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Premier Doug Ford sitting at a microphone

May 13, 2021 - Dr. Archer's Update on COVID-19 response from the DOM and Medicine Program

Headlines

1) Stay home order extended to June 2nd

2) What is it like to have COVID-19 (click here)? The story of a family infected by the virus and the reality of being transferred from Scarborough to KHSC on a ventilator

3) What we know about vaccine induced thrombosis and thrombocytopenia (VITT) (click here) (click here)

4) KFL&A update: vaccine rates high (47%) and new infection rates falling (see update from KFL& A Public Health)

5) Accelerated 2nd dose vaccination for ~1400 health care workers-booking links offered this afternoon (if eligible)-May 17th-June 8th.

6) World vaccine roll-out tops 1.37 billion people (click here)! 

7) Wave 3 begins to subside as Ontario infection rates fall with 2759 new cases and a 5.7% positive test rate (click here(click here): 

8) Canada’s COVID-19 epidemic shows a decrease in new and active cases (down -11 and -6%, respectively) and hospitalizations (-7%) but there are hot spots in Nova Scotia and the Northwest Territories (click here) (click here): 

9) The global pandemic continues to escalate: ~160.6 million cases and 3,334,587 deaths to date and new case rates on the rise, particularly in India (click here): 

10) COVID-19 Vaccines FAQ: Can I take a different second vaccine for COVID-19? (click here)

11) Continued Improvement in COVID-19 in Ontario’s Long Term Care facilities (LTC)…2 deaths in the past week-evidence vaccines working: click here

Reminders

Helping India The Department of Medicine has collaborated with the Red Cross through a fundraising page to help support the Red Cross efforts on the ground in India. To date we have raised over $7000. This funding will provide COVID-19 education, hygiene items and handwashing stations as well as supporting the health care system and quarantine centres. You are most welcome to join us in this effort and will receive a personal tax receipt form the Red Cross Canada.

fundraising poster for India showing young boy on bicycle receiving care package from Red Cross worker
  • All patients admitted to KHSC will undergo Covid-19 testing and all people entering the hospital will be required to wear medical grade masks.
  • Ontario Website open to book vaccines for people over age 40 for all people and is now open for people ages 18-44 in hot spots https://covid-19.ontario.ca/book-vaccine(click here). 
Screenshot of vaccine registration page
  • Universal masking:All patients and visitors to KHSC will be provided with medical masks at the doors of KHSC (to replace their cloth masks upon entry). Please wear your mask beginning on the front steps Do not enter the building without your mask on. Please be polite to the screeners-they are there to keep us all safe!

1) Ford government extends Stay home order extended to June 2nd (click here)

Doug Ford sitting at microphone

There is little need for text-Mr. Ford’s press conference (click hereis self-explanatory. Ontario needs to increase vaccination rates (targeting 65% of all residents over 18 by end of May) and demonstrate a fall in rates of hospitalization and new case numbers to permit a sustained reopening while avoiding wave 4. I suspect we will need to see new case rates fall below 1000/day before the province reopens.

2) What is it like to have COVID-19 (click here)? The story of a family infected by the virus and the reality of being transferred from Scarborough to KHSC on a ventilator.

family photo of four

3) What we know about vaccine induced thrombosis and thrombocytopenia (VITT) (click here) (click here)-any why the Astra Zeneca vaccine is still a safe and effective Many provinces including Ontario have put a hold on using the AstraZenca vaccine because of a rare complication called VITT (click here), which involves unusual clots in veins in the brain and elsewhere. In my opinion this decision is unjustified. However, I acknowledge this is a challenging public health policy. We do not yet know whether the province will approve the use of a 2nd dose of AstraZeneca in those who already received a first dose. I present a summary of the data below to help inform you. 

title of research papertitle of editorial
  • The risk of VITT in Canada as of May 8, 2021 is estimated to be approximately 1 per 55,000 doses (click here).
  • There is tremendous and unexplained variation in the incidence of VITT between countries, ranging from 1 case per 26,500(Norway) to 1 case per 127,300
  • No major safety warnings, other than rare anaphylaxis, were reported in the A-Z clinical trials with tens of thousands of adults.
  • Cerebral venous thrombosis occurs (as seen in VITT) spontaneously in people who are not vaccinated! The incidence of cerebral thrombosis of the venous sinuses in the head is 0.22-1.57/100,000 unvaccinated people which is similar to the incidence of VITT post vaccine (1 case per 100,000 exposures). This raises question about the extentto which the AstraZeneca vaccine actually increases the incidence of cerebral venous sinus thrombosis above that seen normally in the general population
  • The European Medicines Agency has identified 169 possible cases of cerebral venous sinus thrombosis and 53 possible cases of splanchnic vein thrombosis among 34 million recipients of the AstraZeneca vaccine
  • Adverse reactions to the AstraZeneca vaccine (as tracked by Canada) are lower than with the other COVID-19 vaccines
  • Immune thrombocytopenia and bleeding (without thrombosis-clots) have also been reported with Moderna and Pfizer vaccines. The European Medicines Agency has reported 35 possible cases of VITT among 54 million recipients of the Pfizer–BioNTech mRNA vaccine,and 5 possible cases of cerebral venous sinus thrombosis among 4 million recipients of the Moderna mRNA vaccine.
screenshot of tweet re risk of astra Zeneca

