Well folks, we’re officially in the bad place. Or at least, a worse place than we were before. That’s right, Ontario is in a third wave of the COVID-19 pandemic, according to the Ontario Hospital Association and later confirmed by Chief Medical Officer of Health Dr. David Williams. On Wednesday, Ontario recorded more than 1,500 cases, which — FYI — is the highest single-day total since February, with over half of the cases from new strains (variants of concern).
“Unfortunately, I’m not surprised,” says Dr. Ashleigh Tuite, an infectious disease epidemiologist at the University of Toronto’s Dalla Lana School of Public Health. “It’s been anticipated and expected based on what we know about the virus and how it spreads. [Since January], it’s certainly been a period of watchful waiting for epidemiologists.”
But, while epidemiologists aren’t shocked, the rest of us have questions: How did we get here? Are other provinces also in a third wave? And when is this going to end? Here, we asked experts what the third wave means for Canadians, and how it’s going to affect your summer plans.
How do we know we're in a third wave?
If you’re wondering what exactly a third wave is, and what it means, you’re not alone. The term itself is kind of confusing; there’s not necessarily an exact number of COVID cases that would cause a province to declare the start of another wave. “It’s not really a scientific thing,” Tuite says of the waves terminology. “When we talk about waves, we're basically talking about a distinct epidemic curve.” (An epidemic curve is a graph that shows the progression of a disease outbreak over time.)
Pointing to Ontario as an example of this curve, Tuite says that while case numbers haven’t dropped to really low numbers — which might signal to people the end of the second wave — they dropped to a certain degree, stopped, and then started increasing again, leading to the declaration of a third wave. “What it means is that we're seeing an increase in cases, and we don't anticipate that increase is going to stop unless we implement additional public health measures."
Are other provinces or territories also in a third wave?
While average daily COVID case numbers remain high across the country, Ontario is so far the only province to declare a third wave. That doesn’t mean that other provinces aren’t seeing some sort of uptick in cases. In British Columbia, the seven-day average for new cases increased by over 130 cases in the past month, and epidemiologists in Saskatchewan told Global News that if health officials don’t implement additional safety measures, case numbers "could quickly escalate into a third wave." FYI: provinces like Alberta and Quebec have reported fewer cases and it's pretty much status quo in the Maritimes.
What do the variants of concern have to do with the third wave?
A lot. ICYMI, since January, there have been reports of three variants of concern, new mutations of the OG COVID-19 virus: B.1.1.7 (first ID’d in the UK), B1351 (South Africa), and P1 (Brazil). The UK strain is the most prominent in Canada, with doctors saying it spreads faster than others and can be transmitted in less time than the OG strain.
“Right now, over 50% of cases in Ontario are infected with one of these variants of concern,” Tuite says. In fact, these VOC pulled a bit of a fast one on us: Despite the fact that, for a while, it seemed like case numbers in the province were going down, case numbers of the new variants were actually going up.
And, because these variants are more transmissible, they’re actually harder to control, meaning that the safety measures we previously had in place (social distancing, wearing a three-layer cloth mask, and only leaving your home if necessary), may not be enough to control this latest spread. “There's good evidence that if the variants hadn't arisen we would not be seeing this wave,” confirms Dr. Gerald Evans, an infectious disease specialist based in Kingston, ON.
Shouldn’t the vaccine slow all this down?
You would think. The short answer: It takes time. Currently only 5% of the Canadian population has received their first shot. “Cognitively, it's a really difficult time in the pandemic because we're hearing a lot of good news; we talk a lot about the end being in sight, and people are getting vaccinated,” Tuite says. “What’s really important to remember is that vaccines work and they work very well, but it takes time to roll them out. And right now, we just haven't reached the level of vaccination that we need to really prevent spread.”
