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Coronavirus: What are community cases and should Canadians be concerned? – Global News

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As the number of confirmed cases of novel coronavirus increase in Canada, medical authorities are urging Canadians to practise social distancing and prevent the virus from spreading through community transmission. But what are community cases, and why are they cause for concern?

The Canadian government said a community case occurs when the virus has passed within a community, rather than contracted through travel.

Happening across the country


READ MORE:
You can catch coronavirus without travelling. Here’s how

Isaac Bogosh, an infectious disease specialist based out of Toronto General Hospital community, told Global News, “Community transmission is likely happening across the country” and those numbers are expected to rise as more and more people are tested.

Canada’s epidemiological summary of COVID-19 cases in Canada, which was updated on Friday, showed that out of a study of 434 confirmed cases, 24 per cent of them were contracted in a community setting. Another 10 per cent were linked to having close contact with a recent traveller.

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As of Saturday afternoon, deputy chief public health officer Dr. Howard Njoo said there were 1,099 confirmed cases in Canada. Thirteen people have died from the virus.

Following the partial closure of the U.S.-Canada border, which was effective at midnight Friday, Bogosh said the country would likely not be “importing” any new cases of COVID-19.






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Coronavirus outbreak: Trudeau tells Canadians ‘it’s going to get bad’

Why should you be concerned?

The novel coronavirus is a highly infectious disease, but Bogosh said “you need to be pretty close to someone” to catch it.

He said newer cases moving forward are most likely going to be “locally acquired.”

A majority of cases are either mild or asymptomatic, but the disease could still react severely. As of Saturday afternoon, the latest numbers from John Hopkins University said over 12,700 people have died so far.


READ MORE:
Coronavirus: How COVID-19 is spreading across Canada

Bogosh said the disease can only be transmitted through direct contact and respiratory droplets — either from human-to-human or from coming into contact with an infected surface.

According to the infectious disease specialist, there is growing data to support the claim that individuals with mild symptoms are more likely to transmit this virus in community settings than those with noticeable or severe symptoms.

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Those exhibiting milder symptoms may not even know they have the disease and unintentionally pass it to others — which is what makes social distancing crucial in preventing its spread.

At this point in time, Bogosh said a majority of people should be well aware of the risks and preventative measures.

“We’ve been hearing about what we need to do for weeks now. It’s been over a week. We know exactly what it is to do to avoid getting this infection. We know how to prevent ourselves from getting this infection. We know how to prevent transmission in community settings,” he said.






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Is it time to call-out people who aren’t ‘social distancing’ during coronavirus pandemic?

“There is no excuse for people not to act in the appropriate manner with the physical distancing measures that were supposed to be taking.”

Chief public medical officer Theresa Tam said Wednesday that there is “some degree” of community spread happening within Canada.

“What is most concerning is that over the past week, we’ve started to see a sharp rise in cases and a number of provinces have reporter cases with no links to travel,” she said. “Our time to act is now.”

Toronto’s medical officer of health Dr. Eileen De Villa also said Friday she was confident there had been cases of community transmission in addition to travel-related cases in the city.

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READ MORE:
Coronavirus: Canada working with commercial airlines to repatriate stranded citizens

Could more testing help prevent community spread?

Aggressive testing models have been proven to help identify clusters of infected individuals early on and prevent the further spread of infection.

South Korea is a good example of this. In South Korea, health officials have tested over 290,000 people and identified over 8,000 infections. Since they began rigorously testing their citizens, the reported number of cases has decreased. On Wednesday, 93 were recorded, down from 909 two weeks earlier.






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After health officials in Halton region confirmed the death of a Milton man last week, who marked the second person in Ontario to die from the virus, was a case of community transmission, calls were reignited for increasing the amount of Canadians tested.

In response to a question about the man’s death, Prime Minister Justin Trudeau told reporters Saturday the government was ramping up COVID-19 testing more Canadians, having tested over 83,000 already.

“Mass testing is one of the best ways of protecting Canadians and reducing the spread of the virus as well,” Trudeau said. “Tens of thousands are being tested every day.”

— With files from Reuters.

© 2020 Global News, a division of Corus Entertainment Inc.

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Canada not looking to retaliate after U.S. restricts coronavirus mask exports: Trudeau – Global News

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Prime Minister Justin Trudeau says Canada is not considering retaliation after U.S. President Donald Trump told a manufacturer of medical masks not to export them to Canada.


READ MORE:
Coronavirus: Canada to receive ‘millions’ of masks from China, Trudeau says

“We are not looking at retaliatory measures or measures that are punitive,” he said.

Trudeau said he would be speaking with Trump in the coming days and looking for a positive solution on the issue.






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Coronavirus outbreak: Freeland says Canadian government will ‘pull out all the stops’ on medical equipment distribution


Coronavirus outbreak: Freeland says Canadian government will ‘pull out all the stops’ on medical equipment distribution

“We’re continuing to engage at all levels with the administration, having very constructive conversations highlighting that the flow of goods and services that are essential to both of our countries flow both ways across the borders,” he said.

He was referencing the medical professionals who live in Canada and work in the United States, as well as supplies such as gloves and testing kits that Canada ships to the country.

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“It is in both of our interests to maintain this extraordinary close relationship,” he said.

[ Sign up for our Health IQ newsletter for the latest coronavirus updates ]

Trudeau made the remarks in his daily address to Canadians from outside Rideau Cottage in Ottawa.


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Coronavirus: Trump asks medical supply firm 3M to stop selling N95 respirators to Canada

On Friday, 3M said it was asked by the Trump administration not to supply N95 respirators (medical-grade face masks) to Canada and Latin America amid the novel coronavirus pandemic.

Trump has ordered the Minnesota-based company to produce and sell as many masks as the Federal Emergency Management Agency says it needs. He invoked the Defence Production Act in order to speed up the distribution of masks.






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Trump criticized for telling 3M to stop sending masks to Canada


Trump criticized for telling 3M to stop sending masks to Canada

Trump later released a statement saying that nothing in his order “will interfere with the ability of PPE manufacturers to export when doing so is consistent with United States policy and in the national interest of the United States.”

White House trade adviser Peter Navarro told Fox News host Tucker Carlson on Friday that 3M would continue to export masks to Canada.

READ MORE: Trudeau announces $40M for women’s shelters, $10M for Indigenous women and kids amid pandemic

“3M is basically going to be helping the American people fight this battle,” he said. “There will still be some exports from the United States factories to our friends in Mexico and Canada but as for the rest of 3M’s production around the world, we’re going to try to get our fair share.

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“We will get our fair share.”

It was not immediately clear how many masks would be sent to Canada, or whether the Trump administration had walked back its request to the company.

3M did not immediately respond to a request for comment on Saturday.

Trudeau said Canada is working “day and night” to secure additional supplies, using Canadian companies along with suppliers around the world.

A chartered cargo flight with “millions” of masks will be arriving in the next 48 hours from China, he said.

—With files from Maham Abedi, Global News

© 2020 Global News, a division of Corus Entertainment Inc.

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Coronavirus: Canada to receive ‘millions’ of masks from China, Trudeau says – Global News

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Canada is set to receive “millions” of medical masks from China, Prime Minister Justin Trudeau announced on Saturday.

Trudeau made the comments from Rideau Cottage, where he is currently self-isolating.

READ MORE: Coronavirus — Trump asks medical supply firm 3M to stop selling N95 respirators to Canada

According to Trudeau, in the next 48 hours Canada will be receiving a shipment of millions of masks by a chartered cargo flight from China.

Trudeau said included in the shipment are items ordered for Quebec, where the most cases of COVID-19 have been reported in Canada.

Trudeau said the federal government is working with provinces in order to transport the medical supplies.






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Coronavirus outbreak: Freeland says Canadian government will ‘pull out all the stops’ on medical equipment distribution


Coronavirus outbreak: Freeland says Canadian government will ‘pull out all the stops’ on medical equipment distribution

He said Canada has also leased a warehouse in China to collect and distribute additional supplies “as quickly as possible.”

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Trudeau said Air Canada and Cargojet are assisting in this effort.

[ Sign up for our Health IQ newsletter for the latest coronavirus updates ]

“I want to take a moment to thank everyone, whether you’re working in a warehouse, flying the plane or part of the ground crew, for your dedication,” he said.

READ MORE: Coronavirus — More than 11M masks recently arrived in Canada, Trudeau says

Trudeau’s comments come a day after U.S. President Donald Trump asked Minnesota-based company 3M not to supply N95 respirators to Canada.

Trump on Friday ordered 3M to produce and sell as many medical-grade masks as the Federal Emergency Management Agency (FEMA) says it needs.

He invoked the Defence Production Act in order to speed up the distribution of masks.

