COVID-19 pandemic in Ontario
|COVID-19 pandemic in Ontario|
|First outbreak||Wuhan, Hubei, China|
|Index case||Sunnybrook Hospital, Toronto|
|Arrival date||January 22, 2020|
(1 year and 1 day)
|Government of Ontario|
The COVID-19 pandemic in Ontario is an ongoing viral pandemic of coronavirus disease 2019 (COVID-19), a novel infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first confirmed case of COVID-19 in Canada was announced on January 25, 2020, involving a traveler who had recently returned to Toronto from travel in China, including Wuhan. As of November 10, 2020[update], Ontario has the second-largest number of confirmed COVID-19 cases among Canada's provinces and territories, behind only Quebec.
With increasing transmission province-wide, a state of emergency was declared by Premier Doug Ford on March 17, 2020, including the gradual implementation of restrictions on gatherings and commerce. On April 3, 2020, the province released modelling projecting that over the full course of the pandemic with no mitigation measures 100,000 deaths would have occurred, and with the then-current measures 3,000 to 15,000 deaths would occur. Projections for test-confirmed cases April 30, 2020 were 12,500 (best case scenario), 80,000 (expected case scenario), and 300,000 (worst-case scenario).
From late spring to early summer, the majority of the deaths were residents of long-term care homes. In late April, 2020, one out of five of all long-term care homes in Ontario had an outbreak and 70% to 80% of all COVID-19 deaths had been in retirement and long-term care homes. Following medical assistance and observation by the Canadian Armed Forces, the military released a report detailing "a number of medical, professional and technical issues" amongst 'for-profit' long-term-care homes including neglect and lack of equipment and allegations of elder abuse.
From May through August 2020, the province instituted a three-stage plan to lift economic restrictions, subject to the employment of social distancing and other guidelines, and continued restrictions on the sizes of gatherings. The state of emergency was lifted on July 24, 2020. A plan was implemented for the return-to-class of public schools, involving more than 2 million children.
In early-September 2020, the province showed a significant increase in new cases, along with similar spikes in provinces across the country. Throughout the month of October, Ontario began to reintroduce some restrictions, with a focus on controlling spikes in the hotspots of Toronto, Peel Region, York Region and Ottawa. The province later rolled back its reopening in hotspot regions with temporary measures in a modified Stage 2 of the previous economic reopening system. In early November, the province unveiled a new five-tiered colour-coded level system, abandoning its previous reopening stage system. A response framework was created initially in contradiction to the metrics suggested to political officials by Public Health Ontario and later amended by the province to lower thresholds in each category. From late November to mid-December, the province began placing regions in rolling lockdowns, culminating in a provincewide shutdown beginning Boxing Day.
Following Health Canada's approval of the Pfizer–BioNTech COVID-19 vaccine, widespread plans for vaccinations began during the week of December 14, 2020. On December 23, 2020 Health Canada approved the mRNA-1273 vaccine developed by Moderna for use in Canada as well. Both vaccines require two doses for full inoculation. After a highly criticized initial rollout of vaccination across Ontario, the province leads the nation in doses administered.
Timeline of outbreak in Ontario
Provincial government response
On March 15, Ontario Lottery and Gaming Corporation (OLG) ordered the closure of all provincial casinos. On March 17, Premier Ford declared a provincial state of emergency, prohibiting public gatherings larger than 50 people, and ordering the closure of all schools, child care services, libraries, indoor recreation facilities, dine-in bars and restaurants, and all cinemas, theatres, and concert venues. Ford stated the "vast majority" of businesses were not affected by the order, promising that "essential services and essential needs will be available to every individual and families.
On March 20 further measures were announced, including waiving the three-month waiting period for Ontario Health Insurance Plan (OHIP) coverage, the launch of an e-learning portal, and extended privileges for hospitals to re-deploy staff.
On March 23, Ford ordered all "non-essential" businesses closed by 11:59 p.m. A list of 74 "essential" businesses was published later in the day. On March 27 at 2:00 p.m. ET, Alert Ready was activated on all radio stations, television broadcasters and LTE wireless networks in Ontario, broadcasting an emergency alert warning those returning from international travel of their obligation to self-isolate for 14 days under the Quarantine Act.
On March 30, the Ontario government extended the state of emergency through April 13, and also ordered the province-wide closure of all outdoor recreational amenities, including beaches, playgrounds and sports facilities (several Ontario municipalities including Toronto, had already ordered similar closures of their recreational amenities several days prior to the province-wide order).
