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COVID-19
Health Care Provider
      Briefing
Middlesex and London Region
        July 13, 2021

Welcome
          Presenter:
    Dr. Alex Summers
Associate Medical Officer of Health
  Middlesex-London Health Unit

         @alexsummers4

Surveillance Report
As of July 12th :
• Over 186.8 million COVID-19 cases and over 4.03 million deaths
  have been reported worldwide.
• Over 2.9 billion vaccine doses administered worldwide
• 547,263 cases of this illness confirmed in Ontario, including 9,251
  deaths
• Local:

Data source: Ontario Ministry of Health (Ministry) Public Health Case and Contact Management Solution (CCM), extracted
2021-07-13. Data current as of the end of day 2021-07-12.

Cases by Reported Date

Data source: Ontario Ministry of Health (Ministry) Public Health Case and Contact Management Solution (CCM), extracted
2021-07-13. Data current as of the end of day 2021-07-12.

Outbreaks
Outbreaks as of July 13, 2021:
   –   Child Care = 0
   –   Schools = 0
   –   Post-secondary = 0
   –   Congregate Setting = 0
   –   LTCH/RH/Hospital = 0

Variant of Concern (VOC) update

Delta Variant
• Since July 13th, MLHU has reported a total of 55 Delta
  variant positive cases.
• Delta is already the dominant variant in Ontario and
  anticipate it will become so in our region
   – What makes the Delta variant different?
   – Can the Delta variant infect those who are vaccinated?
• PHAC has noted the following about the Delta variant;
       •   Transmissibility is high
       •   Disease severity is unknown
       •   Immunity and re-infection in convalescent patients is low
       •   Vaccine effectiveness is moderate and better after a completed
           series, and
       •   Surveillance programs have a moderate risk of not detecting cases.

Vaccines protect against VOCs
• One dose offers good protection against severe
  illness, hospitalization and death from the Delta
  variant BUT
• Two doses are needed for 90% protection from
  getting and transmitting the virus to others.
• Of the COVID-19 positive cases in the 2 weeks
  prior to July 2nd:
      • 92% were unvaccinated,
      • 8% were partially vaccinated (1 dose), and
      • 0% were fully-vaccinated.

COVID-19 Vaccine Coverage

COVID-19 Vaccine Update

Roadmap to Reopen

          July 16th at 12:01 a.m.

Roadmap to Reopen: Step 3 Limitations
•   Up to 100 people can gather outdoors,
•   Up to 25 people can gather indoors,
•   With physical distance maintained indoors, there are no capacity limits for
    the following;
     •   Religious services, rites or ceremonies, weddings, and funerals,
     •   Restaurants with no limits on the number of patrons per table,
     •   Essential and non-essential retail
     •   Personal care services, including services requiring the removal of a face
         covering, and
     •   Real estate open houses.
•   Up to 50 per cent capacity indoors is allowed for the following:
     •   Sports and fitness facilities,
     •   Concert venues, cinemas, and theatres to a max of 1,000 people,
     •   Meeting and event spaces to a max of 1,000 people,
     •   Spectators to a max of 1,000 people,
     •   Museums, galleries, historic sites, aquariums, zoos, landmarks, botanical
         gardens, science centres, casinos/bingo halls, amusement parks, fairs, rural
         exhibitions, and festivals.

Roadmap to Reopen: Step 3 Limitations
• Up to 75 per cent capacity outdoors is allowed for the
  following;
   •   Spectators to a max of 15,000 people,
   •   Museums, galleries, historic sites, aquariums, zoos, landmarks,
       botanical gardens, science centres, casinos/bingo halls, amusement
       parks, fairs, rural exhibitions, and festivals
   •   Concert venues, cinemas, and theatres to a max of 5,000 people
       unseated or 15,000 people seated, and
• Up to 25 per cent capacity indoors is allowed for food or drink
  establishments with dancing (i.e., nightclubs restobars) to a
  max of 250 people.

Step 3: Key Considerations
• Keep it outdoors as much as possible
• Wear a mask when indoors in public places
• Only gather indoors if absolutely necessary; if indoors
  within the gathering limit (25 people), ensure
  everyone you are indoors with is fully vaccinated
• Families with children under 12 (not yet eligible to be
  vaccinated):
   • Keep it outdoors
   • Stick to close contact with your immediate
     household only
   • Mask if you absolutely must be indoors with
     people who are not part of your household

COVID-19 Vaccine Eligibility
• All individuals 12+ are eligible for accelerated second
  doses

   • The minimum interval between a first dose mRNA
     vaccines is 28 days
   • The minimum interval between a first dose viral vector
     vaccine is 8 weeks.

