Canada's chief public health officer says hospitalizations and deaths from H1N1 virus have spiked this week and is warning that there will be more deaths to come. But some infectious disease experts are saying the second wave may already be cresting.
Dr. David Butler-Jones told reporters Thursday that hospitalizations, intensive-care unit admissions and deaths from swine flu are three times higher this week than last.
He said infections are surging across the country, with the western provinces, the territories and Newfoundland and Labrador hit particularly hard.
"We expect to hear of more illness and deaths in the coming weeks as we go further into the second wave," Butler-Jones told a Thursday news briefing.
But infectious diseases expert Neil Rau suggests that in many areas of the country, the "second wave" may have already peaked.
Rau says in parts of Ontario, the number of flu-like illnesses being reported by doctors is actually falling, and in B.C., the numbers suggest that they're at the tail end of their peak of flu activity.
On Thursday, health officials in eastern Ontario said the spread of H1N1 was clearly waning, with data showing emergency room visits and school absenteeism returning to normal levels.
"This outbreak actually peaked seven to ten days ago," Dr. Richard Schabas, medical officer of health for the Hastings & Prince Edward Counties Health Unit, said in a press release. "We've been watching the number come down for a few days now."
"We can expect to see the same pattern across all of southern Ontario over the next week or two."
Rau echoed those statements earlier.
"In Ontario, yes, we started having a rise in the number of cases, lots of school absenteeism and so on, but it's actually hit its peak. And once it's after the peak, there's less and less new transmission going on," Rau told Canada AM Thursday morning
Rau says he's not surprised to see death numbers rising, but notes that is not an indication that the virus is spreading wildly.
He points out that flu viruses usually take a few days to incubate and a person can often be hospitalized or die many days after being infected. So deaths can be a sort of "lagging indicator" of a virus' spread.
"What can end up happening is that even as an outbreak is getting better, the death counts can still rise. So people can look at those deaths and think it's getting worse, when in fact, it's getting better," he said.
But Butler-Jones says he still expects flu activity this fall to surpass the high point seen during the virus's first wave in June.
"We're now, as of last week, we were below the peak weeks of June," he said. "Now we're catching up. So we're not quite there yet, but over the next few weeks we're going to see perhaps what we saw in June.
He added that he hopes that by then, enough Canadians will be immunized "that we can slow this down." He added that there is still lots more illness to come.
"Anybody that thinks that we've seen anything but the beginning of this, I think it would be lovely, but it's a bit of wishful thinking," Butler-Jones said. "This will continue to increase."
The Public Health Agency of Canada reports that, as of Nov. 3, swine flu had killed 101 people.
More than 1,700 people have been hospitalized with swine flu since the H1N1 virus appeared in April.
Seasonal flu, by contrast, sends about 20,000 Canadians to hospital each year and between 4,000 and 8,000 Canadians die of flu complications each year, depending on the severity of the season.
