By Sue Tiffin
The following are brief reports of a letter penned by medical officer of health Dr. Natalie Bocking on April 20, and items discussed at the Haliburton, Kawartha, Pine Ridge District health unit board of health meeting held virtually on April 21.
A letter sent to the Trillium Lakelands District School Board community on April 20 from Haliburton, Kawartha, Pine Ridge District health unit medical officer of health Dr. Natalie Bocking informs staff, students and parents of a surge in COVID-19 activity in the region.
“Despite the lifting of provincial restrictions, the pandemic is not over,” reads the letter. “As a member of a school community, you have an important role to play in reducing the risk of transmission of COVID-19 and helping keep our school communities healthy and safe.”
The provincial mask mandate had been lifted a month ago, and while masks are still required in high-risk settings including health-care settings, long-term care homes, shelters and public transit, they are not mandatory in schools, retail settings or restaurants. On April 12, Ottawa’s public school board made masks mandatory in schools again. Bocking recommended in her letter that masks be used.
“I strongly recommend that you wear a mask in indoor public spaces, including schools,” said Bocking’s letter. “There is strong evidence that masking is an important layer of protection against COVID-19, especially for those who are not vaccinated (e.g., children under five years), or are at risk of severe COVID-19 illness (e.g., immunocompromised and the elderly). Masks should be three-layered, well-fitted, cover the nose and mouth, and should be replaced if damp or visibly soiled.”
A similar letter from Dr. Charles Gardner, medical officer of health for the Simcoe-Muskoka District Health Unit, was sent to TLDSB students in the Muskoka area on April 13.
Sixth wave update
Bocking addressed the board with a COVID-19 update the day after strongly recommending masks be used in indoor settings as a result of a surge of infection, part of the sixth wave.
“I don’t think any of us imagined we would reach this number of waves, and hard to know how many waves we will see in the future,” said Bocking.
Bocking said there had been a significant increase in COVID-19 activity across the three regions of the health unit, with approximately 46 new lab-confirmed cases reported each day and noted “this is just the tip of the iceberg,” as only those living or working in high-risk facilities have access to PCR testing.
The number of outbreaks has increased dramatically, she said, with 17 at that time, nine hospitalizations had occurred in the past two weeks, and test positivity at 21 per cent was approaching the highest it has been, which was 23.5 per cent in January. Wastewater is showing high signals of viral activity in Lindsay and Cobourg.
Since Jan. 1 there have been 31 deaths in the region associated with COVID-19 and 58 outbreaks.
Risk of re-infection is high
The BA.2 Omicron sub-variant is the most infectious variant the health unit has seen yet, said Bocking, with a similar severity to the original Omicron variant, with a risk of re-infection, even with individuals that might have been infected with the Omicron variant in January.
“Other things that are different this time around, and this wave, is that we don’t have broader public health restrictions or regulations in place, so there are no broad mask mandates in place, capacity restrictions in venues, and the Reopening Ontario Act did expire at the end of March … And in this wave it’s unclear what the overall impact will be on hospital and ICU admissions with severe illness.”
Bocking said while there were high admissions during the Omicron wave, or fifth wave, that the population is highly immunized with booster doses of COVID-19 vaccine, and many people did have infection in January and February.
“Certainly the message we’re receiving from the province is that they’re not expecting the same burden on the acute care system with regards to hospitalizations for severe illness,” said Bocking. “I’m quite hopeful that this will be the case but there is some uncertainty on what the impact will be.”
‘When is this going to end?’
Pandemic fatigue “is a real thing,” said Bocking, and is being seen in the community in general, community partners, health sector colleagues and among health unit staff.
“Everyone is asking, ‘when is this going to end?’ and I think the reality at this point in time is that this is not something that’s going to end, per se, that this is something we now need to ensure we’re planning to enable ongoing responses in a way that doesn’t create the anxiety and stress associated with surges of activity that we have for each of the previous waves.”
Bocking said one challenge that remains is that the health unit has had promises from the province for one-time COVID-19 funding, and funding for 2022 related to school-focused nurses, but not long-term commitments that have enabled the health unit to make permanent hires to support a sustainable approach rather than use contract staff for surges.
Rollout of Paxlovid
Bill Cane, a councillor from Northumberland County who sits on the board of health, asked about access to Paxlovid, an antiviral treatment, noting he’d heard the region had only a small amount of the medication, which is used for people at higher risk of severe outcomes due to COVID-19. He said one constituent had expressed a complaint that they had attempted to access the treatment, “but by the time they jumped through all the red tape and hurdles, they were told it’s too late to bother. That’s frustrating.”
He asked if anything was being done to reduce the red tape in accessing the medication.
“Having tools in the toolbox, it’s not going to do much good if you don’t take it out,” he said.
Bocking said the health unit wasn’t involved in the rollout of Paxlovid at all, with Cane noting, “maybe we should be.”
Prior to this wave, Bocking said eligibility was more restricted, there were fewer doses, and a slower rollout. When this wave started, she said, the province highlighted Paxlovid as being a tool to use, but didn’t have all the puzzle pieces in place. She said access was improving, but said “as is often the case,” policies were being announced prior to rollout being completed.