Lisa Salamon-Switzman, an emergency room physician in Toronto, had already experienced two deadly outbreaks of the coronavirus pandemic when a new batch of patients started arriving recently, which made her uneasy because of her low oxygen levels – and your age.
“They are younger than we have seen before and they don’t really understand how sick they are,” she said of patients in their 40s and 50s. “And now it has become a huge, huge wave.”
Doctors and epidemiologists in Canada’s most populous province have been warning for weeks that loosening restrictions, a lack of sickness aid for essential workers – and the arrival of new infectious variants of the coronavirus would usher in a devastating third wave.
On Thursday, as cases and ICU admissions increased, Ontario’s premier Doug Ford was forced to reverse the reopening plans and instead announced a month-long shutdown.
The move comes at a time when health officials warn that variants of rapid spread of the coronavirus put the province at risk.
“As the variants spread, Covid is killing faster and younger,” said Dr. Adalsteinn Brown, co-chair of Ontario’s Covid-19 scientific advisory board.
Variants – essentially mutant versions of Covid-19 that can infect more easily and are considered more fatal – have become a growing problem in several provinces across the country.
In British Columbia, the P1 variant, first discovered in Brazil, spread rapidly and, in the past few days, the province has recorded the highest number of cases since the pandemic began more than a year ago.
Quebec, which has long resisted the closure of schools, announced the closure of three cities this week, as the variants potentiate an exponential outbreak of the virus.
But in Ontario, the country’s economic center, the most recent outbreak in the province has become emblematic of the way the virus has disproportionately affected essential workers in factories and warehouses, many of whom are members of low-income ethnic minorities.
While province restrictions are expected to slow overall case growth, a new model suggests that about 800 patients are expected to be in the province’s ICU beds by the end of April – almost double today’s rates.
New cases have steadily increased in recent weeks, in conjunction with the gradual reopening of restaurants and schools.
“What is impressive is that our numbers of hospitalizations do not seem as high as in the first or second wave. But our ICU numbers are just as bad, if not worse. Patients are getting sicker and going directly to the ICU, ”said Salamon-Switzman. “It’s like the original Covid strain, but on steroids.”
For doctors, the demographic change in patients exposed the deep inequalities of the virus.
“We know that the racialized populations affected by Covid-19 far outnumber anyone else. And we know that the majority of these populations are essential workers who are working in the factories, but have not yet had the opportunity to be vaccinated, ”said Salamon-Switzman.
Although Canada has secured one of the largest supplies per capita of the vaccine, the launch has been too slow to halt the rapid spread of the virus. Deaths from long-term care have largely disappeared, the result of an initial effort to ensure that the country’s most vulnerable residents were protected.
“If the current situation is described as a race, the variants are a kilometer ahead,” said Eileen de Villa, a Toronto medical officer.
Many of the Salamon-Switzman patients who contract the virus in the workplace have underlying health problems, such as diabetes, heart and lung disease. These conditions make them at high risk, but they still cannot qualify for a vaccine according to provincial guidelines.
The assembly boxes also exposed the difficult choices that workers must make. The province does not offer guaranteed paid sick leave and temporary or work workers are not usually eligible to receive employee benefits.
“Workers have to make a difficult choice: you either stay home sick and don’t get paid, or you go to work,” said Gagandeep Kaur, an organizer at the Warehouse Workers Center. “And since many are also parents, they need to be concerned about the possibility of their children coming home sick and infecting them.”
At the same time, the high cost of living in the city means that many workers tend to live in shared apartments, says Kaur, increasing the spread of the virus. And in the hardest hit regions, many are temporary workers and do not qualify for employer benefits.
Until workers have better access to vaccines and the chance to stay home if they are sick, Kaur fears that the situation will continue to worsen in the coming weeks.
“We keep talking about these essential workers. We call them leaders, heroes and providers, ”she said. “But whatever you want to call them, the way they are treated doesn’t really reflect that.”