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COVID-19 Windsor and Essex County: March 20, 2020 to May 15, 2020
Purpose
• Providing an epidemiologic summary of COVID-19 activity in Windsor and Essex County (WEC) to date
Source
• Windsor-Essex County Health Unit, Infectious Disease Prevention (IDP) database, extracted by Windsor-Essex County Health Unit [2020/05/14].
• Ontario Ministry of Health, integrated Public Health Information System (iPHIS) database, extracted by Windsor-Essex County Health Unit [2020/05/14].
• Ontario Agency for Health Protection and Promotion (Public Health Ontario). Epidemiologic Summary: COVID-19 in Ontario – January 15, 2020 to May 13, 2020). Toronto, ON: Queen’s Printer for Ontario; 2020.
Highlights
• At the time of reporting, there are 751 confirmed cases of COVID-19 in WEC between March 20th and May 14th.
• Overall, cases of COVID-19 in WEC continue to decrease. • The incident rate of COVID-19 in WEC is higher compared to Chatham-Kent, Lambton County
and the overall rate in Ontario. • Between May 5th and May 11th, approximately 3% of the tests on average returned as positive
for COVID-19 when tested for COVID-19. • Facility wide testing in 38 long-term care and retirement homes has indicated that 0.9% of
residents and 0.4% of staff were asymptomatic and positive for COVID-19. • The age of the cases range from 8 to 101 years with females accounting for approximately 57%
of all cases compared to approximately 42% in males. One percent of cases had an unknown sex o Among females, 24% of all female cases were among those 80 years or older o Among males, 19% of all male cases were among those between 20 to 29 years.
• Approximately 63% of the cases reside in the City of Windsor. • Currently, the majority of cases are due to close contacts with individuals that were positive for
COVID-19. • 28% of the confirmed COVID-19 cases are healthcare workers and of these 210 healthcare
workers, 26% of HCW reported travelled to Michigan prior to becoming ill. • Of the COVID-19 cases reporting a risk factor, 22% had a cardiovascular condition, 11% had
diabetes and 10% had asthma. • 37% of cases reported having either a chronic or underlying condition or being
immunocompromised. • Coughing 85% was the most commonly reported symptom among cases with COVID-19
reporting any symptoms followed by fatigue (63%), malaise (62%) and fever (61%). • Approximately 27% of cases are still in self-isolation while 52% of cases have resolved.
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• Approximately 73% of the deaths have occurred in individuals 80 years or older. o 63% of the deaths were in females and 37% in males.
• The overall case fatality rate in WEC is 8.3%. When stratified by long-term care and retirement homes, the case fatality rate within long-term care and retirement homes is 16.4%.
• The trajectory of the doubling rate for COVID-19, since the first reported case, in Windsor is more than five days.
• The day-over-day doubling time has been increasing in Windsor-Essex, Ontario and Canada with the Windsor-Essex doubling time generally higher compared to the province and country since the middle of April.
• The mean R0 value is 0.86 indicating a decrease in community spread of COVID-19
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May 15, 2020
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COVID-19 Epidemiological SummaryContent covered:• Hospital Admissions based on syndromes• Epidemic curves
• By 1) Overall; 2) 3-day moving average; 3) Community vs. LTCH/RH• Regional & provincial rates• Percent positivity of COVID-19 tests• Symptomatic vs. Asymptomatic COVID-19 cases in LTCH/RH• Age & sex distribution• Distribution by municipality• Exposure history• Travel History• Healthcare worker status• Top medical risk factors• Symptoms• Hospitalizations• Outcomes• Breakdown by deaths• Doubling time• Mean R0
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Hospital Admissions Based on Syndromes (asthma, influenza-like-illness, pneumonia, sepsis or suspect COVID)
2020-05-15
September 1st May 10th
Influenza peak in 2018/19 & 2019/20
4.5
5.5
6.5
7.5
8.5
9.5
10.5
11.5
12.5
35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19
% o
f all
adm
issi
ons
Surveillance week
2018/19 2019/2020
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Epidemic Curve by Symptom Onset Date
2020-05-15
0
5
10
15
20
25
30
# of
con
firm
ed C
OVI
D-19
cas
es
Symptom Onset Date
**illness that began during this time may not yet be reported**
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Epidemic Curve by 3-Day Moving Average
2020-05-15
0
5
10
15
20
25
# of
con
firm
ed C
OVI
D-19
cas
es
Symptom onset date
**illness that began during this time may not yet be reported**
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Epidemic Curve by Community vs. LTCH/RH by Symptom Onset Date