4) KFL&A update: vaccine rates high (47%) and new infection rates falling (see update from KFL& A Public Health)

The flow of patients from Toronto is slowing but we still have 21 patients with COVID-19 at KHSC; 12 on critical care and 9 on Medicine’s COVID-19 ward, Connell 3. We also have 17 patients who are admitted, recovering from COVID-19 (green bar, see below). 

various colourful graphs showing bed availability at KHSC

KHSC has adequate bed capacity for care of local patients

The total number of cases of COVID-19 in KFL&A since the pandemic began is 1454, not counting the resolved prison outbreak or people from other regions. This is up 34 cases in the past week. There are now 124 active cases in KFL&A, similar to last week (see below). There are 5 residents of KFL&A in hospital. At KHSC the other 18 COVID-19 patients are from the greater Toronto area (GTA). To date we have cared for 133 patients from the GTA with COVID-19 at KHSC. 

Our lab has done 1971 SARS-Cov-2 tests and the positive rate is 1.3% See green line below; courtesy of Dr. Evans).

very jagged line graphs up and down

There have been three deaths of KFL&A residents since the pandemic began but we have had several additional deaths at KHSC of non-resident patients. In Leeds Lanark Grenville county there have been 58 deaths with 8 deaths in Hastings-Prince Edward County. There are currently 239 active cases in the region, which is a plateau (see below). 

blue bar graph with red dotted line

Active cases of COVID-19 in SE Ontario

47.1% of people in KFL&A over age 16 years of age have received at least 1 dose of a vaccine (see update from KFL& A Public Health)

table showing current vaccine data in KFLA phase 2

We are still seeing active community spread. Most cases in KFL&A are due to variant strains of the SARS-CoV-2 virus (see above-lower panel)

5) Accelerated 2nd dose vaccination for ~1400 health care workers-booking links offered this afternoon (if eligible)-to be administered May 17th-June 8th.

screenshot of title stating expedited 2nd vaccines for high risk health care workers

High-risk health care workers at KHSC who are eligible for the shortened second-dose interval mandated by the province will begin receiving booking appointments this afternoon. This uses new vaccine supply and does not deprive any people of their planned access to first doses of vaccine. Staff and faculty please watch your e-mail for your invitation and please do not share your invitation with anyone else-it is not transferable. These vaccines will occur over a 3 week period. ~1400 eligible health care workers are eligible, including (per province)

  • All hospital and acute care staff in frontline roles with COVID-19 patients 
  • All patient-facing health care workers involved in the COVID-19 response
  • Medical First Responders
  • Community health care workers serving specialized populations including:
  • Long-term care home and retirement-home health care workers, including nurses and personal support workers and Essential Caregivers
  • Individuals working in Community Health Centersserving disproportionally affected communities and/or communities experiencing highest burden of health, social and economic impacts from COVID-19
  • Critical health care workersin remote and hard to access communities, e.g., sole practitioner

Home and community care health care workers

6) World vaccine roll-out tops 1.37 billion people (click here)! 

colourful horizontal bar graphs

Vaccines are they key to ending COVID-19 and the graph above shows some vaccine champs (China in the lead). Unfortunately, the good news about progress in vaccine administration largely applies to a few countries (China, UK, USA, Canada, Israel). If we show not the total number of vaccines given but the number given per 100,000 residents, it becomes clear that India (and most of the world, especially Africa) has had little vaccination.

colourful horizontal bar graphs

Note very low vaccine rates in African countries and in India (vaccines/100 people)

There is real world evidence that the vaccines work. Look at the fall in confirmed COVID-19 cases in the USA, UK and Israel where vaccines have been widely deployed; vs India (where they remain scarce). The per cent of Indian people vaccinated remains low and the country is paying a high price with people dying rapidly. Suffering is intensified by shortages of basic supplies like oxygen. Canada is beginning to show benefits of our vaccine program (green line below).

