing of restrictions and the variety of cases due to the different variants at play.
“I think what my personal view is in some way the political leadership, they hear this data, but they're kind of wishing that maybe it won't happen. I think they're kind of waiting for one of these times for us to be wrong,” he said.
Lifting the stay-at-home orders was against everything the Science Table had suggested at the time, and in Dr. Evans’ view, the province needed at least three to four more weeks of restrictions in place to ensure that cases don’t spike up again. With their advice falling on deaf ears at times, Dr. Evans thinks at times the Science Table looks great, but the suggestions based on their expertise isn't valued.
“I think in all honesty, at times I feel like we're window dressing. Having advisory tables and people looking at them to provide evidence looks really good,” said Dr. Gerald Evans.
Ontario, and Canada as a whole has struggled to get a hold of enough vaccines to inoculate it’s at-risk population, and with vaccine doses at a premium, it was clear that Ontario should have held off on removing restrictions at the time, according to Dr. Evans.
“There's no question it's very easy from my perspective as an ID doctor, if you keep the restrictions on and get a lot of vaccination rolled out, you would totally prevent this third wave,” he said.
How bad could a third wave be?
The second wave of COVID-19 exposed a lack of preparation from the province, from a mediocre school plan, to an unwillingness to increase restrictions quickly enough, and most importantly the danger to seniors living in long-term care homes. However, the second wave was always expected by health experts to be worse than the first. Now, heading into the third wave, Dr. Evans admits the vaccine could be alleviate some of the destruction.
“We're starting to get to better ramp up vaccine distribution here in the province and that will temper how bad things could go,” he said.
Dr. Evans added that being later into the pandemic, more of the population has been immunized, so we’ll see less hospitalizations, and physicians are better suited to handle serious cases. But, with the vaccine being prioritized on a risk basis, Dr. Evans notes we could see another spike in cases similar to last summer among 20 to 40-year-old groups.
“We are still at risk for a third wave, which is generated by large segments of the population which are not vaccinated and for which we know transmission occurs readily,” said Dr. Evans.
“We are going to see rising cases, if this really gets a foothold.”
That’s where as Dr. Evans notes, political will needs to come in play, because by moving quickly to save the economy, the province has opened itself up to another potential lockdown by not waiting for vaccine doses to arrive.
“It would have been way better if we hadn't had to deal with lacking vaccine doses and could have held back on restrictions,” he said.
It’s not the first time a member of Ontario’s Science Table has voiced their concern over how the province has justified making decisions by misusing data. But, in this case, Dr. Evans thinks the voices of groups like the Canadian Federation of Independent Business and others have been able to get the province to shift their timelines and approach.
“At the same time they're listening to us, they're listening to small business people, they're listening to big business. They're listening to their party base, and we get diluted down,” he said.
When it comes down to a third wave, Dr. Evans notes that members of the Science Table provided the Ford government with the correct data, but now with it being almost imminent if not already underway, it was because the premier and company were swayed by non-medical voices to handle a pandemic.
“I feel that our information, we feed it to them as objective, and I think that many other groups come to them with their opinions about what to do with public health restrictions, that is subjective,” he said.