Region’s province-leading case count prompts new public health order

The Greater Sudbury region now has the dubious distinction of having one of the highest COVID-19 case counts in Ontario, even as provincial numbers are dropping.

The rapidly rising case count prompted the region’s medical officer of health, Dr. Penny Sutcliffe, to issue a new order around self-isolation in an effort to stop this new spread of the novel coronavirus. The new class order is enforceable by law.

In a news release this morning, Sutcliffe said the local pandemic trend is a “signal” to take action.

“While the province of Ontario is seeing improvements in COVID-19 case counts, trends in Greater Sudbury are going in the opposite direction. We are currently a COVID-19 hotspot, with a case rate that is among the highest in the province,” Sutcliffe wrote. “These trends signal a call to immediate action. 

“Now is the time for each of us to assess our individual actions and decisions and ramp up COVID-19 precautions — layer on the protective measures such as vaccination, masking, distancing, working from home, and importantly, staying home when even mildly unwell. We have the power in our hands to turn this around.

She continued, saying the number of cases without any identifiable source of exposure is particularly worrying.

“Locally, no single setting or sector is driving the current increase. The number of cases without any known source of exposure has increased over the last few months, which indicates a worrying trend of community spread of the virus,” Sutcliffe said.

She also touched on the number of active outbreaks in the area — seven currently, including outbreaks at Sudbury Jail (59 cases to date), Memorial Park (21 cases) and two schools (six cases). One school, École Ste-Marie in Azilda, was closed this week due to an outbreak.

Health Sciences North currently has the highest occupancy rate percentage among all Ontario hospitals with more than 100 acute care beds, Sutcliffe said.

“Our case count per 100,000 residents is among the highest in the province and the percentage of local COVID tests coming back positive is greater than it has been in weeks,” she said. “The seven-day rate of new cases was 82.5 per 100,000 population, compared with 17 for the province of Ontario.”

The higher the case count climbs, the higher the rate of hospitalization climbs, jeopardizing the ability of the local health-care system to respond to non-COVID-19-related patients.

Sutcliffe said she is not rolling back the provincial reopening framework locally, adding people can continue to “enjoy the benefits” of the government’s Plan to Safely Reopen Ontario, but only if “we strengthen our individual commitment to prevention.”

“Remember that the virus is not selective about who it infects. Any of us could catch COVID-19 and spread it to others — including to those who are more vulnerable, could be inconvenienced by self-isolation, or could develop ‘long COVID’,” Sutcliffe said. “As you make decisions about your day-to-day activities, including plans for outings and gatherings, think about the steps you can take to reduce the risk of COVID-19.”

She encouraged everyone to follow the now familiar steps of wearing a mask, hosting gatherings outdoors instead of indoors, physical distancing, self-screening for symptoms (and getting tested ASAP when symptoms develop), following self-isolation guidelines and, of course, getting vaccinated against COVID-19.

Sutcliffe said efforts to stop the spread and bring case counts back down requires the cooperation of the public as well as strong public health guidelines.

“We can only do this work effectively with the patience, kindness, and full cooperation of everyone we need to contact,” Sutcliffe said.

The full text of the new class order is below.

To: All persons residing or present in the area served by Sudbury & District Health Unit, operating as Public Health Sudbury & Districts who:

a) Are a confirmed case or probable case of COVID-19;

b) Have new symptoms (even mild symptoms) or worsening symptoms of COVID-19, have been tested for COVID-19 and are awaiting the results of their test;

c) Otherwise have reasonable grounds to believe they now have symptoms (even mild symptoms) of COVID-19, or have had such symptoms within the past 10 days; and have not had a COVID test since developing those symptoms;

d) Are a close contact of a person identified in a) even if they do not themselves have any symptoms of COVID-19;

e) Have been advised to self-isolate by Public Health Sudbury & Districts, including in circumstances other than those in a., b., c. or d. above; or

f) Are a parent, or person with responsibilities of a parent, of a person under 16 years of age in a), b), c), d) or e) who resides or is present in Public Health Sudbury & Districts.

