N.B. COVID-19 roundup: Boosters available to everyone 18+, hospitalizations hit record-high

All New Brunswickers aged 18 and older will be eligible to receive a COVID-19 vaccine booster starting Monday, as long as five months have passed since their second dose.

Health Minister Dorothy Shephard made the announcement Friday, as COVID-19 claimed the life of another New Brunswicker and the province reported a record-high number of COVID hospitalizations.

A COVID-19 outbreak has also been declared at the Edmundston Regional Hospital, which has 14 COVID-19 patients, three of whom are in intensive care, and COVID exposures on three nursing units.

Until now, boosters have been limited to certain groups, including people 50 or older.

All pregnant women are also immediately eligible.

Shephard called the accelerated expanded eligibility an "important step forward" in protecting New Brunswickers as the Omicron variant surges.

The pandemic "now poses a grave threat to our health-care system," Dr. Jennifer Russell, chief medical officer of health, told a COVID-19 briefing.

"It is urgent that every New Brunswicker get vaccinated."

A person over 90 in the Moncton region, Zone 1, has died as a result of COVID-19, raising the pandemic death toll to 170.

Sixty-nine people are now hospitalized with the virus, up from 63 on Thursday, including 17 in intensive care, down two.

The highest number of hospitalizations previously recorded was 68 on Oct. 13.

Fourteen people are on ventilators, an increase of three.

Of those in hospital, 50 are over 60 and two are 19 or under.

Public Health reported 840 new cases of COVID-19, based on PCR (polymerase chain reaction) lab tests, which are being limited to groups considered at the highest risk of being hospitalized because of the virus.

That total does not include positive rapid test results, which are not diagnostic but the province is now treating as confirmatory and asking people to self-report online.

This week, 2,009 people have registered as being positive, said Shephard.

A total of 347 health-care workers have tested positive for COVID-19, she said, and another 198 are isolating.

"In the coming weeks, it is likely the health-care system will be tested like never before," Shephard told the briefing.

Get your shot as soon as you can.- Jennifer Russell, chief medical officer of health

Cases and hospitalizations are expected to continue to rise, she said.

More health-care workers will be off.

And service reductions at hospitals, which were moved to the red COVID alert level on Dec. 31, providing emergency or urgent services only, will also continue.

Shephard expects the "already fragile" health-care system is going to be in a "pretty serious crunch" over the next four to six weeks.

"We know that employers are going to be affected every single day throughout the next four to six weeks. We know that critical infrastructure employees will be affected by COVID. It is a serious issue."

No plans to move to Level 3

The province has no immediate plans to move to the more restrictive Level 3 of the COVID-19 winter plan, according to Shephard. But she did not rule out the possibility.

"We have a Level 3, so obviously it has been considered," she told reporters. "There's nothing stating that we won't go to Level 3 as we continue through our circumstances."

Earlier this week, the head of family medicine for the Horizon Health Network in the Miramichi area called on the government to lock down the province.

Dr. Roxanne MacKnight said the virus is "running rampant" and health care is "in crisis," citing staff shortages, as well as elective surgeries, lab work and X-rays being postponed.

Shephard said the province won't hesitate to go to Level 3 if it feels it's "necessary" and if Public Health supports the move.

"So it's not off the table," she said.

Under Level 3, social gatherings would be limited to single household bubbles; no public gatherings would be permitted; restaurants would be takeout only; non-essential retail would be reduced to contactless pickup or delivery only; gyms, salons and entertainment centres would be closed, and faith services would only be allowed outdoors or virtually.

The plan lays out several assessment criteria to determine if a level change is needed. To move to Level 3, the criteria includes an increasing seven-day average of new hospital admissions, and 100 active COVID-19 hospitalizations provincially or 50 COVID patients in intensive care.

"Recently, we have been seeing younger, unvaccinated individuals under the age of 50 and 40 succumbing to the virus," said Russell.

While the province is also seeing "hundreds" of so-called "breakthrough" cases of COVID-19 each day in people who are fully vaccinated, "most" of them don't require hospitalization, she said.

"Severe illness and hospitalization due to COVID-19 continues to hit hardest at those who are unvaccinated."

Since Aug. 1, unvaccinated New Brunswickers have been hospitalized for COVID-19 at a rate of 283.5 per 100,000, said Russell. By comparison, the rate for those vaccinated with at least two doses of a vaccine is 31.1, she told the briefing.

During that same period, unvaccinated New Brunswickers have ended up in the intensive care unit at a rate of 35.9 per 100,000, compared to 7.2 per 100,000 for the fully vaccinated population.

"Make an appointment today," Russell urged, suggesting demand for appointments will increase as eligibility broadens. "Get your shot as soon as you can."

Anyone 30 and older will be given the Moderna vaccine, regardless of which vaccine they received for previous doses. The limited national supply of Pfizer-BioNTech vaccine will be reserved for those aged 12 to 29 "because there is evidence that the risk of myocarditis/pericarditis for this age group is decreased with the Pfizer vaccine as opposed to Moderna," Public Health said.

"The risk posed by the Moderna vaccine is less for those 30 and older."

People shouldn't wait for a different brand because it will be "several" months, said Russell.

