In Ontario, the rate of new COVID-19 infections is at its lowest levels in four months. That’s the good news.
The not-so-good news is that of new infections — there were 132 in the 24-hour period between Sunday and Monday — those with the greatest share continue to be people between the ages of 20 and 39, even as overall numbers of new cases continue to drop. It’s a trend that began 12 weeks ago and shows no signs of abating now that all areas of Ontario are in Stage 3 of reopening.
There are two possible reasons for this, says Raywat Deonandan, associate professor and epidemiologist at the University of Ottawa: one, older people are better protected now, so in comparison younger people now account for a higher proportion of cases; and two, younger people are being more social in unsafe ways.
“It’s commonly felt that young people have a lower appreciation for risk — we see it in other public health behaviours, like speeding and drug use — particularly true for younger men. And the Ontario data do suggest that COVID is now mostly a young male thing,” Deonandan said.
“As well, young people have a much higher need for social contact. We all understand this. The combination of a rampant infectious disease, low risk perception, and high desire to mingle is a recipe for greater transmission in this age group.”
Cases in young adults climb
Provincial data shows that following the spike in mid-April of new coronavirus cases among people aged 80 and over, the 40 to 59 age group accounted for the largest percentage of confirmed cases for the next several weeks. But when late spring turned to summer, the percentage of infections in people aged 20 to 39 began to climb, hitting more than 40 per cent in early June, a threshold above which it has remained.
While those aged 20 to 39 represent the largest group affected by COVID-19, it’s important to note that the actual number of infections in this category are still decreasing. It’s just that they are decreasing at a slower rate than other age groups.
“In general, 20- to 39-year-olds tend to be more social, probably the most social group other than children interacting with each other at school, which is not a current factor in transmission in Ontario,” said Todd Coleman, an epidemiologist and assistant professor in health sciences at Wilfrid Laurier University.
But that alone doesn’t explain why this age group is seeing a higher percentage of cases than others, he said.
“It could be a number of things, more relaxed social distancing compared to other age groups, hanging out with friends again. It could be that this group are more represented in employment settings where they are more likely to come into contact with others. I really doubt that there’s one singular explanation,” Coleman said, cautioning that it’s not clear if a possible lack of use of personal protective equipment in this age group could be playing a role.
Cumulatively, there have been a total of 42,809 confirmed or probable cases of COVID-19 in the province, according to the Star’s tally of public health units. Most of those cases have affected people between the ages of 20 and 59, with women making up a higher proportion of overall cases in the over-40 age groups.
The rolling seven-day average of new cases now sits at 84 cases per day over the last week, the lowest seven-day average Ontario has seen since a mid-April peak of nearly 600 daily.
Rocky Mountain High
Alberta continues to have the highest number of active cases of COVID-19 in the country based on population — 234 cases per million people — with Quebec and Manitoba in second and third with 181.8 and 168.2 cases per million respectively.
The higher trend in Alberta is partly due to the fact that the province of 4.4 million has decided to stay open as long as active cases in regions of the province are below 50 per 100,000 people, a “liberal” cap that has also been adopted by other countries including Germany, says Jim Kellner, an infectious disease expert and professor at the University of Calgary’s Cumming School of Medicine.
Alberta also has universal testing, meaning anyone can be tested even without symptoms, which could account for the higher proportion of cases.
Like many places across the country, Alberta has seen an increase of cases in young adults aged 20 to 39, says Kellner. And many more cases are appearing in Edmonton, which didn’t have much spread at the beginning of the pandemic compared to Calgary, a travel hub.
But the impact to health care in the province remains low, says Kellner, which is another reason the province is staying open.
Currently there are 45 people in hospital with the virus and only 10 in the ICU.
Deaths there total 224, a rate of 5 per 100,000, which is much lower than the average in Canada of 24 per 100,000, a number driven by the higher number of deaths in Ontario and Quebec, says Kellner.
The U.S. has had a little over 50 deaths per 100,000, he says, and in the U.K., that number is more than 70 per 100,000.
Kellner though is concerned about contract tracing, which has been effective in the province but is becoming harder as people are out and about and not staying close to home like they were at the start of the pandemic.
Until recently, the province had around 400 medical students who were contributing to contact tracing but they have since gone back to school, says Kellner.
Although Quebec has the second highest proportion of cases based on population, the province reported 55 new cases Monday, the fourth day in a row that cases have been less than 100, according to media reports. Patients in hospital number 145 with 25 of those in the ICU.
Ontario is sixth, with 62.4 active cases per million people. Thirty-two people are in hospital with the virus, 16 of those in ICU.
Coleman, of Wilfrid Laurier University, says increases of cases in provinces that initially seemed to have the virus under control should serve as a lesson to us all.
“I think there may be some slight confusion that reopening means no more social distancing and I think the messaging needs to be a little bit more firm and concrete that we still need to be on guard for this,” he said. “We still need to employ practices that help prevent this from passing on. And not be calm and relaxed and think this is completely gone from circulation.”
Chatham-Kent has highest COVID rates in Ontario
Outbreaks of COVID-19 among farm workers and temporary foreign workers employed in local greenhouses are under control in Chatham-Kent but the virus is still spreading due to close contact with confirmed cases.
The area has the highest number of weekly cases of the virus in the province based on population — 37 per 100,000.
The majority of close contact cases have occurred within families, including 12 cases related to a boating trip involving multiple families. There have also been some cases in the Low German-speaking communities.
A spokesperson for Chatham-Kent Public Health notes the outbreak in those communities is a regional trend occurring not only in the Chatham-Kent area but in Windsor-Essex, Oxford-Elgin, Huron-Perth, Haldimand-Norfolk and Niagara Region.
Travel outside the province is also accounting for a number of cases in the C-K public health unit, including one where a resident returning from Florida was charged under the Quarantine Act for not isolating.
Windsor-Essex has the second highest rate of weekly cases, 12 per 100,000 people, with continuing outbreaks in the agri-farm and manufacturing sectors.
And the Southwestern Public Health Unit, which covers Oxford, Elgin and St. Thomas, is third with 11 cases per 100,000.
Cases there started to rise in mid-July, says Cynthia St. John, the CEO of Southwestern Public Health, due to spread in some workplaces, family clusters and large social gatherings.
“We have continued to emphasize the need to stay two metres apart from others and to get tested even if displaying only a single symptom,” said St. John in an email, “as both the lack of physical distancing and a reluctance to test may have contributed to the surge in cases.”
Of Ontario’s 132 new cases reported Monday, most were in Toronto (32), Ottawa (19), Peel Region (18) and Hamilton (16).