There are growing signs that the H1N1 flu pandemic is waning in North America, based on a number of indicators from health officials and doctors.

The Public Health Agency of Canada says that, as of the week ending Nov. 14, the number of outbreaks at schools and hospitals, the prevalence of flu-related doctor visits and the number of flu cases for testing across the country declined.

In Ottawa, the number of flu cases fell far enough for local health authorities to closed all but one of the city's flu assessment clinics. In Vancouver, a flu clinic at the B.C. Children's hospital also shut down this week as the number of patients eased.

"This is an outbreak that rose for the first four weeks, peaked three weeks ago and is now in freefall," said Dr. Richard Schabas, Ontario's former chief medical officer.

South of the border, fewer Americans are visiting their doctor because of swine flu, according to the Centers for Disease Control in Atlanta. Absentee rates at U.S. schools have returned to normal as well.

The evidence suggests that the virus is spreading more slowly than it was in September and October, and the number of lab samples testing positive for H1N1 is dropping.

After weeks of public announcements, confusion and long line-ups to get the vaccine, it seems the swine flu pandemic may be easing on the continent.

But the number of cases of H1N1 are still well above those from a normal flu season and they're expected to remain high for several more weeks. There is also a threat that a third wave of the virus will strike during the winter months.

"We're still going to have a little bit of activity with this virus right through the winter and into early spring," Dr. Neil Rau, an infectious diseases specialist, told CTV News.

In spite of the apparent peak in infections, the number of deaths from the flu may not drop off immediately since it can take several weeks to succumb to H1N1 once someone has contracted it.

Meanwhile, immunization efforts are still well underway from coast to coast. Ontario opened clinics for the general public to receive the H1N1 flu shot for the first time this week. Nearly five million doses of the H1N1 vaccine are to be sent to the provinces in the coming days.

Some are saying the cost to Canadian taxpayers for responding to the pandemic could surpass $1 billion.

With a report from CTV's John Vennavally-Rao