In a COVID briefing today, Simcoe Muskoka District Health Unit (SMDHU) medical officer of health, Dr. Charles Gardner, said that there have been 26 COVID-19 cases in the region that have screened as likely the new Omicron variant. Four of those are in Muskoka; they are still to be confirmed to be Omicron through whole genome sequencing.
A method called S-gene target failure (SGTF) screening is used to initially identify the Omicron lineage.
In a December 9 report, Public Health Ontario noted, “Using projections that account for time lags in the incubation period (5 days), and case presentation (2 days), most cases infected on December 13, 2021 (>80%) are likely to be Omicron. It is estimated that each Omicron case is infecting 7.7 times more individuals than Delta in Ontario during the November 28 to December 9 period.”
Dr. Gardner said today that the rise of Omicron is a “major setback”, and that the anticipated wave to come may be the largest the pandemic has seen yet. “It’s certainly a very hazardous time for us right now and a very vulnerable time for us. I think we need to fully realize that the danger of the situation right now, that we all collectively and individually need to do all that we can to deal with it, to really scale back your physical contacts with others, really abide by the control measures, and get third dose immunization as quickly as you can.”
Unlike at the start of the pandemic, however, “one way in which we are ahead…is the great majority of our population has had two doses of vaccine and we do have the capacity to move and get people their third dose.”
Dr. Gardner expects that a shortened interval between second and third doses will come, allowing a greater proportion of the population to receive a third dose more quickly. Currently, people must wait until 168 days after their second dose to receive a third. “This is actively under review right now by the Ontario Immunization Advisory Table and we expect an answer in short order on that, and also the interval to second doses for children,” he said.
“With Omicron, you cannot rely on two doses of vaccine to be protective. It is considerably more transmissible as well,” said Dr. Gardner. A third dose of vaccine has a more protective level against this new variant, “and in my mind becomes the standard for full immunization.”
Of concern with Omicron is its potential impact on the healthcare system. “Even if it were less severe on a case-by-case basis, with something this transmissible that is also affecting people who are…two dose immunized, you can end up with a large number of cases and that could still result in a substantial wave of admissions to hospital,” he noted.
Dr Gardner said that hospitals in Simcoe Muskoka are “very concerned about their capacity at this time, that although the numbers of cases admitted to hospital are about half of what they were at the height of the second and the third wave, their capacity is not what it used to be with some loss of human health resources due to the experience of the previous waves, and also because they are heavily burdened with the catch up of care and procedures that has accumulated over the course of the pandemic.”
If the trajectory of cases continues to rise rapidly, Dr. Gardner said he is concerned that testing need may exceed capacity at assessment centres, “and there will be individuals who have symptoms that won’t be able to get tested.”
If that happens, the health unit will have to rely on people with symptoms to isolate and not wait for testing and a call from the health unit with instructions, as well as to advise people that they have been in contact with. “And if they develop severe symptoms to seek care in a hospital,” added Dr. Gardner.
He acknowledged the extreme strain this pandemic has caused. “All of it is very, very distressing and now to have…this kind of setback is heartbreaking. I am very concerned of course that the inability of people to get testing, which may come very soon with a large surge in cases…will leave people more vulnerable to transmission because it would really depend on them to self-identify and to isolate, and they wouldn’t have the kind of support and reinforcement that we can provide to help make that succeed. It is of concern to me, but I don’t have a solution otherwise to address it.”
As the chair of the Council of Ontario Medical Officers of Health, Dr. Gardner co-signed a letter sent to the Minister of Health last night calling on the province to put capacity and social gathering limits in place.
And earlier today, Dr. Gardner released a statement indicating that if the province doesn’t increase restrictions this week, he will impose them within Simcoe Muskoka starting Monday, Dec. 20. That would include a decrease in capacity limits to 50 per cent at some businesses like restaurants and bars, event spaces, and indoor sports and recreational fitness facilities. Private social gatherings would be limited to a maximum of 10 people, and capacity limits would be placed on weddings, funerals and religious services.
He urged people to greatly reduce their social interactions, including those in their own homes.
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