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herons in the water at dusk

May 28, 2020 - Dr. Archer's Update on COVID-19 response from the DOM and Medicine Program

COVID-19 Update: There is no change in the fortunate situation in the Kingston, Frontenac Lennox and Addington (KFL&A) region. There are no new cases of COVID-19 today (see update from KFL&A Public Health). The positive test rate in KFL&A remains at 0.6% (vs 4.1% in Ontario), see below. The running total for the epidemic remains at 62 COVID-19 cases in the KFL&A region and all infected people have now recovered. Our PPE supply is stable with 3 weeks reserve, at the current level of activity. 

chart of COVID-19 in the KFL&A region

Kingston remains in a bubble with a low incidence of COVID-19 (28.7 cases/100,000 population), positioning us to carefully reopen the city and ramp up activity at KHSC and Queen’s University (read the blog if you’re interested in hearing more re: Queen’s). In contrast Toronto has a rate 10 times higher (312.1 cases/100,000 population) and this rate continue to increase daily, albeit slightly. This is a reminder that the pandemic varies in impact greatly by location. Nonetheless, as the graph for Ontario shows, the number of new cases is decreasing (i.e. the curve is flattening).

How’s the epidemic going? To date there have been 87,519 cases of COVID-19 and 6765 deaths in Canada, 94 since yesterday (see below). Most cases are now acquired from community contact and/or close contact (circle graph below). There are few new cases related to travel; not surprising, since no one is traveling! Nationally, the COVID-19 curve has flattened, with a decline in the number of new cases (see bar graph below, right). Also, the disease remains most prevalent in Quebec (below left), with almost half the burden of disease in all of Canada in this one province.

graph of Case demographics in Canada

COVID-19 continues to disproportionately affect the elderly and particularly the frail residents of 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 ~72.4% of all deaths from COVID-19! There were 4 deaths since yesterday in Ontario LTCs. 

There were 298 COVID-19 outbreaks in long-term care homes (LTCH) (a change of 0 outbreaks), 138 COVID-19 outbreaks in retirement homes (a change of +2 outbreaks) and 84 COVID-19 outbreaks in hospitals (a change of 0 outbreaks) reported to date in Ontario.

numbers summary of LTÇ cases from Jan - May

Testing for SARS-CoV-2: We have tested 4.29 % of all Canadians (1,601,296 people) and are at approximately the same rate of testing in Ontario (4.45%). The rate of testing remains low of late because there are fewer people with respiratory tract infection symptoms of cough and fever (and thus there has been less patient request to be tested). It also remains unclear how to deal with the lower negative predictive value and the higher incidence of poor quality samples when swabs are obtained from asymptomatic people. Poor quality specimens that cannot be analyzed occur in 10% of healthy people vs 1% of people with upper respiratory tract infections, as discussed yesterday.

graph of tests performed vs positives in Canada

To see where Canada stands amongst nations in the COVID-19 pandemicclick here. The global case total has risen to 5,929,312 with 363,425 deaths. America has exceeded 100,000 deaths (101,002), more than the next 4 countries (Brazil, Russia, UK and Spain) combined. The USA also has more cases (1,709,996) than the next 6 most affected countries combined! Here is a list of the countries with over 100,000 reported cases of COVID-19.

Ranking of confirmed deaths by country/regionalarm clock with smiley face

A revised reminder for people in the community (last updated May 27th)

1) People in the community can self-refer for assessment and possible testing. We are now on testing people for much broader indications (we are no longer requiring fever or travel as preconditions for testing). We are now testing people who have only 1 COVID-19-type symptom or who are concerned they have been exposed to the disease. KFL&A has also suggested that health care workers should be routinely and repeatedly surveyed by nasal swabs (discussed above). You can seek out testing at Memorial Centrein Kingston, (see instructions below). Here is a link to the self-assessment tool used to see if you should be tested (although I suspect it will be updated soon): click here

self assessment instructions

The Community COVID-19 Assessment Centre is located at:
Kingston Memorial Centre (please use the well-marked main entrance) 
303 York Street, Kingston, Ontario 
Monday to Friday: 10:00 a.m. - 6:00 p.m.
Saturday and Sunday: 9:00 a.m. - 12:30 p.m. 

2) Our hospitals and clinics are safe places to receive care (in part because everyone including staff is screened prior to entry and in part because the local incidence of COVID-19 remains low). You should not delay accessing care that you or your doctor deem to be urgent.

Your moment of Zen: COVID-19 has provoked changes to all our lives. Here is a photo of a blue jay who also appears stressed by the pandemic! Courtesy of Mr. Ted Dyke. 

picture of a blue jay on a birch tree branch

 

Evening heron from my iPhone -a celebration of the beauty of spring in Kingston.

dusk photo of heron in the water and tree branches in the foreground

Stay well!

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