By Cecilia Nasmith
Almost all the Haliburton Kawartha Pine Ride District Health Unit mass-immunization clinics will be paused next week, to devote that week's supply of vaccines to the vulnerable home-bound population.
Except for the clinic at Lindsay's Exhibition Centre, which is run by Ross Memorial Hospital, staff at the other clinics will team up with paramedics to vaccinate people in congregate settings (like group homes) as well as residents on their own who are unable (for whatever reason) to make a trip to a mass-immunization centre.
The news came from Chief Medical Officer Dr. Natalie Bocking at her first weekly media scrum, continuing the tradition begun by her predecessor Dr. Ian Gemmill.
Dr. Bocking began the session with the latest numbers – a total to date of 1,534 cases, 291 of which were reported in the last 14 days and 124 of which are considered active.
“That was a fairly significant increase from what we had been seeing more recently,” she said.
While cases of variants of concern across the province have plateaued at about 69%, it's closer to about 13% in the HKPR. That must be qualified by saying that laboratory processes and available capacity mean a delay in reporting.
And while the test positivity rate is more than 10% provincially, it's just over 3% locally over the past 14 days.
Over the past two weeks, about 30% of cases identified are among those under age 20 – a big shift from early days when most cases were among the older population groups. Many of those older groups have now been vaccinated, Dr. Bocking pointed out, and the new variants seem to have a greater effect on the younger ones.
She shared another important metric – crude rate per 100,000 population, which is a key factor in the colour-coded system that has been superseded by the provincial Emergency Declaration. Even though the HKPR was yellow when this occurred, the current 65-88 cases per 100,000 population would put the region in the red zone now.
Since she began on the job three weeks ago, Dr. Bocking summed up, there has been an increase in activity.
“It seems to have plateaued a little bit – we see about 20 new cases a day on average,” she said. But as Dr. Gemmill always said, things can change on a dime.
The health unit website updates the vaccination information each Monday. As it stands, it reports 41,156 doses administered to date – either through the mass-immunization clinics staffed by health unit personnel and their partners and volunteer or pharmacies or primary-care practices or the kind of mobile clinics that blitzed the long-term-care homes as soon as vaccines became available locally.
Because some residents get their shots outside the jurisdiction, the site reports that more than 51,000 HKPR residents have received at least one dose. This represents about 27% of the population, consistent with the provincial figures.
“I think we are on the right track,” Dr. Bocking commented.
That said, she added, “we are still in an era of vaccine shortage. A lot of the challenges or struggles or frustrations people are experiencing are rooted just in the fact that Ontario is not receiving enough supply. Canada is not receiving enough supply. So at HKPR, we are not receiving the supply we would like to see to meet demand.”
Another challenge is the sharply increased demand in response to sudden changes in provincially identified priority populations. They had no sooner begun to vaccinate people in the 70+ range, she said, than the province lowered the threshold to 60+.
Another challenge peculiar to Ontario is the move to shuttle more vaccine supplies to so-called hot spots, based on the fact that 80% of infections are happening in 20% of its postal-code areas. Though HKPR numbers have grown alarming, it doesn't qualify as a hot spot.
Dr. Bocking explained that when they are advised of allocations, these are categorized as “confirmed” or “tentative.” The HKPR policy is not to post any appointment as available unless it is backed up by a “confirmed” dose to avoid the situation seen elsewhere in Ontario of people arriving for appointments and being told there is nothing for them.
“Over the next couple of weeks, there will be fewer appointments because we have fewer supplies overall,” she said.
But there is good news on the horizon with the recent announcement of the Federal government of increased Pfizer supplies.
“We are quite hopeful that will enable us to really operate all the mass-immunization clinics at their full capacity, which they haven't been to this point because there hasn't been the vaccine supply.”
Several reporters questioned Dr. Bocking about the AstraZeneca vaccine, including one pointed query whether she'd have any hesitation about receiving it herself – her answer was no.
She explained that there's the data that come from clinical trials and the results seen in real-world inoculations. From the latter has come news of a rare blood clot.
That risk is one in about 100,000, she said.
“The risk of getting COVID and becoming quite ill is higher than any risk identified with the vaccines.”
The news may seem more dire at a time when COVID is top-of-mind for everyone, she said, but people have the right to the information they need to make their own decisions based on their own priorities and values.
Asked about playgrounds, she said she had been impressed as a mother to witness how well children can keep face masks on – and that these should be part of the safe use of these important outdoor facilities.
“We now outdoors is safer than indoors. We know that, even at playgrounds, we want outdoor activities to safe, and that means keeping distances,” she reminded everyone.
Her avid-golfer relatives are disappointed at the closure of facilities like golf courses and outdoor campsites, but she believes this ban was a bid to prevent the opportunity for gatherings with people outside one's own household – which has been identified as a health risk at this time.
Her own suggestion is to review the recommendations of Ontario's Science Advisory Table – and the one she singled out is sick leave for essential workers, especially in manufacturing and other settings where large outbreaks have originated.
“We need to enable people to look after themselves and their families, and not be penalized by having a pay cut for having to stay home,” she stated.
Pete Fisher of Today's Northumberland related going to downtown Cobourg Saturday to cover the weekly anti-lockdown protest in front of Victoria Hall and finding people “nearly wrapped around” a pharmacy as they waited for walk-in vaccinations – aren't they supposed to be giving vaccinations on an appointment basis, he asked.
That is the ideal, Dr. Bocking said, though some pharmacies are finding they can't handle the logistics of that approach. If a walk-in structure is their choice, she said, they have to ensure every possible precaution is in place – like keeping the appropriate distance apart in line.
As for the demonstration at Victoria Hall, she continued, “I can appreciate people's frustrations and being tired of restrictions. There are harms associated with how we have had to respond to COVID-19 – financial, mental health – and that really has been weighed quite closely.
“But the demonstrations do bring people together, often in a closer way than we want to be seeing right now. That certainly could put community members at higher risk of transmission in a setting like that.
“People need to express their frustrations, but there might be other ways they could do that.”
In one thing at least, there's nothing new. Asked frequently what people can be doing, the answer is the same as it has always been – stay home except for essential purposes, do not gather with people from outside your own household, wear a mask, keep a safe distance apart from others, cover your coughs, keep up the hand hygiene, and get tested if you have any symptoms.
“It's the same message we have been saying for a year,” she said.
