On Sunday, everyone had to show proof of double vaccination. Masks were worn except when eating, or some conversations, or taking pictures. That may sound a little like being in a restaurant right now, or a bar, or any number of places in Ontario.
It was a gala, where Toronto Raptors president Masai Ujiri, who got a third-shot booster two months ago, caught COVID for the first time. Everyone at the sold-out Wizards game Sunday is being asked to self-monitor for symptoms.
Omicron is different. It’s been nearly two years, and people want to move on. I know. But the nightmare is here; not for Ujiri, but for the province. Omicron is different from anything we have ever seen.
“This is the scariest it has been since this pandemic started,” says Dr. Beate Sander, a scientist and modeller at University Health Network, a Canadian Research Chair in the economics of infectious diseases, and the head of Ontario’s independent volunteer science table’s modelling group.
“Honestly, I’m not sure I have been as worried as I am now. Probably not. I remember the very first wave, but in the first wave, we didn’t really know what’s coming. And now we know what is coming. New information is coming out pretty much every hour, so it’s just really, really hard to kind of pin something down, and some of the estimates that we talked about this morning that should go into the models are already, almost outdated.
“And what makes me really so concerned is that every piece of information that’s coming out seems to make it worse.”
It’s hard for the human mind to grasp; part of that is the sheer bloody wall of exponential math. The numbers feel imaginary. Sander explains: in places like South Africa, Denmark, Germany and the United Kingdom, in different populations, Omicron has doubled every three to four days, or faster. That’s about a 400 per cent increase in a week. Ontario’s chief medical officer, Dr. Kieran Moore, said Omicron currently makes up about 10 per cent of recent cases. That would mean about 145 Omicron cases in Ontario on Friday.
With a weekly 400 per cent increase, Sander points out, the numbers go like this: 145 today, 600 in a week, 2,400 in two weeks, 9,600 in three weeks. That would be New Year’s Eve, and left unhindered it would mean almost 40,000 cases per day a week after that. We were already on schedule to cancel surgeries with a Delta-only wave. Based on anticipated growth curves, Omicron could become the predominant variant in Ontario within 10 days, and this will be an Omicron pandemic by early 2022.
“We won’t even have the testing capacity,” says Dr. Andrew Morris, a professor of infectious diseases at the University of Toronto, and a member of the science table. “And the public isn’t ready to shut things tomorrow. No matter what the right thing to do it, you can’t do that. But I’m pretty certain that everybody in the next six to 12 weeks will be infected with Omicron, unless they’re living the life of a hermit. That’s just the reality.”
Vaccines help: 76.6 per cent of Ontarians five and up have two doses, protecting them against hospitalization and severe outcomes. But the notion of mild outcomes may not hold for the unvaccinated and vulnerable. In Gauteng, the epicentre of South Africa’s outbreak — with an average age of approximately 27 — hospitalizations have doubled in the last 10 days, and ICU admissions have doubled in a week. In Denmark — which many scientists see as approximately analogous to Canada on vaccine coverage and stringency of restrictions — ICU occupancy nearly quintupled in the last month.
That’s a lot of numbers, and I wouldn’t blame you if your eyes glazed over, or if you looked away. I get it.
But Omicron is so hellaciously transmissible that it moves faster than we can think. It will explode. Even it is was slightly less virulent, the sheer number of cases will make up the difference. And there are 330,000 unvaccinated Ontarians between 50 and 69, and another 500,000 between 30 and 40. Omicron will find them. The hospital system is fragile.
“When I look at the capacity of those local health systems, and how they’ve been able to perform for the last years of weeks, I think there are real concerns,” says Dr. Martin Betts, the critical care chief at Scarborough Health Network, pointing to patient transfers and surgery cancellations in places like Kingston or Cornwall. “We can watch what’s happening in South Africa, in the U.K., in Israel. We’re two to four weeks behind these places. So it’s hard to — it’s hard to see that coming.”
The public doesn’t want to hear it, and has holiday plans. Governments, federal and provincial, are frozen in place, making recommendations that won’t work. And Friday, Ontario announced it would not lift vaccine passports in midJanuary, that vaccine passports would be QR code-only, that false medical exemptions would be reviewed by public health, and that third doses would open to everyone over 18 on Jan. 4 of next year.
It was artifactual progress. Omicron undermines the infection protection of vaccination: English data Friday showed protection with two shots might be as low as 30 per cent for Pfizer, and zero for AstraZeneca. Fixing obvious holes in the vaccine passport system is a fix for a world that won’t exist for much longer. Opening up boosters for everyone after the holidays, when numbers will soar, is not enough.
“I think every day we don’t step up is a lost day,” said Sander.
Ontario should sharply reduce capacities in everything from restaurants to sports arenas to sex clubs; order all office workers who can work from home to do so; reinforce masking and emphasize the airborne nature of the virus; and go all out on third doses, especially to those in long-term care. Smart people worry a lot about long-term care.
“At the moment, the public doesn’t recognize the enormity of what’s ahead of us,” says Morris, grimly. “But they will.”
Canada has seen awful things, but it hasn’t seen the worst of COVID, the way some other countries have. A wave like this, after it seemed like we were winning — with five-to-11year-olds being vaccinated, boosters on tap, society closer to normal — is hard to look in the eye. I don’t want to, either.
We will not have a choice.
‘‘ At the moment, the public doesn’t recognize the enormity of what’s ahead of us. But they will.
DR. ANDREW MORRIS, A PROFESSOR OF INFECTIOUS DISEASES AT THE UNIVERSITY OF TORONTO