Interchangeability of COVID-19
             Vaccine
• mRNA vaccines authorized in Canada can be used
  interchangeably
• Different brands of the same vaccine have been used
  interchangeably in Canada for decades.
• To be used interchangeably the vaccines must:
     ▪ Be authorized for the same indications and populations,
     ▪ Have similar safety, and efficacy, and
     ▪ Have a similar types and quantity of antigen to build
       antibodies.

COVID-19 Vaccine Boosters

• Boosters doses (or third doses) are not
  indicated for any individuals or population
• As more evidence and guidance becomes
  available it will be shared.

Walk-in Pop-up COVID-19
  Vaccination Clinics
           • No appointment or
             health card needed
           • Anyone 12 years and
             older
           • First OR second doses
           • Schedules available at:
             www.healthunit.com/po
             p-up-vaccination-clinics

Clinic Schedules
MLHU Walk-in Clinics:
                           EMS Pop-up Clinics:

COVID-19 Vaccine Mobile Clinics
• Youth School Clinics
   • 1st round completed 3,000 doses (age 12 to 90 years)
   • 2nd round moving up to 28 days from 1st dose
       • All will be contacted and given at the same locations
   • Plan to transition future clinics to walk-in with some
      appointments
• Individuals who cannot access vaccine clinics can call;
   • The vaccine booking line at 226-289-3560 from 8:00 a.m.
      to 7:30 p.m., Monday to Friday to book an in-car vaccine
      at area mass vaccination clinic sites, OR
   • The Health Unit at 519-663-5317 from 8:30 a.m. to 4:30
     p.m., Monday to Friday for homebound individuals
     unable to get to a vaccination clinic

COVID-19 Vaccine Receipts
• Go to https://covid19.ontariohealth.ca/ to access a
  vaccine receipt
   • You will need:
      • Health card (green photo OHIP cards only),
      • Date of birth, and
      • Postal code.

• If an individual received a blank receipt or there is an error
  on their receipt (i.e. name spelled incorrectly):
   • Call 226-289-3560 (8:00 a.m. to 7:30 p.m., Monday to
      Sunday)

Vaccinated Outside of Ontario/Canada
• Records vaccines received outside of Ontario/Canada cannot
  be submitted through ICON or electronically by email to the
  Health Unit (YET)
• These records can be entered into the COVAXon software by;
   • Bringing the following to MLHU staff located at our Citi
      Plaza location;
       • A form of identification with the individuals name and
          date of birth, AND
       • Proof of immunization (name, date, place and type of
          vaccine received).
   • Note: Office hours are Monday to Friday, 8:30 a.m. until
      4:30 p.m.

COVID-19 Vaccines: Preconception, Pregnancy,
              and Breastfeeding
✓ There is NO evidence that vaccines interfere with male or
  female fertility
   • Watch the World Health Organization's short video here:
      www.who.int/emergencies/diseases/novel-coronavirus-2019/media-resources/science-in-5/episode-41---vaccines-
      pregnancy-menstruation-lactation-and-fertility

✓ Yes, people who are pregnant, planning a pregnancy or who
  are breastfeeding should get vaccinated
   • Its better to complete a vaccine series before becoming
      pregnant to better protect from severe infection,
      hospitalization, or death
✓ Yes, vaccinated mothers can pass antibodies while their
  pregnant, or through their breastmilk.
   • Yes, this is very important protection since those under 12
      years of age are not eligible for a vaccine.

COVID-19 Testing Reminder
Starting July 16th, for COVID-
19 testing, please refer clients
to:
• Carling Heights
    Assessment Centre
• Address: 656 Elizabeth St.,
    London
• *NEW* Hours
  (starting July 17th):
   – Monday to Sunday, 9:15 a.m.
     to 6:30 p.m.

FVI – Post exposure
• Asymptomatic FVI do not have to self-isolate after a high-risk
  exposure.
• For other FVI scenarios, please see the COVID-19 Fully
  Vaccinated Individuals: Case, Contact and Outbreak
  Management Interim Guidance from the Ministry of Health
• ANYONE with symptoms of COVID-19 should self-isolate,
  contact their healthcare provider, and get tested for COVID-19.
• Symptomatic individuals SHOULD NOT attend their COVID-19
  vaccine appointments.
• Currently, vaccination is not being used as post-exposure
  prophylaxis (PEP)

COVID-19 Youth Resource

• To support youth
  vaccination efforts, the
  Ministry of Health will
  release a resource guide
  that includes guidance on
  vaccine safety, preparing
  for an appointment, and an
  updated consent form for
  youth.

Questions?
• Ask using chat function now, or after the webinar at:
  healthcareproviders@mlhu.on.ca
• For urgent matters please call the Health Unit’s main line at
  519-663-5317.
• For more information www.healthunit.com/healthcare-
  providers