Dialing physical distancing measures up and down could be a way of sustaining the long-term fight against COVID-19 while not crushing the economy, a new study from Ontario researchers suggests.
The scientists from the University of Toronto and the University of Guelph used mathematical modelling to predict the course of the disease in Ontario.
Their base modelling found 56 per cent of the province's population would become infected with the novel coronavirus over the next two years.
At the peak of the crisis, 107,000 Ontarians would be hospitalized with 55,000 people in the ICU, the modelling numbers suggested, should nothing be done. The province currently has about 2,000 intensive care beds.
However, the research suggested so-called "dynamic" physical distancing could help keep the health-care system from becoming overwhelmed while allowing "periodic psychological and economic respite for populations."
Physical distancing is an effective tool to curb the spread of the disease, Canada's public health agencies have said.
The key, according to study lead author Ashleigh Tuite, is to "ride the wave" — by pegging physical distancing measures to the number of intensive care beds in use, those restrictions can be loosened when ICU numbers drop, then tightened up again when the numbers near capacity.
"Instead of a sharp up-and-down epidemic curve, we have something that is stretched out and kind of goes up and down, up and down, and we basically modulate our responses based on where we are in that curve," said Tuite, an assistant professor of epidemiology from U of T.
"When things start ramping up again, then we know that we need to enhance our social or physical distancing measures. And when things are on the downturn, then we can potentially return a little bit more to normal life."
The paper was submitted in late March to the Canadian Medical Association Journal and published as a pre-print that has not yet been peer-reviewed.
Amy Greer, one of the study's author's, said this is another method to buy society time until a vaccine is available, which is likely more than a year away.
"In the absence of access to a safe and effective COVID-19 vaccine, we will need to work hard to slow down community transmission while also recognizing that we can't reasonably maintain long-term and aggressive physical distancing until a vaccine becomes available," said Greer.
Ben Bolker, a math and biology professor at McMaster University who was not involved in the research, called it a "sensible study."
"The really hard part is figuring out how it's all going to work at a government, logistic and bureaucratic level," he said.
He said one potential method would be to change the laws around how many people can gather at once.
Both Tuite and Bolker said other tools will be arriving soon that could help. For one, they said, exhaustive testing would allow the province to drill down into hotspots and ensure isolation measures are placed on those people.
That also might allow some people to return to work.
"It sucks that we have to keep the economy shut for a bunch longer," Bolker said. "But during that time we're gathering information and figuring out how the hell we're going to get out of this."
Atif Kubursi, a retired professor of economics at McMaster University, said the study is a good starting point for how to fight the disease over the next year or two.
"This is one of the most important questions right now: how can you balance the risk of increased morbidity and death versus destroying the economy?" he said.
Kubursi points out that the study does not get into economic modelling and the effect of starting and stopping businesses — something he'd like to see future research take on.
"It sounds a little simplistic," he said. "I don't know if it's easy to turn the economy on and off, but I guess there are some measures you can take to make businesses essential again."
"We'd need to know the answer to the question: Is it worthwhile? Can we get people back to jobs in big numbers for short periods of time?" Kubursi said.
"If we can, maybe that is a way to keep the economy greased, keep it moving. It could be worthwhile."
This report by The Canadian Press was first published April 9, 2020.
Liam Casey, The Canadian Press
