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photo of General Hillier

January 29, 2021 - Dr. Archer's Update on COVID-19 response from the DOM and Medicine Program

HEADLINES

All patients admitted to KHSC will undergo Covid-19 testing

1) Town Hall at KHSC with General Rick Hillier-The lead for Ontario’s vaccination program talks about Ontario’s 3-phase rollout plan

2) All about COVID-19 Vaccines: 

  • Update on global vaccination programs (click here
  • Results from Canada’s vaccine safety monitoring system provides reassurance of safety (click here), 
  • Updated FAQs about vaccination effectiveness against viral variants and safety of vaccination for people on blood thinners, with allergies or people who are immunosuppressed 
  • Updates on Canada’s vaccination program (click here)

3) KHSC received no new COVID-19 patients from Toronto but we remain on standby 

4) Provincial lockdown order for Ontario (click here) extended until February 9, 2021: Proof that it is working! (click here)

5) Ontario’s epidemic is now better controlled with a rate of test positivity of 3.3% and 1958 new cases (click here).

6) KFL&A COVID-19 rates remain amongst the lowest in the province (see update from KFL& A Public Health)

7) Canada’s COVID-19 epidemic continues to improve: 764,850 total cases to date, 4204 new cases today, 55,585 active cases (a 19% decrease week-week) and 19,634 deaths (a cumulative national case mortality rate of ~1.97%) (click here) (click here). 

8) The COVID-19 global pandemic: Global case burden has now exceeded 100,000,000 with 2,183,169 deaths (25.4 % from the USA which has only 4% of the world’s population) (click here):

________________________________________

1) Town Hall at KHSC with General Rick Hillier-The lead for Ontario’s vaccination program talks about Ontario’s 3-phase rollout plan

General Rick Hillier leads Ontario’s vaccination program. He visited us today by Zoom and thanked KHSC staff and faculty for their diligent and innovative vaccine program, which has made huge progress in vaccinating staff and residents of LTC facilities. Dr. Hillier spoke to the honour in responding to duty (in this case, our duty to care for patients and the public). He highlighted the honour in our service, whether we are vaccinators or other health care workers. He reminded us that like members of the military in a war, we will look back with pride on our contributions to the success in our battle with this virus. He stressed that like all Canadians he is anxious to complete the task, is impatient with supply chain delays and is committed to get needles in all willing arms ASAP. Being a proud Newfoundlander he also thanked all other Canadians for joining Newfoundland in 1949!

General Hillier outlined 3 phases of vaccination. 

We are in Phase 1. The focus in phase 1 is on vaccinating residents and staff in LTC facilities, followed by health care workers and certain vulnerable populations (indigenous people for example). We are currently limited in completing phase 1 by vaccine supply. However, in our region team KHSC has already vaccinated over 70% of our LTC residents and workers. Ontario will only be getting 26,000 Pfizer vaccines/week for the next few weeks, due to vaccine supply. The rest of Phase 1 will involve completing the LTC vaccination program and then rapidly moving on to vaccinate health care workers, beginning with those closest to the front line. During the week of Feb 15th Ontario supply will increase again (to an estimated 140,000 vaccines/week). In each subsequent week Ontario will get 150,000 Pfizer vaccines/week. By the of March, he estimates that ~90%+ of LTC residents and the vast majority of health care workers will be vaccinated.

Phase 2 begins April and runs to July. In this phase we will see vaccination of a) the elderly (~70-80+), b) additional communities at risk and c) essential workers. Phase 2 will likely involve opening mass vaccination sites, such as pharmacies, and adoption of new strategies, like bringing vaccines to factories serving large numbers of workers who might otherwise have trouble getting access to health care centers. In phase 2 he anticipates Ontario getting 2.6 million vaccines/month. General Hillier indicated we are primarily counting on the 2 approved vaccines. Whether the Astra Zeneca vaccine will arrive and whether the J&J vaccine will be approved remain unknown and are not yet factored into the plan for completing provincial vaccination.

