Front Burner - Will Ontario’s second wave become a tsunami?

Episode Date: October 1, 2020

Like many places in Canada, summer felt a bit more normal in Ontario, at least by pandemic standards. But as Premier Doug Ford said earlier this week, the province is officially in the second wave of the COVID-19 pandemic. Today on Front Burner, CBC's Ontario provincial affairs reporter Mike Crawley on what led us to this second wave of COVID-19 cases, the government's response, and what it might take to stop it from becoming a tsunami.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Like many places in Canada, summer felt a little bit more normal in Ontario, at least by pandemic standards. You could sit on a patio and catch up over a beer. You could head out of the city for a quick holiday and even invite some close friends to go along.

But now with the seasons changing, a very different picture has emerged in the province. Ontario hitting a record 700 new COVID-19 cases in a single day. That is the highest daily increase since the pandemic began. Because we know that we're in the second wave and we know that it will be worse than the first wave. But what we don't know yet is how bad the second wave will be. Today, CBC Ontario's provincial affairs reporter, Mike Crawley, on the province's second wave of COVID-19 cases, what led us here, and what it might take to stop it from becoming a tsunami. I'm Josh Bloch. This is FrontBurner.

Hello, Mike. Hi, Josh. I want to go back to the province's response to the first wave of the virus for a moment. It was back in March. Cases grew and we went into lockdown. We saw large events were canceled. Schools were closed. And back then, health officials were imploring us to flatten the curve so that the infection rate wouldn't get out of hand. Can you just remind me, what were the steps back then that were taken to try and bring the case numbers down?

I mean, it was a pretty comprehensive lockdown, and it was announced even as the numbers were still climbing. So it took a while before that took effect. But, you know, the big difference back then is that so many of the cases were coming from people who had traveled and the lockdown measures were to really try to stop it from spreading within the community. And that, you know, that did happen, but it wasn't enough to stop things from spreading really badly into the long-term care homes.

And that was where, you know, the bulk of the deaths really happened. A wake-up call I suppose as we look at the situation nationally. These allegations relate to alleged quote blatant disregard for infection control measures, mistreatment of residents and a level of care described as horrible. The personal support workers they are being told now to wear PPEs like masks as they deal with the residents in these homes. Cases started to kind of taper off as the spring passed and gradually the province, you know, released some of the restrictions and life started kind of getting back to normal.

And, you know, it went through kind of a summer lull. Case numbers got kind of as low as you were seeing, like maybe 100 cases, 100 new cases announced today on average once we got into August. Right. It felt like a bit of a reprieve for a while in the summer. But then the numbers have kind of slowly started to increase and now rapidly started to increase. I mean, on Monday, there was a record 700 new COVID cases, which surpassed the previous record from back in late April. What are health experts saying about the rate of transmission right now? I get a sense that the province was kind of lulled into a bit of a false sense of security through the course of the summer,

that it wasn't necessarily that people were, you know, following all the prevention measures really, really well. It was just that people spending lots of time outside where transmission is not so likely. And you could see things start to accelerate at the beginning of September. And we're on a track right now where it's doubling the sort of average number of cases. You get these day-to-day fluctuations and you get startling numbers like that 700 on Monday. But the real concern is the way the average number of cases just keeps going up. And it's doubling pretty much every 12 days or so. So that's got Ontario on track to be looking at an average of 1,000 new cases a day by mid-October, like right around the Thanksgiving weekend.

Well, how much information do we have about the path of transmission, you know, where these new cases are coming from? Yeah, that's a really good question, Josh, because we don't know a lot. It looks like only about half of the new cases that have been transmitted through the course of September, transmitted through the course of September, that the public health officials actually know where those cases were contracted. The other way of looking at it is that the sort of glass half full perspective is they do know roughly where about half of the cases are coming down with COVID-19. And through those sources of infection infection that prompted the province to announce a couple of specific measures in September to try to try to slow things down a little bit. Premier Doug

Ford announced he's rolling back the maximum size of social gatherings. It's private parties the province wants to crack down on. Get caught hosting one it's a minimum $10,000 fine. New restrictions for bars and restaurants. Last call is now at 11 o'clock and doors have to close by midnight. You know, Ontario Public Health has been pressed to release much more detailed info about where outbreaks are happening. If it's a business, what kind of business? If it's a restaurant, what restaurant?

I mean, why is that information important? Well, I mean, it's obviously important to the people who have been to those places. And that's where the contact tracing is supposed to come in. I think there's also some concern from folks out there around transparency, just kind of wanting to know where are the places where transmission is happening, the more transparency available in a pandemic, the better. And when you weigh that against privacy issues, you kind of just sort of think about what are the big public health implications

of keeping that information secret. There also appears to be issues with testing. I mean, I went to go get a test, a COVID test last Friday, and it was quite an experience. I mean, I had to wait in line for more than three hours. In line with me were young kids, you know, three and four year olds. And then after I got tested, I was told by the health worker that I would have to wait three to seven days to get my results, which, you know, that just seemed incredibly inefficient to me.

