A recent COVID-19 outbreak at a southern Ontario fitness studio is illustrating how certain indoor settings can provide a perfect storm for superspreading events.
The studio, a downtown Hamilton Spinco location, has been connected to 69 cases of COVID-19 as of Wednesday, despite screening customers, operating at 50 per cent capacity and keeping the recommended two-metre radius around bikes.
So how did so many cases originate there? And does it raise concern about how the novel coronavirus can spread in a gym setting?
“Certainly, this event makes you wonder that,” said Dr. Matthew Oughton, an infectious disease expert at Jewish General Hospital and McGill University in Montreal.
“I can see where this could lead to perhaps gyms having serious restrictions placed on them if they want to avoid similar superspreading events.”
Ontario and Quebec recently reintroduced closures at gyms in virus hot spots, including Toronto, Montreal and Ottawa, for a four-week period to help limit spread.
And Dr. Barbara Yaffe, Ontario’s associate chief medical officer, said Wednesday authorities are reviewing guidelines for fitness studios across the province after the Hamilton outbreak.
Oughton said gyms and fitness studios have a few strikes against them when it comes to tailoring them for the pandemic.
Heavier breathing expels droplets farther
They’re operating almost exclusively indoors, which makes for poorer ventilation, and patrons aren’t usually masked when engaging in strenuous exercise.
High-impact activity also leads to heavier breathing, which means droplets are being expelled from peoples’ mouths at an accelerated rate — and being propelled farther distances.
Dr. Andrew Morris, a professor of medicine at the University of Toronto, likens it to throwing a ball. The harder you throw, the farther it goes.
“We still don’t have a perfect understanding of this,” he said. “But we do know that when people are exercising vigorously, the volume and distance of what comes out of their mouth and their lungs is dramatically different than when somebody is speaking [in a normal way].”
WATCH | Dr. Theresa Tam, Canada’s top doctor, on aerosol transmission:
If people are shouting, cheering or singing — which often happens in a spin class where music is blaring and instructors spew out encouragement to keep participants’ intensity up — that can make things worse.
“And if you mix that in with a space that may not have proper ventilation, there is risk for a lot of spread to occur,” Morris said.
Dr. Ilan Schwartz, an infectious disease expert with the University of Alberta, said spin classes may pose more risk than other group settings because of the bikes themselves. In theory, the rapidly spinning wheels could aerosolize droplets by flinging them farther distances.
“I haven’t seen any studies of this, but theoretically it makes sense,” he said.
“I think going to the gym isn’t necessarily high-risk, unless individuals are close together and there’s poor ventilation. But there might be specific circumstances that could make it higher-risk, where something with fast, moving parts [or] a rapidly moving fan can generate aerosols as well.”
But Morris said the real danger comes when people are spewing out droplets in a poorly ventilated space.
Fitness class dangers not equal
The prolonged length of time spent in a spin class, typically one hour, and the number of people in the room will also impact risk.
Not all fitness classes will present the same dangers, he added.
A low-impact yoga class where hearts aren’t racing and breathing is kept under control seems safer than a high-impact spin class but not if it’s crowded and poorly ventilated.
A dance class, where participants are crisscrossing into airspace previously occupied by others, can be risky as well in the same environment.
“Assuming that room has relatively poor ventilation, that’s the kind of setting where yes, you’d be concerned about the potential for transmission,” Oughton said. “But if you had the exact same room with an excellent HVAC system, or the same room where windows were kept open … those are the kinds of things you could do to reduce the risk.”
Morris said finding ways to make these activities safer is always better than banning them.
Masks, while uncomfortable when working out, can be worn in most instances, he said. Improving ventilation and limiting numbers of people even further can also help.
“If we’re going to be successful, we can’t keep telling people they can’t have these things,” Morris said. “We need to be able to point to something and say, ‘This is the better choice.”‘
Schwartz said frequent hand-cleaning and the sanitization of equipment should also be kept in mind, even if surface transmission isn’t as concerning as it was earlier in the pandemic.
“And for now, I think it’s probably a good idea to avoid spin classes,” he added.
