By Paul Minshull
The January 12 announcement by Premier Ford painted a bleak picture for Ontario. We agree the province is facing an unprecedented challenge, but we also believe that informed forecasting provides a prescriptive path forward for Ontario.
Let’s start by taking a look at the forecast slide presented in the provincial update meeting. Slide 15 of the presentation by the Ontario Science Table shows the number of reported cases for the next eight weeks. While it may be informed by other modeling, it is simply applying an assumed daily growth rate and comparing it to other countries where the starting point was at the same concentration.
We recognize this is a potential approach to creating a forecast, but we are concerned that it does not represent an ideal approach, given the next generation solutions available today. Given what is at stake, a more informative approach can and should be applied to help Ontarians.
Better decision tools exist
There are a number of principles that would improve the forecasts for Ontario and provide better information for provincial decision making and public information. These include:
- Generating the forecasts for each Public Health Unit (PHU) to improve local accuracy
- Dynamically taking into consideration daily changes to interventions (school closing, lockdown impacts to retail, workplaces, gatherings, etc.)
- Incorporating the impact of vaccinations on reducing spread
- Measuring the potential risk of more transmissible variants (like B117 UK variant)
The Scarsin system incorporates all these considerations and more. In the fall, we provided an outlook for Ontario based on September 29 data called Wave II will be Long, Local and Late in Ontario. It proved to be extremely prescient in its conclusions.
Ontario’s outlook: Turning the tide in February?
We are providing a more comprehensive overview of the Ontario forecast in the downloadable PDF covering the next 60 days.
The figure below highlights the epidemiology forecast (dark blue) for Ontario, with an upper and lower range. The orange line is a statistical trend of the smoothed seven day cases. The epi model continues in alignment to this trend for the next few weeks, but then begins turning as the impact of the lockdown decreases the rate of the transmission.
Remember, there can be multiple weeks’ delay between actions and observed results. In this case, benefits of the lockdown should materialize in early February if the public remains vigilant and disciplined. Unfortunately, the initial few weeks of the lockdown were overshadowed by holiday case surges.
The assumptions that were implemented for the local PHUs were heavily influenced by comparison and benchmarking, but more than 90% of that focused on other PHU behaviour across Ontario and other provinces (Manitoba, Alberta, BC and Saskatchewan). We strongly believe these are more accurate reflections of future outcomes.
There are lots of insights within the forecast report including:
- Many PHUs see unprecedented acceleration in cases later in December, largely relating to increased mobility prior to the lockdown and potential home transmission over the break
- Ontario was generally unique in the degree of this, although Saskatchewan did have selected similarities
- There is a much broader list of PHUs with high levels of transmission (Windsor, Waterloo, Hamilton)
- Peel, Toronto and York continue to be challenged in terms of managing spread, despite prior status in Grey lockdown
- There is no immediate or easy path out of this; it will take sustained effort from everyone to regain control and exit lockdowns
- We have assumed lockdowns until Feb 21 as a minimum for the majority of PHUs in southern Ontario, with some potentially extending longer. This may be revised outward depending on the progress in the next three weeks
- The healthcare system will be placed under sustained stress for the next 60 days, even under this forecast which represents a path to regain control
Scarsin is currently working on a more comprehensive set of forecasts that measure the impact of various scenarios relating to the vaccine rollout, lockdown effectiveness and the B117 variant risk. These will be produced in coming days.
We continue to look for ways to collaborate with the Province of Ontario to support more robust decision making. However, since it has been 250+ days since we submitted our solution to the Ontario Together Fund, with no response and no meetings, we are not optimistic.