On April 3, it was announced the number of "essential" businesses would be reduced to 44 beginning 11:59 p.m. on April 4; this included Ontario Cannabis Store and the halting of most non-essential construction, including industrial construction, and residential construction that did not begin before April 4, but excluding "critical" infrastructure projects. On May 27, all existing public health orders were extended through June 9, 2020.
On April 27, Premier Ford released "A Framework for Reopening our Province", a roadmap detailing a "gradual" lifting of economic restrictions. The process was divided into three stages, with the first intending to allow reopening outdoor spaces, businesses that can "immediately meet or modify operations" to allow a larger number of participants in certain types of gatherings, and allow the resumption of some non-elective medical procedures. Stage 2 would allow additional businesses and outdoor spaces to reopen, and increase the limit on participants in gatherings. Stage 3 would contain further relaxation of prior restrictions, although restrictions on large public gatherings will remain in place indefinitely. After the process began in mid-May, the entirety of the province reached Stage 3 in mid-August.
On June 12, Chief Medical Officer of Health David Williams issued guidelines for "social circles" — allowance for families to expand their interactions with up to 10 people (including themselves) from outside of their immediate household.
On September 17, in response to a surge in new cases in parts of the province, it was announced that the maximum size of "unmonitored social gatherings and organized public events" in the Ottawa, Peel, and Toronto regions would be reduced from 50 people indoors and 100 outdoors, to 10 indoors and 25 outdoors. Organizers of events that violate this restriction can be fined a minimum of $10,000, on top of the existing $750 fine for violating Ontario public health orders. Ford stated that the rule was primarily intended to target events occurring in parks and private locations, and that staffed facilities not targeted under the rule (such as banquet halls, cinemas, convention centres, and restaurants) have employed safety protocols compliant with the province's health guidance.
On September 19, the aforementioned restrictions on private gatherings were extended province-wide. On September 25, it was announced that effective September 26 province-wide, strip clubs would be ordered closed, and that all bars, restaurants and nightclubs would be required to end the sale of alcoholic beverages at 11:00 p.m. and close their dining rooms between midnight and 5:00 a.m. nightly.
On October 2, Premier Ford announced that the wearing of face masks would become mandatory province-wide in all public spaces and workplaces when social distancing is not possible, effective October 3. A number of health regions had already implemented similar mandates at the regional level.
In addition, new restrictions were introduced in the Ottawa, Peel, and Toronto regions; bars and restaurants must collect contact information from all patrons for contact tracing purposes, and are capped at a capacity of 100 people and six patrons per table. Event facilities were capped at a capacity of 50 people total (rather than 50 per room) and also subject to the six-person cap. Gyms are also capped at 50 patrons, and exercise classes were capped at 10.
Due to heightened cases in the regions, Peel, Ottawa, and Toronto were rolled back to Modified Stage 2 from October 10 to November 7, reinstating closures of indoor dining areas, casinos, cinemas and theatres, gyms, and personal care services that require the removal of face masks. All gatherings are capped at 10 people indoors and 25 outdoors, and team sports are restricted to practices only, with scrimmages and games prohibited. Wedding receptions were also prohibited following the Thanksgiving long weekend. Schools and places of worship will continue operations. On October 16, it was announced that York Region would also be placed under Modified Stage 2 beginning October 19.
On November 25, a report was released by Auditor General Bonnie Lysyk which found that Ontario's initial response to COVID-19 was "slower and more reactive relative to most other provinces and many other international jurisdictions" (in contrast to its response to the SARS outbreak). The report found that Public Health Ontario had a "diminished role" in the response, including the province's Central Co-ordination Table for COVID-19 consisting largely of deputy ministers rather than public health officials such as Chief Medical Officer of Health David Williams (who acted primarily on the advice of Ontario's Health Command Table), and ignoring recommendations made by public health officials.
Schools and daycares
On March 12, the provincial government announced that publicly funded schools would be closed for an additional two weeks after March Break until April 5. On March 24. Premier Ford announced that the reopening of schools would be delayed indefinitely past the original April 6 target.
On March 31, Premier Ford announced that in-person classes would remain suspended through at least May 4; in tandem, Minister of Education Stephen Lecce announced the second phase of its "Learn from Home" program, which would involve "teacher-led" instruction delivered via distance education.
On April 14, Premier Ford delayed the reopening of public schools once again, on April 26 it was announced that there were plans to resume in-person classes on May 31. On May 19, Premier Ford announced that all public schools would remain closed through the end of the semester, with plans to pursue in-person classes when the next school year begins in September.
