Dr. Natalie Bocking /Photo supplied

Respiratory viruses converging, says region’s top doctor

By James Matthews (Local Journalism Initiative reporter)
The healthcare system continues to be quite strained and we need to do everything we can to try to preserve it.
That’s the message Dr. Nicole Bocking, the medical officer of health for the Haliburton, Kawartha, Pine Ridge District Health Unit, delivered to the unit’s board when it met on Oct. 20.
“When we ask people to take preventative measures now in an attempt to relieve pressure on our healthcare system, this is not just because of COVID,” Bocking said. “This is because of many different respiratory viruses, all converging at a similar time.
The region has gotten its first confirmed influenza case and respiratory syncytial virus (RSV) is bringing people to the hospitals, she said. There’s also the shortage of human health resources to staff hospitals.
“All of this will continue to put pressure on our healthcare system, which is already quite strained,” she said.
The BA.5 COVID-19 subvariant has born many children, said Bocking.
“And those children continue to mutate also, so we have multiple different lineages and sub-lineages that are continuing to emerge.”
Some of those sub-lineages tend to disappear. But there are others that are shown to be more transmissible.
“And they continue to develop and mutate and transmit even easier,” she said.
Some of the things healthcare providers then need to consider is whether re-infection can occur and if vaccines will work on the newer, more transmissible variants.

Test positivity and the number of outbreaks continue to be higher, despite the coronavirus’ seventh wave having peaked in August.
She said there are a dozen ongoing outbreaks in the region.
“The majority of those are in long-term care homes,” she said. “Though we are starting to see some more outbreaks in hospital settings as well. We are continuing to see new hospital admissions directly as a result of COVID-19 infection.”
Test positivity in the last two weeks has increased “significantly,” she said. And she wagered that can be attributed to continued long-term care outbreaks. But then wastewater surveillance has indicated low for the district’s three areas.
“As the pandemic continues to evolve, as variants evolve, and our technology and tools evolve, we continue to evaluate and need to look at multiple pieces of the puzzle,” Bocking said. “There’s not just one indicator.”

Two sub-variants that are in line to be particularly troublesome are BQ 1.1 and the BA 2.75.2 strains.
The BQ 1.1 sub-variant seems likely to emerge as the dominant one in the coming months, Bocking said.
“The piece of the pie that it’s taking up is slowly becoming bigger in the United States,” she said. “What we watch for is not the fact that it’s becoming bigger. It’s the pace at which it’s becoming a bigger slice of the pie.”
It’s more infectious: That variant is almost doubling week over week, she said.
Getting vaccines and staying up to date with booster doses will go toward helping lessen the strain on the healthcare system, she said.
Respiratory ailments tracked through Dashboard
Andrew Harris, an epidemiologist at the health unit, described the Respiratory Diseases Dashboard, which was launched in September. The dashboard combines the regional health unit’s COVID-19 reporting, influenza surveillance, and data from the acute care enhanced surveillance system.
Basically, it categorizes such information as test positivity diagnosis, hospital admissions, age groups and municipalities, and admissions to the intensive care unit because of respiratory ailments.
“Over the course of the respiratory season starting the week of Sept. 1, we have seen 1,756 emergency department visits for influenza-like illness or respiratory syndromes,” Harris said.
“To date, 11.75 per cent of all emergency department visits for our catchment area have been related to influenza-like illness or respiratory syndromes.”
He said the unit sees five to 10 weekly hospitalizations for COVID-19.
Work continues on Strategic Plan
An update on the strategic plan was given in May, Bocking said. But that was a quick synopsis of the 2019-2023 strategic plan.
“It had really just kicked off and then the pandemic hit,” Bocking said. “The strategic plan for many different, important reasons stalled during the COVID-19 pandemic.”
They got back to reviewing the plan as things related to the coronavirus began to settle somewhat. The need for such a plan continued to be relevant, she said.
“The pandemic was able to highlight a number of ways that we were excelling in the priorities that we had put forward,” she said.
The strategic plan outlines the health unit’s priorities and objectives.
Given the years missing due to the pandemic, Bocking said they planned to ask the board of directors for an extension.