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COVID-19: 1 death, 71 cases in London-Middlesex as region records 10,000th case

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Linda Silas, nurse and president of the Canadian Federation of Nurses Unions, talks about Ontario’s call for extra nurses from other provinces to help deal with an influx of critically ill COVID-19 patients in hospitals. – Apr 27, 2021

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One death and 71 new COVID-19 cases were reported on Tuesday in the London-Middlesex region as the local pandemic case tally surpassed the 10,000 mark.

The increase brings the local pandemic case count to 10,063, of which 8,981 have resolved, an increase of 151 from the day before.

A total of 197 deaths have been reported during the pandemic. The latest death involved a woman in her 50s who was not associated with a long-term care or retirement home. No other details have been made public.

At least 885 cases are currently active, the health unit says. Roughly 2,880 cases have been reported just since the month of April began, more than any other month of the pandemic.
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As of Tuesday, the region’s rolling seven-day case average stands at 97, down from 115 the seven days previous.

As of the week of April 11, 7.1 per cent of tests in London and Middlesex were coming back positive, down from 7.7 a week earlier, according to data released by MLHU last week.

Of the 71 new cases reported on Tuesday, all but two are listed as being from London. One is from Middlesex County, while the other is pending location data.

As they have for the last several weeks, the cases involve younger residents, with 48 per cent involving people under 30.

Seventeen are 19 or younger; 17 are in their 20s, eight are in their 30s, 10 are in their 40s, eight each are in their 50s and 60s, three are in their 70s and one is 80 or older.

Close contact is listed as the exposure source for the most number of cases at 28. Twenty-four others are pending such data, while 16 have no known link, two are due to travel and one to an outbreak.

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Variant cases continue to make up the majority of recent local cases. Roughly 60 per cent of cases reported during the weeks of April 4 and 11 involved variants.

Data for the week of April 18 is still being analyzed, but so far the tally stands at about 25 per cent of cases involving variants.

As of Tuesday, at least 1,560 variant cases have been reported in London-Middlesex, with all but two involving the B.1.1.7 variant, first detected in the U.K. The tally includes cases presumed to be B.1.1.7, as well as cases that have undergone genomic analysis and confirmed to involve a variant of some kind.

Just two cases so far have been confirmed to involve the P.1 variant, a tally unchanged for more than a week.

A note on the process of confirming and presuming variant cases:
  • Confirming a variant is a multi-step process. Positive COVID-19 cases undergo initial screening for spike protein mutations common to variants (N501Y, E484K and K417N), and if found to have one or more, undergo further genomic analysis to determine the specific variant involved (B.1.1.7, B.1.351 or P.1) — a process that can take up to two weeks.
  • Since last month, the province has stopped conducting genomic analysis on cases that screen positive for just the N501Y mutation. Now, those cases are presumed to involve the B.1.1.7 variant, as that variant has only been associated with the N501Y mutation.
  • Cases that screen positive for either the E484K or K417N mutation are still being sent for genomic analysis as they have been associated with the B.1.351 and P.1 variants, first detected in South Africa and Brazil, respectively.

A separate tally showing the number of cases that have screened positive for a variant-associated mutation, but have not been confirmed or presumed to be a variant, stands at 256. The tally will fluctuate up and down as cases undergo genomic analysis and are confirmed.

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Of those 256 cases, 125 were found to have the E484K mutation, consistent with the B.1.351 and P.1 variants. They are under genomic analysis. Of those 125, 107 had both the E484K and N501Y mutations.

The remaining 131 cases were initially found to have just the N501Y mutation, however they have not been ruled out for E484K. As a result, they are not being presumed B.1.1.7 and added to the main variant tally. It’s unclear if or when these cases may be added.

During Monday’s media briefing, Dr. Chris Mackie said the recent lower case counts were encouraging, but said the numbers came with a caveat.

“I want to stress how tentative our recovery looks at this point in terms of declining case counts, and that’s primarily because we’re seeing declining testing happen,” he said.

More so the province than locally, but if you look at percentage positivity, it’s really not coming down to the same degree as testing. In fact, provincially, percent positivity, is going up.”

Mackie attributed the recent dip in cases to the departure of Western University students following the completion of their semester. Western has been home to numerous student residence outbreaks this month and in late March that have been linked to at least 196 cases.

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“It’s really important to recognize we still have extremely high rates of COVID spread in our community, as high as it has been at virtually any time since the very beginning of the pandemic. Same thing is true at the provincial level.”

He added that the lower provincial case rates have been attributed to a reduction in testing, including at schools, with students at home.