"What matters right now is that everyone gets a booster as soon as possible," she said, describing Moderna as a "safe and effective" vaccine.

The province's original plan called for booster eligibility to expand to people 40 to 49 by "mid-January," people 30 to 39 by "late January," and people 18 to 29 by February, according to the government's vaccines website.

Right now, those who are eligible include people 50 or older, members of First Nations communities, and residents of nursing homes and adult residential facilities, as long as five months have passed since their second dose.

Health-care workers, school employees, and early childhood education and daycare staff are also eligible five months after their second shot, along with their immediate household family members aged 18 or older.

People who are immunocompromised can also book a booster dose if at least five months have passed since their last mRNA COVID-19 vaccine.

Waning demand

As of Friday, 23.6 per cent of eligible New Brunswickers have received a booster dose, up from 22.6 per cent on Thursday.

A total of 83.1 per cent of eligible New Brunswickers have received at least two doses of COVID-19 vaccine, up from 83 per cent, and 90.6 per cent have received their first dose, up from 90.5 per cent.

Jake Reid, executive director of the New Brunswick Pharmacists' Association, said this is a good time to expand eligibility because demand has started to wane.

Interest was high in December, he said, noting one pharmacist even administered 57 shots on Christmas Day.

But not many people have been attending clinics over the past few days.

"I'm aware of a clinic, for instance, in Fredericton here, they had an opening for 250 people for appointments and they could only fill 50 of those. So it seems like the demand for the boosters has started to slow a little bit. And we still see a little trickle, of course, for people for their first and second doses."

Reid said Public Health was also hoping to see about 50 per cent of children aged five to 11 get their first shot by the end December. But it's below that target, at about 46.3 per cent.

"So I think that you'll see a lot of messaging from Public Health and others really reminding those school age children and their parents to try to get them in for their first doses. And that first bunch will be due for their second doses fairly soon."

The breakdown of the 840 new PCR-confirmed COVID-19 cases includes:

• Moncton region, Zone 1 — 220
• Saint John region, Zone 2 — 270
• Fredericton region, Zone 3 — 108
• Edmundston region, Zone 4 — 53
• Campbellton region, Zone 5 — 26
• Bathurst region, Zone 6 — 115
• Miramichi region, Zone 7 — 48

There are now 7,558 active cases of COVID across the province, based on PCR results.

Starting Saturday, new PCR-confirmed cases and "other data updates" will be available only on the province's COVID-19 dashboard and will not be included in future news releases, Public Health announced earlier this week.

On Friday, it also announced there will be no COVID-19 news release issued over the weekend.

"Updated data on vaccination rates, hospitalizations, case numbers and certain other information will be available on the COVID-19 dashboard," it said.

The province has been reporting only PCR-positive cases in its daily case counts since Tuesday; no positive rapid test results.

"We know that we're not going to get every single positive case registered," Shephard told reporters of the new self-reporting system. The hope is to have "a fairly good indication of what our numbers are at."

She did not say whether the province will begin making the positive rapid-test results public.

CBC asked the Department of Health for four straight days, but did not receive a clear answer, as of end of the day Friday.

Use of the free rapid tests is now limited to people aged two to 49 who have symptoms, and they must book an appointment online or by calling Tele-Care 811 to pick up rapid tests.

Shephard said that's because the federal government is going to start allocating the tests to provinces and territories on a per-capita basis.

"So 2.9 million tests are being received from the federal government from their current supply of 140 million," she said. "That's why we've made the change in our testing policy, so that we can be prudent about the distribution of our rapid tests."

"We feel that we're finding a very good balance in helping the people of our province get rapid access to testing."

Federal Health Minister Jean-Yves Duclos has said the 140 million tests are enough to provide one rapid test per week, per person, in Canada for January.

On Wednesday, the province expected to receive 4.7 million tests by next week.

Asked whether the province plans to set aside any rapid tests for front-line workers and first responders who have been testing themselves regularly, to ensure no gaps in those services, Shephard indicated the Department of Health will manage the supply for long-term care facilities.

She pointed out the change in policy is to test only when symptomatic.

Shephard acknowledged "there are bugs" with the new system, including where and when people can access the tests. 

"The Department of Health is working with the [regional health authorities] to try to alleviate some of these barriers," she said.

One of the challenges in using other areas as distribution sites, she noted, is the risk of exposing people to those who are exhibiting COVID-like symptoms.

"As soon as we can make changes that make it easier for people to get their rapid tests, we certainly will."

People who don't have a computer or access to the internet cannot currently register their positive rapid test results, but Shephard said it's possible a phone line could be set up in the future.

A total of 634,368 PCR tests have been conducted to date, including 1,991 on Thursday. That puts the positivity rate at 42.2 per cent.

Another criteria for moving from Level 2 to Level 3 is a positivity rate of 15 per cent provincially or in any single zone.

New Brunswick has had 19,857 confirmed cases of COVID-19, with 12,127 recoveries so far.

