Canada moved past 100,000 cases of the novel coronavirus Thursday, with 100,203 official cases reported by Health Canada and provincial health authorities.
How did Canada make it over 100,000 known cases? In recent weeks, rather slowly. In late April, we saw about 1,800 new cases a day, but recently, that’s held steady at 400 or so.
The official milestone is a chance to ask the question: how are we doing so far with the biggest national crisis since the Second World War?
Canada escaped the high death toll from the virus suffered by many countries in Europe as well as the United States. But as the worst passes in those countries, at least for now, Canada now has a higher death rate than many of them, a Global News analysis shows.
“Canada didn’t experience what other countries did if you compare that to Italy or France where, at the height of this wave of the pandemic, they were experiencing relatively large numbers of cases,” says University of Toronto epidemiologist Ashleigh Tuite. “We didn’t have that high, high peak in Canada, which is good.”
Canada’s coronavirus death rate is now similar to the United States and higher than the European countries in the graph, except for Sweden and the U.K.
“Probably the less reassuring aspect of this curve is that a lot of countries have what looks like a pretty typical epidemic curve when you look at the deaths, when they went up and then they’ve fallen pretty steeply. In Canada, we have a shallower curve, but when you look at the end of that curve, it’s not continuing to drop,” she says.
“It’s definitely stable, and if anything, you might say that it’s starting to increase a little bit at the end there, which is not what you want to see.”
Tuite points to Germany (shown on the chart above) as a country that has handled the pandemic excellently so far.
“Germany is where you would want to be,” she says. “They responded very, very rapidly when they had their first cases, they had a very strong public health response and their reopening plan has been very, very tied to surveillance.
“There are clear metrics in terms of what they need to be seeing in order to move to the next phase of their reopening plan. It’s clear what targets they need to hit, and I think that that’s really important.”
By contrast, some Canadian jurisdictions have been hobbled by slow and outdated public health information systems. Death reports are still commonly filled out on paper and filed by fax in Ontario, for example.
“I think in general we’re hearing a lot of good news stories and this idea that we have things under control and we’re in a phase of starting to think about reopening and having a return to more normalcy,” Tuite says.
“But (the graph) suggests, consistent with what a lot of epidemiologists and clinicians are saying, that we’re not out of the woods yet. We’re continuing to have relatively high numbers of deaths happening, we’re continuing to have relatively high numbers of cases happening, particularly in Ontario.”
York University’s Steven Hoffman points to South Korea — which has too few deaths to be worth putting on the graph — as a country that got its outbreak under control immediately.
“The countries that have been able to respond the best were the ones that were able to scale up their testing regime faster than others. The star country that did that was South Korea,” Hoffman says.
“Today, South Korea performs far fewer tests per capita than we do in Canada. That doesn’t matter because they don’t need to do as many tests, because they now have fewer cases. What really mattered is how fast they were able to scale up that testing, such that earlier in the outbreak, when they needed those tests, they had them.”
Across Canada, many different stories
Looking at a simple national total misses a great deal.
Some large provinces, like B.C. and Alberta, have so far escaped the worst of the virus. Others, like Quebec and Ontario, have suffered much more. Some rural provinces, like P.E.I. and New Brunswick, have escaped almost entirely and plan to keep it that way through ruthless shutdowns.
Why the severe differences? Tuite and Hoffman see it as a mixture of luck, good and bad, and policy decisions. Quebec was unlucky in the earlier timing of March school breaks, for example, while P.E.I.’s relative isolation in winter gave it an extra buffer.
“We often earn our luck or ruin our luck,” Hoffman says. “There’s some luck that we either make use of or we squander. The best way to get more luck in a pandemic is to have made investments in public health before the outbreak started.”
On a national level, he says, Canada was lucky to get more warning of what was coming than many other countries and had two or three extra weeks to brace.
“Some provinces made good use of it, and those two to three weeks have continuously reaped rewards because we’ve been able to look at how other countries have responded to outbreaks, and been able to figure out: ‘Do we want to respond like that country, or do we want to respond like that country?’
“In other provinces, that time wasn’t made the greatest use of, either because testing wasn’t able to be scaled up, or other things.”
The reproduction number
Another important number to look at is the reproduction number, or the number of people who one person with the novel coronavirus will infect, on average. If that number is much above one, infections are growing exponentially at a level that could potentially overwhelm health-care systems.
On a national level, it’s fallen to .65, and in Ontario, one of the worst-hit provinces, it’s now at .54.
That unemployment chart
The sudden shutdown of schools and businesses helped to stop the uncontrolled spread of the virus but devastated the economy. Unemployment has skyrocketed to levels not seen in decades and has increased far faster than in previous recessions.
“What does a society look like that has that kind of high unemployment level?” Hoffman asks. “We could look to other countries. In Italy, for example, there have been decades of 25 per cent youth unemployment.
“I don’t know what that would look like … but at least according to some of the early signs, it looks like very high levels of unemployment are unlikely to sustain once the economy reopens and we get back on track.”
What do the next six months look like?
Tuite sees the summer as a time to prepare for a return of the virus when colder weather returns.
“Right now, the weather is nice, people are able to spend time outside, we have fewer interactions indoors, people are starting to gauge their own risk in terms of what activities they are and aren’t doing, in terms of potentially expanding the activities that they do and doing things like having socially distanced visits with other people,” she says.
The fall will change that dynamic, though.
“We need to use the time that we have right now to figure out what that return to school and university looks like so that we have in place protocols and plans to make sure that we are able to have kids go to school without having an increase in disease transmission.”
Hoffman expects a long period of confusing, and probably demoralizing, reopenings and reclosings.
“I think the next six months are going to be really difficult, in the sense that we are going to have a start to the lifting of these layers of protection but that we are going to have others that remain in place,” he says. “There is going to be a situation where one day we’re going to be able to get a haircut again, and the next day, no more haircuts because the case numbers have gone up again.
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“That kind of uncertainty and change, I think, will be very difficult for people.”