The Omicron variant of COVID-19 is present in the Kingston Frontenac Lennox & Addington (KFL&A) region, announced Dr. Piotr Oglaza, Medical Officer of Health for KFL&A Public Health, in his weekly COVID-19 briefing with the press on the afternoon of Wednesday, Dec. 8, 2021. The public can expect updates to current measures and restrictions to curb the spread of COVID-19 in the community and, more specifically, to contain the Omicron variant.
On November 26, 2021, the World Health Organization classified B.1.1.529 as a variant of concern called Omicron, after the 15th letter of the Greek alphabet. Since then, it has been found in a number of countries and regions, including the confirmation of several travel-related cases in Canada.
This variant has a large number of mutations, some of which are concerning to researchers. Preliminary evidence suggests an increased risk of reinfection with this variant, as compared to other Variants of Concern (VOCs). Several labs have indicated that for one widely used PCR test, one of the three target genes is not detected (called S gene dropout or S gene target failure) and this test can therefore be used as a marker for this variant. Using this approach, this variant has been detected at faster rates than previous surges in infection, suggesting that this variant may have a growth advantage.
“Unfortunately, today at KFL&A Public Health, we’ve received confirmation that the whole-genome sequencing has been completed on a sample [from a] person diagnosed with COVID-19. And that whole-genome sequencing confirmed the presence of the Omicron variant in this community,” explained Oglaza.
He went on that “in response to this – and this is where our approach is one of caution and being proactive – out of the overabundance of caution, we will be implementing new measures.”
These measures, aligned with the provincial guidance on case contact management specific to the Omicron variant, introduce a change in practice when we address the risk and high-risk contacts of cases.
“Mainly,” he said, “if someone is [diagnosed with] a case of Omicron, very high-risk contacts would be required to self-isolate, and they will be required to self-isolate regardless of their immunization status.”
The difference here is that with the Delta variant and previous iterations of the virus, vaccinated individuals who were a close contact with the COVID-19 positive individual would not be required to isolate as long as they were symptom-free and tested negative. “They wouldn’t have to wait for test results in isolation and if the test result was negative, they would be able to continue with their daily activities, just paying extra attention and self-monitoring, but they would not have to self-isolate” he explained.
On the other hand, he explained, “With high-risk contacts of Omicron – regardless of whether they are fully immunized or not – they need to self-isolate, they need to test as soon as possible after being aware of becoming or being a high-risk contact with Omicron. But they also have to be isolated even if the test result is negative. And they have to do the clearance test on day seven. And if they don’t do that clearance test, that self-isolation could be even extended, so there are much much stricter rules around contact management for Omicron cases.”
The reasoning for this overabundance of caution is, “there’s still not sufficient clarity to determine what impact Omicron will have on this province, this community. The science around Omicron about how severe the cases might be – how likely these Omicron cases or Omicron infection is going to escape immunity from the vaccine – is still under investigation,” said Oglaza.
New measures to combat continued rise in COVID-19 cases
Earlier on in the press conference, Oglaza detailed the overall COVID-19 situation in our region.
“Unfortunately, we continue to see cases rising in our community. And yesterday we had 88 new COVID-19 cases, this brings up us to a total of 389 active cases which is an all-time high.”
Though he specified that “our case activity over the past few weeks is consistent with that progression of the fourth wave of COVID-19,” Oglaza also said a letter of instruction to the public would be issued later today or this week, but that he “wanted to give the heads up to the community of what’s coming down.”
“We see spread occurring through the attendance of symptomatic individuals at different gatherings and that enhanced active screening, similar to what we are that we have successfully implemented in schools, is now going to be required in additional places,” he began.
“The letter of instruction will also strengthen the language and requirement of wearing masks while indoors, except when actively eating or drinking… And there’s also going to be additional language that’s going to eliminate the opportunities for mixing and mingling without masks in those indoor places.”
For example, Oglaza explained, “If someone is having a social gathering, [and guests are] seated at the table and consume food or drinks, it is far less likely to transmit the virus to another person… [than] in a setting of an establishment where people are standing, consuming drinks, and maybe walking around mixing, mingling, talking to people. This is what’s linked to the spread [in our region]. So, the language around the letter of instruction is going to be more in terms of how the food and drink service can take place.”
Oglaza explained that mingling and chatting might still be permissible with fully masked and distanced individuals, but that unmasked face-to-face interactions have been “specifically linked to the pattern of spread that we’ve seen so far in this community, based on our case contact investigations.”
“So, the exact language and the letter of instruction that’s still under legal review. We’ll be releasing that as soon as possible, but I wanted to give the community a heads up that these are the additional measures that will be implemented to address the pattern of spread that we’ve seen over the past several weeks in our community as a result of the fourth wave.”
Measures to curb Omicron TBA
Oglaza said to watch for a further letter of instruction from the Health Unit in the upcoming days, which will outline additional measures that may be required of the public to curb the spread of the Omicron variant.
“These additional measures that are under development will be implemented as soon as possible – with consideration in mind that the community needs time to adjust and prepare for the special measures,” he said.
“This introduction of these new measures in the KFL&A region will be, specifically, in response and in anticipation of the potential spread of Omicron in this region. And some of the measures that that will be included in this are the ones we’ve seen in this province already done by other jurisdictions such as Sudbury Health unit.”
Here, Oglaza didn’t get into specifics, but a cursory glance at the Sudbury Health Unit website shows some additional measures listed in a letter of instruction released on November 26, 2021, by Dr. Penny Sutcliffe, Medical Officer of Health, Public Health Sudbury & Districts.
These include: reinforcing the critical importance of Public Health measures to prevent COVID-19 transmission, temporarily reinstating recent provincial changes lifting capacity limits and physical distancing requirements, strengthening masking requirements at organized public events, strengthening provincial proof of identification and vaccination requirements for organized sports, and reinstating the former requirement that people work remotely (i.e., from home), unless the nature of their work requires them to be on-site at the workplace.
As to the individual with the confirmed case of Omicron, Oglaza could not be specific about the age or any other demographics, or, indeed, where the exposure could have occurred, “because it’s a single case.”
“Typically,” he explained, “when we have fairly small numbers of people with health conditions, we really don’t want to be providing any additional information that could be used to identify individuals… So that’s not the level of detail that I’m able to share publicly based on the confidentiality, consideration,and privacy considerations. But we do have that case confirmed by the whole genome sequencing.”
However, a press release delivered to news agencies following the press conference states that, at this time, the individual identified with the Omicron variant does not have a travel history, though KFL&A Public Health continues to investigate the COVID-19 case to identify transmission.
The public can expect the letters of instruction in the coming days, one to address the rise in cases as KFL&A Public Health continues to follow the science of transmission, and a second to address the scientifically uncertain risk of the Omicron variant in our community.