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Covid-19 Outbreak in Northern Waterloo Rural Communities

While Waterloo Region remains in the Red Zone during the second wave of the Covid-19 pandemic, the Region’s northern rural communities are experiencing an alarming uptick in new virus cases, and Public Health is working in several ways to stop the spread in its tracks.

According to a statement from the Region’s Public Health office, “In recent weeks, there has been a significant rise in illness and Covid-19 cases in rural northern Waterloo Region with an uncontrolled spread in Old Order, Markham, David Martin and Old Colony communities in particular, which represents a “significant threat to the health of those from these communities as well as to the broader population of the Region.”

Public health reported three more deaths and 131 more cases of the virus this past weekend and the virus has killed 14 more people since this second wave began in September, with 26 active current outbreaks, 453 active cases and 37 people in hospital, including 13 in intensive care.

One Kitchener hospital alone, St. Mary’s General Hospital, has just declared another outbreak – one on the fifth floor and the first one on the sixth floor (includes 13 patients and eight staff members) and Public Health is becoming alarmed with an increase in northern rural areas, especially among old order Mennonites.

Recently, Medical Officer of Health, Dr. Hsiu-Li Wang ordered Mennonite churches and parochial schools to close after infections soared to more than four times the regional rate in north Wellesley and they more than doubled the regional rate in Woolwich. The highest reported infection rates in rural Mennonite areas are the highest in the region, exceeding the region’s hardest-hit areas of Kitchener, Cambridge and Waterloo (for non-outbreak infections caused by close contact, travel or unknown spread.)

According to a statement Dr. Wang released on December 11, “cases, outbreaks and hospitalizations remain high in Waterloo Region but are not rapidly accelerating at this time. Instructions for workplaces and businesses under the Reopening Ontario Act (came) into effect on December 14 at 12:01 a.m.”

This follows Dr. Wang’s earlier implementation of Section 22 Class Order under the Health Protection and Promotion Act, on Nov. 30, enabling enforcement of public health orders in Old Order Mennonite Communities, with closures of schools and local churches in effect on Dec. 2. Under that order, people who do not comply could get a ticket anywhere from $750 or a court summons with fines up to $5,000 a day due to continued non-compliance.

In the past week, Public Health indicators have improved compared to the previous week, when indicators were at their highest levels, and are similar to where we were two weeks ago on Nov. 27, 2020. As for Nov. 30, there were 202 cases reported in North Wellesley and North Woolwich, with regional officials reporting infection rates in rural areas as having reached 1,778 per 100,000 people, compared to the regional rate itself of 609 per 100,000.

Regional Director of child, family and dental health – and public health spokesperson – Andrea Reist says, “there is a significantly higher incidence of positive cases in a few of the neighbourhoods, particularly in the rural north.”

Here’s a breakdown of the current numbers for outbreaks in rural northern part of the Region of Waterloo as of December 12:

Woolwich Rural North: 1902 cases per 100,000 with 134 cases out of 7045 people; Woolwich Rural East: 931.6 per 100,000 with 62 out of a population of 6655; Wellesley Rural North: 3730.5 per 100,000 with 161 infections out of 4316 people; Wellesley Rural South: 865.2 per 100,000 which is 32 cases out of 3699 people; Elmira: 902.1 per 100,000 with 106 cases per 11,751 people; St. Jacobs NR.

Reist cites statistics from the Region’s Public Health website dashboard, which shows that the numbers are quite high by comparison (https://www.regionofwaterloo.ca/en/health-and-wellness/coronavirus-media-briefing-notes.aspx ).

Waterloo Region – for comparison purposes – has 745 cases per 100,000 with 4387 infections out of 617,870 people.

The statement further reads: “We appreciate everyone who is working intensely to bring the spread under control . . . local COVID testing, voluntary closures of schools and churches when necessary, and ensuring that education and infection prevention and control measures are in place to reduce the likelihood of further spread of the virus.”

Despite those ongoing efforts, however, there has been a sharp increase over the month of November in the numbers of people with illness, and those testing positive for Covid-19 within those communities, which Public Health says was, “highly concerning.”

Dr. Wang’s statement reads: “Outbreaks in care homes, hospitalizations, and sadly, deaths, are lagging indicators, which means we start to see increases in these numbers in the following weeks after we have a rapid acceleration of cases.”

On December 10, Dr. Wang issued instructions to workplaces and businesses under the Reopening Ontario Act, to reinforce measures that will limit the spread of COVID19 in these settings. These instructions went into effect on December 14 at 12:01 a.m.

