How bad could the fourth wave get? Buckle up. It could get worse than the third

Unless we change course, the London region is likely to see a fourth wave that is worse than the third, says Western University professor and member of Ontario's science table Lauren Cipriano.

Cipriano, an associate professor in both Western's Schulich School of Medicine and Dentistry as well as the Ivey Business School, used dynamic compartmental modelling to project the number of COVID cases in Middlesex-London this fall. 

Cipriano spoke with CBC London Morning host Rebecca Zandbergen about her research. 

RZ: What exactly have you found? 

LC: Our projections for the fall indicate that if we stay on the current course, we will have more infections in our community than the hospital system will be able to handle. In our current trajectory, we would be expecting a hospital situation that is worse than wave three. 

RZ: Remind us what wave three looked like.

LC: At the peak, we had enough cases in critical care in our hospital beds in Middlesex-London that we were required to reduce non-COVID health care services, reduce access to things like endoscopy and elective surgeries. And we don't want to do that again.

While it's unpopular to want to be proactive, it is not going to be a choice at some point in the future when the case numbers are high and our hospitals are overwhelmed again.- Lauren Cipriano, member of Ontario's science table

RZ: How can this be with so many people now vaccinated?

LC: Our vaccination rates are doing quite well but they can be higher, specifically in 18 to 35 year olds. That's a group that can really see a much higher rate of vaccination. But we also know that our under 12s cannot yet be vaccinated. Right now, that makes up half of our unvaccinated population. As long as we have unvaccinated kids, we're going to have people in the population where COVID can spread. 

RZ: But most kids with COVID don't end up in the hospital, do they?

LC: It's true that kids are most likely to have mild illness, but if we have enough cases in kids — and our projections indicate that if we do nothing, we will have enough cases in kids — then our pediatric hospital resources could also be stressed. Here in Middlesex-London, we're one of very few children's hospitals and so our catchment area isn't just our our county, but 2 million people across southwestern Ontario and in northern Ontario.

RZ: What are the things we need to do to prevent this?

LC: All of our research and the research of our peers across the province would indicate that being early and proactive can prevent the need for more severe measures later. So, we don't need another lockdown, but we need to make the choice not go down that path.

Right now, I would advocate that we move to policies similar to step two, accounting for the fact that our children are back in school. Getting vaccinated, wearing a mask anytime you can't be outside with people outside your household, reducing unnecessary contacts, capacity constraints on indoor environments and a lot of encouragement around work from home.

RZ: I don't get the sense that the province is moving in that direction. How do you convince policymakers and the general population to get on board with this again? 

LC: It's not a very popular position. It is unfortunate to find ourselves here again but we are dealing with something that is much more difficult this time around. Delta is a really difficult challenge and if we don't use more proactive moderate contact reduction now, then our government officials will not have a choice later. While it's unpopular to want to be proactive, it is not going to be a choice at some point in the future when the case numbers are high and our hospitals are overwhelmed again. 

RZ: There are people rallying against the vaccine. How do you feel watching that, knowing what you know? 

It is frustrating to see the the anti-vaccination protests, especially when those anti-vaccination protests are targeting our health care workers. Our health care workers have been working tremendously long hours, under very difficult conditions, under stressful conditions. Many of our nurses and respiratory therapists and clinicians have been working in units that are different than their own. They've been seconded from endoscopy and surgery into the critical care units to work in a different, very high stress environment to care for COVID patients. I think that reflecting on how hard our health care workers have been working for us, to think about protesting outside their workplace right now, it's disappointing. 

The interview has been edited for clarity and length