By Cecilia Nasmith
Two big highlights emerged from this week's Haliburton Kawartha Pine Ridge District Health Unit media scrum – a great percentage and a serious warning.
Announcing “really exciting news,” Medical Officer of Health Natalie Bocking said that 85,785 residents of the region have at least one COVID vaccine.
“This equates to 53% of the eligible population, and we are describing the eligible population as those 18 and over.”
The warning is that people tend to kick over the traces on a holiday weekend – like the Victoria Day weekend just days away – and the results show up in higher caseloads two weeks later. And looking ahead two weeks, Dr. Bocking pointed out, that would be about the time the Ontario government will be deciding whether to lift its Stay-At-Home order.
Those tempting beach vistas, the prospect of barbecues with loved ones we've been missing, those trips to the cottage with friends to enjoy a beer by the lake are just the latest version of a holiday we want to spend the way we once did. And as we've seen two weeks after each of these holidays, case numbers inevitably go up if we don't abide by the public-health measures now in place.
“Please remember – go outside, enjoy the fresh air, be active, but do it in a safe way that keeps you and your household apart from other households,” Dr. Bocking urged.
“And hopefully we will then be able to enjoy the rest of the summer in ways we are more familiar with.”
Dr. Bocking said that, to date, the region has 1,842 confirmed COVID cases, 76 of which were identified in the last week. At the moment, there are 79 active cases, of which 43 are in Northumberland County.
There are five outbreaks at the moment, all of which are small in scale and none of which are in long-term-care homes.
The seven-day rolling average of cases per 100,000 is 42, down from about 90 several weeks back. And on a typical day, they typically see 10 to 15 new cases. Of these new cases, almost 25% are in the 30-to-39 age group (with the 20-to-29 group in second place).
“Of cases in the last 14 days, the majority are related to being household contacts, or household spread, as well as close contacts – like small gatherings,” Dr. Bocking said.
Almost one-third of these cases have no known source of transmission, which reflects a community level of transmission.
As of May 17, 66,231 doses of vaccine have been administered in the region through mass-immunization clinics, primary-care teams and pharmacies.
As far as supplies, Pfizer is the most abundant and reliable vaccine. This week and next, about 8,100 doses per week are expected. Moving into June, we can expect about 9,300 doses a week. Though there are (to use the current buzzword) no confirmed sightlines for July and beyond, there are encouraging numbers until then.
Moderna supplies are less reliable and tend to be set aside for mobile vaccination clinics and primary-care teams.
AstraZeneca is on pause by provincial directive because of incidences of Vaccine-Induced Thrombotic Thrombocytopenia (a kind of blood clot) tied to their use. Studies are now being done to ascertain what kind of second dose might be best for someone whose first dose was AstraZeneca.
As of Tuesday morning, anyone aged 18 and over can book a vaccination through the provincial on-line-and-phone system. Even though supplies are increasing, Dr. Bocking pointed out, the number of eligible recipients is increasing much more, resulting in a frustrating inability to book appointments for many – though this will balance out eventually.
She also noted the recent announcement regarding the eligibility of those aged 12 and up and a Youth Immunization Strategy to begin in June.
“We are working closely with school boards in our region to determine the best way to roll out this strategy,” she said.
Enough time has passed for second doses to be on the horizon for those who were vaccinated early on. The 16-week interval was recommended by the National Advisory Committee on Immunization, which came down on the side of getting a measure of immunity out to the many as opposed to a full measure for the few in hopes of limiting both the spread of the virus and the severity of the cases (and their impact on the health-care system).
A small percentage of special health cases (as set out by the province) did qualify for an earlier second dose. And those who book through the provincial system get appointments for both shots at the time of contact. But many of those otherwise due for a second dose fall into one of two categories.
One of them is that group of citizens aged 80 and over who were the first to get their shots at the Cobourg Community Centre thanks to a concentrated effort to identify and personally contact them. The health unit is working with Northumberland County to reach out to this demographic again and to contact them proactively with an appointment.
The other group are those who got their vaccination through channels other than the provincial system – essential caregivers at long-term-care homes, for example.
The province is adjusting its system so that these people will at some point be able to book a second-shot appointment through that channel, possibly by the end of the month. The health unit is also encouraging these people to contact them through the Click and Connect feature on their website, and they will work with them to determine the best avenue to get that second dose.
To date, Dr. Bocking is not aware of significant reactions to the vaccines. Where there is a reaction apart from localized reactions (like soreness at the injection site), they are mostly larger body reactions like rashes, fever, nausea, headache and a tired feeling. She hasn't heard of any reaction requiring hospitalization or ER assessment.
If her children were in the 12-17 age group, Dr. Bocking would have no qualms about getting them vaccinated. By the time a new vaccine is approved for that age group, it will have been through a specified hierarchy.
The trials for a new vaccine begin on healthy adults. Given satisfactory results, they go on to more vulnerable populations. Then, given satisfactory results, they move on to youth and children.
“Trials so far have shown it to be very effective in that age group,” she said.
Dr. Bocking discussed some of the protocols being considered that will allow summer camps to operate – isolation for 14 days before arriving, testing at specified intervals, limits on movement.
“I know a lot of thought has been put into this,” she said - “weighing the risks and benefits in terms of the benefits (especially with schools having been moved to virtual learning for such a long period of time) and the risk of COVID exposure in those settings.”
She has heard the figure of 70% being the number of people who must be vaccinated to prevent further transmission. Family members and social groups undoubtedly contain members who do not intend to be vaccinated and, in many cases, it may just be a matter of having accurate information.
But realistically, it isn't likely the 100% level will be reached, and she wonders – at a future time when public-health measures are relaxed – if there might not be different parameters depending on whether or not a person has been vaccinated.