Locally, Mackie says there have been signs of reduced community activity, such as fewer cars on the road and fewer gatherings. In addition, while the number of contacts being seen per case is still higher than it should be, “that is trending down.”

At least 9,000 cases have been confirmed in the city of London since the pandemic began, while 324 have been in Middlesex Centre.

Elsewhere, 292 cases have been in Strathroy-Caradoc, 129 in Thames Centre, 64 in Lucan Biddulph, 55 in North Middlesex, 53 in Southwest Middlesex, 15 in Adelaide Metcalfe and two in Newbury.

At least 129 cases have pending location information.

Hospitalizations

Ninety-five COVID-19 patients were listed as being in the care of London Health Sciences Centre Tuesday, the organization reported.

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Thirty-eight of them are in critical or intensive care. At the same time, at least seven staff members are currently positive with COVID-19, LHSC said.

The numbers are reflective as of 3 p.m. Monday.

At St. Joseph’s Hospital, meantime, no COVID-19 patients were listed as being in their care as of Tuesday. Five staff cases are active within St. Joseph’s Health Care London, however it’s not clear in which facility the staff work.

At least 496 people in London-Middlesex have been hospitalized due to COVID-19 during the pandemic, including 87 in intensive care, the health unit says.

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During Monday’s media briefing, Carol Young-Ritchie, LHSC’s executive vice-president, chief clinical officer and chief nursing officer, said about one-third of the COVID-19 patients in their care had been transferred in from elsewhere, mainly the Greater Toronto Area.

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“The numbers demonstrate we are continuing to care for consistently high numbers of COVID-19-positive patients from within our region, while also continuing to support the province with this effort to load balance patients across the broader hospital community,” Young-Ritchie said.

“While our numbers are increasing at the same intensity as they were the last couple of weeks, I want to be clear that capacity across the health-care system continues to be challenged.”

Young-Ritchie said LHSC was anticipating between two and six patients to be transferred to LHSC from outside of the region every day, something that was expected to continue over the next week.

Last week, LHSC officials said the organization would be opening an additional seven critical care beds to meet the surge in patients — to be opened as they are needed — and that, as part of a provincial directive, they would further ramp down non-urgent surgical activity to open resources and more care spaces.

Three of the new beds are located in the pediatric critical care unit of Children’s Hospital. Young-Ritchie said LHSC has not had to utilize those beds yet. Surgical capacity, meanwhile, is down to about 50 per cent of normal levels, she said.

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LHSC has opened at least 25 new critical care beds in recent weeks to deal with the influx of COVID-19 patients. Other local hospitals, including in St. Thomas, Stratford and Windsor, have also been receiving patients transferred from Toronto-area hospitals.

Institutional outbreaks

No new institutional outbreaks have been declared and none are active, according to the health unit.

The last outbreak to be active was in G5 of Parkwood Institute’s Mental Health Care Building. It was declared over on April 22.

It’s the first time since early September that the region has had no active institutional outbreaks.

A non-institutional outbreak is still active, however, at the city’s Elgin-Middlesex Detention Centre.

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The outbreak, active since Jan. 18, has been linked to at least 64 inmate and 34 staff cases. At least 12 inmate cases were active at the jail on Sunday, according to provincial data.

No active staff case count was available, but none were active as of last Wednesday, according to the province.

No update was available Monday about the large outbreak at Cargill. The outbreak is the second-largest to be seen in the region and has been linked to at least 116 cases.

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Production at the facility resumed on Friday.

Schools

No new school cases have been reported and only two are active, according to the health unit.

One case is located at Rick Hansen Public School, while the other is at Stoneybrook Public School.

No cases were listed as active by the London District Catholic School Board.

Outbreak declarations, however, remain active at the following schools as of Tuesday:

  • École élémentaire catholique Frère André
  • Mother Teresa Catholic Secondary School
  • Providence Reformed Collegiate
  • St. Andre Bessette Secondary School
  • St. Francis School

At least 350 cases associated with elementary and secondary schools have been reported in the region during the pandemic, according to the health unit.

Another 64 cases have been linked to child-care and early years settings. At least 16 cases were listed as active as of Tuesday.

Five cases are associated with London Bridge: Rowntree Park Early Childhood Learning Centre, which has since declared an outbreak as of Sunday.

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Elsewhere, three cases are associated with Miss B’s Childcare, which has also declared an outbreak as of Saturday.

One case each, meanwhile, has been associated with the following child-care settings, according to the health unit website:

  • Amanda’s Home Daycare
  • Angels Daycares Komoka
  • Beba’s Daycare Child Care Service
  • Deb’s Daycare
  • London Bridge: Piccadilly Place Early Childhood Learning Centre
  • London Children’s Connection: Westminster Children’s Centre
  • North Woods Montessori School
  • White Oaks Children’s Centre.