Return to class - Fall Semester
For the next school year, Lecce presented three scenarios: full online learning, a hybrid of online and in=class learning, and a return to full-time in class learning. On July 30, it was announced that that elementary schools would return to class full-time, while high schools in 24 districts with higher enrollment would use a hybrid model, alternating daily between in-person and online instruction to reduce class sizes, with physical classes conducted in cohorts of 15 students each. Students in grade 4 and higher would be required to wear a face mask, parents would have the option to opt out of in-person classes in favour of online classes, and high school students with special needs would be able to attend in-person daily if they are not capable of using remote learning. The province allocated $309 million in funding to cover the costs of additional cleaning supplies, protective equipment, and staffing.
The plan faced criticism from parents, educators, and health care professionals, noting that some schools had insufficient ventilation and that there was no reduction in elementary school class sizes—with only 1 metre of distancing specified between desks. Lecce stated that the distance of desks was in conjunction with the use of masks. The hashtag "#UnsafeSeptember" was used on Twitter to publicize concerns regarding the back-to-school plan. A poll conducted by Maru/Blue in mid-August suggested 38% of parents surveyed were not going to send their children back to school, and a majority believed they stood with teachers and that there should be a staggered start to the school year.
On August 26, details were issued regarding how positive cases will be handled. In the event of a positive case, the entire cohort will be dismissed and required to self-isolate for 14 days. Students may return to class if they have not developed symptoms during the 14-day period. However, they will not be required to receive a test. Schools may be shut down entirely if the local health unit determines that "potential widespread transmission" is occurring. The same day, the federal government announced a $2 billion funding toward schools in Canada, of which Ontario will receive $763 million with the first tranche of $381 million arriving in the fall.
The Toronto District School Board, Canada's largest, debated and later decided to delay the reopening of schools until September 15, one week later than the initial September 8 date. A survey by the board suggested 70% of students would be returning to in class school and 30% of students would be opting for learning from home.
On September 8, the first day of public school for many parts of the province, at least COVID-19 cases reported in Ottawa-area Catholic schools and teachers in a Mississauga Catholic school refusing work until proper personal protective equipment was provided.
On September 11, the Ontario government released a website to track COVID-19 infections in public schools and daycares.
The last day of class for public schools in 2020 was December 18, the province closed the fall semester with 7,292 cases reported in public schools. Before the winter break, there more than 20 schools closed in addition to all public schools in the Windsor-Essex region.
Return to class - Winter/Spring Semester
Due to the province-wide shutdown beginning December 26, all public schools in the Northern section of the province will participate in online learning until returning to in-person class on January 11, 2021, while schools in the South will return to in-person class on January 25, 2021. On January 12, this was later amended, and schools in Toronto, Windsor-Essex, Hamilton, Peel and York region will not return until February 10, 2021.
Ontario Public school & daycare centre statistics
|COVID-19 in Ontario public schools||#||Ref|
|Current number of schools with cases||N/A|||
|Current number of schools closed||N/A (all schools currently closed)|||
|Cumulative total (total number of cases reported in schools)||7,292|||
|COVID-19 in Ontario daycare centres||#||Ref|
|Current number of daycare centres with cases||213|||
|Current number of daycare centres closed||17|||
|Cumulative total (total number of cases reported in daycare centres)||2,017|||
Data as of January 20, 2021
Lifting of restrictions after the first wave
On May 14, it was announced that Stage 1 of Ontario's lifting of restrictions would take begin May 20, focusing primarily on "workplaces that are well-positioned to follow public health advice to maintain physical distancing, implement workplace safety guidance and limit gatherings". Certain outdoor recreation activities that are part of Stage 1 were allowed to resume on May 16, for the Victoria Day long weekend.
On June 8, it was announced that Stage 2 would be implemented across most of the province, excluding 10 Southern Ontario health regions primarily in the Greater Toronto and Hamilton Area and along the Canada–United States border (such as Windsor-Essex County) due to a large number of active cases. In addition, Ford announced that the cap on gathering sizes would be increased to 10 province-wide regardless of phase, and that there would be a moratorium on evictions through the end of August of small businesses which are eligible for the Canada Emergency Commercial Rent Assistance program. On June 15, the Durham, Halton, Haldimand-Norfolk, Hamilton, Lambton, Niagara, and York health regions were allowed to enter Stage 2.
On June 22, it was announced that Peel and Toronto would be allowed to enter Stage 2 on June 24. Windsor-Essex was still excluded from Stage 2 due to outbreaks involving the agriculture industry. On June 24, it was announced that most of Windsor-Essex would be allowed to enter Stage 2 on June 25, excluding Kingsville and Leamington.
On July 3, Premier Ford stated that he did not have a specific timetable for Stage 3; "You see what's happening [in the United States] when you move too quickly, you see what's happening south of the border. We don't want that happening up here."
