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curent covid-19 numbers for KFLA

November 11, 2021 - Dr. Archer's Update on COVID-19 response from the DOM and Medicine Program

Headlines

1) 3rd doses of vaccine for health care worker-vaccinations underway at KHSC.

2) KFL&A update: KFL&A sees surge in COVID-19 cases a (144 local active cases, 10 KFL&A residents hospitalized (5 in ICU) despite 86.6% of eligible residents > age 12 years fully vaccinated).

3) On the road again-Canada USA border open again for land travel -but without harmonization of COVID-19 testing requirements.

4) Ontario’s new wave: New cases and active cases are up 33 and 31%, respectively and hospitalizations are up 3%, with a positive test rate of 1.7%.

5) Canada’s COVID-19 cases on the rise: A 11% increase in new and 4% increase in active cases with 7% decrease in hospitalizations (click here) (click here).

6) World vaccine roll-out tops 7.36 billion people and safety record remains excellent (click here). 

7) The global pandemic is not yet controlled: ~251 million cases to date with most deaths in past 28 days in the USA UK, Russia, Turkey and Ukraine .

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1) 3rd doses of vaccine for health care workers-vaccination underway at KHSC

KHSC will be offering 3rd dose vaccines for health care workers (including residents and faculty). The vaccines will be made available ONLY 168 days after the second dose of vaccine. They will be delivered in the Burr gym (as before). The number of 3rd dose vaccines anticipated at KHSC will be high (>2000 health care workers in November, >4600 in December). Lori Van Manen and her team will be working to set up the Burr Gym for vaccination once again (thanks Lori). If you are a health care worker and your 168 day anniversary occurs in November, you can book your vaccine here: https://khscnow.kingstonhsc.ca/covid19/information-staff/covid-19-vaccination

December bookings will be available soon (stay tuned for link). In addition, you can get your 3rd shot from local pharmacies (again only once >168 days post 2nddose). If you exercise this option, please let Occ Health at KHSC know that you are vaccinated.

I want to offer some perspective on the need for 3rd doses. It is true that immunity against infection wanes with time after the 2nd vaccine does (as shown in this NY Times graphic). Immunity falls from ~95% to ~80% in the two Canadian studies (top lines in graph below).

line and dot graph

However, the main benefit of vacation s to prevent serious complications (hospitalization and death). In this domain the standard 2 shot vaccination regimen yields persistent benefit) see below. Note that hospitalization protection only declines modestly over time in both Canadian studies, remaining at 80% protection whether using Pfizer or Moderna 30 weeks post 2nd dose. While 3rd doses are recommended for people with impaired immunity, the elderly and health care workers for now it appears the benefits of 2 doses are quite sustained. In time we may all be advised to get 3 shots (as in the USA and Israel), but that public policy decision has yet to be made in Canada-stay tuned.

line and dot graph

Protection from hospitalization is sustained 30 weeks post 2nd vaccine does in two Canadian studies

2) KFL&A update: KFL&A sees surge in COVID-19 cases a (144 local active cases, 10 KFL&A residents hospitalized (5 in ICU) and 86.6% of eligible residents > age 12 years fully vaccinated).

table of numbers and graphs showing case numbers in KFLA

A major increase in COVID with a new wave of hospitalization hits KFL&A

We are experiencing a dramatic rise in COVID-19 cases in KFL&A. The cause of this rise relates in part to outbreaks amongst unvaccinated people which has spread within the community. There are also cases in our neighboring regions: Hastings Prince Edward Public Health = 25 and Leeds, Grenville and Lanark District Health Unit= 27 for a regional total = 193 active cases, the highest numbers in many months. 

One major source of cases (at least 15 case) was an outbreak amongst homeless people at the integrated care hub. Care for these people is challenging and it appears the infection spread from this site more broadly, despite actions to test and isolate people at that site.

