By Cecilia Nasmith
There are currently no COVID-19 outbreaks in the entire Haliburton Kawartha Pine Ridge District Health Unit region, Chief Medical Officer of Health Dr. Natalie Bocking announced at this week's media scrum.
It was declared over just this week, with the last case having been diagnosed at the beginning of June. Over its course it affected 10 staffers and 154 inmates, but that's all resolved now.
“Another exciting milestone, and something we haven't seen for a little while,” Dr. Bocking said.
Also something not seen for some time is how low the per-100,000 case number is, now sitting at 7.9. And the test positivity rate stands at 1%.
They were delighted to announce on Tuesday of this week that there were no new daily cases in all three of the HKPR municipalities – the Counties of Northumberland and Haliburton and the City of Kawartha Lakes.
And overall in the province, Dr. Bocking added, numbers are decreasing.
“We are hoping they are trends and they stay this way, but certainly there's some optimism as we look ahead toward summer,” she said.
Over the past 14 days, fully 48% of new cases identified are in those under the age of 29.
Of all new cases, 42% identified the source of transmission as a close contact, 33% named a household contact, and 25% could not identify the source of transmission.
One figure of concern is the estimated 47,000 HKPR residents who are eligible for a shot and to date have not had one.
On the other hand, Dr. Bocking said that 125,221 residents of the HKPR jurisdiction have at least one vaccination – which works out to 73% of the eligible population aged 12 and over. As for those with two doses, that would be 20%.
“We are really looking at excellent coverage,” she declared.
Looking at that group that only became eligible a few weeks back, the 12-to-17-year-olds, fully 47.5% of this group has at least one dose – and a number of youth clinics are being organized.
The goal is simply to have as great a percentage of people vaccinated as possible. The figure of 90% is often floated, Dr. Bocking said, “but there's no magic number, especially as there continue to be different variants circulating.
“We know the more infectious the variant is, the higher percentage of coverage we need for vaccinations. If we can reach 90%, that is amazing. If we can reach 95%, even better.”
Five mass-immunization clinics continue to function in the HKPR region, as well as three other ways to get a shot.
Mobile clinics and pop-up clinics have become a popular option in Northumberland and Kawartha Lakes, thanks to local partners – a variation of the targeted mobile clinics that have been organized for special cases such as those with housing insecurities and those whose health makes it difficult to leave their homes.
Many pharmacies continue to offer vaccinations, as their Moderna supplies continue to grow.
And a limited number of primary-care health teams offer the shot for the patients in their own practices.
Dr. Bocking said that supply continues to be good in spite of fluctuations.
Pfizer has been the most reliable, growing to 9,300 doses per week for the HKPR jurisdiction. There was a shipment delay this week, but not such a shortage that they had to cancel any clinics or any appointments. But they do know that the weekly allotments will fall to 3,500 in early July before starting to rise again.
Moderna supplies are increasing, and 7,200 doses were received last week with a similar amount expected this week.
It almost doesn't matter, as she cited guidance from the province and the National Advisory Council on Immunization that says the two are virtually interchangeable in response to concerns that fluctuating supplies mean that two doses of either one cannot be guaranteed.
“Both have the same mechanisms. Both are safe. Both are effective,” she said.
“There are lots of other examples where a different brand of vaccine might be used for a booster dose, which is really what that second dose is.
“We are urging you, if you receive Pfizer for your first dose and you are offered Moderna for your second dose, don't delay.”
Adding to the uncertainty, she noted that Pfizer is being set aside for those aged 12 to 17, as it is the only one currently approved for that age group.
“We are really trying to get the message out that they can be interchanged. It's safe to do so, and it's effective to do so.”
There are times when people who got Pfizer show up at one of their mass-immunization clinics, hear they are getting Moderna and decide to leave.
“We would encourage them, before leaving – stop and speak with one of the staff. We are finding when people stop for that discussion about what the options are, what the risks and benefits are, many people – after having that opportunity – do choose to have the Moderna vaccine.”
The vaccine supply is good enough that people with a second appointment booked are looking to move it up as soon as they meet provincial eligibility criteria.
If the revised appointment is booked through the provincial system, the older appointment is cancelled automatically. If, on the other hand, you get an earlier second shot through a pharmacy or pop-up clinic, the onus is on you to make the cancellation through the provincial system.
The system can be challenging at the best of times, Dr. Bocking said, with things like long waiting periods. So there is sometimes not that motivation to stick with it just to make a cancellation.
The province did a one-time sweep, where it coordinated those who received a second dose with those who had a second-dose appointment into the future. They expunged those appointments proactively and freed up 80,000 new appointments.
But that was a one-shot, Dr. Bocking said. And unless the province decides to make that an on-going procedure, the right thing to do is file your own cancellation.
And if for whatever reason you cannot, your appointment will come, your dose will go unclaimed – and at the end of the day, leftover doses will be used to whittle down a list of people with special health issues who wait on stand-by to get that dose.
Of course, extrapolating on that system, too many uncancelled appointments could potentially lead to a leftover amount of doses that is so large it might involve some being wasted, so organizers hope those who should make a cancellation will do so.
The feeling of optimism at this stage of the pandemic must be tempered with caution, Dr. Bocking said.
“We remain in Step One of the three-step provincial reopening framework. I know there has been lots of questions already for the Ford government to consider entering into Phase Two and Three sooner than originally planned, especially given that some of the targets for vaccine coverage have already been met across the province, or in certain areas of the province.
“From a public health perspective, we continue to urge some caution with reopening, especially recognizing that some of the unknowns related to the Delta variant we know is circulating in the province. As the total number of cases come down provincially, the proportion expected to be the Delta variant has increased. We know it spreads easier than other variants, and we know that one dose of the vaccine is not as effective at preventing a symptomatic illness from COVID compared to other variants.
“We know the Delta variant will find pockets of the province that are not fully vaccinated,” Dr. Bocking said.
“We want to make sure by fall we can continue to open schools, and have in-person learning and extracurriculars and other social events return. We want to celebrate the progress we have made, and still have some caution as we continue to open up the economy and have some gatherings during the summer.”
