Weekly COVID-19 Update

Confirmed Cases

First Nations in Ontario
As of November 3rd , there are 337 cumulative cases of COVID-19 amongst First Nations people in Ontario. Seventeen new cases were confirmed last week, 11 of which were amongst people living in communities. This is slightly less than half the amount of new cases reported the week prior, which was set a record for new cases. The Southwest area had the largest increases this week and continues to have the highest number of active and cumulative case counts. This area encompasses the regions of Erie St. Clair, South West, Waterloo, Wellington, Hamilton, Niagara, Haldimand, and Brant.

It has been two weeks since Six Nations of the Grand River declared they are in an outbreak situation. The last reports indicated that Six Nations has 90 cumulative cases with over 15 currently active and 72 resolved. One case has resulted in death.

Since the beginning of the pandemic, a total of 21 First Nations have had one or more confirmed case in community. Eighty-five percent of these cases have been resolved. More information on First Nation cases in the province is found in the attached regional report called “First Nation Cases – COVID Testing Report 29.”

Ontario General
On November 10th, Ontario reported 1,388 new case of COVID-19 marking a new single day high for cases reported. The public health regions with the highest cases counts include Toronto with 520, Peel with 395, York with 100, Halton with 72, and Niagara with 50. Other public health regions with double digit numbers include:

• Waterloo Region: 42.
• Durham Region: 36.
• Hamilton: 35
• Ottawa: 23.
• Huron Perth: 22.
• Middlesex-London: 20.
• Simcoe Muskoka: 20.
• Wellington-Dufferin-Guelph: 13.

Eighteen of Ontario’s 34 public health regions have reported five or less cases daily.

Between November 3 rd and November 9 th , daily case counts have fluctuated between 1,050 and 1,328 creating a seven-day average of 1,154 cases per day in the province. This is an increase of nearly 20% from last week’s average setting another new record high for weekly averages. Today’s numbers bring the cumulative total of COVID-19 cases to 86,783. Of these cases, over 10,000 are currently active, 73,417 (about 85%) are now recovered, and 3,260 have resulted in death. Ontario is now averaging 13 deaths per week due to COVID-19, which is an increase of 4 from last week.

Over the past seven days there has been an average of 103 new cases related to schools daily, bringing the total cumulative school-related cases to 2,865 as of November 10th . There are currently three schools closed due to COVID-19 cases. More information on school cases and closures is available here: https://www.ontario.ca/page/covid-19-casesschools-and-child-care-centres

There are 422 patients currently in hospital with COVID-19, which is a 3% increase from this time last week. Eighty-two patients are currently in critical care and 54 are on ventilators.

Just over half of new cases are among people aged 40 and under. The 20 to 29 age bracket still has the highest cumulative and active case count with the 30 to 39 age bracket and the under 20 age bracket following closely behind.

Further detail on case numbers and demographics in the province is available here: https://covid-19.ontario.ca/data

Support for First Nations

Indigenous Community Support Fund
Indigenous Services Canada has opened the application process for the needs-based portion of the Indigenous Community Support Fund (ICSF) Phase II. The deadline for applications is November 30th , as funding must be dispersed by December 31, 2020. Applications will continue to be accepted and evaluated until identified funds are exhausted. This fund is intended to support Indigenous leadership to design and implement community based solutions to prevent, prepare and respond to the spread of COVID-19 within their communities through initiatives including, but not limited to:

• support for Elders and vulnerable community members
• measures to address food insecurity
• educational and other support for children
• mental health assistance and emergency response services
• preparedness measures to prevent the spread of COVID-19

Applications can be accessed here: https://www.sac-isc.gc.ca/DAM/DAM-ISC-SAC/DAMTRNSPRCY/STAGING/texte-text/paw_2021-2022-84458230-fill_1603914603791_eng.pdf

All Ontario Region applicants submit to: sac.covid-19fnihbontario.isc@canada.ca

More information on the ICSF needs-based application process is available here: https://www.sac-isc.gc.ca/eng/1603990521589/1603990645077

First Nations should already have received deposits for the formula-based portions of the ICSF Phase I & II. More general information about the ICSF fund is available here: https://www.sac-isc.gc.ca/eng/1585189335380/1585189357198

Provincial Restrictions & Public Health Measures

New Colour Coding System for Reopening
On Saturday November 7th, Ontario implemented a new framework for opening and restrictions that replaces the stage 1, 2, and 3 system. The new “Keeping Ontario Safe and Open Framework” involves a colour coding system. Within this system, public health units and regions across the province will fall into one of the five colour categories and must implement public health and safety measures accordingly as a minimum. These colour categories introduce more varied restrictions than previously seen, with different rules for bars and restaurants, sports and recreation, workplaces, and other gatherings associated with each colour category. Each category includes the restrictions from the previous category with heightened restrictions added.

As of Saturday, November 7th, the vast majority of Ontario is green, which enables greater opening and less restrictions than implemented under Stage 3. Ottawa and York Region are classified as orange, which limits bars and restaurants to 50 people indoors, with no more than four seated together and requires businesses to close by 10 p.m. Other venues, such as strip clubs must shut down altogether.

