COVID-19 One Year On: Timeline

Looking back at LHSC’s response to the novel coronavirus

On March 11, 2020 the World Health Organization declared a pandemic in response to rising cases of the novel coronavirus (COVID-19) around the world. Until that time, LHSC had seen only one case of COVID-19 in January that year, one of only a handful of confirmed cases in the province. Since the pandemic was officially declared, the numbers have grown to over 117,000,000 cases and tragically more than 2,600,000 confirmed deaths world-wide.

Despite uncertainty, fear and turmoil, the resiliency, dedication and compassion shown by staff and physicians over the past year at LHSC will become a defining cornerstone in our organization’s history. Throughout LHSC’s pandemic response, patients have remained at the centre of everything we do, supported by remarkable research and innovation during the pandemic, from adapting practices to developing new treatment options.

The emotional, mental and physical toll the pandemic has taken on staff, physicians and patients cannot be understated. Supports are available to patients and families, as well as staff and physicians (LHSC login needed).

One Year On provides us with an opportunity to reflect on LHSC’s health-care heroes, the support of our community, and moments that have changed our lives. We could not have done this without our many partners in the community.

This timeline should not be considered exhaustive, and is specific to LHSC's corporate experience, recognizing that individuals' experiences of the events are different. We encourage staff and physicians to share their stories and experiences of the pandemic through the Tell Us Your COVID story (LHSC login needed).

March 2020 – Pandemic declared

Assessment Centre

With the pandemic declared and Ontario moving into a State of Emergency on March 17, LHSC quickly mobilized to respond to the rapidly evolving situation.

  • March 16: In adherence to provincial directives, LHSC announced reductions to non-essential clinical services, visitor restrictions and new screening protocols. Volunteer and non-physician learner activity were also suspended.
  • March 16: London’s first COVID-19 Assessment Centre opened at Oakridge Arena. The second COVID-19 Assessment Centre opened at Carling Heights Optimist Community Centre on March 20.
  • March 18: Lawson Health Research Institute, LHSC’s research institute, limited research activity to essential studies only, and began mobilizing its research efforts in the fight against COVID-19.
  • March 28: LHSC announced London’s first COVID-19 death, extending collective thoughts to the patient’s family.

Throughout the month of March, the Pathology and Laboratory Medicine (PaLM) team began processing COVID-19 test swabs with a goal of increasing from an initial 50 tests per day to 3,000 tests per day.

Meanwhile LHSC’s Infection Prevention and Control (IPC) team implemented evidence-based infection prevention and control measures, including those that address proper use of personal protective equipment (PPE), in accordance with provincial directives.

In recognition of the uncertainty and anxiety these early days brought, LHSC and St. Joseph’s Health Care London launched a citywide Wellness Task Force to support their staff and physicians.

COVID Timeline March 2020, Banner

April 2020 – We are in this together

Thank you front line workers

As COVID-19 cases continued to grow, LHSC focused on building capacity to care for patients while the community rallied around its health-care heroes. Convoys by Emergency Services personnel and members of the construction industry were welcomed at both University and Victoria Hospitals. 

During the month of April, COVID-19 inpatient numbers at LHSC peaked at 38 patients.

  • April 3: LHSC announced the creation of a field hospital at the Western Fair District Agriplex to prepare for a potential influx of COVID-19 patients. The organization also expanded its number of critical care beds and began training nurses to provide support to critical care patients.
  • April 4: LHSC launched a virtual visit program to help patients and families stay connected while their loved one is in hospital. LHSC also increased the provision of virtual care appointments. One year on, virtual visits have reached a high of 7,000 a week; a growth of almost 900 per cent since the beginning of the pandemic.
  • April 4: LHSC’s first COVID-19 outbreak declared at LHSC’s University Hospital on 5IP Cardiology.
  • LHSC launched an Urgent COVID-19 Care Clinic to provide support and continuity of care to individuals diagnosed with COVID-19.
  • LHSC’s staff and physicians continued to receive numerous messages of support from the community.

LHSC expanded its infection prevention and control policies to further reduce the risk of transmission, including new masking policies, in-person meeting limits, enhanced screening and more.

Recognizing community and patient hesitation at coming to the hospital during a global pandemic, LHSC launched a campaign that the hospital remains open and safe for urgent and emergency care.

