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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.

Dashboard

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Data notes

Data sources

  • Halton case data: Public Health Case and Contact Management (CCM) Solution, extracted each 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.
  • Halton vaccination data: IntelliHealth, COVax package, extracted each weekday morning to reflect immunizations administered by end of the previous day.

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 and COVax are dynamic reporting systems which allows ongoing updates to data previously entered.
    • As a result, data extracted from CCM and COVax 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.
  • 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.
  • 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, had indeterminate test results, or had a preliminary positive result from a Health Canada approved point-of-care assay (rapid COVID-19 test).
  • Cases are considered to be variant cases if they have at minimum tested positive for a mutation associated with a variant of concern. This includes individuals whose lab results indicate the specific lineages of B.1.1.7 (UK variant 202012/01), B.1.351 (South African variant 501Y.V2), or P.1 (Brazil variant 501Y.V3), as well as individuals who have been found to have a mutation associated with these variants. Individuals who have been found to have the P.2 lineage are not considered to be variant cases, as this is only a variant of interest.
  • The number of variant cases is typically underestimated for recent days, as it takes additional time for the results of variant testing to be received after a case’s initial COVID-19 positive result.
  • The number of cases should not be considered exactly equivalent to the unique number of individuals in Halton who have been diagnosed with COVID-19, because there are a small number of individuals (<5) who are counted twice because they are confirmed reinfection cases. A confirmed reinfection case is a person who has tested positive for COVID-19 twice, with time-based or test-based clearance between the two infections, who has genome sequencing indicating that the two infections are distinct, or for whom the first infection occurred before November 1, 2020 (when variants were rare in Ontario) and the second infection is a confirmed variant of concern or linked to a confirmed case with a variant of concern.
  • Active cases, resolved cases, and deaths are a subset of total cases.
    • Active cases are cases without a ‘fatal’ or ‘recovered’ outcome in CCM whose episode date was within the past 10 days, as well as cases with any episode date who are known to be currently hospitalized.
    • Resolved cases are cases who do not have a ‘fatal’ outcome, are at least 10 days past their episode date, and are not known to be currently hospitalized. Cases closed while hospitalized, and all cases with the outcome of ‘recovered’ regardless of episode date, are also considered resolved.
      • Please note this automated method could result in overestimating the number of resolved cases as it does not take into account the possibility of a case being immunocompromised (which requires a longer period of isolation), and Public Health may not be notified about a case’s hospitalization or lingering severe symptoms (which also can require longer isolation).
    • 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.
    • Some cases are classified as “missing” on primary exposure group, if no information was able to be collected regarding their possible source of acquisition.
  • It is important to note that cases can have multiple possible sources of exposure, 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.
    • Confirmed cases of COVID-19 in this section 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 hospital who are no longer testing positive for COVID-19 but who previously tested positive will be counted in the occupancy rates, but not in the confirmed hospital case counts.
    • Individuals with COVID-19 who are in Joseph Brant’s Pandemic Response Unit will be included in the confirmed COVID-19 hospital case count, but not in the occupancy rate.
    • Individuals who visited the emergency room but who were not admitted to hospital are not included in the occupancy rates or case counts.
    • 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.
    • Hospital case counts should not be expected to match the data on cases who have ever been hospitalized in the “Case demographics” tab. The hospital case counts include recent data submitted by the hospitals about both Halton residents and non-Halton residents with COVID-19 in their care, whereas the data on the “Case demographics” tab specifically reflects Halton residents only, and depends on hospitalization data for Halton cases being provided to Public Health, which may occur with delay or not at all.
  • 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 (PDF file).

