COVID-19 UPDATES & PROJECTIONS
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COVID-19 UPDATES & PROJECTIONS Dr. Salim Sohani, Senior Director, HiE Dr. Faiza Rab, Doctoral Research fellow, HiE Christina Angelakis, MPH, Health Officer, HiE Dr. Donya Razavi, Post-doctoral Research Fellow, HiE Dr. Mohamed Habsah, Health Advisor, HiE Sadaf Ekhlas, MPH, Public Health Advisor, IPVOT Dr. Mekdes Assefa, Volunteer, HiE May 7 2021
CONFIDENTIAL AND INFORMATIONAL PURPOSES ONLY This presentation is being provided on a confidential basis by the Canadian Red Cross Society (CRC) for the purposes of sharing its internal insights and views. Please do not forward or share this presentation outside your organization. All rights are reserved. The content in this presentation is provided for general informational purposes only and does not constitute professional advice or an opinion. Any reliance on the content of this presentation is at the reader’s/ listener’s own risk. This presentation includes links and references to third party content and websites. The CRC does not endorse the information contained in all linked or referenced content nor does the CRC guarantee its accuracy, timeliness or fitness for a particular purpose and these references are provided for convenience purposes only. The CRC assumes no responsibility or liability arising from the information provided through this presentation.
H1N1 vs. COVID-19 waves: What is different?
COVID-19 Waves
H1N1 (Spanish Flu) Waves • The first and second waves were not fully flattened as the third
• The second wave was thought to be caused by a more wave approached
virulent mutant strain
• The second wave is merging now into a third wave. The second
• Most deaths occurred with the second wave wave caused the greatest number of deaths. It is perpetuated by more
• Those exposed to the first wave and had mild symptoms virulent variants
were protected from the following waves • Vaccines are likely to protect people against subsequent waves
• Cumulative deaths: 50 million to 100 million, mainly young • Cumulative deaths so far: 3 million, mainly in the elderly
adults and pregnant women
3
COVID-19 may become seasonal globally
Why COVID-19 is likely here to stay What the Spanish flu tells us
• History shows that it's nearly impossible to • In 1918 and 1919, the Spanish flu killed at least 50
eradicate any infectious disease million people around the globe.
• COVID and influenza vaccines “don't produce • The virus finally receded mainly because much of
that sterilizing immunity, which means people the world's population had already been exposed
can still get mild infections. and developed immunity or died.
• Vaccine hesitancy and emerging variants • Although the pandemic ended, the virus never
really went away. In fact, descendants of the 1918
flu virus caused deadly outbreaks in 1957, 1968
and 2009.
In a study published in January 2021, Caetano-Anollés et al., found that COVID-19 cases and
mortality rates are significantly linked to temperature and latitude across 221 countries. This
suggests that once the case numbers start to fall, COVID-19 may become a seasonal illness like the
flu that peaks in the fall and winter.
4
Intensify
• Intensify global vaccination efforts.
Monitor
• Monitor the epidemic and the emergence of new variants and
If new variants continue accelerate the modification of vaccines
to appear, winter Manage and finance
surges may become the • Manage and finance winter hospital surges.
norm. Reduce
• Reduce transmission in peak months through employer and
educational institution action.
Five strategies should be Modify
considered and vigorously
debated in the months ahead. • Modify behavior of at-risk individuals.
5
Global Updates
• Global cumulative numbers 153.2 million infections and 3.2million
deaths since the start of the pandemic.
• Last week →Over 5.7 million new cases reported; 9th consecutive week of
cases rising; 93,000 new deaths last week; 7th consecutive week of increase.
• India accounts for 90% of new cases and death incidences in SE Asia as
well as 46% of global cases and 25% of global deaths in the last week
• India (+20%), ), Brazil (4%), USA (-15%,) Turkey (+32%), and France (-23%)
reported the highest number of new cases.
• Case incidence in the regions of Europe, Eastern Mediterranean, Africa and
the Americas decreased.
• As of May 4th, 2021, a total of 1,047,709,623 vaccine doses have been
administered.
