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Four more people have died — three at University Hospital — and a record 46 people have tested positive for the coronavirus, officials with the Middlesex-London Health Unit (MLHU) reported on Wednesday.

It’s the second day in a row the region has set a new daily case record after the health unit reported 38 cases on Tuesday along with two deaths involving a man in his 70s and a woman in her 80s. It also marks the third day in a row that the region has recorded 30 or more cases.

Wednesday’s update brings the region’s total case count to 1,696, of which 1,404 people have recovered, nine more than the day before. A total of 73 deaths have been reported.

Health officials said the four deaths involve a man and woman in their 70s, a man in his 80s and a woman in her 90s. Three are linked to an expansive outbreak at University Hospital, the health unit said. The two deaths reported Tuesday were also tied to the hospital.

Of the 46 cases reported Wednesday, all are from London, according to the health unit.

The health unit says 13 of Wednesday’s 46 cases are tied to the University Hospital outbreak. Nine involve staff of the hospital and four are patients. At least 14 of the 38 cases reported Tuesday involved the outbreak.

Wednesday’s reported cases span all of the health unit’s tracked age brackets, with more than half of the individuals under the age of 30.

Six are aged 19 and under, 18 are in their 20s, four are in their 30s, two are in their 40s, six are in their 50s, four are in their 60s, and three each are in their 70s and 80 or older.

In just two days, the region has recorded 84 cases, more than were recorded during each of July and August.

The region’s seven-day average for new cases stands at 26.28 as of Wednesday, while the 14-day average stands at 21.85.

Since Nov. 1, the region has recorded at least 550 cases, or about 32.4 per cent of all cases seen since the pandemic began.

The region is currently in the yellow-protect tier of the province’s restrictions framework.

According to the health unit, 1,573 cases have been reported in London since the pandemic began, while 38 have been in Strathroy-Caradoc, 35 in Middlesex Centre and 30 in Thames Centre. Lucan Biddulph has seen nine, North Middlesex eight, Southwest Middlesex two and Newbury one.

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Hospitalizations

The number of inpatients with COVID-19 at London Health Sciences Centre stands at 45 as of Wednesday, an increase of two from the day before. The organization says five patients are in critical care or intensive care.

It’s the largest number of COVID-19 patients hospitalized at LHSC at any given time, according to figures from the province.

Previously, 38 people were hospitalized at LHSC on April 26.

In addition, at least 44 staff members are currently positive with the coronavirus, a jump of 10 from Tuesday. Most, if not all, are tied to a large outbreak at University Hospital.

No hospitalized COVID-19 patients were reported at any St. Joseph’s Health Care London facility. The organization said three staff cases had been reported since Nov. 4.

As of Nov. 18, neither St. Joseph’s Health Care London nor Strathroy Middlesex General Hospital has seen more than four COVID-19 patients in their care at any given time. (This is reflected in the data as ‘<5’.)

The health unit says at least 179 people have been admitted to hospital due to COVID-19, including 40 who have needed intensive care.

Institutional outbreaks

A severe outbreak at University Hospital continues to worsen, according to officials with the health unit and London Health Sciences Centre (LHSC).

Both organizations say the number of deaths linked to the outbreak has risen by three to a total of nine as of Tuesday night. (Editor’s note: During an interview with 980 CFPL Wednesday afternoon, the region’s medical officer of health, Dr. Chris Mackie, stated the number of deaths linked to the outbreak had reached 10. That death, however, won’t be officially reported on the health unit’s COVID-19 dashboard until Thursday at noon.)

Patient cases related to the outbreak have risen to a total of 50, according to the health unit, while staff cases have grown to 47, for a total of 97 cases overall, as of Tuesday night.

The outbreak originated in 4IP General Medicine on Nov. 10 but has since spread to five other units, most recently 4TU Multi-Organ Transplant Unit and 6IP Cardiovascular Surgery, with outbreaks declared Nov. 27.

The outbreak also involves 6IP Acute/Decant Medicine, 9IP Sub-Acute Medicine and 10IP Palliative Care/Sub-Acute Medicine, which were all declared on Nov. 24.