In post-secondary, meanwhile, few new cases have been reported as a result of ongoing outbreaks at several Western University student residence halls.

Seven remain active, according to the health unit, after an outbreak at Ontario Hall was declared over on Sunday. It was linked to at least 18 cases.

Active Western residence outbreaks (numbers as of April 26, 2021):
  • London Hall – 10
  • Essex Hall – 12
  • Elgin Hall – 15
  • Delaware Hall – 21 + 1 under investigation
  • Perth Hall – 31
  • Medway-Sydenham Hall – 34
  • Saugeen-Maitland Hall – 55 + 3 probable cases.

Including the recent Ontario Hall outbreak, the active Western outbreaks have been linked to a least 196 cases as of Monday.

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Vaccinations and testing

As of Monday, at least 150,000 COVID-19 vaccine doses have been administered in London-Middlesex so far. At least 22,886 were administered the week of April 19, more than any other.

Currently, all adults 60 and older, including those turning 60 this year, are eligible to get a shot, along with previously identified groups.

Last week, vaccine eligibility expanded to people 16 and older who have certain highest-risk and high-risk health conditions, including kidney disease, obesity and pregnancy.

Eligible residents are asked to visit the local vaccine booking website or call 226-289-3560 to book an appointment at one of the region’s three mass vaccination clinics. Online appointments are encouraged due to the high call volume.

During Monday’s media briefing, Dr. Chris Mackie said the health unit is anticipating expanding eligibility further this week, with an announcement likely on Wednesday.

Mackie said it was indicated by the province in a call over the weekend that it may shift to “more of the age cohort strategy than the at-risk strategy.”

“What that would mean is that we would move to 55- to 59-year-olds before moving to that large group of at-risk health-care conditions,” Mackie said, adding that a separate call Monday night was expected to provide further clarity.

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The province’s definition of ‘at-risk’ includes things like asthma, diabetes, autoimmune disorders, liver and heart disease, and a number of other conditions, and would make tens of thousands of new people eligible.

Mackie also noted that the health unit was anticipating opening its fourth mass vaccination clinic at Earl Nichols sometime in the next month thanks to expected vaccine shipments.

The region is set to see a delivery of about 8,000 Moderna doses on May 3, he said, “but not much beyond that.”

It’s a different story for Pfizer, however. While this week’s Pfizer delivery dipped to just over 9,000 doses, it’s expected to rise next week to 13,000.

“Then we continue for another week at that level and we see big jumps,” Mackie said.

We know that the province and the federal government have been able to acquire more Pfizer vaccine for the May period. We know a big chunk of that is going to hot spots, but some of that will be coming here mid-May as well.”

He added that doses will only increase in June.

As of this week, there are nine primary care sites in the region that are administering vaccines, with another 16 ready to go, Mackie said.

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“There are about 40 family doctors represented in those nine sites that are currently operating with lots more ready to go. And that continues to expand,” Mackie said. “We’ll be moving out to all family docs who are interested sometime over the next month or two.”

When it comes to AstraZeneca shots at local pharmacies as part of the provincial pilot, Mackie said the region has been allocated 21,400 doses.

“Which is great, it’s right on par,” Mackie said.

“Then we still only have 5,700 for family doctors, but hopefully more coming in there soon as well.”

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On Monday, the province announced it was considering allocating half of its COVID-19 vaccines to hot-spot areas to bring down surging cases, and could act as soon as next week if it decides to proceed with the change. The move would raise the amount being allocated to hot spots from 25 per cent.

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Speaking during the briefing, London Mayor Ed Holder said he “absolutely (does) not accept a reduction for London.”

Look, I understand the challenges being faced in some parts of the GTA and elsewhere, but so-called hot spots can change in a very short period of time. Just look at London, where N6A was a hot spot recently and today is not,” he said.

“I absolutely do not want to see London risk becoming one by diverting even greater supplies of local vaccines elsewhere.

“As mentioned, additional vaccines are already being sent to hot spots, not to mention we are receiving patients from elsewhere in our ICU… Allocating up to 50 per cent of provincial vaccine supply to hot-spot neighbourhoods is just a bridge too far for me, and it’s not something I can support.”

Those looking to get tested for COVID-19 can still visit the region’s two main assessment centres, at Carling Heights and Oakridge Arena, which remain open and operating by appointment.

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Ontario

Ontario is reporting 3,265 new COVID-19 cases on Tuesday. The provincial total now stands at 452,126.

