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Update on COVID-19 in Canada:

Epidemiology and Modelling


September 22, 2020
Epidemic growth is accelerating nationally

Daily COVID-19 cases by date of report, Canada


Number of cases

Data as of September 21, 2020

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Incidence rates are increasing in provinces west of the Atlantic region

BC AB SK
Number of cases per 100 000 population

MB ON QC

Date of case report

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Rt in Canada is trending above 1 nationally and in heavily impacted areas

Canada’s Rt over time


2.5 Rt, or the time varying effective reproduction
number, represents the average number of people
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infected by each case
1.5
When Rt is consistently >1, the epidemic is growing
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Since mid-August, Canada’s Rt has been increasing


0.5
and has remained >1
0
2020-03-20
2020-03-27
2020-04-03
2020-04-10
2020-04-17
2020-04-24
2020-05-01
2020-05-08
2020-05-15
2020-05-22
2020-05-29
2020-06-05
2020-06-12
2020-06-19
2020-06-26
2020-07-03
2020-07-10
2020-07-17
2020-07-24
2020-07-31
2020-08-07
2020-08-14
2020-08-21
2020-08-28
2020-09-04
2020-09-11
Cases reported now reflect increasing transmission
one to two weeks ago

Data as of September 16, 2020


Calculations are based on date of case report

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COVID-19 activity continues to be uneven across the country

Incidence rate of COVID-19 cases


per 100 000 population reported
over the last 14 days

Data as of September 21, 2020


Note: Map only shows COVID-19 cases where health region had been attributed in source data
Data sources: COVID-19 Canada Open Data Working Group. Epidemiological Data from the COVID-19 Outbreak in Canada

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Incidence has remained highest among young adults since late June

Incidence of COVID-19 over time and by age group


(3-day moving average)
Reporting lag

80+ years
Number of cases per
100 000 population

20 to 39 years

Data as of September 18, 2020


*First available of illness onset, specimen collection, laboratory test date; cases may not yet be reported in shaded area due to reporting lag

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Rapid detection and response to outbreaks is key to controlling the rate and
extent of COVID-19 spread

Number of outbreaks by setting Average number of cases per outbreak


(July to September)
500

3.6 Corrections/shelter/congregate living


10.1 Healthcare
400 12.8 Industrial (including agricultural)
4.3 Long term care and retirement residences
Number of outbreaks

3.8 School & childcare centres*


9.7 Other (including social gatherings)
300

200

100

0
March April May June July August September
Data sources: Provincial/territorial websites and public information sources
*Note school outbreaks include only those with at least two cases.

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Hospitalizations lag behind increases in reported cases but show early signs of
increase

Data as of September 20, 2020


Provinces with recent COVID-19 cases included

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COVID-19-related deaths remain low

Daily COVID-19-related deaths by date of report, Canada


Number of deaths

Data as of September 21, 2020

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Data driven models forecast short-term epidemic trajectory
Number of cases Number of deaths

Cumulative cases predicted to October 2: Cumulative deaths predicted to October 2:


150 780 to 155 795 9 220 to 9 300

Reported data by September 17


Prediction to October 2
Lower 95% confidence limit for the projected number for a given day
Upper 95% confidence limit for the projected number for a given day
Added data points since September 17 to validate the robustness of predictions

Extrapolation based on recent trends using a forecasting model (with ranges of uncertainty)
When the cases and deaths reported are between the red and green dotted lines, they are within the forecasted range of expected
cases and deaths.
More importantly, if reported data points since September 17 fall outside these limits, the model detects unexpected signals that
require further epidemiologic investigation.
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Public health authorities can’t do this alone; the actions of individual
Canadians are key to keeping COVID-19 to manageable levels

cases
Daily number of new cases

Daily number of new cases

people
cases
per 100 000 people

per 100 000 people

new
people
new
100 000
number of of
‘slow burn’

per 100,00
Daily number
per
Daily
Minimal control Enhanced case detection Case detection + contact tracing +
+ contact tracing individual actions
To keep COVID-19 transmission at low levels or a ‘slow burn’ we need both:
Public health authorities Individual Canadians
• detect cases and trace contacts • wash hands frequently
• monitor case/contact isolation and quarantine • maintain physical distance
• manage risk of importation • wear a mask when distancing is difficult
• detect and respond to outbreaks • stay home if experiencing any symptoms, even if mild
Ng V, Fazil A, Waddell LA, Bancej C, Turgeon P, Otten A, Atchessi N, Ogden NH. 2020. Projected effects of nonpharmaceutical public health interventions to
prevent resurgence of SARS-CoV-2 transmission in Canada. CMAJ. 192(37):E1053-E1064. https://www.cmaj.ca/content/192/37/E1053.long

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Long range forecast - Canada is at a crossroads and individual action to
reduce contact rates will decide our path

• If we maintain our current


rate of contacts – the
maintain epidemic is forecast to
resurge: Grey line

• If we increase our current


rate of contacts – the

increase
epidemic is forecast to
resurge faster and stronger:
Orange line

decrease
• If we decrease our current
March April May June July Aug. Sept. Oct. Nov. rate of contacts – the
epidemic is forecast to come
under control in most
Methods: Anderson SC, Edwards AM, Yerlanov M, Mulberry N, Stockdale J, Iyaniwura SA, Falcao RC, Otterstatter
locations: Blue line
MC, Irvine MA, Janjua NZ, Coombs D, Colijn C. 2020. Estimating the impact of COVID-19 control measures using a
Bayesian model of physical distancing. https://www.medrxiv.org/content/10.1101/2020.04.17.20070086v1

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Experience of other countries shows resurgence can exceed the initial wave
Daily COVID-19 cases per 100 000 population
(7-day moving average)
7-day moving average of daily cases
per 100 000 population

Days since 100th case reported in the country

Data as of September 16, 2020

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Fall/winter with COVID-19 means being more vigilant of risks and precautions

• With rising case counts and activities


shifting indoors, we need to be even
more vigilant.
• Keeping COVID-19 to manageable
levels is a shared responsibility to
protect our health, social and economic
wellbeing
• We can all take individual action to slow
the spread of COVID-19 by considering
our risks and layering on precautions 

Read more in “COVID-19 information and resources: reducing your risks for infection and spreading the virus”, available online at:
https://www.canada.ca/en/public-health/news/2020/07/information-and-resources-on-covid-19-epidemiology-and-reducing-your-risks-for-infection-and-spreading-the-virus.html

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