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Four people have died and another 48 have tested positive for the coronavirus, officials with the Middlesex-London Health Unit reported on Monday.

The update continues the slight downward trend in new cases seen in recent days, but also extends what is now a near three-week-long streak of COVID-19 deaths.

As of Monday, the region’s total case tally to 5,083, of which 3,485 people have recovered, an increase of 67 from Sunday.

At least 152 people have died, the health unit says.

The four most recent deaths involved a man in his 80s and two women in their 80s and 90s who were associated with a long-term care home, and a man in his 60s who was not linked to a seniors’ facility.

Monday marks the 18th day in a row that a COVID-19-related death has been reported in London and Middlesex. At least 46 deaths have been reported just since Jan. 1, more than any other preceding month of the pandemic.

January is also on the verge of surpassing December 2020’s record case tally. Already, at least 1,712 cases have been reported this month — just 12 cases shy of December’s 1,724, and more than the total number of cases reported between March 1 and Nov. 30.

The health unit says at least 1,446 cases are active in the region.

Of the 48 new cases, 35 are from London, four are from Strathroy, and one each are from Lucan Biddulph and Southwest Middlesex.

Those infected skew younger, with people under 40 making up just over half of the cases.

Five individuals are 19 or younger, 11 are in their 20s, 10 are in their 30s, six are in their 40s, eight are in their 50s, two are in their 60s, and three each are in their 70s or 80 or older.

As has been the case for several weeks, exposure source information is not available for nearly all of the new cases as contact tracing efforts play catchup following several days of triple-digit increases this month.

Forty-six cases have their source listed as pending or undetermined while two are due to outbreaks.

More information is expected to be released during Monday’s media briefing. Health officials have said they don’t think the region has seen the peak of its second wave.

Monday’s update follows a weekend that saw nine new deaths, 171 new cases and confirmation that a variant of COVID-19 first discovered in the U.K. had been found in the London-Middlesex region.

Health officials said Saturday that they were notified by the Public Health Ontario lab that a previously confirmed case had been identified as the region’s first of the variant, known as B.1.1.7.

The individual, who is in their 80s, had no history of travel outside of Canada, the health unit said.

In a tweet, Dr. Chris Mackie, the region’s medical officer of health, said the person had been confirmed positive for the virus in December, meaning the variant “has likely been here for about two months.”

The variant has alarmed officials in many nations because studies indicate it may spread more easily than other viral strains, though it is not believed to be more deadly and appears to be vulnerable to vaccines.

Ontario’s first case of the variant was identified in Durham Region on Dec. 26, 2020.

Since Thursday, the province has been under a stay-at-home order.

On Monday, police Chief Steve Williams stressed that the order does not give police the authority to arbitrarily stop people and vehicles to check compliance.

He added that while the order enhanced their ability to enforce compliance, such as the authority to disperse gatherings and ticket those found in contravention of the order, police would much rather residents voluntarily comply.

“However,” he said, “if a police officer has reasonable grounds to believe that an individual(s) or corporation is in contravention of the order, enforcement may result.”

Williams added that he is aware of heightened concern among members of the Black, Indigenous and people of colour (BIPOC) community both locally and throughout the province.

“Some concerns relate to the notion of police conducting arbitrary stops of people or vehicles to check on the compliance of the stay-at-home order,” he said.

“I want to reassure the public once again that this will not happen here in the city of London. The provincial restrictions do not allow for these powers, nor do we want them. Further – we will not be asking for, nor are citizens obligated to produce proof of essential employment.”

Police will also not be enforcing the order when it comes to Londoners who are homeless or are “sleeping rough” and have no stable housing, he said.

The “overwhelming majority” of their enforcement, which has been done in partnership with city bylaw officials and the health unit, has been responding to complaints about large gatherings, Williams said.

As of Monday, the region’s seven-day case average is 82.12, a decrease from 107.0 on Friday. The 14-day average, meantime, is 101.35, slightly down from 107.21 on Friday.

The region’s seven-day case incidence rate stands at 56.4 per 100,000 people, while Ontario’s sits at 54.0. Looking at the entire pandemic, the cumulative incidence rate for London-Middlesex is 1,001.5 per 100,000 people compared to Ontario’s 1,599.7.

