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Ministry of Health coronavirus situation report #443

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Situation:

Case count as of June 3, 2021 / Nombre de cas le 3 juin 2021

Area / Région Area / Région Change from yesterday / Changement par rapport à hier Deaths / Décès Change from yesterday / Changement par rapport à hier
Canada* 1 385 278 + 2 064 25 612 +  46
Ontario** 533 761 +  870 + 8 801 +  10

* Numbers from PHAC current as of 7 p.m. yesterday / Chiffres de l’ASPC à jour à 19h hier.

** Ontario current as of 3 p.m. yesterday / Chiffres de l’Ontario à jour à 15h hier.

 

Ontario:

Vaccination* Vaccination Yesterday / Hier
Cumulative vaccine doses administered Nombre total de doses de vaccin administrées 9 493 005
Confirmed Cases Cas confirmés Data Source / Source des données Yesterday / Hier 7-day % change /
% de changement sur 7 jours
Cumulative Cases Nombre cumulatif de cas CCM / SPGCC 533 761 1%
Health Sector Worker Cases Nombre de cas chez les travailleurs du secteur de la santé CCM / SPGCC 23 289 1%

7 day confirmed cases and deaths / Cas confirmes en 7 jour

Graph: 7 day confirmed cases June 3: 1273, 1057, 1033, 916, 699, 733, 870 Graph: 7 day confirmed deaths June 3: 14, 15, 18, 13, 9, 25, 10

Cumulative Resolved Nombre cumulatif de cas résolus CCM / SPGCC 514 999 3%
Cumulative Deaths Nombre cumulatif de décès CCM / SPGCC 8 801 1%
Long-Term Care Home Residents Nombre de décès de résidents des CSLD  Ontario.ca: Status of COVID-19 cases in LTCH Ontario.ca: État des cas de COVID-19 en FSLD
Retirement Home Residents Nombre de décès de résidents des maisons de retraite  RHRA Dashboard Tableau de bord de l’ORMR
Health Sector Worker Nombre de décès de travailleurs du secteur de la santé CCM / SPGCC   18 0%
Daily Count / Nombre quotidien
Effective Reproduction Number (Rt)* and Confidence Interval Taux de reproduction effectif (Re)* et intervalle de confiance Data Source / Source des données May 28, 2021 – June 3, 2021 / 28 mai, 2021 – 3 juin, 2021 May 26, 2021 – June 1, 2021 / 26 mai, 2021 – 1 juin, 2021
Ontario Ontario PHO / SPO 0.77 [0.75 – 0.79] 0.74 [0.72 – 0.75]
North Nord PHO / SPO 1.00 [0.90 – 1.11] 0.91 [0.81 – 1.01]
Eastern Est PHO / SPO 0.84 [0.77 – 0.92] 0.83 [0.76 – 0.91]
Central East Centre-Est PHO / SPO 0.71 [0.69 – 0.74] 0.70 [0.68 – 0.73]
Toronto Toronto PHO / SPO 0.73 [0.70 – 0.77] 0.68 [0.65 – 0.72]
South West Sud-Ouest PHO / SPO 0.83 [0.76 – 0.91] 0.79 [0.72 – 0.86]
Central West Centre-Ouest PHO / SPO 0.85 [0.81 – 0.90] 0.79 [0.75 – 0.84]
Testing Dépistage Yesterday / Hier 7-day average /
Moyenne de 7 jours
Daily tests completed Dépistages quotidiens effectués NOC / COR 34 277 29 360
% positivity % de positivité NOC / COR 2.8% 3.5%
Tests in process Analyses en cours NOC / COR 15 700 13 813

