Ontario eases restrictions on long-term care residents, updates guidance to allow vaccine mixing

Ontario reported another 870 cases of COVID-19 on Thursday, as the province eased restrictions on long-term care residents and updatedits second-dose guidance for those who received a first shot of the AstraZeneca vaccine.

In a newsconference today, Ontario's Chief Medical Officer Dr. David Williams and Ontario's chief coroner Dr. Dirk Huyer provided an update onthe recent uptick in daily case counts the last few days.

A total of 699 cases were recorded Tuesday, 733 on Wednesday, and 870 today. Williams believes the slight increase could be attributed to the Victoria Day long weekend.

As per cent positivity decreased to 2.8 per cent, Williams said the data shows there's a possibility of 900 cases tomorrow.

"That's concerning as we watch this trend;hopefully we can turn that around," he said.

"I don't want to take away from the fact we've seen excellent improvement in our numbers, but the recent uptick is a bit concerning."

Since Monday, 44 people in Ontario have died of COVID-19.

While there are 546 people in the province's intensive care units, Williams noted that 15 of those were from Manitoba.

The province has administered 9.3 million vaccine doses so far.

As of June 9, residents of long-term care who have been fully vaccinated against COVID-19 can leave their homes for day and overnight trips.

As well,"brief hugs can now take place"regardless of the vaccination status of residents and visitors, the province said in a news release.

"Where both the resident and visitors are fully immunized, close physical contact, including hand holding, can now take place safely," it added.

For residents who have mobility or health issues, they are now allowed to have one visitor inside their facility, in addition to an essential caregiver, the province said.

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Meanwhile, today's total case count marks the fourth straight day with fewer than 1,000 new cases in the province, markedly lower thanlast Thursday, when 1,135 additional infections were confirmed. Because of the cyclical nature of testing in Ontario, it is most illuminating to compare the same day of the week.

Labs completed 34,277 tests and Public Health Ontario logged a positivity rate of 2.8 per cent also down from one week ago when the province reported a positivity rate of 3.6 per cent on 37,705 tests.

The seven-day average of daily cases fell to 940, its lowest point since since Nov. 2, 2020 and below the level seen between the second and third waves in Ontario.

Ontario's chief medical officer Dr. David Williams said in a news conference Thursday that the effects of the May long weekend can be seen in the recent uptick of cases in the last few days.

"Overall, trends continue to move in the right direction," he said.

He added hospitalizations were showing slow improvement, which is is "a better indicator." But the "R" number, or basic reproduction number is 0.74, lower than the preferred number of 0.8.

As of Wednesday, there were 729 people with COVID-related illnesses in hospitals, 546 of whom were being treated in intensive care units, the fewest in eight weeks. Of those, 370 needed a ventilator to breathe.

The Ministry of Health recorded the deaths of 10 more people with the illness, pushing the official toll to 8,801.

Public health units collectively administered another 150, 884 doses of COVID-19 vaccines on Wednesday. A total of 8,658,024 Ontarians, or about 58.7 per cent of the population,have now received at least one shot of a vaccine.

The province has begun publishing a more detailed breakdown of vaccination rates by age. The current snapshot of Ontarians who have had one shot looks like:

• Ages 80 and above: 94.6 per cent.
• 70-79 years old: 91 per cent.
• 60-69 years old: 85.1 per cent.
• 50-59 years old: 73.8 per cent.
• 40-49 years old: 65.8 per cent.
• 30-39 years old: 57.1 per cent.
• 18-29 years old: 50.9 per cent.
• 12-17 years old: 26.2 per cent.

That means that just shy of 70 per cent of adults, those aged 18 and older, have had a first shot.

Delta variant increasingly gaining foothold

Analysis from the Ontario COVID-19 Science Advisory Table showsthat the COVID-19 variant first identified in India, which the World Health Organization has labelled the "delta" variant, is spreading in the province.

The group estimates that the delta variant currently accounts for about 23 per cent of all new cases in Ontario.