Middlesex Centre remains the hardest-hit municipality during the pandemic. The locale has seen 231 cases during the pandemic, equivalent to an incidence rate of 1,307 cases per 100,000 people.

London, which has seen 4,391 cases, has an incidence rate of 1,085.

Elsewhere, Strathroy-Caradoc has reported 180 cases, Thames Centre 87, Lucan Biddulph 32, North Middlesex 29, Southwest Middlesex 28, Adelaide Metcalfe 13 and Newbury two.

At least 90 cases are pending location data.

Hospitalizations

The number of COVID-19 inpatients in the care of London Health Sciences Centre has fallen compared to Friday, down to 29 from 35.

The number of inpatients in critical or intensive care also fell from 14 to 10, the organization said Monday.

At the same time, however, staff cases within LHSC have risen by nine over the same period to 27.

The organization is currently dealing with three outbreaks at its hospitals, including one declared on Friday at University Hospital that has been tied to seven staff cases.

At St. Joseph’s Health Care London, meantime, no COVID-19 patients were reported to be in the care of St. Joseph’s Hospital.

At least 23 staff within SJHCL are currently positive for the virus. At least 16 cases are due to an outbreak at Mount Hope Centre for Long-Term Care that has now been expanded to encompass the entire facility, according to the organization.

At least 325 people have been hospitalized during the pandemic, including 63 in intensive care, the health unit says.

Institutional outbreaks

No new outbreaks have been declared or resolved at local health-care facilities, however a new outbreak has been declared at the provincial jail in the city’s south end.

The health unit says four staff members at Elgin-Middlesex Detention Centre have tested positive, with the initial case reported on Jan. 14 and three additional cases reported on Jan. 16.

No inmates have tested positive.

“The declaration of the outbreak is an acknowledgement that virus transmission has occurred at the facility, and that there will be increased adherence to public health measures and a thorough cleaning of the facility,” the health unit said in a statement.

“It is important to note that there has been no risk of exposure for visitors to EMDC.”

The most recent health-care facility outbreak was declared on Saturday at Longworth Retirement Residence involving the entire facility.

Elsewhere, an outbreak declared on Friday at University Hospital in its emergency department also remains active, linked to seven staff cases — one more than Friday. No patient cases and no deaths have been linked to the outbreak, according to London Health Sciences Centre.

The outbreak comes weeks after the hospital was declared outbreak free for the first time since Nov. 10.  University Hospital had previously been the scene of at least 11 unit-level outbreaks between Nov. 10 and Dec. 28 that left a total of 82 patients and 92 staff members infected and 29 dead.

LHSC is also dealing with two ongoing outbreaks at its Victoria Hospital facility, located in B41 Antenatal on Jan. 6 and the C6-100-Geriatric Behavioural Unit on Jan. 12. Both are linked to fewer than five patient and five staff cases and no deaths.

An outbreak also remains active at Strathroy General Hospital on the second floor of its inpatient unit.

Outbreaks also remain active at multiple long-term care and retirement homes in the region.

The health unit says at least three have grown in size. They include an outbreak at Chelsey Park Retirement Community, which has grown to include the third floor in addition to the fifth floor.

Elsewhere, outbreaks at Extendicare and Mount Hope Centre for Long-Term Care are now listed as facility-wide outbreaks.

Since March, the region has seen at least 90 institutional outbreaks in London and Middlesex, including at least 64 at local seniors’ facilities.

Seniors’ facility outbreaks alone are linked to 335 resident cases. 333 staff cases and 78 deaths.

Schools

No new school cases have been reported in the region.

Only one is currently active, reported on Saturday at Clarke Road Secondary School by the Thames Valley District School Board.

According to the health unit, at least 177 cases have been reported at schools and child-care centres since the start of September.

One case is currently active at a local child-care centre. The health unit says the case is at London Bridge: Huron Heights Early Childhood Learning Centre.

Students in the region, and across southern Ontario, will stay in remote learning until at least Jan. 25, however that may be extended given the province’s state of emergency declaration and the ongoing stay-at-home order.

Vaccinations and testing

An update on the local vaccination effort is expected Monday afternoon.

The health unit says long-term care and retirement home staff are currently being prioritized for the vaccine, given that seniors’ facilities have accounted for a large percentage of COVID-19 deaths in Ontario.

