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COVID-19: 111 new cases in London-Middlesex; pregnant people now vaccine-eligible, MLHU says

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April 23, 2021

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Health officials in London and Middlesex reported 111 new COVID-19 cases on Friday, continuing what has been a steadily high number of new cases over the last several weeks as the region and province combat a devastating third wave of the pandemic.

The increase brings the region’s pandemic case tally to 9,721, of which 8,492 have resolved, an increase of 112 from the day before. At least 195 deaths have been reported, most recently on Monday.

As of Friday, the region has at least 1,034 active cases.

The health unit says roughly 2,537 cases have been reported since the month of April began, more than any other month of the pandemic.

A record 176 cases were recorded on April 13, according to revised health unit data.

As of Friday, the region’s rolling seven-day case average stands at 101, down from 128 the seven days previous.

At least 7.1 per cent of tests in London and Middlesex were coming back positive as of the week of April 11, down from 7.7 a week earlier, according to data released by MLHU this week.

While the N6A postal area continues to see the highest test positivity rate in southwestern Ontario, it is no longer the worst provincewide. New data from the non-profit group ICES shows the postal area recorded a 17.29 per cent positivity rate of April 17, down from just over 31 per cent the previous week.

The postal area includes part of Western University’s campus and some off-campus neighbourhoods. Many post-secondary students recently concluded their semesters and returned home.

Of the 111 cases reported on Friday, 107 are from London while four are from Middlesex County.

Those testing positive skew younger, as they have in recent weeks, with 60, or about 54 per cent, involving people under 30, with most in their 20s.

Twenty-two cases involve people 19 or younger; 38 are in their 20s; 16 are in their 30s; 18 are in their 40s; 10 are in their 50s; four are in their 60s; and three are in their 70s.

At least 45 cases have pending or undetermined exposure source data, while another 45 are listed as being due to close contact. Another 18 have no known link, while two are due to outbreak and one to travel.

The health unit says variant cases have been making up a majority of the local case load recently, with roughly 60 per cent of all cases seen during the weeks of April 4-10, and April 11-17 involving variants. Data for the current week is still being analyzed.

As of Friday, the cumulative number of variant cases in London-Middlesex stood at 1,469, an increase of 109 from the day before.

Health unit figures show that all but two have been the B.1.1.7 variant, first detected in the U.K. The 109 cases reported Friday were B.1.1.7.

Two cases have been confirmed to be the P.1 variant, first found in Brazil, unchanged since last week.

It should be noted that the health unit’s variant tally now includes cases presumed to be the B.1.1.7 variant, as well as cases which have undergone genomic analysis and confirmed to be a variant.

A note on the process of confirming and presuming variant cases:

Confirming a variant is a multi-step process. Positive COVID-19 cases undergo initial screening for spike protein mutations common to variants (N501Y, E484K, and K417N), and if found to have one or more, undergo further genomic analysis to determine the specific variant involved (B.1.1.7, B.1.351, or P.1) — a process that can take up to two weeks.
Since last month, the province has stopped conducting genomic analysis on cases that screen positive for just the N501Y mutation. Now, those cases are presumed to involve the B.1.1.7 variant, as that variant has only been associated with the N501Y mutation.
Cases that screen positive for either the E484K or K417N mutations are still being sent for genomic analysis as they have been associated with the B.1.351 and P.1 variants, first detected in South Africa and Brazil, respectively.

A separate tally showing the number of cases which have screened positive for a variant-associated mutation, but which have not been confirmed or presumed to be a variant, stands at 227, 10 more than the day before. (The tally will fluctuate up and down as cases undergo genomic analysis and are confirmed.)

Of those 227 cases, at least 97 were found to have the E484K mutation, consistent with the B.1.351 and P.1 variants, 12 more than Thursday. They are under genomic analysis. (Of those 97, at least 82 were also found to have the N501Y mutation as well.)

