A month into the academic year, the number of coronavirus cases circulating in the majority of Canada’s largest cities has jumped to worrisome levels that increase the risk of spread in the school system, a Globe and Mail analysis has found.
Only 2 per cent of residents in the five largest cities live in a neighbourhood that a Harvard guide for safely opening schools rates in the lowest risk tier. None of the neighbourhoods in Ottawa, Edmonton and Calgary are in the lowest tier.
The findings are more concerning than they were in late August, when a Globe analysis found that in four of the five largest cities, there was so little coronavirus circulating that most neighbourhoods met the terms of the Harvard guide, as long as there were measures in place to control outbreaks.
Across Canada, many schools have had one or two cases, but only a handful have had actual outbreaks. An outbreak occurs when there are multiple cases at a facility, with evidence that transmission was linked. In most cases, outbreaks have been limited to two individuals in a school.
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There is broad agreement among experts that driving down transmission in the community outside schools is the most important factor in keeping students safe inside schools. As case counts balloon in major Canadian cities and infections enter classrooms, parents and experts alike are concerned about how long schools will stay open.
“We’re talking about whether our kids can be in school, with potentially lasting consequences on our society, and we need to be making sure we’re making the right tradeoffs,” said Dr. Thomas Tsai, a surgeon and health policy researcher in the Department of Health Policy and Management at Harvard T.H. Chan School of Public Health.
“There are no shortcuts to this.”
In its analysis, The Globe used a safe-school reopening guide created by the Global Health Institute, Harvard’s Edmond J. Safra Center for Ethics and other groups at the university.
The guide rates areas as green, or safest to reopen, if they are reporting one or fewer new daily infections per 100,000 people on a seven-day average. The guide designates areas as red, or unsafe to reopen, if new daily case counts top 25 per 100,000. In between are yellow (1-10 daily new cases per 100,000) and orange (10-25 new cases) levels that call for varying degrees of caution.
Risk
level
Case
incidence*
Intensity of control
effort needed
Red
Over 25
Stay-at-home orders
necessary.
Orange
10 to 25
Interventions must be
used for control. Stay-at-
home orders are advised,
unless testing and contact
tracing capacity are at
levels meeting surge
indicator standards.
Yellow
1 to 10
Interventions must be
used for control.
Green
Fewer than 1
On track for containment.
Continued viral testing
and contact tracing are
advised.
*Daily new cases per 100,000 people
Risk
level
Case
incidence*
Intensity of control
effort needed
Red
Over 25
Stay-at-home orders
necessary.
Orange
10 to 25
Interventions must be
used for control. Stay-at-
home orders are advised,
unless testing and contact
tracing capacity are at
levels meeting surge
indicator standards.
Yellow
1 to 10
Interventions must be
used for control.
Green
Fewer than 1
On track for containment.
Continued viral testing
and contact tracing are
advised.
*Daily new cases per 100,000 people
Risk
level
Case
incidence*
Intensity of control
effort needed
Red
Over 25
Stay-at-home orders necessary.
Orange
10 to 25
Interventions must be used for control. Stay-at-home
orders are advised, unless testing and contact tracing
capacity are at levels meeting surge indicator standards.
Yellow
1 to 10
Interventions must be used for control.
Green
Fewer than 1
On track for containment. Continued viral testing and
contact tracing are advised.
*Daily new cases per 100,000 people
The northwest corner of Toronto has continually faced above-average case counts in several of its neighbourhoods, where many residents are racialized and low-income. Elms-Old Rexdale had 1.51 new daily cases per 100,000 in the week ending Aug. 23. In the week ending Sept. 28, it rocketed into the orange zone with 15.11 new daily cases per 100,000. Nearby neighbourhoods in the northwest such as Weston, Maple Leaf and York University Heights are also orange zone hot spots.
TORONTO
% OF POPULATION
AUG.
100%
80
60
40
20
0
Aug.
Sept.
SEPT.
York University Heights: 17.6
Little Portugal: 25.71
Maple Leaf: 22.61
TORONTO
% OF POPULATION
AUG.
100%
80
60
40
20
0
Aug.
Sept.
SEPT.
York University Heights: 17.6
Little Portugal: 25.71
Maple Leaf: 22.61
TORONTO
% OF POPULATION
AUG.
100%
80
60
40
20
0
Aug.
Sept.
SEPT.
York University Heights: 17.6
Little Portugal: 25.71
Maple Leaf: 22.61
In the week ending Sept. 28, just 4.2 per cent of Toronto residents lived in green-zone neighbourhoods. In the week ending Aug. 23, it was 79.7 per cent.
Toronto’s only red zone was Little Portugal, just west of the downtown core. Nineteen cases were reported to be people in their 20s or 30s. As bars and restaurants reopened, young adults have driven spikes in cases across the country. All the cases in this group border the Niagara neighbourhood, an area deep in the orange zone that is connected to the nightlife corridor on King Street West.
“The whole premise of our return to school plan was to keep COVID transmission low in our communities and we’re failing at that,” said Ashleigh Tuite, an infectious disease epidemiologist at the University of Toronto’s Dalla Lana School of Public Health.
