Lisa Salamon-Switzman, an emergency physician in Toronto, has been working through two deadly waves of the coronavirus pandemic when a new group of patients recently arrived arriving that left her uneasy due to their low oxygen levels – and their age.
“They are younger than we have seen before and do not really understand how sick they are,” she said of patients in their 40s and 50s. “And it has now become this great, great wave.”
Doctors and epidemiologists in Canada’s most populous province have been warning for weeks that weakening restrictions, a lack of sick pay for essential workers – and the arrival of infectious new coronavirus variants will usher in a devastating third wave.
On Thursday, as affairs and admissions to the ICU increased, Ontario’s Prime Minister Doug Ford had to reverse plans to reopen, announcing a one-month strike instead.
The move comes as health officials warn that the rapidly spreading variants of the coronavirus are endangering the province.
“As variants spread, Covid dies faster and younger,” said Dr. Adalsteinn Brown, co-chair of Ontario’s Covid-19 scientific advice table.
The variants – essentially mutated versions of Covid-19 that can be more easily infected and are believed to be more deadly – have become a growing problem in a number of provinces across the country.
In British Columbia, the P1 variant, first discovered in Brazil, has spread rapidly, and in recent days the province has recorded the highest number of cases since the pandemic began more than a year ago.
Quebec, which has long refrained from shutting down schools, announced an exclusion in three cities this week because variants allow for an exponential outbreak of the virus.
But in Ontario, the country’s economic hub, the province’s latest outbreak has become a sign of the way the virus has excessively affected essential workers in factories and warehouses, many of whom are low-income members of ethnic minorities.
Although the province’s restrictions are expected to dampen the overall growth of the case, new modeling suggests that nearly 800 patients are expected to be in ICU beds in the province by the end of April – almost double that.
New business has been steadily rising over the past few weeks, along with the gradual reopening of restaurants and schools.
‘What is striking is that our hospitalization numbers do not look as high as in wave one or two. But our ICU numbers are just as bad, if not worse. “Patients come in sicker and go directly to the ICU,” said Salamon-Switzman. “It’s like the original Covid strain, but with steroids.”
For physicians, the changing demographics of patients have exposed the deep inequalities of the virus.
‘We know that the racial populations affected by Covid-19 weigh heavier than anyone else. And we know that the majority of these populations are essential workers who work in factories but have not yet had the chance to be vaccinated, ”said Salamon-Switzman.
While Canada acquired one of the highest per capita stocks of the vaccine, the rollout was too slow to halt the rapid spread of the virus. Deaths in long-term care have largely disappeared, as a result of an early attempt to ensure that the country’s most vulnerable residents are protected.
“If the current situation is described as a race, the variant is a mile ahead,” said Toronto medical officer Eileen de Villa.
Many of Salamon-Switzman patients who contract the virus in the workplace environment have underlying health issues such as diabetes, heart and lung disease. These conditions are high risk but are not yet able to qualify for a vaccine according to the province’s guidelines.
The increasing number of cases also exposed the difficult choices that workers have to make. The province does not offer guaranteed paid sick leave, and temporary or gig workers do not regularly qualify for employee benefits.
“Workers have to make a difficult choice: either you stay sick and are not paid, or you go to work,” said Gagandeep Kaur, an organizer of the Warehouse Workers Center. “And because there are so many parents, they have to worry about their children getting home sick and infecting them.”
At the same time, the high cost of living in the city means that many workers often live in shared apartments, says Kaur, reinforcing the spread of the virus. And in worst-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 when they are sick, Kaur is worried that the situation will worsen in the coming weeks.
‘We keep talking about these essential workers. We call them leaders, heroes and suppliers, ”she said. “But whatever we call it, the way they are treated does not really reflect it.”