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Ontario Chief Medical Officer of Health press briefings

Dr. David Williams and Dr.Barbara Yaffe news conferences

April 3, 2020: graphs

Gov't of Ontario modelling and script

April 20, 2020

modelling document#2

March 25, 2020
 
March 26, 2020
March 27, 2020:
March 30, 2020
March 31. 2020
April 1, 2020
April 2, 2020
April 6 2020

Dr.Yaffe: there are 46 LTC outbreaks (note: these are outbreaks of respiratory illness, not necessarily covid). 56 of the covid-related deaths, not all confirmed, are at LRC's. Re testing: about 10 % of the tests are being done on health care workers, the rest are on people with contacts or symptoms. For people who test positive the hospitalization rate is 6%.

April 7, 2020

Dr.Yaffe: there are 51 LTC outbreaks. Overall, 38% of cases have resolved. Of all the case now (4726), just over 500 are in health care workers. Dr.Williams: there has been a change in the testing (the assessment centres were testing 60% of people who came, but are now going up to testing 80%) but even though the percentage of cases is up yesterday, he says he saw that it's down again today. The call volume to Telehealth is down, self-asse4ssment volume is down, and emergency dept covid cases are down. There are nearly 100 asse4ssment centres. Their capacity is up to 14,000 tests a day but only 4000 tests were done in the last 24 hours and some of those are multiple tests on the same person if ill.

A journalist asked how come only 2900 tests were done yesterday (source?) down from a high of over 6000 abut a weeks ago (not sure of my hearing). Same answer -- less demand, at least for now.

A journalist asked: what will be the roles of the medical students, foreign-trained doctors etc. who are summoned by the premier. Dr.Yaffe said that they'll be doing contact follow-ups. The aim is to call contacts once a day for 14 days.

April 8, 2020

Dr.Yaffe: there have now been 50 LTC outbreaks. (Ed.: So one must have been a false alarm -- 51 yesterday). There have been 78 covid deaths in LTC, not all tested. There are between 400 and 500 LTC and retirement homes, and testing will now be stepped up there.

BC is doing well and Ontario is doing not badly but Dr.Williams says we need to wait to see if that is sustained. He says that assessment centres are now testing around 78% of people who come there.

April 13, 2020

No reports in the interval since April 8. The reason is that the MOH briefings seem to be very defensive and not particularly informative. Specific questions are rarely given a specific answer. Only Dr.Yaffe was there and she seemed veering a bit closer to hostile at times.

What she added to the pool of knowledge:
120 deaths related to covid have been connected to LTC outbreaks. NOt all have been lab-confirmed.
813 health care workers have tested positive over the whole covid outbreak -- she had no information on how many health care workers are currently out of action with that.
The tests are "excellent" and over 90% accurate.
The modellers currently have no plans for any more public media conference but they says they expect the peak of the outbreak to happen this week.

April 14, 2020

- The virus seems to be plateau-ing in Ontario.
- Less than 50% of Ontario's covid-related deaths were in long-term care homes (136 of 334), whereas in other provinces it was mostly about 50%. More men than women are dying of covid.
- 857 health care workers have tested positive (cumulatively).
- Originally, some vital health care workers who were asymptomatic but supposed to self-isolated for 14 days were allowed to work earlier, with full PPE.
- Now, since the hospital staff are not swamped at all, some infection control staff ("underused staff") will be sent out to do more training and monitoring of LTC staff's procedures.
- Re LTC staff working in more than one facility: very hard to stop -- talks between LTC administrators and unions are ongoing.

April 15, 2020

Dr.Williams only. There are a lot of hospital beds available still - about 65% of covid-allocated beds are filled.

221 of the 494 new cases are at LTCs where there's an outbreak. We may be over the peak on the community "aspect." There are 470 LTC places, with well over 77,000 residents and over 100,000 staff.

There will be "swat teams" going in to help at the LTC places, some infection control staff and some medical students as volunteers.

April 16, 2020

Dr.Williams only. Of the 38 new deaths, 27 were in long-term care facilities. Cumulatively, 980 health care workers have been infected, but he doesn't know how many are still ill or isolating.

Of the 514 new cases, 271 are from LTC and 243 are community-based.