“I am issuing these instructions,” Wang’s statement says, “because we have seen as part of the second wave a significant number of outbreaks in these settings, and common areas of concern have been identified through our outbreak investigations and the education and enforcement blitz led by the Ministry of Labour that recently took place in our region.”

“Among other requirements, I am instructing these settings to: Conduct active screening of employees.  Prepare and implement a COVID-19 safety plan and designate a management person responsible for implementation and monitoring compliance to the plan. Ensure physical distancing throughout the workplace, including in employee-only areas. Optimize indoor air ventilation.”

The full details of the instructions are available at regionofwaterloo.ca/PH.

Now, Wang’s release states, is not the time to stop practicing public health measures: people must continue to avoid social gatherings with those outside their immediate household; limit non-essential trips outside the home; practice physical distancing; wear a face covering; wash hands frequently; and avoid enclosed, poorly ventilated spaces and crowded places (https://www.regionofwaterloo.ca/en/health-and-wellness/positive-cases-in-waterloo-region.aspx)

Waterloo Region was already in the RED-Control classification of the Keeping Ontario safe and Open Framework as of Monday, November 23, 2020.

Meanwhile, the rural infection rates have doubled regional rates, which has turned those rural areas into a pandemic hot spot.

“There are 45 neighbourhoods across Waterloo Region,” Reist says, “and you can see in that map that the rural northern area is one of the areas that’s got a really high incidence right now.”

Reist says that recent mapping data shows that some people in one community attended an event in another community and then brought the virus back with them and the inevitable spread that singular event was quite clear.

Right now, Reist says the focus is not on finger pointing or singling out any particular group of people for any reason; the focus is on identifying trends and doing public outreach and education through Public Health’s community partners, so they can get the word out and hopefully, stop the upward trend in recent weeks.

The goal for now, she says, is not issuing fines for non-compliance – except in the case of outright, blatant non-compliance – but, rather, to make sure people in those communities know the risks and closely follow Public Health’s safety protocols and recommendations in order to protect themselves and their communities at large.

Public Health, she says, will give those people every opportunity to comply but warns that they are taking this seriously for anyone who isn’t complying.

One example of that seriousness, she points out, centres around the recent closures of schools and churches in the Mennonite community.

“We have been out to do inspections to those schools and churches,” Reist says, “to ensure that they are complying with the orders and we’re really pleased to say that people are cooperating and endeavouring to abide by the orders.”

Whether it was the result of lack of information on the pandemic or willful stubbornness, Reist isn’t clear but does say that those added measures were, and still are, important because the outbreak numbers have risen so quickly in those areas.

“The majority of people have been (very) aware and when they have the information, they are seeking to comply with the requirements,” says Reist, “so certainly there is an element of ethical people helping them to understand the situation, what the implication are of not following (the guidelines) and being aware of the importance of following public health measures.”

Education, she says, goes a long way towards helping people with compliance and yes, some people may be a bit more hesitant or resistant to following those rules due to different views or misconceptions, not so much because of religious beliefs but simply because of where they happen to live.

The Mennonite community, she says, is a “very social community,” and so it’s important that they reduce or curtail social activity for a short period of time in order to get the spread of Covid-19 under control.

For now, Public Health will continue to send out information that everyone can access. In the coming weeks, Reist says, they are planning to do a teleconference meeting for the public, where people will have the opportunity to call in with their questions about the pandemic.

It should also be noted that, in the early stages of the pandemic, Public Health did not publicly disclose any data in those outlying, rural areas where population density is so small that any public reporting of new cases or outbreaks from those communities might compromise individual privacy concerns. Now that the numbers have risen significantly, the risk of inadvertently identifying someone and violating their privacy becomes much less of a possibility.

Anyone who has symptoms of Covid-19 should do the following: Get tested at a Covid-19 assessment centre (in Waterloo Region there is a temporary mobile testing unit operating the week of Dec. 14 that may come to the homes of those who face significant barriers to getting to assessment centres); stay home and self-isolate unless going to an assessment centre; tell people you were in close contact physical contact with in the 48 hours before your symptoms began to monitor their health and self-isolate; where you are not able to isolate from other members of your household, then your whole household will need to isolate together; seek medical attention if you become seriously ill.

For more information, please visit the Region of Waterloo Public Health website at https://www.regionofwaterloo.ca/

Written by Wayne Collins

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