Hospitalization numbers may not seem high now but Omicron’s rapid spread could be a challenge

Omicron is exploding" across the province - and unless Ontario speeds up its rollout of third doses and intensifies public health measures, things are going to get very challenging" in the health care system, says the head of the province's science advisory board.

What we know right now," Dr. Peter Juni, scientific director of Ontario's COVID-19 Science Table, told the Star, is that there are roughly 1.5 million people in the province, who are older than 11 and unvaccinated. And if they get infected in a very short time - and that's plausible - this can rapidly overwhelm the health care system."

With just 518 patients in Ontario hospitals as of Christmas Eve - 164 in the ICU, according to the Science Table's Ontario Dashboard - and hospitalizations increasing only gradually, the numbers may not seem high just yet.

But, says Juni, the math and modelling tell a different story.

The good news, he says, is that recent analyses from abroad as well as from Public Health Ontario, estimate the risk of being hospitalized from Omicron, whether vaccinated or not, to be about half of what it was with the Delta variant.

The bad news, he says, is that Omicron is much more aggressive and moving much, much faster. At its worst, he said, the Delta variant doubled every two weeks. Omicron, by comparison, he says, is doubling every three to four days. Compared to last year's winter wave," Juni says, it's exploding."

While Ontario's testing system is overwhelmed at the moment, he said, it's hard to estimate just how many people in the province are currently infected with Omicron. But based on previous estimates of other variants, Juni says he assumes that only about 20 per cent of active cases are currently making it into daily statistics. If that's accurate, he says, it means that about 50,000 people per day, in Ontario, are getting this new variant whether they're vaccinated or not.

The challenge, Juni says, is to keep the curve as low as possible so the peak of ICU admissions doesn't overwhelm the health-care system. That's where public health measures become pivotal, he says. On Dec. 19, the Ontario government once again restricted the size of private and public gatherings, but it's unclear whether that's having an impact just yet.

Vaccines are of prime importance, he says, and the focus should be on third doses as well as getting second doses to children between five and 11 years old. An English study, he says, estimates that having three vaccines makes you four times less likely to be infected with this fast-moving variant than someone with two doses - and six times less likely to get than someone who is unvaccinated.

Three doses will protect you robustly," Juni said. What we don't know yet is how much protection two doses will offer against hospital and ICU admissions, but it looks good." He added that the Science Table will have a better understanding of such risks in about a week as hospital admissions due to Omicron inevitably increase and the data about it starts coming in faster and more furious.

While this variant touched down in the province about a month ago, Isaac Bogoch, an infectious disease doctor, says it's been hard to look at statistically so far because it's still early days. To get a full picture on this variant and how it may impact Ontarians and the province's health care system, infections need to percolate through the unvaccinated and vulnerable populations who end up in hospital. And that takes time.

The clock starts around now," Bogoch says, adding hospitals are beginning to prepare for an increase in cases.

Early Sunday, Bogoch said he helped open a designated COVID ward at Toronto General Hospital, even though there still aren't many infected patients in the wards just yet.

As of Sunday afternoon, there were 19 positive patients at TGH and Toronto Western Hospital combined, according to University Health Network spokesperson Gillian Howard.

David Jacobs, a radiologist at Humber River Hospital, told the Star that right now, as of Sunday, the numbers are extremely low compared to last year's peak.

Currently, Humber River Hospital has 25 COVID patients, with three in the ICU, he said, noting that most are over 60 years old, and several included in the tally tested positive incidentally, after being admitted for other reasons.

From what he's seeing on the ground, Jacobs says he doesn't expect Omicron to test Humber's ICU capacity. If anything, he says the bottleneck and strain on the hospital - and health care system in general - may come more from staffing issues.

Because Omicron appears to be causing mild symptoms in the vaccinated, Jacobs says, and those people aren't turning up in hospital, we've got far more Omicron out there than we're counting right now." But because it's so contagious and so prevalent in the population, it's inevitable hospital staff will get sick just like the rest of us.

That," he said, will take them out of active duty for a period of time" and may make it hard to treat patients.

While Humber has been seeing a large number of patients with respiratory symptoms, runny noses and sore throats, Jacobs said the vast majority get diagnosed and go home."

The few who stay are often quite sick and they are also the unvaccinated. So," he said. Please go get vaccinated."

Michele Henry is a Toronto-based reporter for the Star, writing health and education stories. Follow her on Twitter: @michelehenry