Peel region is the only region that is a red zone. Restrictions under red are actually less strict than in modified stage two, allowing indoor dining and gyms with to open with a maximum of 10 people at one time. Toronto is still in modified stage 2, after the mayor requested to not transition to the new colour system immediately in order to keep higher restrictions in place longer. Peel Region officials also requested stricter restrictions in their area, but were not afforded them. Ontario health officials have stated that regions can implement additional regional restrictions in their locales if they choose to do so but, are only required to implement the measures associated with their colour coding.

A broad description of the restrictions in each colour category is provided below:

• Green-Prevent
o The broadest allowance of activities in Stage 3 absent a widely available vaccine or treatment. No limits on the hours of operation for bars and restaurants. 50-person maximum capacity for indoor recreation per room.

• Yellow-Protect
o Enhanced targeted enforcement, fines, and enhanced education to limit further transmission. Limiting hours of operation for bars and restaurants and maximum table size of 6. Face coverings required in all indoor recreation facilities except when exercising.

• Orange-Restrict
o Implement enhanced measures, restrictions, and enforcement avoiding any closures. Increased limits on restaurant and bar hours and maximum table size of four. Closure of strip clubs. Screening and face coverings for gyms and recreation.

• Red-Control
o Restrictions are the most severe available before wide-scale business or organizational closure. 10-person indoor capacity limit for bars and restaurants and no dancing or singing. Gyms limited to 10 people per room.

• Grey-Lockdown
o This would likely coincide with a declaration of emergency in the province, and would include a return to Stage 1.

The full framework is available online here: https://files.ontario.ca/moh-covid-19-responseframework-keeping-ontario-safe-and-open-en-2020-11-03-v2b.pdf

Colour Coding Indicators
The new colour coding system is being widely criticized as setting too high of a threshold for increasing public health restrictions. Indicators used to determine colour category include data such as weekly cases per 100,000 people, positivity rate of tests, the speed of virus transmission, and local hospital capacity.

Ontario has stated that the new system allows public health restrictions to be increased and decreased in response to surges and waves of COVID-19 in a more localized fashion in order to avoid broader closures in the longer-term.

General Public Health Restrictions
Under the new colour coding system, health officials are continuing to recommend that everyone in Ontario limit contact with any person outside of their immediate household, to stay home if you are feeling well, to not allow children who are not feeling well to go to school, to get tested if you are exhibiting symptoms of COVID-19 or have been in contact with a known case, and to avoid all unnecessary travel. Other public health recommendations that have been in place throughout the pandemic, such as physical distancing, proper hand hygiene, and sanitization also remain in place.

Face coverings are still mandatory in all indoor public places in Ontario including, businesses, facilities, and workplaces (if physical distancing cannot be maintained), and public transit. Limits on social gatherings remain in place with a limit of 10 people indoors and 25 outdoors. Indoor and outdoor gatherings cannot be merged to create a gathering of 35 (25 outdoors and 10 indoors). Organizers of events that breach gathering limits can receive a fine of up to $10,000. Individuals participating in such events can receive fines of up to $750.

There are additional allowances for gatherings such as weddings, funerals, recreation, and sports activities which vary according to colour category.

COVID-19 Alert App
It is recommended to download the new COVID Alert app available from the Apple and Google Play app stores. This app will help expedite notifications to individuals that are in contact with someone who has tested positive for the virus. More information on this app is available here: https://covid-19.ontario.ca/covidalert

Testing Testing

Capacity & Positivity Rates
Over the past seven days, Ontario has processed an average of 33,000 tests daily, which is similar the numbers from last week. Ontario has recently increased its new testing capacity goal from 50,000 per day to 100,000, but has yet to consistently reach its former goal.

The positivity rate across Ontario is 3.9%, though this varies significantly by region. Peel Region, for example has a 11% positivity rate, making it statistically the hardest hit region in Ontario.

Rapid Testing
Two types of rapid tests have been approved by Health Canada. Shipments of the “ID now” Abbot Test, which can produce tests results in as little as 15 minutes without lab processing, has now been received by Ontario. It will be put into use as early as the first week in November with priority given to remote and rural communities, early outbreak response, long-term care settings, and other vulnerable settings.

The second type of test is the pan bio test, which produces rapid results but still requires laboratory processing. Shipments of this test are expected to be received by Ontario next week. They will likely be prioritized for high risk and frontline workers. Rollout plans are still being finalized.

Testing Access and Guidelines
COVID-19 assessment centres offer tests by appointment only. The province has updated their testing guidelines advising that low-risk or asymptomatic individuals should not be tested unless they have been in contact with a confirmed case. Any person who has one or more symptom of COVID-19 should be tested. All testing is free.

A list of COVID-19 testing centres is available here: https://covid-19.ontario.ca/assessmentcentre-locations/.

Testing is also available at select pharmacies for asymptomatic individuals by appointment only. It involves a pre-screening process to ensure those seeking tests have no symptoms. A list of pharmacies with the testing service is available here: https://news.ontario.ca/en/backgrounder/58491/ontario-expands-covid-19-testing-topharmacies-1

Check your local public health unit website for availability of testing sites, including pop-up sites, in your area.

