Weekly COVID-19 Update

Provincial Updates
Halloween Recommendations
Public health officials in Ontario are recommending against traditional trick or treating in the regions of the province that have increased or modified Stage 2 public health restrictions due to high rates of COVID-19. These areas include the public health unit regions of Ottawa, Peel, Toronto, and York.

All families in the province are asked not to travel outside of their neighbourhood to celebrate and to check with their local public health unit for any additional advice or restrictions that may be in place. Public health officials suggest everyone consider opting for alternative ways to celebrate this year, such as:

• Encouraging kids to dress up and participate in virtual activities and parties
• Organizing a Halloween candy hunt with people living in their own household
• Carving pumpkins
• Having a movie night or sharing scary stories
• Decorating front lawns

People living outside regions with Stage 2 modified restrictions in place who are considering going trick or treating are asked to:

• Only go out with the members of their household
• Only trick or treat outside

• Both trick or treaters and people handing out candy should wear a face covering (a costume mask is not a substitute for a face covering and should not be worn over a face covering as it may make it difficult to breathe)
• Do not congregate or linger at doorsteps and remember to line up two metres apart if waiting
• Avoid high-touch surfaces and objects

Whether collecting or handing out treats, wash your hands often and thoroughly, or use hand sanitizer

• Do not leave treats in a bucket or bowl for children to grab
• Consider using tongs or other tools to hand out treats.

Public Health Restrictions – Modified Stage 2 Regions

On Monday, October 19, York was added to the list of public health unit regions in the province where modified Stage 2 restrictions are now implemented. Ottawa, Toronto, and Peel Regions have been under modified Stage 2 restrictions since October 10^th. In these regions, indoor dining at restaurants and bars is prohibited and gyms, movie theatres, and casinos are required to close. All modified Stage 2 restrictions are to remain in place for a minimum of 28 days after implementation.

Public Health Restrictions General

Health officials are continuing to recommend that you limit your contact with any person not living in your immediate household, stay home if you are not feeling well, do not allow children who are not feeling well to go to school, and get tested if you are exhibiting symptoms of COVID-19 or have been in contact with a known case. Other public health recommendations that have been in place throughout the pandemic pertaining to physical distancing, proper hand hygiene, and sanitization also remain in place.

Face coverings are still mandatory in all indoor public places in Ontario including, businesses, facilities, and workplaces (if physical distancing cannot be maintained), and public transit. Limits on social gatherings remain in place with a limit of 10 people indoors and 25 outdoors. Indoor and outdoor gatherings cannot be merged to create a gathering of 35 (25 outdoors and 10 indoors). Organizers of events that breach gathering limits can receive a fine of up to $10,000. Individuals participating in such events can receive fines of up to $750.

Businesses selling food and alcohol outside of modified Stage 2 regions must stop serving alcohol at 11 p.m. and must close by midnight and all strip clubs are to remain closed until further notice. Fines for businesses and restaurants not adhering to public health measures are being issued.

Long-term Care Visitors

Since October 5^th, further restrictions have been placed on long-term care homes in areas with high case counts limiting visitors to essential visitors, staff, and caregivers. Ontario has altered regulations to allow family members to be caregivers within long-term care. Further information on long-term care caregivers and visitors is available here: https://news.ontario.ca/en/release/58220/welcoming-caregivers-to-ontarios-long-term-care-homes

Hand Sanitizer Recall
Health Canada announced a recall on Sunday, October 18^th becoming aware of a counterfeit version of the Daily Shield brand. This item was sold at Dollarama stores in Thunder Bay area and may have been sold across stores in Ontario. The counterfeit version may not

contain the formulation capable of killing bacteria and viruses and is therefore not suitable for use. The counterfeit version has been pulled from store shelves but, may have been purchased by consumers. It is difficult to tell the difference between the recalled product and the real one. The real one has a bright blue and red colouring on its label and comes in 236 ML or 1L bottles. The counterfeit/recalled version uses deep blue and dark red in its label and comes in a 250ML size bottle.

Health Canada has a regularly updated list of approved hand sanitizers available here: https://www.canada.ca/en/health-canada/services/drugs-health-products/disinfectants/covid-19/hand-sanitizer.html

COVID-19 Alert App

It is recommended to download the new COVID Alert app available from the Apple and Google Play app stores. This app will help expedite notifications to individuals that are in contact with someone who has tested positive for the virus. More information on this app is available here: https://covid-19.ontario.ca/covidalert

Confirmed Cases
First Nations in Ontario

According to last week’s regional report, there were 19 new cases, 12 of which were in people living in First Nation in communities. The majority of new cases were in the Southwest area which encompasses, the regions of Erie St. Clair, South West, Waterloo, Wellington, Hamilton, Niagara, Haldimand, and Brant. This area also has the largest cumulative number of cases.

