OTTAWA—New federal numbers show a patchwork pandemic playing out across the country, bringing grave warnings of a potential second or third wave as provinces dare to hit the on-switch for their economies.

After nearly seven weeks of effective lockdown, Canadians are “flattening the curve,” meaning the growth of new infections is slowing and health systems are coping under the current strain, according to a presentation by chief public health officer Dr. Theresa Tam.

Four provinces — Ontario, Quebec, B.C. and Alberta — are grappling with 80 per cent of the 49,000 or so cases. And the country’s case fatality rate spiked from 2.2 per cent three weeks ago to 5.5 per cent because of the virus’ rampage through long-term-care homes, including in Nova Scotia.

Tam said no matter how gradually provinces plan to lift restrictions — and she endorsed the idea of “collectively” planning for the future — forecasts show that without effective testing, contact tracing and hospital capacity to treat outbreaks, “We could see a second wave that is even bigger than the first.”

“We all understand that if the virus accelerates again, that would be massive setback to the gains we already have so we have got to keep going at it,” Tam said. “This is absolutely still a marathon.”

Nevertheless Quebec is steaming ahead with plans to reopen stores, manufacturing facilities and schools in the coming weeks. Ontario is holding off until new infections drop.

The strikingly different approaches come as premiers release new guidelines that all provinces agreed to use in their plans to lift pandemic restrictions that have shuttered non-essential businesses and enforced social distancing across the country.

Under those guidelines, announced Tuesday by Prime Minister Justin Trudeau, all levels of government agreed “strong measures” will need to remain in place until there is a vaccine or effective treatment for COVID-19.

Leading experts estimate that could take more than a year, at least.

The guidelines include the need to bring the spread of COVID-19 “under control”; increase capacity to “test, trace and isolate all cases”; expand the ability of health-care systems to deal with future outbreaks; and support vulnerable people like seniors who are at greater risk of being killed by the virus.

Based on information Tam presented (based on about 56 per cent of Canada’s cases) older Canadians and males are at greater risk of severe disease.

People older than 60 made up 95 per cent of Canada’s deaths, and about two-thirds of all hospital admissions and all ICU admissions. Men were more likely than women to be admitted to hospital, and most of the deaths due to COVID-19 in Canada — 79 per cent — are linked to long-term-care homes and seniors’ homes.

And although that fatality rate has spiked recently, Tam did not present a different long-term projection for expected deaths since her last presentation on April 9. She said that ratio could change again over the course of the pandemic. On Tuesday she stuck to a possible range of 4,000 to 44,000 projected deaths overall, based on assumptions that between one and 10 per cent of the population could become infected even with the strong epidemic controls Canada has enacted.

Tam said because Canadians are practising physical distancing and following public health advice, Canada is not on course to hit the more dire “no controls” scenario that projects up to 80 per cent could become infected, with up to 355,000 deaths.

She said the epidemiology of the disease varies from province to province, region to region, even between cities, and the common guidelines provinces agreed to will inform their individualized plans. Her deputy Dr. Howard Njoo said some hot spots, like Montreal, may have to look at delaying school reopenings.

Yet when reporters asked whether a province like Quebec is moving too quickly with a plan for what it calls a “voluntary” reopening of schools, neither Tam nor Njoo would expressly criticize the move.

Loading... Loading... Loading... Loading... Loading... Loading...

Amir Attaran, a professor in the faculties of medicine and law at the University of Ottawa, criticized the federal scenario for suggesting the epidemic can be brought under control with only 10 per cent of the population becoming infected, saying without broader immunity or a vaccine it is highly likely many more Canadians will get infected, and Canada will continue to experience waves of outbreaks.

But Attaran agreed some provinces, like PEI, Northwest Territories and Yukon which are not seeing any community transmission now, or Nunavut which has reported zero cases, may be able to manage gradual returns to work.

While the provincial guidelines for reopening don’t spell out what it means to achieve sufficient testing capacity or how to bring the virus “under control,” they recognize that provinces and territories “may need to move forward at different times and in potentially different ways.”

They also state that international travel restrictions “may only happen in later stages,” based on the spread of the virus outside Canada.

Speaking outside Rideau Cottage on Tuesday, Trudeau said the guidelines will ensure the relaxation of restrictions is done in the safest way. This will mean increased needs for personal protective equipment and safety measures at work, and vulnerable groups like seniors and long-term-care patients will need to be under protective measures for longer, he said.

Alex Ballingall is an Ottawa-based reporter covering national politics for the Star. Follow him on Twitter: @aballinga Tonda MacCharles is an Ottawa-based reporter covering national politics for the Star. Follow her on Twitter: @tondamacc

Read more about: