By Cecilia Nasmith/Today’s Northumberland
Omicron proved itself as not just another COVID-19 variant, Medical Officer of Health Dr. Natalie Bocking said at the January Haliburton Kawartha Pine Ridge District Health Unit board of health meeting.
“The Omicron variant has really shifted the paradigm in thinking about pubic health response to COVID-19. Because it’s so much more infectious, because the vaccine strategy of two doses has not worked as well, an additional dose is needed. And because it doesn’t cause quite as severe illness, we have had to change a number of our strategies.”
Dr. Bocking listed a number of the areas in which shifts have occurred – surveillance, case-management and contact tracing, responses in long-term-care homes and schools.
The new information and new developments have had to be digested by staff and incorporated into how they do their work, resulting in significant change from how things were done two years back.
“What we know is, the number of cases we are reporting – lab-confirmed cases – is not actually a true reflection of COVID-19 activity in the community. It only reflects those accessing lab tests. We know there is limited access right now, so those numbers are lower than what we expect in the community.
“The average community member who might have a rapid test and tests positive – we are not notified of that. It’s not in our numbers. If they have symptoms and no test, we assume it’s positive and we don’t necessarily know about it.”
The test-positivity rate in the HKPR jurisdiction – now standing at 13% – has remained lower than the provincial average. But again, it cannot be taken as a true indicator as it reflects only results from lab-based PCR testing.
She spoke of the “significant” increase in hospital admissions – 21 over the last 14 days. There have also been a higher number of ICU admissions and deaths, even though Omicron is a less-virulent variant.
Dr. Bocking said that at least 50% of hospital admissions, ICU admissions and deaths are in the unvaccinated (a group that makes up only about 10-15% of the HKPR population). There are also some hospital admissions, ICU admissions and deaths among those in their 80s and 90s who had two doses but no booster.
Dr. Bocking also talked about how Omicron has forced a change from earlier health-unit practice, when they contacted every lab-confirmed positive case, calling that individual and doing contact tracing. Now they only have enough resources to focus on the highest-risk settings and population sectors most vulnerable to severe outcomes. For everyone else with COVID, it is on them to let their own contacts know and isolate according to current guidance of five days for the vaccinated and 10 for the unvaccinated.
“Our team is following up on reports associated with long-term-care homes and other congregate settings like group homes to be sure we are not seeing the beginnings of an outbreak.”
Though they have recently seen three deaths and two severe illnesses in long-term-care homes, Dr. Bocking said, this is far fewer than might have been expected in the first wave of the pandemic.
There are about a dozen current outbreaks associated with retirement homes and long-term-care homes. Some of them have very small numbers infected, and much of the illness is relatively mild.
However, she mentioned “significant concerns about strict isolation measures regarding mental, physical and emotional health.” The health unit is working in partnership with these facilities to look at how outbreak measures can be taken without creating undue harm in a bid to keep these residents safe.
“This is a tricky challenge,” she admitted.
The health unit used to respond to every case identified in a school setting – child or staffer – with responsive measures affecting entire cohorts and classes.
“Now we are working closely with school boards to determine how we can best support them, and there are other measures in place to help prevent spread – better masking, infection prevention and controls, ventilation and, of course, vaccinations are all key components of this strategy,” she said.
When a school identifies a positive case (or hears that a child at home has tested positive), they no longer are obligated to contact the health unit.
The health unit partnered with the Peterborough Health Unit to get some of this new information out in an on-line forum, she said. And as they continue to work with such partners as school boards and long-term-care facilities, she hopes it is a move to formulating how to handle respiratory virus in general.
“Not necessarily helping normalize COVID-19, but responding in a way that doesn’t disrupt some of our core normal activities such as education.”
Dr. Bocking said health-unit staff deserve credit for doing so much behind the scenes. Overwhelmed with the sheer volume of work, implementing changes suddenly made necessary, shifting gears when new provincial guidance is announced at a time when there are new and on-going disruptions in their home lives, it is inevitable that the wellness of this work force will suffer an impact. Throw in protests at the health-unit office, and the risk of being demoralized increases.
This is a new wrinkle in recent years, along with the normalization of social distancing and mask wearing. Haliburton County delegate Andrea Roberts wondered if these things might become the new normal, even if COVID recedes to more manageable levels.
“I do think there will be some changes in behaviour, at least I hope there will be,” Dr. Bocking said.
Distance learning and telecommuting for work have become more available and more commonplace, she pointed out.
And as for masks, “there are locations around the world where masking was a normal thing to see. I think those behavioural changes will help overall to prevent the spread of respiratory virus.
“But there will be many, many books written on the sociological and behavioural changes as a result of the pandemic.”