Partial news heading re outbreak

This is a reminder that unvaccinated people remain the major source of infection and transmission. It is not just people experiencing homelessness that are unvaccinated. Indeed, in Ontario 22% of people are not vaccinated and 44% of these are eligible people aged 12 years plus (see tweet-dark blue part of graph).

tweet showing rise in covid-19 cases

The consequences for the running of KHSC are significant. We currently have one declared outbreak (on Davies 3 (Cardiology). Two patients have tested positive for COVID-19. The unit is under quarantine and closed to family visitors. We also have a ward on a COVID-19 watch (Kidd 4) and another (Connell 3) temporarily closed to family visitors (with the exception of essential visitors, i.e., those with a loved one who is critically ill or nearing end of life) to reduce the risk of spread of COVID-19. Although we can safely mange these patients the infections have very negative impacts on volumes of care, we can provide for the 99% of people who do not have COVID-19. The necessary restriction on visitors also impairs family visitation of hospitalized people, which exacts a huge toll. 

In summary, this recent surge in infections is driven by lack of vaccination, relaxation of public health measures and the highly infectious nature of the delta variant of SARS-CoV-2. With continued attention to public health and ongoing efforts to vaccinate the unvaccinated this outbreak will take several weeks to improve. The graphic below shows we have gone from no admitted COVID patients for many months to 9 admitted cases (5 in ICU) and 42 patients in quarantine (awaiting results). The Medicine service is very busy with 182 admitted patients. We do have good ventilator capacity.

colourful graphs bed map for KHSC

Bottom line: We are back in a state of high COVID prevalence and local test positive rates exceed those provincially (see below-green line shows rates in KFL&A). 

red and green line graphs

High test positivity rates indicate SARS-COV-2, the virus that causes COVID-19, is circulating in our area (green line)

We need to practice good public health measures (masks, physical distancing, honesty when answering COVID-19 screening questions) and should stay home when symptomatic. Ending this new surge in case is a mutual responsibility. If you know an unvaccinated person, please share this information with them. Vaccines aren’t perfect but the dramatically reduce the risk of infection and even more effectively prevent death and ICU admission! While doubly vaccinated people can be infected their personal risk and the risk, they will spread the disease are dramatically reduced!

3) On the road again-Canada USA border open again for nonessential ground travel -but without harmonization of COVID-19 testing requirements

After a 19-months of closure, shutdown the land border the USA-Canada border is now open for nonessential ground travel. Snowbirds are heading south and waits to cross the border are long. Traffic is not all you need to consider before you try, and cross-testing needs to be done. Travellers need to be aware the two countries have different testing requirements, with entry to Canada requiring molecule testing (PCR) whilst entry to the USA only requires rapid testing. To enter Canada: You must show proof of a negative PCR test for COVID-19 taken no more than 72 hours before arrival at the border. If you make a quick trip this test can serve you in both directions-but one must carefully check the times-the results are only good for 72 hours. The hassle of securing a PCR test and the cost ($150-$300) may dissuade cross border shoppers for some time.

photo of car and campers lined up to cross Canadian US land border

To enter the US, you only need a rapid antigen test. These test are done while you wait and you can book a test to enter the USA in advance from places like Shoppers Drugs. The Rapid Antigen test costs $40. Reports from people crossing the border are that US customs agents are not checking for tests results; but I would not count on that and advice testing until clear guidance is issued otherwise.

Like everything else in this pandemic people have strong opinions about elective travel. Some Canadians still view travel as an unnecessary luxury, unwise, and frivolous. Many that hold these views do not have family in other countries. We clearly need to “walk a mile” in the shoes of our fellow man/woman to understand why travel is not a simple luxury for the many Canadians who have not seen loved ones for long periods (now approaching 2 years).

