More restrictions might be needed

The provincial lockdown extension to six weeks might not be long enough, the local acting chief medical officer warns.

Dr. Mustafa Hirji of Niagara Public Health says the climbing number of cases, including a significant number of variants of concern, may not be on enough of a downward trajectory by May 20, when this six-week lockdown is scheduled to end, to allow a safe reopening.

He is also suggesting there may be a decreased amount of vaccine coming to Niagara, if the province begins diverting supplies to hotspots, where it will do the most amount of good at reducing serious illness and deaths, he says.

Ontario cases have passed the peak of the second wave, he said Monday, and most parts of the province are seeing large increases that could last for another couple of weeks, until the current restrictions have had a chance to work, and more people are vaccinated.

About 26 per cent of the region’s population has received their first dose of vaccine, while two per cent have received both doses.

Hospitals and intensive care units are becoming increasingly overwhelmed, Hirji says, well past where they were during the second wave, and that too is likely to continue, possibly for a few more weeks, which is a strong concern for the health care sector.

Tracking shows that will flatten out by about mid-May, at a number well above what is considered the danger threshold in the province. 

Hirji points to the U.K. for some lessons that can be learned going forward. After a one-month lockdown last fall was bringing cases down, the country reopened, and “things boomeranged” as the B117 variant took hold.  By mid-December, it was back into lockdown, which just ended last week.

The message, he says, is an arbitrary four-week lockdown doesn’t work, and opening when cases are still high, although falling, is a mistake. It led to a “massive resurgence” of new cases in the U.K.

He is predicting it could be late June before cases in Ontario are low enough, and vaccinations high enough, for the province to be able to safely reopen. 

And for that to happen this lockdown has to work — it needs to actually stop people from social interaction, he says, “and we haven’t seen that reaction with his current lockdown,” suggesting there may need to be increasing measures to get people to stay home.

The positive side is that vaccinations are working, as evidenced in the reduction of cases and serious illness and deaths in the older population of 80-plus residents.

Hirji also encouraged those who are vaccinated to continue following all protocols, including staying home and minimizing social contacts. If they don’t, it would be hard to motivate others who are not vaccinated to follow the rules, he says.

His message is, “we’re all going to do this together.”

From a high of 220 cases reported last Thursday, daily numbers across the region have ranged from 143 on Saturday to 169 Monday.

As of Monday, there were 44 cases in Niagara-on-the-Lake, for a total of 402 since the pandemic began.

The number of variant cases continues to grow in Niagara, with the likelihood that some of them are of the South African or Brazilian variant, although they have not yet been identified, says Hirji.

There have been a total of 1,459 variant cases in Niagara, with 19 confirmed the U.K. B117 mutation, the others unknown.

There is such a high number of variant cases across Ontario, provincial screening to identify the type of variant can’t keep up, says Hirji.

Variants are amounting to about 50 per cent of the cases in Niagara, and 75 per cent in Ontario. The variants are known to be more contagious, causing more serious illness.

Niagara Health released a statement Monday afternoon regarding the state of local hospitals with the rising number of infections.

“We are currently treating 71 patients who are positive with COVID-19. Of these 71 patients, 17 are in our intensive care unit. These patient volumes speak to the increase in infections and seriousness of the illness. In comparison, on April 1, we were treating 11 patients with COVID-19, which included three patients in our ICUs,” says the message from Lynn Guerriero, president of Niagara Health, and interim CEO, and Dr. Johan Viljoen, chief of staff.

Postponement of some scheduled surgeries and ambulatory procedures is taking place, although urgent surgeries and cancer surgeries are not currently impacted.

There are ongoing transfers of critical care patients to Niagara from other ICUs in harder-hit areas of the province, the message says. “We increased our critical care capacity last week by three beds, up to 63, and have plans to add additional beds this week. Redeployment of staff is critical to this planning and is ongoing.”

Patients are also being moved from St. Catharines to other sites to make room for COVID patients, with volumes expected to increase, “including those who require critical care. This will further impact our delivery of health services at all of our sites.”

Niagara Health is urging everyone to remain vigilant with all public health measures, and encourage others to do the same, to reduce the transmission of the virus.