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July 22, 2021 - Dr. Archer's Update on COVID-19 response from the DOM and Medicine Program

headlinesvaccination information for visitors and outpatients

Are you looking for an easy way to receive your first or second dose of COVID-19 vaccine?

Walk-in vaccine clinic at Kingston Health Sciences Centre’s Kingston General Hospital (KGH) site.

Walk-in Clinic Hours:

July 20: 11:30 a.m. to 6:30 p.m.

July 21, 22, 23 and 24: 9:30 a.m. to 4:30 p.m.

July 28 and 29: 9:30 a.m. to 6:30 p.m.

July 30 and 31: 9:30 a.m. to 4:30 p.m.

Drive, walk or bike in to the KGH site:

Enter at 18 George Street

Bring your health card

Wear a short-sleeved shirt

No appointment necessary

Update on KHSC COVID-19 Outbreak: We continue to deal with the COVID-19 outbreak on Davies 5, one of our medical wards. There have been 16 total cases. Currently we have 5 patients with COVID-19 admitted at KHSC, 4 on the Medicine COVID-19 ward and 1 in ICU. The variant causing the outbreak is the alpha variant (the UK variant). Eight of the infected people were unvaccinated and three only partially vaccinated. Contact tracing is underway on all exposed visitors and staff and testing for COVID-19 is being performed on all people at risk of exposure. This is a reminder of the critical importance of: a) health care workers being vaccinated and putting the safety of patients first b) testing of all admitted patients and retesting despite an initial negative test if symptoms develop c) recognizing that fully vaccinated people can get COVID-19, although the symptoms are almost always mild or absent. To help us get the hospital “back to normal”, so we can provide care for the 99.9% of people who don’t have COVID-19, PLEASE get vaccinated. It will keep you and your family safe and allow us to safely provide health care! In the meantime we each need to redouble our attention to proper use of PPE. 

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1) Unvaccinated people and the 4th wave of COVID-19: Increasing evidence that the actions of people who currently refuse to be vaccinated and the leaders and influencers who support their behaviour open the door to wave 4. (click here).

2) KFL&A update: 3rd wave resolving locally, 1 local active case, 1 KFL&A resident hospitalized and 80.6% of eligible residents (12-years and older) vaccinated at least once and 64.1% fully vaccinated (see update from KFL& A Public Health).

3) Wave 3 subsides in Ontario with 7.2 million people fully vaccinated and 10.1 million partially vaccinated and rates of new cases falling (-9% this week) (135 new cases yesterday and a 0.8% positive COVID-19 test rate) (click here(click here). 

4) It is time to institute vaccine certificates: Our best tool to safely reopen Canada.

5) Canada’s COVID-19 epidemic rapidly resolving with > 46.3 million doses of vaccines administered. New and active cases (down -4% and -11% respectively), hospitalizations falling (-15%) and 4 deaths yesterday (click here) (click here).

6) World vaccine roll-out tops 3.76 billion people and safety record remains excellent (click here).

7) The global pandemic: ~192.15 million cases (up over 3 million from last week) with 4,130,864 deaths to date click here with most deaths in the USA, India and Brazil (left column below).

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1) Unvaccinated people and the 4th wave of COVID-19: Increasing evidence that the actions of people who currently refuse to be vaccinated, and the leaders and influencers who support their behaviour, open the door to wave 4. (click here)

The gloves are gradually coming off in the battle to get vaccine hesitant people to change their behaviour and in combatting anti-vaxers. It’s not a moment too soon. Whether we will suffer a 4th wave of COVID-19 will largely be determined by our success in achieving vaccination of the final 30% of eligible people. When people choose not to be vaccinated, they remain targets for the increasing proliferation of SARS-CoV-2 variants, mainly the delta variant and most recently the newly arrived epsilon variant. This is not my opinion, it’s a fact! The proof that it is fact comes from observing the natural experiments being conducted by individuals and state governments in the USA. The USA, specifically red states, have become the world’s unfortunate experimental laboratory. The opening of the border to the US which was scheduled to open in early August has now been delayed. Why? Not because of any hesitancy from Canada but because the USA realizes it is once again losing control of the epidemic within its borders. The US government notes, "Given the outbreak and continued transmission and spread of COVID-19 within the United States and globally, the Secretary has determined that the risk of continued transmission and spread of the virus associated with COVID-19 between the United States and Canada poses an ongoing specific threat to human life or national interests," (click here). 