The province has said it wants the COVID-19 vaccine administered in all long-term care and retirement homes by Feb. 15.

To focus on that effort, it was reported early last week that vaccinations for hospital workers in the region had been put on hold, excluding those who had already received their first shot.

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Phase 1 of the province’s three-phase vaccine rollout is set to run until March, with health-care workers; essential caregivers; adults in First Nations, Métis and Inuit populations; and adults who receive chronic home health care being added to the list of those to be vaccinated.

Phase 2 is set to come into place in April, with older adults, those who live and work in high-risk congregate settings, front-line essential workers and those with high-risk chronic conditions expected to become eligible.

Pfizer announced last week that it was temporarily delaying international shipments of the shots while it upgrades production facilities in Europe.

The Ontario government has said that will affect the province’s vaccine distribution plan, and some people will see their booster shots delayed by several weeks.

London’s two assessment centres continue to see very high demand, as has been the case since late November.

Carling Heights has seen an average of 452 visits per day over the last seven days. Oakridge Arena, which is closed on weekends, reported an average of 331 visits between Monday and Friday last week.

Both centres are continuing to operate by appointment only.

As of Friday, the centres will no longer perform COVID-19 tests for international travel.

Ontario

Ontario is reporting 2,578 new cases of COVID-19 Monday and 24 more deaths linked to the virus.

Health Minister Christine Elliott says there are 815 new cases in Toronto and 507 in Peel Region.

She also says there were 151 more cases in York Region and Niagara Region.

There were 9,691 doses of a COVID-19 vaccine administered since Ontario’s last daily report.

The province is reporting that nearly 40,300 tests were completed since the last daily update.

There have been 240,364 total cases of the novel coronavirus in Ontario since the pandemic began.

A total of 206,310 cases have been resolved and 5,433 Ontarians have died from the virus.

Ontario’s Ministry of Health says 209,788 doses of COVID-19 vaccine have been administered.

Elgin and Oxford

Three people have died and 28 others have tested positive for the coronavirus, Southwestern Public Health reported Monday.

The region’s total case count now stands at 2,068, of which 1,641 people have recovered, an increase of 13 from the day before.

Forty-five people have died, according to the health unit. The deaths reported Monday involved a 73-year-old man and 75-year-old man from Oxford County and a 94-year-old woman from Oxford County whose death was associated with an ongoing outbreak at Maple Manor.

At least 382 cases are currently active in the region. At least 12 people were in hospital as of Thursday, with four people in intensive care.

At least 10 institutional outbreaks remain active in the region as of Monday, declared on:

• Jan. 16 at Chartwell Oxford Gardens (one staff case)
• Jan. 16 at Seasons Retirement Home in St. Thomas (one staff case)
• Jan. 15 at Dayspring Residence in Tillsonburg (one resident case)
• Jan. 8 at Extendicare Port Stanley (two staff cases)
• Jan. 6 at Trillium Retirement Home (13 resident, five staff cases)
• Jan. 4 at Caressant Care Bonnie Place – St. Thomas (two resident cases and one death)
• Jan. 1 at Woodingford Lodge – Woodstock (two resident, one staff case)
• Dec. 19 at Terrace Lodge in Aylmer (five staff cases)
• Dec. 16 at PeopleCare Tavistock (40 resident, 37 staff cases, seven deaths)
• Dec. 12 at Maple Manor Nursing Home (81 resident, 51 staff cases, 17 deaths)

No new school cases have been reported. No cases were listed as active by either the Thames Valley District School Board or the London District Catholic School Board.

Whether any cases have been reported at any other school boards, or at private schools, is unclear. The health unit does not report school cases itself, instead deferring to the province’s online database, which is not being updated amid remote learning.

St. Thomas has reported 364 cases during the pandemic, while Woodstock has seen 328, Aylmer 327 and Tillsonburg 302.

Elsewhere, Norwich has seen 177 cases, Bayham 152, East Zorra-Tavistock 90, Ingersoll 85, Zorra 49, Blandford-Blenheim 45, South-West Oxford 42, Central Elgin 41, Southwold 23, West Elgin 19, Dutton/Dunwich 15 and Malahide seven.