But, speaking to reporters on Saturday, Trudeau said Canada is not considering retaliatory measures in response to Trump’s move.






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Coronavirus outbreak: Freeland says Canadian government will ‘pull out all the stops’ on medical equipment distribution


Coronavirus outbreak: Freeland says Canadian government will ‘pull out all the stops’ on medical equipment distribution

“We are continuing to engage in constructive discussions with different levels within the administration to highlight that the U.S. will be hurting itself as much as Canada will be hurting if we see an interruption of essential goods and services flow back and forth across the border,” he said. “We continue to demonstrate that this is a good thing for both of our countries and we look to continue to ensure that essential supplies get across the border.”

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Trudeau said the government has been working “day and night”to source medical supplies for Canadian frontline workers.

“We have shipments coming in in the next 24 hours. We’ve received shipments over the past days,” he said. “We continue to work with suppliers around the world to ensure that we do get the medical equipment that we need and we have more coming in regularly.


READ MORE:
Canada not looking to retaliate after U.S. restricts coronavirus mask exports: Trudeau

Trudeau said the government is also turning to Canadian manufacturers to develop “made in Canada products, PPE, security equipment and medical supplies.”

“That is going to actually not just supply Canada, but be there to supply other countries who need them as we meet our own needs,” he said. “This is part of what Canada is doing to ensure that we are protecting our front line workers and all Canadians every single day.”

Canada’s chief medical health officer echoed Trudeau’s remarks at a press conference on Saturday, saying Canada was “pulling out all the stops” to secure personal protective equipment PPE for frontline workers.

Dr. Theresa Tam said Canada is looking at “multiple streams of supply” including domestic and international.

© 2020 Global News, a division of Corus Entertainment Inc.

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Why COVID-19 testing varies so much across Canada – CBC.ca

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If you just came back from an overseas trip with a fever and a cough, you’ll be prioritized for a COVID-19 test in Manitoba and Nova Scotia, but not B.C., Alberta or Quebec.

Some provinces are expanding the groups of people who can get tests as others narrow them — and that may change from day to day. Why? And what does it mean for the accuracy of numbers of infections in different provinces and territories?

Here’s a closer look.

How variable is testing across Canada?

Each province or territory has a different rate of testing and different groups that are targeted, sometimes unique to that region. For example, the Northwest Territories lists people who have had lab exposure to biological material, while Manitoba and Ontario prioritize people in remote areas or work camps. 

Many don’t test people outside those targeted groups, even if they have symptoms, and most even require people within those groups — such those who’ve been in contact with someone who has tested positive — to have symptoms before they can be tested.

To make things even more confusing, the priority groups change from day to day: Alberta, Manitoba and P.E.I. have all announced changes to their testing criteria in the past two weeks, and Quebec has announced multiple changes in that time.

Why are only certain groups prioritized for testing?

There is generally a shortage of tests, materials needed to run the tests and lab workers to run them. Exactly what is in short supply — and how short those supplies run — varies from province to province and possibly from week to week. That’s why some provinces, such as New Brunswick, are running relatively few tests, and some, such as Ontario, have long backlogs.

But to some extent, the shortage is Canada-wide — and worldwide.

“You’re just not going to be able to test everybody,” said Greta Bauer, a professor of epidemiology at Western University.

That means tests need to be rationed and each province or territory decides exactly which groups get priority, based on two main goals:

As a result, patients who need treatment in hospital are usually prioritized. Those who don’t need medical treatment, such as those with mild symptoms, often aren’t tested at all — they’re just told to self-isolate at home.

“We’re going to save the tests for the people who are really sick,” said Gaston De Serres, an epidemiologist practitioner at the Institut national de santé publique du Québec and a professor at Laval University, in an interview in French.

And to make sure those people can be properly treated, he said, health-care workers must also have good access to testing to ensure they can continue to safely work with patients.

Many people may think testing — and the daily infection numbers that come from the results — are an important way to measure the spread of COVID-19 in their communities. And more widespread testing would presumably better do that.

But while that is a way that governments might use testing, right now it “is not the primary use of tests,” said Bauer.

Why are priority groups changing so much?

Bauer acknowledged testing criteria are changing quickly — something that she called “appropriate” as the pandemic moves through different stages, particularly since a main goal of testing is to improve government response.

“That is, I think, what’s driving most of the changes we’ve seen,” she said.

Testing also needs to be responsive to what’s happening in different communities, she noted.

