We’re small, we’re rural, we’re old and we’re spread out.
We lack a major metropolitan centre, large-scale public transit and international airline connections.
These are all traits that have been cited at one time or another as holding New Brunswick back. But they may be a blessing when it comes to COVID-19.
“Luck is a big part of it,” said Dr. Raywat Deonandan, an epidemiologist at the University of Ottawa.
Raywat Deonandan, a global-health epidemiologist and an associate professor at the University of Ottawa, says the luck of location plays into how well New Brunswick has handled COVID-19. (Supplied/Raywat Deonandan)
“You’re lucky in your location, you’re lucky in your population density, you’re lucky in your population distribution, and you’re lucky that your major city is not an international travel hub.”
If the numbers over the past two weeks hold, New Brunswick — a province that rarely wins at anything — is poised to reach the pandemic-containment podium.
New daily cases peaked at 15 on March 29. By the second week of April, there were more recovered patients than people still sick with the virus. And there hasn’t been a new case reported since April 17.
As of Sunday’s update, only seven New Brunswick cases were listed as active. Only Nunavut and the Northwest Territories have lower rates of cases per capita.
Colin Furness, a professor and expert in public health information at the University of Toronto, said the province’s success is clear, but it’s not due to demographics alone.
Colin Furness, an infection control epidemiologist and assistant professor at the University of Toronto, says demographics alone would not have been enough. (University of Toronto)
“It really is good luck, good planning, good execution,” he said. “The measures taken by the government to do social distancing were the right measures.”
Here’s a look at several of the factors that seem to have contributed to New Brunswick emerging relatively unscathed from the first wave of the COVID-19 pandemic.
Lack of urban density
Dr. Jennifer Russell says a jurisdiction’s density can be an influence. (Government of New Brunswick)
New Brunswick was never going to be the ideal breeding ground for the coronavirus. The province is more rural than most and lacks a single large metropolis.
Population density in Moncton and Saint John hover around 1,000 people per square kilometre. Compare that to Montreal, where it’s 2,700 people. In Wuhan, China, and Milan, Italy, it’s more than 7,000.
“Jurisdictions that have higher density, it can influence it for sure,” said Dr. Jennifer Russell, the chief medical officer of health “I don’t have a specific ability to quantify that but it definitely does have an effect.”
COVID-19 needs “pretty intimate contact” to spread, Furness said. “People need to be close together.”
There’s an emerging consensus from researchers that the longer and closer someone is exposed to COVID-19, the greater chance they’ll catch it and the worse the symptoms may be.
That’s more likely in large centres where there are lots of apartment buildings with thousands of residents each, and busy public transit systems full of commuters jammed together.
“The population density is not amenable to rapid spread in New Brunswick,” Deonandan said. “So you got lucky in that sense.”
No major air hub
The Greater Moncton Roméo LeBlanc International Airport reported 680,000 passengers in 2018, a small number compared with big cities such as Montreal and New York. (Marielle Guimond/Radio-Canada)
Connected to the lack of dense metropolitan centres is the absence of a major international airport.
“You’re not getting as many travellers coming from high-risk parts of the world,” Deonandan said.
New Brunswick’s three largest cities have jockeyed for years to persuade airlines to add more routes, with some success.
But the numbers are still tiny.
The Greater Moncton Roméo LeBlanc International Airport reported 680,000 passengers in 2018. Trudeau International Airport in Montreal had 19.4 million and JFK in New York City had 61 million.
“When you see the worst cases, it’s almost always close to where they have a lot of travel,” Furness said.
A minister with foresight
In February, Education Minister Dominic Cardy sent an internal memo to senior government officials sounding the alarm that COVID-19 was on its way. (Photo: CBC News)
One possible turning point in New Brunswick’s containment effort was Feb. 24, when Education Minister Dominic Cardy sent an internal memo to senior government officials sounding the alarm that COVID-19 was on its way, if it wasn’t already here.