A separate smaller outbreak at the hospital, linked to six cases, was reported in 9IP Orthopedics on Nov. 11 but has since been declared over.

In total, since Nov. 10, at least seven University Hospital units have been hit by COVID-19 outbreaks, with nine dead and at least 101 cases confirmed.

In an interview last week with 980 CFPL, Dr. Chris Mackie, the region’s medical officer of health, said the major breakdown in relation to the outbreak was when it came to PPE between staff.

“I really empathize with the people working in the hospital, I know everybody’s doing their best and we’re all going through COVID-fatigue… but what we saw is that people weren’t wearing masks when they’re on break, and that meant that the virus spread quickly amongst staff,” he said Friday.

Officials with LHSC implemented measures on Friday to combat the outbreak, and stress that the hospital remains open and that those needing urgent care should not delay seeking care.

Non-urgent and non-emergent surgeries have been postponed at the hospital, and ambulatory or outpatient activity has been reduced to only urgent and emergent appointments, procedures and diagnostic services. All patients admitted to LHSC are also being tested for COVID-19, and all adult inpatients are being masked.

“Strategies like that, that we’ve now put in place in the past four or five days… the wish is that we would have been able to do that earlier, but at the same time, we responded in that way as soon as a signal suggested that we needed to,” said Dr. Adam Dukelow, LHSC’s chief medical officer, in an interview Wednesday.

Dukelow says officials are still investigating what started the outbreak and how it’s grown to become as large as it is.

“Given what we have in terms of the number of people that work in our institution, the shifts that people work, and the mobility of those individuals, there may not be a specific event. It may be related to a number of much smaller one person-to-one person transmissions of COVID,” he said.

“I’m 100 percent confident that none of our staff or team members were working while sick. However, when you’ve been battling this virus and wearing lots of PPE for many, many months now, there’s no question that fatigue can play into it. And, you know, being in the hospital for 12 to sometimes 16, 20 hours or longer at a time, there may be slippages in that.”

Dukelow added the organization was still looking into an unsubstantiated rumour that a potluck was held at the hospital involving staff from different floors of the hospital.

“The first that our team, at least as far as I’m aware, our team had heard that that was even a rumour was earlier on Monday, and as soon as we were alerted to that, started a line of investigation,” he said. “We have no further information to confirm that (there) was a potluck at any point in time that would be related to the outbreak, but (we’re) actively investigating it.”

The rumour had been asked of Dukelow and Mackie during Monday’s health unit media briefing. Mackie was asked about it on Wednesday during an interview with 980 CFPL’s Jess Brady.

“I certainly continue to hear about that sort of rumour. I think the investigation at the University Hospital is ongoing, so it’s probably, you know, best that they comment,” Mackie said.

“We certainly don’t have anything definitive, but if it was a situation where potlucks or house parties or, you know, other social gatherings were contributing to the spread, it would help explain what we’re seeing.”

Asked whether he would have liked to see the measures implemented on Friday by LHSC put in place sooner, Mackie replied:

“I can tell you that we have been giving LHSC advice on this November 22, November 26 — we’ve given lots of documented advice so it’s not as if nothing was happening in that meantime, But absolutely, it would have been really helpful to understand the extent of this earlier so that we could have taken, you know, more definitive measures,” he said.

“I’m very happy with the measures that have been put in place. We’re working with LHSC to make sure that they continue to be in place. And if staff are able to follow those, then I think we will be definitely seeing a turn around the corner of this outbreak.”

Elsewhere, one outbreak remains active in 2 Perth of Parkwood Institute’s Main Building. It was declared Nov. 20 and has been linked to at least one case.

Since March, the region has seen at least 54 institutional outbreaks in London and Middlesex, including at least 40 at local seniors’ facilities.

Seniors’ facility outbreaks alone have been tied to 111 resident cases, 112 staff cases and 39 deaths.

Schools

A class outbreak remains active at St. Marguerite d’Youville School in London after the London District Catholic School Board reported an additional student case at the school on Tuesday.