PCR tests are now reserved for those at the highest risk of being hospitalized due to COVID-19. These include:

• Health-care workers and those who live or work in long-term care facilities, homeless shelters and correctional facilities.
• People who are symptomatic and aged 50 and over.
• People who are symptomatic and immunocompromised.
• People who are symptomatic and pregnant.
• People who are identified as a priority by Public Health.

People who need a PCR test for travel, residents of First Nations communities and children under two are also eligible to receive a PCR test.

Edmundston hospital outbreak

Admissions to the Edmundston Regional Hospital, where a COVID-19 outbreak has been declared, will be evaluated on a case-by-case basis and limited to only those deemed required, the Vitalité Health Network said Friday, citing the risk of transmission.

The hospital has 14 admitted patients with COVID-19, three of whom are in intensive care, and COVID exposures on nursing units.

Vitalité did not state which units in a news release announcing the outbreak.

Patients with appointments can attend the hospital at their scheduled day and time, according to the news release. Vitalité will contact patients whose appointments must be rescheduled.

The emergency room remains open, but people are asked to limit their visits to urgent cases.

Oncology and hemodialysis services continue. Bloodwork services also continue, but Vitalité asks patients only go to the hospital if their bloodwork cannot wait.

Surgical services; ambulatory care services; medical imaging services, such as X-rays and scans; and professional services, such as respiratory therapy, physiotherapy and speech-language pathology are all under a "slowdown."

Visits by designated support persons are suspended until further notice, except for patients at end-of-life (palliative care and medical assistance in dying) and in obstetrics (deliveries), pediatrics and intensive care.

Hospital red alerts continue amid 5th wave

The COVID briefing comes as New Brunswick is entering the Omicron-fuelled fifth wave of the pandemic, according to the regional health authorities.

"As we enter the fifth wave of the pandemic, [the Vitalité Health Network] is getting ready to maintain the health care system in place for New Brunswickers," Vitalité said in a "situation report" issued late Thursday afternoon.

"As a health care leader, we understand that this period can be worrisome. The network is committed to communicating proactively with the public as often as necessary."

Vitalité and the Horizon Health Network both moved to the red COVID alert level on Dec. 31, providing emergency or urgent services only in order to re-assign staff to priority areas, such as emergency departments and ICUs, inpatient units, COVID-19 assessment centres and vaccination clinics.

At that time, Horizon also referred in a "status report" to "dealing with a fifth wave."

"The highly contagious Omicron variant has resulted in a significant increase in the number of COVID-19 cases among our population," it said. "This has impacted Horizon's staffing levels in an already stretched health care system."

The government has made no mention of a fifth wave in its daily COVID-19 news releases.

At Friday's COVID-19 briefing, Dr. Jennifer Russell, chief medical officer of health, thanked the "vast majority" of New Brunswickers who are "doing their part to stem the tide of this latest wave of COVID-19."

Horizon's hospitals remain at red alert, and are beyond or near capacity, according to a status report issued Friday.

The Miramichi Regional Hospital has the highest occupancy at 101 per cent, with five COVID-19 patients, two of whom are in intensive care. The Saint John Regional Hospital, which has the highest number of COVID-19 patients, at 24, including two in intensive care, has an occupancy rate of 97 per cent.

A total of 198 health-care workers have tested positive for COVID-19 and are isolating. The regional breakdown includes:

• Moncton region, Zone 1 — 41
• Saint John region, Zone 2 — 112
• Fredericton region, Zone 3 — 33
• Miramichi region, Zone 7 — 12

This week, 237 surgeries have been postponed and 6,618 lab, diagnostic imaging, or professional services appointments have been postponed.

Oncology services continue.

No social visitors are allowed at Horizon hospitals and health-care facilities, except for patients who qualify for a designated support person.

Vitalité is running at 98 per cent capacity with 36 COVID patients, including 14 in intensive care, according to Thursday's situation report.

The hospital with the highest bed occupancy rate, Stella-Maris-de-Kent Hospital, at 130 per cent, has no COVID patients. Meanwhile the Edmundston Regional Hospital, which has the highest number of COVID patients, at 23, has the third lowest occupancy rate at 89 per cent.

A total of 108 Vitalité health-care workers are off because of COVID. That's up from 70 on Tuesday.

Omicron surge compounds nursing shortage

The president of the New Brunswick Nurses Union says the Omicron surge taxing the health-care system is compounding the longstanding issue of multiple nurse vacancies.

As of Tuesday, 571 health-care workers across the province were isolating at home because of the virus, according to Public Health.

Meanwhile, there are about 1,300 nurse vacancies across the province, said Paula Doucet. In some emergency units, there are six nurses on shift when there should be 15, she said.

"They're left scrambling and taking on more responsibility and trying to do … the best they can with the resources that they have, knowing full well that they're just touching the surface of each of those patients that are requiring their expertise and their care."

Nurses continue to leave the profession through retirements and career moves, said Doucet.

"We're also hearing the stories of nurses, you know, mid-career with lots of experience and expertise just saying, 'I'm not doing this anymore, but I'm going to sign up for travel nursing and I'm going to go somewhere else in Canada, the U.S. or another part of the world for a short period of time … do my nursing there, and then come home and rest and rejuvenate, spend time with my family.'"

Doucet says they're leaving to seek better pay, and a lighter workload.