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COVID-19
Health Care Provider
      Briefing
Middlesex and London Region
       May 18, 2021

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

         @alexsummers4

Surveillance Report
As of May 17th , 2021:
• Over 163.2 million COVID-19 cases and over 3.38 million deaths
  have been reported worldwide.
• 511,486 cases of this illness confirmed in Ontario, including 8,489
  deaths
• Local:

Data source: Ontario Ministry of Health (Ministry) Public Health Case and Contact Management Solution (CCM), extracted
2021-05-18. Data current as of the end of day 2021-05-17

Variant of Concern (VOC) update

Cases by Reported Date

Data source: Ontario Ministry of Health (Ministry) Public Health Case and Contact Management Solution (CCM), extracted
2021-05-18. Data current as of the end of day 2021-05-17

Outbreaks
Outbreaks:
(as of May 17, 2021)
    – 4 outbreaks active in LTCH/RH/Hospitals
    – 2 Congregate settings outbreaks

Schools/Child Care/Post-secondary in Outbreak:
       • No school outbreaks
       • 1 child care centre outbreaks

COVID-19 Vaccine Update

COVID-19 Vaccine Coverage

COVID-19 Vaccine Updates
• As of May 12th , over 50 percent of adults in Ontario have
  received their first dose of the COVID-19 vaccine
• The Earl Nichols Recreation Centre COVID-19 Vaccination
  Clinic
    o officially open Tuesday, May 25,
    o located at 799 Homeview Rd., London.
• Future eligibility:
   o Week of May 31:
      ▪ Youth between the ages of 12 and 17 and their
         family members

Vaccine Eligibility Web Page

www.healthunit.com/covid-19-vaccine-eligibility

Updated Phase Two
                       Eligibility Projections
*subject to change based on Provincial direction and vaccine supply

COVID-19 Vaccine Eligibility

COVID-19 Vaccine Eligibility
*NEWLY* eligible for booking a first-dose appointment
this week:
    ➢Adults aged 18 and older

For Pfizer – individuals turning 18 this year can get the vaccine starting
today.
For Moderna – individuals must be 18 at the time of vaccination, as per
product monograph

COVID-19 Vaccine Eligibility:
         Second dose schedule update
*As of May 8th,
    • Residents of long-term care, retirement and First Nations elder care
       homes.
    • Indigenous people
    • Transplant recipients (including solid organ transplants and
       hematopoietic stem cell transplants).
    • Individuals with malignant hematologic disorders and non-hematologic
       malignant solid tumors receiving active treatment (chemotherapy,
       targeted therapies, immunotherapy), excluding individuals receiving
       solely hormonal therapy or radiation therapy.
    • Individuals receiving hemodialysis or peritoneal dialysis

*As of of May 14th,
    • High risk healthcare workers

COVID-19 Vaccine Eligibility:
        Second dose schedule update
• To rebook a second dose:
     ✓ As of Friday, May 14th at 8am
     ✓ Through the MLHU’s COVID-19 Vaccine Booking Line only
       – (226)289-3560
     ✓ The Vaccine Booking Line is open daily 8am – 7:30pm
     ✓ The on-line booking system cannot be used to reschedule
       an appointment or book a second dose

Homebound Patients
•   MLHU has been working with the LHIN to deliver COVID-19 vaccine
    through home visits to homebound patients receiving LHIN supports.
•   MLHU is requesting the assistance of healthcare providers in
    connecting with patients on your roster who are homebound, not
    receiving LHIN-based homecare, and will not be able to receive COVID-
    19 vaccination through local mass vaccination centres, pharmacies, or
    primary care outreach.
•   Healthcare providers are asked to contact any homebound patients on
    your roster residing in London or Middlesex County and assist them in
    registering for a home visit from our mobile team.
•   We've created a short questionnaire that you can either email to your
    patient or complete on their behalf.
•   Once completed, a member of our team will reach out to them by
    phone to schedule a visit for vaccination.
           Any questions can be sent to CovidData@mlhu.on.ca