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, institutional and school outbreaks will also not be posted until after notification of staff, residents, and families has been completed.
  • The name of the affected location is included only for institutional and school outbreaks. The name of the affected location is not shown for other types of outbreaks for privacy reasons, and will be published only if Public Health is unable to reach all individuals who may be at risk associated with the outbreak.
  • Outbreaks are declared when the appropriate provincial definition is met. Provincial definitions for outbreaks vary by type of outbreak.
  • Open outbreaks are outbreaks that have not yet been declared over by the time of the dashboard refresh. Closed outbreaks are outbreaks that have been declared over by the time of the dashboard refresh.
  • Cases in institutional or congregate living outbreaks 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 shown in both the case and the death views of the table.
  • Cases associated with an outbreak are cumulative (not just active cases only).
  • Although non-Halton cases and deaths are shown in the outbreak table, cases who live outside Halton and any deaths that occur among them are not included in the case and death counts shown elsewhere in the dashboard, which focus exclusively on Halton residents.
  • Cases cannot be linked to more than one outbreak in CCMS. This can lead to outbreaks listed with zero cases.
  • For information on the types of locations included in each outbreak category and outbreak roles, please use the “What do these mean?” pop-up on the outbreaks page.

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 or a municipality within Halton 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/permanent health unit of Halton (meaning the case primarily resides in Halton).

Vaccinations

  • Vaccination data will update dynamically Mondays to Fridays between 12 and 2 p.m, to reflect all doses administered and recorded in COVax by the end of the previous day.
  • Data on the “Doses administered in Halton” subtab are representative of doses administered anywhere in Halton Region, including community and hospital-based clinics run by Halton Region Public Health, Halton Healthcare, or Joseph Brant Hospital; mobile clinics run by the Halton Region Health Department (which includes Halton Region Public Health and Halton Region Paramedic Services); pharmacies; and physicians’ offices.
  • Data on the “Doses administered in Halton” subtab include both first and second doses, and should therefore not be interpreted as the unique number of individuals vaccinated. The data include doses administered to non-Halton residents (e.g. staff who work at a Halton facility but live outside Halton), and do not include any doses Halton residents may have received outside Halton (e.g. Halton residents who work at facilities outside Halton and were vaccinated there).
  • Data on the “Doses administered in Halton” subtab include individuals without a known age (pending data cleaning), but data on the “Vaccine uptake in Halton residents” subtab excludes such individuals, as known age is required to calculate vaccine uptake.
  • Data on the “Vaccine uptake in Halton residents” subtab reflects Halton residents, rather than doses. It includes both Halton residents who have had just one dose, and those who have already had two. It includes known Halton residents who were immunized in Halton, as well as Halton residents who received one or both doses outside Halton, if the dose was recorded in COVax.
  • Vaccine uptake is currently defined as the proportion of the Halton population with at least one dose of COVID-19 vaccine. This should not be interpreted as vaccine coverage, since two doses are required to have full coverage with the currently available vaccines.
  • Vaccine uptake is calculated for the population aged 16 and up because at least one currently available vaccine is approved for use in people aged 16 and up. However, vaccine efforts are concentrated on residents aged 18 and up at this time. This will result in underestimating the overall uptake slightly, compared to using a denominator of 18 and up.
  • Vaccine uptake is calculated using January 2021 Halton Region population estimates provided by IC/ES based on the Registered Persons Database.
  • Data from COVax are subject to misclassification, as assignment to a health unit of residency is dependent on the postal code entered but can be overwritten, and new postal codes may not be correctly assigned by the system. Halton residents may be misclassified as non-Halton residents and therefore not included in the uptake estimates, and conversely, some non-Halton residents could be erroneously classified as Halton residents depending on the address provided or edits to the health unit field by the immunizer. This is especially true when Halton residents with a newer postal code are immunized outside Halton. Due to these concerns, wherever possible, health unit residency has been assigned outside the system on the basis of postal code and municipality entered into COVax using an updated postal code lookup maintained by Halton Region Public Health. Therefore, individuals with a Halton municipality or postal code in COVax but entered with a different client health unit are assumed to actually be Halton residents; and individuals without a Halton municipality or postal code but entered with a client health unit of Halton are assumed to actually be non-Halton residents. If health unit is missing in COVax, but the reason for immunization involves being a resident of a facility in Halton, the individual is assumed to be a Halton resident.

Trends over time

  • Interpret trends from the most recent days with caution, as information-gathering, data entry, and mutation testing is ongoing for recently reported cases.
  • Trends are shown either as the proportion of cases reported in the past 7 days, or as the number of new cases reported in the past 7 days per 100,000 population, for each day of interest.
 

 

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