COVID-19

Summary

• The median age of all cases since the beginning of July is 30 years, compared with 48 years for the previous three months (April to June). 
• Young adults between the ages of 18 and 34 have accounted for the highest proportion of COVID-19 cases in Simcoe Muskoka since June. Half of all active cases are among those between 18 and 34 years of age.
• The rate of COVID-19 infections in Simcoe Muskoka is highest among those that live in areas with greater ethnic diversity when compared to areas with lower ethnic diversity as measured by the Ontario Marginalization Index. For more information on the impact of COVID-19 infections in culturally diverse areas of Simcoe Muskoka see the full report and summary presentation.

COVID-19 Age-Specific Incidence, Case Hospitalization and Case Fatality Rates

COVID-19 Cases by Interventions and Outcomes

Median Age of COVID-19 Cases by Outcome and Time Period

COVID-19 Cases by Sex and Age Group

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COVID-19 Cases by Age Group and Current Status

Select from drop-down to change what is displayed on the age distribution chart. Hover over the bars to see the values

COVID-19 Incidence Rate by Ethno-Cultural Diversity

Summary

• The rate of new COVID-19 cases in Ontario is significantly higher than the Simcoe County rate. The rate in Muskoka is about half the Simcoe County rate and one-fifth of the Ontario rate.
• The vast majority of COVID-19 cases in Simcoe Muskoka reside in Barrie, Bradford West Gwillimbury, New Tecumseth, and Innisfil. 
• There has been an increase in the number of cases reported in Barrie since the latter part of August and more than half of all currently active cases reside in Barrie. There are have been more cases reported in Barrie in September than in any of the previous three months.
• September is seeing an increase in case activity in other municipalities. In Bracebridge there have been more cases reported in September than in all previous months combined. Bradford West Gwillimbury, New Tecumseth, Innisfil and Huntsville already have more cases in September than was reported in all of August. Reported cases continue to decline in most other municipalities.
• Click here to view the epidemic curve by municipality.

COVID-19 Crude Incidence and Case Fatality Rates, by Geographic Area

COVID-19 Cases by Municipality and Current Status

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COVID-19 Cases by Municipality and Month

Summary

• Approximately one-fifth (18%) of COVID-19 cases in Simcoe Muskoka have been associated with an institutional outbreak.
• Unfortunately, residents of long-term care and retirement homes have been the hardest hit by COVID-19, with one-third of cases succumbing to the illness.
• See the list of current institutional outbreaks for more details.
• There have been no COVID-19 outbreaks declared at any school in Simcoe Muskoka.

COVID-19 Workplace and Institutional Outbreaks in Simcoe Muskoka

COVID-19 Outbreak and Non-Outbreak Cases by Outcome

Summary

• The seven-day moving average of new COVID-19 cases in Simcoe Muskoka has steadily increased since early August to mid-September, from less than one case per day to more than four cases per day.
• The effective reproductive number for a given period of time or Rt is the average number of secondary cases that a new case will infect. If Rt is greater than one it indicates that the spread of COVID-19 in Simcoe Muskoka is growing, and if Rt is less than one, the spread of COVID-19 is slowing and containment/mitigation efforts may be working to keep the outbreak under control.
• While the rate of new COVID-19 infections decreased for all age groups since June, now younger adults between the ages of 18 and 34 years have the highest rate of infection - more than double any other age-group.
• The rate of new cases among males has tripled in September when compared to the rates in July and August. The rate of new cases among males in September is nearly double the rate among females.

Epidemic Curve by Date of Symptom Onset

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7 Day Rolling Average of New COVID-19 Cases

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Cases Acquired in the Community

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New COVID-19 Hospitalizations

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Cumulative COVID-19 Cases by Date of Reported

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7-Day Rolling Average of the Median Reproductive Number (Rt)

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Age-Specific Incidence Rate of COVID-19 Infections by Month

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Summary

• There were 98 new COVID-19 tests per 10,000 population in Simcoe County and 43 tests per 10,000 population in Muskoka District for the most recent week. In comparison the provincial testing rate was 127 tests per 10,000 population. NB: testing rates for the most recent week are incomplete and will change in future updates.
• The testing rates among Simcoe Muskoka residents have increased for all age groups, with the exception of those 80 years and older, since July of 2020 when compared with April to June.
• The percent positivity rate in Simcoe County is 0.1% and 1.0% in Muskoka District compared to the provincial percent positivity rate of 0.7%. A low percent positivity rate indicates the outbreak is under control, given more testing is finding a smaller and smaller proportion of positives.
• The percent positivity rate among Simcoe Muskoka adult males between 30 and 59 years of age is approximately twice as high as adult females of the same age. 

