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COVID-19: 140 new cases in London-Middlesex as vaccine eligibility expands again

FILE - A vial of the Pfizer-BioNTech COVID-19 vaccine. Steve Russell/Toronto Star via Getty Images

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The London-Middlesex region recorded 140 new COVID-19 cases on Wednesday, double what was reported the previous day, local health officials said.

The health unit also announced that licensed child-care workers 18 and older will be able to get the vaccine starting on Thursday.

Wednesday’s update leaves the region’s pandemic case tally at 10,202, of which 9,066 have resolved, an increase of 85 from the day before. A total of 197 deaths have been reported, most recently on Tuesday involving a woman in her 50s.

As of Wednesday, 939 cases were listed as active in the region, an increase of 54 from the previous day. A total of 3,020 cases have been reported in London-Middlesex since the start of April, more than any other month. January, the second-worst month for cases, recorded 2,332.

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The region’s rolling seven-day case average stands at 99, down from 108 the seven days previous.

Of the 140 new cases, 129 are from London, while 11 are from elsewhere in Middlesex County.

As they have for several weeks, the majority of cases skew younger, with at least 64 per cent involving people under the age of 40 and 42 per cent under the age of 30.

Eighteen are 19 or younger, 31 each are in their 20s and 30s, 13 are in their 40s, 17 are in their 50s, 10 are in their 60s, seven are in their 70s and three are 80 or older.

Fifty-nine cases are listed as being due to close contact, or about 42 per cent. Fifty-six others still have pending or undetermined exposure source data, while 23 have no known link and two are due to outbreak.

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The health unit says at least 1,570 variant cases have been found in London-Middlesex, an increase of 10 from the day before.

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All but two have involved the B.1.1.7 variant, first detected in the U.K. The other two have been confirmed to involve the P.1 variant, first identified in Brazil. All 10 cases reported Wednesday involved the B.1.1.7 variant.

Variants have made up the majority of cases in recent weeks, including upwards of 60 per cent of cases seen during the weeks of April 4 and 11.

The health unit says its overall variant 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.

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 which have not been confirmed or presumed to be a variant, stands at 264, an increase of eight from the day before. The tally will fluctuate as cases undergo genomic analysis and are confirmed.

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Of those 264 cases, 133 were found to have the E484K mutation, consistent with the B.1.351 and P.1 variants. They are under genomic analysis. Of those 133, 113 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.

A scheduled media briefing is set to be held by the health unit on Thursday.

During Monday’s briefing, Dr. Chris Mackie, the region’s medical officer of health, said the lower number of cases seen over the previous several days was encouraging.

However, he stressed how tentative the local recovery was even with the lower numbers, noting that there has been declining testing.

“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,” he said.

“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.”

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

The local dip in cases, excluding Wednesday’s case jump, has been attributed in part to the departure of Western University students.

For at least two weeks, the postal code area with the highest test positivity rate in Ontario was London’s N6A, which includes part of the university campus, off-campus housing, Richmond Row and downtown.

Recent on-campus student residence outbreaks, of which several remain active, have been linked to more than 196 cases.

At least 9,128 cases have been confirmed in the city of London since the pandemic began, while 325  have been in Middlesex Centre.

Elsewhere, 296 cases have been in Strathroy-Caradoc, 131 in Thames Centre, 67 in Lucan Biddulph, 56 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-three COVID-19 patients are listed as being in the care of London Health Sciences Centre as of its most recent update Wednesday. The number is as of 3 p.m. the previous day.

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Of those patients, 40 are in critical or intensive care, while at least six staff members are currently positive for COVID-19.

At St. Joseph’s Hospital, meantime, no COVID-19 patients were listed as being in its 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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Carol Young-Ritchie, LHSC’s executive vice-president, chief clinical officer and chief nursing officer, told Monday’s media briefing that roughly one-third of the COVID-19 patients in their care that day had come from outside of the London area, mainly the GTA.

