REPORT: COVID-19 Outbreaks in Non-Healthcare Settings – Data Updated to November 18

Posted: November 30, 2020

(November 30, 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

As Ontario introduces new measures to try to minimize the spread of COVID-19 with Peel and Toronto entering lockdown and Hamilton, Waterloo, Durham, Halton and York enforcing stricter regulations, it is important to evaluate the spread of the disease among our community and non-health care workplaces in the weeks leading up to the lockdown on November 23. This report looks at outbreaks in non-health care settings through the first three weeks of November. (We regularly issue a separate report on outbreaks in health care settings which is available on our website here along with the previous reports dating back through the pandemic for both health and non-health care settings: https://www.ontariohealthcoalition.ca/index.php/resources-analysiscovid-19-resources-analysis-of-the-ford-governments-response/.) In this period (October 31 to November 18) the spread of COVID-19 significantly worsened. The numbers of people infected in workplace outbreaks far exceeds the general community spread of the virus in the following workplace sectors: construction; schools and daycares; retail, restaurants and entertainment; and public services.

From October 31^st to November 18^th, cases among the general population increased 22.97% and daily cases had reached a new high at the end of October with a rolling seven-day average of 878 per day[1]. That record has been broken and we are now seeing the highest rate of spread ever. For the week of November 18^th, the rolling average is sitting at 1,369 per day[2].  Due to the way that the provincial government has chosen to define school outbreaks, Public Health has reported an 18% increase in cases in workplaces (excluding health care settings) during this time period. However, that percentage only included an increase of 573 cases (for a cumulative total to date of 843) among schools and childcare settings (as per their definition of outbreak). The province’s tracking of actual cases in schools shows an increase of 1865 cases (for a cumulative total to date of 4,265 cases) among students and education workers as well 639 cases in childcare settings in this period.  Using the increase in the total numbers in schools, we calculate an increase of 39.74% cases in non-health care industries overall in this three-week period (October 31 – November 18). Using the increase in the total numbers in schools, we calculate an increase of 39.74% cases in non-health care industries overall in this three-week period (October 31 – November 18). Among the highest growth rates in COVID-positive cases we found in workplaces, there was a large outbreak in a construction site in Waterloo, which increased the relatively small number of cases we had tracked in construction by 220%. Aside from this, the biggest growth in cases is in schools and childcare settings where they increased 86.9%; followed by retail, restaurants and entertainment which increased 71.65%; and public services which increased 39.14%.  This data is footnoted in the chart below.

Deaths among workplace outbreaks are not included in the provincial epidemiologic data and are not reported unless media find them through another method. We are deeply saddened to report two new deaths among workers in non-health care settings with the death of a child and youth worker employed by the Toronto District School Board[3] as well as the death of Renato Battisti, a cook aboard a chemical tanker docked in Sarnia after an outbreak occurred on board.[4] There are undoubtedly many more that are not publicly known.

Cases in schools continue to outpace the rate of infection in the general public at an alarming rate, and the definition of school outbreak (two or more cases among students or staff with a proven epi-link) underrepresents the issue. There are high numbers of students in classrooms and multiple shared spaces such as bathrooms, recess spaces, school buses. Thus, the low numbers of cases categorized as “outbreaks” among the high number of actual school cases each week may be misleading the public about the growth of COVID-19 among school children and education workers. Since the opening of schools, the number of people who contracted COVID-19 in school and childcare outbreaks included 843 cases (as per their definition of outbreak). As noted above, looking at provincial tracking of actual cases in schools we found 3,626 cases among students and education workers as well 639 cases in childcare settings.

As of the publication of this report, the province and most local Public Health Units are still not reporting the names of businesses with outbreaks. This has contributed to false claims that there is no evidence of transmission in restaurants, retail and entertainment industries. In fact, the number of cases in this sector has increased by 71.65%, far above the number of cases in workplace outbreaks overall, which we found in this period (October 31 – November 18) to be 39.74%.  Only the Hamilton Public Health Unit is reporting the names of all businesses with outbreaks. Shoppers Drug Mart is voluntarily reporting, and it has reported there were 35 cases in Shoppers Drug Marts, primarily in COVID hotspots, from October 31- November 18 and while writing this report, there have been 19 cases in the last five days from November 21-26[5]. The LCBO, comparatively, has reported 3 cases during the same reporting period[6].

Additionally, Ontario’s Premier Doug Ford has also announced that he plans on pushing the federal government to lift the requirement for two-week quarantine after international travel, stating that he would go forward with implementing a replacement protocol if he is unable to get support from Prime Minister Trudeau.[7]  It is important to note that 80% of travellers who have entered Canada have been exempt from the two week quarantine as exemptions were made for truck drivers, emergency response personnel and flight services.[8]  During the first wave of COVID-19, tragically, 10 Toronto Pearson Limo Driver’s passed away from COVID-19 (6 of them were confirmed positive and 4 of them were suspected).[9]

The lack of clear, accessible public data on where transmission is occurring continues to be a problem but the Institute of Clinical Evaluative Sciences (ICES) has released a very useful COVID-19 Dashboard where Ontarians can search their postal codes test positivity and testing rate, accessible here : https://www.ices.on.ca/DAS/AHRQ/COVID-19-Dashboard. At November 25, they report that the Public Health Units with the highest percent positivity rates are: Peel (10.2%), Toronto (6%), York (5.8%), Windsor-Essex (4%), Halton (3.6%), Waterloo (3.5%) and Durham (3.3%).  They have also shown that there is a significant variance among neighbourhoods, with four postal codes in Peel and three in Toronto with 15-20 % test positivity[10].  To put this into perspective, New York, which was one of the worst hit areas in North America during the first wave, has seen positivity rates in the 2.5-3% range and in keeping with international standards, if the positivity rate exceeds the tipping point of 3%, New York will close schools, go into virtual learning and be in lockdown.[11]

