As of late May, most countries have falling numbers of new cases of COVID-19 and are at various stages of easing lockdown orders. This seems a good time to look back on the pandemic experience so far and at what lessons we can apply going forward. Waiting to Be Seen will do so in a series of posts looking at lessons learned and innovations that resulted from this intense first phase.

I’d like to start with a focus on ED safety. Back in March, Canadian emergency physicians were anxious; reports from Wuhan, China, and from northern Italy included tales of overwhelmed hospitals, exhausted staff, and illness and deaths among health care workers.

As Ontario’s “Expert Lead” for emergency medicine, I have been deeply involved in the province’s response to and experience with COVID-19.

As of May 26th, we’ve had 26,483 cases and 2,155 deaths in Ontario, which translates to a very high case fatality rate of 8.1 per cent.

This likely represents both an undercount of community cases due to testing limitations and a high attack rate among the most vulnerable of patient groups: the institutionalized frail elderly in our long-term care and retirement homes.

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