As of October 14^th, there are 81 cumulative cases of COVID-19 amongst First Nations people living in communities and 161 cases in First Nations people living outside of communities for a combined total of 242 cumulative cases among First Nations people in the province. This week’s regional report has been delayed but will be sent out as soon as possible.

Ontario General
Between October 13^th and 20^th, daily case counts since fluctuated between 721 and 821. As of October 20, Ontario is averaging 743 new cases daily, which is a 2% decrease from last week at that time. On October 21, Ontario reported 790 new cases of COVID-19. Of these cases, 321 were recorded in Toronto, 156 in Peel Region, 76 in York Region, 57 in Ottawa. The regions of Durham, Halton, and Hamilton have the next highest numbers of active cases. Nineteen of Ontario’s 34 public health unit regions are reporting less than 5 cases daily.

Wednesday’s numbers bring the provincial total to 66,686 with 6,299 active cases. This is more active cases than Ontario has seen throughout the pandemic to date. As of October 20^th, just over 270 are currently in hospital with COVID-19, which is a 20% increase from this time last week. Seventy-one people currently in hospital with COVID-19 are in critical care, and 49 of these patients are on ventilators. About 85% of total cases (over 57,325) are now recovered, and 3,022 cases have resulted in death. Just over half of the new cases are people aged 40 and younger. The 20 to 29 age bracket still has the highest cumulative and active case court.

As of October 20^th, the reproductive rate for all of Ontario is 1.1. The reproductive rates vary across different regions of the province with highest located in the Southwest, Central West, and Central East Regions of the province. Ontario’s reproductive rate has remained above 1.0 for the past several weeks. A rate of less than one is required for the disease to die out.

Further detail on case numbers and demographics in the province is available here: https://covid-19.ontario.ca/data

Publicly Funded Schools
On October 21^st, the province reported 144 new cases related to school, including at least 66 among students. These reports bring the number of schools with a reported case to 518, which is nearly 11% of Ontario’s 4,828 publicly funded schools. The cumulative number of school-related cases now sits at 1,569 with over 823 reported in the past 14 days. Four schools are currently closed due to outbreak.

A detailed list of the schools, licensed child care centres and homecare agencies with COVID-19 cases can be found here: https://www.ontario.ca/page/covid-19-cases-schools-and-child-care-centres

Testing
Testing Capacity & Positivity Rates
Over the past seven days, Ontario has processed an average of 38,000 test daily, which is a marked decreased from Ontario’s average of 43,000 last week. As of October 20, the positivity rate is 2.6% across the province, which is an increase of 0.5% from last week. The combination of decreased volume and increased positivity rates is not a good indicator for spread of the disease, according to health officials.

The positivity rate for tests coming out of pharmacies in Ontario (asymptomatic cases only) has remained at 0.3%. Positivity rates in different regions of Ontario vary significantly, reportedly reaching as high as 11% in some areas.

Rapid Testing
Ontario has outlined plans for utilizing point of care tests for COVID-19. These tests come in various forms but are all able to produce results in about 15 minutes. Priority for rapid tests will be for remote and rural communities where transportation of swabs to labs creates a lag in result timeframes. These tests will also be prioritized for early outbreak response. An antigen test, which does produce rapid results but requires laboratory processing, will be prioritized for high risk and frontline workers, such as long-term care home staff. Roll outs of these tests are expected in the next week.  

Health Canada first announced it has approved a rapid COVID-19 test on September 30^th.  The federal government has signed a deal securing 7.9 million of these tests.

Updated Testing Access and Guidelines
COVID-19 assessment centres have discontinued walk-in services, offering tests by appointment only. The province has updated their testing guidelines advising that low-risk or asymptomatic individuals should not be tested unless they have been in contact with a confirmed case. Any person who has one or more symptom of COVID-19 should be tested.

A list of COVID-19 testing centres is available here: https://covid-19.ontario.ca/assessment-centre-locations/.

Testing is also available at select pharmacies for asymptomatic individuals by appointment only. It involves a pre-screening process to ensure those seeking tests have no symptoms. A list of pharmacies with the testing service is available here: https://news.ontario.ca/en/backgrounder/58491/ontario-expands-covid-19-testing-to-pharmacies-1

The province is continuing mobile testing and pop-up testing centre initiatives to help reach vulnerable populations. Check your local public health unit website to check availability. All testing is free.

Exposure to a Confirmed Case
If you have had contact with a known case of COVID-19, your should get tested at least 5 to 7 days after your exposure and self isolate for 14 days whether or not you exhibit symptoms. If you were exposed to the same known source as a confirmed case, you should be tested.  