CANADA- COVID-19 Situation and Hot-spots
3rd May 2021 19th April 2021
COVID-19 infection rates across
Canada
Province Effective reproduction no. R0 Doubling/halving time (days)
Alberta 1.1 (0.93 -- 1.3) 31
British Columbia 0.88 (0.76 -- 1) -21
Manitoba 1.1 (0.84 -- 1.3) 19
New Brunswick 1.1 (0.66 -- 1.8) 23
Newfoundland and Labrador 1.9 (0.51 -- 6) 3.1
Northwest Territories 1.3 (0.39 -- 2.4) 9.7
Nova Scotia 1.2 (0.47 -- 2.2) 11
Nunavut 0.62 (0.085 -- 2.2) -6.3
Ontario 0.86 (0.73 -- 1) -17
Prince Edward Island 1 (0.41 -- 2) 140
Quebec 1.2 (0.92 -- 1.5) 16
Saskatchewan 0.94 (0.81 -- 1.1) -40
Numbers &
Change
• In the last 7 days, 53,472 cases were
reported, down 7% from the previous
7 days. There were 335 deaths
announced, down 2% over the same
period. At least 4,006 people are
being treated in hospitals and
1,126,143 others are considered
recovered.
• About 93% of the 14,835,304 doses
of vaccine distributed to provinces
have been administered. That's 36.3
doses for every 100 people in
Canada.
Projected Daily Cases and Deaths, Canada
Daily infections: We have just passed the peak of a 3 wave.
rd
The number of daily cases is expected to continue to steadily
decline until August. In the worst case-scenario projection,
where mobility moves towards pre COVID-19 levels, there
could be a dramatic increase of new infections leading to a
fourth peak observed in mid to late June.
Daily deaths: The modeling shows that we are in the
early stages of the 3 wave. In the current projection
rd
scenario, where vaccines can be scaled up in 90 days
and the UK variant continues to spread in certain
locations, a steady increase of daily deaths is
expected to peak in late May/ early June, after which it is
expected to decline until AugustIHME Projections: Alberta, British Columbia,
Manitoba British Columbia
Alberta
AB Currently just passed the peak in the number of new cases and beginning
Manitoba a decreasing trend from which could continue to August.
BC currently at the end of a second smaller peak, continuous gradual
decrease until August
MB Currently on the peak of a third smaller wave, decreasing trend is
expecting by mid May and will continue until August.
Worst case scenario: AB and BC dramatic increase in cases until early to mid-
June MB will experience a slight increase in cases in May followed by an
elevated trend until August.IHME Projections: Ontario, Quebec, N.S, and Saskatchewan
Saskatchewan Ontario
Quebec Nova Scotia
QC: on the peak of the third wave which is expected to start N.S on the ascending trajectory of a fourth peak which will reach the peak
descending trend by the mid May through to August. by mid May and then will start decreasing trend through to August
SK: Just past the peak of the third wave, decreasing trend ON: just passed the peak of the third wave and will start descending trend
projected through to August through to August
Worst case QC experiences a larger increase in cases peaking Worst case : ON larger increase in cases reaching the peak early
in June. SK: cases will continue to rise until mid-May and then June N.S dramatic increase in cases in mid-April through to August
begin a decreasing trajectory• Covid-19 hospitalizations are increasing in provinces with elevated
disease activity
HOSPITALIZATION • Younger Canadians are ending up in hospital
HIGHLIGHTS FOR • Risk of ICU admission is 2 x higher and risk of death is 1.5 x higher
THE THIRD WAVE for the B.1.1.7 variant
• COVID-19 threatens health system ability to deal with regular ICU
admissions and the ability to care for all patients.COVID-19, STRUCTURAL RACISM, AND MIGRANT HEALTH
• In Ontario, migrants represent just over 25% of the
population but 43·5% of COVID-19 cases, mostly
racialized visible minorities.
• In Toronto, racialized newcomers are over-
represented in hospital admissions for COVID-19.
• Migrants in British Columbia who are waiting for
their applications to be processed are, alarmingly,
slated to be excluded from receipt of public health
care in early 2021.
