Dashboard case counts to give way to wastewater, hospital admission data
By Stephen Petrick
Health officials are ushering in a “paradigm shift” in how COVID-19 is managed and the health unit will have to work closely with several community groups to help them understand broad changes, said the region’s top doctor.
In a lengthy report to the Haliburton, Kawartha, Pine Ridge District health unit board, medical officer of health Dr. Natalie Bocking spoke about how the Omicron variant has led to changes on how the health unit will measure the threat of the virus and actions that are being made to help schools and long-term homes operate with a sense of normalcy.
“It’s helping to not necessarily normalize COVID-19, but handle it in a way that doesn’t disrupt core activities” she said, during the Jan. 20 health board meeting, held virtually.
Bocking said that watching daily case counts on the health unit’s dashboard will no longer be the best way to get an accurate sense of how present COVID-19 is in the community. The new Omicron variant is so infectious that health care workers are now focussing their efforts on controlling the illness in high-risk settings. That means the general public has limited access to lab-confirmed testing, and dashboard numbers won’t reflect the actual numbers. Those who test positive with a home-based kit, or are showing symptoms and are assumed to have COVID are being asked to follow isolation guidelines on their own and inform close contacts themselves.
Bocking said the number of hospital admissions are now a better way to gauge the prevalence of COVID.
The health unit is also inspecting wastewater to get a sense of how prevalent COVID is in the region.
She said that technology is being used at two wastewater lines – one in Cobourg, the other in Lindsay – because when a person has COVID, they ultimately release some of its genetic material in their fluids. The technology filters water and looks for the genetic material that is consistent with COVID-19.
“We call it wastewater signal data,” Bocking said. “It’s not very specific; it does not tell us who has COVID. But it does match well with overall increased cases. When it starts to come down, cases come down as well.”
There are other signs that the Omicron variant is waning. Bocking said that the test positivity rate, as of Wednesday, Jan. 19, was declining. However, the strain on hospitals is still noticeable. In the two previous weeks, there had been 21 hospital admissions in the region, due to COVID.
COVID is also still a concern in long-term care homes, she added, explaining that there had been three long-term care related deaths in the previous two weeks. However, she said that number pales in comparison to what was seen in the first wave of COVID in 2020, and now most cases being observed in long-term care homes involve residents showing mild symptoms.
“We are, on the other hand, hearing concerns about strict measures,” she said, referring to Ontario’s recent move to ban visitors to long-term care home and resident outings for social purposes.
“We’re working with our partners to talk about how we can have a balanced approach to that. This is a tricky balance, it requires a paradigm shift.”
Bocking also spoke about the need to educate parents about a shift in strategy on keeping schools open safely.
She said the health unit will no longer track each individual case of COVID at schools and inform parents when there’s a close contact in their child’s class. Instead, public health’s strategy for schools will shift to ensuring better masks are provided, better ventilation is in place and promoting vaccines for school-aged children.
“We are working closely with school boards to talk about how we can help them,” she said.
She said the constantly changing nature of public health work is leading to “burnout” and officials have to be mindful of the health of their own staff, adding that stories such as protests at public health offices have been detrimental for morale.
Bocking’s report triggered much discussion among the board, as there are still unanswered questions, such as whether a fourth vaccine dose will soon be recommended and the question of when life might get back to normal.
“There’s not one answer to that … it will be a process,” Bocking said, addressing the question of how the pandemic might end.
She said that officials need to see the impact of easing restrictions a little at a time. They can look at wastewater data, hospital admissions and daily case counts to do that.
“We don’t want to loosen everything at once and then see an increase,” she said.
COVID-19 data collected in Minden wastewater last year
Minden also had a wastewater monitoring site in place last summer.
“Wastewater treatment plants in Lindsay and Cobourg (the two largest urban centres in the health unit region) were selected as the main testing sites,” Dr. Natalie Bocking of the HKPR health unit told the Times. “However, due to the increased traffic through Minden from out-of-town visitors during the summer months, the decision was made to set up one monitoring site in Minden last summer. In October 2021, monitoring was moved to Cobourg.”
The last time a wastewater sample was collected from the Minden site was Oct. 8, 2021.
“Surveillance at the Minden plant found an observable increase in COVID-19 signatures on July 26, Aug. 31, Sept. 2 and 28, and Oct. 1, 2021,” Bocking told the Times.