'Watching the data closely:' Moore says province faces a potentially difficult fall and winter with flu, COVID and RSV all circulating

Ontario’s chief medical officer of health is urging people to get their vaccinations as the province prepares to deal with what they anticipate will be a challenging fall and winter season with increased levels of influenza, COVID-19 and RSV.

“It’s the threat of both RSV virus, which chiefly affects the very young and the very old, influenza and COVID 19,” Dr. Kieran Moore told CP24 when asked what keeps him up at night. “And we’re starting to see influenza increase in risk across Ontario.”

Moore said there are already 18 people in Ontario’s intensive care units due to influenza, eight of them on ventilators.

“So the vaccine is now available for the general public and we’re absolutely encouraging all Ontarians to come forward to get vaccinated,” he said. “The next couple of weeks are going to be so important to maintain protection with the vaccine against influenza.”

He also urged people to get their COVID-19 booster shots and noted that uptake of the boosters has generally been low, with only around 1.5 million people in the province getting the jab.

The latest data from the province shows that the number of COVID-19 shots handed out over the past couple of months has been increasing and now stands at an average of around 42,000 per day, the vast majority of them booster shots. But that’s still thought to be a far cry from levels needed to blunt the impact of the virus this season.

Both flu shots and COVID-19 shots are available widely at public health clinics and pharmacies now.

The flu shot is available free of charge to anyone six months or older. According to the province, the shot is especially important for children under five, those who are pregnant and those 65 years and older who are at higher risk of hospitalization and flu-related complications, such as pneumonia, heart attack or death.

The province is focusing its influenza vaccination efforts on those most at risk from the virus such as the elderly and those with underlying health conditions. Still, Ontario estimates that there around 6 million people who are considered higher risk for ending up in hospital if they catch influenza.  

Compounding concerns over respiratory illnesses this season is an increase in RSV, a respiratory virus which primarily affects young children and older adults. There has already been a spike in the virus, with emergency rooms being flooded by parents bringing in young children.

No vaccine is available so far for RSV, though at least two companies are testing vaccine candidates.

At the same time, emergency rooms in Ontario have been overwhelmed in recent months, with lengthy wait times and chronic staff shortages.

Toronto’s Hospital for Sick Children (SickKids) told CP24 last week that their patient volumes are “unseasonably high” heading into flu season and urged parents and caregivers to consider other options before coming to the emergency department.

Moore urged people to use online resources to assess whether they need to seek treatment for a respiratory illness and said the province is trying to build capacity to assess people who are presenting with respiratory illnesses. In the meantime, he said, getting vaccinated is the most important step people can take an order to protect themselves and others heading into what is expected to be a tough flu season.

“Sadly, that risk will rise. But we all have an opportunity now to prevent that increase by getting immunized,” Moore said. “The vaccine for influenza –  what’s circulating right now seems to be a very good match to the vaccine – so we do anticipate it having a strong protective effect against the need to be hospitalized.

He added that “we’ve got a couple of weeks” left to protect as many Ontarians as possible with influenza season starting earlier than usual this year.

“We’re absolutely watching the data so closely — both COVID impact on the hospital, RSV impact, as well as influenza,” Moore said. “So we’ll know if it’s starting to take off.”

He said that typically occurs when the percentage of tests that are positive for influenza reaches above five per cent.

“(It’s then) that we know it typically starts to escalate in our communities, reaches a peak around six weeks later, and then slows down,” Moore said. “So it’s often a three-month annual epidemic that we’re going to be dealing with and we know some of the tools that can help us and number one, it’s immunizations. Number two if you’re at risk, please please please consider masking up as the risk increases across Ontario.”

There are few locations where masks are still mandatory in the province, but health officials have been advising people to mask up in higher-risk areas such as transit, especially if they are vulnerable to infection or are immunocompromised.