'Cautious optimism': SHA modelling estimating fewer infections, deaths as COVID-19 rate slows in Sask.
REGINA -- The latest COVID-19 modelling from the Saskatchewan Health Authority shows the spread of the virus is slowing in the province thanks to “strong compliance” with public health measures.
The latest models, released by the SHA on Tuesday afternoon, show an effective reproductive number of 0.7 as of April 25, meaning the average infected person in the province will infect fewer than one other person.
“This new data brings with it cautious optimism,” SHA CEO Scott Livingstone said in a news release. “Thanks to the Saskatchewan people's efforts and our own robust actions on testing, contact tracing, and other public health measures, we are flattening the curve and helping ensure our health system can manage the surge in demand that may come from COVID-19.”
That number includes cases from the Easter weekend, the SHA said on Tuesday afternoon.
The revised planning scenario estimates 254,756 COVID-19 infections in the province and 3,050 deaths during the course of the pandemic.
Original planning scenarios released earlier this month predicted 335,000 infections and 6,815 in its mid-range scenario.
The modelling continues to be a “what if” scenario that will guide planning going forward, the SHA says.
The model says the SHA is still prepared for a “major surge.”
Livingstone says the restrictions need to stay in place despite seeing lower numbers than the model’s estimates.
“As we move forward with COVID, it’s not going away any time soon,” he said.
He said cases aren’t “skyrocketing” right now because of “intentional” public health orders put in place. However, he said it’s not as simple as returning back to normal.
“The system doesn’t turn on a dime,” Livingstone said. “We have to prepare knowing that COVID will be with us for months.”
“The purpose of the modelling isn’t to predict,” Dr. Jenny Basran, Senior Medical Information Officer with the SHA, said. “It’s to help plan to make sure that our system is ready to provide the best care we possibly can.”
Effective reproductive number vs. basic reproductive number
The models define the effective reproductive number as the “average number of people one person with the virus infects at the current time after the effects of interventions.” The basic reproductive number is the “average number of people one person with the virus could infect where the entire population is susceptible and no interventions have been undertaken.”
The new modelling shows the province’s basic reproductive number at 3.12.
Initial SHA modelling released on April 8 was based on the basic reproductive number.
According to the SHA, the effective reproductive number “changes daily as behaviours and interventions change.”
Basran says the basic reproductive number is used for what if scenarios in the modelling.
“The effective reflects where we are now,” she said.
The SHA is watching to see if the effective reproductive drops and stays below one.
“[That shows] the spread of the virus is declining in the community,” she said.
The SHA is using the new data to adjust its planning scenarios, but says it will still “plan for the worst while aiming for the best.” The health authority will use the basic reproductive number of guide its decisions on relaxing or tightening public restrictions and says it will release that number every week.
According to the SHA, the effective reproductive number has been less than one since early April.
The SHA models say the effective reproductive number is “helpful in determining effectiveness right now” and can be used to choose new measures or loosen existing ones.
“These plans are critically important,” Livingstone said.
He added the numbers can change rapidly as the course of the virus changes in the province.
In its offensive strategy, the health authority highlighted maximizing testing capacity, accessibility and speed. The province plans to expand testing throughout Saskatchewan, including for asymptomatic people or outreach populations who might not be as likely to seek testing.
Testing is currently available to anyone with COVID-19 symptoms in Saskatchewan.
There are 50 testing sites in Saskatchewan, including 18 on First Nations. Lab capacity can handle 1,500 tests per day.
“As the province begins to re-open, care in the community remains the foundation of our health-care system,” the SHA’s modelling says.
The SHA says it will also surge contact tracing to stay ahead of demand. The SHA says it could currently handle up to 300 new daily cases and has a plan to meet scenarios of up to 618 new COVID-19 cases per day.
Staff are restricted to single facilities to combat the spread of the virus. There is also a contingency plan in place to cohort positive patients at hotels for intermediate care if necessary.
There are currently 16 assessment and treatment sites in the province and more are expected to open soon.
Health-care workers will still offer virtual care options or maintain proper physical distancing wherever possible.
Acute surge planning scenarios were adjusted by the SHA based on the new modelling information. A contingency plan remains in place for a “worst case surge.”
The planning scenario estimates 190 daily hospital admissions and 60 ICU daily ICU admissions.
The health authority is still preparing for field hospitals in Regina and Saskatoon if a scale up is needed.
However, the new scenario estimates the SHA will need 1,000 fewer hospital beds, 400 fewer ICU beds and 400 fewer ventilators than what was announced in its initial modelling on April 8.
Regina’s field hospital at Evraz Place could hold up to 400 beds. Saskatoon’s Merlis Belsher could house up to 250 beds.
Elective surgeries to start again soon
The SHA and Ministry of Heath say elective surgeries and diagnostics will be available soon through a phased-in approach to the procedures. Each phase will come into effect following surveilling virus transmission data in the community.
Livingstone says there is no timeline for when the procedures can start again.
“We will be developing that plan plan over the next couple of weeks,” he said.
Livingstone added that 3,800 surgeries have been postponed in the province since the COVID-19 outbreak began. He said the virus isn’t gone and the SHA needs to maintain its capacity “in case something happens.”
Services will return based on patient priority, transmission risks, surge capacity impact and PPE inventory.
Livingstone says the SHA still has about a month of PPE, even with the continuous masking policy, and the organization monitors the numbers daily.
“The supply chain is starting to open up a little bit,” he said. “We are starting to see things trickle in.”
"Going forward there will be ups and downs in our fight against COVID-19," said Dr. Susan Shaw, Chief Medical Officer. "That is why it is so critical that we be guided by the data and be willing to adapt as we learn more about COVID-19 and how the virus is behaving in the Saskatchewan context. While we support the Province's plan for gradually re-opening the Province, it is a critical time to remind Saskatchewan residents that this will be a phased process where we still need our citizens to be vigilant and practice the same precautions that have proven effective to date.”
Saskatchewan residents can help maintain a flat curve through practicing good hygiene, maintaining physical distancing, staying home when possible, following public health orders and avoiding long-term care facilities and hospitals.
Read the latest modelling here: