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COVID-19
Community Stakeholder
      Briefing
 Middlesex and London Region
       January 5, 2021

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

         @alexsummers4

Surveillance Report
As of January 4th 2020:
• Over 84.2 million COVID-19 cases and over 1.84 million
  deaths have been reported worldwide.
• 194,232 cases of this illness confirmed in Ontario,
  including 4,679 deaths
• Local:

Cases by Reported Date

Data source: MLHU COVID-19 Case and Contact Management System, extracted 2021-01-05 at 08:30 EDT. Data current as of the end of day 2021-01-04

Cases by Onset Date

Data source: MLHU COVID-19 Case and Contact Management System, extracted 2021-01-05 at 08:30 EDT. Data current as of the end of day 2021-01-04

Outbreaks/Schools
• Outbreaks:
  – 10 outbreaks active in long-term care or retirement
    homes
  – 2 outbreaks at Victoria Hospital
  – outbreaks at University Hospital declared over

• School update:

COVID-19 Vaccine Update

Phase 1
• Congregate care staff and residents (e.g.
  Long-term care, retirement homes etc.)
• Health-care workers
• First Nations Inuit and Metis populations
• Adult recipients of chronic home care
  services

Phase 2
• Starting later this winter (date TBD)
• Starts when more doses become available
  to Ontario.
• Vaccinations will be expanded to:
  – all members of the groups in phase 1
  – additional congregate care settings (for
    example, shelters)
  – adults over 70

Phase 3
• Starts when vaccines are available for
  everyone who wants to be immunized.
• Will likely function similar to influenza
  vaccination program, with increased
  involvement of primary care and
  pharmacies.

Local Phase 1 Update

Establishment of mass
       immunization clinic
• LHSC identified as hospital site
  – Limitation – Pfizer cannot be forward deployed
• Initial doses prioritized for LTCH/RH staff
  – First shipment did not have enough vaccine for
    all LTCH and RH staff (less than 50%)
  – A prioritized on-call list was established to fill
    as many empty spots as possible
• Partnership of MLHU, LHSC, HPPH and
  SWPH

Establishment of mass
       immunization clinic
• Mass immunization clinic established at
  Western Fair Agriplex
• Will be operating at capacity of 500
  immunizations/day this week, and scaling
  up as more vaccine becomes available

Forward deployment of
            Moderna
• MLHU notified of imminent arrival of
  Moderna vaccine for LTCH and RH residents
• MLHU will be working with facilities to
  deliver to residents starting in mid-January
• Not enough vaccine in the early shipments
  to do all LTCH and RH residents, and
  therefore, it is necessary to determine an
  appropriate sequence of facilities

Forward deployment of
           Moderna
• Will be delivered on site by either
  MLHU/MLPS teams OR by LTCH/RH staff

Establishing sequence of
             delivery
• Given the scarcity of the vaccine, some
  people will receive their vaccine before
  others
• The order is largely articulated by the
  province
• Within those cohorts, efforts will be made
  with sector leaders to prioritize based on
  risk

Ethical framework
•   minimize harms and maximize benefits
•   equity
•   fairness
•   transparency
•   legitimacy
•   public trust

Sequence within cohorts
• Decisions are based on:
  1. Risk of exposure to COVID-19 within a health-
     care setting based on health-care worker role
     or responsibility;
  2. Risk of severe disease or outcomes from
     COVID-19 among patient population served;
     and
  3. Criticality to health system capacity (of the
     individual’s role)

Early HCW recipients
•   COVID-19 units
•   Critical care units/critical care response teams
•   Emergency departments
•   General internal medicine units
•   COVID-19 assessment centres
•   Emergency first response
•   Outreach to high risk COVID-19 satellite clinics,
    such as COVID-19 recovered hostels, hotel

Role of primary care
• Phase 1 and 2
  – Majority of vaccine will likely be delivered
    through mass immunization clinics, with
    periodic outreach through MLHU and MLPS
  – Support of primary care at mass immunization
    clinic is greatly appreciated
• Phase 3
  – TBD, but anticipated that primary care will play
    a substantial role

Communication
• MLHU will continue to keep you updated as
  vaccine availability increases and as further
  role clarity is established

Travel
• Ontario’s Chief Medical Officer of Health strongly
  advises that travel out of the province should be limited
  to essential purposes only.
• The Government of Canada has posted a travel ban on
  all flights arriving from the UK until January 6, 2021.
   o COVID-19 testing required for people flying into Canada
      Starting January 7, 2021, air travellers five years of age or
      older will be required to present a negative COVID-19 test
      result to the airline before boarding international flights
      bound for Canada.
   o Mandatory 14-day quarantine or isolation
      Everyone entering Canada must follow mandatory isolation or
      quarantine requirements. Not respecting the mandatory
      requirements is a serious offence with consequences and
      penalties.

COVID-19 Funding Updates
• The federal government is providing Canadian Red Cross teams with
  funding for short-term support to long-term care and retirement
  homes in Ontario
• Over the next three years, Ontario's Action Plan: Protect, Support,
  Recover plans to offer $45 billion, to make available the necessary
  health resources to protect people, deliver programs and tax
  measures to support individuals, families and job creators impacted
  by the virus, and for Ontario’s long-term economic recovery.
• Ontario released A better place to live, a better place to work:
  Ontario’s long-term care staffing plan to recruit and retain more
  staff, improve working conditions, and drive effective and
  accountable leadership.

Resources
Many more resources this week – linked in e-newsletter
•   New: What you need to know about COVID-19 vaccine for Canada (multiple languages; Government of
    Canada)
•   New: Moderna COVID-19 vaccine: What you should know (Government of Canada)
•   New: Connect to an on-call doctor today by video or audio during the COVID-19 pandemic
•   New: Recommendations of the National Advisory Committee on Immunization (NACI) on the use of the
    Moderna COVID-19 vaccine (Vice Chair of Canada’s National Advisory Committee on Immunization)
•   New: COVID-19 Guidance: Considerations for Rapid Antigen Screening (Ontario Ministry of Health)
•   New: A Guide to Starting a Home-based Food Business (Ontario Ministry of Health)
•   New: Addressing Health Inequities within The COVID-19 Public Health Response (Public Health Ontario)
•   New: Fact Sheet Cold Weather Tips for Schools (Public Health Ontario)
•   New: COVID-19 Prevention Measures in K-12 Schools: Optimizing Screening and Masking (Public Health
    Ontario)
•   New: Adverse Events of Special Interest (AESIs) for COVID-19 Vaccines Surveillance (Public Health
    Ontario)
•   New: COVID-19 UK Variant VOC-202012/01– What We Know So Far (Public Health Ontario)
•   New: HHS Resilience Support Toolkit for Health Care Workers (Hamilton Health Science and Ontario
    Health West)
•   New: Memo RE: Provincial COVID-19 Long-Term Care Home Outbreak Standard Operating Procedures
    (Ontario Ministry of Health)

MLHU Info and Contact
• Weekly webinars held on Tuesdays at 12:30 p.m.
  to 1:00 p.m.

• *Change* Please send your questions to
  health@mlhu.on.ca

• www.healthunit.com

Questions?