The following are brief reports of items discussed during a media press conference held by the Haliburton, Kawartha, Pine Ridge District health unit on Jan. 20, and the health unit’s Board of Health meeting held Jan. 21.

Confirmed case summary
Dr. Ian Gemmill, acting medical officer of health for the HKPR health unit, said last Wednesday that in the past 14 days, just fewer than 150 cases had been reported locally, with about 10 to 15 cases reported each day, and fewer than that on some days.

Gemmill attributed lower cases last week to the effects of the provincial lockdown, which began Dec. 26, and said further effects will be seen from the stay-at-home order as well.

“All these things mean that our cases at least for the last couple of days have been diminishing,” said Gemmill. “I hope that that trend continues, and I thank people for doing the things that need to be in place to make that happen.”

The source of transmission is important to look at, said Gemmill, and 30 per cent of cases can be attributed to household contact, which is difficult to avoid.

More worrisome to Gemmill is the 30 per cent of cases attributed to close contact, possibly from work or transportation but also from social gatherings, and the 20 per cent of cases that can not be traced back to a source, meaning there is community transmission.

“We had quite a bit of an upswing after the Christmas holidays, that’s continued until just recently, and now we’re beginning to see the start of the effect of the restrictions in place since that time.”

Nine outbreaks are being dealt with by the local health unit, eight at long-term care or retirement homes throughout City of Kawartha Lakes and Northumberland County, and one at the Canadian Centre for Addictions in Northumberland County.

The greatest case numbers are currently within the 50 to 59 year age group, and then the 20 to 29 year age group.

“There’s very little documented illness in children,” said Gemmill. “It’s not yet completely clear if that’s because they are less susceptible to coronavirus, or whether they don’t have symptoms and therefore we don’t recognize them as cases and therefore don’t have the testing but before the school break at Christmas, I can tell you, we did have cases in schools but almost all of them were situations in which we could determine that the transmission took place not in schools but outside of schools and that there was very little transmission within the school setting so it’s mostly kids who have been exposed to others outside of the school setting.”

Vaccine planning
“We’ve got a plan, ,” said Dr. Gemmill in the press conference last week.
Gemmill reiterated his message that the health unit is “ready to go when the vaccine arrives” during the Board of Health meeting on Jan. 21.

“The vaccine program, as you know, has run into a number of snags, not only nationally but provincially,” Gemmill said at the Board of Health meeting on Jan. 21, noting that without a supply of the vaccine, the health unit cannot immunize area residents.

The health unit has been working with long-term care homes to prepare to immunize residents, staff and essential caregivers as the first priority. Gemmill said it is possible the health unit will not have enough vaccines for the first doses of those priority cases, and so further priorities will need to be set.

“The priorities will clearly have to do with what is the incidence in the area where the long-term care home is situated, i.e. what is the risk from the outside, and number two, are they in outbreak and can we use the vaccine to protect the wings or the units of the long-term care home that are not in outbreak so we can provide some upfront protection for those residents that may be at increased risk because there’s an outbreak in another part of the home.”

In March, when Gemmill said the vaccine is expected to be plentiful, the general population can be vaccinated beginning with other essential workers and older adults including seniors living in their community in their own places of residence.

“We’re ready to go when the vaccine arrives,” he said, reiterating that the lockdown and stay-at-home order keep the numbers down in the short-term so more people can be immunized rather than infected.

Dysart et al Mayor Andrea Roberts, who sits on the Board of Health, spoke to Haliburton County’s high senior population and asked how the board might advocate for a group she felt was being missed – those seniors who live at home without outside care but rely on family and friends for assistance.

“How can we advocate for those vulnerable population to be included in Phase 1?” she asked. “I see that they’re missing there.”

Gemmill said there is a descending list of people considered most vulnerable based on where complications, hospitalizations and deaths have occurred due to COVID-19.

“The people who are elderly, doing very well in their own homes, are right behind the long-term care homes and high-risk retirement homes, the healthcare workers who are front-line and the home care people,” he said. “The home care people are higher, just because with their chronic medical conditions, they’re high-risk. The elderly people that you’re speaking of are right next on the list. To say, to advocate for them to be in Phase 1 … they are next on the list and they will be our number one priority when we start the community-based immunization programs.”

Advocacy from a number of public health units has taken place on ministry calls to include this demographic in vaccination plans as soon as possible.
Children, under the age of 18, were not included in the clinical trials for vaccines, and neither vaccine being administered in Canada is available for children.