colourful line graphs

Vaccinated countries head toward a post-COVID-19 era with low rates of infection (see USA, UK, Israel); not so for India May 13th 2021

There is “made in Canada”, evidence that the vaccines are safe. Below are the Canadian vaccine safety data for all vaccines (updated May 7thclick here). After > 13.4 million vaccinations in Canada there have been 3,800 individual reports of vaccine side effects (0.028%). Only 748 side effects were serious (0.006% ) and there has been an uncertain number of cases of VITT (estimated), and 2 people with VITT have died.

six text boxes with numbers and text

Amongst vaccinated Canadians adverse events were most common among those ages 18 to 49 years (47.0%), and usually occurred in females; 4-times more often than males (47.9 vs 11.5/100,000, respectively).

purple bar graphs with table of numbers underneath

Vaccine complication rates observed thus far in Canada make it difficult to understand the sidelining of AstraZeneca vaccine, since it does not have a higher complication rate than other vaccines (above).

The bottom line: If you get vaccinated you have less than a 6/100,000 risk of a serious allergic reaction and only two people has died from a COVID-19 vaccine in Canada. In return you get >90% protection from a serious COVID-19 infection and almost complete protection from a COVID-19 death. 

7) Wave 3 begins to subside as Ontario infection rates fall with 2759 new cases and a 5.7% positive test rate (click here(click here): 

red line graph with numbers at each dot

Weekly rolling average of new cases show wave 3 is subsiding (courtesy of Dr. Gerald Evans)

New and active cases are down 18% and 14%, respectively, reflecting the stay home order and increased rates of vaccination (see below). The 12% decline in hospitalization (now 1632 hospitalised COVID-19 patients) is also gratifying.

salmon coloured bar graph

8) Canada’s COVID-19 epidemic shows a decrease in new and active cases (down -11 and -6%, respectively) and hospitalizations (-7%) but there are hot spots in Nova Scotia and the Northwest Territories (click here) (click here): 

map of Canada with surrounding waterssalmon coloured bar graphs with 4 text boxes underneath

With many provinces having enacted stay home orders and with rising vaccine rates in Canada we are seeing new and active case rates fall modestly and hospitalizations decrease 7% (above). This will only be sustained if we follow public health rules while we await vaccination!

various types of graphs

COVID-19 in Canada May 13th, 2021 (high rates of active cases in NS and NWT-above left)

To date we have had 1,309,316 cases of COVID-19 since the pandemic began. The case mortality rate is 1.5% with 24,804 deaths. The current hospitalization numbers are much higher than in the 2nd wave of COVID-19 in late 2020 (with 3773 people in hospital today-down from >4100 on Thursday last week). We have done ~33.7 million COVID-19 tests with a cumulative positive test rate of 3.87%. We each need to do our part to keep the health care system afloat so that people who do not have COVID-19 can continue to receive essential health care. The state of hospitals is slowly improving. 

Rates of COVID-19 remain sharply increased in both Nova Scotia and the Northwest Territory and these jurisdictions have ordered much tighter public health rules; which is the only defense to community spread until their residents are vaccinated.

Canada’s vaccination roll-out: 17.1 million vaccines have been administered thus far (41.6% of population have received at least 1 dose) (click here): To date, 20.2 million doses of COVID-19 vaccines have been delivered and 84.8% of delivered doses have been administered. This vaccine gap reflects recent arrival of vaccines but also our relative inability to quickly administer the vaccine to patients (although 242,000 people per day are being vaccinate). 1,327,899 Canadians are fully vaccinated (click here).

9) The global pandemic continues to escalate: ~160.6 million cases and 3,334,587 deaths to date and new case rates are on the rise, particularly in India (click here): 

satellite image of earth from spacenumber graphics

COVID-29 May 13th, 2021: a global snapshot 

The USA is a success story: The pandemic is improving in the USA largely due to an effective vaccine program. America now has a 3.6% positive test rate (up from 3.1% on Monday) (click here; see below). The American turnaround should offer hope to Canadians-this should be us in 2-3 months!

10) FAQs-answers to common questions about the COVID-19 vaccines:

grey human figure holding hands to head with orange question marks surrounding head

FAQ 1: Can I take a different second vaccine for COVID-19 (click here)

Chances are you can mix and match (i.e. one shot Pfizer; one shot AstraZeneca); but the science is not in yet. Researchers in Britain have launched a study to determine if it’s safe and effective to mix different vaccines (Pfizer and A-Z) that protect against SARS-CoV-2, the coronavirus that causes COVID-19. Participants will be allocated, at random, (rather like a flip of a coin) to receive one dose of one approved vaccine and a second dose of either the same approved vaccine, or a dose of a different approved vaccine. Participants will also be allocated at random to the timing of receiving these doses – some will get a boost dose four weeks after the first dose and some will get a booster at twelve weeks. Some believe that one vaccine type (mRNA vs adenoviral) may be better than the other in triggering the various aspects of the immune response. While we await the research results, I would suggest taking the two doses of the same vaccine brand (but stay tuned for updates).

