The next steps for Canada’s coronavirus patient zero include two weeks of monitoring in isolation and quarantine for those who’ve been in close contact with him, infectious disease physicians say.
The man in his 50s had travelled to Wuhan, China, and is currently in stable condition at Toronto’s Sunnybrook Health Sciences Centre.
Dr. Theresa Tam, Canada’s chief public health officer, said he showed mild symptoms on a flight from Guangzhou to Toronto.
Travellers followed
Tam said the latest scientific data suggests that people transmit the virus when they’re in close contact with others.
“It’s really fellow travellers or family members travelling with a patient that are [at the highest risk],” Tam told a news conference on Sunday. Toronto Public Health officials will provide travellers who were within a two-metre radius of the patient on the plane with information.
Watch | The National looks at what is known so far about Canada’s 1st presumed coronavirus case:
A patient in Toronto is being treated in isolation for what Canadian health officials call the first ‘presumptive’ confirmed case of coronavirus. 2:11
Tam said airline staff who may have served the man will also be informed.
“What I would like to emphasize is that for other people on the flight, or in the airport or not in close contact with the patient, is that they should not be overly concerned,” Tam said.
The latest scientific data suggests that people transmit the coronavirus when they’re in close contact with others, said Chief Public Health Officer of Canada Dr. Theresa Tam. (Justin Tang/The Canadian Press)
CBC News spoke to a passenger who said he was on China Southern Airlines flight CZ311, which took off on Tuesday to Toronto from Guangzhou. Despite Tam’s reassurance, the passenger from Toronto, who didn’t want to be identified because of the stigma associated with the coronavirus, said he was going to self-quarantine on his own initiative for two weeks.
“I am worried,” he wrote to CBC News on Chinese microblogging site Weibo. “I am worried for me and my family.”
The risk of outbreak in Canada remains low, Tam said in reiterating that if someone has travelled to the affected area in Wuhan and has fever or flu-like symptoms, they should call a doctor.
China’s health minister said the transmissibility of the virus “shows signs of increasing.”
A negative pressure isolation treatment room at Toronto’s Humber River Hospital. (Craig Chivers/CBC)
Dr. Andrew Morris, a professor in the department of medicine at the University of Toronto who studies infectious diseases with a focus on antimicrobial stewardship at Sinai Health System, said he’s concerned about how the Canadian public could respond to China’s health ministry information on how people might be infectious when not showing symptoms.
In China, officials strive for people to self-quarantine based on exposure to a high-risk place such as the live-animal market in Wuhan or being in close contact with someone known to be infected.
“What they’re trying to do [in China] is tell people you can’t just go by your symptoms,” Morris said. “If you’ve got an exposure history risk then you may be contagious even though you don’t have symptoms. That may be wise especially where the prevalence of the disease is high.
“I don’t think it’s applicability is there for … many of the other countries in the world, including Canada.”
Morris said he’s telling family and friends outside of health-care settings in Canada they don’t need to do anything differently.
Dr. Jerome Leis, director of infection prevention and control at Sunnybrook, said the care for the coronavirus patient isn’t affecting other patients. (CBC)
In the U.S., Dr. Nancy Messonnier, director of the Center for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases, said to expect more cases to be reported in the U.S. in the coming days. Like Tam, she described the risk to the public as “low at this time.”
“We need to be preparing as if this is a pandemic, but I continue to hope that it is not,” Messonnier told reporters.
The patient’s care
Dr. Jerome Leis of Sunnybrook said day-to-day business at the hospital continues as normal. “It is not affecting the care we provide for all of our other patients.”
Since there are no specific treatments for the virus, currently known in scientific circles as 2019-nCoV, the man will receive supportive care to relieve symptoms, Morris said.
The patient will be kept in isolation until infectious disease physicians consider the risk to the general public negligible, Morris said. Before that, they may conduct virus studies to check that he is no longer contagious.
“He’s been rapidly processed, appropriately processed and the degree of risk reduction has really been quite impressive,” Morris said.
“If you think of what it’s like today compared to how we were 17 years ago with SARS, that change is dramatic and hopefully that’s going to substantially reduce the risk to the public.”
Containment efforts
Paramedics who transported the patient wore protective equipment such as masks.
At the hospital, the patient was put in special isolation in a negative pressure room with a vacuum to suck all of the air out and filter out any infectious particles.
Standard public health protocols include tracing “close contacts” of a patient with the virus, such as those living with the sick person.
In Canada, close contacts are asked to self-isolate at home so public health officials can observe if they get symptoms or not.
According to the CDC, people who have “casual contact,” such as going to the same grocery store, “are at minimal risk for developing infection.”
VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.
Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.
In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.
The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.
Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”
Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”
This report by The Canadian Press was first published Sept. 16, 2024
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
