Ontario's top doctor hopes province will be in the 'green zone' by Christmas. Here's why one physician says that's impossible
TORONTO -- As health officials continue to report new COVID-19 case numbers in the quadruple digits, Ontario’s top doctor says he hopes the province will be in the “green zone” in a little more than five weeks from now.
“We can get these numbers down as we did before, and bring them down to level so you move from the red to the orange, yellow and I would like to think everybody would be in green, especially for the time of Christmas,” Ontario’s Chief Medical Officer of Health Dr. David Williams, said at a news conference on Monday.
The most lenient of the province’s colour-coded COVID-19 framework, the green, or “prevent,” level is aimed at focusing on an “education and awareness of public health and workplace safety measures.”
But one Toronto doctor says that it is “completely impossible” that all of the province’s 34 public health units would be at that level by Dec. 25.
“It troubles me deeply that Dr. Williams, who as the sole medical advisor to the premier, feels that this is something that is even remotely possible,” Dr. Michael Warner told CTV News Toronto.
“It kind of demonstrates, to me, a complete disconnect between what we are seeing on the frontlines, especially in the ‘red zones’, versus what he thinks will happen if we continue to follow along the framework that the government has set.”
Warner is the Medical Director of Critical Care at Michael Garron Hospital in Toronto’s east-end and said that not only is the timeline unrealistic, but that Dr. Williams’ comments are irresponsible.
“Because I think it leads people to believe that we are in a situation that’s far different than the reality that we’re in,” he said.
For example, according to the provincial government’s framework, a region would need to record a weekly incidence rate of less than 10 cases per 100,000 to be moved to the “green zone.”
According to the latest data available from the provincial government, Toronto recorded an incidence rate of 102.5 for the week of Nov. 6 to Nov. 12 and Peel Region recorded 174.5.
Beyond the epidemiologic criteria, Warner argues that the thresholds for health system and public health system capacities as outlined in the green level also present an insurmountable goal for the hardest hit regions by Christmas, based on the modelling data released last week.
“Dr. Williams attended the same briefing that I listened to on Nov. 12, which clearly indicated that even in the best-case scenario, we will reach the point where we don’t have enough intensive care unit (ICU) beds in this province to manage non-COVID-related healthcare, that threshold was deemed to be 150,” he said.
“Today, we have 132 patients in ICUs in Ontario with COVID. We’ll clear 150, probably by Wednesday.”
The only way Williams can justify his thinking is if he believes that cases will “peak and decline,” Warner said, while arguing that too goes against projections provided by the province.
“The same modelling shows that even with three per cent growth in cases, the number of ICU beds that we’ll need will eclipse 200 and in the worst-case scenario will eclipse 400.”
Asked for a more realistic time frame for when the province might expect to be in the ”green zone,” Warner says he’s not even thinking about things getting better, because “they will, by definition, get worse.”
Warner said that the question now becomes when, not if, the government will impose the strictest level of measures found in the “grey zone” which would see a total lockdown for affected areas.
“We’re on a worsening trajectory based on just about every parameter, and the lagging indicators which are deaths, hospitalizations ICU admissions, are the ones that are starting to ramp up now.”
“It’s impossible for them to get better, before they get worse.”