• Ontario's modelling showed three times more
daily confirmed cases among communities with
the most essential workers compared with
communities with the least.
These crucial gaps in Canada's COVID-19
response highlight a need to consider and
intervene in structural racism as a core part of
the pandemic response and recovery process.As of May 4th 2021 (11:33am CST) :
• 14,205,456 vaccine doses
have been administered in
Canada
• 13,052,548 Canadians have
received one dose of vaccine
• 1,152,908 have received two
doses (are fully vaccinated)
• 16,721,432 doses have been
delivered to provinces
and 85% have been
administered
Delivery of vaccines in • 34.342% of Canadians have
received one dose of vaccine
CanadaVACCINATION
DISCREPANCIES AND
CONFUSION IN ONTARIO
Confusion over why certain postal codes met the
criteria for hot spots while other more affected
regions did not is creating mistrust among
residents
• Delays in vaccinating those in some of
Toronto's hardest hit neighborhoods
• The Auditor General is launching an
investigation into this matter
Due to vaccine shortages, Scarborough Health
Network and Michael Garron Hospital in East
York were forced to cancel appointments and
close their doors
• This created a panic as many were not
informed of the cancellation and were
unable to re-book with at other vaccine clinicsVACCINE SHOPPING
• The newest phenomenon
• Tale of two pandemics
• Affluent residents who can continue working from home are
shopping around for vaccines until they get vaccinated with
either Pfizer or Moderna instead of AstraZeneca, often
booking spots at multiple clinics to ensure they receive the
vaccine they want
• More likely to delay getting their first vaccine
• This is likely to continue occurring as Ontario is now
allowing those 40 and over to receive AstraZeneca
• They risk exposing other who have not had the option
to get vaccinated yet
• Delay vaccination eligibility from being expanded to
other groups
• Racialized residents working minimum wage front-line jobs
who do not get paid sick days, do not have this luxury and
are more likely to receive whichever vaccine they can getPfizer approvals for adolescents in Canada • Health Canada has determined that Pfizer vaccine is safe and effective at preventing COVID-19 for use in children between 12- 15 years of age. [May 5th 2021] • However, this approval is contingent and requires Pfizer-BioNTech to continue providing information to Health Canada on the safety, efficacy and quality of the vaccine in this younger age group as the vaccine is administered to the wider population. • Following this statement from Health Canada, the premier of Alberta, Jason Kenny announced that the province plans to begin rollout of the vaccine for all people ages 12 and up in the province on Monday April 10th
• Over 60% received at least one dose of vaccination in March 2021
Israel • Since then there is a steady decline in the number of cases now
reaching baseline for the last couple of weeks• Very rapid decline in number of cases seen after Jan
USA • Rapid vaccination
• Leadership and reinforcement of public health measuresIn most countries (Europe and Israel) We saw a drop in number of cases with increase in vaccination
getting closer to 50% for first dose, this has not been the case in Chile
Some explanation:
CHILE • Loosening the COVID-19 public health restrictions too soon as they started rolling out the vaccine
• Opening lockdowns too soon
• Permission to travel anywhere with in countries and international travel
• P1 (Brazilian) variant suggested to be one of the main reason for rapid transmission
• Type of Vaccine (CoronaVac- Developed in China) 56.5% effective – after two doses. At this point
12 million [~40%] received one dose and 4 million 2 doses• 35% of people have received at least one dose of vaccine Canada • We can already see the number of cases dropping
GLOBAL VACCINE TIMELINES • US and Europe and Israel are likely to have 60 to 70% of their population fully vaccinated by Late 2021 • Canada, Russia, Mexico, South Africa, Australia, New Zealand, Brazil and few other South American countries by mid 2022, • China, India, Pakistan, Egypt, Ethiopia by Late 2022 • The rest of the world which mainly consists of LMIC and conflict affected areas from 2023
Worldwide Vaccine • The results of a new poll
Hesitancy show that vaccine hesitancy
worldwide poses a risk to
ending the COVID-19
pandemic for good.
