March 15, 2021 - Dr. Archer's Update on COVID-19 response from the DOM and Medicine Program

Dr. Archer's Updates on COVID-19

General DOM News & Events

| 16 March 2021

All patients admitted to KHSC will undergo Covid-19 testing

Universal patient masking precautions will be in place

Ontario Website now open to book vaccines for people over age 80 (initially): https://covid-19.ontario.ca/book-vaccine/ (click here). There have been some initial glitches but the process is underway!

instructions on how to book a covid appointment

1) Vaccines for people age 60-64 now available in local pharmacies: Emerging evidence shows Astra-Zeneca vaccine effective in people over age 70 years (click here)

2) Astra Zeneca vaccine is safe and reports of increased thromboembolism are likely incorrect (click here): There is a difference between a cause and a coincidence!

3) World vaccine roll-out tops 350 million people (click here)! Real world evidence that vaccination is safe and effective.

4) Vaccination of frontline health care workers at KHSC: Team Vaccine has now administered over 10,000 doses of vaccine KUDO and thank you!

5) All about COVID-19 Vaccines: Updated FAQs about vaccination

7) Ontario infection rates have risen significantly with a 31% increase in new cases, a 19% increase in active cases, and a 3.8% rate of positive testing (click here) (click here).

8) Canada’s COVID-19 epidemic continues to improve: There have been 911,182 total cases with 2956 new cases yesterday. Rates of hospitalizations have unfortunately plateaued (click here) (click here).

9) The global pandemic (click here)

10) Improvement in COVID-19 in Ontario’s Long Term Care facilities (LTC)-evidence vaccines working: click here

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1) Vaccines for people age 60-64 are now available in local pharmacies. Emerging evidence shows Astra-Zeneca vaccine effective in people over age 70 years (click here) Vaccinations have begun for people age 60-64 in a local pilot program. This program administers (by appointment) the Astra Zeneca vaccine via local pharmacies (click here). Like much of the response to the pandemic things are confusing. As previously noted our provincial plan is largely based on risk and so started with LTC staff and residents and are working our way from those people over age 80 years down to age 60 years (in phase 2) and then on to the general population in Phase 3. However, Canada recently acquired a large supply of the Astra-Zeneca vaccine. The initial studies for approval of this vaccine only included small numbers of people over age 55 years (1418 people over age 65 years-12% of study population) (click here). While various advisory groups have therefore suggested that this vaccine not be used for older people, there is no evidence of lack of effectiveness. It is not that this vaccine doesn’t work in older people it’s that the evidence is less robust. That said this vaccine is used for people over age 65 years in the UK and many other countries. Indeed a pre-print study looking at all vaccinated people over age 70 years in the UK (click here) found substantial benefit in the elderly, noting “a single dose of either vaccine (Pfizer or Astra-Zeneca) is approximately 80% effective at preventing hospitalization and a single dose of the Pfizer vaccine is 85% effective at preventing death with COVID-19. Moreover, in people over age 70 years, the Astra Zeneca vaccine (one dose) results in protective effects within “14-20 days after vaccination reaching an effectiveness of 60% from 28-34 days and further increasing to 73% from day 35 onwards”. This article (see below) is awaiting peer review.

research article about effectiveness of vaccine

My advice is that if you are eligible, take the Astra Zeneca vaccine. The totality of the evidence is that it is safe and effective (and I believe the age restrictions will soon be removed, based on the data from the UK that I cited).

screenshot of tweet from Dr. Archer listing local pharmacies providing vaccines

2) Astra Zeneca vaccine is safe and reports of increased thromboembolism risk are likely incorrect (click here): There is a difference between a cause and a coincidence!