Daily Count 7-day % positivity / Nombre quotidien

Graph: 7 day percent positivity June 3: 3.4, 3.6, 4.2, 4.3, 3.6, 2.8, 2.8

Daily Count / Nombre quotidien
Acute Care Soins aigus Data Source / Source des données Yesterday / Hier 7-day % change /
% de changement sur 7 jours
Confirmed patients hospitalized Cas confirmés hospitalisés dBCS / RqL 729 -32%
Cumulative hospitalized health sector workers Nombre cumulatif de travailleurs du secteur de la santé hospitalisés CCM / SPGCC 447 1%
Cumulative health sector workers in ICU Nombre cumulatifs de travailleurs du secteur de la santé aux soins intensifs CCM / SPGCC                         97 1%
7-day average /
Moyenne de 7 jours
Current vented patients (includes COVID+) Patients actuellement branchés à un respirateur (incluent les COVID+) CCSO / SOSMPC 851                       871
CRCI Vented COVID+ sur respirateur CCSO / SOSMPC 371                       408
Daily Count / Nombre quotidien

Daily Count current confirmed cases hospitalized / Nombre quotidien

Graph: Current confirmed cases hospitalized June 3: 1023, 934, 749, 731, 804, 708, 729

Congregate Care / Habitations collectives

Active Outbreaks Éclosions actives Data Source / Source des données Yesterday / Hier 7-day average /
Moyenne de 7 jours
LTCH FLSD CCM / SPGCC 23 27
RH MR CCM / SPGCC 12 16
Hospital Hôpital CCM / SPGCC 8 15
Congregate Living / Hébergement collectif
Group Homes / Supportive Housing Foyers de groupe / logement avec services de soutien CCM / SPGCC 28 29
Shelter Refuge CCM / SPGCC 13 17
Correctional Facilities Établissements correctionnels CCM / SPGCC 5 5
Short-term Accommodation Logement temporaire CCM / SPGCC 0 0
Other congregate Autre hébergement collectif CCM / SPGCC 5 5
Education / Éducation
Childcare Garde d’enfants CCM / SPGCC 34 48
Elementary school École élémentaire CCM / SPGCC 4 4
Secondary school École secondaire CCM / SPGCC 1 1
Elementary/Secondary school École élémentaire/secondaire CCM / SPGCC 0 0
Post-Secondary Postsecondaire CCM / SPGCC 4 4
Workplaces / Lieu de travail
Farm Exploitation agricole CCM / SPGCC 5 7
Food Processing Transformation alimentaire CCM / SPGCC 8 9
Retail Vente au détail CCM / SPGCC 29 35
Medical/Health Service Service médical / de santé CCM / SPGCC 6 6
Other Workplace Autre lieu de travail CCM / SPGCC 119 140
Recreational / Loisir
Bar / Restaurant / Nightclub Bar / restaurant / boîte de nuit CCM / SPGCC 14 17
Recreational Fitness Activités de conditionnement physique récréatives CCM / SPGCC 2 3
Personal Service Setting Établissement de services personnels CCM / SPGCC 0 0
Other recreational setting Autre établissement de loisir CCM / SPGCC 9 11
Other / Autre
Other Autre CCM / SPGCC 4 4
Undefined Indéfini CCM / SPGCC 4 5
CCM = Provincial Case and Contact Management Solution; PHO = Public Health Ontario; NOC = COVID19 Provincial Diagnostic Network Operations Centre; CCSO = Critical Care Services Ontario; dBCS = Daily Bed Census; CRCI = COVID-Related Critical Illness (COVID-Related Critical Illness (CRCI) is defined as: Admission to the ICU because of a clinical syndrome consistent with COVID, AND the patient has had a positive test that is consistent with acute COVID illness. COVID+ is a sub-set of CRCI patients whose last COVID test was positive.)

*Effective reproduction number (Rt) is updated twice weekly and not daily.  Rt is not calculated for PHU Regions with case counts < 12 over the reporting period.