Blood oxygen monitor

May 2020 – Hope springs

COVID Nursing

The efforts of our community were realized as we began to see “the curve” flatten with case numbers trending down. A gradual re-opening of the province began with the Government of Ontario recommending the use of face masks in public areas. Meanwhile, research began to provide more information on the COVID-19 virus including new treatment and diagnostic methods.

  • Children’s Hospital at LHSC started a virtual emergency clinic to help parents decide whether their child needs to visit the ED.
  • LHSC’s Women’s Care team developed resources to support expectant parents during COVID-19.
  • LHSC’s IPC team continued refining infection prevention and control measures, including enhanced physical distancing measures and mandatory masking for all staff and physicians throughout LHSC.
  • LHSC’s Patient Experience team developed oversized photo badges for staff and physicians to wear on top of their PPE to “add a smile”.
Women's Care

June 2020 – Gradual expansion of services

With a continued decrease in cases, Ontario moved into the second stage of a cautious reopening with increased social gathering limits, loosening of restrictions and the gradual resumption of clinical services in hospitals across the province.

Screeners

July 2020 - Summer heats up

Samples

There was a semblance of normalcy in the London region as the province entered stage three of reopening, enabling indoor gatherings of up to 50 people and outdoor gatherings of up to 100.

  • LHSC continued its resumption of services, including an increase in surgical volumes which, by September, were above pre-pandemic volumes in an effort to address the back-log from Wave 1.
  • LHSC’s PaLM team digitalized lab test ordering and results for COVID-19.
Procedure

August 2020 – Calm before the storm

Information

Summer continued with relative quiet as case numbers remained low across the province.

  • Volunteers were welcomed back to LHSC.
  • The community continued to support staff and physicians with donations of meals.
  • LHSC celebrated an impressive milestone with PaLM conducting 3,000 COVID-19 tests per day (increasing capacity to 60 times the initial volume in March).
  • Children’s Hospital at LHSC highlighted its Cystic Fibrosis drive-up model of care that helps patients and families to avoid unnecessary entrance to the hospital.

September 2020 – Moving forward

During September, schools reopened across the province. In mid-September, an outbreak of COVID-19 was declared at Western University and shortly after the province began reducing the maximum size of gatherings to 10 people indoors and 25 people outdoors. By the end of the month, the country and the Government of Ontario officially declared the start of the second wave of the pandemic due to increasing case numbers.

  • LHSC moved forward with the implementation of an electronic screening tool to reduce time spent by staff and physicians at screening entrances.

October 2020 – A Thanksgiving and Halloween like no other

In October, a month with two holiday celebrations, there was a wide-spread call for people across the province to reduce gathering sizes and find creative ways to celebrate. This was supported by a province-wide requirement for masking in indoor places.

  • LHSC opened an on-site testing centre at Victoria Hospital for staff, physicians, midwives and dentists.
  • Online bookings for appointments at the Community COVID-19 Assessment Centres became available to streamline the process.
Assessment Centre

November 2020 – Recognition and outbreaks

PPE

As Ontario coped with the second wave, the Province implemented a new colour-coded response framework. At LHSC, November was marked with COVID-19 outbreaks at University Hospital that would ultimately impact 13 units, 102 staff and physicians, 84 patients, and tragically result in 28 patient deaths. Lessons learned from these outbreaks have resulted in changes to infection and prevention control protocol  which have prevented further outbreaks from spreading.

  • Nov. 8: A handful of LHSC staff and physicians were invited to speak with Prime Minister Justin Trudeau about their experiences during the pandemic.
  • Nov 10: LHSC introduced staff and physician ID badge readers at perimeter screening to reduce waiting times at entrances.
  • November 10: A COVID-19 outbreak was declared at LHSC’s University Hospital on 4IP General Medicine, followed by outbreaks on 9IP Orthopaedics (Nov. 11), and an expansion to include 6 and 9 SAMU, and 10 SAMU/Palliative Care (Nov. 24).
  • At the direction of Middlesex-London Health Unit, LHSC implemented more stringent infection and prevention control measures across all sites to help combat outbreaks, including masking at all times on LHSC property, on-site surveillance testing for staff, physicians and patients, limiting community interaction and work-quarantine for the medicine units, reduction of ambulatory care, and increased visitor restrictions at University Hospital.
  • Staff across the organization rallied around colleagues on work-quarantine to support them during the outbreaks.

December 2020 – Outbreaks, vaccines and holidays

As LHSC continued to address outbreaks at University Hospital, the conversation around vaccines quickly escalated with the first vaccine approved for use in Canada. By the end of the month, LHSC and Middlesex-London Health Unit had opened the region’s first COVID-19 vaccination clinic.

