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If cases don't slow, added restrictions could be on the way: Gardner

Case counts predicted to reach 100/day soon; health unit already struggling to keep up with contact tracing/outbreak investigation
2021-12-01 Dr. Charles Gardner
Dr. Charles Gardner, medical officer of health for the Simcoe Muskoka District Health Unit, speaks to members of the media on Wednesday, Dec. 1, 2021.

An open letter is coming soon from Dr. Charles Gardner to Simcoe-Muskoka residents urging them to keep following public health measures, get vaccinated, and reduce their social contacts in the wake of surging case counts. 

With no change, the region’s medical officer of health may impose stricter restrictions for the regions, which could include reduced capacity allowances at some businesses and indoor facilities.

While hospitalizations are not climbing as fast as they have in previous waves of COVID case surges, the Simcoe Muskoka District Health Unit is stretched past its capacity, struggling to manage case and contact tracing. 

The health unit reports it is able to reach 65.7 per cent of new cases within a 24-hour period, and is not always contacting high-risk close contacts. The provincial standard is for health units to reach 90 per cent of new cases within 24 hours of a positive test report.

During a media briefing on Wednesday, Dec. 1, Gardner said there are 36 “exposure sites” currently called “clusters” where there are two or more cases. A little over 70 per cent of those sites are in Simcoe County. In quieter times, those might be identified as outbreaks.

“Due to our own limitations, we haven’t been able to determine if there are outbreaks,” said Gardner. “The cases have been contacted, most close contacts were also contacted, but it takes a greater degree of resources to determine if transmission happened at that site.” 

An outbreak is only declared where the health unit finds strong evidence COVID transmission happened at the site, and not elsewhere in the community. 

The sites include 13 workplaces, four multi-unit dwellings, one place of worship, 10 food premises, five recreation facilities, and three hotel or short-term rental locations. 

This is in addition to 29 active outbreaks in the region, 23 of which are in schools. The health unit has prioritized its attention on investigating school transmission in an effort to keep schools open. 

Gardner said last week he expects to be reporting 100 new cases per day by early December. 

The open letter coming next week, according to Gardner, will “identify the situation we’re in, the trajectory we’re headed on, and the need for all of us to abide by public health measures.” 

Gardner will be urging the community, both businesses and the public at large, to comply with health measures. 

“If [cases] keep going up, more measures will come,” said Gardner. 

He cited other measures implemented in health units in Northern Ontario where some regional medical officers of health have ordered reduced capacity restrictions for restaurants and fitness centres, similar to the ones the whole province was under in September. 

“It’s not something I’m intending to do immediately, it’s something I’m looking at, if it proves to be necessary,” said Gardner during the Wednesday briefing. “I have become very concerned with the trajectory of where we are headed.” 

For more than six weeks the incidence rate of cases per 100,000 people in Simcoe-Muskoka has been significantly higher than the province, sometimes more than double the provincial average.

For the week of Nov. 21-27, the Simcoe Muskoka District Health Unit incidence rate was about 85 cases per 100,000 people, but the provincial average was between 36 and 37 cases per 100,000 people. 

Larger and neighbouring health units have case incidence rates in the 20s for the same week, with Toronto at 23, York at 28, Peel at 21 and Grey Bruce at 26. 

In Northern Ontario, however, it’s a different story with Algoma Public Health at nearly 170 cases per 100,000 people, Timiskaming at 194, and Sudbury at 100 cases per 100,000 people. 

Algoma Public Health implemented capacity and gathering restrictions on Monday, with limits of 10 people indoors and 25 people outdoors, and no extracurricular activities at schools for 28 days. 

Public Health Sudbury rolled back COVID-19 restrictions to the former Ontario Step 3 levels back in November and those restrictions remain in place. 

Temiskaming Health Unit also implemented additional measures on Nov. 23, reinstating provincial capacity limits that had been lifted in September.

Simcoe Muskoka District Health Unit does have some region-specific measures in place already, requiring proof of vaccination for all coaches and volunteers entering a sports or recreation facility. Soon any participants between 12 and 17 years old will also have to show proof of vaccination before entering a sports, fitness, or recreation facility. Participants aged 18 or older are already required to show proof of vaccination. 

Additional letters of instruction issued by Gardner require anyone who is unvaccinated and who shares a household with someone identified as a close contact of a COVID case to self-isolate and get tested for COVID. 

Instructions previously issued to businesses and organizations requiring contact tracing information to be collected, masks indoors, screening before entry, and physical distancing now also applies to places of worship.