The school board says the case affects the same class as a student case reported on Nov. 28. Health officials, it says, determined the two cases met the criteria of a class outbreak.

“Students and staff of the affected class were already self-isolating at home as a result of the first case,” the school board said in an online statement Tuesday. “The school will remain open and school buses will continue to operate.”

The two cases are among at least six school cases that are currently active in London and Middlesex:

• Two student cases are active at Catholic Central High School.
• One student case is active at Lord Dorchester Secondary School.
• One student case is active at John Paul II Catholic Secondary School.

At least 48 school cases have been reported in London and Middlesex since the start of September. At least 37 have involved students. All but eight cases have been reported in London.

In the post-secondary setting, outbreaks remain active at two Western University student residences: Saugeen-Maitland Hall, declared Nov. 19, and Perth Hall, declared Nov. 21. An updated number of cases tied to the two outbreaks was not immediately available.

Testing

At least 8,055 people were tested for the coronavirus during the week of Nov. 22, according to new testing figures issued by the health unit.

The tally is slightly higher than the 7,624 reported the week prior.

The region’s test per cent positivity rate stood at 1.6 per cent as of the week of Nov. 22, up from 1.3 per cent the week before.

Both of the city’s assessment centres, Carling Heights and Oakridge Arena, are continuing to operate by appointment only. Appointment testing for certain asymptomatic people is also continuing at eight local pharmacies.

Carling Heights reported a five-day average of 381 visits from Nov. 23 to 27, compared to 318 at Oakridge Arena.

Ontario

Ontario reported 1,723 new cases of COVID-19 Wednesday and 35 new deaths due to the virus.

Health Minister Christine Elliott says there are 500 new cases in Peel Region, 410 cases in Toronto and 196 cases in York Region.

The province says it has conducted 44,226 tests since the last daily report.

In total, 656 people are hospitalized in Ontario due to COVID-19, including 183 in intensive care.

The province is also reporting that 106 people are on ventilators in hospital.

The latest figures bring the total number of COVID-19 cases in Ontario to 119,922, with 3,698 deaths and 101,698 cases resolved.

Elgin and Oxford

One new death and 13 new cases have been reported by Southwestern Public Health, along with 11 new recoveries.

The update brings the region’s total case count to 576, of which 504 people have recovered and seven have died.

According to the health unit, the death involved a man in his 40s. Few other details have been released.

There are at least 65 known active cases of the virus in the region. At least 48 are in Oxford County, with 26 in Woodstock alone, while 17 are in Elgin County.

Elsewhere, St. Thomas has 10 active cases, Ingersoll nine, Tillsonburg four, Zorra four, Norwich Township three and South-West Oxford two.

Two people were hospitalized as of Nov. 26, the most recent figures available. One person was in intensive care.

Health officials reported eight cases and 14 recoveries on Tuesday. The region is currently in the orange-restrict tier of the province’s colour-coded restrictions framework.

The number of school cases in the region has risen by one after a case was reported at St. Joseph’s Catholic High School in St. Thomas, according to the London District Catholic School Board.

It’s unclear yet if the case involves a staff member or student.

It’s among at least six school cases that are active in Elgin and Oxford as of Wednesday. Cases also remain active at:

• Laurie Hawkins Public School involving one staff member.
• Forest Park Public School involving one student.
• Springbank Public School involving one student.
• East Elgin Secondary School involving one student and one TBD.

At least 16 school cases have been reported in Elgin and Oxford counties since the start of September.

One institutional outbreak remains active in the region as of Monday. It was reported on Nov. 24 at Woodingford Lodge in Woodstock and involves one staff case.

At least 10 outbreaks have been declared since March at nine facilities, linked to at least 20 cases, of which four have involved residents.

By location, Woodstock has seen the largest number of cases overall: 127.

Elsewhere, Aylmer has seen 117 (recording an incidence rate of 1,561 cases per 100,000 people), while Bayham has seen 78, St. Thomas 68, Tillsonburg 44, Norwich Township 41, Ingersoll 29, East Zorra-Tavistock 13, Blandford-Blenheim 12, Dutton/Dunwich 11 and South-West Oxford 10.