The remaining 130 cases screened, initially, for just the N501Y mutation, however they have not been ruled out for the E484K mutation, and as a result, have not yet been added to the main variant case tally. It’s unclear if or when these cases may be added.

During Thursday’s media briefing, Dr. Chris Mackie, the region’s medical officer of health, noted that while case rates recently have been plateauing in contrast to last week, things were not in a place yet where the health unit is comfortable.

“The trajectory is starting to look better, but we absolutely still need to maintain public health precautions and respect the lockdown for the coming weeks if we want to see that progress continue and get life back to normal,” he said.

At least 8,683 cases have been confirmed in the City of London since the pandemic began, while 315 have been in Middlesex Centre.

Elsewhere, 286 cases have been in Strathroy-Caradoc, 122 in Thames Centre, 61 in Lucan Biddulph, 54 in North Middlesex, 53 in Southwest Middlesex, 15 in Adelaide Metcalfe and two in Newbury.

At least 130 cases have pending location information.

Hospitalizations

Ninety-one people with COVID-19 were in the care of London Health Sciences Centre as of noon Friday, with at least 41 in intensive care, a new ICU record.

Nine staff members remain positive with COVID-19, unchanged from the day before.

LHSC set a new single-day patient record Wednesday afternoon when at least 95 COVID-19 patients were reported to be in its care.

At St. Joseph’s Hospital, meantime, no COVID-19 patients were listed as being in their care as of Friday. Five staff cases are active within St. Joseph’s Health Care London, however it’s not clear in which facility the staff work.

At least 473 people in London-Middlesex have been hospitalized due to COVID-19 during the pandemic, including 82 in intensive care, the health unit says.

LHSC officials announced Friday that the organization will be increasing its critical care capacity and further reducing the number of scheduled surgical and procedural activities it conducts.

It comes as LHSC deals with a recent surge of COVID-19 patients, including from the London-Middlesex region and those transferred from overwhelmed hospitals in the Greater Toronto Area (GTA).

LHSC says it’s seeing between two and eight medical ward-level and ICU patients transferred into its care every day from Toronto-area hospitals, such as Brampton and Mississauga.

The move to reduce scheduled procedures comes as a result of a provincial directive. Cancer, cardiac, vascular, trauma, transplant, and neurosurgery cases will be prioritized, LHSC says.

“In order to reduce our surgery and free up people and space, we decreased our overall operating capacity to about 50 per cent,” said Dr. Adam Dukelow, LHSC’s chief medical officer, on Friday.

“What that means is that only those surgeries or procedures that are absolutely necessary to occur within the next 30 days will be done in our operating rooms at LHSC… It’s never something we want to do, but it’s necessary in order to free up the people to open up those ICU beds as well as free up space in other parts of the hospital.”

LHSC says it will also open an additional seven critical care beds, to be ready for use by the end of the weekend but opened only as they are needed. They are in addition to the 18 that were opened earlier this month at University and Victoria hospitals.

Four of the new beds will be at Victoria Hospital in an already-utilized temporary critical care space, while three will be in the Paediatric Critical Care Unit of Children’s Hospital to accommodate adult patients needing non-COVID-19 critical care.

LHSC says occupancy has been low in the PCCU during the third wave, but notes that protocols are being created to ensure that critical care adults are decanted appropriately and safely should the beds be needed by children.

“I do wish we were in a different scenario and didn’t have to make that move to open adult beds or switch children’s beds over to adult beds in our critical care, but we need to respond to the needs of the system, both in London and across the province,” Dukelow said.

“Opening the three beds in the children’s hospital is an important step, but it’s one of many. The decreasing of surgeries and procedures to around 50 per cent of normal activity is another way that we’re freeing up human resources or people to open more ICU beds, and similarly, decreasing that activity also opens up inpatient beds that would normally care for surgical patients to care for medical and COVID patients.”

The news comes a day after St. Joseph’s Health Care London announced that it too would begin ramping down all elective surgeries and procedures as part of a provincial directive starting Monday.

