Ontario is now in the second wave of the COVID-19 pandemic. How bad will it get?

When will new COVID-19 cases peak in Ontario? The province reported 700 new cases of COVID-19 on Monday, the highest single-day increase so far.

TORONTO — Ontario Premier Doug Ford says the province is now experiencing a second wave of COVID-19, and that it may be worse than the first.

The premier confirmed the anticipated fall second wave while speaking to reporters at Queen’s Park hours after health officials confirmed an all-time high in daily reported infections.

“We know that we are in the second wave and we know that it will be worse than the first wave,” the premier said. “But what we don’t know yet is how bad the second wave will be.”

“The reality is it’s up to each of us, together our collective actions will decide if we face a wave or a tsunami.”

This is the first time that Ontario’s public health officials have said the province is experiencing a second wave of COVID-19.

The confirmation comes as 700 new lab-confirmed infections were reported in the province, with the majority located in COVID-19 hotspot Toronto, Peel Region, York Region and Ottawa.

Four other public health units are also reporting new cases in the double digits.

On Monday, Ontario’s Chief Medical Officer of Health Dr. David Williams said that experts looked at a variety of factors in categorizing the second wave, including hospitalizations, patients in the intensive care unit, outbreaks in long-term care facilities, contact management, lab testing and positivity rates.

“All of those factors indicate to us, one is that we are as the premier said in a second wave. The question is what type of second wave is it?”

“Right now we are in a second wave that looks like one of those undulating waves. How big it is, we don't know yet. It's not like the tsunami-type second wave but watching to see if this will have an impact on our systems.

Williams added that the province is much better prepared than it was during the height of the first wave. At the same time, he said that health officials are assuming the worst.

“It doesn't seem to be going away,” he said. “We like to hope that we can keep on top of this.”

Second wave could peak in October, modelling projects

Dr. Kelly Barrett with the COVID-19 Modelling Collaborative, a group of scientists and clinicians from expert facilities in Toronto, said that Ontario could see a peak in infections in mid-to-late-October.

“We are confident that we’re expecting a surge soon,” she said. “Our percent positivity is going up, which tells us that both the number of cases in the community is increasing but also that our ability to record or capture all of those cases is diminishing with our decreased testing capacity.”

“Our testing centres are getting overwhelmed with people looking for a test and certainly we are seeing more people who are positive among those in line.”

According to COVID-19 Modelling Collaborative's projections, there could be more than 1,000 new cases of the novel coronavirus reported per day in mid-October if further public health measures aren't taken.

Barrett added that the project is not focused on single-day reporting but rather focuses on overall seven-day averages in order to determine trends.

“There will be expected blips in numbers from day-to-day, but it’s the sort of general trend that we see over time that’s really important.”

“But we are seeing an increase in the numbers of new cases reported.”

She said it is too early to determine what will happen in December, noting that it depends on how well everyone adheres to public health measures such as physical distancing, mask wearing and hand washing.

Roll COVID-19 hotspots back to Stage 2, hospitals urge

The Ontario government has not committed to rolling any regions back to Stage 2 of its economic reopening plan, despite a new call from the Ontario Hospital Association (OHA) to do so.

In a news release issued on Monday, the OHA said they are concerned about a potential increase of hospitalizations in the second wave and urged the Ford government to reinstate Stage 2 restrictions in the Greater Toronto Area and Ottawa—areas where the number of daily reported infections appear to be surging.

“Ontario hospitals have been the anchor of Ontario’s pandemic response, opening assessment centres, conducting laboratory testing and deploying staff to assist in long-term care but they are gravely concerned that the current rate of spread will mean that hospitals will be unable to fulfill these roles while delivering life-saving care,” OHA President and CEO Anthony Dale warned in the statement.

“Without public health measures in place to limit opportunities for disease transmission, Ontario will soon see higher numbers of hospitalizations, admissions to intensive care units and more deaths.”

In Stage 2 of the province’s economic reopening plan, bars and restaurants were prohibited from offering dine-in service, with the exception of patios. A number of other businesses such as gyms and movie theatres were shuttered.

Residents were also only allowed to meet with those within their 10-person social circle.

As the number of daily infections climbed in recent days, the premier rolled back gatherings from 50 people indoors to 10, and from 100 people outdoors to 25. His government also made it illegal to sell alcohol at bars and restaurants after 11 p.m.

Ford has constantly said that “everything is on the table” when it comes to further public health restrictions, but on Monday his government said they will not be rolling back to Stage 2 just yet.

“We don't want to turn back a stage unless we absolutely have to,” Ontario Health Minister Christine Elliott said. “But if we do have to, we will, because the most important thing is to help the wellbeing of the people of Ontario. So we're watching this very closely as I know Dr. Williams and his team are.”

While moving some regions back to Stage 2 would severely impact the economy, Dale said recent evidence that indoor settings like bars and restaurants could be “significant drivers of rising COVID-19 cases” needs to be taken into consideration.

“Keeping these settings open while restricting private gatherings sends a confusing message to the public,” he said. “While changes to these establishments' operating hours may have a small impact on transmission, we cannot afford to wait and find out. In order to keep schools open, protect our province's most vulnerable, and conserve our health system's limited resources, stronger restrictions are needed now."