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Status of COVID-19 cases in Halton

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Halton’s COVID-19 interactive dashboard provides a summary of the current local situation and information on COVID-19 activity in Halton to date. You can use the dashboard to easily explore Halton’s COVID-19 data on overall case counts, demographics, institutional outbreaks and lab testing.

Notice: case counts for November 25 and 26

Please note that approximately 50-60 cases entered by laboratories into the provincial Case and Contact Management (CCM) solution from November 17 to 24 did not get reported to Halton Region Public Health until November 25. Ongoing data remediation led to a delay in the dashboard refresh on November 25, and is resulting in a large number of new cases being added to the dashboard on November 26.

Dashboard

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Data notes

Data sources

  • Halton case data: Public Health Case and Contact Management (CCM) Solution, extracted each weekday morning to reflect cases reported by end of the previous day.
  • Halton test volume and percent positivity data: Institute for Clinical Evaluative Sciences, Weekly counts of COVID-19 diagnostic test recipients, received weekly.
  • Halton hospital data: Ministry of Health, SAS Visual Analytics Tool, COVID Regional Hospital and Hospital Utilization reports, extracted Monday to Saturday inclusive.

General

  • Numbers should not be expected to match numbers reported by other sources, due to different data extraction times.
  • All data are dynamic and subject to change with future updates.
    • CCM is a dynamic disease reporting system which allows ongoing updates to data previously entered.
    • As a result, data extracted from CCM represent a snapshot at the time of extraction and may differ from previous or subsequent reports.
    • Data are updated once per day. Numbers update dynamically within the dashboard between 12 and 2 PM as server times allow.
    • Based on information gathered while doing case investigation, numbers may increase or decrease daily to reflect our most up to date information. Numbers may change significantly when data cleaning initiatives are completed.
  • The change in the case count reflects the net change from the last update and shows how much higher or lower the count is compared to the most recently published data. The change does not reflect the number of new cases reported per day or when cases’ symptoms began. This information can be viewed in the “Cases over time” graph.
  • Probable cases are individuals presumed to have COVID-19 because they have symptoms of COVID-19 and are travelers returning from an affected area, have had close contact with a confirmed case, lived/worked in a facility experiencing a COVID-19 outbreak, or had indeterminate test results.
  • All data except hospital occupancy/counts includes only individuals whose main usual residence is in Halton Region. Cases who have municipality information pending are excluded.
  • Active cases, resolved cases, and deaths are a subset of total cases.
    • Cases are considered to be active if the case is open in CCM and/or is not listed as resolved.
    • Resolved cases are cases who have been closed in CCM without a fatal outcome, and/or have had a non-fatal outcome indicative of resolution entered in CCM. Typically this refers to cases have been discharged from isolation at 10 days after symptom onset if they did not have a fever and their symptoms were improving for at least 72 hours OR 10 days from when they were tested if they were asymptomatic. For cases with no significant improvement in symptoms, Public Health continues monitoring until the case meets resolution criteria and the case is closed in CCM. For cases in hospital, a test-based approach may be used and isolation is continued until 2 consecutive negative tests are obtained, at least 24 hours apart.
    • Deaths include any fatality where the cause of death is recorded as COVID-19 on the death certificate or other official documentation, or fatalities among COVID-19 cases who were still symptomatic/infected with COVID-19 at the time of death; were experiencing residual effects or complications of COVID-19 infection that persisted; and/or were children experiencing multi-system inflammatory syndrome.
    • Case outcomes (resolved cases, deaths) reflect the latest available information reported to Halton Region Public Health and recorded in CCM by the extraction time.
  • The dashboard provides the ability to view cases using either episode date or reported date. Reported date is the date the case was reported to public health. This does not represent the day the case was first publicly reported in the dashboard, and there may be delays between when the case is reported to public health and when it appears in the dashboard (e.g., due to time required to receive confirmatory lab results, or receive a case referral from another health unit). Episode date is a field that is intended to approximate the symptom onset date for each case. It is calculated hierarchically, using the earliest date among symptom onset date; specimen collection date; or the date the case was reported to public health, as available.
  • Primary exposure group (the most likely source of acquisition for a case) is determined by examining the epidemiologic link and risk factor fields in CCM to consider whether a case travelled, was associated with a known outbreak inside or outside Halton, was a contact of a case, or none of the above. If an investigator has stated that the case has an epidemiologic link, the nature of the link as specified by the investigator (contact, travel, or outbreak) will determine the category. If the investigator has stated the case does not have an epidemiologic link, or the investigator has not yet entered any information related to epidemiologic link, the case’s risk factors and association with any outbreaks are examined and a hierarchy is applied as follows:
    • Cases with episode date before April 1: Travel > Associated with any type of outbreak (institutional, congregate care, workplace, school, child care, or community) in or outside of Halton > Close contact of a confirmed case > None of the above (indicating community acquisition) > Information pending.
    • Cases with episode date on or after April 1: Associated with any type of outbreak (institutional, congregate care, workplace, school, child care, or community) in or outside of Halton > Close contact of a confirmed case > Travel > None of the above (indicating community acquisition) > Information pending.
      • If the investigator stated the case has an epidemiologic link, but has not yet specified the nature of the link, entered any related risk factors, and the case is not associated with an outbreak, the case is categorized as “Unspecified link”.
    • Some cases who are associated with an outbreak may not be categorized in the outbreak exposure group, if an investigator has specified their epidemiologic link as travel or contact.
    • It is important to note that cases can have multiple exposures, and these data reflect only their primary exposure group.

