Public health statistics suggest there has been a clear shift in the ways people are contracting COVID-19 in York Region — from travel and close contact to community spread and institutional outbreaks.

At first, confirmed COVID-19 cases were primarily confined to those who travelled outside Canada and those who had close contact with the travellers.

While travel-related infections originally accounted for the majority of confirmed cases in York Region, patients are increasingly reported as having caught the virus in the community, such as gyms, seniors homes and hospitals.

So, what do these trends mean and how are they affecting our lives?

Community spread expanding

As of Monday, confirmed coronavirus cases acquired through “local transmission” had jumped from zero to 81 in less than a month, according to public health data.

Local transmission, widely known as “community spread”, means the infected individual has not travelled outside of Canada and had no close contact with any known cases. In other words, the individual was infected through unknown sources in the community.

While the first confirmed coronavirus case was reported in the region as early as Feb. 27, there had been no known infection from the community until early March, when the first local transmission case was confirmed by York Region Public Health.

A Vaughan woman in her 60s tested positive for coronavirus after contracting it in the community on March 7.

Since then, the virus has started spread fast across the community, and local transmission now accounts for 17 per cent of all confirmed cases.

There have been a total of 464 confirmed cases in the region, as of Monday. The stats show that 184 are under investigation, 96 are listed as travel, 81 is blamed on community spread, 65 as close contact and 38 as institutional outbreak.

Fatal institutional outbreaks

York Region has also seen an increase in institutional outbreaks and community clusters since late March.

Public health authorities have reported four outbreaks of COVID-19 in three long-term care homes: Markhaven Home for Seniors and Yee Hong Ho Lai Oi Wan Centre in Markham, and Villa Leonardo Gambin in Woodbridge.

There have been 38 cases of COVID-19 in these institutional outbreaks, resulting in seven deaths, as of Monday.

The deaths in the long-term care homes have accounted almost half of all COVID-19-related deaths in the region so far.

An institutional outbreak generally means the occurrence of at least two acute respiratory infections within 48 hours, with a common link such as sharing a unit or a floor in a facility, as it is defined by the Health Protection and Promotion Act.

Facilities include long-term care homes, retirement homes, group home, child-care centres, hospitals or correctional facilities.

Meanwhile, “community cluster” has become another way of contracting the virus in the region, which means a group of confirmed cases can be traced back to a single common source, such as a gym, grocery store or restaurant.

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At the moment, at least three community clusters have occurred in the region: two gyms in Vaughan — Al Palladini Community Centre Gym and Body Barre Fitness and Training Studio — and the psychiatrist level of the Mackenzie Richmond Hill Hospital.

Silent spreaders

It is now a known fact that many individuals who have contracted coronavirus may develop mild symptoms, and some have no symptoms at all (known as asymptomatic carriers).

Are these symptom-free cases being tested in York Region?

The short answer is no.

“COVID-19 assessment centres are testing based on clinical assessment of the individual,” Scott Cholewa with the public health department said.

Certain groups of individuals are prioritized for testing. For example, all health-care workers should be tested for COVID-19 if they are experiencing symptoms, he added.

Can the asymptomatic carriers infect others?

The short answer is yes.

“Our current guidance in terms of following contacts of a case is precautionary and assumes that it is possible a person may be infectious, or able to transmit COVID-19, right before their symptoms develop,” Cholewa noted.

While there isn’t much data available in Canada, the U.S. Centers for Disease Control and Prevention estimated that around 10 per cent of new infections are being spread by either healthy-looking, asymptomatic people or people who have yet to develop symptoms.

Federal and regional public health authorities have continued to urge people to practise physical distancing and good hand hygiene.