• In 79 out of 117 countries
surveyed, the number of
people who said they were
willing to be vaccinated was
below 70%, the minimum
percentage of the population
that scientists say needs to
have immunity to stop the
virus from circulating.Timeline of Variants in Canada
91 cases of new variants 1,515 cases of new
Canada reported its first (85 of the UK and 9 of variants (1,408 UK, 108 41,818 cases of VOC Canada reported its first
case of UK variant the South African) SA, and 3 Brazil) (39,663 UK, 375 SA, case of India variant
(Ontario) reported in Canada reported in Canada 1,780 Brazil) (Quebec)
8 Jan. 2020 7 Feb. 2021 16 Mar. 2021 20 Apr. 2021 04 May 2021
26 Dec. 2020 31 Jan. 2021 03 Mar. 2021 13 Apr. 2021 21 Apr. 2021
Canada reported its first Canada reported its first 3,998 cases of VoC 66,159 cases of VOC 126,450 cases of VOC
case of SA variant case of Brazil variant (3,777 UK, 238 SA, 71 (63,543 UK, 415 SA, & (120,835 UK, 735 SA &
(Alberta) (Toronto) Brazil) 2,201 Brazil) 4,880 Brazil)Canada is seeing a mental health ‘crisis’ • A new Ipsos poll suggests 50% of those surveyed being deemed at “high risk.” • Nearly one in 10 Canadians seriously considered suicide or self-harm several times over the past year, the poll suggests, while 13 per cent considered it at least once. • 53% are willing to discuss their issues with family, health professionals or publicly on social media.
DRIVERS FOR MHPSS ACTION – COVID-19 AND BEYOND
Climate change exacerbates risk Increasing severity of 51 % of adults in 7 countries
to mental health and wellbeing disruptive events perceive COVID affected their MH
(CCA 2019) (WEF, 2019) (ICRC, 2020)
Prevalence of MH issues Pre-COVID, over 1.6 million
doubled in humanitarian crises Canadians with unmet
(IFRC 2019), especially among mental health needs
most vulnerable/marginalized (CMHA 2019)
Lack of cohesion, minimal Neurological and social Every 40 seconds someone dies by
coordination in the MHPSS impact of COVID on suicide globally (IFRC 2019)
Sector in Canada (Khan 2018) MH (Lancet 2021) 300% in calls to distress lines (US)
170% in calls to Kids Help PhoneSituation in India
• India continues to record the greatest
number of daily COVID-19 cases and
fatalities in the world. The country
accounts for one in every two infections
and one in four deaths recorded
worldwide every day.
• The average cases in India are six times
that of Brazil, which records the second
most infections globally and 1.5 times
more average deaths than Brazil, which
records the second most deaths globally.
• India’s test positivity rate is about 21.5%.
That is, approximately one in five persons
tested are positive (Goa has positivity rate
of 48.5% which is the highest.)• Vaccine cover for people between 18-
44 ( total doses given — 11.81 lakh).
Overall, 16.50 crores doses
Vaccination administered so far.
• India-All States needs about 24.9
rollout in India months to administer 150,020,648.00
doses (required to vaccinate 75% of its
population) at the current rate of
2,529,722 doses per day.Several major Indian cities are
reporting a chronic shortage of
New variant of concern hospital beds.
originating in India
• As cases surge in India, a new variant strain has been identified as originating in
the country and has been designated - B.1.617.
• The new strain has been detected in at least 5 Indian states.
• 6 cases of the B.1.617 variant have been identified in California, cases reported
in Quebec and BC, Canada, as well as cases identified in the UK, Australia,
and Singapore.
• The two separate mutations found in this strain are both characterized by their
high infectivity and transmission rates.
Impact on vaccination
• Scientists believe that the double mutant variant may not have an impact on
vaccine efficacy
• Initial reports [April 20th 2021] coming from Israeli health officials on suggest
that Pfizer-BioNTech vaccine is at least partially effective against the new
variant emerging from IndiaProjected Daily Cases and Deaths, India
Daily infections: India is getting at the peak of its second
wave in new daily infection numbers. The incidence of new
daily cases is projected to peak in mid to late May after
which it will decline until August.
