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Lockdown 2.0? Case spikes could lead to more coronavirus restrictions

COVID-19: Canada’s delicate balancing act in reopening
WATCH: Large crowds at a Toronto park are sparking new concerns that easing restrictions could trigger a second wave of COVID-19, faster than the health system can manage.

About a week ago, one of Canada’s most-watched novel coronavirus charts — new infections in Ontario — started to head definitely, unmistakably, in the wrong direction.

Canada’s most populous province has endured one of the country’s stricter shutdowns, with schools now closed until September.

READ MORE: What the coronavirus reproduction number is, and why we should keep an eye on it

For much of May, it seemed to help tame the virus, with the line marching reassuringly downward. But recently, Ontario’s daily new cases have stayed above 400, with the curve showing no sign of the hoped-for flattening.

Coronavirus around the world: May 25, 2020
Coronavirus around the world: May 25, 2020

Ontario’s R number, the number of people who an infected person will, in turn, infect on average, has remained stubbornly over one, University of Toronto epidemiologist Ashleigh Tuite wrote in an email.

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As our struggle with the pandemic has its advances and setbacks, victories and defeats, it’s unavoidable that restrictions will sometimes be tightened, warns Steven Hoffman of York University.

“All Canadians need to be ready for the need to reimpose layers of protection that are now being lifted in the event that we have an uptick in cases that represents a threat to our public health,” he says.

“We all hope to go back to the way things were before the outbreak started, but we need to be ready, and prepare for the likely scenario that some of these layers actually have to be reinstated.”

How soon can we expect a second wave of COVID-19?
How soon can we expect a second wave of COVID-19?

The R number is the main indicator that governments will look to as they decide whether or not to relax — or tighten — restrictions, Hoffman explains.

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“There’s no magic number, but one helpful number to look at is the reproduction number,” he says. “A reproductive number of one means that the number of cases flatlines. That means that the infection continues, and people are still affected, but it’s not growing. That’s where you want to get to, or ideally, even better than that, a reproduction number below one. That means it’s petering out.

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“The problem is that once it gets above one, we start to see exponential spread of the virus, and that can get us to a place like we were in the middle of March, where it was getting uncontrolled, and we needed some unprecedented measures to stop it in its tracks.”

Explaining COVID-19’s reproduction number
Explaining COVID-19’s reproduction number

With it, hopes for a further loosening of restrictions and a return to some version of normal, such as reopening daycares, seem to have faded for now.

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READ MORE: ‘Selfish and dangerous’ — Officials disappointed after thousands crowd Toronto park

On Saturday, thousands of people crowded Trinity Bellwoods Park in west-end Toronto, which the city’s chief medical officer of health condemned as “selfish and dangerous behaviour.”

Coronavirus outbreak: Ford ‘absolutely shocked’ by images of crowds in Trinit Bellwoods park
Coronavirus outbreak: Ford ‘absolutely shocked’ by images of crowds in Trinit Bellwoods park
 

But upticks in case numbers may happen for reasons that are out of our control, Hoffman says.

“Some of them might be our own fault,” he says. “If we lift too many layers of protection too quickly, then the existing cases we still have in Canada might end up further spreading and getting us to a place where we need to reimpose the extreme measures that we’ve been depending on up until now.”

But “even if we do everything right in Canada,” the virus could still make its way across the border, he says.

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READ MORE: As Canada reopens, are we ready for a ‘second wave’ of coronavirus infection?

So it’s wisest to see it as inevitable.

“It’s not something we can fully control, even with the most robust measures at the border. This is something I think we just need to be ready for and be on guard for.”

Coronavirus outbreak: Here’s why you need to stay away from public parks
Coronavirus outbreak: Here’s why you need to stay away from public parks

The University of Toronto’s Vivek Goel expects new restrictions, if they end up being imposed, to be more precisely tailored to problem areas than the sweeping ones ordered in March.

“We are gathering more data as each week goes on, in terms of knowing which measures have what effects. That is because over time we have been imposing and then lifting different measures across jurisdictions,” Goel said.

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How to teach kids to cope with the COVID-19 Pandemic
How to teach kids to cope with the COVID-19 Pandemic

“So instead of a strict reimposition of everything at once, as we have better information globally, if we start to see cases rise in a certain type of work setting, we might have constraints applied there and not necessarily across all of society.”

READ MORE: Fears of coronavirus ‘second wave’ hang over successes, relaxed measures

With a widely available vaccine possibly years away, and the population a very long way from herd immunity, we will have to figure out how to live with the virus for now as best we can, Goel says.

Health matters: Social distancing key to limiting 2nd COVID-19 wave
Health matters: Social distancing key to limiting 2nd COVID-19 wave

“At some point, the general public, and businesses, are going to have to really look at it from a societal perspective: how long can we continue to keep our society on life-support? That’s’ really what we’re doing.”

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“The COVID-19 deaths are visible, and they’re on the news every night. But all these other deaths that are going to be taking place because people aren’t getting their cancer surgery, or kids are getting abused at home.”