By August 12, after a region-by-region roll-out, all regions in Ontario had entered Stage 3. On September 8, in response to growing case numbers, the provincial government announced a moratorium on further lifting of restrictions (such as expansion of "social circles" and gatherings) for at least four weeks, besides those already ongoing (such as schools, and reopening of selected casinos on September 26).
|Stage||Effective date(s)||Restrictions lifted||Notes|
||Stage 1 includes eased restrictions on the following:
|2||Province-wide, regardless of their stage or not, were given some looser restrictions. Social gatherings were extended to include up to ten people. Places of worship are allowed to operate at 30% of their normal capacity.
Stage 2 allows certain businesses to reopen, with heavy restrictions:
||The following restrictions are re-implemented:
Regional advisory system
On November 3, 2020, Premier Ford stated that future modifications of restrictions during the second wave will be performed regionally using a colour-coded "response framework". The framework went into place on November 7.
On November 11, it was reported by the Toronto Star that the Ford government had allegedly ignored recommendations by Public Health Ontario regarding the metrics used for the advisory system — which were four times narrower than what was actually implemented by the government.
Two days later, Premier Ford announced that the thresholds for each level would be decreased: for example, the criteria for the "Control" (Red) level was reduced from a weekly incidence rate of 100 or more per-capita, to 40 or more. Regions included in each tier were adjusted to match the new thresholds effective November 16. Ford stated that the original criteria was based on earlier models that had anticipated only 950–1,250 new cases per day by the time it was implemented and that he would not have used them if case numbers had reached the point they had on November 10.
|1||Prevent||Daily cases per-capita (100,000) below 10, test positivity under 0.5%, basic reproduction number(Rt) less than 1.||Focused on promotion and education of indefinite public health measures until a vaccine or effective treatment for COVID-19 becomes widely available.||None|
|2||Protect||Daily cases per-capita between 10 and 24.9, test positivity between 0.5 and 1.2%, Rt ≈ 1.||Targeted enforcement and education is used to control increasing spread.||None|
|3||Restrict||Daily cases per-capita between 25 and 39.9, test positivity between 1.3 and 2.4%, Rt 1 - 1.1.||Additional compliance measures are enforced to mitigate a heightened risk of infection.||None|
|4||Control||More than 40 daily cases per-capita, test positivity above 2.5%, Rt ≥ 1.2.||Broader public health measures are employed to mitigate a severe risk of infection.||None|
|5||Lockdown||Trends continue to worsen after measures from Control level are implemented.||Non-essential businesses are ordered closed (equivalent to Stage 1 or the original orders) as a last resort to control worsened spread.||• Algoma Public Health • North Bay-Parry Sound District • Porcupine Health Unit • Renfrew County and District Health Unit • Public Health Sudbury & Districts • Chatham-Kent Public Health • Grey-Bruce Health Unit • Peterborough Public Health • Hastings-Prince Edward Public Health • Lambton Public Health • Northwestern Health Unit • Haliburton, Kawartha, Pine Ridge District Health Unit • Leeds, Grenville & Lanark District Health Unit • Timiskaming Health Unit • Ottawa Public Health • Huron-Perth Public Health • Southwestern Public Health • Haldimand-Norfolk Health Unit • Thunder Bay and District Health Unit • Eastern Ontario Health Unit • Kingston, Frontenac, and Lennox & Addington Public Health • Halton Region Public Health • Durham Region Health Department • Region of Waterloo Public Health and Emergency Services • Middlesex-London Health Unit • Simcoe-Muskoka District Health Unit • Wellington-Dufferin-Guelph Public Health • Brant County Health Unit • Niagara Region Public Health • Peel Public Health • Toronto Public Health • Windsor-Essex County Health Unit • York Region Public Health • City of Hamilton Public Health Services|
On December 21, 2020, Premier Ford announced that in order to "save lives and prevent our hospitals from being overwhelmed in the coming weeks", a "strict" Provincewide Shutdown would begin in all health regions (regardless of their current status on the COVID-19 Response Framework) at 12:01 a.m. ET on December 26, 2020 (Boxing Day). This measure will last for 28 days. It was originally to last only 14 days in the northern regions of the province (north of Sudbury), but on January 7, 2021 it was announced that the Provincewide Shutdown will be extended in these regions to the same length as in Southern Ontario.
