COVID-19: Gradual increase in cases likely for Hamilton, according to public health early spring forecast

One of two public health forecasts is expecting a gradual increase in COVID-19 cases and hospitalizations for Hamilton over the next month amid Ontario’s easing of measures, particularity the lifting of a mask mandate.

During a board of health meeting on Monday, the latest Scarsin forecasting revealed a pair of scenarios going into the spring, with one anticipating that infections are not likely to dip below November 2021 levels seen at the end of a wave fueled by the Delta variant.

Epidemiologist Ruth Sanderson told city councillors a “resurgence scenario,” taking into account the lifting of prevention measures, could result in a “small swell” of cases leading to 200 hospitalizations between now and late May.

“The swell is forecast to peak in mid- to late April and remain below previous January Omicron peak levels,” Sanderson said.

A second “no resurgence scenario,” assuming Hamiltonians will voluntarily continue health measures recently eased, could prevent 140 new hospitalizations over the same period.

Sanderson said those aged between 20 and 59 were most likely to experience hospitalization, as opposed to those over 80, due to lower levels of booster doses in that demographic.

“Severe outcomes are predicted to continue to occur primarily among those 60 and older in 50 per cent of cases, but 70 per cent of admissions and 95 per cent of deaths,” said Sanderson.

About 30 intensive care (ICU) admissions are anticipated with the “resurgence scenario” between now and the end of May.

“The ‘resurgence scenario’ predicts 13 deaths among Hamiltonians from March 21 to May 31st, but six of these deaths could be prevented if the resurgence was avoided,” Sanderson said.

“Just to underline this point, the forecast anticipates that approximately 95 per cent of deaths will occur in those aged 60 and over.”

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Hamilton’s medical officer of health anticipates COVID-19 will continue to circulate in Hamilton during the spring at a “manageable level” but “that doesn’t mean it’s going away.”

Dr. Elizabeth Richardson told councillors the agency is tracking the latest variant BA.2 and has not seen any major impacts but did say the size of the next wave will really depend on what residents “choose to do” in the community with the newly eased health measures.

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“The biggest threats to us will be mostly among the waning of immunity that may come in,” Richardson said.

“So continuing to look at booster doses and how they fit into our vaccination program as we move forward with the possibility of a brand new variant … and the degree of severity that variant may have.”

Public health is reporting a “levelling off” of COVID-19-related hospitalizations in Hamilton compared with the peak of the Omicron wave in mid-January.

Over the last seven days, city hospitals reported an average of about 1.6 new hospitalizations per day. That’s on par with the one to two a day recorded since Feb 19.

“Which is about one new hospitalization higher than what we saw in the levelling off period prior to Omicron,” epidemiologist Erin Rodenburg told councillors.

Admissions to ICUs are also lower than compared with the peak of the Omicron wave, with the number averaging close to zero per day as of Friday.

“When we look at the seven-day average … that average has been at 0.1 or below since Feb. 22, so very low ICU admissions currently and over the past month,” said Rodenburg.

The city’s hospital networks reported 54 COVID-19 patients are receiving care in the system as of Monday, up by about seven week over week but down 25 month over month.

Patients requiring ICU care are at the same level over seven days, at seven cases. The number is slightly lower than the same day in February in which the institutions recorded nine.

That’s significantly lower than the 35 reported on the same day in January.

Ontario is reporting 551 people in hospital with COVID-19 on Monday, with 181 in intensive care units.

Although underestimated due to restrictions on who can receive a PCR test, public health case data suggests infections are beginning to increase this month, with the seven-day average moving from 56 per day on Feb. 23 to an estimated 74 per day as of March 18.

The city’s per cent positivity number – the proportion of individuals who’ve tested positive compared with the number of individuals who have had a test completed – is now at 15.6 per cent as of the weekend.

The number is up month over month from the 12.1 per cent reported on Feb. 21, however, significantly lower than the 31.4 per cent recorded in mid-January during the peak of Omicron.

Institutional outbreaks in recent weeks have decreased to an ongoing average of five to 10 surges reported per day since mid-February. During the peak of the Omicron wave in January, the city had as many as 90 or more outbreaks on a given day.

As of Monday, there are six active outbreaks – three in long-term care homes, one in a retirement home, one in a hospital setting and one in a hospice.

The total number of cases combined among the facilities is 45 with the bulk of them related to long-term care homes (LTCH) – 35 cases.

A surge at St. Joseph’s Villa LTCH, which began on Mar. 9, accounts for 20 of those cases.

With uptake in COVID-19 vaccinations across the city declining and fewer overall infections since January, public health is set to scale back its mobile clinics in March.

As of March 28, the team will be facilitating just a single clinic per day for five of the seven days in a week.

At the end of March, the Lime Ridge Mall clinic will also be ramping down to a general “catch-up” clinic adding non-COVID-19 vaccinations for Grade 7, 8 and 9 students.

“Due to COVID-related school closures and prioritization of the COVID-19 vaccine rollout, our teams have not been able to do routine school based clinics for two and a half years,” program manager Melissa Biksa said during the board of health meeting.

The clinic will offer hepatitis B and meningococcal vaccines.

Hamilton’s COVID-19 vaccination program has reached over 90 per cent of Hamiltonians aged 12 and up in first dose coverage. About 88 per cent have had second doses while 53.5 per cent have had at least one booster.

About 91 per cent of Ontarians aged 12 and older are fully vaccinated. First-dose coverage stands at 92.8 per cent. Third-dose immunization is at 55.2 per cent — more than 7.1 million have received a booster shot.

As of March 21, the city has put about 1.22 million COVID-19 vaccine doses into arms with about 469,000 second doses and 290,000 third shots.