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COVID-19
Health Care Provider
      Briefing
Middlesex and London Region
        July 20, 2021

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

         @alexsummers4

Surveillance Report
As of July 19th :
• Over 190.7 million COVID-19 cases and over 4.09 million deaths
  have been reported worldwide.
• Over 3.4 billion vaccine doses administered worldwide
• 548,347 cases of this illness confirmed in Ontario, including 9,294
  deaths
• Local:

Data source: Ontario Ministry of Health (Ministry) Public Health Case and Contact Management Solution (CCM), extracted
2021-07-20. Data current as of the end of day 2021-07-19.

Cases by Reported Date

Data source: Ontario Ministry of Health (Ministry) Public Health Case and Contact Management Solution (CCM), extracted
2021-07-20. Data current as of the end of day 2021-07-19.

Outbreaks
Outbreaks (as of July 19, 2021):
• Congregate Setting = 0
• LTCH/RH/Hospital = 0 [UH outbreak declared over]
• Schools/Child Care/Post-secondary in Outbreak: 0

• *Continue to see outbreaks among groups who are
  gathering indoors and among those who are
  unvaccinated

Variant of Concern (VOC) update

Delta Variant
• We continue to see the Delta variant reported
  in our region.

• Best protection against severe outcomes
  associated with the Delta variant?

COVID-19 Vaccine Coverage

COVID-19 Vaccine Update

Roadmap to Reopen

          July 16th at 12:01 a.m.

Roadmap to Reopen: Step 3
• Outdoor gatherings: up to 100 people
• Indoor gatherings: up to 25 people
• No capacity limits for the following (with physical distancing in place):
    •   Religious services, rites or ceremonies, weddings, and funerals
    •   Restaurants - 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
    •   Real estate open houses
• Up to 50 per cent capacity indoors for the following:
    •   Sports and fitness facilities
    •   Concert venues, cinemas, and theatres (max of 1,000 people)
    •   Meeting and event spaces (max of 1,000 people)
    •   Spectators (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

• 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.

Our Public Health Advice Remains the Same:
• Keep it outdoors as much as possible
• 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

Section 22 lifted
• Lifted as of July 15, 2021
• Covers all gyms, health clubs, community centres,
  multi-purpose facilities, arenas, exercise studios,
  yoga studios, dance studios, and other fitness
  facilities
• Order made face coverings mandatory for class
  instructors
• Limited classes to 10 participants or barriers
  between

Reopening Canada’s Border
•   Starting August 9, 2021, Canada plans to begin allowing entry
    to American citizens and permanent residents, who are
    currently residing in the United States, and have been fully
    vaccinated at least 14 days prior to entering Canada for non-
    essential travel
•   On September 7, 2021, open Canada’s borders to any fully
    vaccinated travellers who have completed the full course of
    vaccination with a Government of Canada-accepted vaccine at
    least 14 days prior to entering Canada and who meet specific
    entry requirements

Reopening Canada’s Border

COVID-19 Mass Immunization Clinics
• First and second dose walk-ins at all mass vaccination clinics
   • Appointments encouraged, but no longer required
   • Walk in options available at all four mass vaccination
      clinics between 9am to 5pm.
   • Transition planning for clinic hours for EN, NLOCC and Mt
      Brydges for August

Moderna and Pfizer available
• Pfizer vaccine available to anyone 12+ at all
  MLHU vaccination clinics.
• Moderna vaccine available to anyone 18+
  at:
  – Western Fair Agriplex,
  – North London Optimist Community Centre, and
  – Caradoc Community Centre in Mount Brydges

COVID-19 Vaccine Distribution
• Pop-Up COVID-19 Vaccination Clinics
   o Check out the Health Unit’s website regularly for updates
      on new Pop-up COVID-19 Vaccination Clinic listings
• Vaccine continues to be delivered to all health care providers
  and agencies who provide doses in the MLHU area
• Individuals who cannot access vaccine can call:
   o Vaccine booking line for in-car vaccines at area mass clinic
     sites
   o MLHU phone line for home visit requests

Primary Care outreach to
           unvaccinated patients
• Ontario Health (OH) has made the COVaxON Aggregate Primary Care
  Vaccination Report available to all physicians participating in a patient
  enrollment model.
• The report identifies rostered patients that have received a COVID-19
  vaccine.
• Instructions will be provided to help physicians use this information to
  determine which of their enrolled patients have not yet been fully
  vaccinated.
• The memo from Ontario Health constitutes a formal request to contact
  as many of these patients as possible to provide them with assistance in
  the registering and/or booking of their COVID-19 vaccinations, which
  garners a one-time payment of $6 per patient. (Billing code - Q007)

Long-term care home update
• Directive #3 for long-term care homes has been updated to
  include the following changes;
   o Asymptomatic, fully-immunized staff, caregivers and visitors do not
     need to be tested for COVID-19 before entering the facility,
   o Asymptomatic, fully-immunized residents without close contact with a
     positive COVID-19 case, do not need to be tested or quarantined on
     admission or transfer to a facility,
   o Residents need to be symptom screened ONCE daily,
   o Eye protection should be worn by all staff and essential visitors
     providing care within 2 meters of a resident under Droplet and Contact
     Precautions or in a setting in an outbreak, and
   o Residents returning from a temporary absence must follow the same
     testing and quarantine protocols as those for admissions and transfers.

Congregate settings update
• The Ministry of Children, Community and Social Services has
  updated their guidance document and website for congregate
  care settings with the following changes;
   o Scheduled indoor and outdoor visits for non-essential
      visitors can occur while adhering to Step Three in Ontario’s
      Roadmap to Reopen, and
   o Resident’s overnight absences can occur with an updated
      screening process that does not require a negative COVID-
      19 test for fully immunized residents.

Highlights of First Wave
• Health Canada report
• Analysis of social and economic factors linked to higher rates of
  death from COVID-19 between January and August of 2020
• Key findings in the report included significant inequalities in
  COVID-19 death rates for people living in:
       o Large Cities
       o Apartments,
       o Lower income neighbourhoods,
       o Neighbourhoods with more people who:
           ▪   Are a visible minority,
           ▪   Recently immigrated to Canada,
           ▪   Were born outside of Canada, or
           ▪   Neither speak English or French.

COVID-19 Instagram Live
•   To promote vaccine uptake in
    the under 30 years
    demographic, the Middlesex-
    London Health Unit will be
    offering an Instagram Live
    event
•   Youth can have their COVID-19
    vaccine questions answered
•   Dr. Rod Lim and Dr. Alex
    Summers presenting
•   July 23, from 12:30 p.m. to
    1:30 p.m.

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