To be clear-the virus is spreading again and not surprisingly its victims and its vectors are unvaccinated people. Although it’s a side bar-Canada will still allow fully vaccinated Americans into Canada when the Canadian border opens to Americans in early August. However, the point is not the border; it’s the US roller coaster! The US was first pummeled by the virus (and still has the dubious record of having the most deaths of any country). This occurred because of a failure to control the virus by good public health measures. Then the USA became a beacon of hope as it implemented a vaccine program rapidly. However, the USA is now again being harmed by the same wrong minded, unsubstantiated, refusal to “do the right thing” that led to the wave 1-2 carnage. Large numbers of Americans refuse to be vaccinated (despite the fact that the supply of vaccines is abundant). The proof vaccine works is clear and the USA is once again proving it. Where vaccines are not being used in the USA, infections are rising.

line graphs

Vaccine rates plummet in the USA (above) and infection rates rise (below)

line graphs

What is driving vaccine resistance? Let’s take a quick trip to Tennessee. Read this text describing what Republican legislators have done and it could be called a trip to crazy town. Republican legislators have not only stopped promoting COVID-19 vaccines but all vaccines! This unimaginable decision comes just as case numbers in Tennessee rise (from 177/day to 418/day) and test positivity rates more than double (from 2.2% to 5.4%). Sadly, in the USA whether to get vaccinated has become a political issue-Democrats pro; Republicans con. The virus is not partisan. If you are not vaccinated, you are vulnerable. If you are not vaccinated, you are a vector and thus a risk to you friends and family.

memo stating Tennessee with halt all vaccine events

The map below shows that sharp rise in cases of COVID-19 in the past 2 weeks-The USA is oxblood in colour-reflecting a >200% rate of new cases….that’s what the beginning of a new wave looks like!

world map with various colours depending on covid-19 casesline graphs

Worsening USA positive test rates (click here)

If you don’t think this is a partisan issue look at NY and California vs Texas and Tennessee.

line graphline graph

New York and California (blue states)-72.5 and 69.6% of adults aged 18-64 years are vaccinated (click here)

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Texas and Tennessee 60 and 47% of adults 18-64 years of age are vaccinated (click here)

The point for Canada and the world is if we are “too nice” to insist people get vaccinated, if we fail to offer advantages for vaccination (like the privilege of walking around without PPE, travel benefits, attendance at schools etc.) we put ourselves at grave risk for a 4th wave. The decision not to have a 4th wave is one we have to have the courage to make-and the decision must be to make vaccination the expectation and the norm!

2) KFL&A update: 3rd wave resolving locally (despite outbreak in KGH), 1 local active case, 1 KFL&A resident hospitalized and 80.6% of eligible residents (12-years and older) vaccinated at least once and 64.1% fully vaccinated (see update from KFL& A Public Health)

The resolution of the 3rd wave continues. One major reason for this is high rates of vaccination (> 80% of eligible people in our region have had at least one vaccine) (see below). There is little virus circulating in KFL&A with a 7-day average rate of positive tests way below 1% (0.04%).

table showing information for KFL&A phase 3 of vaccination

Vaccination rates in KFL&A, July 22nd, 2021

Another reason for the decline in cases is the season-coronaviruses seems less prone to spread in warm weather with lots of outdoor activity. A third reason may be the relative lack of more infectious delta variant viruses (we mostly have the British alpha variant locally). Since the pandemic began, we have had 1580, cases in KFL&A, not counting the resolved prison outbreak or people from other regions (see below). There have been 6 deaths of KFL&A residents since the pandemic began.

The Medicine program remains extremely busy with non-COVID-19 care. We are looking after >186 patients at KHSC and run an additional ward at HDH (see below). We have ramped up clinics toward pre-pandemic levels (although volumes are still be limited by the size of waiting rooms and ongoing masking/physical distancing requirements). All physicians are being asked to see patients in person whenever possible and appropriate.

3) Wave 3 subsides in Ontario with 7.2 million people fully vaccinated and 10.1 million partially vaccinated and rates of new cases falling (-9% this week) (135 new cases yesterday and a 0.8% positive COVID-19 test rate) (click here(click here): 

The good news is clear in the graphic below, new and active cases, hospitalizations and deaths are all decreasing further as phase 3 resolves. This reflects (mostly) and effective vaccine program.

salmon coloured bar graph

Wave 3 resolving in Ontario, June 30th 2021 (active cases back to rates seen last summer)

Ontario has made amazing progress toward quashing wave 3. The rates of new and active cases are down 9 and 10% respectively in the past week. Deaths and hospitalizations are also significantly decreased compared to last week (-15% and -14%, respectively). 

