British Columbia is at a critical point five months along its pandemic timeline: For the first time since COVID-19 took hold, case projections have rebounded to peak levels. And that's amplifying voices questioning why the backslide isn't enough to ratchet up restrictions.
When B.C. spiked early on, a state of emergency was declared and society was shuttered. Now, daily rates are accelerating, on pace to surpass the initial surge — yet there is no ominous foreshadowing of broad shutdowns to come.
The trends are troubling. The latest projections show the province's curve could climb at a faster rate in September than it did in March.
"We are on an upward trajectory. That is concerning, but it's not a predictive model," cautioned Provincial Health Officer Dr. Bonnie Henry during her epidemiological modelling update on Thursday.
Initially, B.C. was peaking at about 70 to 90 new cases on a daily basis. The past three days in a row have seen similar case counts for the first time since.
It's fuelling the call for another crackdown. After all, the first time B.C. saw numbers surge like this, schools were closed. Now, they're about to fully reopen.
Early on, hospitals were cleared out in an extraordinary move to make room for a potential influx in COVID-19 patients. Now, surgeries have restarted in full force.
In March, people were told to stay inside as much as possible and not see their friends. Dining service inside restaurants was banned. Travelling outside one's own city was strongly discouraged.
Yet a reversal back to those sweeping measures isn't being publicly considered by the government at the moment. And looking at the "then" versus "now" numbers, there are parallels in the charts. But not in the policies.
Below the surface of the data lies a provincial strategy that's entirely different — and there's a reason. Several reasons, actually.
Health officials have seen this next wave coming and bolstered their line of defence to brace for it. B.C. is banking on a beefed-up team of contact tracers to keep the pandemic under control.
The province is hiring 500 more health-care professionals to triple its team of infectious disease detectives who follow the virus and track down potential exposures. It's rooted in an attempt to manage the transmission rather than locking down to eliminate the spread entirely.
The strategy itself traces back to the provincial health officer's months-old hints of a "philosophical point" in the pandemic: the juncture where reopening society will trigger a higher caseload. The key is to keep it manageable.
Protecting the elderly
The source of the surge in new cases has swung the pendulum from one side of the age demographic to the other.
Initially, it was the elderly who accounted for most of B.C.'s caseload, with the virus tearing through long-term care homes. It killed nearly 100 care-home residents provincewide. Several more also died in assisted-living facilities
But the outbreaks in those facilities have gradually subsided, easing the risk to the most vulnerable — so much so that in-person visits have now resumed, allowing loved ones to reunite after several heart-wrenching months apart.
Low hospitalization rates
Most importantly, hospitalization rates remain static. This is a critical metric health officials are watching because the overarching goal is not to overwhelm the health-care system.
At its peak, 150 people were hospitalized with COVID-19 in B.C., with 70 of them in intensive care.
Currently, only 12 patients are in the hospital provincewide, four of whom are in ICU.
This week's updated modelling underscored what's been clear for a while: Numbers are rising quickly and they're being driven by young people, although fewer of them are ending up in the hospital.
The data reveals a broad increase since June in the number of infections in people in their 20s and 30s. The bulk of those cases stem from social interactions in environments that breed transmission: indoors and with close contact for longer periods of time.
"We've moved from having household contacts to having a shift in the connections and exposure sites where younger people are getting infected," Henry said. "Places like bars, clubs, parties and social events that we know have been an issue in the last few weeks."
While the province's overall approach hasn't changed drastically in the last few weeks, its messaging has.
Quieting critics calling the government's approach too soft, Health Minister Adrian Dix came out with his firmest message yet around enforcement.
"If you have banquet halls where a private party takes place, you will be seeing environmental health officers and people in public health," he warned Thursday.
It echoes the premier's tougher-than-usual talk just the day before.
"If people continue to disregard the rules the rest of British Columbians are following, then we will of course take action," John Horgan said. "We're going to be looking hard at enforcement ... starting with warnings, then getting into more severe penalties."
There was no elaboration on what exactly that might be, but the goal is clear: Target the problem areas and trigger another round of shutdown-style measures only as a last resort.
But what if it doesn't work?
Left unsaid by Horgan, Dix or Henry is what happens if their plan doesn't work.
Because while the government has consistently said it expected an increase in cases once we reopened in Phase 3, the goal was a gentle increase based on our interactions reverting to 60 per cent of normal — not 70 per cent, which is where we are now.
And the plan wasn't to have cases double every two weeks — from about 10 a day at the beginning of July, to 20 by mid-month, 40 at the beginning of August and about 80 now.
It also wasn't to have active cases triple in a single month. And the plan definitely wasn't to have the rise happen in the weeks right before school restarts, stoking anxieties.
Because if it continues, B.C. has the type of exponential growth that contact tracers can't keep under wraps. Stopping that requires a change in behaviour among certain demographics.
The government is betting that change can happen through tweaking regulations in bars and recruiting celebrities like Ryan Reynolds and Seth Rogen to make public service announcements instead of political scoldings.
If they're wrong, a lot of goodwill they've built up through this pandemic will evaporate almost as quickly as cases have gone up.