Nine Little Portgual cases were from people in their 60s and older. A long-term care home in the area had been grappling with an outbreak at the time.
“I think because we saw a low number of the cases, because the weather was nice and it was easy to do a lot of things outdoors, I think it gave us a false sense of security moving into the fall,” Dr. Tuite said.
The Globe’s analysis is a snapshot in time, based on September data. As COVID-19 cases rise and fall, the risk levels for neighbourhoods will change. The analysis does not include neighbourhood-level positivity rates. The Harvard guideline does not rely solely on daily new case counts. If testing is inadequate, such figures can underrepresent the true burden of COVID-19.
The situation in Canada’s capital city has worsened as well. All of Ottawa’s wards were at least in the yellow zone on the 14-day rolling average ending on Sept. 21.
OTTAWA
% OF POPULATION
AUG.
100%
80
60
40
20
0
Aug.
Sept.
SEPT.
Beacon Hill-Cyrville: 12.08
Rideau-Rockcliffe 9.44
OTTAWA
% OF POPULATION
AUG.
100%
80
60
40
20
0
Aug.
Sept.
SEPT.
Beacon Hill-Cyrville: 12.08
Rideau-Rockcliffe 9.44
OTTAWA
% OF POPULATION
AUG.
100%
80
60
40
20
0
Aug.
Sept.
SEPT.
Beacon Hill-Cyrville: 12.08
Rideau-Rockcliffe 9.44
In B.C., data are split into the province’s 16 local health service delivery areas. In the 14 days ending Oct. 1, the area that covers Vancouver had 4.05 daily cases per 100,000 residents. A month prior, that figure was 2.95.
BRITISH COLUMBIA
% OF POPULATION
AUG.
100%
80
60
40
20
0
Aug.
Sept.
SEPT.
Vancouver: 4.05
Fraser South: 4.35
BRITISH COLUMBIA
% OF POPULATION
AUG.
100%
80
60
40
20
0
Aug.
Sept.
SEPT.
Vancouver: 4.05
Fraser South: 4.35
BRITISH COLUMBIA
% OF POPULATION
AUG.
100%
80
60
40
20
0
Aug.
Sept.
SEPT.
Vancouver: 4.05
Fraser South: 4.35
Montreal was the hardest hit municipality in the Globe’s analysis. Montreal was the only one in the orange zone in the week ending Sept. 28. The borough of Outremont was firmly in the red zone with 36.98 daily cases per 100,000. A month earlier, it was in the green zone.
MONTREAL
Data unavailable
% OF POPULATION
AUG.
100%
80
60
40
20
0
Aug.
Sept.
SEPT.
Montreal-Nord: 24.08
Outremont: 36.98
MONTREAL
Data unavailable
% OF POPULATION
AUG.
100%
80
60
40
20
0
Aug.
Sept.
SEPT.
Montreal-Nord: 24.08
Outremont: 36.98
MONTREAL
Data unavailable
% OF POPULATION
AUG.
100%
80
60
40
20
0
Aug.
Sept.
SEPT.
Montreal-Nord: 24.08
Outremont: 36.98
High case counts persist in northeast Calgary, which had the highest number of cases on a rolling average in the week ending Sept. 29, as was the case in the week ending Aug. 23. Four schools in the Calgary area closed this week.
CALGARY
% OF POPULATION
AUG.
100%
80
60
40
20
0
Aug.
Sept.
SEPT.
Calgary-
Upper NE:
9.69
Calgary-
Lower NE:
10.68
CALGARY
% OF POPULATION
AUG.
100%
80
60
40
20
0
Aug.
Sept.
SEPT.
Calgary-
Upper NE:
9.69
Calgary-
Lower NE:
10.68
CALGARY
% OF POPULATION
AUG.
100%
80
60
40
20
0
Aug.
Sept.
SEPT.
Calgary-
Upper NE:
9.69
Calgary-
Lower NE:
10.68
In Edmonton, most neighbourhoods are near the top of the yellow zone, while Northgate stood out in the orange zone in the week ending Sept. 29.
EDMONTON
% OF POPULATION
AUG.
100%
80
60
40
20
0
Aug.
Sept.
SEPT.
Edmonton-
Northgate:
12.31
Edmonton-
Mill Woods
West: 7.86
EDMONTON
% OF POPULATION
AUG.
100%
80
60
40
20
0
Aug.
Sept.
SEPT.
Edmonton-
Northgate:
12.31
Edmonton-
Mill Woods
West: 7.86
EDMONTON
% OF POPULATION
AUG.
100%
80
60
40
20
0
Aug.
Sept.
SEPT.
Edmonton-
Northgate:
12.31
Edmonton-
Mill Woods
West: 7.86
With the weather cooling, Dr. Tuite warned that it will become more difficult to suppress the virus by being outdoors.
“For COVID-19, the concern is really ventilation, and thinking about schools, right now, we’re telling people to keep their windows open as much as they can if it’s possible in the classroom. With the colder weather that’s not going to be as palatable.”
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