COVID-19: Modelling Update
Advice from the Science Advisory and Modelling Consensus Tables
October 29, 2020

 Purpose
• Share latest trends in Ontario epidemiology, health system indicators
• Provide an update on progress in controlling pandemic

2

 Current projections show slower growth, similar to
Michigan
Number of Cases per Day (aligned at 300 cases/day for 7-day average)
1,400
1,200
1,000

800
600
400
200

ON 2nd wave - Reported Date

ON 2nd wave predicted - increase to 1,200

ON 2nd wave predicted - increase to 1,000

ON 2nd wave predicted - decrease to 800

ON 2nd wave - 7-day average

ON 1st Wave

Michigan

Victoria adj.

12/15

12/13

12/11

12/09

12/07

12/05

12/03

12/01

11/29

11/27

11/25

11/23

11/21

11/19

11/17

11/15

11/13

11/11

11/09

11/07

11/05

11/03

11/01

10/30

10/28

10/26

10/24

10/22

10/20

10/18

10/16

10/14

10/12

10/10

10/08

10/06

10/04

10/02

09/30

09/28

09/26

09/24

09/22

09/20

09/18

0

3

 Positivity rates continue to increase in older age groups
with significant health and health system consequences

"

Data Source: Ontario Laboratory Information System (OLIS), MOH – extracted from SAS VA October 25.
Note: Includes all data submitted to OLIS up to October 24, 2020. The last six days are considered interim data (week 42) and subject to change
Weekly % positivity = total number of positive tests within the week (based on reported date)/COVID tests within the week

Week
ending
Oct 24

4

 Growth in hospitalizations is slowing, but spillover
risk persists
Over last 3 weeks (October 5October 26) there has been a 56%
increase in confirmed COVID bed
occupancy

350

300

Confirmed COVID19 Acute Inpatients (excluding ICU)
Confirmed COVID19 ICU Patients

250

200

150

100

50

0
01-Aug

08-Aug

15-Aug

22-Aug

29-Aug

05-Sep

12-Sep

19-Sep

26-Sep

03-Oct

10-Oct

17-Oct

24-Oct

5
Data Sources: Daily Bed Census Summary COVID-19 Report + Critical Care Information System. Extracted via MOH SAS VA Oct. 27

 Slower growth means that risk to ICUs is lower
Predicted ICU Occupancy
250

200

Ontario ICU occupancy predicted to
exceed lower threshold of 150 beds within
30 days in only the worst case scenario.

150

100

50

0

ON - 1,200

ON - 1,000

ON - 8,000

6

 Cases in LTC continue to increase with cumulative
mortality up substantially (85 deaths since August 15)
Current status (Oct 27)

400

•

350

87 homes currently in outbreak, 677
active confirmed cases in these homes

•

396 residents, 281 staff active cases

•

1,934 cumulative resident deaths, 8
cumulative staff deaths

•
•

21 of the 87 homes in outbreak are
based on 1 staff case
Oct 26 showed the highest daily count of
deaths since Aug 1 (11 deaths), with 27
deaths in the past 7 days.

COVID-19 cases and deaths for LTC residents and staff

Daily Active Cases Residents

Daily Active Cases Staff

Daily Deaths, Residents

Daily Deaths, Staff

300
250
200
150
100
Oct 26:
11 resident
deaths

50
0
Aug 1

Aug 15

01-Sep

15-Sep

01-Oct

15-Oct

Active cases are the number of people who have tested
positive for COVID-19covid 19. This number does not include
cases that have been changed to resolved or deaths.

0 staff
deaths

7

 Substantial variation in new cases per 100,000 population by PHU
90

Sept. 17
In-person classes
started for all major
school boards

80

Sept. 19
Limits on
social
gathering
sizes

Sept. 25
Restrictions
on bars and
restaurants

Oct. 9
Modified
Stage 2
begins in
Toronto,
Ottawa, Peel

Oct. 16
Modified
Stage 2
begins in
York

Peel 83.1

Toronto 72.0

7-day average new cases per 100,000 residents

70

York 54.7

60

Eastern 53.2
50

Ottawa 47.4
40

Durham 38.3

30

Halton 30.7

20

All other PHUs 12.8
10

0
01-Aug

08-Aug

15-Aug

22-Aug

29-Aug

05-Sep

12-Sep

Date case reported to PHU
Data Source: Case and Contact Management System (CCM), extracted Oct 27

19-Sep

26-Sep

03-Oct

10-Oct

17-Oct

24-Oct

8

 Substantial variation in percent positivity by PHU
7%

Peel 6.5%
6%

% positivity of daily testing episodes - 7 day moving average

5%

Toronto 4.8%
York 4.5%

4%

Ottawa 3.1%
3%

Halton 2.5%
Durham 2.3%

2%

Eastern 2.1%
All other PHUs 1.0%

1%

0%
01-Aug

08-Aug

15-Aug

22-Aug

29-Aug

05-Sep

12-Sep

Date test performed
Data Source: Ontario Laboratory Information System (OLIS), extracted via MOH SAS VA Oct 27