Tuesday’s case count is lower than Monday’s 3,510 new infections and is the third day in a row cases have been lower than 4,000.

According to Tuesday’s report, 1,044  cases were recorded in Toronto, 673 in Peel Region, and 452 in York Region.

All other local public health units reported fewer than 200 new cases in the provincial report.

The death toll in the province has risen to 7,964  as 29 more deaths were recorded.

The province has reported 404,248 resolved cases, an increase of 3,908 from the previous day.

At least 2,336 people are hospitalized with COVID-19 (up by 65) with an all-time high of 875 patients in intensive care units (down by two) and 589 patients in ICUs on a ventilator (down by 16).

Health providers and union leaders are denouncing the Ontario government’s proposal to provide paid sick days for workers by enhancing the federal sick-leave benefit.

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The provincial government is offering to double the federal benefit for essential workers who contract COVID-19 if Ottawa can administer it in the province.

Prime Minister Justin Trudeau says Ottawa is in talks with Ontario, but stresses that such leave should be delivered directly through employers — which the federal government can’t do.

CUPE Ontario and health-care providers including an emergency room physician say the province is just doubling down on a flawed federal program that is inaccessible.

Elgin and Oxford

Twenty new COVID-19 cases were reported on Tuesday by officials with Southwestern Public Health.

The update brings the region’s pandemic case tally to 3,360, of which 3,134 have resolved, an increase of 30 from the previous day. At least 76 deaths have been reported, most recently on Friday.

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At least 150 cases are active in Elgin-Oxford, including 45 in Woodstock, 40 in St. Thomas and 14 each in Ingersoll and Tillsonburg.

The health unit says nine people from its jurisdiction are currently in the hospital, including two in intensive care. Officials note, however, that figure does not accurately reflect capacity of local hospitals, which have also fielded patients transferred in from the Toronto area.

The number of variant cases identified in the region currently stands at 367, an increase of 15 from the day before.

Of those, 332 have been either confirmed through genomic analysis to be, or are presumed to be, the B.1.1.7 variant, first detected in the U.K. At least 36 are active, the health unit says.

According to the province, cases are presumed to be the B.1.1.7 variant if they screen positive for just a single specific spike protein mutation, named N501Y. The B.1.1.7 variant has been associated with only this mutation.

The health unit says at least 35 cases have screened positive for the E484K mutation, which has been associated with the B.1.351 and P.1 variants, detected in South Africa and Brazil, respectively, and are still undergoing genomic analysis. Of those, at least eight are still active.

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Starting Tuesday, vaccinations are now being doled out at a new mass vaccination clinic in Tillsonburg.

The health unit announced the new clinic last week, which is running at the Tillsonburg Community Centre. Two other clinics remain in operation in St. Thomas and Woodstock.

Also starting Tuesday, residents 45 and older living in the N5H postal area, deemed a COVID-19 hot spot by the province, are also eligible to get a shot. The age cutoff is 60-plus elsewhere in Elgin-Oxford.

The health unit says proof of age and proof of residence is required for residents from N5H.

Eligible residents are asked to visit the area’s vaccine booking site or call 226-289-3560 to book an appointment.

Even younger groups of people, those 40 and older, are eligible to get vaccinated at pharmacies across the region as part of a province-run pilot program. Appointments should be made directly with a participating pharmacy, however wait-lists are lengthy.

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More than 38,100 people have seen at least one dose of the vaccine as of April 17. Updated figures are expected this week.

No new school-related cases have been reported.

Only one was listed as active in the region on Tuesday, located at Winchester Street Public School in Woodstock, according to the Thames Valley District School Board.

Meanwhile, no new outbreaks have been declared and none are currently active.

Overall, the health unit says a total of 739 cases have been reported in Woodstock during the pandemic, while 614 have been in St. Thomas, 494 in Aylmer and 403 in Tillsonburg.

Elsewhere, 223 cases have been in Norwich, 179 in Bayham, 165 in Ingersoll, 129 in East Zorra-Tavistock, 80 in Central Elgin, 79 in Blandford-Blenheim, 75 in Zorra, 64 in South-West Oxford, 43  in Dutton/Dunwich, 27 in Southwold, 27 in West Elgin and 18 in Malahide.

The region’s test positivity rate stood at 3.2 per cent the week of April 11, up from 2.9 the previous week. Updated figures are expected this week.

Huron and Perth

No new COVID-19 cases or deaths were reported on Tuesday by officials in Huron-Perth.

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The region’s pandemic case tally remains unchanged at 1,557. Four additional cases have been marked as resolved, bringing that total to 1,478.