“This is not a question of if, but when,” Cardy wrote. “The extent of the damage and disruption cannot yet be predicted, but it will occur.”
With footnotes, appendices and hyperlinks, “memo” isn’t quite the right word for the 19-page document, which was obtained by CBC News. It reads more like a university term paper.
Cardy’s own department was already laying the groundwork for the closure of schools, but he went further in the memo, sketching what each level of government was responsible for, how each provincial department might respond, and which laws applied.
Many measures he suggested were later adopted by the Blaine Higgs government, including a special cabinet committee including the leaders of New Brunswick’s three opposition parties.
“All governments will struggle to maintain legitimacy and confidence in the face of the pandemic,” Cardy wrote. “Sharing a plan to address COVID-19, being honest about the risks and realistic in terms of a response, is essential.”
Cardy “put us on a learning curve which gave us a tremendous advantage,” Health Minister Ted Flemming said in an interview. “Some of us might have been a little sceptical at the start. … He really was the spearhead. He was the leader on it.”
An early move in schools
New Brunswick first closed schools on March 13. (François Gagnon/Radio-Canada)
Cardy’s next move, controversial at the time but prescient in retrospect, was to ban any student who’d been on a March break trip outside Canada from returning to school.
“That was extremely wise, extremely prudent,” Furness said. “Children mixing in schools is a really potent way for infections to spread.”
Deonandan agreed: “The elephant in the room is kids in schools, because kids get their hands in everything.”
Furness said he can “guarantee” some children came back from the break carrying COVID-19 but not showing symptoms. If they’d gone to school, the virus might have spread to classmates, and then to more vulnerable adults, in large numbers.
“That obviously didn’t happen, so you got away with it,” he said. “Our success is predicated on things that don’t happen. We can never know. But I think your education minister is to be congratulated.”
Jumping on the early cases
There have only been 10 cases of confirmed community transmission so far. (CBC)
The first trickle of cases into the province, which began showing up March 11, was small enough and manageable enough that public health measures were able to keep them under control.
“It definitely was helped by the fact that we had measures in place very early on around informing people that they had to self-isolate when coming from outside the country, and then … when they came from outside the province,” Russell said.
The first batch of New Brunswick cases were people who had travelled to France, the United Kingdom, the United States, the Caribbean and on cruise ships.
Testing those people and getting them to self-isolate, and then quickly tracing any contracts they had, was key, as was the closure of schools and businesses and the banning of mass gatherings, Russell said.
“This all had an effect on being able to contain those early travel-related cases for sure, because it limited the number of contacts that each person had.”
The result is only 10 community transmission cases until now.
No nursing home outbreaks
Nursing homes such as Tabusintac Nursing Home have yet to be hit by the coronavirus in New Brunswick. (Tabusintac Nursing Home/Facebook)
That in turn reduced the chances of someone with COVID-19 unwittingly bringing the virus into a nursing home or special-care home full of seniors.
One employee of a Shannex nursing home in Quispamsis tested positive for the virus in early April, but there has been no major outbreak.
Compare that to neighbouring provinces: as of Sunday, 249 of Nova Scotia’s 873 cases were residents or employees of Northwood, a long-term care facility in Halifax. Of the province’s 24 deaths, 18 have been Northwood residents.
In Quebec, more than 20 per cent of all COVID-19 cases, and a staggering 80 per cent of all COVID-19 deaths, have been in seniors residences.
Tony Weeks, CEO of York Care Centre in Fredericton, said his facility decided early on to stay ahead of the virus, ensuring that employees working in multiple residences limited themselves to only one to reduce the chance of spread.
“We haven’t waited for a first case to show up,” Weeks said. “We’ve planned as if that first case was here.”
