REPORT: Tracking of COVID-19 Outbreaks in Non-Health Care Settings – Data Updated to October 28

Posted: November 3, 2020

(November 3, 2020)

Click here for full version of the non-health care outbreaks report with a list of all outbreaks. A summary of the report can be found below.

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Introduction

COVID-19 cases in Ontario’s general population hit an all-time high in this period both in single day total positive cases and in the rolling averages, increasing 24% in two weeks from October 13, 2020[1], to October 28, 2020[2]. Yet clear data on how the virus is being transmitted amongst the general population is still not available. Peel, with the highest rate of case positivity (6.5 percent of people tested are testing positive) did not contact trace 16.9 percent of the cases in the last week of October. In other areas considered “hot spots” the state of contact tracing ranges widely. In the last week of October, the percentage of COVID-positive cases that have not been contact traced are: Toronto 65 percent; Durham 27.5 percent; Ottawa 48.8 percent; Peel 16.9 percent.[3] During the two week period ending October 28, and limited by the poor contact tracing,  Public Health Ontario tracked an increase of 14.49% in non-health care workplace outbreak cases. [4] [5]  This report looks more deeply at the spread of COVID-19 in those workplace settings that are not health care settings. (We are releasing a separate report on outbreaks in health care settings.)

Clear information to the public about where they are most at risk is still not being provided, but the available data, incomplete as it is, gives some insight into the trends. Even with insufficient reporting in almost all public health units we were able to find that several industries are far surpassing the increase in cases in the general public.  Cases in school have grown the most significantly, increasing 67.76% in two weeks while general community spread increased 24% in those same two weeks. Retail outbreaks have continued to grow at a rate of 27.97% in this reporting period and outbreaks public services have also grown at a rate of 26.34% in this report. Developmental services have also seen a significant increase, increasing 21.26% in two weeks.

While the Ontario government is reporting all cases in schools on their website, they are only classifying 233 cases[6] out of 2,001 cases in schools[7] as being a part of an outbreak.  The government has adopted a different definition of “outbreak” in schools, requiring a known epi-link,[8] which means proven, direct contact or exposure between cases. But students and teachers share washrooms, playgrounds, gyms, locker spaces and lunch rooms. The bottom line is that growth in the numbers of cases in schools is far higher than in the general public. There is no explanation for this in the Public Health data that has been released. Currently, they are declaring that only 11.6% of cases in schools are the result of an outbreak. Outbreak protocols in schools include the isolation of potentially exposed students or a partial or full school dismissal. As the second wave is progressing we are seeing more and more schools remaining open with multiple cases in both students and staff. There is no way to verify the quality and thoroughness of contact tracing that is being done in schools but the growth in school COVID-positive case numbers which are so much higher than the general population raise questions about what is happening.

The report below includes the data that is available on outbreaks in workplaces that are not health care settings. In a separate report, also released today, we dig more deeply into outbreaks in health care settings. In the latter report, we can see that the general population spread is now seriously impacting long-term care, retirement homes and hospitals. Yet while a full opening is being planned, even with the highest case numbers per day that our province has yet seen and with case numbers and deaths increasing among the most vulnerable populations, there remains no plan to disclose information that would enable people in an “open market” to be able to make informed choices to reduce their most risky behaviour and contacts. There appears to be no plan to improve public information and data about where transmission is occurring, to provide resources for contact tracing in Toronto and other hot spots, or to require the release of information about outbreaks in workplaces. This raises serious questions: what is the goal of Ontario’s COVID response? What are the plans for the sectors that are seeing increases far above the general population’s? If the market is going to be allowed to rule, and we are not condoning this approach, then why cannot people be given full information to make safer choices?

Even with our best efforts at tracking, we were only able to find a small portion of cases in workplace outbreaks by name of the facility, because only Hamilton Public Health is reporting all local workplace outbreaks.  Ottawa and York are reporting congregate care (Developmental Homes and Social Services), Windsor-Essex and Chatham Kent are reporting agriculture cases and Toronto is not reporting any workplace outbreaks at all outside of schools, long-term care, retirement homes and homeless shelters.

*Public Health Ontario is now reporting some cases associated with school outbreaks, however their definition of a school outbreak requires a known epi link (same class or direct contact) and does not reflect the number of cases in schools even when there are multiple cases in the same school.

**Other is defined as any workplace open to the public (i.e. restaurants, community centres).

This total includes cases that we had previously tracked plus all of the cases that the province is reporting since September.  We have also included outbreaks in faith schools, administrative offices, student residences and private schools in our total.

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[1] Weekly Epidemiologic Summary. Public Health Ontario. October 13 2020. https://www.publichealthontario.ca/-/media/documents/ncov/epi/2020/10/covid-19-weekly-epi-summary-report-oct-10.pdf?la=en

[2] Weekly Epidemiologic Summary. Public Health Ontario. October 28 2020. https://www.publichealthontario.ca/-/media/documents/ncov/epi/covid-19-weekly-epi-summary-report.pdf?la=en

[3] Declerq, Katherine. New modelling shows where COVID-19 outbreaks are happening in hot spots CTV Toronto October 29 2020 https://toronto.ctvnews.ca/new-modelling-shows-where-covid-19-outbreaks-are-happening-in-hot-spots-1.5165764

[4] Weekly Epidemiologic Summary. Public Health Ontario. October 13 2020. https://www.publichealthontario.ca/-/media/documents/ncov/epi/2020/10/covid-19-weekly-epi-summary-report-oct-10.pdf?la=en

[5] Weekly Epidemiologic Summary. Public Health Ontario. October 28 2020. https://www.publichealthontario.ca/-/media/documents/ncov/epi/covid-19-weekly-epi-summary-report.pdf?la=en

[6] Weekly Epidemiologic Summary. Public Health Ontario. October 28 2020. https://www.publichealthontario.ca/-/media/documents/ncov/epi/covid-19-weekly-epi-summary-report.pdf?la=en

[7] Government of Ontario Ministry of Health. COVID19 cases in schools and child care centres. October 15 2020. https://www.ontario.ca/page/covid-19-cases-schools-and-child-care-centres

[8] An outbreak in a school is defined as two or more lab-confirmed COVID-19 cases in students and/or staff (or other visitors) in a school with an epidemiological link, within a 14-day period, where at least one case could have reasonably acquired their infection* in the school (including transportation and before/after school care).

[9] Epidemiological Summary. Public Health Ontario.  September 22 2020. https://www.publichealthontario.ca/-/media/documents/ncov/epi/covid-19-weekly-epi-summary-report.pdf?la=en

A printable version of the full report can be found here.