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REPORT: Tracking of COVID-19 Outbreaks in Health Care Settings – Data Updated to July 13

Posted: July 23, 2020

(July 23, 2020)

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

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Introduction

Each number included in this tracking data represents a human being who is loved and who has experienced the terrible toll of COVID-19: staff who have gone to work despite the risk and the fear; residents and patients who have contracted COVID-19; families and communities who have lost their loved ones; staff who have made the ultimate sacrifice. You are in our hearts. To the media, the Public Health and Ministry staff who have been tracking and compiling this information for public scrutiny, thank you for your work. To all of you, we give our commitment to advocate to the best of our ability and to do everything we can do for the best protection and care for all affected.

This report is the result of many hours of work by our staff and volunteers.

A special thank you is due to the following volunteers who have gone above and beyond to help track the spread of COVID-19 in health care settings in their communities:

Nick Alpin, Rose Anderson, Roy Brady, Elyse Chaikalis, Rolf Gerstenberger, Matthew Gventer, Sue Hotte, Xiaohan (Erica) Hou, Dot Klein, Claire Lownie, Alma Martin, Mary Catherine McCarthy, Magee McGuire, Zaid Noorsumar, Veda Popal, Tracey Ramsey, Zoya Retiwalla, Shirley Roebuck, Mervyn Russell, Stuart Ryan, Samrin Sobahan, Bryan J. Smith, Jim Stewart, Jules Tupker

A special and heartfelt thank you also to Megan Lee, Riley Sanders and Salah Shadir, our intrepid and talented staff who have worked day and night to research, fact check and distribute these tracking report updates throughout the pandemic.

We are deeply grateful and we simply could not have continued to do this work without all of you. Thank you.

Natalie Mehra, Executive Director

 

Summary & Charts

Since the week of March 12, the Ontario Health Coalition has been tracking all people who have been infected with COVID-19 in outbreaks in health care settings including hospitals, long-term care, retirement homes, public health units, clinics and congregate care settings, as well as among other health professionals such as paramedics. This has become a gargantuan task but an important one because it enables us to see more fully than is possible from the government data where the spread in health care is happening and whether infection control measures are working to control it.

This report shows the trend from June 17 to July 13. There are notable changes. First, both Public Health Ontario and the Ministry of Long-Term Care have discontinued publishing on the website vital pieces of the data as listed below with no explanation. We are extremely concerned as there must be a consistent set of data to compare in order to see the trends. We cannot imagine what justification can be used for hiding the data that has been discontinued as it has been measured and publicized for months now. In terms of the spread of COVID-19, this period shows further evidence of a clear downward trend. Both the number of active outbreaks and the number of people (both residents/patients and staff) in health care settings with new infections have gone down, as they did four weeks ago. The death rate, however, is still climbing. However, the rate of increase in deaths, though still tragic and significant, has decreased from the previous four weeks.

Here are the key findings from the most recent tracking contained in this report of cases in health care settings across Ontario up to the afternoon of July 13:

  • Public Health Ontario has ceased to report the following in the daily epidemiologic report as of June 10[1]: the total number of health care workers infected, the numbers of confirmed cases by likely source of acquisition (exposure), and the total number of cases among retirement and hospital outbreaks. June 9 was the last time they included this information in the daily epidemiologic report. [2] It is still reported separately on the Weekly Epidemiologic Summary that was first released almost six months after Ontario started confirming COVID-19 cases (May 31 to June 6). [3] However, it does not specify how many cases are reported among staff as opposed to patients/residents, nor the total number of deaths, deaths among residents/patients, and deaths reported among staff. They have not provided any explanation for discontinuing the reporting of these vital pieces of data.
  • The Ministry of Long-Term Care data has also been changed. For the aggregate numbers, they are now only reporting the currently active cases each day in long-term care homes (see Chart 2) not the cumulative totals of residents and staff infected by COVID-19 in long-term care outbreaks to date. In their chart of outbreaks in long-term care homes they are now only reporting currently active cases and have discontinued reporting the totals to date. Again, there is no explanation for discontinuing this reporting.
  • The total number of people infected by COVID-19 in health and congregate care settings including staff and patients/residents is 11,357 as of July 13, up from 11,173 as of June 17. This total increased by 184 people or 1.6 percent in two weeks, approximately half the growth rate from the previous four weeks when the increase was 3.1 percent.
  • The total number outbreaks in health care and congregate care settings that the Ontario Health Coalition found as of July 13 is 694 (including 595 resolved) in 570 facilities including hospitals, long-term care homes, retirement homes, Public Health Units, clinics and other congregate care settings. As of June 17, we found 664 outbreaks (including 526 resolved) in 557 facilities. The number of outbreaks that are active across health care settings that we have found is now 99 compared to 138 four weeks prior (June 17, though we may not have been able to find all outbreaks as there is less public reporting now than there was in April through to early May).
  • We have added Chart A to show the new outbreaks that we have found since our last report on June 17. We have found 30 new outbreaks, 12 of which are from new long-term care homes, retirement homes, and hospitals that that did not previously have outbreaks. From these new outbreaks there are a total of 36 staff members who have contracted COVID-19 in health and congregate care settings, and 27 patients/residents. We found 1 resident deceased among the new outbreaks.
  • The total number of patients/residents that have been infected by COVID-19 in health and congregate care settings has also increased. By July 13 we have tracked a total of 6,934 patients/residents who have contracted COVID-19 in health and congregate care settings. This is an increase of 66 patients/residents in four weeks (since June 17) or 1.0 percent. This is down from the 2.3 percent increase we calculated between June 2 and June 17.
  • The total number of staff that have been infected by COVID-19 in health and congregate care settings has also increased. By July 13 we have tracked a total of 4,394 staff members who have contracted COVID-19 in health and congregate care settings. This is an increase of 115 staff in four weeks (since June 17) or 2.6 percent. This is down from the 4.2 percent increase we calculated between June 2 and June 17
  • Despite the decrease in infection rates, tragically, the death toll among patients, residents and staff in health and congregate care settings has continued to increase although the rate of increase has slowed. The Ontario Health Coalition is deeply sorry to report that as of July 13, we found a total of 2,153 patients and residents deceased in outbreaks in health and congregate care settings, up from 2,107 deceased as at June 17. That increase amounts to a heartbreaking 46 residents and patients over four weeks or an increase of 2.1 percent. This is down from the 9.8 percent increase we calculated between June 2 and June 17.

 

Note about Methodology: In order to compile this list, we have tracked the daily updates from the 34 Public Health Units in Ontario, including the epidemiological details and outbreak reports where they are publicly available. We have searched each facility name to identify whether it is long-term care or a retirement home and to find details about the cases reported in the aggregate numbers by Public Health Units. We have tracked and compiled media reports of outbreaks with details from across Ontario that contain credible source information (for example, they cited the Public Health Unit, long-term care home administration or hospital administration). Local Public Health Units report in different ways with varying levels of detail. Some do not provide breakdowns of staff/patients/residents. Local Public Health Units usually post outbreak reports for public hospitals, long-term care and retirement homes. The provincial-level information from Public Health Ontario does not include retirement homes or other health care and congregate care/living settings. We have tried to capture everything we can about retirement homes and other health care settings in addition to hospitals (public and private) and long-term care homes using the methodology outlined here. We have not been able to catch up on shelters, group homes and all the various congregate care settings. For that we apologize and will try to capture as much as we can going forward. It is not clear why Public Health Ontario’s numbers for the outbreaks in long-term care and public hospitals are lower than ours. We have repeatedly checked ours for accuracy and we have provided information in the most transparent way possible. In addition, Public Health Units are reporting retirement home outbreaks separately and these numbers should be available to Public Health Ontario but Public Health Ontario does not report the aggregate numbers for retirement homes. Given the number of outbreaks in these private for-profit homes, it is important that the spread in them is also tracked and that they are subject to improved public health measures (and the support needed) to protect residents and staff. Overall, we have tracked every individual case and report in the most credible manner possible and have included sources for each report in the footnotes.

[1] Daily Epidemiologic Summary. Public Health Ontario. June 10, 2020. Note: it is not clear why the case numbers do not add up to the totals. These are Public Health’s numbers.

[2] Daily Epidemiologic Summary. Public Health Ontario. June 9, 2020. Note: it is not clear why the case numbers do not add up to the totals. These are Public Health’s numbers.

[3] COVID-19 in Ontario: Focus on May 31, 2020 to June 6, 2020. Public Health Ontario. https://covid-19.ontario.ca/covid-19-epidemiologic-summaries-public-health-ontario#weekly

 

Chart A:

Chart 1:

Chart 2:

 

Chart 3:

Click here for full report