What are the challenges that we're seeing right now in terms of testing? You know, there's two ends of the testing. There's the getting the swab, the standing in line at an assessment center to have the sample taken from you. And then there's the lab processing. And it seems like the constraints are in both of those the the province has a a benchmark that basically they want to see 80 percent of test results communicated within 48 hours of the sample being taken and you know very clearly that's not happening in particular in toronto we've got some stats on that that that percentage has fallen way, way down. So the turnaround time on the

tests is a problem. The lab capacity, Ontario is really only able right now to handle roughly sort of 40,000 tests a day. In its plan that it just released, it says it's going to ramp up that capacity to 75,000 tests a day. But we've even heard that the province is looking at sending test samples out of the province and across the border to the states to be processed because they're saying that there's not enough lab capacity to handle it here. This is clearly a thing that the system was not ready to handle. Even though this second wave was predicted,

you shouldn't have seen that large number of lineups at the assessment centres and these kinds of delays in the lab testing if the province had really been ready with the capacity to handle the demand for tests. Both because, you know, there were testing delays back in March as well. And then, as you said, the second wave was anticipated. And presumably there was some anticipation that there was going to be more testing required as kids go back to school. school and there's pretty strict guidelines around the kinds of symptoms that would see a kid, you know, be required to go get a test because they have a runny nose or a cough.

The testing system is clearly stronger now than it was, you know, even March, April, May. Ontario's maybe only running around, you know, 10, 15, 20,000 tests a day. You know, it did really ramp up through the course of the summer. We're knocking off over 40,000 tests we're going to ramp that up to 50,000 tests and we're leading leading the country leading North America. They've been doing a lot of testing really accelerated and their percent positive is still relatively low. But they should have known that there would be a bunch more people wanting tests as the infection rate started rising and as therefore people were fearing that they were potentially exposed. What do you know about why it hasn't been fixed?

That's a really good question. I wish I knew the answer. Maybe they didn't expect that there would be so many people wanting tests. The province says they're going to have the capacity to surge up to something like 75,000, 78,000 tests a day as part of their plan for the future. But the second wave is here. And why this wasn't done already, I have no idea. The federal government just bought almost 8 million rapid COVID tests. Health Canada regulators today approved the ID Now rapid COVID-19 testing device for use in this country. The Abbott Laboratories-backed molecular devices can be administered by trained professionals at places like pharmacies without the need for a laboratory to determine if someone is infected with the virus. How much of a game changer could that be? I mean, these tests

would give you a result, I think, in 13 minutes. Now, in the defense of the Ford government, they have been saying that having these rapid tests would really alleviate the pressure on the system, on its assessment centers and its testing labs. So for sure, that would help. You know, the rapid tests aren't perfect. They're not as totally reliable as the nasopharyngeal swabs. You know, it does have a little bit of limited utility, but if, you know, we can see those things spread out, that might actually be good for a lot of those cases where the risk that someone

actually has COVID-19 is pretty low. That's, you know, like you say, for kids wanting to be cleared to go back to school or people to be cleared to go back to work where they might have been exposed. In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization. Empowering Canada's entrepreneurs through angel investment and industry connections. Hi, it's Ramit Sethi here.

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I help you and your partner create a financial vision together. To listen to this podcast, just search for Money for Couples. The Ontario government finally released its full plan to deal with this second wave. And you've mentioned already that they are planning on ramping up their capacity to do these tests. And you've mentioned already that they are planning on ramping up their capacity to do these tests. But what else are they planning to do in response to the surge in cases that we're seeing right now? Yeah, so there's quite a few things that they're going to do as part of this plan. The irony here, though, is that they're calling this the fall preparedness plan. And, you know, by my calendar, we're already nine days into fall.

So that's, you know, preparing for fall. You would have thought that this would have been out a little earlier. In addition to ramping up the testing capacity, there's a commitment to increase contact tracing, have more staff there. There's money to expand hospital capacity in some ways to clear some of the patients who don't really need to be in the main hospital wards, to move them out into community settings, to help prepare for the potential of a surge in demand for hospital beds. There's some money in there to try to work to clear the surgical backlog that has been created by the postponement of non-emergency surgeries. A key thing that this plan says, and it is sort of the philosophy that the government is going to take with this second wave of COVID, that they

don't want to go to full-on lockdown, if at all possible, that they want to try to full-on lockdown if at all possible that they want to try to use targeted prevention measures to reduce the spread. We don't want to turn back a stage unless we absolutely have to but if we do have to we will. Dr. Williams and Mr. Ford and Ms. Elliott are all emphasizing the importance of managing these things surgically. So targeted, you know, specific things to shut down a certain sector, you know, be very localized, very much wanting to avoid a step back to what Ontario called stage two of its reopening plan, which would, you know, see if they were to do that, that would be a more sort of widespread closures of indoor service at bars and restaurants, for instance.

