JMIR Publications

ABSTRACT

Background:

The COVID-19 global pandemic has disrupted structures and communities across the globe. Numerous regions of the world have had varying responses in their attempts to contain the spread of the virus. Varying factors such as public health policies, governance, and sociopolitical factors, have led to differential levels of success at controlling the spread of SARS-CoV-2. Ultimately, a more advanced surveillance metric for COVID-19 transmission is necessary to help government systems and national leaders understand which responses have been effective and gauge where outbreaks occur.

Objective:

The goal of this study is to provide advanced Canadian surveillance metrics at the Province level for COVID-19 transmission that account for shifts in the pandemic, week over week, speed, acceleration, jerk and persistence, to better understand country risk for explosive growth and those who are managing the pandemic successfully. Existing surveillance coupled with our dynamic metrics of transmission will inform health policy to control the COVID-19 pandemic until an effective vaccine is developed and provides novel metrics to measure the transmission of disease.

Methods:

Using a longitudinal trend analysis study design, we extracted 52 days of COVID data from public health registries for 14 Provinces and Territories. We use an empirical difference equation to measure the daily number of cases in Canada as a function of the prior number of cases, the level of testing, and weekly shift variables based on a dynamic panel model that was estimated using the generalized method of moments (GMM) approach by implementing the Arellano-Bond estimator in R.

Results:

We compare the week of October 11-17 with the week of October 18-24. Canada, as a whole, had an increase in 7-day average COVID-19 cases from 1965 per 100,000 population during October 11-17 to 2043 per 100,000 population during October 18-24. Evaluating Canada’s COVID-19 at the subnational level is necessary to identify where the novel coronavirus is transmitting to prevent future outbreaks. Alberta, BC, Ontario and Manitoba had positive acceleration of cases for October 11-17 at 2.21, 1.23, .97, and .71 respectively per 100,000 population, however, these same provinces experienced deceleration one week later at -2.06, -1.06, -.71, and -.16.; Moreover, the positive jerk experienced during October 11-17 at 2.18, 1.19, 2.15 and 1.57 reversed course and jerked downward during October 18 to 24 at -4.96, -2.44, -1.39, and -.19 respectively.

Conclusions:

While Canada maintained good COVID-19 control policies that resulted in fewer transmissions, the first week of this study on October 11-17 resulted in increases in new cases, increased rates of infections, increased acceleration and jerk in infections for the most populated provinces. These same provinces reversed course whereby the number of new cases decreased, the speed of new infections decelerated, and experienced a negative jerk in COVID-19 per 100,000 population during the week of October 12-24. The surge followed by a significant decrease is consistent with Canadians celebrating Thanksgiving on October 12, 2020. While no Province or Territory has exceeded 1000 cases per day, new sources of COVID-19 expected from the pending Wave 2 of COVID-19 transmissions could result in novel outbreaks. It is not time for Canada to declare victory over COVID-19 transmissions or to be complacent just because there were decreases this past week. To that end, Canada must remain vigilant and continue implementing those policies that caused the Canadian outbreak to reverse course and decrease. Clinical Trial: NA