2020-05-15
0
5
10
15
20
25
30
# of
con
firm
ed C
OVI
D-19
cas
es
Community LTCH/RH
**illness that began during this time may not yet be reported**
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**Alternative** Epidemic Curve by Community vs. LTCH/RH by Symptom Onset Date
2020-05-15
0
2
4
6
8
10
12
14
16
18
20
# of
con
firm
ed C
OVI
D-19
cas
es
Date
Community LTCH/RH
**illness that began during this time may not yet be reported**
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Regional & Provincial Rates
2020-05-15
231
194 191175 172 168 163 161 154
12294 91 85 83
145
0
50
100
150
200
250
Rate
per
100
,000
pop
ulat
ion
Geography
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Percent Positivity of People Tested for COVID-19
2020-05-15
0%
10%
20%
30%
40%
50%
60%
0
100
200
300
400
500
600
700
800
900
1000
% o
f tes
ts p
ositi
ve fo
r CO
VID-
19
Tota
l # o
f tes
ts
Date
Total Tests % of tests positive
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Symptomatic Vs. Asymptomatic Positives
2020-05-15
1.7%
0.9%
2.1%
0.4%
0.0%
0.5%
1.0%
1.5%
2.0%
2.5%
Symptomatic Positive Asymptomatic Positive
% o
f tes
ts
Test Results*
Residents Staff
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Age & Sex Distribution
2020-05-15
0 to 19years
20 to29
years
30 to39
years
40 to49
years
50 to59
years
60 to69
years
70 to79
years
80+years
Males 2% 19% 17% 14% 14% 11% 8% 15%Females 1% 16% 12% 14% 16% 11% 7% 24%
0%
5%
10%
15%
20%
25%
% o
f kno
wn
conf
irmed
cas
es
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Distribution of COVID-19 Cases by Municipality
2020-05-15
Amherstburg3%
Essex3% Kingsville
12%
LaSalle3%
Lakeshore4%
Leamington9%
Tecumseh3%
Windsor63%
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Exposure History by Reported Date
2020-05-15
0
10
20
30
40
50
60
# of
con
firm
ed C
OVI
D-19
cas
es
Reported Date
Travel Close Contact Community Transmission
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COVID-19 Cases by Healthcare Worker
2020-05-15
55
15547
464
30
0
50
100
150
200
250
300
350
400
450
500
Healthcare worker Visited a healthcare facility
Not applicable Unknown
# of
con
firm
ed C
OVI
D-19
cas
es
Healthcare worker status
Travelled to Michigan
All other HCWs
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Top Medical Risk Factors
2020-05-15
22%
11% 10%8% 7% 7% 6% 5%
3%
0%
5%
10%
15%
20%
25%
% o
f CO
VID-
19 c
ases
Top Medical Risk Factor
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Underlying Health Conditions
2020-05-15
Chronic/ Underlying/
Immunocompromised37%
None63%
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Most Common Symptoms
2020-05-15
85%
63% 62% 61%54%
44% 41% 40% 37% 35% 33%
0%10%20%30%40%50%60%70%80%90%
% o
f con
firm
ed C
OVI
D-19
cas
es
Symptom
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Hospitalizations
2020-05-15
0
10
20
30
40
50
60
70
# of
con
firm
ed C
OVI
D-19
cas
es
Date
Hospitalizations ICU Field Hospital
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Outcomes
2020-05-15
Resolved51.5%
Deceased8.3%
Self-isolating26.6%
Hospitalized3.1%
ICU0.4%
Unknown10.1%
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Age & Sex Breakdown of COVID-19 Deaths
2020-05-15
0% 0% 0% 2% 3%8%
15%
73%
37%
63%
0%
10%
20%
30%
40%
50%
60%
70%
80%
0 to 19years
20 to29
years
30 to39
years
40 to49
years
50 to59
years
60 to69
years
70 to79
years
80+years
Male Female
% o
f con
firm
ed C
OVI
D-19
dea
ths
Age Group & Sex
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Case Fatality Rate
2020-05-15
3.2%
16.4%
8.3% 8.4%
31.5%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
Community LTCH/RH Overall WEC Ontario OntarioLTCH/RH
Case
fata
lity
(%)
Setting
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Doubling Time (Cumulative Comparison)
2020-05-15
1
10
100
1000
10000
100000
1000000
10000000
100000000
1000000000
Mar/20 Mar/28 Apr/05 Apr/13 Apr/21 Apr/29 May/07 May/15
Tota
l con
firm
ed c
ases
of C
OVI
D-19
Days Since First Case Reported
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Doubling Time (Day over Day Comparison)
2020-05-15
1
10
100
28-Mar 4-Apr 11-Apr 18-Apr 25-Apr 2-May 9-May
Doub
ling
Tim
e (lo
g10)
Reported Date
ONT Doubling Time WECHU Doubling Time Canada Doubling Time
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Mean R0
2020-05-15
0
0.5
1
1.5
2
2.5
3
Mea
n R0
Date of Symptom Onset
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Summary• Case counts in Windsor-Essex continues to
decline even with increased testing• 2% of tests were positive for COVID-19 in the
past 7 days• Case-fatality rates are higher in long-term care
and retirement settings compared to the community
• Doubling time of cases is generally similar to the province and the country
• R0 < 1 signaling a decline in community spread
2020-05-15