Phase 3 begins in August and we anticipate completing vaccination for Ontarians by late fall. In Phase 3 (august and beyond) we will get everyone else vaccinated. Interestingly if one approximates Ontario as having 15 million people and recognizing that the vaccine is not approved for people <16 years old (yet), and that ~15% either cannot or will not take the vaccine, we have a target to vaccinate ~10.5 million people by fall. The General estimates that by the end of July we should have 8.5 million Ontarians vaccinated! The remainder will be vaccinated between August and later fall.

                                                  zoom screenshot of Dr. Hillierzoom screenshot of Dr. Pichora sitting at a desk in his office

General Hillier concluded by thanking Dr. Pichora and team KHSC!

2) All about COVID-19 Vaccines: 

  • Update on global vaccination programs (click here
  • Results from Canada’s vaccine safety monitoring system provides reassurance of safety (click here), 
  • Updated FAQs about vaccination effectiveness against viral variants and safety of vaccination for people on blood thinners, with allergies or people who are immunosuppressed 
  • Updates on Canada’s vaccination program (click here)

Here is a snapshot on how we are doing globally in administering vaccine (read out is vaccine/100 people).Israel is doing the best and Canada is in the middle of the pack)(click here).

line graph with many coloured lines on left and bar graph on right

Global vaccine progress, Jan 25th 2021

COVID-19 vaccines are in general safe. Based on the clinical trials and experience in millions of people who have been vaccinated world-wide we can be reassured of both their safety and efficacy. All the side effects (called adverse events and abbreviated AEFI) are tracked and reported weekly by the government of Canada. Here is what we have seen to date (no update since Monday) (click here):

table with 6 squares of writing and text below outlining info re vaccinations

Overall the vaccines in Canada are safe with only 27 serious adverse reactions in the >800,000 vaccines administered to date (and no fatalities).

Here are answers to some updated FAQs with answers to common questions about the COVID-19 vaccines.

FAQ 1) Does the vaccine work against the new variants (mutations) in the SARS-CoV2 virus: Short answer YES. The slide below (from Dr Evans) shows the mutated virus on the right. Each line is a mutation. Although I don’t show the data today, they show that both vaccines do introduce neutralizing antibody that are protective (albeit a little less well) against new viral variants. Fortunately, the antibodies the vaccine creates still recognize the mutated spike protein and neutralize the virus.

2 circular pie charts

On a related note, I have shown the efficacy of the Pfizer vaccine in prior notes, and today show that Moderna vaccine (which works equally well). Note the very low infection rate in vaccinated people once 2 doses of vaccines given (the blue bottom line). This is amongst the best vaccine responses seen with any vaccine (COVID-19 or otherwise).

line graph

FAQ 2) I’m on a blood thinner, can I be vaccinated for COVID-19? Short answer YES. Here is a more detailed answer from an Canadian agency with expertise on the use of blood thinners, Thrombosis Canada

memo providing information for people on warfarin and getting vaccinated

FAQ 3) I have a history of allergic reactions, can I be vaccinated for COVID-19? Short answer YES. Out of ~1.8 million vaccinations there have only been 21 reported episodes of anaphylaxis (the most serious type of allergic reaction). Most (70%) of these events occurred within 15 minutes of the vaccine (while the patient is still being monitored, as summarized in a Jan 6th MMWR CDC article). There were also 83 cases of non-anaphylaxis allergic reaction after Pfizer-BioNTech COVID-19 vaccination with symptom onset within the 0–1-day risk window. Most (87%) of these allergic reactions were classified as non-serious.

logo for Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report

So while there is not zero risk, the risk of severe allergic reactions to the Pfizer vaccine are low and manageable. Allergy testing is NOT necessary prior to COVID-19 vaccination even in people with history of allergies. It is important note that none of the people who developed anaphylaxis after vaccination died and most did not have a prior history of anaphylaxis (see table below). The incidence of anaphylaxis is lower still with the Moderna vaccine.

