Ontario’s top doctor gives COVID-19 update as province tightens rules in long-term care homes

December 14, 2021
Ontario's top doctor gives COVID-19 update as province tightens rules in long-term care homes

Dr. Kieran Moore, Ontario’s chief medical officer of health, is holding a news conference at 3 p.m. ET in Toronto. Watch it live in this story.

Ontario is introducing enhanced COVID-19 testing and vaccination measures for residents, staff and visitors of long-term care and retirement homes as the province faces a potential surge in cases caused by the omicron variant.

Starting today, all general visitors will need to be fully vaccinated against COVID-19 to enter a long-term care home, the Ministry of Long-Term Care said in a news release.

As of Dec. 17, all staff, caregivers, volunteers and students working in long-term care facilities will be tested twice weekly, regardless of vaccination status. Support workers and visitors who provide essential services to residents will need to test negative for COVID-19 in order to enter.

Caregivers will be required to be vaccinated to enter a home, with the exception of those seeing a dying resident or those who have a medically valid exemption. Caregivers who are unvaccinated will need to get a first dose by Dec. 20, the Ministry of Long-Term Care says, and a second by Feb. 21, 2022.

 In the meantime, caregivers who aren’t fully vaccinated are restricted to the room of the resident they are going to see.

Furthermore, indoor visits will be limited to two guests or caregivers. Outdoor visits can involve up to four guests or caregivers at a time.

Ontario’s Ministry of Long-Term Care is bringing in new rules for those working in long-term care homes, residents of those facilities and visitors. (Evan Mitsui/CBC)

Cohorting will be implemented for dining and higher-risk activities such as singing and dancing, according to the ministry. 

Only residents who have had two shots of vaccine will be permitted to take day absences for social purposes, while overnight absences for social purposes will be prohibited, the ministry said. Anyone who does leave the premises for a visit must be actively screened upon returning.

“Our priority is to protect long-term care residents from COVID-19,” said Minister of Long-Term Care Rod Phillips said in a news release. “These further measures build on the ones already taken, including mandatory vaccinations, priority for third doses, and randomized testing, [which] will provide the best level of protection possible.”

Retirement home measures

The new measures for retirement homes will take effect on Dec. 22.

Starting that day, staff, volunteers, contractors and essential caregivers will need to take rapid tests twice weekly. General visitors and support workers will also need to take rapid tests before they enter a home.

The ministry is strongly encouraging retirement homes to restrict visitors to only those who are fully vaccinated, and develop “additional requirements” for unvaccinated and not fully vaccinated visitors. 

Homes are also being encouraged to limit visitors and group sizes for all social activities and events, as well as test people when they return from overnight trips outside the homes.

The changes come as the omicron variant is expected to overtake delta as the dominant variant in the province. Early data from other countries suggests that while vaccination provides robust protection against omicron — particularly for those who have had a third dose or booster shot — the high transmissibility of the variant means that even those with some degree of immunity can become infected.

Omicron becoming dominant variant

Meanwhile, Ontario reported 1,429 new cases of COVID-19 on Tuesday, as a leading member of the province’s science advisory table estimated that omicron is likely to become the dominant variant at some point today or tomorrow.

Peter Jüni told CBC Radio’s Metro Morning that omicron, first confirmed in Ontario just more than two weeks ago, will replace delta as the variant responsible for the majority of new cases.

Omicron has a doubling time of roughly three days, far faster than any previous variants.

“If this doubles every three days or so, case numbers can become very high very swiftly,” Jüni said.

Today’s total is a 54 per cent increase over last Tuesday. 

The seven-day average of new daily cases has risen to 1,400, about 44 per cent higher than the same time last week.

Jüni said that two doses of COVID-19 vaccine seems to provide robust protection from omicron, though that defence starts to wane after three months from a second shot. The unprecedented transmissibility of omicron means that even those with two doses are at a considerable risk of infection.

The key to curbing the expected “tidal wave” in omicron cases will be ramping up capacity for booster shots in the province, Jüni said. The current supply of doses is not the problem, Jüni added, but rather the number of people and venues available for a renewed mass immunization campaign.

Ideally, public health units would collectively be administering at least 100,000 booster doses every day for “quite a long time,” Jüni said. He noted that Ontario was doing about 250,000 shots per day at the peak of its earlier vaccination campaign last summer.

People wear masks in downtown Toronto earlier this month. (Evan Mitsui/CBC)

Yesterday, 85,245 third doses were administered across the province. Ontarians aged 50 and older who received their second shot at least six months ago became eligible for booster doses on Monday. Eligibility is set to open up to all adults on Jan. 4 but the province’s top doctor has said the schedule could move faster if capacity allows.

In a tweet late Monday, the president and CEO of the Ontario Hospital Association said that hospitals are “moving to implement instructions to urgently re-activate mass vaccination programs.

“This will have a major impact on other clinical services, but there’s no other choice … This is truly a race against time,” Anthony Dale said.

Even with an immediate increase in vaccination capacity, Jüni said, there is not enough time to reach optimal coverage levels before the holiday season begins in earnest.

Jüni said he supports a temporary reintroduction of targeted public health measures to reduce social contacts in the face of the omicron surge. Specifically, a reduction in capacity for indoor dining and major sports venues is needed, he said.

“I think we need those structural measures,” he told guest host Jason D’Souza, adding that Ontarians should plan to keep holiday gatherings “intimate” if there is any hope of containing the uptick in cases.

Some public health units have already chosen to impose renewed restrictions and offer revised guidance in recent days.

Peterborough is the latest region to instruct workplaces to have all non-essential staff to work from home if possible, as part of new measures set to take effect on Wednesday.

The new rules also require restaurants to ensure tables are at least two metres apart or separated by a barrier, and to set a cap on the number of patrons at each table.

Similarly, Ottawa Public Health is warning of a backlog in its contact-tracing system due to a surge in Omicron cases, and urging residents who test positive for COVID-19 to immediately self-isolate and alert their close contacts themselves.

Test positivity rates spiking

While cases are rising across most of the province, so too is the number of COVID patients requiring hospital care, albeit much more slowly. That said, the overall burden of COVID on intensive care units has remained relatively stable thus far.

As of Monday evening, there were 162 patients being treated for COVID-related illnesses in ICUs, according to the health ministry. Of those, 98 needed help from a ventilator to breathe.

Moreover, Public Health Ontario this morning reported a 6.6 per cent positivity rate on 33,400 tests for the virus. That’s the highest on a given day since May 18, amid the depths of the third wave in the province.

The Ministry of Health also recorded the deaths of five more people with COVID, pushing the official toll to 10,084.

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