During this period, community cases of COVID-19 continued to rise and London was moved to the Red-Restrict level of the new provincial response framework. Provincially, the number of patients in ICU increased and the province announced the first case of the B117 variant of COVID-19. By the end of the month, the second province-wide lockdown had begun.

  • December 3: First responders rallied behind their University Hospital colleagues with a convoy to show their support.
  • December 4: LHSC hosted a media conference to address the cause and rapid spread of the UH COVID-19 outbreaks
  • December 5: 5IP Cardiology at University Hospital is added to list of clinical units involved with UH COVID-19 outbreak, followed by 8IP General Surgery (Dec. 9), and the Epilepsy Monitoring Unit (Dec. 11).
  • December 9: Canada approved the Pfizer-BioNtech vaccine for use with the first vaccine given in Ontario on December 14.
  • December 15: A COVID-19 outbreak is declared at LHSC’s Victoria Hospital on C5 100 ENT/Burns/Plastics unit, followed by the C6-400 Acute Medicine Unit the next day.
  • December 18: LHSC and MLHU announced the creation of London’s first COVID-19 vaccination clinic at the Western Fair District Agriplex. The collaborative team worked tirelessly to rapidly build and operationalize  the vaccine clinic.
  • December 22: In anticipation of the provincial lockdown taking effect on Boxing Day, LHSC announced new visitor restrictions.
  • December 23: The first vaccines in London were administered at the COVID-19 Vaccination Clinic at the Western Fair District Agriplex. On the same day, Canada approved the Moderna vaccine for use.
  • December 30: LHSC’s University Hospital is declared outbreak free for the first time since November 9.
Delivery

January 2021 -  A new year, a new hope

With the new year, hope was bolstered as vaccination of health-care workers and residents of long-term care homes continued. This initial excitement was tempered with global disruptions in vaccine supply.

Unfortunately, COVID-19 case numbers continued to rise and stay-at-home orders were extended provincially. By the end of the month, LHSC was accepting patients transferred from areas including Windsor and Toronto that were beyond capacity.  

  • LHSC’s PaLM testing capacity reached 8,000 tests per day with a 24-hour turnaround time for 95 per cent of all specimens
  • January 16: MLHU reported the first case of the COVID-19 B117 variant in London.
  • January 20: LHSC and MLHU announced that the COVID-19 vaccine clinic at the Western Fair District Agriplex would temporarily cease operations due to limited vaccine supply.
Vaccine

February 2021 – Hope renewed

The month of February started on a positive note as all COVID-19 outbreaks at LHSC were resolved and LHSC remains outbreak-free as of March 11, 2021. The COVID-19 vaccination clinic reopened and case numbers began to fall across the province. The Government announced a return to its colour-coded response framework.

  • The PaLM team increased COVID-19 testing capacity to 10,000 tests a day.
  • February 3: COVID-19 Vaccine Clinic at the Agriplex resumed operations to fulfill second dose vaccine appointments.
  • February 22: Children’s Hospital at LHSC, St. Joseph’s Healthcare Hamilton and Hamilton Health Sciences announced joint pilot initiative to offer virtual urgent care services to residents of southwestern Ontario.
  • February 26: Canada approved the Astra-Zeneca vaccine for use.
Support

March 2021 – One Year On

While the country is still facing a potential third wave with the increasing threat posed by new variants, vaccines continue to be delivered and the eligibility for vaccination is expanding based on government directives.  

  • Surgical volumes at LHSC have once again resumed at or above pre-pandemic volumes.
  • Vaccine eligibility is announced for the general public to now include additional Phase 1 priority groups in the community, including individuals 80 years and older and Indigenous adults 55 and over. Phase 2 vaccinations are expected to begin in April for adults 60-75 and those at risk with chronic conditions. 
  • March 11: designated a Day of Reflection at LHSC to acknowledge the trauma and loss experienced since the pandemic was declared, but also to recognize the innovation, resiliency and achievements that have been made over the past year.

While the COVID-19 pandemic continues, the promise of a vaccine is on the horizon, having already become reality for some. The skills, fortitude, commitment, and adaptability demonstrated by each of LHSC’s staff, physicians, students, researchers, and volunteers over the course of this pandemic will always be remembered as part of LHSC’s history of care, teaching, and research.