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REPORT: Tracking the Spread of COVID-19: Large Outbreaks in Health Care Settings Summary & Report: Second Wave in Long-Term Care Infections & Deaths have Surpassed First Wave – Data updated to February 9

Posted: February 17, 2021

(February 17, 2021)

Click here for full version of the health care outbreaks report with a list of all outbreaks. A summary of the report can be found below.


 

 

 

 

 

Analysis: Status of Current Large Health Care Outbreaks

Since our last update January 19, the large outbreaks (as defined by >10 people infected) in health care settings (hospitals, long-term care, retirement homes) continue to be alarming, despite overall case numbers in Ontario which, though still significant (we are back to end-of-October overall daily active case rates) are coming down:

  • The number of large outbreaks, although they have decreased slightly, remain high. However, the number of large outbreaks in long-term care homes has increased since our last update (January 19).
  • Almost half of the long-term care outbreaks are large
  • The geographic area in which there are large outbreaks has grown again in this report.

This report shows the growth of the 155 currently active large outbreaks in health care settings. This is a decrease from our report on January 19 in which we found 177 large outbreaks. Of the 155 large active outbreaks (those which include more that 10 residents, patients, and staff) as of February 9, 2021:

  • 102 are in long-term care homes
  • 19 are in 15 hospitals
  • 30 are in retirement homes
  • 4 are in other health care facilities.

The sizes of these 155 large outbreaks across all health care settings as of February 9 are as follows:

  • 155 outbreaks include 10 or more residents and staff infected;
  • 63 outbreaks include 50 or more residents and staff infected;
  • 24 outbreaks include 100 or more residents and staff infected;
  • 8 outbreaks include 150 or more residents and staff infected;
  • 4 outbreaks include 200 or more residents and staff infected;
  • 1 outbreak includes 250 or more residents and staff infected, and;
  • 1 outbreak includes 300 or more residents and staff infected.

By comparison, the large long-term care outbreaks as of January 19 were as follows: [1]

  • 177 outbreaks included 10 or more residents and staff infected;
  • 66 outbreaks included 50 or more residents and staff infected;
  • 33 outbreaks included 100 or more residents and staff infected;
  • 16 outbreaks included 150 or more residents and staff infected;
  • 7 outbreaks included 200 or more residents and staff infected;
  • 3 outbreaks included 250 or more residents and staff infected, and;
  • 1 outbreak included 300 or more residents and staff infected.

By our calculations, the number and size of these large active outbreaks has decreased as a number of extremely large outbreaks were resolved within the last week, though with significant deaths, such as the outbreak at Tendercare Living Centre (Toronto) that resolved on February 8th after 263 people were infected and 81 died, and the outbreak at Banwell Gardens (Niagara) that resolved on February 5th after 179 people were infected and 23 died.

Consequently, the total number of people infected in active large outbreaks has also decreased. As of February 9, the cumulative number of residents and patients infected just in the currently active large outbreaks in health care settings is 5,092. This is an 11.4% decrease from our last report, January 19, when the cumulative number of residents/patients infected in the then-active large outbreaks was 5,750. The cumulative number of staff members infected in active large outbreaks is 3,289, which is an 14.6% decrease from 3,850 three weeks ago on January 19. The number of other cases (including unspecified cases and visitors) is 194, for a total of 8,575 cases cumulative in the currently active large outbreaks. Three weeks earlier, the total number of cases in the then-active large outbreaks was 9,779; thus, there was a 12.3% decrease in cases in currently active large health care outbreaks overall.

Regardless of the decrease in the number of large outbreaks, almost half of the long-term care outbreaks that are currently active are large and have not been controlled effectively. Of the 208 active outbreaks in long-term care homes, 102 of them or 49% have more than 10 patients, residents, and staff infected and a number of these outbreaks are still growing. Additionally, 27% of all active outbreaks in retirement homes are large, as well as 32% of all active hospital COVID-19 outbreaks.