As of April 22, there will be no PSWs working at more than one LTC home. Can't be done faster because otherwise there will be staff shortages at some of the places.

A reporter asked how many people on ventilators because of covid in Ontario recover versus how many are off the ventilator list because they have died, but Dr.Williams said he doesn't know.

A reporter asked how many false negatives there are with the PCR (MRVP) test. Dr.Williams said that there aren't really a lot of false negatives, it's just that sometimes there may not be enough of the virus fragments to show up in the lab test and then a few days later there will be enough. (??)

April 17, 2020

Dr.Yaffee only. She said the percentage of new cases is slightly down. The modellers will give their new scenario on Monday.

A reporter asked about the OMA's announcement that they're worried the health system will be overwhelmed with all the cases now put on hold. Does the MOH/control centre have a plan for how to reintegrate "elective" procedures?

Dr.Yaffee says there are ongoing conversations about this issue but it has to be handled very carefully. How to do that is "very much an item of discussion." A reporter asks whether the MOH will urge people to go to Emergency departments, since those are now so empty. She said, people should know enough not tn o be worried about getting the virus at a hospital, and they should go if they have a medical emergency.

Reporter: Can she give the breakdown in new cases (564) into LTC and community? She says their two sources of data don't match but her estimate is 334 from LTC and 230 from, community. Reporter asks about new deaths (55) are 54 from LTC? She says they have the same problem, can't be sure. Now that there are LTC and retirement homes where everyone is being tested,their data will no longer have any untested deaths or cases (i.e. no more cases just based on symptoms).

Reporter asks (like yesterday) what are the survival rates for people on ventilators. She says it's an interesting question but she doesn't know. (!)

They are trying to "ramp up" to 18,000 or 19,000 tests a day.

Reporter: Are things looking better or worse? Dr.Yaffe: "they're generally looking better but we're not out of the woods." Reporter: What would you tell parents? "We're looking at the evidence around transmission by children."

April 18, 2020

Dr.Williams only. Although Dr.Yaffe said there had been two deaths of health care workers, it turns out there's only been one -- a long-term PSW, who (The Globe says) worked for 31 years at Anson Place LTC in Hagersville.

He says that of the 485 new cases, the public health data system says there were 227 LTC cases and 258 community cases.

But the Long Term care Ministry reports 44 LTC deaths plus one staff death, whereas the total deaths reported by the Ontario MOH is 36. Dr.Williams says this discrepancy will have to be worked out.

Re loosening things up: he says there will be a big emphasis on "yes, but" -- with a very long requirement on physical distancing.

April 20, 2020: Modelling panel

modelling document#2

Dr. Matthew Anderson (the president and CEO of Ontario Health), Dr. Adalsteinn Brown (the dean of the Dalla Lana School of Public Health at the University of Toronto), and Dr. Barbara Yaffe (Ontario’s associate chief medical officer of health) gave the talk.

Reporter, to Dr.Brown: the Ontario MOH report for today says there are 114 outbreaks in LTCs and 249 deaths, but your said there are 127 outbreaks and 367 deaths. Which is it? Dr.Yaffe: there are two data bases. (She implies that the higher number comes from the LTC ministry). Dr. Brown says that often when an assumption has been made they finds to later it wasn't a death related to covid. But even it it was covid, it doesn't really change the curve. He doesn't explain this further. But he says emphatically that "the vast majority of cases are in older people." So the idea is that there are actually two different curves -- one is just pertaining to LTC. He also say they haven't really beg with "surveillance testing" yet -- i.e. to see what the incidence is in random people. He says that one type of test suggests about 50% of population has had covid without symptoms, another one (or theory?) says 90% of the population. Dr.Yaffe says the province wants to get into serology testing to get a better idea.

Question: was a prison shut down because of covid and the prisoners transferred? Dr. Yaffe says she's unaware of this. She says there is not much testing going in prisons yet.

April 21, 2020

Dr.Williams and Dr.Yaffe. They say the community curve has plateau'd but the LTC spread is still growing, haven't reached their peak. The numbers from the LTC Ministry are different than the PH numbers, and Yaffe says they're probably more accurate: 128 outbreaks in LTCs, 399 residents plus 1 staff have died. 1618 residents have tested positive and 867 staff have tested positive. About 10,000 tests have now been done in LTC.

