Dr. Natalie Bocking, now a year into her role as medical officer of health with the Haliburton, Kawartha, Pine Ridge District health unit speaks at a virtual media briefing moderated by Bill Eekhof, HKPRDHU communications officer, held April 6. /Screenshot from April 6 meeting, via YouTube

Health unit monitoring ‘fairly significant increase’ in COVID-19 activity

The following are brief reports from a Haliburton, Kawartha, Pine Ridge district health unit press conference with medical officer of health Dr. Natalie Bocking, held virtually on April 6.

By Sue Tiffin
“When we saw lifting of provincial measures lifted, many public health professionals and community members reminded everyone the pandemic wasn’t over and I think just in case we forgot that, COVID-19 virus is here to remind us,” Bocking said. “We are seeing quite a lot of COVID-19 activity across all of Haliburton, Kawartha, Pine Ridge region right now.”
Looking at main indicators being followed, Bocking said the number of new lab-confirmed cases of COVID-19 each day has doubled in the last two weeks, with approximately 25 to 30 new cases per day, compared to being down to about 15 cases per day previously.
“As access to PCR testing is limited, we know that this is just the tip of the iceberg of actual case activity,” Bocking said. “Likely many, many more people that are having a positive rapid antigen test at home or might be symptomatic and don’t have a test at home but are presumed to have COVID-19.”
She said test positivity has also increased over the past two weeks, being up to 12 or 13 per cent, after being at a low of eight per cent.

Wastewater surveillance data shows an increase in viral signal both in the Lindsay and Cobourg watershed, Cobourg demonstrating a “steep climb” in virus activity, being at the highest point since wastewater has been monitored and five times higher than the peak of the Omicron wave in January.
“Certainly our wastewater surveillance information mirroring that of what’s being seen across the province with an increase in activity and fairly significant increase in activity,” she said.
Bocking said early signs of increases in hospital admissions are being seen, and are expected to continue over the next few weeks across all three geographic areas based on the amount of virus activity being seen.
When asked about the Minden wastewater site, which has had data available in the past, Bocking said the health unit is “continuing to explore with the province” if it can be up and running again as an additional site.
Bocking said when wastewater testing was first available, the health unit region was limited to two sites and testing was being done in Minden in part due to the increased population during the summer. The hope is it will return, she said.

HKPR region enters sixth wave
Bocking said the health unit is seeing the surge equivalent of a wave.
“While we certainly all, I think, hoped that the fifth wave would be our last big wave, or at least we’d have a bit of a longer period of time to catch our breath, I think it is fair to say that we are entering another wave, or we have entered another wave,” Bocking said. “… The question now really is, how large will this wave be?”
Bocking said the increase in activity is being fuelled by the cumulative impact of provincial public health measures being lifted, including capacity limits and mandates regarding indoor masking, as well as the sub-variant of Omicron, BA.2, which is more transmissible and becoming dominant. She repeated that vaccinations, staying home while sick, masking, avoiding or limiting social gatherings and hand washing continue to be important to reduce spread of the virus and prevent severe illness. While Bocking said wearing a mask inside is no longer a rule, she said, she “strongly recommends” that individuals wear a well-fitting mask indoors when with those from outside the household as it’s a good tool to protect members of the community that are at higher risk of severe illness, and strongly encourages people reconsider their social gatherings indoors right now.

Bocking was asked by a reporter if, based on the increase in cases and surge of the sixth wave, she felt it had been premature for the province to lift public health measures at this time.
“I think it comes back to what the goal is, and the province made a decision that if our goal is to prevent severe strain on our acute care system, that there were other mechanisms in place to try to prevent this strain other than broader provincial public health restrictions,” she said. “I think there’s lots of different ways we can analyze this, but I think for me right now the most important thing is looking at what we can do moving forward to mitigate illness from this wave.”
Living alongside COVID-19
“I think we had in general moved toward trying to wrap our heads around what living with COVID looks like, or living alongside COVID, and recognizing that COVID-19 is not going away, that it is still here, it is still causing more vulnerable community members to develop severe illness, and also has the potential to still be a tremendous strain on our healthcare system, and wanting to protect our healthcare system, not cancel surgeries, not cancel other care that is desperately needed,” Bocking said. “And so living alongside COVID, while it might not include provincial legislation that limits capacity limits, I think it behooves all of us that it includes being aware of when COVID activity is high, we’re taking those steps to protect ourselves and each other. And then as COVID-19 activity comes down, we share that, people are aware and we can back off of some of those measures. But I think this is really an important piece of the puzzle in terms of what living alongside COVID looks like, that it’s still here, we use the tools we know we have that work well, and we continue with them.”

Vaccinations encouraged, including second booster doses
Of the 29 deaths that have been confirmed across HKPR region since Jan. 1 of this year, almost 50 per cent were among individuals who were unvaccinated, said Bocking.
“We know that the vaccines do work very well in preventing severe illness and there’s very good data locally, provincially, nationally and globally to demonstrate this,” she said.
Currently 86 per cent of people aged 70 and older in the HKPR region have received a booster dose, but Bocking said among those aged 60 and over, there’s still almost 12,400 people across the region that could get their booster dose now, and a large population that hasn’t received any dose.
Second booster doses are available now for people aged 60 and over, or Indigenous people aged 18 and older. The recommended interval by the province is five months between first and second booster dose, but there must be a minimum interval of at least three months between doses.
That vaccine is available through pharmacies, primary care providers, and through health unit clinics. A clinic at Haliburton Highlands Secondary School will be held on April 30 from 10 a.m. to 5 p.m. The clinic is available through the provincial booking system only, with no walk-ins.
Small percentage of pediatric cases hospitalized
Bocking said locally, pediatric cases have not necessarily been identified by the public health unit as being on the rise, as some health care professionals have reported is happening provincially, because PCR tests are limited to those who live and work in high-risk settings like long-term care homes and hospitals. Bocking said there have been five admissions to hospital among children under nine since Jan. 1, which is more than what was previously seen during the pandemic.
“That’s not because Omicron is more severe among this age group, but because we know there’s that many more infections and we also know that the very young – infants less than one or two years old – are not eligible for vaccination and are often at higher risks from viruses just because their immune systems are still building,” she said.

Bocking said within the five to 11-year-old age group across the region, the rate of vaccination is incrementally increasing to just 50 per cent. She said access has been available, but some parents were waiting to be more comfortable with the vaccine and its impact within the age group.
“We certainly have lots of data at this point in time to demonstrate its safety among this age group, and more and more data being accumulated to demonstrate vaccine effectiveness in this age group,” Bocking said. “Our challenge as health care providers moving forward is to communicate this out to parents in a way that makes sense and builds confidence and comfort with this vaccine.”