A quick note re the concern in Europe re the possibility of increased blood clots with the Astra Zeneca vaccine. Denmark, Austria and eight other countries—Norway, Iceland, Austria, Estonia, Lithuania, Luxembourg, Italy, and Latvia, put a temporary hold on the vaccination with the Astra Zeneca vaccine because a concern had bene raised it increased the rate of venous thromboembolism (pulmonary embolism, deep venous thrombosis). This is likely coincidence not a true event. We are all getting a course in statistics and probability. When you vaccinate people their lives and all events that normally occur continue to occur. People continue to have strokes, heart attacks, cancer, blood clots etc. The question is always are the rates of the “bad event” (in this case blood clots) more with the vaccine than without it. This has been carefully reviewed and the answer thus far is that there is no evidence that the vaccine is increasing blood clots. The European Medicines Agency (EMA) and the UK’s regulatory body safety committee is reviewing the issue but said that there was currently no indication that vaccination has caused these conditions, which are not known side effects. It said that the information available so far showed that the number of thromboembolic events in vaccinated people was no higher than that seen in the general population. As of 10 March, 30 cases of thromboembolic events had been reported among the five million people given the AstraZeneca vaccine in the European Economic Area (click here). In the UK rates of venous thrombosis are down amongst vaccinated people. While the cases in Scandinavia understandably raise concerns, I worry that the pause in vaccination will lead to more morbidity and mortality than if they had continued the vaccine program. Stay tuned!

3) World vaccine roll-out tops 350 million people (click here)! Real world evidence that vaccination is safe and effective.

line graph ranking the countries who have given the most vaccines

The good news is our vaccines work against these variants; however the emergence of increasing numbers of variants is a reminder of the urgency of vaccine roll-out globally. Variants emerge when large numbers of people are infected. For the undecided 20% of Canadians who are unsure they want to commit to taking a vaccine now, please believe me when I say that time is of the essence. The more the virus has to infect unvaccinated people the more time it has to mutate and develop the ability evade vaccine-induced antibodies. All approved vaccines in Canada are safe and effective. No corners have been cut in the Health Canada review of their safety. What was accelerated was their production and the duration of initial study prior to approval shortened. Vaccine production was accelerated because we can now safely use mRNA and adenoviruses, courtesy of lessons learned in the past 2 decades from the Human Genome project. While the vaccine studies for initial approval were compressed (because we are fighting a pandemic), the ongoing results are shared with the medical profession weekly. We now have unprecedented evidence of safety from the tens of millions of people vaccinated world-wide (click here). To date over 350,000,000 people have been vaccinated! So if you are “waiting” for more safety data I would argue that all the data a reasonable person should need are there already. If you were vaccinated today you are benefitting from the safety data generated on the 350 million people who were vaccinated before you. We also have safety data from numerous clinical trials, which in combination with the re-world experience, should be reassuring!

4) Vaccination of frontline health care workers at KHSC: 3971 KHSC health care workers have been vaccinated (and interval to second dose will be prolonged to as long as 16 weeks). As of today, KHSC has been allotted approximately 5000 vaccine doses by KFL&A Public Health for frontline health care workers. The dashboard below shows the amazing job Team Vaccine has done. They have issued 6274 invitations to health-care workers , people who are in Phases 1-5 of the MOHLTC’s priority grid. Currently they have booked 4967 people to be vaccinated by weeks end and 4772 KHSC health care workers (staff, trainees, faculty) have already received their first doses of vaccine (84% of the workforce). The interval between dose 1 and 2 will be extended for varying intervals (up to 16 weeks). E-mails have been sent out in ~1 week notifying people of that they will need to book a new date for their vaccine. The vaccine uptake rate (offered/accepted) is 84%. Also for those in Groups 7-8, we anticipate getting to you shortly (stay tuned for a date).

chart of how many healthcare workers at KHSC have received vaccine

Progress in vaccinating front line health care workers at KHS March 15^th 2021

When combined with the vaccination of residents and staff in local long-term care facilities Team Vaccine has now administered over 10,000 doses of vaccine KUDO and thank you!

5) Here are answers to some updated FAQs with answers to common questions about the COVID-19 vaccines (most recent at the top).

animated image of grey human figure with hands holding head and orange questions marks surrounding head

FAQ 1) 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)

FAQ 2) 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 3) 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 4) 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 providing info for those on blood thinners

FAQ 5) 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 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 of 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):

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 6) 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 7) 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 protocol has been approved by Health Canada.

syringe and needle drawing vaccine from bottle

FAQ 8) Can I get COVID-19 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. Again, there is no 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 9) 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 Feb 26^th).

FAQ 10) 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 to 40 days (and longer) 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.

6) KFL&A COVID-19 rates remain low but there are 2 school outbreaks with variants of concern are at 6% of all cases and rates of COVID-19 are on the rise in SE Ontario (see update from KFL& A Public Health)The total number of cases in KFL&A since the pandemic began is 762, not counting the prison outbreak. This is up 17 cases since Monday and another new case caused by a variant of concern (i.e. mutant virus) (see below). There are 27 active cases in the region. There are a total of 7 variant virus cases in KFL&A. The case rates are rising in SE Ontario, particularly in Leeds-Grenville county (74 active cases). There are 114 cases in our part of SE Ontario.