“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.

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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, she said.

Last week, LHSC announced the opening of seven more critical care beds to meet the surge in patients, to be opened as they are needed. Three of the beds are located in the pediatric critical care unit of Children’s Hospital. As of Monday, Young-Ritchie said LHSC had not had to utilize the beds yet.

LHSC has opened at least 25 new critical care beds in recent weeks to deal with the influx of COVID-19 patients.

In addition to the new beds, as part of a provincial directive, LHSC said it would further ramp down non-urgent surgical activity to open resources and more care spaces. As of Monday, surgical capacity was down to about 50 per cent of normal levels, Young-Ritchie said.

Other local hospitals, including in St. Thomas, Stratford and Windsor, have also been receiving patients from hard-hit Toronto-area hospitals.

On Wednesday, the province announced that hospitals will be able to transfer patients waiting for a long-term care bed to any nursing home without their consent in an effort to free up space.

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Health Minister Christine Elliott says the government has issued a new emergency order to allow for such transfers in a bid to free up hospital capacity for COVID-19 patients in need of urgent care.

She says hundreds of patients currently in hospital are waiting to be discharged to a long-term care home. Transfers without consent will only be done in the most urgent situations, she said.

Institutional outbreaks

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

A non-institutional outbreak is still active at the city’s Elgin-Middlesex Detention Centre. It has been linked to at least 64 inmate and 34 staff cases since it was declared on Jan. 18.

No active cases were listed at the jail as of Monday, 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 on the large outbreak at Cargill was immediately available either, but it had been linked to at least 116 cases as of late last week. It’s unclear if the health unit still considers it active.

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The facility restarted production on Friday with the support of the health unit.

A new report from the province’s auditor general found that Ontario’s nursing homes were woefully unprepared for the onslaught of COVID-19 — the culmination of years of neglect and failure to address known problems.

The latest health and medical news emailed to you every Sunday.

Both the provincial government and nursing-home sector had failed to heed lessons learned from the SARS epidemic, while concerns raised repeatedly for years went unaddressed, the report from Bonnie Lysyk said.

COVID-19 hit Ontario’s long-term care homes with brutal effect last spring. In all, the disease killed at least 3,756 residents and 11 staff members. At one point, the military had to go in to help the worst-hit homes.

While vaccinations have now blunted the impact of COVID-19, the sector remains vulnerable, Lysyk said.

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Among the issues focused on were overcrowding, poor ministry oversight and a severe staffing shortage that existed even before the pandemic struck.

Schools

No new school-linked cases were reported in the region. One remains active, according to the health unit, involving Rick Hansen Public School.

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

Outbreak declarations remain active at the following schools as of Wednesday:

  • 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.

Another 66 cases have been linked to child-care and early years settings. Seventeen cases were listed as being active involving 10 facilities, the health unit said Wednesday.

At least six active cases are associated with London Bridge: Rowntree Park Early Childhood Learning Centre, which has had an outbreak declaration since April 25.

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Elsewhere, three active cases are associated with Miss B’s Childcare, according to the health unit. It, too, has an active outbreak declaration as of April 24.

One case is active at each of the following locations, according to the health unit website:

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

In post-secondary, meanwhile, a student residence outbreak has been declared over at Western University.

The outbreak in Essex Hall had been declared on April 4 and was linked to at least 12 cases.

It’s the second outbreak to be declared over, after an outbreak in Ontario Hall, declared March 25 and linked to at least 18 cases, was deemed over as of Sunday.

Six student residence outbreaks remain active, according to the health unit.

Active Western residence outbreaks (numbers as of April 26, 2021):
  • London Hall – 10
  • 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 now-resolved Essex Hall and Ontario Hall outbreaks, outbreaks declared at Western residences since late March have been linked to a least 196 cases.

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Vaccinations and testing

Starting Thursday, eligible child-care workers 18 and older will be able to book an appointment to receive a COVID-19 vaccine shot in the London-Middlesex region.