4) Time for vaccine certificates: Our best tool to safely reopen Canada.

screenshot of article showing hands holding two cell phones

The Ontario science table is advocating for vaccine certificates to safely accelerate reopening of the province. They published a 21-page brief Wednesday providing their key considerations on a possible vaccination certification program, concluding Ontario could use vaccine certificates a short-term basis to help reopen higher risk settings, such as indoor dining, bars, gyms, cultural and sports events, sooner or at an increased capacity (click here). This is sensible and is the kind of rationale approach that we need to avoid wave 4. Surveys suggest 70% of Ontarians agree with the use of vaccine certificates (see graph below). Society cannot expose itself to risk of a 4th wave to placate a minority declines to participate in a free, safe vaccine program. Ultimately while there may be equity concerns, if properly handled, we can still make life easier and the economy healthier and schools safer by flagging vaccination in a convenient, standardized way. Society is a collective and the preferences of an individual cannot trump the public good. Most importantly, an individual can opt out-they will still be able to work and travel; just not as conveniently. In light of the global pandemic this is an inconvenience they should expect. We are required to drive on the right side of the road, follow speed limits, wear a seat belt, and have a driver’s license. Our children must be educated and vaccinated. It’s time to do the logical and safe thing and create vaccine passports!

Survey says: Most Canadians want a vaccine passport

multi coloured horizontal bar graphs

4) Canada’s COVID-19 epidemic rapidly resolving with > 46.3 million doses of vaccines administered New and active cases (down -4% and -11% respectively), hospitalizations falling (-15%) and 4 deaths yesterday (click here) (click here)

map of Canada and its surrounding watersvarious types of graphs

Resolution of Wave 3 in Canada July 22nd, 2021

New and active case rates are falling rapidly, and hospitalizations are declining across Canada. We have had 1.42 million cases of COVID-19 since the pandemic began. The case mortality rate remains 1.45% with 26,512 deaths. We have done 38.5 million COVID-19 tests (with a cumulative positive rate of 3.7%). We have administered a 46.3 million COVID-19 vaccinations (vaccinating 300-500 thousand people per day). Hospitalizations are also declining (445 people in hospital today, 200 less than last week).

Canada’s vaccine story: 69.9% of Canadians have had at least one shot and 52.2% are fully vaccinated! 46.5 million doses have been administered (click here): 55.2 million doses of COVID-19 vaccines have been delivered but only 84.3%of delivered doses have been administered. Canada is near the top of the pack in vaccines administered per day now! The graph below shows the % of people vaccinated by country as of July 22nd, 2021 (see below) (note Canada, 4th from top).

light and dark green horizontal bar graphs

Canada is now a top vaccinator country (more than half of eligible people fully vaccinated)

6) World vaccine roll-out tops 3.76 billion people and safety record remains excellent (click here): If you have a vaccine hesitant friend you might want to show them the graph below. 

multi coloured horizontal bar graphs

In addition to many clinical trials, the safety record of vaccines has been established in the real world, where we have administered 3.7 (+) billion jabs! The complication rates remain very low. Vaccines are safe (click here for Canada’s safety data) and effective against all forms of the coronavirus. They are particularly good at preventing hospitalization or death. 

6 boxes each with text and numbers

The serious complication rate in Canada remains low (5 serious adverse events/100,000 vaccines administered). Data as of July 9th, 2021

Vaccines are the key to ending COVID-19; however, low-income countries remain vaccine deserts

wave looking type graph

The graph above shows how much slower the roll-out has been in lower income countries (red) vs high income countries (green).

23.4% of the world’s eligible population has been vaccinated (click here). However, progress is uneven: good in wealthy countries; poor in low-income countries This is not only unjust; it also allows for the creation and spread of viral mutants, like the delta variant, which is more infectious and may lead to immune evasion, thereby keeping the pandemic going. Both the USA (click here) and Canada (click here) have committed to sharing vaccines abroad by the end of 2021. 

7) The global pandemic: ~192.15 million cases (up over 3 million from last week) with 4,130,864 deaths to date click here with most deaths in the USA, India and Brazil (left column below).

satellite image of earth taken from space

Here is today’s map of the global pandemic. Daily cases are rising (red graph). Deaths have plateaued (white graph), which usually lags behind increases in cases. We can expect a rise as the new cases advance to cause a 1.5% mortality rate. This shows that globally the pandemic is not yet under control. Vaccine use is on the rise (green graph).

world map with red dots, red and white bar graphs, and ranking of countries by cases and deaths

Global COVID-19, July 22nd 2021

COVID-19 Vaccine FAQs and report on Long Term Care Facilities are on hiatus (no updates of significance)

A big thank you to the hard-working staff in the Department of Medicine and the Medicine program. Here are some flowers as a thank you! Stop and smell the flowers (like Henry the Beagle)! 

photo of rocks trees and flowersphoto of flower and sun raysphoto of yellow flowersphoto of white lacy flowerphoto of pink flowerphoto of dog smelling flowers

Get Vaccinated!!!  

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