COVID-19 Vaccine Updates: AstraZeneca
•   Tuesday’s announcement from the Province to pause the administration of
    AstraZeneca was made out of an abundance of caution - and not because the
    AstraZeneca vaccine was proven unsafe or not worthwhile.
•   One to two weeks ago, the risk of COVID-19 in the community was significantly
    higher than it is now with little evidence of decline. Although it remains high,
    the Province and MLHU is starting to see evidence of dropping incidence.
•   AZ remains tremendously effective at preventing hospitalization and death.
•   Given the risk of contracting COVID-19 in the region, it most certainly kept
    people out of hospital.
•   The rate of blood clots resulting from AstraZeneca still pales in comparison to
    the burden of illness from COVID-19 that these doses of vaccine prevented.
•   No VITT events have been reported to date in MLHU.
•   Whether the Province sorts out the data and resumes using AstraZeneca or
    the data on vaccine mixing comes in, there are plenty of Pfizer and Moderna
    vaccines that will be available in the coming weeks and months. People will
    not be left behind.

Moderna Vaccine – Primary Care
o Seeking more healthcare providers in London and Middlesex County
  interested in being part of COVID-19 vaccine deployment in our
  community.
o We have a dedicated, steady supply of Moderna vaccine for primary care
  to deliver within their practices.
o Support is available to new practices to assist with onboarding including
  end user support with the COVax data system and lessons learned from
  practices already administering vaccine.
o To indicate your interest in having your office participate in this effort,
  please complete the survey linked in the e-newsletter

                 Please forward any questions to:
              covidvaccine.deployment@mlhu.on.ca

COVID-19 Positive Patient
               Monitoring
•   Ontario Health released Implementing home monitoring for COVID-19
    patients through primary care that describes remote monitoring
    programs supporting patients with COVID-19 throughout Ontario by
    various local models (e.g., hospital-based, COVID-19 assessment centre,
    community paramedicine, and regional home and community care
    models).
•   In the London and Middlesex County, there are two pathways for clients
    to receive follow up;
     • primary care providers are asked to ONLY refer to the London
         Health Science Centre’s Urgent COVID-19 Care Clinic (LUC3) for
         triaging of these services.

COVID-19 Positive Patient Monitoring
1.    The London Health Science Centre virtual Urgent COVID-19 Care Clinic
      (LUC3):
      o for patients considered Medium to High-Risk:
          ▪   age > 40 years, OR
          ▪   age < 40 years with:
               ▪ respiratory disease (e.g., asthma, COPD),
               ▪ obesity,
               ▪ diabetes,
               ▪ ESRD or
               ▪ immunosuppression
2.    South West Home & Community Care Support Services (SW HCC)
      Remote Patient Monitoring (SW-HCCSS-RPM):
          o for patients considered Low-Risk:
               ▪   age < 40 years without respiratory disease (e.g., asthma, COPD),
                   obesity, diabetes, End Stage Renal Disease (ESRD) or
                   immunosuppression.
      ▪ Please Note: Referrals must go to LUC3 for triage.

Long Term Care Updates
• Public Health Ontario released on updated guidance document on De-
  escalation of COVID-19 Outbreak Control Measures in Long-term Care and
  Retirement Homes.
   o They highlight the conditions for discontinuation of Droplet and
      Contact precautions for;
        ▪ Residents in an outbreak area under the following conditions;
            • previously positive for COVID-19
            • tested negative for COVID-19
            • previously positive for COVID-19 where they meet the clearance
              criteria but remain in the room with COVID-19 positive roommate(s)
              on precautions
        ▪ Staff
            • Exposed, previously COVID-19 positive or symptomatic staff return to
              work
            • COVID-19 immunized exposed staff
        ▪ Meals and activities
            • Resuming meals in the dining room
            • Resuming programs/activities for residents outside of their rooms

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