The adverse effects of the COVID-19 vaccines clinical trials are similar in vaccinated people vs people (in the clinical trial who got a placebo-saline injection) except for local pain at the vaccine site and increased muscle ache and headache, all of which were short-term (see below). This is a very good safety profile relative to other vaccines.

table listing side effect for people with Pfizer vaccine vs placebo

The CDC does advise against the use of the two mRNA vaccines for a very select group of people with the following allergy histories (click here):

CDC considers a history of the following to be a contraindication to vaccination with both the Pfizer-BioNTech and Moderna COVID-19 vaccines:

  • Severe allergic reaction (e.g., anaphylaxis) after a previous dose of an mRNA COVID-19 vaccine or any of its components
  • Immediate allergic reaction of any severity to a previous dose of an mRNA COVID-19 vaccine or any of its components (including polyethylene glycol [PEG])*
  • Immediate allergic reaction of any severity to polysorbate (due to potential cross-reactive hypersensitivity with the vaccine ingredient PEG)*

The table in blue below offers advice from the CDC on the issue of allergies and vaccines (see below). This is a reasonable approach and suggests careful monitoring for allergic response post vaccination; rather than avoidance of vaccination for most people with allergies.

text in a blue box re vaccine and allergic reaction

FAQ 4) I’m immunosuppressed, should I get vaccinated? This question has a less clear answer. First, be reassured is no virus (dead or alive) in the Pfizer or Moderna vaccines so it is not possible for a person to get infected from the vaccine. However immunosuppressed people were not included in the initial clinical trials. That said, they probably are safe to be vaccinated but this is more a matter of expert opinion. In Canada the National Advisory Committee on Immunization (NACI) currently advises that the COVID-19 vaccine should not be offered to populations excluded from clinical trials “until further evidence is available.” However, they also say (an immunosuppressed person or those with an autoimmune disorder can still be vaccinated if a risk assessment deems that the benefits of vaccine outweigh the potential risks for the individual.” (click here).

The British Society for Immunology recently issued a statement indicating that vaccination is safe in immunosuppressed people (click here), albeit the resulting immune response may be weaker. They remind us that because there is no virus in the vaccine there is absolutely no risk of acquiring COVID-19 from the vaccine.

memo from the British Society for immunology re patients who are immunosuppressed or compromised

Our own Dr. Mike Beyak (gastroenterology) nicely summarized evidence from a registry of ~4500 patients who were immunosuppressed for their inflammatory bowel diseases (Crohn’s disease and ulcerative colitis) at this morning’s Zoom Medical Grand Rounds (see below).

                                                 photo of ppt slide on overhead screenphoto of Dr. Beyak presenting at podium with overhead screen behind him

There was no increased risk of contracting COVID-19 in these 4500 patients. Apart for patients on prednisone, there was also no increased complications from COVID-19 when it occurred. Interestingly, some biologic therapies (antibody treatments for IBD) actually appear to reduce adverse outcomes in IBD patients who contracted COVID-19. This is not surprising since the truly bad outcomes in COVID-19 seem to occur in people who mount a hyper-aggressive immune response. 

Overall these data are good news for our many patients with rheumatoid arthritis, asthma and IBD who are on immunosuppressive therapies. However, since these people were not included in the vaccine clinical trials, it is advised they consult the physicians/clinic that is managing their care to inform their vaccine decision.

FAQ 5: How long can I wait after my first dose to get a second vaccine dose? The Ontario science table which deals with COVID-19 (on which our own Dr Evans participates) has looked at the efficacy of delaying the second vaccine dose to 42 days. It appears a second dose at day 42 is as effective in producing a neutralizing antibody response as when the dose is given at day 21 (the normal interval from dose 1). This more lenient 42-day protocol has been approved by Health Canada.

syringe and needle drawing vaccine from a bottle

Vaccination roll-out update (click here): The roll out is moving along but encountering logistical challenges and supply chain problems (notably Pfizer stopped vaccine supply entirely this week and then reducing supply for a month as it retools a factory in Belgium). To date we have not had to deal much with people declining vaccines; rather we are dealing with a pent up demand for vaccines that far exceeds supply. Mr. Trudeau has indicated all Canadians who wish to be vaccinated will be vaccinated by September (click here). 