19-Sep

26-Sep

03-Oct

10-Oct

17-Oct

9

 Substantial variation in % 2-day test turnaround by PHU
100%

Sept. 24
Testing
guidance
update

% of testing episodes with results released within 2 days of test - 7 day moving
average

90%

York 88.4%
Toronto 85.9%

Durham 81.5%
Ontario 78.7%

80%

Peel 77.4%
Ottawa 73.0%

70%

Eastern 62.5%
Halton 61.8%

60%

50%

40%

30%

20%

10%

0%
01-Aug

08-Aug

15-Aug

22-Aug

29-Aug

05-Sep

12-Sep

19-Sep

Date test result released
Data Source: Ontario Laboratory Information System (OLIS), extracted via MOH SAS VA Oct 27

26-Sep

03-Oct

10-Oct

17-Oct

10

 Substantial variation in % of cases with no epidemiological link by PHU
80%
Interim data
subject to
change

% of new cases with no known epidimiological link - last 7 days

70%

Toronto 65.0%

60%

Ottawa 48.8%

50%

40%

30%

Durham 27.5%
All other PHUs 20.3%

20%

Peel 16.9%
York 15.5%

10%

Halton 8.4%
Eastern 4.5%

0%
01-Aug

08-Aug

15-Aug

22-Aug

29-Aug

05-Sep

12-Sep

19-Sep

Date case reported to PHU
Data Source: Case and Contact Management System (CCM), extracted Oct 27

26-Sep

03-Oct

10-Oct

17-Oct

24-Oct

11

 Changes in outbreak location suggest impact from shifts
to modified Stage 2 (1 of 2)
Other Health Units

Ottawa, Peel, Toronto, York Health Units

Proportion of reported outbreaks

1.00

0.75

0.50

0.25

0.00
Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Outbreak start month
LTC or retirement home

Group home, shelter, or correctional facility

School or daycare

Hospital

Workplace

Other or unknown setting

12

 Changes in outbreak location suggest impact from shifts
to modified Stage 2 (2 of 2)
Other Health Units

Ottawa, Peel, Toronto, York Health Units

Number of reported outbreaks

100

75

50

25

0
Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Outbreak start month
LTC or retirement home

Group home, shelter, or correctional facility

School or daycare

Hospital

Workplace

Other or unknown setting

13

 Substantial variation in source of outbreak by PHU since August 1, reported October 24
Grocery,
Retail &
Service, 8, 4%

Toronto
Gyms &
Sports, 6, 3%

Events,
Ceremonies
& Religious
Services, 5,
3%

Restaurants,
Bars & Clubs,
3, 2%

Ottawa

Other, 11, 6%

LTC &
Retirement
Homes, 36,
18%

Restaurants,
Bars & Clubs,
27, 14%

Grocery,
Retail &
Service, 2, 1%

Healthcare,
12, 6%

LTC &
Retirement
Homes, 63,
33%

Industrial
Settings, 0,
0%

Congregate
Settings, 13, 7%

Schools &
Daycare, 45,
22%

Other, 23,
12%

Events,
Ceremonies
& Religious
Services, 4,
5%

Healthcare,
21, 10%

Congregate
Settings, 20,
10%
Industrial
Settings, 9,
4%

Gyms &
Sports, 9, 5% Events,
Ceremonies
& Religious
Services, 2,
1%

Peel

LTC &
Retirement
Homes, 1, 1%

Gyms &
Sports, 3, 2%

Schools &
Daycare, 74,
39%

Gyms &
Sports, 3, 4%
Schools &
Daycare, 17,
20%
Grocery,
Retail &
Service, 16,
19%

Restaurants,
Bars & Clubs,
10, 8%

Grocery,
Retail &
Service, 14,
11%

York

Events,
Ceremonies
& Religious
Services, 1,
1%
LTC &
Retirement
Homes, 22,
17%
Schools &
Daycare, 13,
10%

Congregate
Settings, 7,
8%
Other, 28,
22%

Restaurants,
Bars & Clubs,
3, 3%

Data Source: Case and Contact Management System (CCM), extracted Oct 25

Other, 15,
18%

Industrial
Settings, 19,
22%

Healthcare,
0, 0%

Congregate
Settings, 9,
7%

Industrial
Settings, 24,
19%
Healthcare, 4,
3%

14

 Access to care continues well below 2019 volumes

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CDUID Volumes

Key Findings: pandemic spread continues
according to several indicators but is slowing
• Most indicators show slowing growth in COVID-19 cases, trajectory appears to be
moving away from worst case but cases are continuing to climb
• Levelling up public health capacity to respond to the disease is necessary to
respond to and control disease spread
• Continuing to respond on a PHU by PHU basis to account for regional variations
will be important
• Health system able to respond to pandemic at current levels of growth but
pandemic trajectory can change quickly
• Long-term consequences of COVID-19 pandemic continue:
•
•
•
•

Case growth and spillover into older age groups will increase mortality due to COVID-19
Potential for long-term health system burden from COVID-19 “long-haulers”
Access to necessary care continues below 2019 levels
Mental health and long-term consequences of economic impacts deserve further study

16