OTTAWA — How is Canada progressing when it comes to the all-important goal of flattening the curve of COVID-19 infections? The answer is complicated, and it depends which part of the country you look at.
For the most optimism that the first wave has been squashed, look to B.C. and Alberta. For the areas that look most concerning, but show some signs of progress, look to Quebec and Ontario. And at least for now, the situation looks under control in the rest of the country.
“I think we are very much trying to figure out where we are on the curve within the various models,” said Prime Minister Justin Trudeau on Wednesday when asked if Canada was approaching a national peak of infections.
“What is very, very clear is there are significant differences across the country in where various provinces are on their own curves. Overall as a country, I can say we have reached the point where we are later than many other countries.”
Nationally, the daily growth in identified COVID-19 cases has slowed down. But within Canada, case counts remain a problematic metric due to widely varying testing regimes across provinces.
The main problem is Ontario, whose numbers are especially questionable due to a low testing rate. Ontario’s per capita testing rate is last in the country and lingers around 575 tests per 100,000 people, compared to roughly 1,500 tests for Alberta, 1,300 tests for Quebec, and 1,000 for B.C.
Ontario completed just 3,237 tests on Wednesday and 2,568 tests on Tuesday, despite now having lab capacity to test more than 13,000 per day.
“It’s unacceptable, there’s no more excuses why we’re testing 3,000 a day,” said Ontario Premier Doug Ford on Wednesday, saying his patience has “run thin.”
“We need to see 13,000 people tested every single day moving forward,” he said. “The more we test, the better we’ll be.”
Experts have instead recommended hospitalization rates as a gauge for how provinces are doing. Because hospitalized cases are always a high priority for testing, they are less subject to differences in testing standards. (The main drawback is they lag further behind as an indicator due to how long it takes for severe symptoms to develop.)
Among the four most populous provinces, the hospitalization charts for B.C. and Alberta look very promising. In both places the number of people in hospital each day has flat-lined and even started to fall, and officials have started expressing cautious optimism.
“To date, Alberta has fared better than most,” said Alberta Premier Jason Kenney on Wednesday while presenting modelling scenarios for the province. Alberta’s hospitalizations have flattened off at around 40 — a much smaller number than other large provinces. Alberta has also done extensive testing, giving more credibility to their case count.
B.C.’s hospitalizations are much higher, at around 140. But they have stabilized over the past week and are starting to come noticeably down. Although the province is not widely testing at this point, new cases have slowed substantially, with just 45 new cases announced on Wednesday, 25 on Tuesday, and 26 on Monday.
The picture is much different in Ontario and Quebec, where hospitalizations have been rising to over 600 in both provinces. Quebec is still seeing steady growth in hospitalizations each day, while Ontario’s growth has started to slow.
But there is still some optimism in each province. Quebec presented its modelling on Tuesday, and officials expressed optimism that the situation looks to be manageable.
In Montreal, which has seen the worst outbreak in Quebec, the chief public health officer told reporters on Wednesday that she believes the city has crested and will hopefully start to slide down the other side of the epidemiological curve. “Today, tomorrow and the day after we will be at the peak in terms of the number of cases,” Mylène Drouin said.
In Ontario, chief medical officer David Williams said the province’s hospital cases have so far stayed well within the “best case” modelling scenario for not overwhelming hospital resources.
“We are better than we thought we would be at this time, both in the number of cases as well as in the hospitalizations, ICUs and deaths at this stage,” he said. “But let’s get a few more days of data in there, let our modellers have a look at it and see, much like a report card, how are we doing. Have we moved off the Italy scenario, more towards another scenario? Much like you heard B.C. doing?”
Elsewhere in the country — Manitoba, Saskatchewan, Atlantic Canada and the territories — the numbers have remained relatively small, even on a per capita basis. Newfoundland and Nova Scotia have the most identified cases per capita, but hospitalizations remain very low at less than a dozen in both places.
Trudeau said that at this point, it’s too soon to consider relaxing the physical-distancing restrictions that have crippled the economy. But once it’s clear the peak of infections has passed, the country can hopefully move into a phase of widespread testing and contact-tracing to try to keep the pandemic contained, he said.
“We will be calibrating very carefully our behaviours as a country, as a society, as an economy to managing the existence and persistence of COVID-19,” Trudeau said. “Better testing, careful isolation of vulnerable communities, measures of gradually bringing back the economy will come.”
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