By Cecilia Nasmith
There are currently two COVID-19 outbreaks in the Haliburton Kawartha Pine Ridge District Health Unit jurisdiction, Medical Officer of Health Dr. Natalie Bocking said at this week's media update – one minor one plus one at Lindsay's Central East Correctional Centre that is big enough to cause a large blip in the epidemiology.
For example, fully 140 of the region's 174 active cases are in the City of Kawartha Lakes, thanks mostly to the 122 inmates and nine staffers testing positive. And it pushed the cases-per-100,000-population figure up to 82 from where it was before at fewer than 30.
It was pointed out that there are similarities between this and the earlier outbreaks in long-term-care homes in terms of many individuals in a setting where distancing is quite a challenge. And the initial incubation period where no symptoms are apparent allows a COVID carrier plenty of opportunity to spread the infection.
“We are still identifying new cases 10 days into the outbreak,” Dr. Bocking said.
Many staffers had the opportunity to be vaccinated previously due to their high-risk occupation. A vaccination roll-out was almost ready to go when the outbreak hit, and was delayed by the outbreak response.
Of the seven new hospital admissions throughout the HKPR region (one of whom was a CECC inmate), five are in ICU beds.
As of Monday, 74,661 vaccinations have been administered in the HKPR jurisdiction – at mass-immunization clinics, mobile clinics, pharmacies and primary-care sites. At the same time, 95,921 individuals residing in the HKPR geography have at least one shot, or 59% of the population aged 18 and over. That figure rises to 80% of the population for those aged 60 and over.
“These are pretty significant achievements in vaccination roll-out,” Dr. Bocking said.
The province has set a goal of 65% of the eligible population being vaccinated by the end of May, she added.
“I think we will be quite close to achieving that,” she predicted.
“Pfizer still remains our most regularly received and most reliable in terms of shipment of amount received. We don't have July amounts yet, but in June we are expecting approximately 9,300 doses of Pfizer per month.”
Moderna is less reliable in that there have been so many deliveries delayed, or arriving with a different amount than had been anticipated.
With AstraZeneca, the province has said that anyone who got this as a first dose can get it as a second dose with a 12-week interval (compared to 16 weeks for the other two vaccines for all but certain targeted populations). Or they can wait the 16 weeks and get a shot of Pfizer or Moderna.
Vaccines are mostly administered in six mass-immunization clinics, with one – at an arena in Haliburton County – soon to close up. Mobile teams will soon wind down in favour of mass-immunization clinics, having advanced quite far in inoculating identified populations (people with certain health risks or health concerns, as well as those living in congregate settings and the staff, residents and essential care givers at long-term-care homes and retirement residences). And pharmacies and primary-care settings will eventually take up the brunt of vaccinations at some future time when enough people get their second shots.
As supplies have risen, Dr. Bocking pointed out, so has eligibility. At this point, anyone aged 12 and up is eligible, and the Ministry of Health and Ministry of Education are discussing the possibility of some kind of immunization effort in June for students aged 12 to 17 and their family members – though there are no commitments yet on school resuming.
“I think there's a growing urgency related to the mental, social, emotional impact of virtual learning and not having in-person learning for children and youth,” she said.
“Based on evidence and data, the benefits of opening schools and having a couple of weeks in June outweigh the risks of a small potential increase in case counts associated with school openings. And we know there has not been a lot of transmission in schools – when we see school cases, it's generally from community contact.”
Data are less available for the question of whether boosters will be necessary and how often.
“We have learned a lot about COVID in the last year and a bit, and I think there are still some things we don't know about COVID and how it will respond,” she said.
“The vaccines we have developed show very good effectiveness of 94, 95%. What we don't know for sure at this point – because there hasn't been enough time yet – is how long that immunity lasts for.”
Dr. Bocking revisited the AstraZeneca risk to state that, if she'd had an AstraZeneca shot initially, she'd opt for a second AstraZeneca shot.
The risk of Vaccine-Induced Thormbotic Thrombocytopenia is roughly one in 600,000, posing a serious but remote risk, although it is an individual's own decision what level of risk he or she is comfortable with. The risk that comes with a first shot of AstraZeneca is lower for a second dose, she pointed out, but it's a conversation she urges anyone to have with a pharmacist of health-care provider.
She ended with a reminder that a Stay-At-Home Order is still in effect.
“Those public-health measures – the distancing, not gathering outside your immediate household, wearing masks, hand washing – continue to be what is really going to bring us out of lockdown until we have enough of the population vaccinated,” she said.
