With Canada’s coronavirus cases escalating at a worrying rate, health officials say they are preparing for what many call a “second wave” of the pandemic, with some suggesting it may have already arrived.
But experts say framing the rise and fall of COVID-19 cases in “waves” is inaccurate, and ignores how human behaviour is playing a role — and how it’s critical to controlling the spread of the virus.
The country has seen a dramatic resurgence of the virus in recent weeks, along with long lines for testing in some cities. In the last two weeks alone, the number of cases reported nationwide each day has risen by nearly 50 per cent.
While Canada saw a brief rise in cases earlier this summer, cases have now risen back to levels last seen in late May and early June, when daily cases were falling from their peak in mid-to-late April.
Yet even when the pandemic was at its lowest point during last spring’s widespread economic lockdown, Canada was still reporting over 200 new cases daily — which experts say is proof that we’re still dealing with the first wave.
“It didn’t go anywhere,” said Caroline Colijn, a mathematics professor at Simon Fraser University in Vancouver who specializes in infectious disease modelling.
“What does a wave do? It comes and then recedes and disappears by itself, not because you jump off the towel and push it back. We haven’t had that sort of natural thing where the infection burns itself out. We brought it down through our own behaviour, but it’s still here.”
Sarah Otto, an evolutionary biologist and modelling expert at the University of British Columbia, is even more blunt.
“Technically, we’re nowhere near a ‘second wave’ as it’s defined in terms of a disease,” she said. “The second wave happens when people lose immunity to that disease and it comes back.
“Instead, what we’ve had are ebbs and flows based on how we’ve changed our behaviour to combat the spread of the virus. So as we’ve returned more and more to so-called ‘normal’ behaviour — and especially now that schools have reopened — we’re seeing more cases.”
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Epidemiologists largely agree that a “second wave” of a disease occurs when infection rates die off among the first impacted group, only to rise among a second group.
While younger people have appeared to lead the way in recent infections, older Canadians have also continued to contract the virus at steady rates.
Several provinces have also reported cases in schools among both students and teachers since in-class learning resumed earlier this month, with some schools — including in Winnipeg and parts of Ontario — shutting down and moving classes online.
Health officials and experts say they have yet to see community transmission result from those school outbreaks. However, Colijn and Otto both say their models suggest cases across the country may continue to rise over the short term, particularly in the provinces driving the surge: British Columbia, Alberta, Quebec and Ontario.
But Daniel Coombs, a mathematical modelling expert at the University of British Columbia, says that rise could be tempered the same way cases were brought down the first time: by managing our behaviour.
“The problem I have with the language of ‘waves’ is it suggests (the pandemic) is out of control, where I strongly feel that we have the capacity in this country to control it,” he said.
“I think what we’re going to see over the fall and winter is health officials pulling those levers to sort of tune their policies so that schools can stay open — as they’re really critical to our society — while adjusting regulations elsewhere to keep transmission low.”
Coombs pointed to last week’s order in British Columbia that closed nightclubs and banquet halls while putting new restrictions on bars and restaurants. Although it was met with some opposition from owners, he said the order struck a balance between cutting down on large gatherings while doing relatively minimal economic damage.
Cases have continued to climb in that province, however, reaching a new record high on Thursday with 165 new infections.
The premiers of Ontario and Quebec have warned of similar restrictions, along with fines and minimal lockdowns, if behaviour doesn’t change and cases don’t start falling again.
A new Ipsos poll suggests 75 per cent of Canadians would approve a widespread shutdown of non-essential businesses if cases reach another peak like last spring’s. Roughly the same number said they anticipate another rise in cases this fall, which they called a “second wave.”
But Otto says those penalties can be avoided if people remember that they’re part of the solution, and remember their responsibility to their community.
“Especially now that kids are back in school, it’s so critical they get that in-person learning, so I want to reduce my own activities so they can have that opportunity,” she said.
She also suggested keeping an eye on the case numbers and which communities are seeing surges, and adjusting behaviour accordingly if cases start rising closer to home.
“Our health officials are reading the thermometer and saying, ‘Oh, it’s too warm in here, it’s getting out of control there,'” she said. “But we’re the switch on the furnace, and it’s our decision to go, ‘Oh, I have to listen to the thermostat, I better shut off.’ We’re part of the solution.”
Colijn agrees.
“We’ve had some successes in Canada that we can be proud of, and we still have models of clear, compassionate public health messaging,” she said. “We just need to keep listening to them and not be complacent.
“We’re not the kind of society that will nail your door shut to make sure you stay quarantined. We’re not going to have surveillance on people’s indoor parties. This is still a matter of trust, and we need to keep working ourselves while trusting each other. Because this isn’t over.”
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