COVID-19: Record case jump in London-Middlesex prompts new health unit guidance

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Experts weigh options to keep Ontario healthcare staff on shift despite surging Omicron variant
WATCH: Experts weigh options to keep Ontario healthcare staff on shift despite surging Omicron variant – Dec 22, 2021

Local health officials are releasing urgent new guidance in a bid to crack down on soaring COVID-19 case rates that set a new single-day pandemic record on Wednesday, and continue to overwhelm local contact tracing efforts.

The Middlesex-London Health Unit says at least 228 new cases were reported to the health unit on Tuesday, the most of any day during the pandemic so far. The tally will be reflected on the MLHU’s COVID-19 dashboard when it updates around noon Wednesday.

The new single-day record is 52 cases higher than the previous record set on April 13 at 176, according to health unit data. The region’s third-highest single-day increase was recorded just this past Tuesday at 169.

“The Health Unit is now advising anyone who tests positive for COVID-19 to self-isolate immediately and not wait to be contacted by public health,” officials said in a media release issued late Wednesday morning. “These individuals are also asked to tell all those who are part of their household to isolate as well.”

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The health unit says it’s also advising anyone who develops respiratory symptoms to treat them as COVID-19, even if they haven’t tested positive for it, and to self-isolate immediately, notifying members of their household to do the same.

Read more: Ontario reports 4,383 new COVID cases, highest single-day count since late April

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The surge in cases has left MLHU resources overwhelmed, officials said. As of Wednesday, more than 300 positive cases in the region had not yet been advised of their status by the health unit.

“Given the number of cases that are coming in, our teams are moving as quickly as they can, but there are now delays in us being able to reach everybody in as quick a manner as we would wish,” said Dr. Alex Summers, the region’s acting medical officer of health.

“(That) is why we are asking people to not wait for us to tell you what to do, but to take action immediately once you have a positive result. This is really about recognizing that there is going to be a delay in receiving contact from the health unit because of the volume of cases that are coming in.”

Local case counts have risen rapidly in the region over the last two weeks since the first Omicron case was confirmed locally. Health unit data shows the region’s seven-day moving case average has nearly quadrupled in that time, from 36.1 on Dec. 7 to 134 as of Tuesday.

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“We are asking people to dramatically limit their close indoor contacts. At this time, every time an individual gathers in an indoor environment, particularly if it’s in a public indoor environment, their risk of being exposed to COVID-19 goes up,” Summers said.

“We have to presume as though COVID is nearly everywhere, particularly in public gatherings that are indoors.”

Ontario implemented limits on social gatherings and capacity limits in stores and restaurants on Sunday, with indoor gatherings now capped at 10 and outdoor gatherings at 25.

The province’s top doctor, Dr. Kieran Moore, said Tuesday that the province was preparing to change its strategy on COVID-19 testing and case management in light of Omicron, with guidance expected in the coming days.

Read more: COVID-19: Rapid test site for children, health-care workers to open in London

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Summers described daily case counts as being a “dramatic underestimate” of COVID-19’s spread in the community, given people may be asymptomatic and not realize they have it, are not getting tested, or want to get tested but can’t find an available appointment.

The case surge has resulted in significant demand for COVID-19 tests, with appointments booking up as fast as they become available.

Appointments at the city’s Carling Heights COVID-19 assessment centre, which only books five days in advance, are reserved until Dec 27. On Dec. 16, the assessment centre surpassed 600 tests in a single day for the first time, clocking in 635.

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The availability of local testing alternatives has been no better. As of late Wednesday morning, MyHealth’s testing clinic on Wharncliffe Road North and Dynacare’s Dundas Street East facility had no appointments until at least Jan. 4.

Similarly, LifeLabs‘ Fanshawe Park Road site, open Thursdays and Sundays, was booked up until at least Jan. 6. More than a dozen pharmacies in the city also provide testing, however, what is offered is inconsistent and varies by pharmacy.

As of Sunday, 6.7 per cent of tests in the region were coming back positive.

Vaccine appointments, such as third-dose boosters, have also been in high demand since the province lowered eligibility to all adults on Monday. As of Wednesday, slots at the Western Fair Agriplex vaccination clinic were booked up until mid-January.

Ontario’s science advisers have said two doses of COVID-19 vaccine are only 35 per cent effective against the Omicron variant three months after being administered, while a third dose bumps efficacy up to 75 per cent.

Read more: No known ICU admissions due to Omicron in Ontario yet, but impact expected: top doctor

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While the region recorded a new case record on Wednesday, local COVID-19 hospitalizations fell slightly.

London Health Sciences Centre reported 13 COVID-19 patients in their care, a decrease of two from Tuesday. Five or fewer patients were in intensive care, and five or fewer were located at its Children’s hospital. No COVID-19 patients were reported in its pediatric critical care.

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“Because of the impact and protection of the vaccine, at this point, we are not seeing the increase in hospitalizations, and that’s a good thing,” Summers said.

“However, it’s always important to note that hospitalizations and deaths are a lagging indicator, which means that they will start to peak or start to go up two to four weeks after the cases start to go up.”

While COVID-19 patients dropped, more health care workers were confirmed positive at LHSC. At least 36 staff members at the organization are currently positive with COVID-19, up from 28 on Monday.

Ontario’s chief medical officer of health, Dr. Kieran Moore, said Tuesday that most people in hospital in Ontario due to COVID-19 — including 165 intensive care patients as of Tuesday — were hospitalized with the Delta variant, but added the province anticipates Omicron will likely hospitalize more people eventually.

Moore said early figures show that 15 out of 4,600 Ontarians with laboratory confirmed Omicron cases have been hospitalized. He noted that most of the infected people are in their 20s, an age group not typically hit with the worst of COVID-19 outcomes.

Moore said he was still reviewing evidence of Omicron’s virulence before making a conclusion on the severity of the illness it causes. A “much better understanding” may come over the next week.

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—with files from Andrew Graham and The Canadian Press

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