As of today a total, 1,122,450 doses of COVID-19 vaccines (including both Moderna and Pfizer-BioNTech) have been delivered (no increase since Monday since no vaccine delivered to Ontario since then). Thus far, 80.9% of delivered doses have been administered. As of today, the vaccine tracker reports that 818,967 Canadians have received at least one dose of an approved COVID-19 vaccine (see below). At least 89,252 Canadians are fully vaccinated (count revised downward for some reason), having received both required doses (click here).

map of Canada echo province named and a red number in each province denoting the doses administered

There is some interesting sociology afoot in Canada’s COVID-19 pandemic with five broad groups of people, as defined by their approach to vaccination. 

CORRECTION:In my last note I said that people seem to be in one of four groups re: vaccines; I should have said five groups. I neglected to mention people with genuine concerns who want information, are open to persuasion and are best described as being vaccine hesitant (click here). Vaccine hesitancy has many legitimate origins, fear, prior experience, experience of one’s ethnic/racial group with the health care system etc. Some tips to address vaccine hesitancy are found in an article by Shen and Dubey (click here) and include: “presenting vaccination as the default approach, building trust, being honest about side effects, providing reassurance on a robust vaccine safety system, focusing on protection of the child and community, telling stories, and addressing pain”.

Second, there is the majority, who are largely grateful for the vaccine and are impatient with the wait for vaccination. Third, there are vaccine deniers who believe the vaccine is part of some large plot and/or strongly believe that the vaccines are untested and dangerous. They are a diverse and often angry group who are hard to convince. Their views appear to be stoked by a general distrust of government and establishments (including the medical profession). They often refute expert opinions, believing that “experts disagree”, a view promulgated by the media that they consume. A fourth group has also emerged: vaccine queue jumpers: people who misrepresent themselves to get early access to the vaccines and bypass protocols (such as the one in Ontario that prioritizes vaccination of people in LTCs) (click here). Cheating the queue may land a person in the newspapers or worse. Finally, there is a 5th group, people who are flying south to try and get American vaccines (click here). This is a bit tone-deaf (in my view) as the US government is struggling mightily under the new administration to get its vaccine program up to speed for its own residents and citizens. Many Americans are less than thrilled with visitors taking “their vaccines” (click here). It is likely unwise to travel south just for a vaccine. Canadians may not be able to easily get back on short notice and may be at substantial risk (at least financially) if they get sick while traveling abroad. The government may soon make return to Canada from elective travel more difficult. The policy for returning Canadians is as follows (click here) and requires a negative COVID-19 test:

Starting January 6, 2021 at 11:59 PM EST, air travellers 5 years of age or older travelling to Canada are required to provide proof of a negative COVID-19 molecular test taken, at their own expense, no more than 72 hours before the aircraft's initial scheduled departure time. Travellers who cannot provide proof of a negative test, or who test positive, will not be allowed to board, with limited exceptions. Canadians who are planning to travel abroad should consider how they will meet these requirements before departure, and make plans for the possibility of needing to extend their stay. Travellers who receive a negative test result and are authorized to enter Canada must still complete the full, mandatory 14-day quarantine

3) KHSC received no new COVID-19 patients from Toronto but we remain on standby 

We remain on standby to receive patients from Toronto and Scarborough but no cases arrived over the weekend or as of noon today. Hopefully with a new MacKenzie hospital opening in Vaughan (click here) and flattening of the provincial COVID-19 curve transfers will not occur in large numbers. 

4) Provincial lockdown order for Ontario (click here) extended until February 9, 2021: Proof that it is working! (click here)

Ontario update on status of covid-19 shutdowns

New Ontario lockdown rules (see last note), intensified a lockdown which began Dec 26th. These data (from a nice CBC website) shows clear evidence this lockdown is reducing new cases. The graph below shows a decline in new cases in Ontario, coincident with the post-Christmas lockdown. However, with most Ontarians unvaccinated and with no natural immunity we remain susceptible to infection as we reopen (and reopen we must). The lockdown is extended 2-weeks at a time and is currently ending (potentially) Feb 9th, stay tuned. The reopening post lockdown will require accelerated vaccination and continue good public health practices.

graph showing decline in cases in Ontario due to lockdown

Evidence that the post-Christmas lockdown in Ontario is working as of Jan 27th: a sustained decline in new cases

5) Ontario’s epidemic is now better controlled with a rate of test positivity of 3.3% and 1958 new cases (click here).