Monitoring indicators

  • Hospital occupancy and counts:
    • ICU beds and cases are a subset of acute care beds and cases.
    • Individuals who are admitted to Halton hospitals may not be Halton residents, and conversely, Halton residents may be hospitalized in hospitals outside Halton. Therefore, the counts of COVID-19 patients in hospital/ICU may not always include the same individuals represented as cases elsewhere in the dashboard, which focuses on Halton residents only.
    • Confirmed cases of COVID-19 are individuals who are admitted to the hospital and/or ICU who have tested positive for COVID-19. However, COVID-19 may not be the main cause of their hospitalization.
    • Individuals who are in the ICU who are no longer testing positive for COVID but who previously tested positive will be counted in the occupancy rate, but not in the confirmed case count.
    • Individuals who visited the emergency room but who were not admitted to hospital are not included in the occupancy rates or case counts.
  • Rates and counts are influenced by testing levels, and should be considered in conjunction with the most recent testing counts shown on the “Lab testing” tab. Rates and counts earlier in the pandemic were particularly susceptible to underestimation and changes in testing policy, until testing was made more widely available.
  • For more information on the monitoring indicators, please see the technical notes.

Outbreaks

  • Our main priority in outbreak management is prevention. Ensuring appropriate measures are being taken requires time, in addition to collecting information on the status of cases. Data on outbreaks may therefore take additional time to be entered and reflected in the dashboard. Out of consideration for those affected, outbreaks will also not be posted until after notification of staff, residents, and families has been completed.
  • Outbreaks are declared when provincial definition is met. Provincial definitions for outbreaks vary by type of outbreak.
  • Open outbreaks are outbreaks that have not yet been declared over. Closed outbreaks are outbreaks that have been declared over.
  • Information on outbreaks associated with other settings (e.g. private social gatherings, sports & fitness, workplace, congregate settings including child care) is provided at a summary level only. For more information on each category, please use the “What do these mean?” pop-up on the outbreaks page.
  • Institutional and school outbreaks are displayed with more detail. Institutional outbreaks include outbreaks of COVID-19 in long-term care homes, retirement homes, and hospitals. School outbreaks include outbreaks of COVID-19 in elementary or secondary schools.
    • Cases are included only if they reside in Halton. Staff members who work at Halton institutions or Halton schools but who live outside Halton are not included. Similarly, students who attend Halton schools but who live outside Halton are not included. This can lead to outbreaks listed with zero cases.
    • Cases who have not yet had sufficient data entry to reflect their role will be shown in the outbreak table as “Role not specified”.
  • Cases associated with an outbreak who pass away are counted in both the case columns and the death columns.

Lab testing

  • Test volume and percent positivity data are updated once per week.
  • Test volume and percent positivity data reflect only lab tests that have been assigned to Halton Region based on the methodology used by the Institute for Clinical Evaluative Sciences. There are several considerations associated with these data:
    • The unit of analysis is the testing episode (unique individuals tested per day). Individuals tested multiple times on different days are counted once in each week’s counts for the appropriate weeks.
    • Testing episodes after the individual's first confirmed positive COVID-19 test are excluded from subsequent weekly counts (numerator and denominator).
    • The COVID-19 test results are captured in the Ontario Laboratories Information System (OLIS). The testing date represents the date of specimen collection. Due to the time required for transportation and processing of specimens, it takes six days for approximately 95% of results to be finalized and reported for a given testing date. Some laboratories do not report all or part of their COVID-19 test results to OLIS. Unconsented test results are excluded.
    • Counts less than six are suppressed.
    • The location of tested individuals was based upon the test recipient’s postal code (and corresponding health unit) recorded in the OHIP Registered Persons Database (RPDB) for those residing outside a long-term care (LTC) facility, and the LTC address on the OLIS test requisition for specimens collected from LTC facilities. These address assignments can lead to misclassification of the health unit.

Neighbourhood map

  • All data are dynamic and subject to change with future updates.
  • Maps can be viewed interactively with case counts or rates per 10,000, and can be re-calculated to include or exclude cases associated with institutional and congregate outbreaks in Halton, and to change the period of time (based on case reported date). The map legend includes the starting value for each category, and changes to reflect the selected options.
  • Rates have been calculated using 2016 census estimates as the denominator. However, these rates should be viewed as estimates since many Halton neighbourhoods have experienced significant population growth since the 2016 census was conducted. This means that the number of COVID-19 cases in the numerator may be consistent with how many residents are actually living in the neighbourhood, but the denominators may be low since they have not changed since the 2016 census. This can result in rates per 10,000 that are overestimated.
  • Neighbourhoods in the map are based on neighbourhoods developed by Our Kids Network as part of a consultative process that took into account census, natural, municipal, and regional boundaries, while considering borders and names that would be meaningful to residents. For more information, please see the Neighbourhood Profiles page of the Our Kids Network website.
  • Rates per 10,000 were calculated because most neighbourhoods have between approximately 10,000 and 40,000 residents. This allows the rates to be accurately interpreted with respect to case counts. The area surrounding Bronte Park has no cases due to few individuals residing in that area.
  • These rates are crude rates, meaning they do not take into account demographic differences between neighbourhoods (for example, differences in age distribution).
  • Confidence intervals are not included and therefore rates are not necessarily statistically significantly different from each other, nor from the overall Halton rate.
  • Cases of COVID-19 that could not be assigned to a neighbourhood (for example, due to inaccurate or missing address information) have been excluded from the maps and table (<5% of cases).
  • Only includes cases with a diagnosing health unit of Halton (meaning the case primarily resides in Halton).
 

 

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