Five other municipalities have seen case totals under 10.

As of the week of Nov. 22, the region had a test per cent positivity rate of 1.3 per cent. About 4,183 people were tested that week.

Huron and Perth

Two new cases and seven recoveries were reported Wednesday by Huron Perth Public Health.

That brings the region’s total case count to 343, an increase of one from the day before. The health unit says one previous case has been reassigned to a different health unit.

At least 276 people have recovered and 18 have died. The most recent death was reported on Nov. 28 involving a resident of Cedarcroft Place.

The new cases were reported in Perth East and West Perth, according to the health unit.

There are at least 43 active cases in the region. Five people are currently hospitalized due to the virus. At least 18 have been hospitalized since March.

The region is currently in the orange-restrict tier of the province’s colour-coded restrictions framework.

Two outbreaks remain active at seniors’ facilities in the region, including one at Cedarcroft Place in Stratford.

Since being declared on Oct. 27, the outbreak has been linked to at least 68 cases, including 45 residents and 23 staff members.

Eleven of those residents have since died, according to the health unit.

Three staff cases and one resident case has been reported since Friday afternoon.

Elsewhere, an outbreak also remains active at Knollcrest Lodge in Perth East (linked to one staff case) and at Spruce Lodge in Stratford (linked to one staff case.)

At least 14 outbreaks have been declared at 11 facilities since March, linked to 97 cases and 15 deaths (11 at Cedarcroft and four at Greenwood Court).

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No new school cases have been reported in the region. At least nine are currently active.

Of those, four are at St. Mary’s Catholic Elementary School, which reported three student cases and one staff case on Nov. 30.

Elsewhere, active cases remain at:

• Northside Christian School involving one staff member. An outbreak was declared Nov. 25 at the small private school. It’s not clear when the school will reopen. The outbreak was active as of Wednesday.
• Goderich District Collegiate Institute involving one student.
• St. Ambrose Catholic Elementary School involving two students.
• Anne Hathaway Public School involving one student.

One non-school case is also active involving an employee of the Avon Maitland District School Board, according to officials.

At least 15 school cases have been reported in the region since the start of September.

At least 135 cases have been reported in Stratford, while 134 have been in Perth County and 67 in Huron County.

St. Marys has seen eight cases and one death.

As of the week of Nov. 22, the region’s test per cent positivity rate was 1.7 per cent. At least 3,529 people got tested that week.

A total of 60,839 have been tested during the pandemic.

Sarnia and Lambton

One new case and one recovery were reported Wednesday by Lambton Public Health.

The region’s total case tally stands at 413, of which 374 people have recovered and 25 have died. The most recent death was reported in early June.

As of Wednesday, 14 cases remain active in the region. One person is in hospital at Bluewater Health, the same as the day before, according to the organization. The health unit says 61 people have been hospitalized due to the virus.

Two new cases and four recoveries were reported Tuesday.

The region is currently in the yellow-protect tier of the province’s restrictions framework.

No new school cases have been reported.

None appear to be currently active, according to the Lambton Kent District School Board and the St. Clair Catholic District School Board.

Three student cases at St. Patrick’s Catholic Catholic High School in Sarnia have since resolved.

At least eight school cases have been reported in the county, all involving students.

No outbreaks are active. A total of 13 have been declared since March, linked to 115 cases and 16 deaths.

Two outbreaks earlier in the pandemic, located at Landmark Village and Vision Nursing Home in Sarnia, are linked to a vast majority of those cases, and all 16 deaths.

Ten of the region’s 13 outbreaks have involved seniors’ facilities, while two have involved workplaces and one has been at Bluewater Health.

As of the week of Nov. 22, the region had a weekly test per cent positivity rate of 0.49 per cent. About 2,623 people were tested that week. At least 58,284 people have been tested in total.

— With files from Jacquelyn LeBel and The Canadian Press