TORONTO -- As COVID-19 testing numbers have increased, so too has the sentiment that the boosted swabbing capacity is the reason for the 鈥渟econd wave.鈥
Experts warn that that line of thinking, one that has been adopted by U.S. President Donald Trump, is misguided and that the "lagging indicators" of hospitalization and deaths are still to come.
鈥淭he math doesn鈥檛 lie. This [second wave] is not a reflection of only increased testing," said CTV Infectious Disease Specialist Dr. Abdu Sharkawy told 麻豆影视 Channel on Tuesday.
鈥淚t鈥檚 a real statistic that indicates that there is a real signal of increased transmission within our community. It鈥檚 not surprising. It is obviously alarming to some who didn鈥檛 predict this happening as quickly as it has.鈥
But experts are not suggesting that the current wave is as bad as the first right now, said infectious disease specialist Dr. Isaac Bogoch. But we have reached a last-ditch moment.
鈥淲e鈥檙e still at a point where we can get these cases under control with targeted public health measures,鈥 he told CTVNews.ca over the phone from Toronto General Hospital. 鈥淲hen case numbers rise, you start to have fewer and fewer options to get the epidemic under control.鈥
Despite warnings from infectious disease experts and public health officials, some social media users continue to spread false mathematics and conspiracy theories. Among the popular mantras online is "more tests mean more cases," a similar phrase to that used by Trump earlier in the pandemic, when he suggested he would interfere with testing regimes to reduce the case count. Some of the users sharing similar thoughts have gone even further, suggesting increased testing is a means for government officials to incite fear and control.
YES, THERE ARE MORE TESTS
Though most jurisdictions are performing than they were earlier in the pandemic, the increase in testing alone doesn鈥檛 account for the increase in cases, experts stress.
In April, there were about 10,000 tests completed daily in Ontario. In September, the daily figures have been two to four times that amount.
But that comparison is not useful, said Bogoch.
鈥淭hat was a time when we didn鈥檛 have very good testing capacity and people were being turned away from testing facilities and testing was largely restricted,鈥 he said. 鈥淵ou have to take things with a grain of salt and look at other metrics when you鈥檙e comparing it to April.鈥
Now, the number of positive cases is 鈥渇ar more reflective鈥 of the actual burden of disease in our communities, said Bogoch, but the testing numbers don鈥檛 explain the rise in cases. Other pandemic metrics are equally concerning.
OTHER WORRISOME METRICS
The increased testing is providing a clearer picture of the second wave of the COVID-19 pandemic and it鈥檚 not a pleasing image. The greater testing capacity is revealing a real shift in the spread of the disease from the summer months into early fall, said Bogoch.
鈥淏ecause we have a greater ability to have a better appreciation of what the ground truth is 鈥 we can watch this change over time. We can watch this change from July and August to the present day,鈥 said Bogoch.
One key factor is the shift in demographics. In the summer months, we saw young people, largely in their 20s, making up a disproportionate number of cases. This was a trend seen in many other countries too, countries that are now seeing a shift that Canada is just getting a hint of: COVID-19 is finding its way into communities of older people again.
鈥淚t鈥檚 such a contagious infection, it doesn鈥檛 stay restricted to a particular age cohort or particular geographic location for long,鈥 said Bogoch. 鈥淭hat鈥檚 exactly what happened in many parts of the world and that鈥檚 what鈥檚 starting to happen here in Canada.鈥
It is expected that, as older age groups contract the disease more during the second wave, that hospitalizations will go up as a result. It has been well documented that people over the age of 60 are at greater risk of more severe health consequences, including death.
鈥淚f you look at just about every metric, it鈥檚 clear that there are a growing number of cases. This is not all explained by us doing more tests,鈥 said Bogoch. 鈥淭here really is a trend in the wrong direction, showing a growing number of cases and unfortunately we鈥檙e going to see a growing number of hospitalization associated with them.
鈥楲AGGING INDICATORS鈥
Though the cases are rising, the number of deaths has remained relatively low in recent weeks. That鈥檚 because hospitalizations and deaths are what researchers call 鈥渓agging indicators,鈥 meaning that a disease needs time to spread to enough people for the harsher consequences to materialize.
鈥淪adly, if we keep seeing a steady rise in cases we will ultimately see an uptick in hospitalizations and, sadly, there鈥檚 a predictable rise in deaths that will follow,鈥 said Bogoch on CTV鈥檚 Your Morning on Tuesday. 鈥淲e鈥檙e already starting to see early signs of a rise in hospitalizations in many of the provinces that are infected with these COVID-19 outbreaks.鈥
OVEREMPHASIS ON NEW CASES
With each new day, public health officials across Canada announce a new set of metrics, the most prominent of which remains the number of new known cases recorded in the previous 24-hour period. On Tuesday, Canada鈥檚 largest provinces recorded more than 1,350 new cases. But some experts believe that there is an overemphasis on the daily case count and individual figures in general.
鈥淭he daily number of new cases is one piece of a much larger puzzle,鈥 he said. 鈥淎ny metric in and of itself isn鈥檛 going to tell the whole story. You need to have a combination of metrics to tell the whole story.鈥
Instead, he recommends people also look at the seven-day average, and in particular the trend over time of the seven-day average. The reproduction number (also known as the 鈥淩鈥 number) is another useful metric, which shows the number of secondary cases one infected person is likely to produce. Any R number greater than 1.0 means that an epidemic is growing in a given area. Earlier this month, Dr. Theresa Tam, Canada鈥檚 chief public health officer, warned that that number was 鈥渉overing above one鈥 nationally.
鈥淭hat鈥檚 not a good sign,鈥 she said. 鈥淲e do not want that to happen.鈥
鈥業T DOESN鈥橳 HAVE WINGS鈥
While the pandemic appears to be changing again for the worse, the behaviour required to stop it remains the same. Canadian experts have faith that the spread of COVID-19 can be slowed.
鈥淲e did it in the spring,鈥 said Sharkawy. 鈥淭here鈥檚 absolutely no reason why we can鈥檛 do it again. We鈥檝e just got to be motivated and support one another to make sure we get on track again.鈥
Key to flattening the curve again is hand-washing, mask-wearing and physical distancing. Human behaviour remains pivotal, stressed Sharkawy:
鈥淭his virus is insidious, but it also doesn鈥檛 have wings or feet. We are the vehicle that allows this virus to be transmitted in our gatherings, in our activities with others, especially indoors and especially in larger groups,鈥 he said.
鈥淲hen we let our guard down, the virus simply pounces and it thrives.鈥