The health unit announced the change on Wednesday, saying it comes following a provincial directive to expand eligibility to the group.

Local health officials say the eligibility criteria for child-care workers is defined as follows:

  • Licensees, employees and students on an educational placement who interact directly with children in licensed child care centres and in authorized recreation and skill building programs.
  • Licensed home child care and in-home service providers, employees of a home child care agency and students on an educational placement who interact directly with children in a licensed home child care setting.

The health unit notes eligibility will be expanded to those working in unlicensed child-care settings once such direction has been given by the province.

Eligible workers 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.

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

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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.

Vaccines continue to be doled out at three mass vaccination clinics in the region, along with some primary care settings and pharmacies. More than 150,000 have been administered locally so far.

During Monday’s media briefing, Mackie said the health unit anticipated that, due to an expected increase in vaccines in May and June, a delayed fourth vaccination clinic at Earl Nichols Arena would open sometime in the next month.

Mackie noted that the region had seen a dip in Pfizer vaccines this week, down to about 9,000 doses, but was expecting roughly 13,000 next week and the week after. The week after that, he said, “we see big jumps.”

“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,” Mackie said, adding that doses will only increase in June.

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

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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 on Monday.

“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.

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

“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.”

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Ontario

Ontario is reporting 3,480 new cases of COVID-19 Wednesday and 24 more deaths linked to the virus.

Health Minister Christine Elliott says there are 961 new cases in Toronto, 589 in Peel Region, 341 in Niagara Region and 290 in York Region.

The Ministry of Health says the case counts for some health units, including Hamilton and Niagara, may be higher due to a data catch-up process.

Wednesday’s data is based on nearly 50,200 completed tests.

Ontario reports that the positivity rate for the latest tests is 7.2 per cent.

The province says 2,281 people are hospitalized with the novel coronavirus, with 877 in intensive care and 605 on a ventilator.

Ontario says 116,173 doses of a COVID-19 vaccine were administered since Tuesday’s report. A total of 4,907,203 vaccine doses have been given in the province.

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Elgin and Oxford

Thirteen new COVID-19 cases have been reported in the Elgin-Oxford region, officials with Southwestern Public Health reported on Wednesday.

They bring the region’s pandemic case tally to 3,373, of which 3,156 have resolved, an increase of 22 from the day before. At least 76 deaths have been reported, most recently on Friday.

The health unit says at least 141 cases are currently active in the region, including 44 in Woodstock, 30 in St. Thomas and 17 in Tillsonburg.

At least 10 people from the SWPH area are in hospital including two in intensive care, officials said.

“I believe this is the highest number of hospitalizations we have seen so far in the region,” Dr. Joyce Lock, medical officer of health for SWPH, said Wednesday.

The number of variant cases identified in the region currently stands at 370, an increase of three from the day before.

Of those, 333 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 28 are active, the health unit says.

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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 37 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, eight are still active.

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Nearly 59,000 residents in SWPH have seen at least one dose of COVID-19 vaccine, according to local health officials.

Lock, the region’s medical officer of health, said Wednesday that there were still “lots of appointments available” at the three mass vaccination clinics in operation, located in St. Thomas, Tillsonburg and Woodstock.

The Tillsonburg clinic officially opened its doors on Tuesday.

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Eligibility in the region remains at 60 and older, including those who are turning 60 this year, in addition to previously identified groups, including people 18 and older who are licensed child-care workers, and people 16 and older who are pregnant or have other certain high-risk and highest-risk health conditions.

Elsewhere in the region, people 45 and older in the N5H postal area, centred around Aylmer, can also get the vaccine at a mass clinic but must provide proof of age and address.

N5H was designated a COVID-19 hot spot by the province earlier this month.

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

People 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 have been lengthy.

No new outbreaks have been declared and none are active, the health unit says.

Meanwhile, one new school-related case was reported by the Thames Valley District School Board.