SPGCC= Système provincial de gestion des cas et des contacts; SPO = Santé publique Ontario; COR = Centre des opérations du réseau provincial de diagnostic de la COVID-19; SOSMPC = Services ontariens des soins aux malades en phase critique; RqL = Recensement quotidien des lits; MGLC = maladie grave liée à la COVID-19 ( une maladie grave liée à la COVID-19 s’entend d’une maladie entraînant l’admission aux soins intensifs en raison d’un syndrome clinique correspondant à la COVID-19, ET le résultat du dépistage concorde avec une COVID-19 active. COVID+ est une série secondaire de patients dont le dernier dépistage de la COVID a été positif.)

*Le taux de reproduction effectif (Re) est mis à jour deux fois par semaine et non pas quotidiennement. Le Re n’est pas calculé pour les régions desservies par les BSP enregistrant < 12 cas pendant la période visée par le rapport.

Data are provided in English format / Le format des chiffres est le format anglo-saxon

Update

  • Ontario Updating AstraZeneca Second Dose Guidance. The Ontario government, in consultation with the Chief Medical Officer of Health and other health experts, is providing updated guidance for individuals who received the first dose of the AstraZeneca vaccine and who have not yet received their second dose, to allow for the mixing of COVID-19 vaccines if desired. This decision is in alignment with updated guidance from the National Advisory Committee on Immunization (NACI) recommendation.
  • Considerations for Antigen Point-of-Care Testing has been updated and is available on the Ministry’s website.
  • Given the international reports and attention relating to myocarditis and pericarditis following vaccination with mRNA COVID-19 vaccines, the Public Health Agency of Canada has prepared the attached communique. COVID-19 vaccines continue to be recommended. More information will be shared as it becomes available. To report an Adverse Event Following Immunization in Ontario, please complete the Ontario AEFI reporting form and send this to your local Public Health Unit.

Mise à jour

  • L’Ontario met à jour les directives concernant la seconde dose d’AstraZeneca. Le gouvernement de l’Ontario, en consultation avec le médecin hygiéniste en chef et d’autres experts de la santé, fournit des directives mises à jour pour les personnes qui ont reçu la première dose du vaccin d’AstraZeneca et qui n’ont pas encore reçu leur seconde dose, afin de permettre la combinaison des vaccins contre la COVID-19, si elles le souhaitent. Cette décision est conforme aux recommandations mises à jour du Comité consultatif national de l’immunisation (CCNI).
  • Facteurs à considérer pour les tests antigéniques au point de service a été mis à jour et affiché sur le site Web du ministère.
  • Compte tenu des rapports internationaux et de l’attention accordée à la myocardite et à la péricardite à la suite de la vaccination avec les vaccins contre la COVID-19 à ARNm, l’Agence de la santé publique du Canada a préparé le communiqué ci-joint. Les vaccins contre la COVID-19 continuent d’être recommandés. D’autres renseignements seront communiqués dès qu’ils seront disponibles. Pour signaler une manifestation clinique inhabituelle à la suite d’une immunisation en Ontario, veuillez remplir le formulaire de déclaration de manifestations cliniques inhabituelles à la suite d’une immunisation en Ontario et l’envoyer à votre circonscription sanitaire locale.

 

Looking for more information?

 

Vous cherchez d’autres renseignements?

 

Communique to health practitioners

Reports of Myocarditis/pericarditis after COVID-19 vaccination (June 3, 2021).

Printable PDF version.

Background

In May 2021, international reports1 of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the lining around the heart) following vaccination with COVID-19 mRNA vaccines emerged, including from Israel and the United States2.

Available information indicates that:

  • Cases were more commonly reported after the second dose
  • Symptom onset was typically within several days after vaccination
  • Cases were mainly adolescents and young adults
  • Cases were more often males compared to females
  • Cases experienced mild illness, responded well to conservative treatment and rest, and their symptoms improved

Follow-up on these cases is ongoing. No clear association has been established between myocarditis/pericarditis and mRNA vaccines, and to date, no regulatory action has been taken in Canada or internationally.

