It’s an area of around 200,000 people with a large university, several federal prisons, a large elderly population – and only 21 active cases of COVID-19.
The Kingston area, despite its many institutions and proximity to the U.S. border, has seen only one virus-related death during the pandemic. There have been no deaths in long-term care facilities and was one of only three health regions in Ontario allowed to go green on February 10.
How did Kingston do it?
Just check out the local health unit’s YouTube page, where Medical Officer of Health Dr Kieran Moore – armed with a sharpie and flip chart – outlines the region’s strategy to respond to the pandemic.
It is a confluence of factors that has resulted in Kingston keeping its case count low. Basically, he was able to flatten the curve by going ahead of the curve.
“It’s a whole series of a community that is ready to get tested, a lab system that works locally with a high turnaround time, a public health system that responds within 24 hours and when you all have it. those dominoes lined up, you can have a very effective response system, ”Moore said.
The region recognized the importance of physical distance early in the first wave, introduced mandatory mask policies long before it became provincial policy, and implemented a system of in-depth testing with 24-hour results.
At first glance, Kingston hardly looks like a fortress protected from COVID-19. As well as being a retirement destination for many, it is three hours from Toronto and Montreal – cities that saw high numbers of cases in the first wave. It is also close to the US border, which has raised concerns.
“I was worried about us in our positioning between cities and countries at very high risk, but we were able, thanks to this multimodal approach, to limit the infection,” said Moore.
Kingston, with its rich history and quaint downtown area, is also popular for tourism. Few people know this better than Michael Argiris, owner of Restaurant Morrison. His restaurant, often described as a Kingston institution, is set to celebrate its 100th anniversary this year.
“You’d be surprised how many people come here from all over the place,” Argiris said, noting that he receives clients from Toronto, Montreal and the United States.
In his 31 years of operating the restaurant, he said he had never seen the streets as empty as they were during the first lockdown. Since reopening on February 10, he has acknowledged that some loyal customers are returning, but he acknowledged that it can be difficult to determine where everyone is coming from.
“Sometimes I ask where you’re from, and they say we’re from here,” Argiris said. “It’s very difficult… We don’t ask everyone.”
The key to Kingston’s success was to be extremely proactive. As early as March 5, even before the World Health Organization declared a global pandemic, Moore was meeting with primary care partners to discuss how they could prevent the virus from sweeping through their vulnerable populations.
It was obvious from the start, from the way the virus was spreading internationally, that the elderly population was most at risk. Moore said Kingston has already enjoyed a strong relationship with doctors and nurses at local long-term care homes.
About 18% of Kingston’s population is over 65.
“I was very anxious to monitor this data,” Moore said. “And we were determined in February 2020 not to let this virus enter our vulnerable environments.”
On March 17, about a week before Ontario’s first major lockdown, Moore restricted visitors and non-essential appointments. A turning point came in the summer, when the city had an outbreak at a nail salon in June.
Public health has linked 10 cases of the virus to the salon, cases that have been determined to be from staff not following best practices for mask-wearing and hand hygiene.
On June 26, a day after the outbreak was declared, Kingston introduced a mandatory mask policy in all indoor workplaces, making it one of the first municipalities in the province to do so. Ontario didn’t make masks mandatory until October 2.
“It was a very early lesson for us… It wasn’t well received at first, and people certainly don’t like being forced into public health measures,” Moore said.
“But our community embraced it. And from that day forward, I think being one of the early implementers (with) early adherence to best practices really saved us.
Moore acknowledges that it was a “risky” time to introduce a mandatory mask policy as there was still a lot of controversy over their effectiveness.
“Even though the science had a certain level of uncertainty, in the face of an epidemic, I thought it was reasonable,” he said. “Afterwards, science supported us.”
Public acceptance of restrictions and testing was crucial to the success of the community. Moore said that in the week after the mandatory mask policy was introduced, around 8,000 people showed up for testing.
Other factors worked in the region’s favor. He has a Public Health Ontario laboratory at the local hospital, which made it possible to retrieve test results within 24 hours. Queen’s University also has a testing site on campus.
Kingston has a large number of government and post-secondary education workers who were able to work from home during the first wave, and it lacks food processing plants.
“We knew this virus spreads quickly in meat packing plants and other dense areas where a lot of workers work together,” Moore said. “We don’t have that.”
Dick Zoutman, infectious disease specialist at Queen’s University, praised the public health unit for its handling of the pandemic.
“The most remarkable thing is that we had a death. He’s one too many and he’s someone’s loved one. But it’s a death.
He credits clear and consistent public health messages, extensive testing and most importantly his rapid response to the summer outbreak to the low number of cases in the region.
“It makes all the difference,” Zoutman said. “When responding to a public event, you have to act fast because, as they say, perfection is the enemy of good.”