There are two school outbreaks with variants of concern ( 1 each at Winston Churchill school and St. John XXIII school). This has resulted in a significant increase in testing and quarantining of contacts.

number chart summarizing current KFL&A covid data

KFL&A March 15^th 1957

There has only been one death of a KFL&A resident since the pandemic began. There are no COVID-19 patients hospitalized at KGH (one case being investigated). Active cases in our SE region are rising back to levels seen in mid-January, a cause for caution. This largely relates to the rise in the B117 variant.The KHSC lab remains very busy and the rate of positive tests from our region is 1.1%, roughly 1/3 the provincial rate. A concerning sign is the rise in variants of concerns (mutant viruses which are more infective). These variants spread rapidly particularly in children and account for 6% of recent positive tests -see below (still better than in most of the province where they cause 35% of all cases).

Variant viruses beginning to take hold in KFL&A

7) Ontario infection rates have risen significantly with a 31% increase in new cases, a 19% increase in active cases, and a 3.8% rate of positive testing (click here) (click here).

salmon coloured bar graph with 4 text boxes of info underneath

Ontario’s COVID-19 prevalence new case rates show recent increase (March 15^th)

There were 1268 cases yesterday. It continues to be the case that ~ 5% of infected people require hospitalization. Death and hospitalizations remain unchanged (but these events usually follow a rise in case numbers by several weeks). We have done 11.76 million COVID-19 test thus far. The rate of test positivity is rising and is now 3.8% (up from ~2.5% on Monday). Positive tests are due to N501Y mutation variants in 30-35% of cases. This is not the case in KFL&A (thus far), where mutants remain rare.

green blue and white map of Canada and northern usa

There have been 22,482 COVID-19 deaths thus far and a cumulative national case mortality rate of ~2.01%. Canada has performed 26.7 million COVID-19 tests with a cumulative test positivity rate of 3.4%. 3.1 million people have now received at least 1 vaccine dose.

COVID-19 in Canada March 15^th 2021: Hospitalizations have plateaued at a high rate

salmon coloured bar graph with 4 text boxes underneath

Improvement in wave 2 stalls: March 15th 2021 (click here).

various types of coloured graphs showing current Canadian Covid data

Rates of COVID-19 (orange line) have plateaued in Canada, as have hospitalizations

Rates of COVID-19 have finally begun to decline in PEI. Rates of infection remain at a low plateau in all other provinces and territories, as a result of introduction of more aggressive public health measures.

Canada’s vaccination roll-out is accelerating (click here): To date, 3,982,220 doses of COVID-19 vaccines (including both Moderna, Pfizer-BioNTech and Astra-Zeneca) have been delivered. This is an increase of ~1 million doses since Monday! Thus far, 79.1% of delivered doses have been administered (reflecting a surge in supply). 2,550,387 Canadians have received at least one dose of an approved COVID-19 vaccine (see below). 600,918 Canadians are fully vaccinated (click here). Still, Canada is well back in the pack with only 6.7% vaccinated (see below).

9) The global pandemic is again on a slight rise, although daily deaths (click here) and rates of positive tests rise in the USA decline (click here):

satellite picture of planet earth from space

Global COVID-19, March 15th, 2021: The number of active cases (yellow dots on map) has begun to increase again but deaths are declining (white graph, bottom right)

world map with yellow dots showing areas with most covid and a ranking list of countries with most covid

There have been 120,162,952 cases and 2,657,831 deaths since the pandemic began. Active case rates were declining but have now hit a plateau and are rising slightly which is concerning (click here) Daily death rates are continuing to decline. The USA, with 29,485,159 cases and 535,552 deaths has roughly the same total number of cases as the next four most affected countries combined (India, Brazil, Russia and the United Kingdom). The USA has accounted for ~25.2% of the global pandemic but things are improving rapidly in the USA, due likely to natural immunity, vaccine acquired immunity and better adherence to public health measures (in some states).

America now has a 4.6% positive test rate, down from 6%, last Monday (click here; see below). Unfortunately, in states with populist governors, like Texas and South Dakota, rates remain higher (Texas now has a positive test rate of 7%). South Dakota (though improved from its 30%+ rate 2 months ago) is now at 18%. This epidemiology is a testimonial of the importance of adherence to public health measures while we await completion of mass vaccination (which in the USA should be May 2021).