In addition, the organization said it would also open additional beds at for non-COVID-19 patients not requiring acute care, and redeploying staff and resources.

As LHSC has fielded more COVID-19 patients from the GTA, St. Joseph’s has been helping alleviate pressure by taking in patients from LHSC who no longer need acute level care or who are awaiting long-term care and can’t be safely sent home. Other local hospitals, including in St. Thomas, Stratford, and Windsor, have also been receiving patients transferred from Toronto-area hospitals.

SJHCL said it has received funding for up to 44 additional beds, which will be made available at Parkwood Institute as the need arises.

“Twenty-seven of these beds already exist at Parkwood Institute Main Building and have been used at various points in the pandemic. More beds will be added and staff will be redeployed from other areas of St.Joseph’s as needed to ensure safe and expert care.”

Outbreaks

No institutional outbreaks are currently active at any seniors’ facility, hospital, or other health-care setting.

The lone active outbreak at Parkwood Institute’s Mental Health Building has been deemed resolved as of late Thursday, according to the health unit.

More from the good news archive: @MLHealthUnit continues to report no outbreaks of COVID in long-term care and retirement homes.

At the peaks of waves 1 & 2, there were 10 and 10 such OB's respectively.

Important because 80% of deaths have been in these settings.#VaccinesWork

— Dr. Chris Mackie (@Healthmac) April 23, 2021

Elsewhere, a large workplace outbreak at Cargill’s London facility has been connected with at least 116 cases.

The facility has been given the go-ahead from the health unit to resume operations on Friday after it was temporarily closed due to the outbreak.

“We have taken time during the idle to conduct a full, deep-clean of the facility,” Cargill said in a statement to 980 CFPL.

“We have also closed locker rooms, removed microwaves from the cafeteria and taken other additional steps to respond to the community-wide impacts of the virus.”

The outbreak is the second-largest to be seen in the London-Middlesex region, behind a significant and deadly outbreak at University Hospital from Nov. 10 to Dec. 29, 2020.

An outbreak is also still active at Elgin-Middlesex Detention Centre. At least 12 inmate cases were active at the jail as of April 19, the most recent figure available.

Declared over three months ago on Jan. 18, the outbreak has been linked to at least 64 cases among inmates and 34 among staff. No staff cases were listed as active at the jail as of Wednesday, according to a spokesperson with the Minister of the Solicitor General.

Outbreaks also remain active involving eight Western University student residences. More information is below.

Schools

At least three new school-linked cases have been reported by the health unit and by local school boards.

The health unit reported that one new case each had been reported involving Rick Hansen Public School and St. Andre Bessette Secondary School, while the London District Catholic School Board reported one new case involving St. Francis School.

They’re among at least 10 active school-linked cases in London-Middlesex.

Full lists of active cases can be found on the websites of the Thames Valley District School Board, the London District Catholic School Board, and the health unit.

Elsewhere, an outbreak has been declared over at St. Anne’s Catholic School. The outbreak had been declared on April 9.

Outbreak declarations, however, remain active involving the following schools, according to the health unit:

East Carling Public School
École élémentaire catholique Frère André
Mother Teresa Catholic Secondary School
Providence Reformed Collegiate
St. Andre Bessette Secondary School
St. Francis School

At least 350 cases associated with elementary and secondary schools have been reported in the region during the pandemic, according to the health unit.

Another 52 have been linked to child care and early years settings.

As of Friday, at least six cases were active involving such settings.

The health unit says one case each involves Beba’s Daycare Child Care Service; Blossoms Childhood Education Centre-West; Faith Day Nursery; London Bridge: Piccadilly Place Early Childhood Learning Centre; North Woods Montessori School; and White Oaks Children’s Centre.

One outbreak also remains active involving Faith Day Nursery, declared on April 13.

A previous outbreak, declared on April 8 at Kidorable Child Care Centre, has been declared over, the health unit said.

