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Canada prepared to face coronavirus thanks to lessons learned from SARS: experts – CTV News

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TORONTO —
As the number of coronavirus cases continues to rise, including the first confirmed case in the U.S., so do concerns over the potential for an outbreak similar to the deadly 2003 SARS epidemic.

But experts say the Canadian health care system is well equipped to handle any potential coronavirus cases thanks to the lessons learned during the SARS outbreak, which led to the deaths of 44 Canadians and 774 people worldwide.

“Luckily, we’ve been through this before… I mean, sadly we’ve been through this before, but Canada is sensitized to this,” University Health Network researcher Dr. Isaac Bogoch told CTV’s Your Morning Tuesday.

“We’ve experienced the importation of a new virus and have systems in place should an infection get imported.”

The new illness, described by the World Health Organization as a novel coronavirus, falls under a larger family of coronaviruses which includes severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).

While these coronaviruses come from the same family and feature the same flu-like symptoms, Bogoch explained that much has changed since the deadly SARS outbreak. In fact, health officials didn’t confirm SARS was a coronavirus until the mid-way point of the outbreak.

“It’s only been 22 or 23 days since we’ve known that there is an outbreak occurring… we [the medical community] have sequenced the virus, which has been made publicly available, and there’s a World Health Organization meeting tomorrow, so there’s been a lot more cooperation and communication with this outbreak compared to years past,” he said.

On Tuesday, the U.S. became the fifth country to report a case of the illness, following China, Thailand, Japan, and South Korea.

The man returned to the Seattle area last week after travelling to the Wuhan area, where the outbreak began. Officials say the man, in his 30s, is in hospital in good condition.

No cases have been reported in Canada, and the country’s chief public health officer said there is no reason for panic as the risk to Canadians remains low.

Ontario’s Chief Medical Officer Dr. David Williams said hospitals are already employing protocols established during the 2003 SARS outbreak in anticipation of any Canadian cases.

“We’re getting calls already from hospitals and others that have clients they’ve seen that are concerned because they had some travel history to China,” Williams told CTV News Channel Tuesday.

“We still have no cases in Canada, but that doesn’t mean we shouldn’t be aware of that and shouldn’t be alert to setting out systems up and being prepared in case that does occur.”

“This is our stress test”: Crowded hospitals the ultimate test of SARS lessons

But the proficiency of these systems could be challenged by overcrowded emergency rooms.

“SARS came to a hospital in Toronto in 2003. One case made three cases, three cases made 12 cases, and so on, and so on,” David Fisman, infectious disease expert and professor at the University of Toronto’s Dalla Lana School of Public Health, told CTVNews.ca by phone Tuesday.

“What you see here is a bug that is behaving just like SARS did; just like MERS did… What we know from our experience from SARS is that we do have vulnerability in Toronto from hospital outbreaks.”

Fisman said that it’s likely Canada could see a case of coronavirus considering the number of Chinese nationals and Chinese-Canadians who live here, or have family here.

“In general, that should be no big deal outside of the healthcare context,” he explained.

“The difficulty is just the physical plant. People come to you, they’re sick and you can’t say go away. We don’t have a lot of space especially in our ERs.”

Overcrowding, especially during the height of flu season, is the perfect breeding ground for these types of outbreaks, Fisman said.

“I think people are more knowledgeable, and it’s a totally different world now in terms of how people with respiratory issues are handled,” he added.

“This is our stress test. Did we learn enough from SARS to not drop the ball this time?”

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Another presumptive case of COVID-19 confirmed in Toronto | News – Daily Hive

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Ontario health officials announced a fourth presumptive case of the novel coronavirus in the province Sunday, bringing the total number of cases Canada has seen to 10.

The latest patient is a woman who arrived in Canada from China on February 21. That same day, she followed advice from Telehealth Ontario and went to North York General Hospital because she had an intermittent cough.

Her illness was mild, and after being tested for COVID-19 she was discharged and is now self-isolated at home.

Ontario’s lab returned a presumptive positive test for the virus Sunday, and further testing will be done at the national lab in Winnipeg to confirm that result.

“Because of all the proper protocols and procedures that are in place to contain this virus and exposure to others was limited, I want to assure the public that the risk to Ontarians remains low,” said Dr. David Williams, Ontario’s Chief Medical Officer of Health.

The woman wore a mask on her flight back to Toronto, and has not been in touch with many people since she returned.

Right now, this woman is the only known active case of COVID-19 in Ontario. The first three patients who all returned from China earlier this year have recovered and cleared the virus from their bodies.

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[Wuhan Woman With No Coronavirus Symptoms Infects 5 Relatives Revealing New Extent of Challenge] – Mash Viral

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China: A 20-year-old Chinese woman from Wuhan, the epicenter of the coronavirus outbreak, traveled 400 miles(675 km) north to Anyang where she infected five relatives, without ever showing signs of infection, Chinese scientists reported on Friday, offering new evidence that the virus can be spread asymptomatically.

The case study, published in the Journal of the American Medical Association, offered clues about how the coronavirus is spreading, and suggested why it may be difficult to stop.

“Scientists have been asking if you can have this infection and not be ill? The answer is apparently, yes,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center, who was not involved in the study.

China has reported a total of 75,567 cases of the virus known as COVID-19 to the World Health Organization (WHO) including 2,239 deaths, and the virus has already spread to 26 countries and territories outside of mainland China.

Researchers have reported sporadic accounts of individuals without any symptoms spreading the virus. What’s different in this study is that it offers a natural lab experiment of sorts, Schaffner said.