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The case involves Arthur Voaden Secondary School in St. Thomas, the school board said. It’s among at least two active cases in the region. The other is located at Winchester Street Public School in Woodstock.

No cases were reported by the London District Catholic School Board.

Overall, the health unit says a total of 742 cases have been reported in Woodstock during the pandemic, while 614 have been in St. Thomas, 495 in Aylmer and 408 in Tillsonburg.

Elsewhere, 223 cases have been in Norwich, 179 in Bayham, 165 in Ingersoll, 129 in East Zorra-Tavistock, 82 in Central Elgin, 79 in Blandford-Blenheim, 75 in Zorra, 64 in South-West Oxford, 44 in Dutton/Dunwich, 28 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

Eight new COVID-19 cases have been reported in the Huron-Perth region, local health officials reported on Wednesday.

They bring the region’s pandemic case tally to 1,565, of which 1,478 have resolved, unchanged from the day before. At least 52 deaths have been reported, most recently on April 13.

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The health unit says three of Wednesday’s new cases were reported in Perth East, while two each are from North Perth and Stratford, and one is from Howick.

At least 35 cases are currently active in the region, including 12 in North Perth, seven in Stratford and five in Central Huron. At least one person is in hospital due to COVID-19.

The number of variant cases found in the region, meanwhile, has risen by 12 to 87.

Forty-two of those cases have been confirmed through genomic analysis to be, or are presumed to be, the B.1.1.7 variant, according to Public Health Ontario. Nineteen variant cases are still active.

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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The health unit says that, as of April 26, more than 39,462 COVID-19 vaccine doses have been administered in the region. The tally includes first and second doses.

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“Overall, HPPH is very pleased with the coverage rates that we have been seeing, especially among our senior populations,” the health unit said in an update on Tuesday.

“We are committed to not just speed, but access – we want to make sure that our vulnerable populations have the opportunity to receive vaccine and are protected. This has also meant mobile clinics for some vulnerable people who live in group settings, and we are grateful for partners such as primary care and EMS, who have helped us bring vaccines to people.”

In Huron-Perth, all adults 60 and older, or who are turning 61 this year, are eligible, along with all people 16 and older with certain high-risk health conditions.

As of Thursday, child-care workers in licensed child-care settings will also be able to book an appointment, as part of a provincial announcement.

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

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.

Adults 40 and older can also book a vaccine appointment at a participating pharmacy as part of a provincial program. Bookings should be done with the pharmacies themselves.

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Four new school-related cases have been reported, according to local school boards.

The Avon-Maitland District School Board reported two new cases involving Milverton Public School and one at Listowel District Secondary School.

In all three cases, the school board said there was no school exposure.

The Huron-Perth Catholic District School Board, meanwhile, reported one new case linked to St. Mary’s Catholic Elementary School in Goderich.

At least 11 school-linked cases are active. 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 one is active at an unnamed workplace.

A total of 624 cases have been reported in Perth County, with 388 in North Perth and 144 in Perth East, while 509 have been reported in Huron County, with 110 in South Huron and 105 in Huron East.

Stratford has reported at least 394 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.

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Sarnia and Lambton

Nineteen new COVID-19 cases have been reported in Lambton County, local health officials said Wednesday.

They bring the region’s pandemic case tally to 3,217, of which 3,083 have resolved, an increase of 10 from the day before. At least 56 deaths have been reported, most recently on Saturday.

Seventy-eight cases are active in Lambton, the health unit says. Ten people are in hospital, according to Bluewater Health.

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

Of those, 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, also unchanged from the day before.

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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The health unit says more than 45,341 doses of COVID-19 vaccine have been administered in Lambton so far, about 39 per cent of the eligible population.

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 40 and older as part of the province-run pilot program.

The health unit says the pharmacies will continue to offer the shot “once more supply becomes available.” 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. No cases are active under the school board’s purview.

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, both unchanged from Tuesday.

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

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 The Canadian Press

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