Indoor social gatherings that involve people from outside of one's immediate household are prohibited. Outdoor gatherings are limited to 10 people with social distancing. All non-essential businesses, retail outlets (which include all businesses deemed non-essential under lockdown, as well as hardware stores and pet shops), cultural amenities, sports and recreation facilities (unless "being used by high-performance athletes and specified professional leagues"), and personal care services must close to the public. Essential retail businesses are subject to capacity limits stricter than those used under lockdown (50% for supermarkets and pharmacies, 25% for liquor stores and allowable big-box stores that sell groceries). Bars and restaurants are prohibited from offering dine-in service. All drive-in or drive-through events are prohibited, excluding drive-in religious services.
All publicly-funded schools will remain closed to in-person classes (resuming remotely after the holiday break) until January 11, 2021 in Northern Ontario, and January 25, 2021 in Southern Ontario. Elementary schools were originally slated to reopen in Southern Ontario on January 11, but on January 7 it was announced that this would be delayed.
On January 12, citing models forecasting that Ontario's health care system will be "overwhelmed" with cases and mortality exceeding those of the first wave unless actions are taken, Premier Ford declared a second provincial state of emergency and announced stricter province-wide measures, to take effect on January 14 at 12:01 a.m. ET and last through at least February 11. These measures upgrade the Provincewide Shutdown to a stay-at-home order; all Ontario residents must remain at their homes unless conducting an activity deemed essential. These include shopping at grocery stores or pharmacies, receiving health care, exercise, or conducing essential work that cannot be performed remotely (all employees must work from home if they have the capability of doing so). The province states that what is considered "essential work" is based on "[the] best judgement and common sense of employers". All other restrictions enacted under Provincewide Shutdown remain in force.
Certain businesses, such as liquor stores, hardware stores, and stores offering delivery or curbside pickup services, must close from 8 p.m. to 7 a.m. nightly. Non-essential construction activity will also be suspended. Outdoor gatherings are limited to five people, and guidance now recommends masks be worn outside (in addition to the existing indoor mandate) if social distancing is not possible. The closure of schools in Hamilton, Peel, Toronto, Windsor-Essex, and York will be further-extended to February 10.
The Ontario Provincial Police (OPP), municipal police departments, bylaw officers, and provincial workspace inspectors, will have the authority to issue tickets to enforce the stay-at-home order and mask mandate, however they will not have the authority to stop drivers or pedestrians for questioning. Premier Ford stated plans for a compliance "blitz" of retail store inspections beginning the weekend of January 15. Results of the inspection "blitz" revealed 36 of 110 stores visited in violation of COVID-19 measures, or 70% compliance rate. The measures have faced criticism for disproportionately favouring big box retailers, by not restricting the times of day in which they may offer curbside pickup or delivery services, or preventing them from selling non-essential goods. It also does not include funding to cover paid sick days for essential and low-wage workers.
On December 9, 2020, Health Canada approved the Pfizer–BioNTech COVID-19 vaccine. Vaccines were distributed amongst the provinces by the Federal government. Ontario received an initial delivery of 6,000 doses of the Pfizer vaccine of a total of 90,000 to be received before the end of 2020. On December 14, the first vaccination was delivered in Ontario in Toronto, kicking off a vaccination rollout.
On December 23, 2020, Health Canada approved the mRNA-1273 COVID-19 vaccine developed by Moderna. The first tranche of vaccines of a total 53,000 designated for Ontario by the end of 2020 arrived at Toronto Pearson International Airport on December 24.
Over the Christmas and holiday season, many vaccination clinics were paused. The Ontario government has been criticized for this delay, the government officially responded that the cessation was due to staff shortages. Rick Hillier, in charge of the Ontario vaccine task-force later apologized, calling the cessation a "mistake". On December 29, 2020, he added that that the task-force was looking into applying single doses of the Moderna vaccine in order to inoculate even more people more efficiently.
Due to manufacturing delays with Pfizer (aimed at retooling in order to speed up vaccine production), Ontario is slated to receive less doses of their vaccine over four weeks of late January and early February. This will mean 66,000 less vaccines than initially slated for allocation to the province, however, due to contractual obligations to the country as a whole, Pfizer will be providing more vaccines beginning mid-February.
|Ontario vaccination rollout||#||Ref|
|Doses allocated to Ontario by the Canadian government||411,650|||
|Doses administered in Ontario||264,985|||
|Ontarians fully vaccinated (administered two doses)||49,292|||
Data as of 8 p.m. January 21, 2021
Phases for vaccine rollout
A plan for widespread inoculation is currently laid out in three phases.
|1||December 14, 2020 - March, 2021||Phase 1
Vaccinations began December 14, 2020 in a pilot program to vaccinate health-care workers working in long-term care homes and later expanded to front-line health-care workers. Ontario's vaccination task force later announced their plan to inoculate all long-term care home residents and staff in Toronto, Peel, York and Windsor-Essex with a goal date of January 21, 2021. The government expanded this to all long-term care home residents in the province by February 15. On January 15, it was announced all LTC homes in Toronto had been vaccinated, ahead of the January 21 goal date. On January 19, the Provincial government announced all LTC residents and staff in hot zones had received at least their first dose, two days ahead of schedule.