Cottage country cases
Roberts also made note of a situation unique to areas with numerous seasonal residents, including Haliburton County.

“One thing that’s very controversial in our area, maybe not in other parts of the [health unit region] is that Haliburton is cottage country and so we have a number of people in the stay-at-home order who have chosen to make their cottage their second home and are here,” said Roberts. “There’s quite a grumble that the numbers aren’t representative of positive cases of people who are actually here in the county because of course we know that the reporting goes to their principal residence. So how can we combat that or assuage the people to know that the numbers aren’t skyrocketing through the roof, that there’s hundreds of cases in Haliburton County?”

Gemmill said currently under the restrictions issued by the province, though a stay-at-home order is in place, he had not seen that it’s not allowed to stay at a recreational property during this time.

“You’re right, if somebody came, stayed at their cottage, got tested and turned out to be positive … if they’re doing it right, their contact should not be in [the area]. Maybe they got groceries but they shouldn’t be doing anything else, it is a stay-at-home order. If they’re working, they can’t work from their cottage if they work in Toronto, they must be working remotely, so they’ve got to stay at home.”

He noted that gathering and travelling, even throughout the province, is what is causing the disease to spread.

“I can’t stop you from going to your cottage in Haliburton, but I can reinforce and plead with you to stay in your home, if that’s what you’re doing and to – if you have to go out for example for essential things like getting groceries – do it in the safest possible way, and please, please, please, don’t put anybody else in the area at risk,” he said.

He noted he will bring the topic to the next press conference held by the health unit, but reiterated that if people are choosing to travel from one home to another, they should “do it once, and stay at home.”

“If you are somebody that is staying in your recreational home, there are certain guidelines that you have to follow to keep the people of Haliburton County as safe as possible from infection,” he said.

Stay-at-home snowmobiling
When asked if the health unit would put further restrictions on snowmobiling and close trails, Gemmill said the answer had already been put in place by the provincial stay-at-home order.

“First of all, we have a stay-at-home area in our province,” said Gemmill. “It’s not just on the trails, it’s all over the province. The stay-at-home order means we go out for groceries, we go out to medical appointments, we go out to work.”

Currently, snowmobilers are not to travel to places outside their own region, and are to only use designated and available snowmobiling trails in their area. It is recommended they only snowmobile with members of their own immediate family and household, and stay at least two metres apart from others. The current limit on outdoor gatherings remains only five people.

If people are not obeying stay-at-home orders, Gemmill said that’s a matter of concern for those in enforcement.

“I would say it’s important for people to get out to get exercise, and I suppose to have a little fun as well,” said Gemmill, though he later noted: “I’m thinking that walking is probably more exercise than snowmobiling.”
He said he was pleading with people to respect the stay-at-home orders, and avoid travelling and gathering, to protect hospitals and keep people unaffected until immunization.

“I have no problem with people going out for recreation and for exercise, but do keep within the spirit of the regulations so we don’t have transmissions,” he said, stressing that social gatherings have been responsible for outbreaks and amplification of the virus.

Message for anti-maskers
In response to anti-mask protests happening in the region, Dr. Gemmill said gatherings without masks and while spreading anti-mask messaging or frustration with public health restrictions to curb the virus was not helping.
“The enemy out there is not each other,” he said. “The enemy is a virus, and we’re in a situation that is unprecedented.”

Gemmill said that he recognizes the word ‘unprecedented’ is often used, but that it accurately describes this time of pandemic.

“In my lifetime, I’ve never lived through such a bizarre time where socially I’m restricted, if I’m seeing friends it’s on the computer, I don’t see my grandchildren the way I would before, and I’m wearing a mask every time I go out to get groceries, and that’s because not only is it the right thing to do to protect myself, but it also is the right thing to do to protect others in case I might have the infection and to show that we all are united on this, to go forward to try to stop this virus. That’s the goal here.”

Gemmill said the restrictions in place are to help protect the hospital system, vulnerable people, and protect others until the vaccine can offer further protection.

“I just don’t think that fighting at this point in time with each other is useful,” he said, noting that he recognizes the restrictions are not fun, but also that they will not be in place forever.

“My parents lived through the war and Depression,” he said. “These were not fun times to get through but they got through them together.”

He said there is no question the spread of the virus is amplified or restricted based on our own behaviours.