'We're at a high degree of spread': What you need to know about COVID-19 in Ontario

Specimens to be tested for COVID-19 are seen at LifeLabs after being logged upon receipt at the company's lab, in Surrey, B.C., Thursday, March 26, 2020. THE CANADIAN PRESS/Darryl Dyck

It’s hard to believe it’s been nearly five years since COVID-19 emerged. In that time, it has gone from a world-wide pandemic that shut down countries to another infectious disease that is part of day-to-day reality. 

Still, the disease poses a risk to many people, especially those who are elderly or immunocompromised. As we head into another respiratory illness season, here’s a look at where Ontario stands when it comes to the virus and what you need to know.

How much COVID-19 spread is there right now?

Getting a clear picture of how much COVID-19 is circulating is trickier now than it was a few months ago. That’s because the province made a decision to end the wastewater surveillance program, which had been providing data about COVID-19 spread in communities across the province. While some monitoring is still being done by the federal government, it is mainly in the large population centres like Toronto.

“Now we're left with a situation where we only get information for about 20 per cent of the population, and essentially only in the Greater Toronto Area,” Dr. Fahad Razak, an internist at St. Michael’s Hospital and the former scientific director of the Ontario COVID-19 Science Table, told CP24.com. “So if you're in other parts of the province, you just don't know.”

That said, there has been a high degree of spread this summer that has been “challenging,” Razak says.

“What we do see right now suggests that we are at a high degree of spread. So if you look at the Public Health Agency of Canada website, Ontario is now flagged as a high degree of spread in the remaining monitor that exists.”

How big a problem is COVID-19 at the moment?

The impact of the virus today is a far cry from the height of the pandemic. However, it still puts some people in hospital and can still be deadly for certain individuals.

“The number of people ending up in hospital is clearly significantly lower than we've seen earlier in the pandemic, where each time we had a wave of infections, we had a wave of people ending up in hospital with severe illness, even in the ICU or dying,” Razak says.

“We're not seeing that anymore. We are seeing some people in hospital, but it's far fewer. So that's the good news – the decoupling of infections to severe disease. But we still have to keep our eye on the fact that infections prevented wherever possible are a good thing.”

He points out that some people in non-vulnerable groups who get COVID still end up dealing with long COVID, and risk passing it on to someone else who may be more vulnerable to an infection.

Why can’t you get a COVID-19 shot right now?

As of Sept. 1, COVID-19 vaccines are not widely available in Ontario. That’s because Health Canada mandated a withdrawal of previous COVID-19 vaccines. They did so in order to make sure that people get the new vaccine, which will be better-tailored to target the latest variants.

“Vaccinations will begin to be available once Ontario receives supply from Health Canada following their regulatory authorization of the updated vaccine formulation,” the provincial government said in a statement on its website.

In an email, Toronto Public Health had a similar message,

“Since Health Canada has withdrawn the current XBB COVID-19 vaccine, that vaccine is no longer available,” the health unit said. “Residents should receive the new KP.2 vaccine formulation when it is available as it will provide better protection against circulating COVID-19 strains this respiratory virus season.”

When can you get a COVID-19 shot in Ontario?

The Ontario government has said it expects to receive shipments of the updated COVID-19 vaccine from the federal government by early October following approval by Health Canada. The Ministry of Health said initial doses will be prioritized for higher-risk populations.

If it is available, people can get a COVID-19 shot at the same time as they get a flu shot.

The vaccination campaign is also being timed to try and offer maximum protection at the anticipated peak of spread in the season.

Who should get a shot?

The province is recommending that everyone get flu and COVID-19 shots as soon as they become available in order to avoid getting sick and to help prevent the spread of illness.

However, in its latest guidance, The National Advisory Committee on Immunizations (NACI) slightly changed the wording of its recommendation from past notices.

“The interesting thing with COVID is – look at the wording. The National Advisory Committee on Immunizations has already released their suggestions for COVID-19. They said there's groups of people who ‘should’ get the vaccine, and other groups of people who ‘may’ get the vaccine,” Dr. Isaac Bogoch recently told CP24. “The ‘should’ group are people over the age of 65, people who live in congregate care settings like long-term care facilities, and people with underlying medical conditions that put them at greater risk for severe infection. Those people should really go out and get a COVID vaccine when it's available.

“Everyone else is really in the ‘may’ group. So, you know, some people will think about this and some people will choose to get a vaccine. Others might not. It's important to talk to a health care provider if you have any questions about whether or not this is the best thing for you or your child.”

Razak said the new guidance comes as evidence shows the strongest benefit of vaccination is in more vulnerable populations.

“For everyone else, it's a ‘may’ and it may mean that it's more of an individual risk decision, where it could give you some benefit, and you have to consider your own exposure,” he said.

Individual risk factors, one’s exposure to vulnerable individuals, and the level of spread in a community may be factors that could go into a decision about vaccination, he added.

While the strongest recommendation is now being targeted at more at-risk groups, Toronto Public Health (TPH) is still advising that all those six months and up get a shot.  

“When updated COVID-19 vaccines are available this fall, it is recommended that all individuals six months of age and older consider getting vaccinated, especially if they are at higher risk,” TPH said.

What about flu and RSV shots?

The province says that it will begin rolling out flu shots for the most vulnerable and high-priority populations in early October. That includes hospitalized individuals, hospital staff, residents, and staff in long-term care homes. It will then be rolled out to retirement homes and another congregate settings, as well as those 65 years and older.

Free flu shots will become available to the general public starting on Oct. 28 in doctors’ offices, through pharmacies and through public health units.

Starting in October, families with infants and high-risk children up to 24 months old will have access to the new RSV vaccine. Families will be able to access the vaccine through their healthcare provider as well as within hospital settings for infants born during the 2024 and 2025 respiratory illness season. Pregnant women also have the option of getting a single-dose vaccine that can provide protection for their infant from birth to six months.

Should people still mask and take other precautions in some situations?

“Remember that infections are unpredictable still. So where you can prevent an infection, that's always beneficial,” Razak said. “And that there's a lot of strategies that we now know work very well, for not only COVID, but for other respiratory infections in general.

He said that at times when the spread is highest, good strategies for preventing the spread of illness still include not exposing people when you're sick, increasing ventilation wherever possible, and using a mask in crowded settings.

However, he said those strategies can now be employed as people continue with their lives.

“People should get out and enjoy life to the fullest extent. Think about these strategies as the equivalent of wearing a seatbelt, right? You drive, you got to get where you're going, but you take basic precautions to reduce risk as you're going.”