The following people will be prioritized in this phase:
|2||March - July 2021||Phase 2
The following people will be prioritized in this phase:
|3||August 2021||Phase 3
Vaccinations for the general public
- General (retired) Rick Hillier, former Chief of Defence Staff for the Canadian Forces (chair)
- Mario Di Tommaso, Deputy Solicitor General, Community Safety, Commissioner of Emergency Management (vice-chair)
- Helen Angus, Deputy Minister of Health (vice-chair)
- Ontario Regional Chief RoseAnne Archibald of Taykwa Tagamou Nation
- Dr. Isaac Bogoch, infectious diseases consultant and internist, Toronto General Hospital
- Dr. Dirk Huyer, Ontario's Chief Coroner
- Angela Mondou, President and CEO, Technation
- Mark Saunders, former Toronto Police Chief
- Dr. Maxwell Smith, bioethicist and assistant professor, University of Western Ontario
- Dr. Homer Tien, trauma surgeon and President and CEO, Ornge
- Dr. Regis Vaillancourt, Director of Pharmacy, Children's Hospital of Eastern Ontario
- Linda Hasenfratz, CEO, Linamar, resigned due to her travel outside of the country in December, 2020
Long-term care homes
On April 15, 2020, the Ontario Nurses' Association released a statement saying that long-term care (LTC) homes pre-COVID-19 were already understaffed, but now they are in "crisis" mode. Prior to the pandemic, long-term care home staff who were part-time or casual staff were allowed to work at multiple locations, increasing the risk of transmission and spread between LTC homes. The province issued a new Emergency Order on March 28 that introduced temporary additional staff members to help in the facilities and allowed homes more flexibility in staff deployment. Many LTC homes in Ontario are considered old and small and feature shared bedrooms, increasing the difficulty in isolating sick residents from those who are well.
On April 15, CBC reported that the Ontario Ministry of Long-Term Care had conducted resident quality inspections (RQI) at only nine out of 626 long-term care homes in the province in 2019, down from a bare majority in 2018 and larger proportions from 2015 to 2017. RQIs are proactive, unannounced and more comprehensive than the other main category of care home inspections in the province, complaint and critical incident inspections, where facilities know of the impending scrutiny in advance; the 2018 Long Term Care Homes Public Inquiry noted that "focusing only on specific complaints or critical incidents could lead to missing systemic issues." As of 15 April 2020[update], 114 care facilities in Ontario had experienced COVID-19 outbreaks, and those that had multiple COVID-19 deaths last had their RQI in 2018 or earlier.
On April 7, Ontario reported that there are 51 long-term care homes in the province that are experiencing COVID-19 outbreaks, and by April 10, it had surged to 69 LTC homes in Ontario. Some LTC workers pointed to a lack of personal protective equipment as a cause of the outbreaks. By April 21, 121 outbreaks have been reported in long-term care homes.
On April 8, the Ontario Ministry of Health released directives to ramp up coronavirus testing and infection control. Also, new residents entering a home must be isolated for 14 days and tested within that period. The directives also require that all long-term care home staff and essential visitors for gravely ill residents wear surgical masks, "whether the home is in outbreak or not." LTC homes are expected to take "all reasonable steps" to follow the new long-term care rules. Prior to this directive, LTC staff were not required to wear masks or other PPE, and testing levels were considered low for at-risk seniors and LTC staff.
On April 28, Chief Public Health Officer Theresa Tam stated that as many of 79 percent of Canada's COVID-19 fatalities occurred in long-term care homes, with Ontario and Quebec accounting for most of the cases.
As part of Operation Laser, assistance from the Canadian Armed Forces at five Toronto-area nursing homes, beginning in April, led to a report by the Brigadier General in charge documenting extreme conditions and abuse. The Ontario Ombudsman announced the launch an investigation into long-term care facilities on June 1.