A medical staff member of a COVID-19 testing unit collects samples from people at a drive-thru location at the Santa Maria della Pieta hospital complex in Rome on April 3. (Alessandra Tarantino/Associated Press)

Why are some regions broadening their testing?

Initially, most cases across Canada were travel-related, so travellers and their close contacts were prioritized for testing in the hopes that COVID-19 could be contained in the way SARS was.

But now more than half of cases in Canada have been spread through community transmission and the numbers are getting higher, prompting many provinces to de-prioritize travellers.

Some provinces, such as P.E.I. and Nova Scotia, have broadened who they test in a bid to get a better handle on community spread.

Why are others making their testing more targeted?

Many provinces are now facing a shortage of tests and a strain on their health-care systems from COVID-19 infections, forcing them to narrow their criteria.

Alberta, for example, used to test more broadly, but on March 23 announced it would stop testing contacts of someone with COVID-19 and returning travellers to instead prioritize health-care workers, long-term care residents and clusters of cases.

And Quebec has changed its criteria twice in the past two weeks, as it struggles to balance testing shortages and a growing strain on its health-care system with a desire to get a better handle on community spread.

On March 19, the province announced that it would test more widely, and as recently as earlier this week, it said it would test asymptomatic contacts of people with symptoms. But on April 2, Quebec’s public health director, Dr. Horacio Arruda, said the province was no longer testing travellers, contacts of people who tested positive and people with mild symptoms.

The province’s priorities for testing are now hospitalized patients, people in long-term care, health-care workers, people in remote regions, and first responders, police and other essential services.

“There are lots of practical considerations that determine how the tests are going to be used,” said De Serres.

There has been a lot of debate about which groups should be considered priority in Quebec, he said, as the current list is beginning to represent a lot of people.

Members of the RCMP are seen at a COVID-19 testing area in Burnaby, B.C., on April 1. (Jonathan Hayward/The Canadian Press)

Who will be the big priorities for testing going forward?

Health-care workers and others who work in health-care settings are getting increasingly important, said Bauer. “And that’s because our response to the pandemic depends on those people.” 

While other people are being told to self-isolate for two weeks if they have any respiratory symptoms, doing that for health-care workers could lead to a severe shortage. We need to know for sure whether they have COVID-19 or a different respiratory illness, she said, and then get them back to work as soon as possible after they recover.

But she said she thinks testing should be broadened to other groups that help to supply essentials to locked down communities, such as those connected to pharmacies, groceries and deliveries of things like food. 

“Those are workers who are being asked to put themselves at risk and they are workers who we need on the job,” she said. “We need to not just think of essential services as people working in health-care settings.”

A nurse wears a protective mask and shield at a drive-thru clinic at Sainte-Justine children’s hospital in Montreal on April 1. Health-care workers are now prioritized for testing in many parts of Canada. (Paul Chiasson/The Canadian Press)

How do differences in testing change the apparent number of confirmed infections?

“They’re a function not just of what’s happening with the underlying pandemic, but with what’s happening with testing as well,” said Bauer.

An increase or decrease in testing, more targeted testing and changes to delays in getting test results can all impact the numbers of positive tests — even if the number of actual infections stays the same.

In a plot of the number of new cases to new tests before and after Alberta made its testing criteria more targeted, there were suddenly a lot more new cases, or positive tests, even while the same number of people were tested. 

You can also see a pretty dramatic rise when Quebec removed a requirement to get lab results verified on March 23.

Small delays in getting results can have a big impact on the number of apparent cases, as the disease spreads exponentially; in Canada, it has been doubling about every three days.

For example, in Ontario, tests have been delayed at least four days — the same length of time it takes for the number of cases to double in that province. That means there are about half the number of cases reported than you would expect to see if test results were immediate.

An infected person detected through testing is not typically counted until two weeks after infection anyway, and obviously, only certain groups of infected people are even tested, so testing results are huge underestimates of actual cases. 

“We’re looking at, you know, multiple cases that are undiagnosed for each one of those diagnosed at present,” Bauer said. “We have to remember that what we’re seeing is the tip of [the] iceberg. We’re seeing cases that have become symptomatic, where people have met testing criteria, [and] enough time has passed for them to have that positive test.”

Those are some reasons why epidemiologists like Bauer say hospitalizations and deaths provide a better understanding of the course of the pandemic than test-based reporting of cases.

Given that testing is so varied among the provinces, when it comes to the number of confirmed infections in each province, “we have to remember we’re almost never comparing apples to apples right now,” said Bauer.

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