N.B. changes definitions of COVID deaths and hospitalizations, launches Respiratory Watch

New Brunswick has revamped the way it reports on COVID-19 again, including the launch of a new Respiratory Watch report that combines updates on both COVID-19 and influenza, and new definitions of COVID deaths and hospitalizations.

"With the arrival of the new respiratory illness season, it makes sense to monitor both of these diseases together so that New Brunswickers can be informed of the impacts these diseases are having on the health of the population," Dr. Jennifer Russell, chief medical officer of health, said in a statement.

The respiratory report, which is located on the province's COVID-19 site, also includes only seasonal vaccination data and has a section dedicated to nursing home outbreaks.

The new format reflects similar reporting approaches in other provinces, including British Columbia, Alberta, Manitoba, Ontario, and Saskatchewan, Russell said.

A COVID death is now defined as "a confirmed case who was admitted to hospital and whose death occurred during their stay."

"A death due to COVID-19 or influenza does not mean that it was necessarily the primary or contributing factor to the cause of death," Health Department spokesperson Sean Hatchard said in an emailed statement. "Therefore, only deaths that occur in hospital will be reported."

Since March 2022, Public Health has been reporting COVID deaths as those where the virus was either the primary cause of death or a directly contributing factor.

Previously, the province used the national surveillance case definition for a deceased COVID-19 case: a probable or confirmed COVID-19 case whose death resulted from a clinically compatible illness, unless a clear alternative cause of death is identified, such as trauma, poisoning, or drug overdose.

Deaths that occur outside hospital are subject to a reporting lag that can last months, said Hatchard, while in-hospital deaths are "a more timely indicator for disease severity."

The pandemic death toll of 935 has also been dropped and replaced with a respiratory season total of zero.

Back to counting hospitalized 'for' and 'with' COVID

COVID hospitalizations, meanwhile, now include patients who have been hospitalized both for and with COVID-19, rather than only those who have been hospitalized because of complications from the disease.

"The department recognizes that both types of patients have an impact on the system," said Hatchard.

Since April 2022, the province has been counting only people who were hospitalized because of the virus. People who were initially admitted to hospital for another reason and later tested positive for COVID were no longer included.

No deaths, 44 COVID hospitalizations, cases up

According to the new report, no COVID deaths occurred between Aug. 27 and Sept. 2.

That's down from seven COVID deaths in the previous COVIDWatch report, which covered July 23 to Aug. 26. 

While COVIDWatch provided only three age categories for deaths, with the youngest being under 50, Respiratory Watch includes five age categories — under four, five to 19, 20 to 44, 45 to 64, and 65 and older.

Forty-four people were hospitalized for or with COVID-19 during the latest reporting week, including one person who required intensive care, up from the 24 admitted to hospital because of the virus in the previous report.

One person was aged 20 to 44, three were 45 to 64 and the other 40 were 65 or older, including the one in ICU.

250% jump in hospitalizations at Horizon

Horizon Health Network, meanwhile, has seen a 250 per cent jump in the number of people it has hospitalized for or with COVID-19 in the past two weeks, its updated COVID-19 dashboard shows.

It has 42 active COVID-19 hospitalizations, as of Sept. 9, up from 12 on Aug. 26. Two people are in intensive care, up from one.

Vitalité has not updated its COVID website. Although the province and Horizon have both switched to bimonthly reports, as of Tuesday, it plans to continue with monthly updates "for the time being," an unidentified spokesperson told CBC.

Horizon also reported COVID outbreaks on six hospital units, up from none, and 21 health-care workers off the job because they tested positive for the virus, up from 11.

A total of 95 new lab-confirmed cases of COVID have been reported across New Brunswick, an increase from the previous report week.

The positivity rate also increased, to 14 per cent, and eight lab-confirmed outbreaks were declared.

COVID activity is described as "moderate."

No influenza activity has been recorded yet this respiratory season, which began Aug. 27.

Vaccination rate changes

As for vaccination data, the department will focus on how many people have received a vaccine for COVID-19 or influenza within the current respiratory illness season.

This is "in order to portray the level of protection in the community," Hatchard said.

The statistics aren't available on the Respiratory Watch page yet, but 31,113 COVID-19 vaccine doses have been administered between March 12 and Sept. 11, according to Hatchard. He did not provide the total eligible population.

On Tuesday, Health Canada approved Moderna's updated COVID-19 vaccine, which targets the Omicron XBB.1.5 subvariant, for all Canadians six months or older.

Health Canada said Canadians age five and up should receive one dose. Children from six months to four years old should receive two doses if they have never had a COVID vaccine, or one dose if they've had at least one dose.

Public Health will be offering eligible New Brunswickers vaccines for COVID-19 and influenza this fall, said Russell. She could not provide details.

"In the meantime, Public Health recommends that patients speak with their health-care provider to determine the level of risk they may face if they choose to wait for the new vaccination formulation to arrive," Russell said.

As it stands, the only New Brunswickers eligible since July 1 have been those aged 65 and older or those 18 and older who are moderately to severely immunocompromised, who did not receive a spring booster and whose last shot or infection was at least five months ago, and new residents of long-term care facilities aged 18 and older who did not receive a spring booster and whose last shot and/or infection was at least five months ago.

Health Canada is still reviewing updated vaccines from other companies, including Pfizer-BioNTech's Omicron XBB.1.5 vaccine for Canadians aged six months and older and Novavax's shot for people aged 12 and older.

Nursing home outbreaks

Lab-confirmed COVID outbreaks were reported at two unidentified nursing homes in the province Aug. 27 to Sept. 2, while six outbreaks were reported in "other" vulnerable settings, the report shows. No other details are provided.

An outbreak is defined as two or more positive cases among residents or staff with an epidemiological link within 10 days.

Info on positive rapid tests and sequencing dropped

Submitted positive rapid test results will not be posted on the Respiratory Watch page.

"Now that the COVID-19 state of emergency has ended the department feels regular reporting of this information is no longer required," said Hatchard.

In addition, the province is no longer including sequencing breakdowns for COVID-19.

Public Health will only confirm the presence or non-presence of a subvariant upon request, said Hatchard.

"It should be noted, however, that if the situation was to change, and a new subvariant was to emerge and pose more severe health risks to New Brunswickers, Public Health would inform the population as needed," he said.

On Monday, Hatchard confirmed the highly mutated new Omicron variant BA.2.86 has not been detected in the province. "Nearly all circulating strains are of the XBB family," he said.

The first Canadian case of BA.2.86, which has health experts watching closely because of its high number of mutations, was recently confirmed in British Columbia. So far, it does not appear to be more severe.