Daily deaths: India’s daily deaths is currently at the
early stages of the second wave. It is expected to
continue to increase until late May. IMHE modeling
projects 1,018,879 COVID-19 deaths based on Current
projection scenario by August 1, 2021.RETURN TO WORK - WHAT THE FUTURE MAY HOLD
THE NEW WORLD OF WORK • A recent study released by Robert Half, a global staffing firm, shows that about one in three professionals, or 33 per cent, currently working from home due to the ongoing COVID-19 pandemic would quit their job to find a new one if they were required to return to office full-time. A separate poll by the recruiter Robert Half showed that 89% of firms expected some form of hybrid working to become permanent after the Covid pandemic. • According to a survey by Boston Consulting Group, 53% of workers have said they would prefer a hybrid model in future.
The future of Canada’s labor market in a post-COVID world • Eight megatrends with the potential to impact employment in Canada by 2030 • Topics that may at first seem unrelated to Canada’s labor market, such as floods, air pollution, and responsible AI, all have the potential to impact the future of work. • To support future-focused planning and avoid blind spots, it is important to recognize and understand weaker signals, such as wide-scale adoption of cognitive enhancements and the potential of another pandemic within the decade, as well as the more mature trends like market consolidation and delaying retirement.
2020 2021 2022 2023 2024
Acute phase Moving from
Acute phase transition to Transformation and
continued - moving Transition phase
of the Pandemic transformation and recovery
into transition phase recovery
Declaration of pandemic Third wave, driven by VOC Pandemic is likely to start Sporadic epidemics, the
(mutations), may see receding with pockets of SARC COV-2- Endemic
early in the year virus will become endemic
decline in cases in summer Epidemics in different parts
First later a bigger second and a potential surge or Routine vaccinations Vaccinations – routine
wave of the World
spike again in Winter against the virus
Health systems: Vaccinations: ongoing Economic boom: as
Vaccinations: Roll out cycles and maybe booster Socio-economical
Overwhelmed, stretched to started – uncertain duration vulnerable likely to have people would start to make
limits and gaps in doses for potential mutations
of protection [at least 6 may be required increased gap in health up for the missed social
pandemic preparedness months] related inequities. Need activities
identified Health systems: More to refocus on aftermath of
VOC- spread of virus adaptive and organized to COVID-19- Lung and heart
Health information: Time to reflect on the
Evolving and messaging Health systems: respond to pandemic related related issues from Long-
emergencies response and start better
uncertain sporadically becoming COVID planning for future
overwhelmed Mental health issues: More Continued need for
Natural immunity: pandemic responses
Uncertainties Long term impacts of likely to be reported after the supporting Mental Health
last two years (long term [likely 50 to 100 years]
COVID-19 on physical and related issues
Social: Uncertainties, mental health surfacing stress related issues)
reluctance/difficulties in Economy is likely to have Health system recovery
adapting to protocols Lock down fatigue: Long-COVID, with millions of a slight boost as people and building up
Physical and mental health people with respiratory and slowly return to pre COVID
Social disparities impact of lock downs and fatigue related symptoms. activities
highlighted LMICs will need support in
social isolation COVID also has long term
impact on heart muscles Permanent changes in Health system recovery –
Economic uncertainties: Economy adapting to workplace situations pandemic preparedness,
Lockdowns, uncertain restriction, very slow Economy: Some (with more remote work)
duration also refocusing on Pre
resurgence uncertainty, slow growth. expected
Loss of female workforce COVID priorities [SRHR,
Drastic changes in work Adapting: To public health Health systems: NCDs] and on aspects that
and social life (large number)
measures, new working Recovery phase suffered as a result of the
Scientific innovation: realities Long term changes in
Important to have pandemic [drop in global
Vaccines in record time, social and work
Socio-economic environments as people continued political will to vaccination uptake]
innovative approaches to inequities: increasing gaps ensure public health
delivery of services continue to use protective
public health advice readiness for future
pandemicsYou can also read
