COVID-19TestPg

Summary

• The median age of cases who have recovered is 48 years compared to the median age of 83 years among deceased cases.
• The rate of COVID-19 infections 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 this report.

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

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

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COVID-19 Cases by Sex and Age Group

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Age Distribution of COVID-19 Cases by Type and Outcome

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COVID-19 Incidence Rate by Ethno-Cultural Diversity

Summary

• Approximately one-fifth of COVID-19 cases in Simcoe Muskoka have been associated with a local 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.

COVID-19 Workplace and Institutional Outbreaks in Simcoe Muskoka

COVID-19 Outbreak and Non-Outbreak Cases by Outcome

Summary

• Since mid-May, there has been a downward trend in the seven-day moving average of new COVID-19 cases in Simcoe Muskoka.
• 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.

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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COVID-19 Cases by Most Likely Acquisition and Month

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Summary

• There were 81 new COVID-19 tests per 10,000 Simcoe Muskoka residents for the most recent week, this was lower than the provincial testing rate of 91 tests per 10,000 population.
• The percent positivity rate in Simcoe Muskoka is 0.5%, compared to the provincial percent positivity rate of 1%. A low percent positivity rate indicates the outbreak is under control, given more testing is finding a smaller and smaller proportion of positives.

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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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. Two confirmed cases reside out of province/country, but were investigated by the health unit while staying in Simcoe County, and are reported as such.

Case Type Definitions:

• Sporadic cases are those not associated with an outbreak at an institution in Simcoe County or Muskoka District and are among those that do not live or work in a long-term care facility, retirement home or group home. These infections are usually acquired from travel, within the community or from a close contact with a known case.
• Outbreak cases are those associated with an ongoing or resolved COVID-19 outbreak at a local institution and includes both residents/patients and staff. These infections are sometimes called nosocomial and the source of acquisition have been identified as outbreak-related (for patients) and undetermined (for staff).
• Workplace Outbreak cases are confirmed COVID-19 cases that are linked to a non-patient care setting workplace outbreak, 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.

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: most likely acquisition of illness is from somewhere within the community. This excludes transmission due to travel and due to close contact with a known case.
• Outbreak-Related: a confirmed COVID-19 case that is a resident of a long-term care institution, retirement home, hospital, or group home. These types of transmissions are often referred to as nosocomial.
• Workplace Outbreak-Related: multiple confirmed COVID-19 cases in employees of a workplace 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.
• Undetermined: most likely acquisition of illness is not clear and investigation is complete; or a confirmed COVID-19 case who is a health care worker linked to an outbreak where most-likely acquisition cannot be determined (community versus institution).
• 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.