At least 52 deaths have been reported, most recently on April 13.

As of Tuesday, 27 cases are considered active in the region, including 10 in North Perth and five each in Central Huron and Stratford.

The health unit says one person is in hospital with COVID-19.

Meanwhile, the number of variant cases identified in the region stands at 75.

Of those, at least 34 have been confirmed through genomic analysis to be, or are presumed to be, the B.1.1.7 variant, according to Public Health Ontario.

The rest remain under investigation. The health unit has not said what spike protein mutations those remaining cases screened positive for, which may indicate what variant is involved.

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More than 39,440 vaccine doses have been administered in the region as of April 25, the health unit says. The tally includes both first and second doses.

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Local health officials say people 16 and older with certain high-risk health conditions are now able to book an appointment to get a vaccine, along with all adults 60 and older who don’t already fall under a previously eligible group.

On Tuesday, booking slots were available for clinics in Goderich and Stratford for between May 11 and 15, May 18 and 22, and May 25 and 29.

Those looking to book an appointment once spots are available are asked to do so via the local booking system or by calling 1-833-753-2098.

More information on the local vaccine campaign and eligibility can be found on the health unit’s website.

No new school-related cases have been reported.

At least eight remain active in the region. Lists can be found on the websites of the Avon-Maitland District School Board and the Huron-Perth Catholic District School Board.

Meanwhile, no new outbreaks have been declared and none are currently active.

At least 619 cases have been reported in Perth County, with 386 in North Perth and 141 in Perth East, while at least 508 have been reported in Huron County, with 110 in South Huron and 105 in Huron East.

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Stratford has reported at least 392 in total, while St. Marys has seen 38.

The region’s test positivity rate stood at 1.7 the week of April 11, up from 1.5 the week before. New figures are expected this week.

Sarnia and Lambton

Eight new COVID-19 cases have been reported in Lambton County, local health officials reported on Tuesday.

They bring the region’s pandemic case tally to 3,198, of which 3,073 have resolved, an increase of 14 from the day before. Fifty-six deaths have been reported, most recently on Saturday.

At least 69 cases were listed as being active within the region on Tuesday. Ten people were in hospital at Bluewater Health, down two from the day before.

The health unit says 343 variant cases have been identified in Lambton so far, unchanged from the day before.

Of those, at least 260 have been either confirmed through genomic analysis to be, or are presumed to be, the B.1.1.7 variant, according to the province.

Note on the presumption of B.1.1.7 cases:
  • According to Public Health Ontario, the B.1.1.7 coronavirus variant has been associated with the N501Y spike protein mutation, while variants B.1.351 and P.1, first detected in South Africa and Brazil, respectively, have been associated with mutations N501Y, E484K and K417N.
  • As a result, any specimens screening positive N501Y and negative for E484K are presumed by the province to involve the B.1.1.7 variant and aren’t being sent for further genomic testing.
  • Specimens that screen positive for either the E484K or K417N mutation will undergo genomic testing.

The remaining 83 cases have either screened positive for the E484K mutation and are undergoing genomic analysis, or screened positive for N501Y but their E484K status is unknown.

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An update on the local vaccination campaign is expected late Tuesday.

As of early last week, more than 40,100 doses had been administered in the region.

Three main clinics are operating in Lambton, including at The Shores Recreation Centre (Forest Arena), Point Edward Arena and Wyoming Fair Grounds.

Vaccine registration is open to people 60 and older, or who are turning 60 this year, along with other previously identified groups. More eligibility information can be found on the health unit’s website.

Eligible residents are asked to visit the health unit’s website to book an appointment or to contact the health unit at 519-383-8331, Monday to Friday from 8:30 a.m. to 4:30 p.m.

Multiple pharmacies in Lambton are also continuing to offer the AstraZeneca vaccine to those aged 55 and older as part of the province-run pilot program. Residents are asked to book appointments with the pharmacies directly.

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No new school cases were reported by the St. Clair Catholic District School Board.

The Lambton-Kent District School Board, meanwhile, has paused public reporting of new cases while students are learning remotely.

Four outbreaks remain active in the region.

One is located in a residence of Lambton College and involves 10 cases, while another involves North Lambton Childcare Centre – St. Peter Canisus Site, linked to two cases.

The two other outbreaks are both located at unnamed workplaces, involving three and eight cases, respectively.

The health unit says the county’s test positivity rate was 1.9 per cent as of the week of April 11, down from 2.8 the week before. Updated numbers are expected later this week.

— With files from Global News’ Jessica Patton, and The Canadian Press

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