Exposure to a Confirmed Case
If you have had contact with a known case of COVID-19, you should get tested at least 5 to 7 days after your exposure and self isolate for 14 days whether or not you exhibit symptoms. If you were exposed to the same known source as a confirmed case, you should be tested.

If a person comes in contact with a known case and receives a negative COVID-19 test result, they are still required to self-isolate for 14 days after their last exposure to the case. If an asymptomatic person who had contact with a known case received a negative COVID-19 test result and then subsequently becomes symptomatic, they should be re-tested. These are precautionary measures taken in case of a false negative test result.

Symptoms and Screening
Because the disease is new, the symptoms of COVID-19 are wide and changing. When assessing for symptoms, it is important to focus on evaluating if they are new, worsening, or different from an individual’s normal state of health. With this considered, the following are considered symptoms to monitor for:

• Fever (temperature of 37.8°C/100.0°F or greater)
• Cough
• Shortness of breath (dyspnea, out of breath, unable to breathe deeply, wheezing)
• Feeling feverish
• Chills
• Fatigue or weakness
• Muscle or body aches
• New loss of smell or taste
• Headache
• Gastrointestinal symptoms (abdominal pain, diarrhea, vomiting)
• Feeling very unwell
• Children tend to have abdominal symptoms and skin changes or rashes

Symptoms may take up to 14 days to appear after exposure. Ontario’s updated COVID-19 symptom list is available here: http://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/2019_referenc e_doc_symptoms.pdf

The Ontario COVID-19 self-assessment tool available here: https://covid-19.ontario.ca/selfassessment/

Regular Flu Vaccine
The regular flu vaccine is now available in Ontario. Flu shots can be given to people as young as 6 months of age. A high dose flu shot for seniors is available for people aged 65 and over this year as well. Officials reports that distribution processes for the flu vaccine are similar to those placed over the past several years with tests being distributed in phases. Approximately 3.4 million vaccines have been dispersed across the province already.

Access the Ontario press kit for the regular flu vaccine here: https://news.ontario.ca/en/advisory/58485/electronic-press-kit-now-available-ontario-set-tolaunch-largest-flu-immunization-campaign-in-provin

Federal Updates

Confirmed COVID-19 Cases – First Nations in Canada
According to federal reports, as of November 10th there are 1,802 cumulative COVID-19 cases confirmed amongst First Nations people living on-reserves across Canada. Approximately 1,200 of these cases are now recovered, at least 15 have resulted in death, and about 600 are currently active. The vast majority of new cases are in the provinces of Manitoba, Alberta, and Saskatchewan.

More specific demographic breakdowns from Indigenous Services Canada are available here: https://www.sac-isc.gc.ca/eng/1589895506010/1589895527965

Confirmed COVID-19 Cases – Canada
Canada is reporting an average of 4,000 new cases daily over the past week. The number of daily deaths has increased by 17 per day since this time last week with an average of 51 deaths daily now reported. All the provinces from British Columbia and eastward to Quebec are reporting record high case counts and many are implementing increased public health controls in an attempt to reduce spread. This is especially true in major city centres.

There are currently over 41,000 active cases in the country. The cumulative total of cases in the country is 273,000 with 221,000 now recovered and just over 10,632 cases (4%) having resulted in death.

More detailed information and trends across the country are available here: https://healthinfobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html

Border Closures
Due to increasing COVID-19 numbers in Canada, the European Union removed Canada from its permissible travel list in October.

The Canada-U.S. land border has been closed to non-essential travel since mid-March 2020. The closure is currently extended to November 21st, 2020. The Prime Minister has indicated that extensions to the closure will continue until COVID-19 case counts in the U.S. decrease.

Restrictions between inter-provincial borders within Canada vary. It is recommended to research each region’s policies prior to any travel. International travel suspension orders limiting non-essential travelers and non-citizens from entering Canada remain in place. The mandatory 14-day self-quarantine for all individuals entering or returning to the country remains in place. Canada is continuing to advise against all non-essential travel.

Additional Information & Resources
• Ontario COVID-19 website: https://covid-19.ontario.ca
• Canada COVID-19 website: https://www.canada.ca/en/public health/services/diseases/coronavirus-disease-covid-19.html
• Chiefs of Ontario COVID-19 webpage: https://chiefsofontario.wordpress.com/
• Generic email for Indigenous Services Canada COVID-19 information: sac.covid19fnihbontario.isc@canada.ca
• List of Health Canada approved hand sanitizers: https://www.canada.ca/en/healthcanada/services/drugs-health-products/disinfectants/covid-19/hand-sanitizer.html
• Red Cross Support The Canadian Red Cross virtual help desk for Indigenous communities’ COVID-19 responses is available from 8 a.m. to 8 p.m. (CST), 7 days a week at: 1-833-937-1597.
• InfoPoint A single point of contact for credible and reliable info on COVID-19. Health managers can call or email to ask specific questions. Toll free: 1-855-446-2719 or Email: Infopoint@fnhma.ca