How did Waterloo Region become one of Ontario’s major COVID-19 hot spots?

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On Wednesday, Waterloo Region, long known as one of Canada’s major tech hubs, raised eyebrows across the province when the Ontario government reported it had the highest number of new COVID-19 cases.

While most of Ontario is experiencing a decrease in cases, the region, which is home to around 588,000 people, had 71 new cases, according to the province. Much larger centres such as Peel Region (60), Toronto (54) and Ottawa (21) were well below the number of new cases reported for Waterloo Region which encompasses the cities of Kitchener, Cambridge and Waterloo as well as four smaller townships.

The region and province announce COVID-19 numbers at different times of day using different timelines, so things were slightly worse that afternoon when the local numbers showed to be slightly higher (72).

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A day later, a similar story played out as the province reported 57 more cases in Waterloo Region, second only behind Toronto (67) which is home to around 3 million people. Again, the local numbers reported (67) in Waterloo Region were higher than the province (57).

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Experts are pinpointing the Delta variant (B.1.617.2), originally detected in India, as one of the main reasons why Waterloo Region’s numbers have flipped in the opposite direction of most other Ontario communities.

It would be near impossible to say why it first arrived, but Dr. Hsiu-Li Wang, the region’s medical officer of health. says travel was likely to blame.

“It normally comes through travel initially, that’s the way we get the variants,” she told the Waterloo Board of Health on Wednesday. “But then it spreads quickly through community transmission, through the usual ways.”

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One of the usual ways was through shelters for the vulnerable population in Kitchener and Waterloo where a COVID-19 outbreak was declared on June 3 which is now connected to 94 cases.

“We have heard from the local public health teams that a lot of the transmission or at least amplification of this is in sheltered communities and shelter populations,” Dr. Isaac Bogoch, an infectious disease physician and member of the province’s COVID-19 vaccine task force, told Global News.

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“And we know, of course, indoor settings, especially where people may not be able to physically distance from one another, especially in poorly ventilated settings and settings where masks are inconsistently used.”

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He said the region’s public health unit is working closely with the shelters to get as many jabs in arms as possible.

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While the shelter system is a part of the problem, clearly the Delta variant is also in other parts of the community. Wang expects it will quickly become the most dominant strain in the region.

“Because it’s 50 per cent more transmissible than or what was at least the most dominant strain we’ve had until now, the U.K. variant, this is the most transmissible that we’ve had,” she said.

Wang also noted that it will spread quicker through those who are unvaccinated which leads to another issue the region has had: a lack of vaccine.

Waterloo Region was not initially among the areas designated as provincial hot spots and when there was boasting about a clinic in Toronto administering 10,000 vaccines on a Sunday, most clinics in Waterloo Region were shuttered a day later.

Bogoch says the strategy of putting vaccines into hot spots was key in quelling the surge of infection.

“Every bit of modeling and epidemiology pointed in the direction of pouring vaccines onto hot spots because it does quell the pandemic faster, not just for the hot spots, but for everybody else,” Bogoch said. “And in fact, you’re we’re all reaping the rewards of that right now.”

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While Bogoch acknowledged that the hot spots could and have changed, Zahid Butt, an infectious disease epidemiologist, says they probably should have shifted the focus away to other areas sooner which may have prevented some of the new hot spots from appearing.

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“If you’re seeing that in your hot spots you have reasonable coverage, you should be able to then direct your resources to places that are that are their neighboring areas,” the University of Waterloo associate professor explained, suggesting the province has been playing whack-a-mole with the virus.

“The problem here is that if you don’t really vaccinate the other regions, you would see cases ending up in areas that are not hot spots. So you have to plan for vaccinating both the hot spots and the non-hot-spots at the same time.”

While the area lacked a steady supply of vaccine, Bogoch says that is not the only reason for local COVID-19 spread.

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“What does it come down to? Probably several things. One is really good policy, really strong community outreach, really strong public health measures and involvement of the community with the with public health measures,” he explained.

“There’s also probably a bit of luck as well.”

So as the virus continues to spread through Waterloo Region, the vaccination numbers have also begun to climb of late.

In the last two days alone, there have been more than 15,000 vaccinations in the area, according to the region’s COVID-19 vaccine distribution task force.

And more help is on the way, according to Waterloo Regional Police deputy chief Shirley Hilton, who heads up the local ask force.

“The Ministry of Health is sending two mobile teams to set up in Waterloo region and assist in administering vaccine,” she told the Board of Health on Wednesday evening. “These are self-contained trailers and tents.”

Hilton said the region is still in the planning stages for where the clinics will be stationed.

While most of Ontario and Canada continue to see vaccination numbers drop, the experts warn this virus is not going away.

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“The virus is still there because most of the community has not been vaccinated. And you don’t get full protection from first doses, you get partial protection,” Butt warned.

“Reopening doesn’t mean that you don’t follow public health guidelines or you relax … it means a bit of a return towards normalcy but it doesn’t mean that everything is normal.”

Bogoch seconded those thoughts while also noting that the government needs to maintain a carefully measured approach for reopening.

“Don’t let your foot off the gas pedal, right? It’s still here. It’s still an issue. The infection hasn’t gone anywhere,” he said.

“I think following the key metrics for reopening is crucial,” he noted. “And those key metrics are what is the pace and coverage of vaccination? The second one is what is your hospital and public health capacity? And the third one is what is the community burden of COVID-19?”

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