/What makes for a COVID-19 ‘outbreak’

What makes for a COVID-19 ‘outbreak’

By Jenn Watt

The following are brief reports of items discussed at the board of health meeting for the Haliburton, Kawartha, Pine Ridge District Health Unit on Thursday, Oct. 15.

Deciding whether to label a case of COVID-19 in a long-term care facility or public school an “outbreak” goes beyond simply confirming a positive case of the virus: precise criteria must be met, something that can create confusion for the public.
Anne-Marie Holt, director of health promotion for the HKPR District Health Unit, gave board members an overview of how public health officials make determinations of when an outbreak has happened.
In long-term care facilities, one case of COVID-19 deemed contagious makes for an outbreak.
“Because we already had a wave of COVID [of those who] were infected in the spring, they could still get a positive test now, but they’re not really infectious, [the test is] just actually picking up genetic material from the virus from their COVID experience in the spring,” Holt said.
In those cases, while there may be a positive test for COVID-19, an outbreak would not be declared, she said.
In schools or hospitals, which have more people coming and going, an outbreak would be declared if two or more cases were detected where it appears COVID-19 was contracted within the facility.
“So there has to be person-to-person transmission that happened in the school. That means that you have evidence that they actually got it at school, not that they actually got it in community and then came to school and happened to get it,” Holt said.
With mask-wearing and physical distancing protocols, the chance of in-school transmission is lessened. However, some students may socialize outside of the school building, contracting the virus.
Holt said she was aware that the term “outbreak” can create anxiety and noted that Premier Doug Ford had issues with its usage. However, the term is a technical one used within the public health sector. Some confusion could come from how the term is used regarding community spread.
“Because at times, we also use the word ‘outbreak’ when you have significant community spread of a virus. So you might have heard us say in previous years, ‘oh, it’s our influenza outbreak,’” she said. “…So certainly I think there is the potential for confusion.”

Tracking opioid use
The health unit will be developing an opioid surveillance system to track information from community partners and first responders to monitor opioid trends in the region.
Funding from the Public Health Agency of Canada will allow for the hiring of a research analyst who will gather data from various partners, analyze it and make it available to those who need it.
The grant is for $60,000 and the project must be complete by August 2021.
“By implementing the Opioid Enhancement Surveillance System, community partners can take further actions to respond to opioid trends in our communities,” a report from Dr. Lynn Noseworthy, medical officer of health, reads.

COVID trends website
Board members were informed of a new website called COVIDTrends, which allows users to search for locations in Canada and access the number of confirmed COVID-19 cases in the county or region in the last 14 days. The site can be accessed at https://health-infobase.canada.ca/covid-19/covidtrends.

Flu vaccine rolling out
The fall flu vaccination campaign is to launch at the end of October though the vaccine is already available at several locations in the region, Anne-Marie Holt, director of health protection, told the board.
“We have been actively providing vaccine out to all of our health-care providers and our long-term care facilities starting with providing the service to our high-risk populations,” she said.
For the most part, vaccination is happening by appointment, even at pharmacies, which in the past frequently allowed walk-ins. However, there are some locations still providing walk-in service. “If you’re interested in receiving the vaccine, [you should be] phoning a pharmacy, your local pharmacy, to make an appointment,” Holt said.
This year, pharmacies are offering high-dose vaccines for those who are immunocompromised or over the age of 65.