By Shanker Nesathurai, MD, MPH, FRCPC
Medical Officer of Health, Haldimand County and Norfolk County
To The Haldimand Press
April 17, 2020—COVID-19 has had a significant impact on Haldimand County and Norfolk County. In this communication, I wanted to share some salient data related to COVID-19 in the community.
The key to mitigating the effects of COVID-19, on a community level, is to identify, test and self-isolate appropriate individuals. Most of the tests have been completed at community testing sites in Delhi and Hagersville. A third testing site will be operational in Dunnville next week. Some patients have been tested in the emergency departments of local hospitals; on a few occasions, testing has been completed at family physician’s offices.
Over the past month, approximately 700 people have been tested for COVID-19. The first confirmed case of COVID 19 was on March 26, 2020. The number of positive cases has increased. As of this evening, there have been approximately 160 positive cases.
Figure 1: Incidence of Cases by Date and Cumulative Incidence by Date of Symptom Onset
Figure 1 summarizes the number of cases per day since the identification of the first case. Of note, there is some variability in the cases reported on any particular day (yellow bars). The red line represents the cumulative frequency; this is the number of total cases as the pandemic progresses. The data indicates that the number of cases is likely to increase.
Figure 2: Age Distribution of COVID-19 Residents
Figure 2 summarizes the age distribution. With regards to age, a disproportionate number of cases are older residents. Of the positive cases, approximately 70% are women, and 30% are men. This is not unexpected, as women are disproportionately represented in the elderly. As well, the data includes testing of healthcare workers, who are more likely to be women.
Figure 3: Geographic Distribution of Cases in Norfolk County
Figure 4: Geographic Distribution of Cases in Haldimand County
Figure 3 and Figure 4 summarizes the cases by larger population centers throughout the health district. The cases are assigned by the residential address.
Approximately 14% of the cases are in Norfolk County and 86% in Haldimand County. Conclusions related to geographic location should be contextualized to the fact that people may reside at one location, but work and/or travel to other locations.
Approximately 60% of the cases are related to individuals residing or working at Anson Place. There is preliminary evidence of epidemiological link to the cases at Anson Place and a funeral and related visitation in the community. This should not be interpreted that individuals who attended the funeral were the “cause” of the outbreak at Anson Place or vice versa. The identification of the link permitted additional public health measures to control the transmission of COVID-19; this included enhanced testing.
At the current time, the Public Health Unit can confirm 25 deaths attributed to COVID-19. Twenty-three of these deaths were residents of Anson Place. The remaining deaths were related to individuals residing in the community. The deaths primarily affected men and women in the seventh, eighth and ninth decades of life. This is consistent with the experience throughout the world, where the older individuals with multiple medical problems are at the highest risk of death.
The public health unit is sharing this data to provide additional insights into the impact of COVID-19 in Haldimand County and Norfolk County. When data of this nature is presented, the goal is to balance a number of competing interests. This includes protecting the privacy of the individuals affected and concurrently informing the community on matters of public health.