I, Dr. Penny Sutcliffe, Medical Officer of Health for Public Health Sudbury & Districts, order   you to comply with the following actions:

1. Isolate yourself immediately in accordance with all instructions provided by Public Health Sudbury & Districts. This includes remaining in your home (in a private room if sharing with roommates or family members) or isolation facility. Do not go outside, unless on to a private balcony or enclosed yard where you can avoid close encounters with others. You must not have any visitors into your home except as permitted by Public Health Sudbury & Districts.
2. For persons in category a) above, you must remain in self-isolation:

• Until the expiry of the 10-day isolation period of communicability (infectiousness) which begins on the day on which you first show symptoms, are tested or are diagnosed with COVID-19 as directed by Public Health Sudbury & Districts or another health unit, or for a duration as otherwise directed by Public Health Sudbury & Districts or another health unit; as long as on the final day you are required to be in self-isolation you have no fever and your symptoms have been improving for at least 24 hours (48 hours if your symptoms are gastrointestinal, e.g., nausea, vomiting, diarrhea or stomach pain).
• If you have a fever and/or your other symptoms are not improving on the final day of self-isolation, contact Public Health Sudbury & Districts for direction at 705.522.9200 (toll-free 1.866.522.9200).

3. For persons in category b) above, you must remain in self-isolation until you receive a negative test result, have no fever and your symptoms have been improving for at least 24 hours (48 hours if your symptoms are gastrointestinal, e.g., nausea, vomiting, diarrhea or stomach pain). If you receive a positive result, you are then subject to this order as a person described in a) above.
4. For persons in category c) above:

• If tested, you must remain in self-isolation until you receive a negative test result, have no fever and your symptoms have been improving for at least 24 hours (48 hours if your symptoms are gastrointestinal, e.g., nausea, vomiting, diarrhea or stomach pain). If you receive a positive result, you are then subject to the order as a person described in a) above.
• If not tested for COVID-19, you are then subject to this order as a person described in a) above, i.e., as a probable case of COVID-19.

5. For persons in category d) above, remain in isolation, even if you are not experiencing any symptoms or have tested negative, until the expiry of a 10-day period that begins on the day you were last in close contact with a person identified in a) above, unless otherwise directed by Public Health Sudbury & Districts. The following also apply:

• If tested, and you receive a positive result, you are then subject to this order as a person described in category a) above; see paragraph 2 above for directions.
• If tested, and you receive a negative test result, complete the remaining 10-day period of isolation.
• If you develop symptoms and do not get tested, you are then subject to the order as a person described in category a) above, i.e., as a probable case of COVID-19.

6. For persons in category e) above, you must remain in self-isolation for the duration directed by Public Health Sudbury & Districts.
7. For persons in category f) above, you are to ensure that the child in a), b), c), d) or e)  above, for whom you have the responsibilities of a parent, follows the directions in this order which apply to them.
8. During the self-isolation period, conduct yourself in such a manner as not to expose another person to infection of COVID-19 by following infection control instructions on the  Public Health Ontario website located at https://www.publichealthontario.ca/en/diseases- and-conditions/infectious-diseases/respiratory-diseases/novel-coronavirus/public- resources, and as given to you by Public Health Sudbury & Districts or any other staff of a health care facility at which you may seek or receive treatment.
9. Inform Public Health Sudbury & Districts if you require any help or resources to properly self-isolate or while you are self-isolating such as food, medication, water, accommodation, clothing, appropriate medical treatment, and family or other religious arrangements. To do so, call 705.522.9200 (toll-free 1.866.522.9200).
10. Provide, immediately upon request, all information requested and follow any further directions provided to you by Public Health Sudbury & Districts and/or other public health staff pertaining to COVID-19 and/or the terms of this order.  This includes, but is not limited to, sharing the names and contact information for all contacts and such other information as may be requested by Public Health Sudbury & Districts and/or other public health staff to permit appropriate case and contact management for COVID-19.
11. During the periods described in 2, 3, 4, 5 and 6 above, remain reachable for monitoring and/or case and contact management by Public Health Sudbury & Districts and/or other public health staff.
12. Follow any further directions provided to you by Public Health Sudbury & Districts pertaining to COVID-19 and the terms and conditions of this order.
13. Seek prompt medical attention if your illness is worsening (for example, difficulty breathing) by calling 911 and report your COVID-19-related diagnosis, exposure, and/or symptoms.
14. The requirements of this order are subject to necessary modifications for persons or a class or persons, such as:

• a) A person or class of persons who, in the opinion of Public Health Sudbury & Districts, is asymptomatic and is required to provide an essential service**, using mandated PPE, for the limited purpose of providing that essential service;
• b) A person or class of person whose isolation, in the opinion of Public Health Sudbury & Districts, would not be in the public interest; or c) A person or class of persons who, for other reasons, as authorized by the Medical Officer of Health or designate, require modifications or this order.
• **essential service means clinical health care that would, in the opinion of the Medical Officer of Health, be severely compromised without the availability of the person or class of persons to provide the service.

15. If you have any questions about what you must do, contact Public Health Sudbury & Districts for direction at 705.522.9200 (toll-free 1.866.522.9200).