In general things are markedly improved in Ontario since the lockdown. Daily case rates are hovering slightly above 2000 (2093 today, see below). We have had a 23% reduction in new cases for the week compared to the prior week. Likewise, hospitalizations have declined 10%.

table with numbers re confirmed cases in Ontario as of Jan 27

Peel (on Toronto’s western border) remains the hot spot in Ontario with 3331.3 cases/100,000 population, as measured form the beginning of the pandemic (click here). However, a look at recent infections(infections within the past 2 weeks, expressed as cases/100,000 population) puts Windsor in the unenviable spot, once again, as being the leading site of infection:

Rate of cases/100,000 population in the past 2 weeks

Peel:412.0

Toronto:356.4

Windsor:434.1 

Ottawa:141.2

KFL&A:16.0

Cornwall: 185.9

photo of Torontos waterfront taken from the water with CN tower and rogers centre in background

Although COVID-19 is increasing in Toronto as a whole, case load is widely variable amongst neighbourhoods. The burden of COVID-19 disproportionately affects black, middle eastern and southeast Asian populations (relative to Whites) Since the pandemic began, the Thistletown-Beaumond neighbourhood has had 7,481 cases/100,000 residents, ~ 10X the burden of COVID-19 in the Beaches neighbourhood (770 cases of COVID-19/100,000 residents). When one examines recent cases, since Jan 6th 2021, case prevalence is still high-ranging from 59 cases/100,000 residents in Yonge Eglington to 1139 cases/100,000 residents, in Humbermede (click here).

We should avoid elective travel to and from these hot spots from lower prevalence areas, like Kingston.

6) KFL&A COVID-19 rates remain amongst the lowest in the province (see update from KFL& A Public Health)

The total number of cases in KFL&A since the pandemic began is now 663, not counting the prison outbreak. There has only been one death of a KFL&A resident since the pandemic began. There are 16 active cases in the community, down markedly from the 52 active cases 2 weeks agoThere is 6 COVID-19 patient hospitalized at KGH (down from 5 last week).

2 graphs with yellow bars and red lines on top of each other

COVID-19 rates remain low in KFL&A

The graph below shows how well the public health measures, and the related actions of individual residents in SE Ontario, have worked, reducing case rates back to rates seen in Nov 2020.

bar graph showing SE Ontario active cases ever 4 days

That said, COVID-19 is not so well controlled elsewhere and thus travel between regions for elective purposes should be avoided. The graph above (courtesy of Dr. Evans) shows the marked difference between Kingston (second arrow from bottom) versus Windsor or Toronto (at top) in weekly case rate and % positive test rates.

listing of Ontario districts on the left and dots with numbers on the right

Bottom line: The vaccine will ultimately protect us; however, it will take months to get a critical mass of Canadians vaccinated. Meanwhile we have to rely on good public health practices. This is the final leg of a marathon and the next 3-4 months will challenge us all to remain patient and follow policies that we acknowledge have harsh financial and social consequences. We are in a race against new viral variants that seem even more adept at infecting us. However, there is light at the end of the tunnel in the form of the vaccines.

black and white photo of tunnel with train tracks and daylight at the end of the tunnel

7) Canada’s COVID-19 epidemic continues to improve: 764,850 total cases to date, 4204 new cases today, 55,585 active cases (a 19% decrease week-week) and 19,634 deaths (a cumulative national case mortality rate of ~1.97%) (click here) (click here). 