During the second wave of the pandemic, LTC homes began to experience outbreaks again. Tendercare Living Centre in Scarborough for example has experienced 43 deaths related to COVID-19. On December 25, 2020, North York General Hospital took over control of the home.
|COVID-19 in Ontario Long Term Care Homes||#||Ref|
|LTC homes currently with an outbreak||244|||
|LTC homes with resolved outbreaks||252|||
|Active cases of COVID-19 amongst LTR residents||1,346|||
|Active cases of COVID-19 amongst LTR staff||1,130|||
|LTC home resident deaths||3,298|||
|LTC home staff deaths||10|||
|Percentage of overall provincial deaths in LTC homes||57.85%|||
Data as of January 22, 2021
New cases (2020)
New cases (2021)
Confirmed deaths (2020)
Confirmed deaths (2021)
Active cases (2020)
Active cases (2021)
This section needs to be updated.January 2021)(
|Public Health Unit||Cases||Cases per m||Resolved||Deaths||Deaths per m|
|Brant County (including Brantford)||1,277||9,473||1,101||8||59|
|Eastern Ontario (Stormont, Dundas and Glengarry-Prescott and Russell)||1,958||9,657||1,467||46||227|
|Haliburton, Kawartha, Pine Ridge District||670||3,741||573||28||156|
|Hastings Prince Edward||328||2,035||301||5||31|
|Kingston, Frontenac and Lennox & Addington||617||3,191||567||1||5|
|Leeds, Grenville & Lanark District||746||4,408||663||54||319|
|North Bay-Parry Sound (including most of Nipissing District)||177||1,429||151||1||8|
|Northwestern (Most of Kenora District, Rainy River District and part of Thunder Bay District)||224||2,930||186||0||0|
|Peterborough (City and County)||445||3,219||389||5||36|
|Porcupine (Cochrane District, Hornepayne, James Bay communities, Timiskaming panhandle)||164||1,948||130||9||107|
|Renfrew County & District||285||2,751||253||1||10|
|Southwestern (Oxford, Elgin, St. Thomas)||1,928||9,648||1,493||37||185|
|Sudbury & Districts (including Greater Sudbury)||375||1,909||281||2||10|
|Thunder Bay District (including First Nations communities in the far north)||671||4,418||587||21||138|
|Timiskaming (including Temagami)||85||2,572||78||1||30|
Updated as of January 13, 2021.
|Age range||Cases||Cases per m||Resolved||Male||Female||Transgender, other||Unknown sex||Deaths||Deaths per m||Male deaths||Female deaths||Male deaths per m||Female deaths per m|
|19 and under||5,033||1,603||20,714||12,189||11,181||5||187||1||0.3||0||1||0||0.7|
|90 and over||2,647||20,362||3,143||1,363||3,816||0||56||1486||11,431||490||981||12,250||10,900|
Institutional outbreaks versus other spread
This section needs to be updated.December 2020)(
Public Health Ontario has six testing laboratories to which samples can be sent. The main laboratory is the top four floors of the MaRS Centre in downtown Toronto. As of early April, accounting firm KPMG has been contracted to organize all the labs in the province that are capable of microbial testing. In addition to the six public health labs, this includes 10 hospital networks and three private lab networks, including Dynacare and LifeLabs.
Access to testing is set by Public Health Ontario who publishes a guidance document that defines the conditions for an individual to be tested. Conditions have included close contact with a test-confirmed case, recent travel, admission to hospital for serious symptoms, healthcare worker, longterm care home resident, etc. The set of conditions has been updated repeatedly from January to April 2020, at times reducing access and at other times increasing access to testing. Starting in March, the public health units across the province have opened over 70 assessment centres, which members of the public can visit if directed by a health professional. These range from mobile units, to walk-up locations, to drive-through locations. This diverts potentially infected people from hospitals and doctors' offices. If warranted, the centre will collect a swab from a visitor for testing. Swabs are also collected at hospitals and by public health officials, for example, at long-term care facilities.
Since many cases are not tested, the number of test-confirmed cases, which are the infection numbers reported by the Ontario government, should not be misconstrued as the actual number of infections, which have been estimated to be substantially higher. Unlike some countries, the number of suspected or probable infections is not reported by the Ontario government.
In an effort to reduce a burden on provincial assessment centres amid a continued surge in cases, Ford announced on September 23 announced that it would expand testing of asymptomatic people by-appointment into pharmacies across the province, beginning with 60 locations by September 25. He also announced plans to deploy saliva-based rapid testing at three hospitals in Toronto. Accordingly, the province announced on September 24 that it would discourage asymptomatic patients from receiving tests at assessment centres.
Amount of testing
In late March and April, Ontario was performing the lowest number of tests per capita of all the provinces. As of early May 2020, among the larger provinces, Ontario is second to Alberta and ahead of British Columbia and Quebec in daily tests per capita.