In post-secondary, no change has been reported in the ongoing outbreaks at Western University student residences.

Eight remain active, according to the health unit, associated with more than 175 cases.

Active Western residence outbreaks (numbers as of April 19, 2021):

London Hall – 6
Ontario Hall – 8
Essex Hall – 12
Elgin Hall – 15
Delaware Hall -19 + 1 from out of area who did not get tested
Perth Hall – 28
Medway-Sydenham Hall – 33
Saugeen-Maitland Hall – 54 + 3 probable cases who have not yet been tested.

Vaccinations and Testing

Adults 16 and older who are pregnant are now eligible to receive the COVID-19 vaccine at one of the region’s mass vaccination clinics.

The health unit announced the change on Friday. It comes two days after eligibility was expanded to people 16 and older with certain highest-risk and high-risk health conditions. Pregnancy is now among them.

Eligible residents are asked to visit the local vaccine booking website or call 226-289-3560 to book an appointment at one of the region’s three mass vaccination clinics. Online appointments are encouraged due to the high call volume.

More than 125,000 vaccine doses have been administered in London-Middlesex so far. As many as 18,370 were administered last week, the most of any week so far.

On Thursday, Dr. Chris Mackie, the region’s medical officer of health, noted that vaccine uptake has been good in London-Middlesex, especially at local pharmacies after the age was lowered to those 40 and older.

The pharmacy program is being led by the province. Residents are asked to book a spot with the pharmacies themselves, however waitlists for the shot have been long and demand has been outpacing supply.

Local health officials have stressed that Londoners should get the vaccine they’re eligible for rather than wait.

Asked why vaccine eligibility at the mass clinics wasn’t wider, Mackie said the health unit was hoping to expand it to even more at-risk groups, as defined in the province’s Phase 2 plans, possibly next week.

However, vaccine supply limitations were the main stumbling block.

Opening it up to those defined as ‘at-risk’— a provincial definition behind ‘high-risk’ and ‘highest-risk’ which includes asthma, diabetes, autoimmune disorders, liver and heart disease, and a number of other conditions — would make tens of thousands of new people eligible.

“So we, as you can imagine, need to have the ducks in a row to be able to open to such a large group, and we do hope and anticipate that we’ll be able to do that at some point next week,” Mackie said.

It’s not clear yet whether all at-risk people will be eligible at once or whether the health unit will break the at-risk category into subgroups.

It’s still not clear whether the province will designate the N6A postal code, or any region of London-Middlesex, as a provincial COVID-19 hot spot.

As a result, N6A, which previously had the highest test positivity rate in the province, is now 31st on that list behind areas in Peel, Toronto, and York region.

N6A still has the highest positivity rate in southwestern Ontario, however, with N9G in Windsor-Essex second with 13.22 per cent.

Meanwhile, the region’s two main assessment centres, at Carling Heights and Oakridge Arena, remain open and operating by appointment.

At least 7.1 per cent of tests in London and Middlesex were coming back positive as of the week of April 11, down from 7.7 a week earlier, according to data released by MLHU this week.

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Ontario

Ontario is reporting 4,505 new cases of COVID-19 and 34 more deaths linked to the virus.

Health Minister Christine Elliott says there are 1,257 new cases in Toronto, 1,232 in Peel Region, and 412 in York Region.

She also says there are 247 new cases in Ottawa and 224 in Durham Region.

The province says nearly 134,000 people received a dose of COVID-19 vaccine since Thursday’s report.

Ontario is reporting its first case of a rare blood clot in a person who received the Oxford-AstraZenenca COVID-19 vaccine.

The province’s top doctor says the patient is a man in his 60s who had received his first dose.

Dr. David Williams says the man has been treated and is recovering at home.

Ontario says it’s the fourth case of the rare clotting condition in Canada out of more than 1.1 million Oxford-AstraZeneca doses administered across the country.

— This story will be updated with data from neighbouring health units.

— With files from The Canadian Press

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