Our second wave of COVID-19 (orange line-top panel below) has reached a plateau and after a week or two of decline in case numbers we are now seeing the expected fall in hospitalizations (table below). ~89.7 % of all cases have already recovered. There has been a 1.97% national mortality rate amongst people diagnosed with COVID-19 (see below). Canada has performed 21.67 million COVID-19 tests with a cumulative test positivity rate of 3.51%.

table with 4 boxes with text and arrows showing increase and decrease

Decline in new and active cases this week in Canada (click here).

Rates of infection have plateaued in all Western provinces (BC to Manitoba) as a result of introduction of more aggressive public health measures. Saskatchewan too has now resumed a plateau trajectory. Rates in Ontario and Quebec (home to almost 63% of all Canadians) are in a lockdown-induced decline. Rates of new infection have remained high but have stopped increasing in New Brunswick. Infection rates remain flat in the other Maritime provinces. The outbreaks in the North have been controlled with few new cases in the NWT, Yukon, and Nunavut.

4 graphs showing active cases in Canada

Active cases (orange line) have plateaued in Canada

8) The COVID-19 global pandemic: Global case burden has now exceeded 100,000,000 with 2,183,169 deaths (25 % from the USA which has only 4% of the world’s population) (click here):

There has been a total of 2,183,169million deaths and 101,211,750 million cases since the pandemic began.The number of cases has increased >6-fold since early August, 2020, when there were 16 million cases. The pandemic hot spots are in the USA, India, Brazil, and Russia, with the UK, France and Turkey in hot pursuit! (click here). A positive note is plateauing of the daily number of active cases (see bottom right orange graph).

global map with dots and ranking of countries with highest covid cases

Global COVID-19: New cases may have peaked (bottom right): Jan 28th 2021

The USA with 25,680,413 cases and 419,228 deaths tops the COVID-19 list and accounts for ~25.4% of the global pandemic (up from 21% pre-Christmas). The USA only accounts for ~4% of the world’s population (see below). There are as many cases in America as in India, Brazil and Russia combined! The COVID-19 active case map (above) shows the high incidence of active infections in the US and South America, as well as in Europe (the bigger the salmon-colored dot the higher the active cases/100,000 population). The ONLY solutions to this are adherence to public health measures and rapid, mass vaccination.

Improving USA positive test rates and extension of border closure (click here): The USA has seen continued improvement in positive test rate and is now at 8.9%, the lowest since mid-November 2020 (click here) (see below). California has a positive test rate has also decreased to 7.7% whilst South Dakota remains at a staggering 27.2% rate of test positivity today. For snowbirds: rates in Florida remain high (10.2% today). 

graph showing decline in US cases

Improvement in positive test rates in the USA

The US-Canadian border closure has been extended until at least Feb 21st, 2021 (click here). That said, Canadians can still fly to America (certain rules apply) and as discussed in my note in early December, Canadian citizens can return to Canada from America, with a number of requirements, including quarantine) (click here).

steel border bridge with Canadian and USA flag in the forefront

Regular reminders

KHSC bed capacityBed capacity is adequate with 84 beds available and good ventilator capacity (see graphic below). Our ventilator supply remains good; however, critical care beds are in short supply (see below). We are committed to providing care to the 99.9% of patients in SE Ontario who do not have COVID-19. In addition to acute care for heart attacks, strokes and trauma etc., we are continuing to provide elective care. We recognize that the term “elective care” is really a misnomer. Many “elective” patients have chronic pain and disability or suffer from cancer and other serious diseases and will not tolerate delay in care. We continue to encourage physicians to optimize the use of e-health visits. We are also reminding patients who are coming to clinics in person that unless it is essential (and approved) they need to come alone, to minimize crowding in our clinic waiting areas. That said, it remains VERY safe to attend appointments at our clinics or to come to hospital for needed care!

graphs and numbers for KHSC bed capacity

Use the Mobile Screening Tool to expedite clinic visits: Complete the COVID-19 pre-screening tool here and you will be able to “skip the line”: One way to safely expedite entry of patients into our facilities is to have all patients complete our pre-screening questionnaire before their clinic visit. This will screen out people who are sick and expedite entry to the facility for everyone. Reducing lines waiting to enter the clinics will be particularly important as colder weather arrives. The mobile screening tool only takes a few minutes to complete and you will receive an email with confirmation to bring with you, along with your appointment slip, in printed form or on your mobile device. To complete the mobile-screening in English, click here and in French, click here.

