Outbreaks in healthcare and congregate institutions:

Definitions:

• Number of new respiratory outbreaks declared in healthcare (i.e. long-term care homes, retirement homes, hospitals) and congregate (i.e. group homes, shelters) institutions in the past week. Includes COVID-19, influenza, and respiratory syncytial virus (RSV), and other respiratory outbreaks.
• Number of new enteric outbreaks declared in healthcare (i.e. long-term care homes, retirement homes, hospitals) and congregate (i.e. group homes, shelters) institutions in the past week. Includes rotavirus, norovirus, and other enteric outbreaks.

Data sources:

• COVID-19 outbreaks: The provincial Case and Contact Management (CCM) solution, Ministry of Health
• Influenza, RSV, other respiratory outbreaks, and enteric outbreaks: The integrated Public Health Information System (iPHIS), Ministry of Health

Data considerations: COVID-19 outbreak definitions changed over the course of the pandemic and outbreaks were declared based on the definitions in place at the time.

Hospital bed occupancy

Definition: The average daily hospital occupancy count per week of people admitted to local hospitals primarily being treated for active infection of COVID-19, influenza, and/or respiratory syncytial virus (RSV). People may be counted in bed occupancy data for multiple days.

Data source: Inpatient Data File (Hospital Bed Census) from the Ministry of Health (Capacity Planning and Analytics Division) SAS Visual Analytics Hub

Data considerations: Includes hospital admissions (including ICU admissions) to local hospitals, regardless of whether the patient is resident of RCD. Does not include emergency department visits.

COVID-19 case counts and rates

Definition: Number of confirmed COVID-19 cases among RCD residents in the past week. Rate calculated by dividing weekly case number by total population and multiplying by 100,000

Data sources:

• Cases and rates in RCD: The provincial Case and Contact Management (CCM) solution, Ministry of Health
• Rates in Ontario: Public Health Ontario Respiratory Virus Tool (as of June 24, 2024)

Data considerations: Includes cases meeting the confirmed case classification described by the Ministry of Health: https://www.ontario.ca/files/2023-12/moh-ophs-novel-coronavirus-en-2023-12-01.pdf. Cases of confirmed reinfection are counted as unique cases. Testing eligibility for COVID-19 changed throughout the pandemic, which impacted case counts and rates.

Influenza case counts and rates

Definition: Number of confirmed influenza cases among RCD residents in the past week. Rate calculated by dividing weekly case number by total population and multiplying by 100,000.

Data sources:

• Cases and rates in RCD: The integrated Public Health Information System (iPHIS), Ministry of Health
• Rates in Ontario: Public Health Ontario Respiratory Virus Tool (as of June 24, 2024)

COVID-19 percent (%) positivity

Definition: Percent of all COVID-19 molecular tests processed in the past week which have a positive result.

Data source: Ontario Laboratories Information System (OLIS) from the Ministry of Health (Capacity Planning and Analytics Division) SAS Visual Analytics Hub

Data considerations: Includes reports submitted to the Ontario Laboratory Information System (OLIS). Not all laboratories report to OLIS and only individuals with health card numbers are included in the OLIS dataset. Does not include results from rapid antigen tests (RAT) tests.

Influenza percent (%) positivity

Definition: Percent of all influenza tests (influenza A and B) processed in the past week which have a positive result.

Data source: Public Health Ontario Laboratories

Respiratory-related emergency department (ED) visits

Definition: Percentage of all ED visits by RCD residents that are specifically for respiratory-related concerns in the past week (syndrome = RESP).

Data source: The Acute Care Enhances Surveillance Application (ACES), KFL&A Public Health

Data considerations: Includes data from most local emergency departments and non-local emergency departments that RCD residents may visit. ACES, or Acute Care Enhanced Surveillance (ACES), is an Ontario-wide system that monitors hospital registration records in real time to identify potential disease outbreaks or other public health threats. It uses natural language processing to scan the words or phrases included in the “chief complaint” or “reason for admission” and to sort the records into “syndromes”. Monitoring syndromes in real time can identify an outbreak much faster than is possible using laboratory results, but syndromes are not clinical diagnoses and therefore need to be interpreted with care.

Population estimates for RCD

Data sources:

• 2020-2022: Statistics Canada. Table 17-10-0134-01 Population estimates, July 1, by health region and peer group, 2018 boundaries
• 2023-present: Statistics Canada & Ontario Ministry of Finance. Population Projections by PHU, 2023-2032 [data file]. Toronto, ON: Ontario Ministry of Health, IntelliHEALTH Ontario [distributor]; Date extracted by Renfrew County and District Health Unit: [2024-03-11]