Resources

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 |  March 31, 2021

Mobile In-Home COVID-19 Vaccination of Ontario Homebound Older Adults by Neighbourhood Risk

Homebound individuals face substantial barriers to receiving COVID-19 vaccines as they cannot or rarely leave their homes because of medical, psychiatric, cognitive, functional, transportation-related and social reasons. There are at least 75,000 Ontarians aged 65 years and above who are homebound, with the majority being women and people aged 85 years and above. Much of this older homebound population requires mobile in-home COVID-19 vaccination, which could be prioritized by residence in high SARS-CoV-2 risk neighbourhoods.
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 |  March 29, 2021

COVID-19 Hospitalizations, ICU Admissions and Deaths Associated with the New Variants of Concern

New variants of concern (VOCs) now account for 67% of all Ontario SARS-CoV-2 infections. Compared with early variants of SARS-CoV-2, VOCs are associated with a 63% increased risk of hospitalization, a 103% increased risk of intensive care unit (ICU) admission and a 56% increased risk of death due to COVID-19. VOCs are having a substantial impact on Ontario’s healthcare system. On March 28, 2021, the daily number of new SARS-CoV-2 infections in Ontario reached the daily number of cases observed near the height of the second wave, at the start of the province-wide lockdown, on December 26, 2020. The number of people hospitalized with COVID-19 is now 21% higher than at the start of the province-wide lockdown, while ICU occupancy is 28% higher (Figure 1). The percentage of COVID-19 patients in ICUs who are younger than 60 years is about 50% higher now than it was prior to the start of the province-wide lockdown. Because the increased risk of COVID-19 hospitalization, ICU admission and death with VOCs is most pronounced 14 to 28 days after diagnosis, there will be significant delays until the full burden to the health care system becomes apparent.
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 |  March 26, 2021

Vaccine-Induced Prothrombotic Immune Thrombocytopenia (VIPIT) Following AstraZeneca COVID-19 Vaccination

This Science Brief provides information for health care professionals about Vaccine Induced Prothrombotic Immune Thrombocytopenia (VIPIT), a rare adverse event following the AstraZeneca vaccine. This brief describes the pathophysiology, presentation, diagnostic work-up and treatment of VIPIT. Figure 1 presents a decision tree for diagnosis and rule out of VIPIT.
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 |  March 23, 2021

Routine Asymptomatic SARS-CoV-2 Screen Testing of Ontario Long-Term Care Staff After COVID-19 Vaccination

SARS-CoV-2 screen testing is routine serial testing of asymptomatic individuals outside of outbreak or known exposure settings to identify staff infectious with SARS-CoV-2 and exclude them from work. Routine asymptomatic screen testing of staff has been proposed as a potential mitigating strategy to reduce SARS-CoV-2 introduction and transmission in long-term care (LTC) homes. A rapid review of the literature found no real-world evidence to either support or refute screen testing in preventing LTC home COVID-19 outbreaks. There are several direct harms associated with screen testing, as well as opportunity costs, including exacerbating LTC staffing shortages. SARS-CoV-2 screen testing is routine serial testing of asymptomatic individuals outside of outbreak or known exposure settings to identify staff infectious with SARS-CoV-2 and exclude them from work. Routine asymptomatic screen testing of staff has been proposed as a potential mitigating strategy to reduce SARS-CoV-2 introduction and transmission in long-term care (LTC) homes. A rapid review of the literature found no real-world evidence to either support or refute screen testing in preventing LTC home COVID-19 outbreaks. There are several direct harms associated with screen testing, as well as opportunity costs, including exacerbating LTC staffing shortages. On the basis of the evidence reviewed, and given the high rates of protection of COVID-19 vaccines against symptomatic and asymptomatic SARS-CoV-2 infection, the potential harms and costs of screen testing among vaccinated LTC home staff likely outweigh the benefits.
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 |  March 17, 2021

Mobile On-Site COVID-19 Vaccination of Naturally Occurring Retirement Communities by Neighbourhood Risk in Toronto

Naturally occurring retirement communities (NORCs) are apartment, condo, co-op and social housing buildings that while not purpose-built for older adults, have become home to a high number of them. In Toronto, there are 489 residential buildings that are NORCs. Of these, 256 are located in neighbourhoods with the highest cumulative incidence of SARS-CoV-2, and are home to 40,955 older adults 65 years of age and above, including 18,144 older adults 80 years of age and above. Prioritizing COVID-19 vaccination by both age and neighbourhood of residence is an effective strategy to minimize deaths, morbidity, and hospitalization. Targeting people living in NORCs in high-risk neighbourhoods for early vaccination is a practical application of that strategy, which will also address barriers to vaccination in this population.
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