FAQ 2: I’m pregnant, should I get the vaccine? 

Vaccination is recommended for all women who are pregnant or breast feeding at any time in pregnancy unless there is some specific reason not to be vaccinated. The reason for this advice is that the mRNA vaccines for COVID-19 appear to be safe in pregnant women (click here) whereas COVID-19 has higher morbidity (is more severe) when contracted during pregnancy.

pregnant woman getting vaccine from healthcare workertext screenshot with graphs re pregnancy and vaccines

FAQ 3: New FAQ: Does one dose of vaccine provide protection from COVID-19? Short answer: yes (within 2 weeks). Pfizer vaccine confers 80% immunity within 2 weeks of first shot (click hereA real world study by the U.S. Centers for Disease Control and Prevention (CDC) evaluated the vaccines’ ability to protect against infection, including infections that did not cause symptoms. The study looked at the effectiveness of the mRNA vaccines among 3,950 participants in six states over a 13-week period. About 74 % of people had at least one shot, and tests were conducted weekly to catch any infections without symptoms. BothCOVID-19 vaccines developed by Pfizer-BioNTech and Moderna reduced risk of infection by 80% two weeks or more after the first shot. Immunity rises to >90% 2 weeks after the booster shot. This is reassuring, since Canada has spread out the interval from 1 month to 4 months, due to limited vaccine supply, as we try to get more people their 1st shot.

FAQ 4: If I have a solid organ transplant or I am a cancer patient should I have my second vaccine dose at the original interval? 

The short answer is yes (although it is not based on clinical trial data). Emerging “real world” data (aka experience) suggests that transplant recipients and active cancer chemotherapy patients (with specific treatment and timing considerations) are now eligible to have their 2nd dose of COVID-19 vaccine at the original interval (<30 days from dose 1); rather than the revised 16-week interval. KHSC is currently in the process of operationalizing this new recommendation (which was issued at noon today).

FAQ 5: Which vaccine will/should I get? The short answer is that all vaccines effectively prevent COVID-19 death and severe adverse outcomes-so take the one that you are offered. They are all safe. That said, the vaccine someone receives will depend on your age, where you live and where you are vaccinated. The AstraZeneca-Oxford vaccine, which has an overall effectiveness of 62%-vs >90% for Moderna and Pfizer, will be administered mostly through pharmacies and primary care clinics, as will the Johnson & Johnson vaccine (I suspect). This is the case because they both can be stored safely in a regular freezer (click here). The AstraZeneca vaccine is recommended for people between 18-64 years of age. The mRNA viruses (Pfizer/Moderna) are recommended for people over age 64 years. The advantages of getting a vaccine earlier (even if it’s a little less effective) outweigh waiting longer for a more effective vaccine. This is especially true since all vaccines seem to prevent death and severe COVID-19 complications. Emerging data show that the Astra-Zeneca vaccine is safe and effective in people over age 70 years (based on real-world data emerging from its use in the UK) (click here). In the recent US study it was over 90% effective in preventing severe COVID-19 and prevented death with 100% effectiveness!

FAQ 6: Which COVID-19 Vaccines have been approved by Health Canada? Currently Canada has 3 approved vaccines: Pfizer, Moderna, and Astra-Zeneca (as of last week). The Astra Zeneca vaccine was approved on Friday and may arrive as soon as Wednesday (click here). Canada is expecting 445,000 doses of this vaccine this week. The vaccine appears to prevent COVID-19 spread and severe COVID-19 pneumonia and death; however, it has the lowest effectiveness overall (62% protection). The J&J vaccine was just approved by the FDA in the USA (click here). It has not been approved in Canada yet but this is expected to occur in the next 2-3 weeks. The J&J vaccine has several advantages. In a study with people in 3 continents one dose of J&J was 85 per cent protective against the most severe COVID-19 illness and the safety profile was as good as other vaccines. The J&J vaccine is a single shot vaccine (unlike two shots for Pfizer and Moderna). In addition, it can be stored in a simple office refrigerator, allowing it to be rapidly deployed in the community. The bottom line: All approved vaccines are protective against severe adverse outcomes and I would advise you to take the first vaccine you are offered!