Even though there are fewer large outbreaks, the number of people deceased from those outbreaks has increased. With great sadness we report that 1,081 of those residents and patients have died in the currently active large outbreaks. These are huge numbers and they capture only the largest of the currently active outbreaks in health care. These numbers represent human beings and they underline the fact that the measures being taken to improve infection control and care in those facilities are not adequate to stop the spread of the virus.

Long-term care:

Over the winter holidays the case numbers in long-term care sky-rocketed, and we are still seeing a slight increase in the number of large long-term care outbreaks. In contrast, we are seeing the number of active long-term care outbreaks (of all size, including small ones) decrease. The death toll is increasing tragically, and we are now seeing the deaths following infections by several weeks. The geographic area of large long-term care outbreaks continues to expand, and large long-term care outbreaks can now be found across the entire breadth of southern Ontario and into northern Ontario.

Growth in the number of people infected in long-term care 2nd wave:

The number of cumulative cases in the second wave has far surpassed the amount from the first wave. Using Public Health Ontario’s daily epidemiologic reports, we have tracked the number of people infected by COVID-19 in long-term care homes since mid-March, and from the beginning of the pandemic to September 1 there had been 8,568 cumulative cases. From September 1 to current day, what we are counting as the second wave, the cumulative number of cases is 12,732 (8,910 residents and 3,801 staff). The total number of long-term care cases in the second wave is 4,164 more than there were at this point in the first wave (March 31 to August 25), or an increase of 49% from that of Wave 1. This is an enormous amount, and although the graph above (page 1) indicates that rate of infection in the second wave might be slowing down, it is not over. Since January, there have been 5,824 long-term care residents and staff infected with COVID-19, with 962 deaths as of February 9. This averages out to 1,165 new cases in staff and residents every week of 2021, and 194 deaths each week.

Trend in the number of active long-term care outbreaks:

  • As of February 9 there are 208 active outbreaks in Ontario’s long-term care homes. [2]
  • As of January 19 there were 257 active outbreaks in Ontario’s long-term care homes. [3]
  • As of January 8 there were 231 active outbreaks in Ontario’s long-term care homes.[4]
  • As of December 1 there were 118 active outbreaks in Ontario’s long-term care homes. [5]
  • As of November 17 there were 100 active long-term care outbreaks.[6]
  • As of October 31 there were 76 active long-term care outbreaks.[7]
  • As of September 30 there were 42 active long-term care outbreaks. [8]
  • As of September 1 there were 18 active long-term care outbreaks [9]

Growth in the size of the active long-term care outbreaks:

Out of all health care settings, the outbreaks in long-term care remain the largest. There continue to be more long-term care large outbreaks each period of several weeks that we measure, however the severity of those outbreaks is starting to decrease as some of the worst outbreaks COVID-19 in long-term care have resolved, such as the one at Tendercare Living Centre in Toronto and the one at Banwell Gardens long-term care home in Niagara as previously mentioned. Six of the currently active large long-term care outbreaks are at homes that have already had another, now resolved, large outbreak earlier in the second wave.

Of the current large Ontario long-term care home outbreaks (as of February 9th, not counting outbreaks in retirement homes, hospitals, or any other health care setting):

  • 102 outbreaks include 10 or more residents and staff infected;
  • 52 outbreaks include 50 or more residents and staff infected;
  • 23 outbreaks include 100 or more residents and staff infected;
  • 8 outbreaks include 150 or more residents and staff infected;
  • 4 outbreaks include 200 or more residents and staff infected;
  • 1 outbreak includes 250 or more residents and staff infected, and;
  • 1 outbreak includes 300 or more residents and staff infected.

By comparison, the large long-term care outbreaks as of January 19th were as follows: [10]

  • 99 outbreaks included 10 or more residents and staff infected;
  • 53 outbreaks included 50 or more residents and staff infected;
  • 29 outbreaks included 100 or more residents and staff infected;
  • 15 outbreaks included 150 or more residents and staff infected;
  • 7 outbreaks included 200 or more residents and staff infected;
  • 3 outbreaks included 250 or more residents and staff infected, and;
  • 1 outbreak included 300 or more residents and staff infected.

