After reporting nearly 100 cases in four days, the Middlesex-London Health Unit’s medical officer of health is expecting the province will soon re-classify the region under its new system for determining COVID-19 measures.
The region recorded its highest daily case count on Sunday with 37 new cases, breaking a record set just two days earlier on Friday of 27 cases. As well, 13 cases were reported on Saturday and 20 on Monday.
“I certainly do anticipate the province will look closely at our numbers and it’s hard to see how the case counts that we have would not qualify for the (yellow) protect level,” Dr. Chris Mackie said Monday.
“But again, that’s a decision that happens on a weekly basis at this point, not daily. So probably something would go into effect either later this week or maybe on the weekend but also we don’t know for sure.”
The decision is based, in part, on five different epidemiological criteria:
- The incidence rate, which works out to how many people per 100,000 population are infected;
- Positivity rate, meaning how many tests are coming back positive;
- Reproductive number, which Mackie described as “how do your cases this week compare to your cases last week?”;
- The number and severity of outbreaks of COVID-19;
- The level of community transmission, which refers to cases where the source of infection is undetermined.
However, exactly what data the province looks at and when is unclear.
“If you’re using data that’s a week old, you would have missed all of those record-breaking days. But if you are able to use the most recent data, then it becomes clear we’re in a pretty high level of spread compared to where we were two weeks ago,” he said.
“From our view, we do meet the criteria and we would expect the province to make that move later.”
Mackie added that there’s no “clear picture of a single point of cases in the community.”
“These are really coming from across the community: taxi drivers, restaurant workers, people who do Uber, long haul truckers, anyone with a significant public exposure or travel risk seems to be generally at higher risk,” he said.
“But beyond that, about ballpark, a third of the cases are among those whose family members have tested positive — (it’s) very difficult to stop the spread of this illness within a home. The other source, we have about a third of cases that are unexplained, that’s ballpark and it changes obviously day-to-day. All of that to say that it’s something that’s very widely distributed.”
If London and Middlesex County move to the province’s yellow, or protect, tier, the region would see “strengthened measures” in addition to the standard measures in place across the province, which include limits on the sizes of gatherings and requirements for the use of face coverings, for example.
The strengthened measures would include mandating that restaurants and bars close by midnight, require contact information for all seated patrons, limit the volume of music to be no louder than the volume of a conversation, and other measures.
Measures for sports and recreation include increasing the space between people to 3 metres “for areas of a sport or recreational facility where there are weights/weight machines and exercise/fitness classes,” and limiting recreation programs to 10 people per room indoors and 25 outdoors. The measures are fairly similar to a Section 22 order the health unit issued in late October.
Full details of the province’s new tiered framework can be viewed online.
Mackie added on Monday that he doesn’t anticipate “at this point” issuing additional orders on a local level.
“We have a framework that will be very useful, I think, across the province. (There are) some outstanding questions about exactly what impact the framework will have long term but at this point, I think it’s a really useful document and we definitely are standing beside and behind that framework.”
Mayor Ed Holder called on everyone to take public health guidelines seriously, suggesting that much of the transmission is occurring outside of workplaces and public spaces.
“All Londoners, regardless of age, must pay mind. They must follow the health protocols in those private residences because it isn’t just a younger person problem,” he said Monday.
According to Holder, bylaw officials have had nearly 3,000 interactions with individuals and businesses since provincial orders and a municipal masking bylaw came into effect, but only two charges have been laid.
“It’s not because of a reluctance to issue fines or lay charges, we’re well beyond the point of education. Rather, it’s because compliance has been exceptionally high and essentially universal,” Holder said.