FAQ 7: Does the vaccine work against new variants (mutations) in the SARS-CoV2 virus? Short answer is a qualified YES. The vaccines work albeit not quite as well for the variants. In the 144,000 participants in all randomized clinical trials of vaccines to date, those receiving any active vaccine had only 3 cases of severe COVID-19 (vs 37 in the control group). There were no deaths in people who were vaccinated with any of the vaccines versus 5 deaths in the control group. Even though absolute protection is slightly less for UK and South African variants the vaccines (including the AstraZeneca vaccine and J&J) prevent serious adverse outcomes (like hospitalization and death). Thus, despite variant viruses the vaccines are lifesavers!

FAQ 8: 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 from thrombosis Canada for those getting vaccines

FAQ 9: 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 (which is why you will be monitored for this period of time post vaccine). There were also 83 cases of non-anaphylaxis allergic reaction after Pfizer-BioNTech COVID-19 vaccination with symptom onset within a 0–1-day risk window. Most (87%) of these allergic reactions were classified as nonserious. Thus, 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 Canadian Society of Allergy and Clinical Immunology has recently updated and reinforced this advice (see Tweet below):

tweet re allergies and vaccines

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

side effects Pfizer 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):

  • 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)*

FAQ 10: 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. 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). 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 11: How long can I wait after my first dose to get a second vaccine dose? 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 interval is necessitated by our vaccine shortage and has been approved by Health Canada. 

syringe with needle drawing vaccine from bottle

FAQ 12: Can I contract a COVID-19 infection from the vaccines? This answer is simple-NO! None of the approved vaccines in Canada contain the virus itself. They do not contain live virus; they do not contain dead virus. Canada’s approved vaccines (from Pfizer and Moderna) contain only the messenger RNA (genetic code) to allow you cells to make the viral spike protein which then triggers your immune cells to build anti-spike antibodies which protect you. The Astra Zeneca vaccine is much the same but delivers the SARS-CoV-2 spike protein gene via a chimpanzee adenovirus-vector. The J&J vaccine also uses an adenoviral vector but again, there is no SARS-CoV-2 virus (not dead; not alive) in this vaccine (click here). So, while you might get a sore arm or a fever from vaccination this is just your immune system responding as it should; there is no chance of getting COVID-19. Obviously, one could contract COVID-19 around the time of vaccination the normal way, before the vaccination’s protection develops (i.e. in the first 2 weeks after vaccination). 

FAQ 13: Are vaccines safe? Yes, serious adverse effects of vaccines are rare (occurring in only 167 of 1.4 million Canadians vaccinated). Most people get (at worst) sore arm at the injection site, fatigue, or fever, all signs the immune system is being activated. Based on the clinical trials and experience in millions of people who have been vaccinated world-wide we can be reassured of vaccine safety and efficacy. All the side effects (called adverse events and abbreviated AEFI) are tracked and reported by the government of Canada (see below). (click here) (last updated April 16th).

FAQ 14: Is it safe to increase the time span between dose 1 and 2 of the COVID-19 vaccine? Most vaccines are given with an initial dose and a booster dose 3 months later. The reason the COVID-19 vaccine regimen initially specified a shorter interval was simply the rapid pace of the clinical trials which compressed the vaccination interval. Regulators approved the vaccine based on the information that came from these trials. With time it is now clear that spacing out the interval up to 4 months is safe and effective. This longer interval between vaccines allows more people to get the first dose asap and as the data have shown, the first dose yields substantial immunity within 1-2 weeks. That said, once vaccines become more available it would be prudent to return to the initial interval between vaccine doses. My second dose of Pfizer vaccine will occur 4 months after the first dose I received.

11) Sustained improvement in COVID-19 in Ontario’s Long Term Care facilities (LTC)…evidence vaccines working: click here

three senior citizens sitting at a table all wearing masks

Most COVID-19 deaths occur in people who are not only old but who are also frail and live in nursing homes and LTC facilities. While LTC residents account for only 5.3% of all cases in Ontario, they account for 51.8% of all 8029 deaths in Ontario. As of today, the 3,764 deaths in nursing homes account for ~46% of all deaths. There were 2 new deaths in LTCs due to COVID-19 in the past week. There are 66 active COVID-19 cases in LTC residents and 149 active cases in LTC staff, the lowest numbers in months. These numbers remain low and stable, which is testimony to the effectiveness of mass vaccination in a high risk population! For example 2 months ago we were seeing death rates of >100/week; now it is 0-5/week.

Stay calm, Stay informed, Stay Home, Stay Well! …. Get Vaccinated!!!

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