Elementary schools seeing highest number of outbreaks across province

The following are brief reports from a Haliburton, Kawartha, Pine Ridge (HKPR) district health unit press conference with medical officer of health Dr. Natalie Bocking, held virtually Dec. 8.

By Sue Tiffin

Provincially, elementary schools continue to be the setting of the highest number of outbreaks of COVID-19, Bocking told media gathered at the press briefing. An outbreak is defined by two or more cases with demonstrated transmission within the school setting. While throughout the local health unit region, outbreaks have been declared because of two cases without further cases being identified, in some districts, schools have reported more than 20 cases during outbreaks. The morning of the press briefing, elementary school outbreaks were at the highest they’ve been since the beginning of the pandemic, with 239 outbreaks ongoing.
“I think we’ve been quite fortunate here in HKPR [region] to have not had quite the same amount of activity but we are starting to see increased activity throughout our school base population,” said Bocking.
To date in this school year, the HKPRD health unit has confirmed 47 cases of COVID-19, 20 of those in the past 14 days, with 14 classes closed.

High number of high-risk contacts due to active school cases
Since the beginning of the pandemic, 2,612 COVID-19 cases have been identified in the health unit’s region. Last Wednesday at the time of the press meeting, there were 40 active cases – two in Haliburton County, 27 in City of Kawartha Lakes and 11 in Northumberland County. Connected to those cases, there were 335 high-risk contacts.
“That number of high-risk contacts is higher than previous briefings and that’s directly related to the number of contacts identified through school cases, so the entire class or an entire class cohort becomes identified as a high-risk contact and that really pushes our overall numbers of high-risk contacts up,” said Bocking.
The seven-day overall incidence rate continued to “creep up,” she said, with 22 cases per 100,000 people, a number that has more than doubled in the past two weeks and which Bocking said will continue to rise.

“To put this in perspective, there are some health unit jurisdictions right now that have incidence rates higher than 200 cases per 100,000, if we look to northern Ontario, Timiskaming region, Algoma region, are experiencing significant surges in COVID-19 activity and quite high incidence rates associated with that.”
HKPR region’s test positivity is at 2.2 per cent, which is also lower than in other regions, but which Bocking said is increasing.
“The amount of testing that’s taken place is really remaining the same, and across HKPR is somewhat actually less than other regions in the province, but the number of cases is continuing to increase.”
Four outbreaks in the region were ongoing during last week’s media briefing, those being the local Haliburton school bus cohort outbreak, the J.Douglas Hodgson Elementary School outbreak, patient and visitor cases at Campbellford Memorial Hospital, and two cases at a childcare facility in Lindsay. (See COVID graphic on page 3 for most updated information).

Most cases now in the youngest age group
Of the 75 cases identified across the health unit’s region in the past two weeks, 18.7 per cent were identified in the zero to nine-year-old age group. Sixteen per cent of cases were confirmed in those 30 to 39, and also 16 per cent in those aged 60 to 69. The majority of cases in the past 14 days – 32 per cent – have been household contacts, with one individual exposed, and then spread within the household. Twenty per cent of cases have had no known source of exposure and 16 per cent are related to close contact.
Of those confirming infection – 453 cases have been identified since July 1 – 59 per cent have been unvaccinated, 4.4 per cent have had one dose but 14 days haven’t passed, 11 per cent are partially protected (have had a first dose and 14 days has passed or have had two doses but 14 days hasn’t passed) and 25.4 per cent are fully protected.

Vaccination update
As of Monday, Dec. 6, 87.2 per cent of people 12 and older in the HKPR region had received one dose of COVID-19 vaccine, while 84.8 per cent have received two doses.
The province recently celebrated the milestone of 90 per cent vaccination, said Bocking, but noted numbers in our local health unit region tend to be about one to two per cent lower than the provincial average. She recommended people continue seeking out vaccine, especially in light of rising case numbers and a new variant.
Approximately 13 per cent of kids aged five to 11 have received their first dose throughout the region, just under 1,500 kids.
“I think rollout has been quite positive and clinics have been well-attended, and lots of relatively happy kids – no one’s happy to get a needle in the arm – but quite supportive of vaccination overall,” said Bocking of the clinics.
A booster shot, or third dose of vaccine, will be available to those 50 and older as of Dec. 13, and will open up to those 18 and older at the beginning of January.
Children can certainly get the virus just as easily as anyone else, they’re less likely to become sick with it, and certainly much less likely to become sick enough to need to be admitted to hospital, but they can certainly get the virus to the same degree as anyone else and also have the ability to spread it onwards the same as anyone else.

Reiterating holiday recommendations
While Bocking had shared her guidance on holiday gatherings in the previous week’s media briefing, she did so again at the most recent session to stress the message:
“We need to be cautious with our gatherings and our enthusiasm for returning to normal over the holiday season,” she said. “Given the current trend in increasing cases, I think we will continue to see an increase across HKPRD health unit jurisdiction and now is not the time to be hosting large holiday parties with people from across different households, across different work places. Now is the time to be having small gatherings, to be engaging in smart planning of the gatherings, and also using safe practices so that we’re being … small, smart and safe is our key reminder messages here.”
Bocking said those planning a small gathering should “be smart about it,” and “look at the space that you have available.

“Consider whether or not you’ll be asking individuals that are fully vaccinated to be participating, or unvaccinated individuals. Engage in all of the public health measures we know do work to help prevent the spread of COVID-19: masking, distancing if you’re not able to mask well, washing hands frequently, cleaning high touch surfaces, but really the biggest practice that contributes to the spread of COVID-19, especially at this time of year, is large gatherings indoors of people from multiple households that will be in close proximity, talking lots, perhaps singing, but those venues are really the places where we see COVID spread fuel. So I think again, echoing the same messages, to really be looking at your schedules for the holidays, continuing with small gatherings, smart planning for them and safe practices.”

Looking ahead at possible public health measures
“We’re not at that point yet,” said Bocking when asked if the public health unit might add further restrictions to help stall the rising case numbers. “We could reach that point. Definitely restrictions that limit the potential for people to be coming into contact with each other, so limit capacity limits or gatherings are a key tool in our COVID-19 toolbox to further limit cases that are increasing. There’s not a magic number at what point we say we need these measures to be in place.”
While the current local incidence rate of cases is 22 per 100,000, Bocking said “certainly if we’re getting up to 60s, 70s, 80s, that’s quite high, significant challenges at a health unit level, and we would be considering different measures that will help to limit gatherings.”
“I think if people take some of our messaging to our heart and limit their gatherings then we can potentially curb this current increase in cases. If the current trajectory continues to increase and starts to match that of other health units then I think we likely will move to having some further restrictions in place.”