Right. And this seems to be kind of a contentious issue. I mean, I know several epidemiologists have spoken to the CBC about the need to stop indoor services at bars and restaurants as a way of dealing with this rise in cases we're seeing. In these establishments, it is very difficult to adhere to those preventative measures to prevent the spread from one person to another. We need to make sure that workers and businesses are supported through these next few weeks or longer if need be. But the most important priority has to be to stop the second wave. There's also been a lot of criticism of the province's communication strategy

from the way Doug Ford has chastised young people for holding these wild parties. There must be a few fries short of a happy meal of these people because I just don't get it. They go out there, they know the rules, and they just blatantly ignore it. And they're hurting families. To the leadership of Dr. David Williams,

Ontario's chief medical officer of health, there's even calls for him to resign. Why is that? I've heard from some public health experts who have said that, you know, the decisions that are being made around what's open and shut and what the rollbacks have been or have not been, that they've been poor decisions. Dr. Williams, with all my respect to him for the many years he has given to the health system, is not the right leader for a pandemic. We started absolutely too late on all the upstream initiatives that we needed for the province.

The other chief criticism against Dr. Williams has been his communication style. I actually can talk a little bit about communications because as a journalist, that is sort of my job, and I do find that he has a very rambling way of answering questions. And so we're trying to understand that data better as you could even lower down to 0.6 and 0.3 percent it gets even more higher but then you're dealing with a smaller number overall if you do the mathematics. I have often found myself after having asked him or heard one of my colleagues ask him a pretty straightforward question literally not understanding what the answer has been and i don't mean to cast any

aspersions at all on his medical background and and or on how hard he's working because he's you know been at the front and center of this uh for months now i can can't imagine the pressure. But it is not a master class in communicating what the public should be doing or where the province is going related to this pandemic. Does the province currently have any set criteria for what it would take to move back into stage two or is that still being worked out right now? We're still bringing that forward to the public health measures table. The difference we see between this one and when we moved out of stage three, when you moved out and stage back down on phase two, was that we had clear overall... One of the things I think many people are looking to is the rise in hospitalization rates and the kind of

stress that this could all potentially put onto the healthcare system. I mean, already we're seeing, I think there's 5% of schools have reported at least one COVID case. We have over 40 long-term care facilities that are reporting outbreaks. What are the potential implications for the healthcare system? The trick on the implications for the health care system? The trick on the implications for the health care system, for the hospital system, is that you don't really see those numbers until well after the infections have happened. And then by that time, it's too late to rein that in. There's, roughly speaking, a sort of two to threeweek lag between when you start to see an increase in infections, and then that starts to reflect in the hospitalization numbers.

But yeah, the number of people in hospital today, it's doubled basically in the space of a week. The biggest concern that we see from the modeling, the projections that have been put in about what's going to happen in Ontario's second wave, it's about the intensive care units. The doctors and nurses who provide that care are really specialized. I've actually been in an ICU and you get one-to-one nursing care there and they just can't overnight suddenly, you know, create a whole bunch more ICU nurses and intensive care doctors, no matter how many, you know, create a whole bunch more ICU nurses and intensive care doctors, no matter how many, you know, ventilators you can build or intensive care bed spaces you could create. Mike, as you mentioned, I mean, the government has laid out a plan. Here we are in fall. They have finally laid out a plan for how they're going to deal with the second wave.

But the second wave has long been predicted by epidemiologists. We knew that this virus would be harder to control in colder weather. We know how deadly it can be. Given all that, I mean, shouldn't we have been better prepared for the surge that we're currently seeing in infections? There are a lot of people out there saying that Ontario should have been better prepared for this. We're only going to know how well prepared the province has been when the wave peaks. It is kind of odd that it took so long for the province to admit that the second wave was here because you could see it coming. You know, we're already seeing, on an average, case numbers that are higher than what they were at

the peak of the pandemic. And it's, you know, it's been heading on that trend through September. This is a classic pattern of pandemics, that in the summertime, infections fall off, not necessarily because of things that the province is doing, but just because of the weather. There's less likelihood of transmission. I saw an interesting editorial in The Globe today that said, you know, not being prepared for Ontario's second wave and then announcing, you know, the pandemic plan now. announcing the pandemic plan now. It's kind of like being a Canadian government and putting out a tender for snow plows in January because you've noticed that it started snowing. This second wave was coming.

It was really just a question of exactly when and what would the intensity be. But it was going to happen. Well, I will certainly be watching closely and praying that the schools stay open and that people stay safe. I'm sure everyone is. Mike, thank you so much for your insight into this. You're welcome, Josh. As this second wave looms over the province, advocates for long-term home care are worried.

In the spring, an estimated 82% of deaths in Canada related to COVID-19 were among residents in these homes. On Tuesday, Ontario Premier Doug Ford announced stricter visitation rules for care homes in the province's COVID hotspots. He's also promised nearly $540 million for infection control and prevention initiatives. But there's already concerns that the money won't come soon enough to deal with staffing shortages. Stay tuned. We'll have more on this in the coming days. I'm Josh Bloch. Thanks for listening to Frontburner.