SHA’s revised COVID-19 modelling shows progress in Sask.

While the numbers are looking good in Saskatchewan and health professionals say the province is flattening the curve, the provincial health authority is planning for a much darker day.

A media release from the province states Saskatchewan is in “a significantly better position to manage COVID-19” than it had been at the start of the pandemic.

But the new modelling done to help the Saskatchewan Health Authority (SHA) plan for COVID-19 uses an infection rate of 3.12 rather than the province’s current effective reproductive number of 0.7. The 3.12 rate is the average number of people a single person with the virus would infect if no measures had been taken and everyone was susceptible.

Scott Livingstone, CEO of the SHA, said modelling isn’t a crystal ball; it’s a tool the authority uses to plan. He explained the health system doesn’t turn on a dime.

“I wouldn’t say it was easy to postpone procedures across the province, but it’s not as easy to gear them up, and it’s not as easy to shift directions if something happens that is unpredictable,” Livingstone said Tuesday.

“We have to prepare, knowing that COVID is going to be with us for months, and we have to prepare knowing the system needs to restart. But at the same time we need to build that capacity in, even if we’re not using that capacity for COVID.”

Livingstone said the modelling and constant reassessment of the current effective reproduction number can also help the authority monitor what’s happening in the province as the reopen plan gets put into effect and public health measures start to relax.

“We need to remember this isn’t gone, it’s not going away any time soon and it’s really in the hands of the public, and the other folks working in the system, around how well we do,” said Livingstone.

He explained that if the numbers don’t stay flat in the coming weeks, officials will know they have to back off with respect to things like offering other services and using some of the province’s capacity, and that the province might have to start installing more restrictions.

Postponed surgeries and procedures

About 3,800 elective and non-emergency surgeries have been postponed in the province to give the health system the capacity it felt was needed to deal with a COVID-19 surge.

Now the new modelling will allow the authority to plan for less need for things like hospital beds and ventilators.

While the SHA is working on a plan to ramp up other services like those postponed procedures, it won’t happen all at once.

Livingstone said there are those surgeries and procedures, but the health system will also have to deal with people who might have stayed away from health services when they shouldn’t have because of some fear.

Livingstone said, like the province’s reopening plan, any plan to offer those services again will be slow and methodical. He said the SHA will have to assess which are needed first and for whom.

“What we’re trying to do now is use … data to help inform where is the best to open up the system carefully, but also to address the highest needs in our population. The last thing we want to do is start burning through elective surgeries only to have our facilities fill up with people with medical needs that we haven’t met or diagnostic needs that went postponed,” said Livingstone.

There’s growing unrest in the population in Saskatchewan as six weeks of public health orders come and go. Livingstone pointed out that the province’s success in battling the virus is one of the things that’s aggravating people.

“You’re not seeing us blow out the hospitals with demand and you’re not seeing cases skyrocket, but that’s because of some very intentional things that have been put in place,” he said.

He repeated several times that COVID-19 isn’t going away any time soon and the province’s success continues to depend on the actions of regular people.

“If the worst thing that happened is I was getting crap from (reporters) three months later, from today, that we overplanned the system, I’ll take that criticism,” he said.

The modelling

In the SHA’s original modelling released April 8, the worst-case scenario (which included more than 400,000 cases and 8,370 deaths) had a basic reproductive number of 4.00. The mid-range scenario (with 262,000 cases and 5,260 deaths) had a basic reproductive number of 2.76.

The revised planning scenario issued Tuesday said the SHA now can prepare for a maximum of about 255,000 cases and 3,050 deaths. As of Tuesday, there have been 366 cases in the province and five deaths.

With all the countermeasures that have been taken to date such as hand-washing and physical distancing, the province’s effective reproductive number — the average number of people one person with the virus is likely to infect — is now 0.7. That number has been under 1.0 since early April.

In its media release, the SHA said it had flattened the curve “with a hammer” and noted the low number showed residents’ strong compliance with public health orders.

“This new data brings with it cautious optimism,” Livingstone said in the 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.”

The effective reproductive number will be released weekly so residents can see the effect of relaxed restrictions or strengthened measures on the spread of the virus.

The SHA has altered its offensive and defensive plans for handling COVID-19 due to the updated data.

It’s maximizing testing capacity, accessibility and speed; upgrading its contact tracing capabilities; requiring staff to work in just one facility; planning to use hotels to cohort COVID-19 patients who need immediate care; and, expanding virtual care options for doctors and patients.

There currently are more than 50 testing sites in the province. The SHA’s plan also is to reach out to populations who are less likely to seek testing.

While it prepares for a surge in demand for acute care services, the new data allowed the SHA to lower its estimates for the number of hospital beds and ventilators that will be needed. Those numbers dropped by 1,000 and 400, respectively.

As a result, the province would have enough ventilators in that scenario.

However, the SHA is still preparing to have field hospitals in Saskatoon and Regina as required.

As well, the SHA and the Ministry of Health are working on a plan to resume services that previously were shut down — including elective surgeries and diagnostic services — in a staged approach. The details of that plan will be unveiled in the future.

“Going forward there will be ups and downs in our fight against COVID-19,” Dr. Susan Shaw, the SHA’s chief medical officer, said in the release. “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 reopening 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 practise the same precautions that have proven effective to date.”

The scenarios also included Google-generated figures showing how life has changed in Saskatchewan since the start of the pandemic.

Compared to baseline figures from March 6, transit use has dropped by 53 per cent and visits to stores and recreation facilities have fallen by 43 per cent. Trips to workplaces have fallen by 48 per cent, while 20 per cent more people are staying at home.