The COVID-19 pandemic is on the retreat locally, but the “shadow pandemic” of opioid-related deaths requires continued attention, according to discussions undertaken by the Board of Health (BOH) for Kingston, Frontenac, Lennox & Addington (KFL&A) on Wednesday, Feb. 23, 2022.
To begin the meeting, Dr. Angela Ma, Public Health Preventative Medicine Resident, provided the BOH with a COVID-19 update detailing the latest modifications to provincial requirements in Ontario. These upcoming changes, scheduled to come into effect on Tuesday, Mar. 1, 2022, include further lifting of capacity limits for business and venues, as well as no longer requiring individuals to provide proof of vaccination when attending events or patronizing businesses.
The majority of COVID-19 cases locally and provincially continue to be infections of the Omicron variant of the virus, though the Delta variant is still being seen among those who are hospitalized, Dr. Ma explained. Wastewater data shows that the percent positivity in KFL&A has stabilized, she detailed, and “our hospitalizations are low… [both] are consistent with what we’re seeing in terms of trends across the province, as well,” she said, noting that percent positivity is the proportion of positive results among those who have been tested.
Dr. Ma acknowledged that testing for COVID-19 has significantly changed in 2022, with only higher-risk populations being tested through professionally-administered PCR tests. “But overall,” she noted, “since our last update [in January], we’re seeing this downward trend and present positive progress.”
Also, KFL&A is seeing a downward trend in total hospitalizations, she said. “And in fact, our hospitalization numbers are at the lowest seen since [the end of the] Delta [outbreak]. So overall, again, this is reinforcing less severe burden [on our hospitals].”
Dr. Ma added that there are encouraging trends to note regarding local long-term care residents. “We saw positive news with residents who were infected with COVID-19 mostly having asymptomatic or mild disease, and many of them were at least double vaccinated. And in fact, most of the cases we saw in long-term care were staff, and we saw good infection prevention and control, in that those cases were not being transmitted to residents.”
This data, she explained, reinforces the overwhelming effectiveness of being fully vaccinated. “Those with one or no doses are certainly over-represented in the hospitalized population, and that trend is more and more apparent as we get older and age. And then we can see… that two doses protect against hospitalization. And even more so, three doses [protect against] ICU admissions, as well as in the deaths.”
When asked if these positive trends are indicating a potential end to mask-wearing requirements, Dr. Piotr Oglaza, Medical Officer of Health for KFL&A Public Healtrh, responded, “There’s a light at the end of the tunnel; eventually every pandemic in history [came to an end] and so will this one. And this particular pandemic will end with the virus retreating, and it will have that seasonality pattern [like other endemic respiratory viruses].”
“There may be subsequent waves,” Dr. Oglaza continued, “but as we move forward, these waves will be less intense and create less impact on acute care, [and] less severe impact on hospitalization rates, because most of the population will have already been exposed to it or are protected by vaccine, which will reduce suffering and illness. So, that’s something that we anticipate will eventually happen with COVID-19.”
Further to that, Dr. Hugh Guan, Associate Medical Officer of Health, explained that, in the future, it will be likely that individuals will be able to receive a yearly COVID-19 booster along with the currently available flu shot. “Hopefully, it can be combined into one shot,” he noted. “That will make it easy for everyone.”
Integrated Care Hub
The discussion moved on to the topic of the Integrated Care Hub (ICH) on Montreal Street, which is facing an end to their municipal funding at the end of March 2022. The ICH provides 24/7 low-barrier and wrap-around services to vulnerable citizens with immediate needs such as safety, food, and rest, and provides support for longer-term needs such as addiction and mental health services. It was proposed that the BOH members pen a letter to the Ontario Minister of Health, Christine Elliot, recommending that the Provincial Ministry of Health should take over funding the ICH (the following day, local residents staged a rally at the downtown Ministry of Health office in Kingston regarding the lack of funding for the ICH).
Before agreeing to the motion, City Councillor and BOH member, Jeff McLaren, asked if there was supporting data indicating the ICH was creating a significant benefit to the community.
Dr. Oglaza explained the importance of the ICH to Mr. McLaren and the other BOH members, noting that an important pillar of the ICH mandate is harm reduction, and one of the ways the ICH fulfills this mandate is through providing a safe, supervised injection site.
“A statistic that’s really important to put into this perspective is that the Integrated Care Hub has responded to more than 600 overdoses on-site since it opened, and these overdoses, it’s fair to assume, if they were not happening in a controlled environment [like the ICH], would have resulted in opioid-related deaths,” Dr. Oglaza stated.
He continued by putting this statistic starkly in perspective. “In KFL&A, there were 42 opioid-related deaths in 2020 alone [outside the ICH’s purview]. Let’s compare that to the 31 COVID-19 deaths since March 2020 – over two years. So in one year, we had more opioid overdoses than [two years of] COVID-19 deaths combined.”
The motion passed.