After a “substantial jump” in COVID-19 cases, the region’s medical officer of health undertook a deeper investigation into transmission sources for the 27 new cases reported since Tuesday.
During what is supposed to be the downward slope of the first wave of COVID-19 infections, the Simcoe-Muskoka District Health Unit logged the highest number of cases ever reported in a single day, with 25 today.
“I became aware of it late yesterday,” said Dr. Charles Gardner, Simcoe-Muskoka’s medical officer of health. “I had to understand what was happening … because you can only respond to something when you understand it.”
The outcome of the investigation revealed several factors behind the increase in cases.
Nine of the new cases are linked to an outbreak on a Simcoe County farm. There are two farm outbreaks at unnamed locations in the county.
There have been nine cases linked to the first farm outbreak and 15 cases linked to the second. Not all those who have tested positive for COVID-19 live in the Simcoe-Muskoka jurisdiction, so not all have been included in the total cases reported by the health unit.
Gardner confirmed there is one temporary foreign worker living on the first farm in outbreak who has tested positive and nine temporary foreign workers have tested positive at the second farm.
He said in all those cases, transmission happened locally and each of the workers had already completed a 14-day isolation before contracting COVID-19.
“We have done a site assessment on both of those farms from an infection control perspective,” said Gardner. “Some sanitation issues were identified and managed.”
Gardner noted there is a “high vulnerability” for workers at a farm, particularly if they are living in bunkhouses on site. Because people are working and living together, there is more potential for the virus to spread.
The health unit has ordered everyone working at the two farms in outbreak be tested for COVID-19.
There has also been one more outbreak declared at Stayner Care Centre after a staff member tested positive at the long-term facility. All long-term care staff are now required to be tested once every two weeks.
Outbreaks previously declared at Creeden Valley Care Community (Creemore) and Owen Hill Care Community (Barrie) have now been declared over. Owen Hill was previously out of outbreak when a staff member tested positive. There were no other positive tests since then. At Creeden Valley, one staff member tested positive.
With the remainder of the cases considered “sporadic” or not linked to an outbreak, Gardner said it’s significant there were 11 people who tested positive but have no symptoms of COVID-19.
“I wanted to understand why people got tested,” said Gardner.
With case follow-up, Gardner and the health unit determined there were four people who were tested because they had contact with a known case, and four others who got tested because they wanted to visit a family member at a long-term care facility or retirement home.
A negative test result is one of the province’s requirements for going to visit someone in a nursing or retirement home.
Additionally, each of the people working at the farms in outbreak had to be tested regardless of symptoms.
“The fact that we’ve got a large number that were asymptomatic due to requirements … was of note to me,” said Gardner. “It tells me something about the fact that we might expect more of such positive test results as a result of that kind of thing. It is bringing to the surface cases we wouldn’t have known about otherwise.”
It is possible some of the cases confirmed today, especially those people who have no symptoms of COVID-19, received false-positive results on their test. When the likelihood of the virus is low, such as in an asymptomatic person, the possibility of a false positive is increased.
“We’re treating all tests as positives because that is the safest thing to do,” said Gardner. “You are never able to clearly determine, at the end of the day, that someone had a false positive.”
Testing in the region increased by about three-fold when Premier Doug Ford announced anyone could get a COVID-19 test even without symptoms.
Gardner said it’s stayed pretty steady over the past few weeks. The region’s per cent positivity statistics have gone down from about two to three per cent of all tests being positive to about 0.7 per cent of all tests done in the region being positive.
“There’s a lot of testing happening in order to get that low of a per cent positivity result,” said Gardner.
Since the province announced stage two of its reopening plan, it has made case and contact tracing a little more work for the health unit, but Gardner said he’s not willing to attribute the region’s spike in cases to the stage two reopening.
“I think it’s a bit too soon to be able to say transmission of these cases would be related to moving to Stage 2,” said Gardner, noting it’s only been one week with fewer restrictions.
“We’ve noted it has complicated our investigations … we’ve had more contacts and more social environments outdoors than was the case before we moved into stage two.”
Friday’s spike in cases is what prompted Gardner to host a media briefing. He said it was a good reminder to continue practising physical distancing, proper handwashing, and to wear a mask where physical distancing isn’t possible.
“We need to not let our guard down, because clearly the potential for community transmission is there,” said Gardner.
Of today’s 25 new cases, 10 were listed as community-acquired, nine were linked to outbreaks on the two farms, and the remainder were close contact or are still under investigation.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