At least six per cent of tests were coming back positive as of the week of Jan. 3, a slight decrease from 6.2 the week before. The health unit says about 5,081 people were tested, down slightly from 5,149 the week before.

Huron and Perth

One person has died and 51 others have tested positive for the coronavirus, Huron Perth Public Health said Monday.

The region’s total case tally now stands at 1,032, of which 880 people have recovered, 35 more than in the previous update.

Twenty-six people have died. No information has been released about the deceased.

As of Monday, at least 126 cases are active in the region. At least 67 of them are in North Perth, followed by 20 in Stratford. Five people are currently in hospital. At least 24 active cases are health-care workers.

One new outbreak has been declared in the region, located at Exeter Villa’s retirement home in North Perth. It’s linked to two resident and two staff cases.

Elsewhere, an outbreak continues at Stratford’s hospital. The outbreak, declared on Friday, is linked to four staff cases, one more than the previous update.

Outbreaks also remain active at the following facilities, declared on

Meantime, no new school cases have been reported by either the Avon-Maitland District School Board or the Huron-Perth District Catholic School Board.

Thirteen cases are presently active in the region at the following schools, all under the Avon-Maitland Board:

• Avon-Maitland board employee
• Clinton Public School (two cases)
• Listowel District Secondary School
• South Huron District High School (four cases)
• St. Marys District Collegiate and Vocational Institute (three cases)
• Stratford District Secondary School (two cases).

Of the region’s overall cases, 449 have been in Perth County, while 292 have been in Huron County.

Stratford has reported 263 cases and St. Mary’s 28.

The region’s test positivity rate stood at 3.3 per cent as of the week of Jan. 3, a minor drop from the 3.5 per cent the week before.

At least 3,616 people were tested during the week of Jan. 3, slightly higher than the 3,537 tested the week before.

Sarnia and Lambton

Two people have died and 31 others have been reported by Lambton Public Health.

The region’s pandemic case tally stands at 1,647, of which 1,374 people have recovered and 33 have died. No details were immediately available about the deceased.

At least 240 cases are active in the region. Fifteen people were listed as being in the care of Bluewater Health for COVID-19 on Monday, an increase of two from the day before.

No new outbreaks have been declared and none have been resolved.

Over the weekend, an outbreak was declared at the Sarnia jail after four staff members there tested positive.

Meantime, an outbreak at Vision Rest Home in Sarnia has grown exponentially since the health unit’s last outbreak update on Friday. Sixteen additional resident cases and one staff case have been confirmed at the facility.

Currently, 14 outbreaks are active, including 10 at long-term care and retirement homes, declared on:

• Jan. 15 at Marshall Gowland Manor in Sarnia (one staff case)
• Jan. 13 at Vision Rest Home (16 resident cases, three staff cases; 16 resident cases and one staff case more than the previous update Friday)
• Jan. 11 at Landmark Village in Sarnia (two staff cases; one more than the day before)
• Jan. 9 at Sumac Lodge in Sarnia (one staff case)
• Jan. 8 at Fiddick’s Nursing Home in Petrolia (one staff case)
• Jan. 8 at Fiddick’s Retirement Home in Petrolia (one staff case)
• Jan. 8 at Twin Lakes Terrace (LTC) in Sarnia (16 resident, five staff cases; one resident and three staff cases more than Friday)
• Jan. 8 at Twin Lakes Terrace (Retirement) in Sarnia (one staff case)
• Jan. 4 at Fairwinds Lodge in Sarnia (five resident, two staff cases)
• Dec. 30 at Village on the St. Clair in Sarnia (22 resident, eight staff cases; one more case each than Friday).

Elsewhere, three outbreaks are active at unnamed workplaces, linked to a total of 18 cases.

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In terms of possible school cases, no information is available from the two main local boards.

The Lambton Kent District School Board says it is not reporting case data during the mandated remote learning period, while the St. Clair Catholic District School Board has not updated its online COVID-19 page since before the holidays.

The region’s weekly test positivity rate stood at 6.2 per cent as of the week of Jan. 3, with some 4,614 people tested, roughly the same as the previous week, when the test positivity rate was 6.8 per cent.

A total of at least 80,552 people have been tested in Lambton.

— With files from The Canadian Press