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University Hospital outbreaks ‘not the driver’ of COVID-19 cases in London area

Snow lays at the base of a sign of London, Ontario in the city's south end on Nov. 2, 2020. Andrew Graham / Global News

The number of COVID-19 cases associated with the London Health Sciences Centre’s University Hospital outbreaks continues to grow, but the local health unit says the outbreaks are “not the driver” of consistently high daily case counts in the region.

As of Monday, a total of 60 staff and physicians and 71 patients have tested positive for COVID-19 in connection with the University Hospital outbreaks while 13 people have died. An additional but entirely separate outbreak was also declared at UH on Saturday at 5IP Cardiology and cardiology offices, with less than five cases linked to it.

Read more: Coronavirus: 45 cases in London-Middlesex as region officially moves to orange restriction level

However, Middlesex-London Health Unit medical officer of health Dr. Chris Mackie said Monday that the UH outbreaks are not the major driver of cases in the region.

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“Yesterday’s 45 cases, only about 10 of those came from the outbreak directly. It is not the driver of our case counts in the broader community at this point,” Mackie said.

“The case counts are high for a number of reasons. UH is contributing, but you’ve also got a couple of smaller outbreaks that are in the sort of three to six positives range. And then most of the cases that we’re able to trace at this point are related to previous cases, so somebody who’s a household contact or another close contact of a previous case, that’s the majority of our cases right now.

“And we still have in the range of a quarter to a third of cases where we’re not able to trace, so truly community-acquired with no known source.”

Read more: Bar owners feel frustrated, ‘picked-on’ as London and Middlesex enters orange-tier

The region officially moved to the orange-restrict level of the province’s COVID-19 response framework on Monday and is already meeting some of the criteria for the red-control level, according to Mackie.

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Mackie says the region fits the criteria for case counts per 100,000 population and the reproductive number. He added that the public health capacity is “right on the bubble” of being overwhelmed and the MLHU is in discussions with local hospitals to determine whether they are at risk of ICU capacity being overwhelmed.

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When it comes to the test positivity rate, Mackie says the local level is usually lower than other regions because of the high number of long-term care facilities, which require mandatory screening of people with no symptoms.

“That is part of the provincial approach to keeping long-term care safe. So that criteria, you might argue, should be adjusted for this area,” Mackie continued.

“Essentially, there’s a strong case, I would say, that we meet at least half of the criteria and likely a case to be made saying we meet some of the rest.”

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Meanwhile, London Health Sciences Centre’s chief medical officer Dr. Adam Dukelow is hopeful that measures currently in place will limit further spread of the virus at University Hospital, especially in regards to the new and separate outbreak in the cardiology unit.

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“We believe the transmissions associated with this new outbreak occurred just before or around the time when additional outbreak containment measures were implemented across the entire hospital,” he said.

“As such, we have confidence the current strategy in place will limit additional spread associated with this new outbreak … I want to take another opportunity to reassure our community that our emergency departments and hospitals are safe so you definitely should not delay seeking care.”

Dukelow added that many staff members remain under work quarantine, meaning that they have no social contact outside of work. LHSC provides a list to the MLHU so they can track which staff members are on quarantine.

Mackie said he doesn’t have exact figures but that the number of staff on work quarantine is “in the hundreds.”

“This has been given as a letter of instruction and public health direction. We don’t have an order in place. We’re not issuing public health orders in these circumstances, but certainly wouldn’t hesitate to do so if there was any evidence that the directives were not being followed.”

Read more: 39 new coronavirus cases in London and Middlesex, UH outbreak impacts 2 more units

Additionally, COVID-19 testing of staff and patients has also been ongoing at UH. Dukelow says staff and patients in outbreak units are being tested every three to four days.

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General testing of staff and providers who have “touched University Hospital in any way” since Nov. 17 is almost completed with “close to 100 per cent complete of that 3,000 or so team members.”

Dukelow said LHSC and MLHU would be further discussing testing on Tuesday, looking into whether or not testing should be further expanded and whether the entire building should be tested again.

Dukelow added that Middlesex-London Paramedic Services, London police, and London fire organized a convoy in front of UH on Sunday in a show of support for hospital staff.

“I received many comments and messages from staff at UH as to how much they appreciated this.”

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