COVID-19 Testing Rate (per 10,000), Simcoe Muskoka and Ontario

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COVID-19 Percent Positivity Rate, Simcoe Muskoka and Ontario

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COVID-19 Testing Rate (per 10,000), Simcoe Muskoka by Age Group and Quarter

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COVID-19 Percent Positivity Rate, Simcoe Muskoka by Age and Sex

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Researchers from the University of Toronto have released a forecasting model - Design your own COVID-19 exit strategy - to help us understand the possible impacts of the COVID-19 pandemic in the next few months. Please see the linked presentation for use of the model and interpretation of findings.

In summary, the results suggest that as Ontario progresses through the provincial plan to re-open, physical distancing intensity will certainly decrease. In order to prevent a considerable increase in transmission and associated health and health care burden, to the extent possible we will need to:

• Primarily: maintain physical distancing as directed in the appropriate provincial plan’s phase, and use masks where physical distancing isn’t possible
• Also: increase testing intensity, and follow-up with cases and contacts

Simcoe Muskoka’s previous local model that included results to the end of April 2020 was quite accurate in its findings. The model had predicted that, with the use of the public health intervention ‘enhanced detection and moderate social distancing’, Simcoe Muskoka could expect 15 to 25 deaths and 170 to 300 reported cases by April 30th. In fact by May 1st, Simcoe Muskoka reported 20 deaths and 283 reported cases.

Cases are assigned to the Simcoe Muskoka District Health Unit based on the address of the patient when the health unit conducts their investigation, not the location of the hospital the patient was seen at. For cases that reside outside of Ontario, cases are assigned to the health unit that is actively following up with the patient.

Data for confirmed COVID-19 cases are taken from the Case and Contact Management (CCM) Management System. Data for confirmed COVID-19 outbreaks are taken from the Integrated Public Health Information System (iPHIS). Data related to COVID-19 testing are taken from the Ontario Laboratories Information System (OLIS).

Case Type Definitions:

• Active cases are confirmed COVID-19 cases that are currently self-isolating, are under isolation precautions or are in hospital (including those in an ICU bed or on a ventilator). Excludes those with unknown status. 
• Sporadic cases are those not associated with an outbreak at an institution, workplace, community setting, educational setting or congregate setting in Ontario. These infections are usually acquired from travel, within the community or from a close contact with a known case.
• Institutional outbreak cases are COVID-19 cases that are lined to long-term care homes, retirement homes, hospitals, correctional facilities. Applies to residents, staff, volunteers and third party service providers. Institutions may be located in Simcoe Muskoka or in other health unit jurisdictions. The health unit is only able to comment on institutional outbreaks in our area.
• Workplace outbreak cases are confirmed COVID-19 cases that are linked to a place of employment that is not open to the public (e.g., farms, food processing plants, manufacturing). Excludes institutions, congregate settings, educational settings and community setting workplaces. Applies to employees and employers. Based on epidemiological investigation of cases in employees of a workplace who worked in proximity and at the same time of other confirmed cases. Workplaces may be located in Simcoe Muskoka or in other health unit jurisdictions. The health unit is only able to comment on workplace outbreaks in our area.
• Community outbreak cases are confirmed COVID-19 cases linked to workplaces that are open to the public (e.g., restaurants, bars, funeral homes, gyms, community centres, personal service settings etc.), community events (e.g., concerts) or social gatherings. Based on epidemiological investigation of cases that were in close proximity and at the same time of other confirmed cases at the facility, event or gathering. These community settings may be located in Simcoe Muskoka or in other health unit jurisdictions. The health unit is only able to comment on community setting outbreaks in our area.
• Congregate settings outbreak cases are confirmed COVID-19 cases linked to settings in which people temporarily or permanently reside such as group homes, supportive housing or shelters. Applies to residents and staff. Based on epidemiological investigation of cases in residents/staff of a congregate setting who were in proximity and at the same time of other confirmed cases. Congregate settings may be located in Simcoe Muskoka or in other health unit jurisdictions. The health unit is only able to comment on congregate setting outbreaks in our area.
• Educational settings outbreak cases are confirmed COVID-1 cases linked to day care centres, elementary and secondary schools as well as trades school, college and university. Applies to students and staff. Based on epidemiological investigation of cases in students/staff of an educational setting who were in proximity and at the same time of other confirmed cases. Educational settings may be located in Simcoe Muskoka or in other health unit jurisdictions. The health unit is only able to comment on educational setting outbreaks in our area.
• For all of the above, only cases where the Simcoe Muskoka District Health Unit is the investigating health unit (previously referred to as responsible health unit) are included.

