This morning, Ontario reported 1,418 positive COVID-19 cases bringing the total to 100,790 cases to date. Breaking the 100000-case ceiling will be seen as a milestone of sorts. Of these 100,790 cases, 84716 cases are considered resolved meaning that the number of active cases is currently 16,074. Of these cases, 518 are presently in hospital with 142 of them in the ICU. What this means is that of the current number of active cases, about 3.2 percent currently require hospitalization.
Many Ontarians going about their daily lives have probably made similar calculations and concluded the risk of COVID-19 is small. Even if you catch it, they think the odds of requiring hospitalisation are slim and skewed towards an older or health compromised demographic. Constant warnings to social distance and not engage in unnecessary social activities are going in one ear and out the other because most have concluded the risk of something bad happening is small.
However, the flip side of this behaviour is the potential of exponential increases in cases and, when combined with Ontario’s diminished hospital capacity, it is this where the real risks lie. In 1990, Ontario had close to 35,000 acute care hospital beds and a population of 10.3 million people. By 2000, after a decade of fiscal crisis and “health care reform”, the number of acute care beds had declined dramatically to approximately 22,000 - about a 35 percent decline - and have remained practically constant at that level ever since. However, by 2019, Ontario’s population had increased to 14.5 million – an increase of 41 percent while the population aged 65 and over had increased by over 70 percent. As a result, acute care beds per capita in Ontario have declined to practically the lowest levels in Canada but in the OECD.
While COVID-19 may appear manageable at current rates of new cases, if the number of active cases doubled every week, the system would rapidly be overwhelmed even if only 3.2 percent of active cases require hospitalization. Here is the math:
Essentially, by Week 3 there would be crisis as nearly 10 percent of acute care beds in the hospitals would have to be given over to COVID cases – and this does not factor in any regional differences in severity of the active case count or the need for ICU beds. By Week 5, essentially 40 percent of acute care beds would be needed for COVID and by this stage the system would not need to reach Week 6 to essentially collapse. Having 1990 acute care bed numbers would help but only buy you a week or two. And this is the result of only a doubling of active cases every week. If cases tripled every week or they doubled in less time, the system would be overwhelmed even more quickly.
The average member of the public may think that only 3 percent
of active cases needing to be hospitalized is a small number and with currently just under 1500 new cases a day it is not so bad. So they carry on paying lip service to any rules and figure there are
no consequences to their behavior.
Think again.
