Where can I find more information about the data used within the Respiratory Illness Data Summary?

For more information on the definitions, data sources, data considerations, weekly level cut-off values, and comparison with previous week cut-offs, click on the Data Notes section below.

What is a respiratory illness?

Many respiratory illnesses have the same symptoms but can cause different outcomes. No matter what the respiratory illness is, there are actions that can be taken to help keep yourself and others healthy and stop the spread of respiratory illness. For lists of symptoms and tips to help reduce the spread of respiratory illness, visit our webpage: Respiratory Illnesses: Flu, RSV, COVID-19.

What does it mean when the weekly level for an indicator changes?

Weekly values for the indicators in the Respiratory Illness Data Summary have been established using data from previous respiratory seasons and it is anticipated that weekly values will change throughout the 2023/2024 season, with “low” suggesting relatively low respiratory activity with respect to that indicator and “very high” suggesting relatively high activity.

It may be difficult to identify clear increasing and/or decreasing local trends using information from a single weekly update. Assessing information from consecutive updates is recommended to help recognize and understand local trends. Individuals and healthcare providers should consider trends across all indicators in their overall assessment of respiratory illness transmission.

For respiratory illness data and trends in Ontario overall, visit the Ontario Respiratory Virus Tool.

How should I use the data within the Respiratory Illness Data Summary to understand my risk of respiratory illness?

The indicators in the Respiratory Illness Data Summary were selected to provide a comprehensive overview of respiratory illness activity in Renfrew County and District.

When multiple indicators consecutively show “high” or “very high” weekly levels, there is increased risk of respiratory illness transmission.

During periods of increased risk of respiratory illness transmission, individuals and health care providers may consider implementing additional measures to help keep themselves healthy while also protecting those most vulnerable in our community.

Regardless of weekly indicator levels, the highest risk of respiratory illness transmission generally occurs between December and February.

If most of the indicators show a weekly level of “low”, does that mean I don’t have to take precautions?

Even if most indicators show a weekly level of “low”, respiratory illnesses may still be circulating in our communities. Taking the following steps to prevent respiratory illness should be a year-round consideration:

• Keep your vaccinations up to date, including your annual flu shot and any new COVID-19 vaccines that you are eligible for
• Stay home when sick
• Clean your hands often with soap and water or use hand rub containing at least 60% alcohol, and avoid touching your face with unclean hands
• Clean and disinfect high-touch surfaces and objects frequently
• Consider wearing a mask in public settings
• Improve indoor ventilation and air quality
• Pay attention to public health alerts and advice in your community

For more information, visit: Respiratory Illnesses: Flu, RSV, COVID-19.

Why are we measuring COVID-19 signals in wastewater?

People with active COVID-19 infection shed the SARS-CoV-2 virus in their stool, regardless of whether they received a COVID-19 test or are ever diagnosed. While eligibility for molecular COVID-19 testing has changed over the course of the pandemic, methods to capture local COVID-19 wastewater signals have remained consistent. In combination with other indicators, RCDHU uses COVID-19 wastewater signals to help identify periods suggestive of high-risk community transmission.

Wastewater sampling in RCD is currently limited to Pembroke and Petawawa wastewater treatment plants, which service 30% of RCDHU’s total population. As such, trends in wastewater may not necessarily reflect COVID-19 levels in Renfrew County and District overall and should be interpreted with caution.

Cut-offs for weekly levels and comparison with previous week have been established using indicator data from previous respiratory seasons in Renfrew County and District and will be routinely reviewed, assessed, and updated as needed throughout the 2023/2024 respiratory season. The indicators and definitions may also be revised.

Indicator Details

The following section provides detailed information on the indicators found in the Respiratory Illness Data Summary.

New respiratory outbreaks in healthcare and congregate institutions:

Definition

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.

Data source

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

Weekly level cut-offs

Based on distribution (approximate quartile cut-offs) of local data for last respiratory season (September 2022 – August 2023)

• Low= 0 outbreaks
• Moderate= 1 outbreak
• High= 2 to 3 outbreaks
• Very high= 4 outbreaks or more

Comparison with previous week cut-offs

Based on differences exceeding the 66th percentile of historical weekly differences for past 2 respiratory seasons (January – August 2022 and September 2022 – August 2023)

• Lower = Any decrease to 0 or a decrease of 2 outbreaks or more
• Similar = A change between -1 and 1 outbreak
• Higher = Any increase from 0 or an increase of 2 outbreaks or more

New hospital admissions for COVID-19:

Definition

Number of new COVID-19 hospitalizations by RCD residents in the past week

Data source

The provincial Case and Contact Management (CCM) solution, Ministry of Health

Data considerations

Categorized using start date of hospital admission (or reported date of case if start date of hospital admission not available). Includes hospital and ICU admissions of RCD residents to both local and non-local hospitals, but excludes admissions by non-RCD residents to local hospitals. Does not include emergency department visits.