About 400 requests for more LTC staff have been processed.

Reporter asks for benchmarks: what are you looking for to loosen restrictions? Wait until we have no cases for two weeks? Dr.Yaffe says we can't wait that long. Dr. Williams says maybe we have to wait until we get back into the low 200s of new cases, because that means PH will be able to keep up with contact tracing. "Not surveillance, contact tracing."

Dr.Williams says they're still looking into the work from elsewhere about whether children are not big factor in spreading the virus.

April 22, 2020

Dr.Yaffe said that there are 127 outbreaka in LTC, with 1985 cases among residents and 957 among staff. The ministry of LTC says there have been 447 deaths of residents plus 1 staff person. But the MOH update for today says there have been 125 outbreaks and 295 deaths in LTC. There is still no explanation about the difference in numbers.

Dr.Williams said that the positivity rate of the testing is about 12% and it needs to go down below 7%. He also said that they're going to bring out the military -- 5 teams of about 50 people each, to go to "red zones" (undefined) among the LTCs and help. Each team is headed by an officer who is a nurse, and made up of army medics.

A reporter said that the premier "threw you (Dr.Williams) under the bus" today, saying that public health is not solving the LTC problem fast enough. Williams said no, the premier and he are on the same track, calling for "all hands on deck."

The numbers continue to be confusing, and the reporters sounded impatient -- why didn't they do more testing in LTCs earlier (over and over).

Final question was about whether kids can go back to school because they may not spread the virus. Dr.Yaffe said they're examining the literature and it seems like not only do kids not catch the virus but they seem not to spread it readily either. She and Dr.Williams both said that it's early days and more deliberations would have to take place -- for example, if others in the family test positive, then would the kids spread the virus to schoolmates.

April 23, 2020

Most questions were answered with "we're still working on that." Dr.Williams said that in Toronto, 5 hospitals have contracted to support 40 LTCs in the city, but no more details were given. The army medic teams have not yet been settled or assigned.

April 24, 2020

Dr.Yaffe only. Reporter: how long do you expect the "plateau" will last? Answer -- maybe for weeks. We won't know that we've peaked until the number start going down. But we have more testing so there are more numbers, esp. from long-term care homes.

New cases in LTC (residents and staff included): 259 of the 640 new cases. Question: what's the recovery rate of people in LTC who get sick? Answer: I can only tell you the general death rate: the LTC system says there were 105 new deaths, the PH system says 50. Reason for the difference: it may be that LTC is telling all the deaths, not only covid-related. PH data is more detailed for cause.

April 25, 2020

Dr.Williams only. He says that they have done risk assessments of the approximately 700 LTC Centres in Ontario and labelled them green, yellow or red according to their ability to deal with covid infections. He can't remember how many are designated yellow but about 85 are designated red. He says only about 20 LTC centres have had a lot of infections or deaths.

He was asked about testing for "immunity passports" and says the serological tests that are reliable for testing immunity "might be available over the summer."

April 26-29, 2020

The main thing to note is the remarkably scant data that both of the doctors seem to have. They say that it will be important to find out the details of the more recent infections. They are not told them?? What about the use of ventilators vs. oxygen? How about the virus transmissions from/between children? And the reporters have not even been asking about co-morbitities. And they've been saying for more than a week that they'll separate the community cases from the LTC cases, but that's still in future. Kind of shocking. How can they be experts if they haven't gt the basic information?

April 30,May 1:

Two points mentioned on both days:
1. The number hospitalized on both days is artificially high because some patients transferred to hospital from LTC are not being "repatriated" as soon as they could be.
2. Masks should not be used as a way to prevent people from having to observe physical distancing -- Dr.Williams did not say that masks don't help but did say they don't need to be used if distancing is possible.

May 6, 2020

Dr.Williams said that the usefulness of masks is "limited but they are of some value." The Ontario "R" rate is "hovering just around 1, but in parts of Ontario it's 1.3, so we can't relax yet."

My 7, 2020

R rate province-wide is .9


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Content last modified on May 08, 2020, at 07:13 PM EST