That comes from something called the herd immunity threshold (a certain percentage of people are immune from COVID, either due to receiving the vaccine or because they’ve already had it and recovered). In the case of COVID-19, Tuite says around 70% of the population has to either be vaccinated or have already been infected to effectively prevent spread. While that may sound dauntingly high, Tuite emphasizes that we’ll start seeing the effects of vaccines before then. Phew. “Even with a small percentage of the population that's already been vaccinated, those people are protected from severe infection. And once we get more and more people vaccinated, we can dial back the different restrictions.”
Does this mean Ontario will go back into lockdown?
Toronto and Peel regions are still hanging out in the grey zone, with retail stores operating at 25% capacity and grooming closed. Regions across Ontario are in differing stages of re-opening. But this new rise in numbers doesn’t necessarily mean we’ll be going back into a total lockdown or state of emergency.
In fact, on March 19, the government announced amendments to the grey zone, tweaking the rules to allow patios in regions like Peel and Toronto to re-open for outdoor dining on March 20, with the caveat that tables are limited to members of the same household. More tweaks around outdoor fitness and dining may come in the next few weeks.
But that may not be the best idea. As Dr. Jeff Kwong, an epidemiologist at the University of Toronto told Refinery29 in February, loosening restrictions would most likely lead to a third complete shutdown. Others are suggesting preventative measures: This week, Dr. Peter Juni, the scientific director of Ontario’s COVID-19 scientific advisory table, recommended parts of the province, including Toronto, go into a strict three-week lockdown. “To make it without a renewed lockdown in the situation we’re in, that’s next to impossible unless a miracle occurs,” he told CTV. FWIW, Toronto’s chief medical officer Dr. Eileen de Villa has said she won’t hesitate to tighten rules if the cases become worse.
What does this mean for my hot girl summer?
TBD. It's thought this latest wave will be about six weeks long. “At some point in late April or early May, we're going to get this seasonal forcing effect,” Evans explains, meaning the virus likely won’t spread as quickly once people are able to distance outside. (Mild temperatures also appear to slow spread.) This timeline is also dependent on whether or not new variants emerge, and vaccine rollout speed. “Right now, I would tell everybody to hold on to your seats, we're probably in for a good month to month and a half of rising cases before we might expect to see some drop."
In the meantime, it's best to continue to do everything we’ve been doing to prevent transmission: washing your hands, avoiding crowds, social distancing, and staying home (aka no international summer vacations). This especially goes for people in their 30s and 40s. As older populations are receiving the vaccine first, the third wave’s VOCs will largely affect younger people who have yet to be inoculated, and, these variants are making people sicker than before, according to Tuite. Equally as important is tempering our expectations. It can be easy to get caught up in the excitement of potentially being able to hang out with people again — especially because, as our American neighbours continue to vaccinate, rules there are relaxing, with the CDC saying people who are fully vaccinated can gather together indoors without a mask.
It’s important to remember that these rules only apply to fully vaccinated people, Tuite says. “Because we're spacing out the time [three to four months] between the first and second doses in Canada, it may be a while until you're fully vaccinated.” Meaning many people may be stuck in a weird limbo of being partially vaccinated and wondering, Can I hug my friends? Make out with my Tinder date? Bump a stranger’s arm in the supermarket without stressing out? For now, keep it at six feet.
Will the third wave will be the last wave?
Hopefully — at least of this current strain of COVID. “By the time we get to the summer, we'll have enough of the population vaccinated [that there won’t be additional waves]," says Tuite. Which is not to say that there won’t be flareups in the future, especially among pockets of unvaccinated people or during the more-infectious winter season.
“The $64,000 question is, is this going to become an endemic virus, (meaning it’s maintained or pops up recurrently), or will it disappear?” Evans says. “A lot of us believe it's going to be an endemic virus. But once we vaccinate lots and lots of people, it'll become a lot like all the other coronaviruses, which typically cause a common cold.”
This story was originally published on March 18. It has been updated with new information.
COVID-19 has been declared a global pandemic. Go to the Public Health Agency of Canada website for the latest information on symptoms, prevention, and other resources.