The city's top doc spoke to Greater Sudbury city council on Nov. 10, exactly eight months to the day since the city's first positive case of COVID-19.
Fast forward to Tuesday evening, the health unit had confirmed five more cases, including a pair of outbreaks bringing the total number of cases since March 10 to 186.
"Almost one-third of all of our local cases have been reported in the last week alone," said Dr. Penny Sutcliffe, chief medical officer of health, Public Health Sudbury and Districts. "So we are very suddenly thrust into the second wave of COVID-19 locally."
Statistics presented by Sutcliffe showed a sharp spike in test positivity, with a rate of 1.3 per cent and a case rate of 26 per 100,000 people.
"In the previous seven days we were seeing a rate of about one per 100,000," said Sutcliffe. "The tip of the iceberg is the cases and underneath the iceberg is all the additional work around contacts and careful followup and investigation. We are seeing about 12 contacts per case, some are more some are less but on an average (of 12)."
Highlighted by Sutcliffe on Tuesday was the age groups where cases seem to be becoming more frequent, as the health unit has seen more frequent cases among people in their 20s.
"We're seeing more younger people, people in their 20s, and this is maybe not unexpected or unusual, this has been seen in other parts of the province that hit this part of the wave sooner than we did," said Sutcliffe. "It really speaks to, I think, the need for young people to be social and to have connections, but also to make sure that they're aware of how to do that in a way that is safe."
The city's top doctor stressed the importance of following public health direction in order to limit community spread of the virus, and while she didn't recommend more strict enforcement at the municipal level, Sutcliffe cautioned that a lockdown could be necessary if the case numbers continue to climb.
"Really there's no one incident or smoking gun, but multiple incidents that arguably are preventable," said Sutcliffe. "Not preventable by high tech or really restrictive measures, but really preventable by very simple precautions that we've been talking about for the last eight months and that we've been practicing. Not a big lockdown, but of course that could be necessary if we don't get this better under control."
Ward 7 coun. Mike Jakubo raised the question of what level of enforcement does the health unit hold, should it be found that people who have been told to self-isolate due to a possible contact with COVID-19 choose not to do so.
"Is the health unit issuing an order to self-isolate and if so, how enforceable is that and how is that being followed up on?" asked Jakubo.
Sutcliffe said that there has been a tremendous level of cooperation when speaking with contacts and those who come in for COVID tests.
"People who we contact are forthcoming, they comply if we ask them to self-isolate, to get tested, share with us their contact information. We have not had a need to resort to what would be an order under the Health Protection and Promotion Act, but make no mistake I would not hesitate to do that if necessary to protect the health of our community," said Sutcliffe.
Jakubo questioned if enough was being done to get the messaging out to Greater Sudbury youth and educating them on how to prevent and protect themselves from the spread of COVID-19.
Sutcliffe was blunt in stating that not enough was being done at this time and that the health unit is currently working to improve their communication with Greater Sudbury youth.
"Are we doing everything we can? We are not and we need to do more; having said that we have done a lot through our social media, a lot through our work with schools, we have additional provincal and federally-funded public health nurses in schools and they're working closely on messaging," said Sutcliffe.
"We are in the midst and nearing the end of development of a program aimed at post-secondary and secondary aged youth and although there will be an aspect of it that is fear-based, it's factual-based in terms of relaying what the risks and the fears are because this is not only seriously impacting the health of older populations but can also have a very serious and sometimes deadly impact on younger populations."
One of the key messages from the program being developed by PHSD however, is strength-based and informing youth of what is in their control when it comes to the fight against COVID-19.
"Don't just tell them what not to do, but tell them how to do things in a way that will reduce their risk," said Sutcliffe. "It's not telling them not to do stuff, but if they are going to do something, here are key strategies that they can use."
Those strategies and more are among the myriad of talking points that are circulating the table at the Community Control Group (CCG) that was established in January and has been meeting regularly throughout the course of the pandemic.
The CCG, which includes Mayor Brian Bigger and leaders from the city, Health Sciences North, Public Health Sudbury & Districts, and the Greater Sudbury Police Service, reviews the local status of the virus, assesses response and takes action. Their role is to establish coordinated emergency action plans in Greater Sudbury.
For the past several months, the CCG has used scenario planning to develop a pandemic response strategy for the fall/winter. To develop the plan, the team used each of the three scenarios established by the Public Health Agency of Canada and the World Health Organization:
- Peaks and valleys: continuous waves throughout 2020 and 2021, with clusters of COVID cases in places like schools and workplaces.
- Fall peak: a large wave in the fall or winter followed by successive waves.
- Slow burn: ongoing spread of the virus through periodic cases, with no specific pattern.
The CCG determined objectives and key areas of focus for the four agencies, which will be used to monitor and act on these potential virus scenarios throughout the fall and winter. The objectives for fall/winter include:
- Hospital and long-term care capacity
- Community strategies for health, wellness and equity
- Human resources support
- Critical services at City, hospital, Public Health and police
- Supply chains and PPE
- Economy preservation and recovery
- Public order and safety
- Governance and finance
- Communications
“Close cooperation and awareness continue to be needed as winter approaches and the risk of COVID remains in our community," said Ed Archer, Chief Administrative Officer, City of Greater Sudbury
"We are in an emergency situation that continues to evolve. I thank city staff and our community partners for their ongoing commitment to responding thoughtfully, and keeping the health and safety of our community top of mind.”
The areas of focus for fall/winter include:
- Testing, resources to perform effective contact tracing and clearing people to return to work and school
- Keep people healthy and at work
- Provide community supports
- Increase uptake of flu vaccine
- Provide protection in long-term care
- Monitor supply chains
- Plan for other potential emergencies
“Early in this pandemic, we recognized the importance of having a coordinated, city-wide response guided by the experts at Public Health. That collaboration, paired with our community’s commitment to following public health advice, helped us make it through the first wave with relatively low case numbers and manageable hospitalization rates," said Joseph Nicholls, General Manager of Community Safety, City of Greater Sudbury.
"As the case numbers hit record highs, we need to go back to following those simple rules. They will keep us going for the long haul.”