During the week of this report, 35.4%[12] of COVID-19 cases had not been traced back to a source.  These unknown exposure sources have been increasing during the second wave as public health units in hotspots have been unable to keep up with contact tracing[13].  The auditor general’s report revealed that in the period of her study it took Toronto 4 days to contact someone after testing positive for COVID-19, Ottawa 4.5 Days, Peel 3.25 Days and York 2.25 Days, during which time there is potential for further spread of the virus.[14]  We are calling on the Ford government to give Public Health adequate resources to contact trace and quarantine effectively and to provide transparent reporting so that Ontarians can make informed decisions about their health.

*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.

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] Davidson, Sean. Ontario Hits Highest Seven Day Average of COVID-19 since the Pandemic Began. CTV News. October 26 2020. https://toronto.ctvnews.ca/ontario-hits-highest-seven-day-average-of-covid-19-cases-since-pandemic-began-1.5160872

[2] Wilson, Codi. Ford warns ‘tough’ measures coming for COVID-19 hot spots as province reports another 1,210 cases, 28 deaths. CP24. November 19 2020. https://www.cp24.com/news/ford-warns-tough-measures-coming-for-covid-19-hot-spots-as-province-reports-another-1-210-cases-28-deaths-1.5195858

[3] Rodrigues, Gabby. Coronavirus: Staff member at Toronto School dies from COVID-19. Global News. November 18 2020. https://globalnews.ca/news/7469772/toronto-school-child-youth-worker-dies-covid19-coronavirus

[4] Bridge, Terry. Canada’s first COVID-19 casualty in the shipping industry docked in Sarnia. The Observer. November 5 2020. https://www.theobserver.ca/news/local-news/cook-taken-from-ship-in-sarnia-dies-from-covid-19-reports

[5] Metro COVID-19 Tracker. Metro. October 15, 2020. https://corpo.metro.ca/en/archives-cases-covid-on/august-on.html

[6] LCBO. November 25 2020. COVID-19 Statement. https://www.lcbo.com/content/lcbo/en/homepage/statement-on-lcbo-employee-testing-positive-for-covid-19.html

[7] Katawazi, Miriam.  Ontario pushing to drop 14-day quarantine for travellers. Here’s what would replace it. CTV News. November 9 2020 https://toronto.ctvnews.ca/ontario-pushing-to-drop-14-day-quarantine-for-travellers-here-s-what-would-replace-it-1.5181322

[8] Harris, Sophia. Majority of travellers entering Canada during COVID-19 given OK to not quarantine. November 18. CBC News. https://www.cbc.ca/amp/1.5804848?__vfz=medium%3Dsharebar&__twitter_impression=true&s=07&fbclid=IwAR28K5fqWuPfNb6hiAjzuzwxT6_gfKOi3OYRehQc-GD6C91bRjsqdMc3UiU

[9] Fox, Chris. Six taxi and limo drivers working out of Pearson Airport have died of COVID-19. May 6 2020. CTV Toronto. https://toronto.ctvnews.ca/six-taxi-and-limo-drivers-working-out-of-toronto-pearson-airport-have-died-of-covid-19-1.4927304#:~:text=At%20least%20six%20taxi%20and,COVID%2D19%2C%20union%20says.&text=NOW%20PLAYING-,At%20least%20six%20taxi%20and%20limo%20drivers%20working%20out%20of,testing%20positive%20for%20COVID%2D19

[10] IC/ES. COVID-19 Dashboard. November 25 2020 https://www.ices.on.ca/DAS/AHRQ/COVID-19-Dashboard

[11] Millman Jennifer.  NYC on Verge of ‘Full-Blown’ 2nd Wave as Positivity Rate Nears School Shutdown Mark. November 10 2020 https://www.nbcnewyork.com/news/coronavirus/this-is-our-last-chance-nyc-mayors-pleas-to-stop-2nd-wave-avoid-new-closures-grow-urgent/2714495/

[12] Epidemiological Summary. Public Health Ontario.  November 18 2020. https://www.publichealthontario.ca/-/media/documents/ncov/epi/covid-19-weekly-epi-summary-report.pdf?la=en

[13] Epidemiological Summary. Public Health Ontario.  November 18 2020. https://www.publichealthontario.ca/-/media/documents/ncov/epi/covid-19-weekly-epi-summary-report.pdf?la=en

[14] Crawley, Mike. Delays, conflicts and confusion hampered Ontario’s COVID-19 response: auditor general

CBC News. November 25 2020. https://www.cbc.ca/news/canada/toronto/ontario-covid-19-lab-testing-case-management-auditor-report-1.5814949

[15] Epidemiological Summary. Public Health Ontario.  November 3 2020. https://www.publichealthontario.ca/-/media/documents/ncov/epi/covid-19-weekly-epi-summary-report.pdf?la=en

[16] Epidemiological Summary. Public Health Ontario.  November 18 2020. https://www.publichealthontario.ca/-/media/documents/ncov/epi/covid-19-weekly-epi-summary-report.pdf?la=en