Of the 208 active outbreaks in long-term care homes, 102 of them or 49% have more than 10 residents, and staff infected and a number of these outbreaks are still growing. This is a large increase from three weeks ago on January 19th, when the percentage of active long-term care outbreaks that were large was 39%. The thirteen long-term care homes with active outbreaks of 150 or more cases in both residents and staff are in Table 1 (page 5), with full details in the report as per the region the home is in.

Geographic spread of the outbreaks:

Most of the large long-term care outbreaks in Ottawa, where the second wave began, are now resolved. Barrie has a devastating large outbreak that is now confirmed to include the U.K. variant of COVID-19. London is now seeing large outbreaks, as are the regions of Guelph (listed under Wellington/Dufferin/Guelph in this report) and Waterloo. Toronto, Halton, Hamilton, and Peel have been consistent hotspots throughout the second wave. Niagara, Windsor, and Eastern Ontario are seeing many new large outbreaks in the last 3 weeks. Northern regions such as the district of Thunder Bay were nearly untouched by COVID-19 in the first wave, but started seeing large outbreaks at the end of November, along with Durham which is once again growing into a “hotspot”. The public health units of Chatham-Kent, Lambton-Sarnia, and Timmins all saw their first large outbreaks of the second wave within the last two weeks, and Haliburton/Kawartha/Pine Ridge within the last month.

 

 

 

 

 

[1] REPORT: Shocking Number of Long-Term Care Homes with Majority of Residents Infected – Data updated to January 19. Ontario Health Coalition. January 22 2021. https://www.ontariohealthcoalition.ca/index.php/report-shocking-number-of-long-term-care-homes-with-majority-of-residents-infected/

[2] Daily Epidemiologic Summary- COVID-19 in Ontario: January 15, 2020 to February 9, 2020. Public Health Ontario. February 10 2021. https://files.ontario.ca/moh-covid-19-report-en-2021-02-10_v2.pdf

[3] Daily Epidemiologic Summary- COVID-19 in Ontario: January 15, 2020 to January 19, 2020. Public Health Ontario. January 20 2021. https://files.ontario.ca/moh-covid-19-report-en-2021-01-20_v2.pdf

[4] Daily Epidemiologic Summary- COVID-19 in Ontario: January 15, 2020 to January 8, 2020. Public Health Ontario. January 9 2021. https://files.ontario.ca/moh-covid-19-report-en-2021-01-06.pdf

[5] Daily Epidemiologic Summary- COVID-19 in Ontario: January 15, 2020 to December 1, 2020. Public Health Ontario. December 2 2020. https://files.ontario.ca/moh-covid-19-report-en-2020-12-02.pdf

[6] Daily Epidemiologic Summary- COVID-19 in Ontario: January 15, 2020 to November 17, 2020. Public Health Ontario. November 17 2020. https://files.ontario.ca/moh-covid-19-report-en-2020-12-02.pdf

[7] Daily Epidemiologic Summary- COVID-19 in Ontario: January 15, 2020 to October 31, 2020. Public Health Ontario. October 31 2020. https://files.ontario.ca/moh-covid-19-report-en-2020-12-02.pdf

[8] Daily Epidemiologic Summary- COVID-19 in Ontario: January 15, 2020 to September 30, 2020. Public Health Ontario. September 30 2020. https://files.ontario.ca/moh-covid-19-report-en-2020-12-02.pdf

[9] Daily Epidemiologic Summary- COVID-19 in Ontario: January 15, 2020 to September 1, 2020. Public Health Ontario. September 2 2020. https://files.ontario.ca/moh-covid-19-report-en-2020-12-02.pdf

[10] REPORT: Shocking Number of Long-Term Care Homes with Majority of Residents Infected – Data updated to January 19. Ontario Health Coalition. January 22 2021. https://www.ontariohealthcoalition.ca/index.php/report-shocking-number-of-long-term-care-homes-with-majority-of-residents-infected/