4) Ontario’s new wave: New cases and active cases are up 33 and 31%, respectively and hospitalizations are up 3%, with a positive test rate of 1.7%.

salmon coloured graphs

There is a concerning uptick in COVID-19 in Ontario. This is why the province has delayed further relaxation of public health rules (wisely) for another 28 days. In the meantime, we need to get people vaccinated as outbreaks are largely occurring amongst unvaccinated people, which is particulay problematic in remote areas.

outdoor restaurant patio with red tables, chairs and umbrellas

5) Canada’s COVID-19 cases on the rise: A 11% increase in new and 4% increase in active cases with 7% decrease in hospitalizations (click here) (click here).

map of Canadasalmon coloured graphs

Canada’s part of the pandemic remains very active and wave 4 has stopped the decline we enjoyed in early October (click here) (click here). The map below shows that despite 59 million vaccines administered to date, many parts of Canada have rising COVID-19 rates. Most hospitals have capacity but are very busy with non-COVID care. However, if case rates continue to rise hospitalizations will follow in 2-3 weeks (as always occurs with this virus).

map and numbers showing current covid data for Canada

COVID-19 is down in the West and up in the East

Canada has had 1.74 million cases of COVID-19 since the pandemic began. The case mortality rate remains ~1.5% with 29,256 deaths. 75.8% of Canadians that are eligible are fully vaccinated.

6) World vaccine roll-out tops 7.36 billion people and vaccine safety record remains excellent (click hereCanada remains near the top of the international pack when it comes to vaccinating its population. 

colourful horizontal bar graph showing vaccine doses administered for the world

However, vaccination rates are appallingly low in low-income countries (See below). 

colourful line graph showing vaccine doses given to countries depending upon their income level

These vaccine deserts cause human death and suffering and allow the virus fertile ground to mutate and create new variants. This is one of the reasons Canada has not yet advocated universal 3rd doses of vaccines. It can be argued we should first share the wealth with low income countries-both out of fairness and to prevent spread of mutant virus.

Vaccines are safe: In addition to many clinical trials showing safety, the safety record of vaccines has been established in the real world (see item 1 in today’s note). The complication rates remain very low based on Canadian data showing that vaccines are safe (click her for Canada’s safety data), as well as being effective against all forms of the coronavirus. Getting vaccinated reduces your risk of hospitalization for COVID-19 33-fold! It carries a very small risk of serious adverse reactions (10/100,000 vaccines given) and virtually no risk of death. There are virtually no medical reasons not to get the vaccine for, apart from: severe allergy with a 1st does of the vaccine (a condition called anaphylaxis) and documented allergy to a vaccine component. Sadly, some people are using “fake science”, pseudo-religion and Canada’s human rights legislation to justify their vaccine hesitancy-ergo, we have wave 4!

6 boxes with text and numbers

The serious complication rate of vaccines in Canada remains low (10 serious adverse events/100,000 vaccines administered). Data as of Oct 29th, 2021

7) The global pandemic is not yet controlled: ~251 million cases to date with most deaths in past 28 days in the USA UK, Russia, Turkey and Ukraine (left column below).

satellite image of earth taken from spaceworld map and graphs and ranking of countries with covid-19

Global COVID-19, Nov 11th, 2021

Here is today’s map of the global pandemic. Daily cases are rising (red graph), as are deaths (white graph). Vaccine administration is seen in the green graph (I’m not sure of reason for recent spike).

Final Thoughts

1) It’s influenza season-Get ready to roll up your sleeve again…for your annual flu shot The predicted influenza rates may be higher this year, and the similarity between symptoms of flu and COVID-19 can make it difficult to self-diagnose. Reduce your risk of the flu by getting the influenza vaccine. My team and I did this several weeks ago (see below). 

tweet of masked people getting flu shot from nurse

2) Please encourage your friends and family to get vaccinated! Unvaccinated people not only put themselves at risk; but when they fall ill, risk overwhelming our hospitals, blocking care for the 99% of people who do not have COVID-19. Unvaccinated people are also a major pool in which the virus can circulate. This source of virus can potentially infect our children (under age 12 years), who are not protected since they are not yet eligible for vaccination.

3) Don’t be discouraged-we will emerge from this pandemic and this recent surge will pass!

On this Remembrance Day we should be reminded of past challenges we have face and overcome as a country. Like the soldiers of WWI we will defeat this pandemic!

Flanders field poem and a picture of a poppy

 

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