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Toronto health officials say respiratory illnesses high, but levelling off

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Public health officials in Toronto say that the level of respiratory illness in the city remains high, but appears to be decreasing following a wave of infections over the holidays.

"COVID 19 and influenza activity are high in Toronto, but we know that influenza levels are decreasing," Associate Medical Officer of Health Dr. Irene Armstrong told the Toronto Board of Health during a presentation Monday.

Per cent positivity for influenza sat at 6.6 per cent for the most recent week, compared to 15.6 per cent for the week previous. COVID-19 per cent positivity was "high but stable," Armstrong said, sitting at 17.6 per cent for the most recent week, down slightly by one percentage point from the previous week.

Ontario’s COVID-19 wastewater signal has also leveled off after reaching more than a year-long high. The latest data from Public Health Ontario puts the number at 2.38. That is still nearly double what it was one year ago (1.38) but is virtually unchanged from where it stood in mid-December, suggesting that transmission of the virus has at least plateaued for the time being.

Meanwhile, after seeing a steady rise since September, and a spike over the holidays in late December, Toronto emergency department visits for respiratory disease are decreasing, though they remain at moderate levels.

"Influenza levels at this time are higher than the pre-pandemic historical average typical for this time of year," Armstrong said. "Historically before the pandemic, influenza activity started in November and peaked at the end of December or early January. For the 2023-2024 season, it started a little bit earlier in mid-October and appears to have peaked towards the end of December."

While there are signs that infections may be declining somewhat, the overall level of viral activity remains high.

"While we are currently unable to update our wastewater dashboard, we are still monitoring the raw data and we see that both influenza and COVID 19 signals in Toronto wastewater are high but stable at this time," Armstrong said.

Health officials said there were 72 active COVID-19 outbreaks in healthcare institutions in the city as of Jan. 12. In addition, there were 15 influenza outbreaks and nine RSV outbreaks.

Those numbers are similar to the amount of outbreaks seen around the same time in the 2022-2023 season, Armstrong said.

"Respiratory outbreak activity is high in hospitals, long term care homes and retirement homes across the city," she said. "This is not unexpected for this time of year. It is too early to determine if we are at a peak of overall respiratory outbreak activity in Toronto."

For the period of Jan. 2-10, TPH received reports of 122 COVID-19-related hospitalizations, eight new ICU admissions and 44 COVID-related deaths.

In Hamilton, health officials urged people last week to do what they can to reduce the spread of respiratory viruses as hospitals there are currently "under extreme pressure" and over capacity.

"We are seeing a high volume of sicker people in our EDs due to the viral season," Hamilton Health Sciences (HHS) said in a statement last week. "At the same time, staff absences due to illness are posing a challenge to meeting the needs of this increased volume of patients."

Adult acute occupancy across all HHS sites is consistently more than 100 per cent and some patients are currently being treated in surge spaces such as hallways, the hospital network said.

HHS said nine surgeries were deferred last week because of the situation and it is expediting patient discharges, where appropriate, in order to keep up with demand.

"Hamilton’s healthcare partners are asking for the community’s help in preventing the spread of respiratory illness this fall/winter season and preserving access to the city’s urgent care and emergency resources for those who need them most," HHS said.

In order to reduce the spread of respiratory illnesses, people are still being encouraged to stay home if they feel sick and to use rapid tests to check if they have COVID-19. Health officials have cautioned that a single negative rapid test is not necessarily a conclusive indicator that person does not have COVID-19. Those who are sick should do multiple tests over several days in order to get a more accurate assessment.

Armstrong said that TPH is also working to provide access to the Novavax vaccine, a non-mRNA COVID-19 vaccine, which was approved by health Canada on December 5.

The health unit also expanded eligibility to the new RSV vaccine on December 7. 

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