Kingston’s Medical Officer of Health Dr. Kieran Moore addressed City Council on Tuesday, Dec. 1, 2020 to provide an update on COVID-19 in the area.
He said Kingston Frontenac Lennox & Addington (KFL&A) Public Health is working with Kingston Health Sciences Centre (KHSC) to plan the distribution of the Moderna and Pfizer COVID-19 vaccines early next year.
“We are having very good messaging from our federal and provincial partners about early access to the vaccine,” Dr. Moore said. “I think it’s going to be in the first quarter, certainly for at-risk individuals in long term care (LTC) facilities, retirement homes, healthcare workers, essential workers. I think they’ll be part of the first wave of immunization.”
“That will allow all of us to walk back to a normal life once we can protect those who are most at risk for this virus,” he said.
Dr. Moore confirmed that KHSC has the freezer capacity to store the vaccines, which must be kept at temperatures up to – 80 C.
The vaccine supply will being to become available to Canadians in waves throughout 2021, as it is manufactured. Dr. Moore explained that the National Advisory Committee on Immunization will ultimately determine who the priority recipients are.
“If I had a vote… my vote would be to protect people in long term care facilities where we’ve seen the death rate can be significant. Then I think we have to preserve and protect the healthcare system.” He suggested that healthcare employees, including those in long term care and retirement homes, as well as first responders such as police, fire and paramedics, could qualify in the first wave.
Councillor Jim Neill asked Dr. Moore if he felt that teachers should be considered frontline workers, and qualify for the initial immunization.
“Teachers in general have less risk given that they have good personal protective equipment (PPE), and we’ve seen very low risk in our schools. I would think they would be part of a second tier,” he said.
He went on to predict that children will be among the last to receive the vaccine. “Children won’t be offered the vaccine until we are very, very confident in the safety, the effectiveness, and that we’ve protected the vulnerable,” he said. “Children with this virus predominantly don’t get ill, and don’t need to be in hospital.”
Increased severity of outcomes for other illnesses
During the initial wave of the COVID-19 in Ontario, the provincial government instructed hospitals to ramp down elective surgeries and non-emergent clinical activity.
Though the directive was gradually lifted starting Tuesday May 26, 2020, a surgical backlog was created across the province, and clinical practices are generally still triaged between in-person and phone appointments.
“In terms of a build-up of morbidity and mortality, I do believe the delay in access to care has had a significant impact on our community,” Dr. Moore said.
“Patients are showing up very much delayed — ruptured appendix, gallbladder, sepsis from kidney infection… They haven’t had primary care in some instances,” he said. “They didn’t seek care for common symptoms such as angina,” or chest pain.
He said the delay in their illness has resulted in a higher burden of care, which he has observed both in his work as a coroner and in the hospital. He called it “a lesson learned” about the impact of shutting down hospital procedures.
He also said that staff shortages could be an issue if hospital admissions surge.
“Staffing is the issue. Staff are very much hard to find these days. So much of our staff has been pulled into supporting long term care facilities in other jurisdictions,” he explained. “Sadly we’ll have to look at reduced staff-to-patient ratios initially as we try to provide the best care.”
Across the province, he said the healthcare system is now being significantly impacted, observed in the number of individuals hospitalized cumulatively as well as those in the ICU.
“I look at bed capacity every day,” he said. Between Monday, Nov. 30, 2020 and Tuesday, Dec. 1, the number of people in ICU in Ontario jumped from 168 people to 185.
“That increasing pressure on the acute care system is, I know, something decision makers are monitoring very, very carefully,” he said. “Without further control we are going to get to double the daily cases that we’re seeing now, and be losing ICU capacity.”
Locally, he said Kingston is currently in the middle of its fifth wave of the pandemic, with previous peaks observed in March, June, September and October. Notably he said the time between the peak in cases is shortening, giving the healthcare system and workers less time to recover.
Travel remains the highest risk factor for contracting COVID-19
In his presentation to Council, as well as in a YouTube video published on Tuesday afternoon, Dr. Moore explained that travel remains the highest risk factor for Kingstonians. Every single recent case of COVID-19 he said, has been traced back to a traveller to or from the Greater Toronto Area (GTA). Previously, travel to big cities like Montreal and Ottawa as well as international travel, have been factors.
“Leaving our community is the highest risk. Whether it’s for business, or essential or non essential reasons,” he said. Cases are popping up in all corners of the KFL&A region as well, he added, including Napanee and four cases in Sharbot Lake.
“As you can see there’s a theme — travel travel travel. If you leave our region the risk is 10 to 20 times higher. The best thing to do is stay within our area,” he said in his YouTube video.
Looking ahead to Christmas, he advised: “Our fate is in our hands — wash them, and stay within your family unit.”
A large surge in cases in January could potentially push the region into the Orange or even Red status of provincial public health restrictions, and impact the healthcare system, he said.