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Even with strict measures in place in Canada to slow the spread of the novel coronavirus, between 11,000 and 22,000 people could die over the course of the pandemic, according to federal models released Thursday.

The models from the Public Health Agency of Canada (PHAC) show that under a best-case scenario, one per cent of the Canadian population, or 376,000 people, could become infected with COVID-19. As of April 8, there are 19,774 confirmed cases, and 461 have died.

Under a scenario where nothing is done to stop the virus from spreading, roughly 30 million Canadians, or four-fifths of the population could ultimately become infected and 350,000 could die before the pandemic is over.

“We cannot prevent every death, but we must prevent every death that we can,” Chief Public Health Officer Dr. Theresa Tam said Thursday during a briefing on Parliament Hill in Ottawa.

“Put that image in your head of what could happen...it is a matter of life and death.”

A slide from the Public Health Agency of Canada's models of the coronavirus pandemic show that with strong measures in place, between 2.5 and five per cent of Canadians could become infected, leading to between 11,000 and 22,000 deaths. With no controls, deaths balloon to the hundreds of thousands. PHAC screenshot

'Put that image in your head of what could happen'

The models illustrate a grim reality: that more Canadians are likely to die from this virus in the coming months, even as governments across the country take unprecedented steps, like closing borders, shutting down businesses and prohibiting all gatherings.

With a holiday weekend in Canada coming up, Dr. Tam pleaded with Canadians that they must avoid having any friends or family over for religious celebrations, despite the temptation to do so.

“These stark numbers tell us that we must do everything that we can now to remain in the best-case scenario, to stay in the lower range.” she said.

Still, officials stressed that the models are imperfect. Deputy Chief Public Health Officer Dr. Howard Njoo said they were “not a crystal ball.”

“We cannot prevent every death, but we must prevent every death that we can." Canada releases coronavirus models showing tens of thousands of people could die even with strict measures in place to slow the spread of the disease.

PHAC used two kinds of models in its calculations: "forecasting" models, for estimating how many new cases of COVID-19 can be expected, and "dynamic" models, for illustrating the impact that different actions will have on that caseload.

These models have a built-in limitation: they simulate a controlled scenario. The real world can be less predictable.

While data and models can help paint a picture, Dr. Tam said, the collective efforts of Canadians going forward is critical. “Models are highly sensitive to our actions,” she said.

Measures such as staying home as much as possible and practicing a "high degree" of physical distancing, which means staying at least two metres away from other people, can help buy time for Canada to better understand COVID-19 and develop treatments and vaccines.

Don't travel, says B.C. health minister

Provinces have been conducting their own modelling and the federal models are a composite picture of those, and include different measurements such as a variable attack rate of the virus.

Federal Health Minister Patty Hajdu had previously said that Ottawa had been waiting for the provinces to release precise data before it could compile and release Thursday's models.

The outbreak in Canada is highly regionalized, with 94 per cent of cases and 98 per cent of deaths concentrated in four provinces — Quebec, Ontario, British Columbia and Alberta.

In B.C., where there are 1,336 confirmed cases and 48 people have died, health officials released modelling data at the end of March showing that the province was closer to South Korea when it came to the spread of the virus, with hospitals able to deal with the influx of patients.

Under a scenario more like the spread in Italy, the model showed that B.C. would still have a sufficient amount of ventilators but all hospital space would be taken up and some sites would become over-crowded, requiring patients to be shuffled around.

On Thursday, B.C. Health Minister Adrian Dix released a joint statement with Alberta Health Minister Tyler Shandro asking Albertans and British Columbians not to travel to either province for the upcoming holiday weekend.

While many people in both provinces have family and friends on either side of the provincial border, they said, “this long weekend is different."

"These are extraordinary times. A global pandemic puts us all at risk, and we all must stay home, stay in our communities and stay at a safe physical distance from others when outside," they said.

“Let us be clear: Staying home means no travelling, especially across our borders. Instead, we encourage everyone to find ways to connect virtually this long weekend, including by video chat or with phone calls."

A slide from the Public Health Agency of Canada's models of the coronavirus pandemic show that the short-term trajectory anticipates between 500 and 700 deaths by April 16. PHAC screenshot

Between 500 and 700 deaths next week

The government’s short-term epidemic trajectory predicts between 22,580 and 31,850 cases of COVID-19 by April 16. This means Canada could reach between 500 and 700 total deaths by that date.

Compared to other countries, the outbreak is at an early stage in Canada. Officials pointed out that several countries had hit 500 cases before Canada saw community transmission.

Although the data is very preliminary, it appears the epidemic curve is starting to bend toward cases doubling every five days, instead of every two days.

The virus, however, is expected to attack Canada in waves. With early epidemic control, the first wave could crest by this summer. But future waves could come in the fall and winter, and Canadians should be prepared for control measures to continue.

Dr. Njoo declined to speculate if the summer will bring any relief on its own, pointing out that "summer" means different things depending on where one is in Canada.

Dr. Tam said the model showing between 11,000 and 22,000 deaths even with strict controls will be calibrated as the outbreak evolves. The government is monitoring the trajectory of the virus daily and adjusting as needed, she said.

Does anyone really believe these numbers?

The death numbers are probably correct or nearly so. Case numbers are undoubtedly severely underreported, because so little testing has been done.