screen shot of prescreening app showing a finger scrolling on iPhone

KHSC visitor policy: One of the hardest aspects of COVID-19 care in the hospital is the need to restrict visitors to ensure we don’t import COVID-19 into the hospital. If a family member is coming in from a high prevalence area they cannot enter KHSC (i.e. they will fail the screening question). There are exceptions made for exceptional circumstances; but this policy is necessary to prevent importation of infection to the hospital which would impair our ability to care for all patients. A very few cases of COVID-19 can paralyze the hospital, particularly if they are brought in by visitors and then spread undetected. All details on the policy can be found using this link (click here). 

COVID-19 testing at Beechgrove Community Assessment Center: (click here): All COVID-19 test must be scheduled appointments (versus walk in). Appointments can be scheduled using our on line scheduling system. Before booking a test, individuals should complete the online tool to determine whether they qualify for testing (click here). The Beechgrove Complex is south of the King St. West/Portsmouth Avenue intersection. Signage will direct people through the Complex to the Recreation Centre building at 51 Heakes Lane for walk-in testing. Operating hours: Testing hours will return to 9 a.m. to 4 p.m. daily. To be tested you will require: A valid Ontario health card or a piece of photo identification. You must also wear a mask and maintain physical distancing at all times while in the walk-in line (click here).

animated photo of female getting a nasal covid swabthree young boys dressed a doctors with their arms crossed and wearing stethoscope

Because health care workers (doctors and staff) are increasingly having to miss work because their children have been sent home from school or daycare with symptoms of a upper respiratory tract infection, we have arranged that their children can access expedited testing at Beechgrove . The goal of this service is simply to allow the healthcare worker to return to work as quickly as possible for the public good. The children of staff will be tested between 1230 -1300 by appointment, 7 days/week. The new program for families applies to children up to age 18, an includes children of staff and physicians who provide clinical care and service. Staff and physicians themselves should contact occupational health to book their testing appointment. To book an appointment for a child, KHSC staff should call 613-548-2376. Testing of clinical staff and faculty and their children is processed at the KHSC lab with an average turnaround time of less than 24 hours.

Increased outbreaks and deaths in Long Term Care facilities (LTC): As discussed in many prior notes, most COVID-19 deaths occur in people who are not only old but who are also frail and live in nursing homes and LTC. As of today, the 3462 deaths in nursing homes (up 126 deaths since Monday) account for ~57.3% of all deaths in Ontario, click here. There are also ~ 1041 active cases in LTC residents and 938 active cases in LTC staff (numbers for both decreasing for the first time in recent months)! In the last month the rate of death amongst LTC residents has continued to increase daily and is now >100/week! Outbreaks in nursing homes usually imported by a person coming in from the community (health worker or family) acquiring the infection and importing it into the facility. Thus, protecting LTCs is best done with a combination of reducing community spread of COVID-19 and ensuring single occupancy rooms in LTCs (as well as appropriate pay for PWS workers, provision of PPE and rapid testing capacity). It is because of these grim statistics (see below) that the province has prioritized vaccination of health care workers and residents of Ontario’s LTCs.

three senior citizens sitting around a table wearing maskstable of covid data in LTC

COVID-19 in toddlers and young children: (click here). School is back (in 7 regions) and with this a return to reporting on COVID-19 in schools. Below is the new baseline report for school age children in publicly funded Ontario schools. School boards report every weekday from Monday to Friday. There have been 5140 students with COVID-19 since the pandemic began (see below).

4 young teens sitting on a bench using iPads and iPhonestable showing number for school related covid casesphoto of young children sitting on the floor in a classroom

Here are the parallel data from licensed child care facilities in Ontario-where there have been 1062 children infected since the pandemic began.

table with numbers for covid cases found in children in licensed child care centres

Stay well! 

 

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