Vulnerable seniors are also spread out — and engaged
Seniors such as Lucy Jarratt of Bathurst have been able to stay out of harms way. (Melynda Jarratt/Facebook)
New Brunswick has the second-oldest population in Canada, and seniors are the most susceptible to serious and even fatal cases of COVID-19.
Yet other characteristics of that greying demographic mitigated the risk, the experts say.
The densest areas of the province are also the youngest. The places that skew oldest also happen to be more rural and more spread out from each other. Except in nursing and special-care homes, seniors tend to be farther away from each other.
“That’s a protective effect,” Deonandan said.
And Furness said older people are also paying the closest attention to coverage of the pandemic. They’re engaged and informed.
“I get the smartest questions and the most careful, mindful questions from older people, questions like ‘How do I handle my mail?'” he said. “People who are thinking that way aren’t going to get sick. With age comes wisdom, and wisdom is a very potent protector.”
Choosing to comply
Deonandan said it’s important that people have followed the government’s rules. (NIAID-RML via Reuters)
Another obvious factor is that New Brunswickers have not defied recommendations on handwashing, physical distancing and other ways to avoid risk.
“People did have choices that they could make,” Russell said. “The higher number of people in the population that makes wise choices … the better off we all are. It only takes a few people to impact the population as a whole.”
“There’s something to be said for the compliant population that followed orders and stayed home when they were supposed to stay home,” Deonandan said. “You can’t underestimate the power of that.”
Pure luck
Caul’s Funeral Home says it was contacted by the department of health and told that a person who has tested positive for COVID-19 attended two funerals between March 15 and March 17. (Google Maps)
And then there’s the intangible factor: dumb luck.
In St. John’s, one person with the virus but no symptoms visited Caul’s Funeral Home in mid-March and became the so-called “index case” for at least 176 people who had contracted COVID-19 by April 8.
That’s more than two-thirds of the province’s 258 cases to date. Without that one index case, Newfoundland and Labrador’s case numbers would be lower than here.
“New Brunswick didn’t get unlucky by getting a whole bunch of virus [at] a super-spreading event, where one person attended an event and infected 30 others,” Deodandan said. “You didn’t get that kind of early boost to the virus that makes it so hard to control.”
The next phase
Chief medical officer Dr. Jennifer Russell said the province will now move to gradually reopen society. (CBC)
Russell said the next phase, a gradual reopening of the economy and society, will shed even more light on what works and what doesn’t.
She has said that there could be a cycle of loosening and then reimposing restrictions if the virus flares up. Some of the factors that kept numbers down could reduce the risk of new outbreaks as measures are lifted.
“It will be very interesting to see how all of those things contribute to the numbers moving forward and what kind of resurgence we might see,” she says.
TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.
The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.
It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.
Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.
Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.
They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.
This report by The Canadian Press was first published Sept. 17, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”
Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.
“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.
The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.
The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”
The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.
Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.
Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.
The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.
Sanniah Jabeen, 32, Toronto
Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.
“I just wasn’t functioning like a normal human being,” Jabeen says.
Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.
“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.
Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.
“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.
Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.
She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.
“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.
She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.
Natalie Grant and her seven year-old daughter, Bowmanville, Ont.
Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.
She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.
“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.
Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.
“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.
Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.
“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.
Thelma Feldman, 89, Toronto
Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.
“I’m kind of depressed,” she says.
“It’s caused me a lot of physical and emotional pain.”
Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.
“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.
“I don’t even feel like being with people. I just sit at home.”
Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.
Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.
When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.
“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.
“I never got a call back. I never got an email”
At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.
“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”
Joseph Desmond, 50, Sydney, N.S.
Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.
His third seizure happened the next morning while walking to the nurse’s station.
In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.
“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.
When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.
“It was pretty scary. Terrifying. I honestly thought I was going to die.”
Cheryl McCombe, 63, Haliburton, Ont.
The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.
A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.
“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”
Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.
“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.
“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.
Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.
But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”
This report by The Canadian Press was first published Sept. 16, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
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