In mid-April, polling firms Forum Research and Mainstreet Research released results of a pair of surveys about COVID-19 symptom prevalence and testing. Four to five thousand Ontario households were randomly selected. Of them, 2% of households contained someone who had been tested by April 12, increasing to 5% on April 19, whereas the incidence of COVID-19 symptoms in a household decreased from one in five to one in seven households. The second survey indicated that one-third of Ontarians report an underlying condition that might aggravate a COVID-19 infection.
Since January 2020, Ontario has been increasing its capacity to perform testing based on RT-PCR. Various factors have impeded this increase, including shortages of reagent chemicals for the RT-PCR machines and shortages of validated swabs. To tackle these challenges, labs have adapted. In particular, RT-PCR machines from multiple manufactures have been obtained, each of which takes different sets of chemicals. New suppliers of swabs have been found but each must be tested and validated to perform properly. Returning tests results to individuals is automated with an online portal.
Testing capacity projections
|Date of Projection||Stated Current Capacity/Day||Projection of Testing Capacity/Day|
|March 13, 2020||2,500||5,000 by unspecified date|
|March 26, 2020||2,500||Each week, an increase by 3 to 4,000 tests per day and 19,000 by April 17|
|April 9, 2020||13,000||19,000 by April 29, 2020|
|April 10, 2020||14,000||8,000 by April 15, 2020, 14,000 by April 29, and 16,000 by May 6, 2020|
|May 12, 2020||unstated||20,000 by unstated date|
|May 29, 2020||18,525||16,000|
|May 29, 2020||18,525||20,900 by unstated date|
|October, 2020||35,000 - 40,000||50,000 by unstated date|
|December 10, 2020||62,000 (record number of tests completed by the Province)||90,000 by unstated date|
On March 18, The Toronto Star reported that test results announced by the provincial government were several days old, with turnaround times increasing from 24 hours to 4 days, leading the government to "making decisions based on old information". The province was only able to process around 2,000 tests per day by March 19, which caused the backlog. The backlog increased to over 8,000 unprocessed samples on March 24 with patients waiting at least four days for results, partially due to fact that private and university laboratories are not allowed to process samples.
More backlogs emerged in September and October amid increased demand for tests and a heightened caseload, reaching 68,000 by the weekend of October 4. On October 5, CBC News reported that COVID-19 tests administered at pharmacies were being sent to Quest Diagnostics laboratories in California for processing by means of the local partner for the scheme, In-Common Laboratories (ICL).
Management of testing in Ontario
Officials for Public Health Ontario include the following individuals:
- Dr. Vanessa Allen, chief of medical microbiology with Public Health Ontario
- Dr. Peter Donnelly, president and CEO of Public Health Ontario (on leave as of April 9, 2020)
- Colleen Geiger, interim president and CEO of Public Health Ontario (as of April 9, 2020)
- Dr. David Williams, Ontario's chief medical officer
- Dr. Barbara Yaffe, Ontario's associate chief medical officer of health
In early April, the Ministry of Health brought in a multinational accounting firm KPMG to assist in the organization and optimization of testing capacity in Ontario. Premier Doug Ford said on April 8 that he was losing his patience with Ontario's inadequate testing numbers, showing testing capacity was not being fully utilized. Later that day, the province appointed a former Toronto public health head, Dr. David McKeown to troubleshoot and rethink the province's response to the pandemic. The following day on April 9, amid mounting criticism of the province's testing, the president and CEO of Public Health Ontario Dr. Peter Donnelly temporarily stepped down for medical reasons and was replaced in the interim by Colleen Geiger, Public Health Ontario's chief of strategy, stakeholder relations, information and knowledge.
Regional public health experts suggested that Ontario's initial incremental response — adding new voluntary measures piece by piece — had been ineffective. Businesses of all sizes remained open, and unnecessary social contacts continued. Describing Ontario's efforts to battle COVID-19 as piecemeal and ineffective, Dr. Shanker Nesathurai, who was one of Ontario's 34 regional medical officers of health, urged his colleagues to band together and use more powerful measures to contain the pandemic than provincial leaders had endorsed by the third week of March. In an email, Dr. Nesathurai, who worked for Haldimand Norfolk Health Unit, wrote on March 19 that Ontario's response had undermined the province's attempt to contain the outbreak, as businesses remain open and travellers ignore advice to self-isolate.
On April 25, there were small protests totalling 200 protesters in front of the Ontario Legislative Building in Queen's Park, Toronto, demanding that Doug Ford end all emergency measures. Some of the protesters consider the coronavirus a hoax. Ford called them "a bunch of yahoos."
On May 2, there was another protest with 100 protesters in front of the Ontario Legislative Building.
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