10) Improvement in COVID-19 in Ontario’s Long Term Care facilities (LTC)-evidence vaccines working: click here

three senior citizens sitting around a table 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, click here, they account for 52.7% of all 7109 deaths in Ontario. As of today, the 3,750 deaths in nursing homes (up 1 death since Thursday) account for ~57% of all deaths. There are ~ 51 active COVID-19 cases in LTC residents and 137 active cases in LTC staff, the lowest numbers in months. These numbers continue to decline, which is very encouraging! For example a month ago we were seeing death rates of >100/week; now it is <5/week; still too many but heading in the right direction rapidly. These graph below shows the beneficial impact of the province’s decision to prioritize its limited initial vaccine supply of health care workers and residents of Ontario’s LTCs. Note the rapid decline in both staff (yellow) and resident (orange) COVID-19 case numbers coincident with vaccination!

line graph showing decline in cases in LTC after phase one of vaccines

Vaccines crush COVID-19 in LTCs

Regular reminders-On hiatus today

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”: All patients should complete our pre-screening questionnaire before their clinic visit. This will screen out people who are sick and expedite entry to the facility. 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 khsc prescreening app index finger scrolling on iPhone

KHSC visitor policy: Details on our visitor policy can be found using this link (click here). This is one of the hardest aspects of COVID-19 care in the hospital. Nurses in particular bear the burden of fielding numerous requests for visitation and while many requests tug on the heart strings we need to keep our hospital safe so it can function for the good of all residents. There are exceptions made to allow visitors under exceptional circumstances, particularly for palliative or dying patients. These exceptions are usually for a single visit. Our 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.

COVID-19 testing at Beechgrove Community Assessment Center: (click here):

Update March 8^th: The center has been very busy, especially testing children < 12 years old (in light of school outbreaks). They have been doing over 600 tests/week in these children, KUDOS Team Testers! They also continue to test asymptomatic individuals who are going to and from LTCs and for essential visitors to hospitals.

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). 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 receiving nasal covid swab

three young boys dressed as doctors wearing white coats and stethoscopes

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.

COVID-19 in toddlers and young children: (click here). It has remained true throughout the pandemic that children in general are less severely affect by the virus and young children are somewhat less infectious (perhaps because they are less sick). Rates of infection are very low in preschool children.

The situation in Ontario schools remains stable. The good news is the reopening in the 7 areas where it was permitted has not resulted in major increases in new cases. Below is the new baseline report for school age children in publicly funded Ontario schools. School boards report every weekday from Monday to Friday. In person classroom education is back in Toronto, Peel and York. With more kids back in school we are seeing more infections (although not at alarming rates). There have been 7277 students with COVID-19 since the pandemic began with 1225 new cases in the past 2 weeks. This is a continued increase compared to last week, consistent with more young people being back in school. 17.4% of Ontario schools have reported at least one active case (see below).

four teenagers sitting on a bench 2 with iPhones one with iPad and one with book

Here are the parallel data from licensed child care facilities in Ontario-where there have been 1588 children infected since the pandemic began, 226 new cases in the past 2). This relatively stable number of infections in the licensed child care facilities is a reminder that it is the older school age children (>10 years old) not the toddlers, who are contracting COVID-19 most often.

group of young children sitting on classroom floor

Final thoughts: Taking the vaccine is safe and it’s the right thing to do. I am one of the 350,000,000 people globally that have been vaccinated. It was an experience like all other vaccines I have had (uneventful). I recommend that when you are called you confidently roll up your sleeve and help us end the pandemic! I would also advise taking whatever vaccine you are offered as the benefits in preventing severe adverse outcomes (death and mechanical ventilation) are provided by all approved vaccines. The Astra Zeneca vaccine being offered at pharmacies is safe and effective. You can now book your vaccine on line if you are over age 80 years (click here)! In addition by “going earlier” (rather than waiting for your vaccine of choice) you are accelerating the creation of herd immunity and protecting the public at large.

Stay well!

March 15, 2021 - Dr. Archer's Update on COVID-19 response from the DOM and Medicine Program

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March 15, 2021 - Dr. Archer's Update on COVID-19 response from the DOM and Medicine Program