By Cecilia Nasmith
The sixth wave of COVID-19 is bringing significant increases to the communities served by the Haliburton Kawartha Pine Ridge District Health Unit, the board heard at its April meeting.
Medical Officer of Health Dr. Natalie Bocking said that the current test positivity rate of 21% is nearing the highest-ever test positivity rate – 23.5% on Jan. 21.
For the past seven days, the average daily new lab-confirmed cases number 46 – and since the province drastically narrowed exactly who can get a lab-confirmed test, Dr. Bocking said this represents only the tip of the iceberg.
There have been nine new hospital admissions over the past two weeks, and the 17 outbreaks they are currently monitoring represents what she called a drastic increase over the past week.
Looking at year-to-date figures – which pretty well represent the picture since the Omicron variant took hold – there have been 109 hospital admissions, 24 ICU admissions, 31 deaths and 58 outbreaks.
Waste-water viral monitoring rates are high. However, while they previously correlated with positive diagnoses, they now far outnumber lab-confirmed cases. To Dr. Bocking, this indicates a number of infections among individuals who don't meet the new lab-testing criteria.
Dr. Bocking pointed out three key differences between this sixth wave and previous waves.
First, it is largely fueled by the BA2 subvariant of the Omicron variant. It is the most infectious variant seen to date, similar in severity to Omicron and with a significant risk of reinfection.
Second, the mask mandates, capacity limitations and other broad public-health regulations and restrictions that can play a role in prevention are no longer in effect.
Third, the population at this point is highly immunized, both through vaccinations and through having caught the Omicron variant previously. For this reason, the province does not expect such a devastating impact on the health-care infrastructure.
Dr. Bocking also listed four important tools for mitigating the sixth wave.
First, vaccines are “absolutely a tremendously important tool, highly effective at preventing serious illness,” Dr. Bocking said. And eligibility for a second booster shot has recently expanded.
Second, heightened prevention-and-containment measures remain in place in high-risk settings like long-term-care homes.
Third, there are more COVID-19 therapeutics available. The eligibility for Paxlovid has expanded. And Health Canada has approved Evushield, which is seen as a prophylactic measure for those at extreme high risk (such as transplant recipients) to provide additional protection and, in a worst-case scenario, mitigate the severity of a case of COVID.
Fourth, there is the on-going work of supporting individuals in practising preventive behaviours and protecting the most vulnerable - “making sure people have the right information at the right time,” Dr. Bocking said.
She returned to the topic of vaccinations to point out that more than 12,000 HKPR residents are eligible for a first booster.
“There's very good evidence of the role of booster doses in upping the immune response and protecting against severe illness,” she stressed.
She displayed a graph illustrating the point. On a basis of per-million residents, there were 87.5 boostered residents in hospital with COVID versus 303.8 unvaccinated residents. For ICU patients, the ratio was 11.2 boostered residents to 57.9 unvaccinated ones.
Health unit-led vaccination clinics are ramping up again, with more mobile and school-based clinics planned as well. And there is on-going vaccine support in long-term-care and retirement homes, while paramedics provide in-home vaccinations for housebound residents and pharmacies continue to offer shots.
Then there's the behind-the-scenes support the health unit provides to these efforts related to inventory, statistics, surveillance, data analysis, infection-prevention and -control, public education and outbreak management.
The wide-ranging nature of pandemic support was echoed by epidemiologist Andrew Harris, who opened his presentation with a timeline.
They began reporting on COVID-19 Jan. 30, 2020, at a time when Canada only had three cases but China had more than 7,000.
The World Health Organization declared the outbreak a pandemic on March 11, 2020 – two days before the first confirmed case appeared in the HKPR region.
Premier Doug Ford declared a state of emergency in Ontario on March 17, 2020 – one day before the HKPR region had its first outbreak.
Harris provided a look at numbers by region, showing 106 active cases in Northumberland County. To date, 3,671 cases have been resolved. Of 3,807 confirmed cases, 36% were associated with outbreaks. Of deaths among confirmed cases, 60 have taken place in outbreak settings and 34 in other settings.
Meanwhile, Dr. Bocking said, “pandemic fatigue is a real thing. We all had hoped we would have a longer period of time to catch our breath before there was another wave.”
Along with health-unit staff, she said, they see it in their community partners and colleagues in other health-care sectors.
Everyone is asking when it will end, but she doesn't see this happening. Instead, she called for smarter planning to enable a response that doesn't create anxiety and stress resources unduly.
