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COVID-19
Health Care Provider
      Briefing
Middlesex and London Region
      August 24, 2021

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

         @alexsummers4

Surveillance Report
As of August 23rd :
• Over 211.7 million COVID-19 cases and over 4.43 million deaths
  have been reported worldwide
• Over 4.4 billion vaccine doses administered worldwide
• 560,151 cases of this illness confirmed in Ontario, including 9,453
  deaths
• Locally:

Data source: Ontario Ministry of Health (Ministry) Public Health Case and Contact Management Solution (CCM), extracted
2021-08-24. Data current as of the end of day 2021-08-23.

Cases by Reported Date

Data source: Ontario Ministry of Health (Ministry) Public Health Case and Contact Management Solution (CCM), extracted
2021-08-24. Data current as of the end of day 2021-08-23.

Outbreaks
Outbreaks (as of Aug 23, 2021):
•   Congregate Setting = 0
•   LTCH/RH/Hospital = 0
•   Schools/Child Care/Post-secondary = 0
•   Other:
    – A number of workplace outbreaks
    – We continue to see outbreaks among groups
      who are gathering indoors and among those
      who are unvaccinated

Vaccination Status of Cases

Data source: Ontario Ministry of Health (Ministry) Public Health Case and Contact Management Solution (CCM), extracted 2021-08-17.
Data current as of the end of day 2021-08-16.

Variant of Concern (VOC) update

Data source: Ontario Ministry of Health (Ministry) Public Health Case and Contact Management Solution (CCM), extracted 2021-08-17.
Data current as of the end of day 2021-08-16.

COVID-19 Vaccine Update

Data source: Ontario Ministry of Health (Ministry) Public Health Case and Contact Management Solution (CCM), extracted 2021-08-24.
Data current as of the end of day 2021-08-23.

COVID-19 Vaccine Coverage

Data source: Ontario Ministry of Health (Ministry) Public Health Case and Contact Management Solution (CCM), extracted 2021-08-24.
Data current as of the end of day 2021-08-23.

4 th   COVID-19 Wave
• The 4th wave of the pandemic has arrived.
• COVID-19 case counts continue to rise in Middlesex-London
  and across Ontario.
• The MLHU reminds all Middlesex-London residents to:
   o   Get vaccinated.
   o   Wear a mask when indoors in public places.
   o   Limit social contacts.
   o   Keep activities outdoors.
   o   Get tested if you have symptoms.

• Reminders from healthcare providers are essential – thank
  you for your ongoing support.

COVID-19 Vaccination extended
                  eligibility
• Tuesday, August 17th, the Province of Ontario
  announced extended eligibility for the COVID-19
  vaccine
   – anyone who is currently 11 years-old and will be turning 12 before the
     end of 2021.
   – Any youth born in 2009 who has already received a first dose of the
     vaccine is now eligible to book their second dose appointment, so long
     as it is scheduled at least 28 days after they received their first dose.
• You can immunize your patients in your office or
  direct them to the Health Unit’s clinics listed on our
  website.

Third Doses
o For those with the highest-risk health conditions to
  protect them from the Delta variant
o These groups include:
   ▪ Transplant recipients (including solid organ transplant and
     hematopoietic stem cell transplants);
   ▪ Patients with hematological cancers (examples include
     lymphoma, myeloma, leukemia) on active treatment
     (chemotherapy, targeted therapies, immunotherapy);
   ▪ Recipients of an anti-CD20 agent (e.g. rituximab, ocrelizumab,
     ofatumumab); and
   ▪ Residents of high-risk congregate settings including long-term
     care homes, higher-risk licensed retirement homes and First
     Nations elder care lodges.

Third Doses
• Please wait for further direction from MLHU
• MLHU is working with our hospital partners to deliver
  third doses to those with relevant medical conditions and
  will shortly provide a process for patients not associated
  with hospital clinics.
• Long-term care home and high-risk retirement home
  operators have been contacted directly to arrange for
  third doses for residents

COVID-19 Vaccination Policies
     Mandatory in High-Risk Settings
• Ontario’s Chief Medical Officer of Health has issued a directive
  mandating hospitals as well as home and community care
  service providers to have COVID-19 vaccination policies in place
  for employees, staff, contractors, students and volunteers.
• Ambulance services will also be required to have COVID-19
  vaccination policies in place for paramedics.
• The vaccination policy must be effective no later than
  September 7, 2021

COVID-19 Vaccination Policies
     Mandatory in High-Risk Settings
• At minimum the policy will require individuals to provide proof
  of one of the following:
   – Full vaccination against COVID-19,
   – A medical reason for not being vaccinated against COVID-19, or
   – Completion of a COVID-19 educational session
• These are the minimum criteria, and all organization are
  encouraged to mandate vaccines.
• The Directive #6 Resource Guide has been developed to
  support hospitals, home and community care service providers,
  and ambulance services establish, implement, and ensure
  compliance with a COVID-19 vaccination policy.

Vaccine or Test
         ≠
Mandatory Vaccination

Provincial Approach to Vaccine
                  Wastage
• Unused vaccine doses as a result of program implementation
  are expected.
• In Ontario, the goal remains to optimize the use of COVID-19
  vaccines and limit the number of unused doses through
  effective storage, handling, and program and clinic strategies.
• The province has also highlighted the need to increase efforts
  to reach the vaccine hesitant and those who may be less likely
  to return for their second dose of vaccine

Provincial Approach to Vaccine
                  Wastage
• Therefore, opening a vial to vaccinate one or a small number of
  individuals will be necessary to support vaccination efforts in
  trying to reach provincial targets. This is especially important
  where a vial is reaching its “must use by” date. Wherever
  possible, efforts should continue to be made in these instances
  to locate other potential individuals for vaccination (e.g.,
  waitlists).

COVID-19 Vaccine Mobile and Pop-up Clinics
                      • New dates and locations
                        for mobile and pop-up
                        clinics continue to be
                        created – check our
                        website for updates
                        https://www.healthunit.
                        com/pop-up-
                        vaccination-clinics

COVID-19 Fixed Vaccination Clinics
• The demand for booked appointments at mass
  vaccination clinics in London and Middlesex
  County continues to decrease.
• Clinic staff continue to see between 50 and 100
  walk-ins for vaccination at all clinic locations
  daily.

COVID-19 Fixed Vaccination Clinics
 • The Earl Nichols Recreation Centre, Caradoc
   Community Centre, and North London
   Optimist Community Centre (NLOCC)
   vaccination clinics are now operating with
   shorter hours:
    o five days a week
    o from 9am-3pm
 • The Western Fair District Agriplex will move to
   reduced hours starting September 2nd.
 • The last day of operation at NLOCC will be
   September 4th

Vaccines and school planning
• The Health Unit’s Vaccine Preventable
  Disease team is collaborating with schools
  in the region to plan for the rollout of
  COVID-19 vaccine in schools as well as
  other vaccines, such as Meningococcal
  conjugate (Men-C-ACYW), Hepatitis B, and
  Human papillomavirus (HPV).

AEFI form updated
• The Health Unit has updated the Adverse Events
  Following Immunizations (AEFI) to Report form on
  its website.
• This form will help you determine which reactions
  to report, when to report and whether the event
  falls within the Temporal Criteria indicated on the
  form.
To report an AEFI, please visit the MLHU
website at https://www.healthunit.com/aefi

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

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