Weekly level cut-offs

Based on distribution (approximate quartile cut-offs) of local data for last respiratory season (September 2022 – August 2023)

• Low = 0 to 1 admission
• Moderate = 2 admissions
• High = 3 to 4 admissions
• Very high = 5 admissions or more

Comparison with previous week cut-offs

Based on differences exceeding the 66th percentile of historical weekly differences for past 2 respiratory seasons (January-August 2022 and September 2022-August 2023)

• Lower = Any decrease to 0 or a decrease of 2 admissions or more
• Similar = A change between -1 and 1 admissions
• Higher = Any increase from 0 or an increase of 2 admissions or more

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. For information of current testing eligibility, visit the Ministry of Health’s COVID‑19 testing and treatment.

Weekly level cut-offs

Based on distribution (approximate quartile cut-offs) of local data for past 2 respiratory seasons (January-August 2022 and September 2022 – August 2023)

• Low = Under 7.0% positivity
• Moderate = 7.0 to 9.9% positivity
• High = 10.0 to 12.9% positivity
• Very high = 13.0% positivity or higher

Comparison with previous week cut-offs

Based on differences exceeding the 66th percentile of historical weekly differences for past 2 respiratory seasons (January-August 2022 and September 2022 – August 2023)

• Lower = Any decrease to 0 or a decrease of 3.0% or more
• Similar = A change between -2.9% and 2.9%
• Higher = Any increase from 0 or an increase of 3.0% or more

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

Data considerations

For information of current testing eligibility, visit the Public Health Ontario Respiratory Viruses (including influenza) webpage.

Weekly level cut-offs

Based on the thresholds for influenza percent positivity levels used in the Ontario Respiratory Virus Tool by Public Health Ontario (described in the Technical Notes). Local data too variable and sporadic to establish meaningful cut-offs.

• Low = Under 10.0% positivity
• Moderate = 10.0 to 24.9% positivity
• High = 25.0 to 39.9% positivity
• Very high = 40.0% positivity or higher

Comparison with previous week cut-offs

Based on the comparison with previous week cut-offs for COVID-19 percent (%) positivity for consistency across indicators related to percent positivity. Local data too variable and sporadic to establish meaningful cut-offs.

• Lower = Any decrease to 0 or a decrease of 3.0% or more
• Similar = A change between -2.9% and 2.9%
• Higher = Any increase from 0 or an increase of 3.0% or more

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.

Weekly level cut-offs

Based on distribution (approximate quartile cut-offs) of local data for last respiratory season (September 2022 – August 2023)

• Low = Less than 9.0% of visits
• Moderate = 9.0 to 10.9%% of visits
• High = 11.0 to 13.9% of visits
• Very high = 14.0% of visits or higher

For more information on respiratory-related emergency department visits in Ontario, visit KFL&A’s Viral Respiratory Mapper.

Comparison with previous week cut-offs

Based on differences exceeding the 66th percentile of historical weekly differences for last respiratory season (September 2022 – August 2023)

• Lower = Any decrease to 0 or a decrease of 1.5% or more
• Similar = A change between -1.5% and 1.5%
• Higher = Any increase from 0 or an increase of 1.5% or more

COVID-19 wastewater signal (Pembroke)

COVID-19 wastewater signal (Petawawa)

Definition

Weekly average concentrations of viral COVID-19 (SARS-CoV-2) N1N2 gene copies per milliliter divided by copies per milliliter of the pepper mild mottle virus (PPMoV), a seasonally stable biological marker. Weekly averages are typically based on 3 to 5 samples.

Data source

RCDHU appreciates the support and collaboration of Ontario Wastewater Surveillance Initiative partners that make the collection, analysis, and sharing of local wastewater data possible. Wastewater samples are collected by the Pembroke Pollution Control Centre and the Petawawa Wastewater Treatment Facility and analyzed at Carleton University. Data is uploaded to the Ontario Wastewater Surveillance Initiative Data and Visualization Hub (Ministry of the Environment, Conservation and Parks).

Data considerations

Wastewater sampling in RCD is currently limited to Pembroke and Petawawa wastewater treatment plants, which service 30% of RCDHU’s total population. As such, trends in wastewater may not necessarily reflect COVID-19 levels in RCD overall and should be interpreted with caution.

For more information on COVID-19 wastewater surveillance in Ontario and for Eastern Region public health units (where Renfrew County and District is situated), visit COVID-19 Wastewater Surveillance in Ontario.

Weekly level cut-offs

Based on distribution (quartile cut-offs) of local data for past 2 respiratory seasons (January-August 2022 and September 2022 – August 2023)

Pembroke

• Low= Less than 0.006
• Moderate= 0.006 to 0.013
• High= 0.014 to 0.025
• Very high= 0.026 or higher

Petawawa

• Low= Less than 0.005
• Moderate= 0.005 to 0.008
• High= 0.009 to 0.018
• Very high= 0.019 or higher

Comparison with previous week cut-offs

Based on differences exceeding the 66th percentile of historical weekly differences for past 2 respiratory seasons (January – August 2022 and September 2022 – August 2023)

Pembroke

• Lower= A decrease of 0.010 or more
• Similar= A change between -0.009 and 0.009
• Higher= An increase of 0.010 or more

Petawawa

• Lower= A decrease of 0.007 or more
• Similar= A change between -0.006 and 0.006
• Higher= An increase of 0.007 or more