Ontario's latest COVID-19 modelling 'catastrophic,' doctor says

An "unthinkable" number of deaths could be in store for Ontarians if strict public health measures are not implemented and followed, according to critical care physician Dr. Kali Barrett.

Her predictions follow new modelling presented by the province's COVID-19 science advisory table on Friday which, in a sobering update, said the pace of vaccinations alone is not enough to contain increasing transmission of the coronavirus and that it could take until the end of June to see case counts drastically drop.

The latest projections say Ontario could see more than 10,000 new cases per day by late May, and 15,000 by late June. 

"It's catastrophic," Barrett, a member of the science advisory table secretariat, said of the modelling. 

Barrett says keeping Ontarians safe includes public health measures like stay-at-home orders, keeping schools closed while cases are high, masking orders and not forcing people to go to work who don't need to.

The provincial government on Friday extended its stay-at-home order to a minimum of six weeks, stepped up enforcement powers for police and said it would set up checkpoints along the borders with Manitoba and Quebec, among other measures.

But, contrary to the repeated recommendation of the science advisory table, Premier Doug Ford stopped short of instituting paid sick days.

The table also called for doubling down on vaccinations in the highest-risk communities, limiting which businesses are allowed to stay open, and making essential workplaces safer. 

Barrett says the health-care system could face the triage scenario in the coming weeks — physicians having to make choices about how to use their resources based on patients' overall health and probability of survival. 

If two critically ill patients entered a hospital where the ICU could accommodate just one, a group of independent clinicians would assess who would be most likely to benefit from the bed and survive after admission, she said in an interview on CBC's News Network. 

This would be based on factors like the patient's past medical history and how sick they are at the time.

The other person would be offered full medical care, but not critical care. If their condition worsened, they would be offered palliative care. It has been described as a worst-case scenario by other experts.

"It would mean that there would be people who would die, who otherwise would have survived, or would have had a higher likelihood of surviving, if they would have gone to critical care," she said.  

"The moral distress this will create for my colleagues and my profession as a whole — people will quit, people will leave." 

Barrett says 1,372 people been admitted to ICUs in Ontario hospitals since March. 

She says if the numbers don't improve, "the number of lives that will be lost and the number of people who will lose loved ones is going to be unthinkable." 

"If there was ever a time for us to really adhere to public health measures … this is the time," Barrett said.

Affecting most vulnerable 

Barrett says essential workers, racialized people and those living in multi-generational homes are among those most affected by COVID-19. She spoke of one patient, whom she treated this week, who was desperate to leave the hospital despite being on oxygen. 

That was because his wife, mother-in-law and six-year-old child all had COVID-19 at home and he worried for his wife's ability to take care of everyone, including herself. 

"It is affecting the most vulnerable in our society. It is infecting those with the least social capital … those with the least amount of representation in cabinet and in government, and it's completely unmasked the inequities in our society," she said, visibly upset.