“You had this patient from Wuhan where the virus is, traveling to where the virus wasn’t. She remained asymptomatic and infected a bunch of family members and you had a group of physicians who immediately seized on the moment and tested everyone.”

According to the report by Dr. Meiyun Wang of the People’s Hospital of Zhengzhou University and colleagues, the woman traveled from Wuhan to Anyang on January 10 and visited several relatives. When they started getting sick, doctors isolated the woman and tested her for coronavirus. Initially, the young woman tested negative for the virus, but a follow-up test was positive.

All five of her relatives developed COVID-19 pneumonia, but as of February 11, the young woman still had not developed any symptoms, her chest CT remained normal and she had no fever, stomach or respiratory symptoms, such as cough or sore throat.

Scientists in the study said if the findings are replicated, “the prevention of COVID-19 infection could prove challenging.”

Key questions now, Schaffner said, are how often does this kind of transmission occur and when during the asymptomatic period does a person test positive for the virus.

Get the best of News18 delivered to your inbox – subscribe to News18 Daybreak. Follow News18.com on Twitter, Instagram, Facebook, Telegram, TikTok and on YouTube, and stay in the know with what’s happening in the world around you – in real time.

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SARS lessons help Canada prep for COVID-19, but hospital capacity a worry – Nanaimo News Bulletin

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Canadian medical experts say the country’s already overstretched emergency rooms would find it difficult to cope if a true outbreak of the novel coronavirus, or COVID-19, were to take hold in Canada.

So far, the virus has been relatively contained to mainland China, thanks in part to one of the largest quarantines in modern history.

“We must not look back and regret that we failed to take advantage of the window of opportunity that we have now,” Dr. Tedros Adhanom Ghebreyesus, director general of the World Health Organization, said in a message to all the world’s countries Friday.

The risk of contracting the virus in Canada right now is extremely low, and public health officials have been lauded for their efforts to detect and isolate the nine cases confirmed in the country so far.

The hundreds of patients across the country who have tested negative for the virus are also a sign that containment efforts are working as they should.

But Canada’s most recent case in British Columbia has raised fears about where and how the disease is being transmitted abroad. Unlike others who’ve imported the virus from China or from people who have recently been to China, the woman in her 30s contracted the illness while in Iran.

“Any imported cases linked to Iran could be an indicator that there is more widespread transmission than we know about,” said Canada’s chief medical officer Dr. Theresa Tam Friday.

Canada has taken major steps to prevent the kind of shock that befell Ontario during the outbreak of the coronavirus known as SARS in 2003 that led to 44 deaths. Creating the Public Health Agency of Canada, which Tam heads, is one of them.

The country is now better co-ordinated, has increased its lab-testing capabilities and is prepared to trace people’s contacts to find people who might have caught a contagious illness without knowing it.

But once the number of incoming cases reaches a critical mass, the approach must change, according to infectious-diseases physician Dr. Isaac Bogoch of Toronto’s University Health Network.

He likens the response to trying to catch fly balls in the outfield: as the number of balls in the air increases, they become harder and harder to snag.

READ MORE: Woman in Fraser Health region confirmed as sixth COVID-19 case in B.C.

“Every health care system has limits,” Bogoch says. “The question is, if we start getting inundated with cases, how stretched can we get?”

Many emergency-room doctors argue Canada’s ERs are already as stretched as they can get and are worried about what would happen if they suddenly had to start treating COVID-19 cases en masse.

From the public-health perspective, the greatest challenge may be as simple communicating across all parts of the health system across the country, said Dr. Jasmine Pawa, president of the Public Health Physicians of Canada.

“We cover a very wide geographic area,” she said, though she added that Canada has made great strides over the course of the SARS experience and the H1N1 flu outbreak in 2009.

Dr. Alan Drummond of the Canadian Association of Emergency Physicians, who works at the hospital in Perth, Ont., says he doesn’t want to fearmonger, especially considering all the lessons Canada has learned from past outbreaks, but the reality of life in the ER gives him pause.

“Our day-to-day experience in crowded hospitals, unable to get the right patient in the right bed on a day-to-day basis … makes us really question what the integrity of our health-care system would be like in a major severe pandemic,” Drummond says.

He envisions that a disease like COVID-19, if it spread widely, would have a major impact, including the possibility of cancelled surgeries and moving stable patients out of hospitals who would otherwise stay.

“I think there would have to be hard decisions made about who lives and who dies, given our limited availability by both speciality and (intensive-care) beds and we would probably see some degree of health-care rationing,” he says.

The problem may be even more pronounced because of Canada’s aging population, he said. The virus tends to hit older people harder, according to observations made in China and abroad, and is also particularly dangerous for people with other health problems.

Older people also tend to stay admitted in hospital beds even when they are in relatively stable condition because of a lack of long-term-care beds across the country.

That keeps emergency rooms from being able to move acute patients out of the ER and into those beds, limiting hospitals’ capacity to handle new cases.

Tam agreed Friday that hospital capacity is a “critical aspect” of Canada’s preparedness for a potential coronavirus outbreak, but said even very bad flu seasons can have a similar effect on emergency rooms.

“If we can delay the impact of the coronavirus until a certain period, when there’s less influenza for example, that would also be very helpful,” she said.

She also suggested people who are concerned about the possibility that they’re developing COVID-19 symptoms should call ahead to a hospital so they can make proper arrangements for containment and isolation.

Canada is doing its best, along with every other country in the world, to seize this time of relative containment and plan ahead, Tam said.

Laura Osman, The Canadian Press

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