 

 

Situation in Canada

As part of ongoing COVID-19 vaccine safety efforts, the Public Health Agency of Canada (PHAC) and Health Canada are closely monitoring myocarditis/pericarditis in passive and active Canadian safety surveillance systems, including the Canadian Adverse Events Following Immunization Surveillance System (CAEFISS)3, the Canada Vigilance Program (CV)4, the Canadian National Vaccine Safety Network (CANVAS)5 and the Canadian Immunization Monitoring Program ACTive (IMPACT)6.

In Canada, there have been a small number of reports of pericarditis or myocarditis7, following vaccination with a COVID-19 mRNA vaccine, however it is important to note that adverse events occurring after vaccination are not necessarily related to the vaccine. Based on the few reports received in Canada, we are not currently seeing higher rates than would be expected in the general population. The Canadian weekly online adverse events report8 provides updates on the latest numbers.

 

 

Diagnosis and reporting

Myocarditis and pericarditis both involve inflammation of the heart in response to an infection or some other trigger. Symptoms can include shortness of breath, chest pain, or the feeling of a rapid or abnormal heart rhythm.

Healthcare providers should consider myocarditis and pericarditis in evaluation of acute chest pain or pressure, arrhythmias, shortness of breath or other clinically compatible symptoms after vaccination. They should consider doing an electrocardiogram (ECG), troponins, and an echocardiogram, in consultation with a cardiologist. It would also be important to rule out other potential causes of myocarditis and pericarditis, as such, consultation with infectious disease and/or rheumatology is recommended, to assist in this evaluation, particularly for acute COVID-19 infection (e.g., PCR testing), prior SARS-CoV-2 infection (e.g., detection of SARS-CoV-2 nucleocapsid antibodies), and other viral etiologies (e.g., enterovirus PCR and comprehensive respiratory viral pathogen testing).

All cases of myocarditis or pericarditis following vaccination should be reported to the local health authority9. Health Canada, PHAC, and the provincial and territorial health authorities will continue to closely monitor reports of myocarditis and/or pericarditis. Health Canada is also working closely with the manufacturers and international regulators to review information as it becomes available and will take appropriate action as needed. More information will be shared as it becomes available.

The benefits of the mRNA vaccines continue to outweigh their risks in the authorized populations, as there are clear benefits of mRNA vaccines in reducing deaths and hospitalizations due to COVID-19 infections.

 

References and links

 

  1. COVID-19 subcommittee of the WHO Global Advisory Committee on Vaccine Safety (GACVS) reviews cases of mild myocarditis reported with COVID-19 mRNA vaccines. https://www.who.int/news/item/2605-2021-gacvs-myocarditis-reported-with-covid-19- mrna-vaccines
  2. Myocarditis and Pericarditis Following mRNA COVID-19 Vaccination. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/myocarditis.html
  3. Canadian Adverse Events Following Immunization Surveillance System (CAEFISS). https://www.canada.ca/en/publichealth/services/immunization/canadian-adverse-?utm_source=sefpo events-following-immunization-surveillance-system-caefiss.html
  4. Canada Vigilance Program. https://www.canada.ca/en/health-canada/services/drugs-?utm_source=sefpo health-products/medeffect-canada/canada-vigilance-program.html
  5. Canadian National Vaccine Safety Network (CANVAS). https://cirnetwork.ca/network/national-ambulatory-network/
  6. Canadian Immunization Monitoring Program ACTive (IMPACT). https://www.cps.ca/impact
  7. Brighton Collaboration Myocarditis Decision Tree. https://brightoncollaboration.us/wp- content/uploads/2021/05/Myocarditis-decision-tree_brief-?utm_source=opseu pdf
  8. Reported side effects following COVID-19 vaccination in Canada. https://health- canada.ca/covid-19/vaccine-safety/
  9. Reporting Adverse Events Following Immunization (AEFI) in Canada. https://www.canada.ca/en/publichealth/services/immunization/reporting-adverse-events-?utm_source=sefpo following-immunization/form.html