If a person comes in contact with a known case and receives a negative COVID-19 test result, they are still required to self-isolate for 14 days after their last exposure to the case. If an asymptomatic person who had contact with a known case received a negative COVID-19 test result and then subsequently becomes symptomatic, they should be re-tested. These are precautionary measures taken in case of a false negative test result.

Symptoms and Screening
Because the disease is new, the symptoms of COVID-19 are wide and changing. When assessing for symptoms, it is important to focus on evaluating if they are new, worsening, or different from an individual’s normal state of health. With this considered, the following are considered symptoms to monitor for:

• Fever (temperature of 37.8°C/100.0°F or greater)
• Cough
• Shortness of breath (dyspnea, out of breath, unable to breathe deeply, wheezing)
• Feeling feverish

• Chills
• Fatigue or weakness
• Muscle or body aches
• New loss of smell or taste
• Headache
• Gastrointestinal symptoms (abdominal pain, diarrhea, vomiting)
• Feeling very unwell
• Children tend to have abdominal symptoms and skin changes or rashes

Symptoms may take up to 14 days to appear after exposure.

Ontario’s updated COVID-19 symptom list is available here: http://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/2019_reference_doc_symptoms.pdf The Ontario COVID-19 self-assessment tool available here: https://covid-19.ontario.ca/self-assessment/

Regular Flu Vaccine
The regular flu vaccine is now available in Ontario. Flu shots can be given to people as young as 6 months of age. A high dose flu shot for seniors is available for people aged 65 and over this year as well. Officials reports that distribution processes for the flu vaccine are similar to those

placed over the past several years with tests being distributed in phases. Approximately 3.4 million vaccines have been dispersed across the province already.

Access the Ontario press kit for the regular flu vaccine here: https://news.ontario.ca/en/advisory/58485/electronic-press-kit-now-available-ontario-set-to-launch-largest-flu-immunization-campaign-in-provin

Ontario Fall Preparedness Plan & COVID-19 Response
Ontario released its Fall Preparedness Plan for Health, Long-Term Care and Education on September 30, 2020. The full plan is available here: https://files.ontario.ca/moh-preparing-for-future-waves-of-covid-19-en-2020-09-30-v1.pdf

Federal Updates
Confirmed COVID-19 Cases – First Nations in Canada
October 10^th, there are 968 cumulative COVID-19 cases confirmed amongst First Nations people living on-reserves across Canada. Increases are noted in the provinces of Manitoba, Saskatchewan, Ontario, Quebec, and Alberta. According to federal reports, there are now 242 active cases of COVID-19 amongst First Nations people living in communities across Canada, representing the highest number of active cases since the start of the pandemic.

Over 713 First Nations people in communities across Canada have now recovered from COVID-19 and 13 have died.

More specific demographic breakdowns from Indigenous Services Canada are available here: https://www.sac-isc.gc.ca/eng/1589895506010/1589895527965

Confirmed COVID-19 Cases – Canada

Canada officially entered the second wave of COVID-19 two weeks ago, according to health officials. On Wednesday October 21^st, Canada reported 2,251 new cases, bringing the cumulative case count to 203,689. The total number of daily cases in Canada is now higher than it was during the virus’s peak in April. There are currently 22,450 active cases in the country, which is about 2,000 more active cases than this time last week. Just over 173,000 cases in the country have now recovered, representing over 80% of the total transmissions. The death toll as of October 21^st is 9,823, which is about 5% of the total.

More detailed information and trends across the country are available here: https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html

Border Closures
The Canada-U.S. land border has been closed to non-essential travel since mid-March 2020. This week, the closure was extended by another month to November 21^st, 2020. The Prime Minister has indicated that extensions to the closure will continue until COVID-19 case counts in the U.S. decrease. Restrictions between inter-provincial borders within Canada vary. It is recommended to research each region’s policies prior to any travel. International travel suspension orders limiting non-essential travelers and non-citizens from entering Canada remain in place. The mandatory 14-day self-quarantine for all individuals entering or returning to the country remains in place. Canada is continuing to advise against all non-essential travel.

Additional Information & Resources

• Ontario COVID-19 website: https://covid-19.ontario.ca
• Canada COVID-19 website: https://www.canada.ca/en/public health/services/diseases/coronavirus-disease-covid-19.html
• Chiefs of Ontario COVID-19 webpage: https://chiefsofontario.wordpress.com/
• Generic email for Indigenous Services Canada COVID-19 information:  sac.covid-19fnihbontario.isc@canada.ca
• Red Cross Support
  The Canadian Red Cross virtual help desk for Indigenous communities’ COVID-19 responses is available from 8 a.m. to 8 p.m. (CST), 7 days a week at: 1-833-937-1597.

InfoPoint
A single point of contact for credible and reliable info on COVID-19. Health managers can call or email to ask specific questions. Toll free: 1-855-446-2719 or Email:Infopoint@fnhma.ca