Newfoundland and Labrador is reporting 493 new cases of COVID-19 as the province enters a modified version of Alert Level 4, tightening public health restrictions to slow the spread of the fast-moving Omicron variant.
Tuesday's total is a slight drop in the number of reported cases, marking the first day the province hasn't recorded a new record high in eight days.
There are 267 new cases in the Eastern Health region, including 167 people under the age of 50. There are 125 cases in the Labrador-Grenfell region, 57 cases in the Central Health region, 33 in the Western Health region, and 11 cases found in a private testing lab outside the regional health authorities.
The new case totals, offset by 164 reported recoveries, raise the province's active caseload to a new high of 3,254. One person is in hospital due to COVID-19.
Since Monday, 4,033 tests have been done, with a positivity rate of 12.2 per cent. Test positivity is the percentage of the COVID-19 tests performed that produced a positive result.
The higher the positivity rate the higher the amount of transmission, but doesn't necessarily reflect overall positivity in the general population, if a province isn't testing enough people or people aren't seeking out tests. The rate also does not include rapid test results, which are usually done by individuals and not reported to officials.
In the first few weeks of the pandemic in Newfoundland and Labrador, the provincial positivity rate generally ranged from about four per cent to 10 per cent and then swiftly dropped as the government imposed sweeping lockdowns. Last February, when cases surged again, the positivity rate topped out at about six per cent before dropping again.
The rate is significantly higher in some other provinces. Ontario is grappling with a near 31 per cent daily positivity rate, and in Manitoba the rate skyrocketed to 37.9 per cent on Monday. Alberta's was around 30 per cent on Thursday, the last time the province reported new numbers.
Although the number of tests completed is rising daily, public health reaffirmed changes to the criteria for PCR testing announced at Monday's COVID-19 briefing.
Effective immediately, says public health, anyone who is a close contact of a case and has symptoms should assume they are positive for COVID-19. Officials say a test is not needed to confirm the result, but any close contacts who are asymptomatic should get tested. Anyone who has symptoms and is not a close contact of a case should also be tested.
The change was made as the demand for testing is exceeding processing capacity, Chief Medical Officer of Health Dr. Janice Fitzgerald said Monday. She said the time to get test results back from the province's laboratory is around three days.
All outpatient appointments cancelled at Miller Centre
New cases continue to crop up in hospitals in the province. On Tuesday morning Eastern Health said five patients on a unit at the Dr. L.A. Miller Centre in St. John's tested positive for COVID-19.
Eastern Health subsequently cancelled all outpatient appointments at the hospital. Patients will be contacted by their health-care team regarding their next appointment.
"Following the first positive case reported on Dec. 29, testing and investigation have been ongoing, resulting in the identification of an additional number of positive cases on the unit," the health authority said in a media release.
"Eastern Health is awaiting some test results and has moved quickly to minimize any potential spread of the COVID-19 virus at this site."
The release said testing of affected patients is complete, and all COVID-19 positive patients on the unit were close contacts of each other. They are in isolation, Eastern Health said, and following infection-control procedures. All other patients on the unit have tested negative for COVID-19 to date, and the unit is closed to new admissions and to visitors.
Staff members who were considered direct contacts of the positive patients have also been tested.
"A small number of staff at the site have tested positive to date," said Eastern Health's statement.
Eastern Health said it hasn't confirmed the positive cases are connected to the patients on the unit. Contact tracing is underway and the movement of staff is limited in and out of the unit.
On Monday an Eastern Health spokesperson told CBC News there are about 330 staff and physicians in isolation for a variety of reasons in the region, including people who are asymptomatic contacts of confirmed cases, staff who have symptoms of COVID-19 and people who have tested positive.
Eastern Health has also opened another COVID-19 vaccine clinic at the Reid Community Centre in Mount Pearl. Appointments — open to anyone 30 years old and older — began Tuesday morning and the clinic will run until Jan. 14.
Elsewhere, Newfoundland and Labrador provincial court is limiting its regular operations starting Tuesday. Public access to all provincial courthouses and all in-person hearings are shut down.
All adult and youth criminal appearances, trials, hearings, and sentencings scheduled until Jan. 17 will be rescheduled to two weeks from the date of the scheduled court appearance or the next court date thereafter. Civil matters scheduled until Jan. 17 are adjourned indefinitely and parties will be contacted by the court for rescheduling.
Officials in the Western Heath region say routine bloodwork appointments have been cancelled for the rest of the week due to an increase in the number of workers impacted by COVID-19. Appointments will continue in urgent circumstances for INR patients, transplants or chemotherapy blood work.
'You just can't keep up with it'
Rod Russell, a virologist and immunologist at Memorial University, said it's still too early to call Omicron mild — particularly for people who are unvaccinated, including children.
"How severe this variant affects you is really going to depend on your age and your immune status, and it's not going to be mild for everyone," he said.
On the positive side, Russell said there's less chance a person will need to be hospitalized with the virus but it's overall hospital numbers that need to be watched.
"Even if the virus is a little bit less severe on an individual basis, if you've got five times as many cases, we're still going to have hospital overload, which is why they're putting restrictions in place now," he said.
Chief Medical Officer of Health Dr. Janice Fitzgerald said Monday "most people" will acquire COVID-19, given how infectious Omicron is. She said the health-care system can't stand the pressure of everyone getting infected at the same time
Russell said he believes Fitzgerald is right, and getting a booster dose is important.
"People with third shots typically have very mild symptoms. Of course that can change with age," he said.
"You just can't keep up with it. You can't test and trace like we did in the past because it just spreads too fast. So I believe, yes, we are all going to get infected with this within the next little while."