Status definitions:

• Recovered: a confirmed COVID-19 case that is 14 days past symptom onset that is without fever and has improving symptoms and is not currently hospitalized.
• Ever Hospitalized: a confirmed COVID-19 case that has ever been admitted to hospital. This includes any patients that have ever been admitted to an intensive care unit and those that have ever been on a ventilator in hospital.
• Hospitalized Never in ICU: confirmed COVID-19 case that has ever been admitted to hospital but has never been admitted to an intensive care unit nor been on a ventilator in hospital.
• Hospitalized - ICU: confirmed COVID-19 case that has ever been admitted to an intensive care unit or been on a ventilator in hospital.
• Currently Hospitalized: a confirmed COVID-19 case that has not recovered and is currently admitted to hospital. This includes any patients that are currently admitted to an intensive care unit and those that are currently on a ventilator in hospital.
• Self-Isolating: A confirmed COVID-19 case that has not recovered and is not currently hospitalized that is self-isolating at home.
• Isolation Precautions: A confirmed COVID-19 case that has not recovered and is not currently hospitalized resides in an institution (e.g. a long-term care home) and is under isolation precautions within the institution.

Acquisition definitions:

• Travel: most likely acquisition of illness is from travel outside of Ontario.
• Close Contact: most likely acquisition of illness is from close contact with another confirmed COVID-19 case.
• Exposures include: close personal contact, shared airspace, and household contact. This excludes anyone with travel history within 14 days of symptom onset.
• Community-Acquired: signifies a sporadic case in an individual where most likely the acquisition of illness is from somewhere within the community but not associated with a community outbreak. This also excludes transmission due to travel and due to close contact with a known case.
• Institutional Outbreak-Related: a confirmed COVID-19 case that is a resident or staff member of a long-term care institution, retirement home, correction facility or hospital. These types of transmissions are often referred to as nosocomial.
• Workplace Outbreak-Related: multiple confirmed COVID-19 cases in employees of a workplace that is not open to the public who worked in proximity and at the same time of other confirmed cases and, based on epidemiological investigation, a higher level of disease transmission within the workplace than what would be expected given current local COVID-19 activity and incidence in the community.
• Community Outbreak-Related: multiple confirmed COVID-19 cases in individuals who attended a community event or social gathering at the same time of other confirmed cases, and based on epidemiological investigation, were deemed to be potentially infectious during the event or may have acquired the infection while attending the event.
• Congregate Setting Outbreak-Related: a confirmed COVID-19 case that is a resident or staff member of facilities in which people temporarily or permanently reside such as group homes, supportive housing or shelters. These cases are not included in either the institutional or workplace outbreak cases.
• Undetermined: most likely acquisition of illness is not clear and investigation is complete.
• Under Investigation: a confirmed COVID-19 case with current status under investigation at the time of reporting.

 

Please note that 95% confidence intervals were not included on the charts and tables for simplicity; however, statistical significance between groups (e.g. geographic areas and age groups) was determined by non-overlapping confidence intervals.