While Ontario does not screen specifically for the delta variant, labs began sequencing some tests in early May and results suggest that in various regions, it has begun to displace the B117 variant which was first found in the United Kingdom and drove the third wave of the pandemic in Ontario as the dominant strain.

The delta variant is growing in urban centres, Williams said. Which is another reason why he wants to check next week's numbers before offering any advice on an earlier reopening.

One such area is Peel Region, where the science table estimates the delta variant will become dominant withina few weeks.

Dr. Lawrence Loh, the local medical officer of health in Peel, said in an interview this morning with CBC Radio that the delta variant appears to be even more transmissible than previous strains, and that research has found that a first dose of currently available COVID-19 vaccines is only about 33 per cent effective against it.

While still inconclusive, preliminary research also suggests it could result in more severe illness, Loh said.

During a news conference yesterday, Premier Doug Ford pointed to the delta variant as a primary reason for his decision to keep schools closed until September.

On the possibility of an earlier reopening, Williams said the low numbers were encouraging, but the "data is less promising this time" with the recent uptick.

"I hope we don't have a continuing rise. Getting over 1,000 again would be disappointing, he said.

He added a look at the numbers early next week would offer a better idea as to whether or not the province can reopen earlier.

Ontario moving ahead with mixing vaccines

Meanwhile, Ontarians who received a first shot of the AstraZeneca COVID-19 vaccine can opt to stick with it or choose to getPfizer or Modernafor their second dose, the province officially said Thursday.

The move was expected after the National Advisory Committee on Immunization (NACI) updated its guidance earlier this week to allow for mixing and matching of vaccines.

"Both second-dose options available to individuals who received their first dose of the AstraZeneca vaccine are safe and provide strong protection against COVID-19 and will count as a completed series," the province said in a news release.

"These second dose options will be provided at the recommended 12-week interval."

Starting tomorrow, June 4, individuals who received the AstraZeneca vaccine at least 12 weeks ago and wish to have a second shot of the same vaccinecan contact the pharmacy or physician who provided it for their subsequent dose.

Or, if they choose to get a dose of the Pfizer or Moderna vaccines, they can get a shot at a pharmacy that is offering those.

Beginning on June 7, those who got the AstraZeneca vaccine will be able to book their second of shot of either Pfizer or Moderna through the province's central system or via their local public health unit, depending on where they live.

"Combining similar vaccines from different manufacturers in a series is not a new concept. Different vaccine products have been safely and effectively used to complete vaccine series for influenza, hepatitis A, and others," the province said.

Officials in Ontario had already said they wanted to move ahead with mixing vaccines, but were waiting for NACI to revise its recommendations before going forward.

Ontario received a shipment of 254,500 doses of the AstraZeneca the week of May 18, and Health Minister Christine Elliott said this week that she expects they will be distributed to public health units imminently.

Officials also expect millions of doses of Pfizer through the month of June. The province is still awaiting a finalized delivery schedule for further shipments from Moderna, officials said at a briefing last week.

Ontario's chief coroner, Dr. Dirk Huyer, said in a press conference today there's plenty of evidence and clinical trials that show the second dose of the AstraZeneca vaccine offers protection from serious illness, hospitalization, and death at the 12 week interval.

While Williams assured that vaccine mixing is common,Huyer said the province is waiting on data for combining AstraZeneca and mRNA vaccines.

"We don't know the clinical evidence of immune protection with AstraZeneca and mRNA, the studies are notcomplete," Huyer said. "We do know when mRNA is given after AstraZeneca, there's more reaction, more side effects that occur."

Huyer added that the province would provide information based on the evidence and data as it comes in.

Earlier second doses based on supply, order in which first dose received

On accelerating second doses for Ontarians, Huyer added that people over age 80 are eligible to book now, and the next group to be eligible would be people aged 70 to 79.

Huyer said the groups next in line to get their second dose would be based off which groups got their first dose in order - notably people working in congregate settings and hot spots.

He also said vaccine supply will determine whether or not the groups "move closer" and are able to get their second doses sooner than later.