July 8, 2020 - Dr. Archer's Update on COVID-19 response from the DOM and Medicine Program
Important update (new masking policy ramping up for full implementation on July 14th)
New mask policy begins by July 14th: For consistency we will be shifting to a policy of universal masking for all patients, staff and the public in all locations in the hospital, beginning July 14th. As a result masks will be provided at entrances to the hospital facilities, improving ease of acquiring a mask. When this policy begins you (as a staff member) will be given a reusable medical grade mask and paper bag in which to store it. You can reuse your masks if they are not damaged. Masks will be required at all times (except when alone in a private office). This will apply in all spaces, including Tim Horton’s, the lobby etc. The policy will be gradually implemented starting today and being complete by Tuesday (stay tuned for more detail). Exceptions to mandatory masking will include children under age 2 years, or if wearing a mask exposes a person to a mental or physical risk (i.e. severe asthma, allergic reaction, underlying anxiety/metal health issue). If an exception is to be sought by an employee you will need prior approval for the exception from Occupational Health (otherwise entrance to the facilities will be denied). Face shields may be permitted as an accommodation as a mask alternative. The goal of this policy is modeling consistency for the public. It is less clear scientifically if this will alter our local epidemiology, which remains favourable. This is one of the challenges of the pandemic-erring on the side of caution, even though it is inconvenient.
Local COVID-19 Update KFL&A: As everyone likely knows we have had a local outbreak of COVID-19, largely related to infections acquired in nail salons. This outbreak now appears to be contained. This outbreak, though unfortunate, does not indicate a reversal of the gradual improvement in the epidemic we are seeing across Canada and in Ontario. It is not a cause for panic, although it has triggered a change in public policy, requiring public masking in indoor spaces (at Queen’s University and in all places of business in our region). It is also a reminder that the virus is circulating and maintaining physical distancing and hand washing (plus masking in indoor spaces) are required.
There are no new cases today. Thus the running total for the epidemic is now 105 cases in the KFL&A region, with 68 cases recovered (see update from KFL&A Public Health) (Table below). Over the past 2 days we have performed 1040 SARS-CoV-2 tests and there were no new positive tests (good news). Our test positivity rate in KFL&A continues to fall. The Leon’s Centre testing facility is available for community members to be tested (click here).
There is one patient with COVID-19 in KHSC on Connell 3. All other cases are recovering from COVID-19 in the community. The Davies 5 quarantine has been lifted and there was no evidence of transmission related to the single staff member who had contracted COVID-19 two weeks ago.
KHSC has good capacity to deal with a potential COVID-19 surge, with adequate beds and ventilators on hand.
Symptomatic KHSC staff: Should KHSC staff develop symptoms consistent with COVID-19, do not come to work! Please contact occupational health and safety and they will tell you how to proceed (ext 4389 at KGH site, or email COVIDrtwadjudication@kingstonhsc.ca). You will likely be tested at the Hotel Dieu testing centre.
Ethics of health care in the COVID-19 era: This article summarizes a consideration of the need for our health care policies to balance prevention of the spread of COVID-19 with the health care needs of the 99.9% of the population that do not have COVID-19 (click here). Thanks to Renate Ilse for the invitation to write this article.
Kingston’s COVID-19 outbreak (click here) Our disease prevalence in the KFL&A region has risen to 48.9 cases/100,000 population. Toronto still has a rate ~8 times higher (433 cases/100,000 population). The prevalence in Toronto has increased every day for the past month, reflecting neighbourhood hot spots. Provincially the epidemic is in decline (see bar graph below). There were “only” 118 new cases yesterday (up 0.3% from yesterday). Ontario has had a total of and 36,178 total cases and 2689 deaths to date. The 0.9% rate of positive SARS-CoV-2 tests remains at the lowest rate to date. All good news!
The prevalence of cases in Toronto is still increasing daily due to over a dozen neighbourhoods which are COVID-19 hotspots, defined as rates over 1000 case/100,000 (click here), including: Moss Park, Newton Brook West, Yorkdale Glen-Park, Downsview Roding CFB, Maple Leaf, Rexdale-Kipling, Black Creek, Mount Olive, Beechborough, York University Heights, Mount Dennis, Glenfield Jane Heights, and Weston. Humber Heights-Westmount with 1772 cases/100,000 remains the highest prevalence neighbourhood in Toronto. The ministry has deployed public health experts, mobile testing facilities and contact tracers to deal with these “epidemics within epidemics”.
How’s Canada’s epidemic going? We have had 106,284 cases of COVID-19 in Canada and 8720 deaths (see below). As seen below, women (pink) are more often infected (but men have higher mortality) (top left below). The number of active cases per day is declining slowly (bar and line graphs, right upper and lower panels). Quebec remains the hot spot with more active cases than the rest of the provinces combined (below left-in the gold part of the bar).
Canadian aggregate data July 8th
The epicentre for COVID-19 mortality remains our long term care facilities (LTC) (see today’s data below). The ~78,000 residents of Ontario’s LTC facilities account for less than 0.5% of the population but they account for 68% of all deaths from COVID-19! There have been 1822 deaths to date; with 1 death since yesterday. Canada had the highest rates of mortality in LTCs of any survey country. 81% of all COVID-19 deaths occurred in residents of LTCs (click here)! This is sad, embarrassing and requires rapid change in how we license, fund and monitor LTCs.
Testing for SARS-CoV-2 (click here): We have tested 8.58% of all Canadians (3,274,565 people). Nationally, 3.24% of all tests are positive (vs 2.31% in Ontario). Ontario SARS-CoV-2 testing (see below) continues at a rate that exceeds the national average, with a rate of 10.93%.
The COVID-19 pandemic is approaching 12 million cases. The pandemic hot spots are in the Americas (Brazil and USA), Russia, UK and India (click here). The global case total is 11,884,799 and the number of death is 544,996 (click here). Here are the countries with more than 100,000 cases (note America and Brazil where the disease is rampant)!