Ford hints at more regions heading into Stage 2 as Ontario reports 826 new COVID-19 cases

Ontario reported an additional 826 cases of COVID-19 on Friday and nine more deaths connected to the illness, as Premier Doug Ford hinted that more regions could be headed for a modified Stage 2 next week. 

The new deaths reported today mean that 49 people with infections of the novel coronavirus have died in the last eight days. The seven-day average of new daily cases, a measure that helps limits noise in the data, continued its upward climb to 778, the second-highest it's been since the resurgence of COVID-19 in Ontario began in early August. 

Today's newly confirmed cases are once again concentrated mostly in four public health units:

• Toronto: 292
• Peel: 186
• Ottawa: 87
• York: 72

A handful of other areas saw double-digit increases as well:

• Durham Region: 38
• Halton Region: 34
• Eastern Ontario: 19
• Hamilton: 15
• Waterloo Region: 13
• Middlesex-London: 10

At his daily news conference Friday, Ford called the current situation in Halton with regard to COVID-19 cases "concerning" and suggested that Halton and potentially Durham could join Toronto, Peel, York and Ottawa in a modified Stage 2 in the coming days.

"We're going to have that discussion. It's very concerning out in Halton," Ford said, adding that more information will be coming on Monday.

Toronto, Peel and Ottawa will have been in a modified Stage 2 for two weeks as of tomorrow, with at least another two weeks to go before the province decides whether those regions can move back into Stage 3. Asked if he plans to extend the rollback, Ford said he will listen to the advice of COVID-19 public health advisers.

"We have to focus on the health and the safety of everyone across the province," Ford said. 

Echoing Ford, Health Minister Christine Elliott said decisions will be based, at least in part, by the capacity of Ontario hospitals to handle a further potential surge of cases.

"The idea is this will flatten the curve and bring our numbers down to a manageable level [and] not overwhelm our hospitals," she added.

There are currently 6,474 confirmed, actives cases of COVID-19 provincewide, a new record-high.

Hospitalizations also rose slightly, up six to 276. Of those patients, 78 are being treated in intensive care and 47 are on ventilators.

Meanwhile, the province's labs processed slightly more than 40,000 tests.

(Note: All of the figures used in this story are found in the Ministry of Health's daily update, which includes data from up until 4 p.m. the previous day. The number of cases for any particular region on a given day may differ from what is reported by the local public health unit, which often avoid lag times found in the provincial system.)

Rollout of rapid tests

Public health officials held a media briefing this morning to detail the province's plan to deploy 100,000 rapid COVID-19 tests beginning sometime next month. Initially, the molecular tests will be sent to remote communities, areas or facilities experiencing an outbreak and used to screen asymptomatic priority groups.

For at least three to four weeks, all of the rapid tests will be done in duplicate with the traditional laboratory test currently being used to help experts gauge their sensitivity and accuracy, said Dr. Vanessa Allen, chief of medical microbiology at Public Health Ontario. 

Rapid tests are not as sensitive as those done in a laboratory. Lab tests have about a 95 per cent accuracy rate as long as the test is processed within seven days of collection, and the sample is taken using a nasal-pharyngeal swab, as is the case currently.

The rapid tests, alternatively, are known to have about 70 to 80 per cent accuracy if the sample is taken within one to seven days after the onset of symptoms. Allen warned that in practical terms, it means the rapid tests could miss cases. They do, however, provide a result within five to 15 minutes, if a test was done on site rather than being transported to a different location for processing.

Public Health Ontario has not yet received either the instruments or antigens required for rapid tests, however the agency expects to have both in hand by next month. Once the initial analysis of accuracy and turnaround time is completed, the rapid tests could be rolled out elsewhere, such as in urban neighbourhoods experiencing particularly high numbers of cases of COVID-19. 

 A second type of rapid test, based on antigens but even less accurate, will also be put to use in Ontario. Officials could not say how many will be available, or when exactly they will be deployed.

Long-Term Care COVID-19 Commission provides recommendations

Ontario's Long-Term Care COVID-19 Commission released a host of recommendations today that it sent in a letter to Minister of Long Term Care Minister Merrilee Fullerton in an effort to improve conditions amid the pandemic.

The commission says these are early recommendations, and don't represent its full findings, which are expected to come in a report to the province by next April. Officials say they have met with more than 200 people as part of the investigation so far.

"Many witnesses have shared heart-wrenching accounts of their experiences during the first wave of the pandemic that resulted in tragic loss of life, suffering and devastating impacts on residents, families and staff," the letter reads.

"We have heard that long-term care (LTC) homes were forgotten in the initial provincial plans to control the spread of COVID-19 until residents started dying, and pleas that this not be repeated when this crisis is over."

The letter notes that at the end of April 2020, 55 per cent of all LTC homes experienced COVID-19 outbreaks, and 75 per cent of all COVID-related deaths in the province were in long-term care.

The commission says it is making early recommendations that focus on staffing, "collaborative relationships," and infection prevention and control.

They include, in part:

• More full-time positions be created to ensure staffing stability and retention.
• A minimum daily average of four hours of direct care per resident, enabled by an increase in permanent funding for more nurses and support staff.
• A mandated "collaboration model" between care homes and hospitals/health units that is proactive, not simply instituted after outbreaks.
• Residents who are COVID-positive, especially in older homes, should be given the option to transfer to alternate settings to avoid further transmission of the virus and to help them recover.

Speaking Friday, Ford said that preventing further outbreaks of COVID-19 in long-term care facilities is his "number one priority."

New outbreaks at 2 Toronto hospitals

The Centre for Addiction and Mental Health (CAMH) is reporting a new outbreak of COVID-19 at its Queen Street location after a patient in Unit 2-3 tested positive, the hospital announced in a statement. 

CAMH, which reported an outbreak last week, says it has implemented the same standard infection prevention and control procedures it instituted for the earlier outbreak, including closing the unit to admissions and transfers.

"We continue to remain vigilant about policies and procedures to keep staff and patients safe and we are working with our partners at Toronto Public Health on reporting, surveillance, and infection control," CAMH wrote in a statement. 

Another patient has also tested positive Friday in relation to the existing outbreak of the novel coronavirus in Unit 1-4/1-5 at the centre's Queen Street site. 

Sunnybrook Hospital also declared an outbreak in its surgical unit Friday morning. Five people have tested positive so far, the hospital says. 

"An initial three cases linked to each other were identified through our regular surveillance, which triggered initial control measures and broader testing on the unit that identified two additional cases," the hospital said in a statement.

All of the individuals who tested positive are asymptomatic and four remain in hospital while one was discharged. Outbreak control measures are in place and there has been no transmission to other patient care areas, the hospital said. 

The new outbreaks come after  three Toronto hospitals, including CAMH, reported positive cases last week.