Status of Cases in KFLA

When does the overall community status change?

What is the criteria for a case to be considered resolved?

What is the criteria for a case to be considered resolved?

• For a case that has mild to moderate symptoms: 10 days after symptom onset and provided that the individual does not have a fever (without the use of fever-reducing medication) and symptoms have been improving for at least 24 hours. If person did not have symptoms, then 10 days from the date of the positive test

• For a case that has severe symptoms (such as requiring ICU care): 20 days after symptom onset (or 20 days from positive test date if asymptomatic with severe immune compromise), provided that the individual does not have a fever (without the use of fever-reducing medication) and symptoms have been improving for at least 24 hours.

It is important to note that clearance testing is not recommended to determine if someone is no longer infectious – individuals can remain positive on tests for several weeks and this does not indicate they are infectious.

After an individual completes their isolation period, they should continue to practice physical distancing measures and use of masking for source control as recommended for everyone at this time.

When is an outbreak declared?

Different settings have different rules for when outbreaks are declared based on the risk factors of the populations in the setting. All cases, regardless of whether or not they meet the outbreak definition, will also appear under the main case count on the dashboard.

Long-Term Care Facility, Retirement Home, and other congregate living settings with vulnerable populations (e.g., group home, shelter) outbreak:

• At least 1 lab-confirmed case of COVID-19 in a resident of staff member in the facility.

Acute care facility (e.g., hospital) outbreak: 

• At least 2 lab-confirmed cases of COVID-19 in staff or patients within a specified area (e.g., unit, floor or service) within a 14 day period. 
• At least 2 of those cases have a clear link of being acquired within the hospital (e.g., admitted for 5 or more days before symptom onset or no obvious source of infection outside the hospital).

Post-secondary residence (e.g., university residence):

• At least 2 lab-confirmed cases of COVID-19 in students or staff within a 14 day period.
• At least 2 of those cases have a clear link of being acquired in the residence (e.g., a known exposure in the residence or no obvious source of infection outside of the residence)

Child care centre (licensed child care or home daycare) outbreak: 

• At least 1 symptomatic, lab-confirmed case in a child, staff member or home child care provider, in consultation with the Medical Officer of Health.

School outbreak:

• At least 2 lab-confirmed cases of COVID-19 in staff or students reported within a 14 day period
• At least 1 of those cases has a clear link to being acquired within the school (e.g., a known exposure in the school setting or no obvious source of infection outside of the school setting).

Workplace outbreak:

• At least 2 lab-confirmed cases of COVID-19 in the same workplace (e.g. same work area, same shift) within a 14 day period. At least 2 of those cases have a clear link of being acquired in the workplace (e.g., a known exposure in the workplace or no obvious source of infection outside of the workplace).

What does overall community status mean?

Each status represents a different level of severity, based on the number of cases in the KFL&A area and local capacity to deal with outbreaks and testing. Proper infection prevention control measures are to be maintained at every level, and increase as the status changes.

Notes:

• Local context and conditions will inform movement, including potential regional application of measures.
• Thresholds within a region may not all be met at the same time; decisions about moving to new measures will require overall risk assessment by government.

Grey - Lockdown (Maximum Measures)

Trends continue to worsen after measures from Control level are implemented.

Red - Control (Stringent Measures)

Epidemiology 

• Weekly incidence rate ≥ 40 per 100,000
• Percent positivity ≥ 2.5%
• Repeated outbreaks in multiple sectors or settings, increasing or number of large outbreaks
• Level of community transmission or non-epi linked cases increasing

Health System Capacity

• Hospital and intensive care unit capacity at risk of being overwhelmed

Public Health System Capacity

• Public health unit capacity for case and contact management at risk or overwhelmed

Orange - Restrict (Intermediate Measures)

Epidemiology

• Weekly incidence rate is  to 25 to 39.9 per 100,000
• Percent positivity is 1.3-2.4%
• Repeated outbreaks in multiple sectors or settings, increasing or number of large outbreaks
• Level of community transmission or non-epi linked cases stable or increasing

Health System Capacity

• Hospital and intensive care unit capacity adequate or occupancy increasing

Public Health System Capacity

• Case and contact follow up within 24 hours adequate or at risk of becoming overwhelmed

Yellow - Protect (Strengthened Measures)

Epidemiology

• Weekly incidence rate is 10 to 24.9 per 100,000 
• Percent positivity is 0.5-1.2%
• Repeated outbreaks in multiple sectors or settings, or increasing or number of large outbreaks
• Level of community transmission or non-epi linked cases stable or increasing

Health System Capacity

• Hospital and intensive care unit capacity adequate

Public Health System Capacity

• Case and contact follow up within 24 hours adequate

Green - Prevent (Standard Measures)

Epidemiology

• Weekly incidence rate is < 10 per 100,000
• Percent positivity is < 0.5%
• Outbreak trends or observations
• Level of community transmission or non-epi linked cases stable 

Health System Capacity

• Hospital and ICU capacity adequate 

Public Health System Capacity

• Case and contact follow up within 24 hours adequate

What does community-spread mean?

Community-spread happens when individuals in the community are confirmed positive for COVID-19 but have no known contact with another confirmed case or have not travelled to an area with documented cases.

In order to slow or stop community-spread infections, everyone in our community must continue to practice infection prevention measures including hand washing, mandatory self-isolation for 14 days after returning from travel, and physical distancing.

What does no known epi-link mean?

KFL&A Public Health investigates all confirmed cases to determine how the individual contracted COVID-19. If an individual has no known contact with another positive case, and has not travelled to an area with confirmed positive cases, they have no known epidemiological link. If multiple cases within the KFL&A region have no known epidemiological link, this may indicate that there is community spread of COVID-19.

In order to slow or stop community spread, everyone in our community must continue to practice public health prevention measures including; hand washing, monitoring for symptoms, physical distancing from others outside your social circle of 10, and staying home when feeling sick.

How to use the dashboard

Click on the button on the top left of dashboard to switch between the two pages of information.

Cases

The graphs and map are interactive. Hover mouse over the bars, lines, and map region to show the details. Switch between date positive case received on date onset (or swabbed) by clicking on the date type buttons. Select a date range to filter the graphs. Clicking on one bar (region) will highlight that subgroup in the other graphs and filter the map. Deselect the bar (region) to turn off the highlighting and filtering. It is not possible to filter by both region, and age and gender.

Assessment and Testing

Tests complete reflect all tests done in the region, not just at the assessment centres. Percent positive is reported as a seven-day moving average. This is the number of positives over the previous seven days divided by the number of tests completed over the previous seven days. Statistics for numbers assessed and swabbed at the community COVID-19 assessment centre sites. The graphs show both sites together. Click on the dropdown in the top right corner of the graphs to filter to show only one site. Select a date range to filter the graphs. 

Reported data is compiled daily for confirmed COVID-19 positive cases in the KFL&A Region from the provincial Case and Contact Management Tool (CCM). Number of tests complete and the assessment centre data are based on internal data collection at KFL&A Public Health and Lennox & Addington County General Hospital. Data may be updated at different times based on availability. Check the top right corner of the page to see the date when the data was last updated. The case data from CCM reflects the status of cases at the same time of update. Cases are counted by health unit region, as health units are responsible for following up with patients who reside within their region. Not all patients hospitalized in the region may reside within it. Also, the Assessment and Testing data reflect the data from the previous day.