Oughton foresees people taking their workouts outdoors in new ways over the winter if gyms and fitness centres are deemed too risky.
That could mean dusting off the skates or ski boots.
“I think this is going to re-emphasize the safety and the necessity of being able to get some activity and fresh air outside,” he said.
“Hopefully, we find new appreciation for outdoor winter sports that we can all enjoy.”
Researcher predicts 4,000 daily new COVID-19 cases in Alberta by mid-December if measures not taken – CBC.ca
A researcher is sounding the alarm about Alberta’s significant increase in the number of new and active cases of COVID-19, warning that things could rapidly get worse in the province should additional measures not be taken.
Malgorzata Gasperowicz, a developmental biologist and associate in the school of medicine at the University of Calgary, says that given the province’s current doubling time, the province could be reporting more than 1,000 new cases per day by Nov. 11.
But Gasperowicz also told CBC Calgary News at 6 that without “strong, decisive measures” given the province’s current doubling time, Alberta could see around 2,400 daily new cases of COVID-19 on Dec. 5, and 4,800 on Dec. 23.
WATCH | Malgorzata Gasperowicz discusses the COVID-19 numbers Alberta could be seeing in the coming months:
But even should the province shut everything down today, it’s not as though the numbers will instantly drop.
“They usually take like, what we [saw] in the first wave in [introducing restrictions], it took at least three or four weeks to see the cases drop down,” Gasperowicz said. “So we will still be doubling for three weeks at least.”
That would mean the province would still be seeing around 1,600 or 2,000 daily new cases before dropping down, Gasperowicz said.
Given a situation where the province shut down on Nov. 15, Gasperowicz said, the province would see 3,000 daily new cases before bending the curve.
AB doubling time is 2.5 weeks.<br>It seems to be über-exponential➡️the doubling time shortens with time.<br><br>At this rate we will have:<br>Nov 11, 1000+ daily new cases<br>Nov 28, 2000+ daily new cases<br>Dec 15, 4000+ daily new cases<br>and so on.<br><br>Cases beget hospitalizations and deaths.<br>1/ <a href=”https://t.co/dIa0vqmf9l”>pic.twitter.com/dIa0vqmf9l</a>
Alberta at ‘a tipping point’
On Monday, Alberta introduced new social gathering restrictions, bringing in mandatory limits of 15 people in Edmonton and Calgary.
“You have heard me say many times that we need to achieve a balance between minimizing the risk of COVID-19 and minimizing the risk of harms of restrictions,” Dr. Deena Hinshaw, the province’s chief medical officer of health, said during a news conference.
“This requires us to keep the spread of COVID-19 manageable. We have now crossed a tipping point and are losing the balance we have been seeking.”
WATCH | Dr. Hinshaw says Alberta is at a tipping point for COVID-19
When asked whether the province would consider implementing another shutdown, Tom McMillan, a spokesperson with Alberta Health, pointed to the measures introduced Monday.
“We announced new measures on Monday. We are watching the data in Alberta closely and will consider if adjustments to the public health approach are needed in the days to come,” McMillan said in an email.
Speaking Thursday, Hinshaw reiterated that the province’s focus at this time was to strike “a difficult, but necessary balance when responding to COVID-19.”
“We must follow the evidence, and take the steps needed to prevent cases from rising exponentially and overwhelming our health system,” Hinshaw said.
“At the same time, every element of Albertans’ health is important. We must also limit the harms that our measures can have, as much as possible.”
Implementing ‘strong measures’
Gasperowicz pointed to a “cocktail of measures” that have worked to decrease numbers in other western jurisdictions.
The cocktail of measures that worked (turned exp. growth into exp. decrease) in Western jurisdictions:<br><br>- quarantine of all incoming travellers / travel rstrxns<br>- shut down *with financial support for businesses and people*<br>- support for marginalized/vulnerable groups<br><br>5/
“I’m convinced that if strong measures would be implemented, we would have the decrease,” she said. “But if we won’t implement strong measures and just have little tweaks, I don’t think it will slow the virus down.
“Strong measures worked in Australia, and they have zero cases now, and they’re celebrating.”
Speaking Thursday, Hinshaw said the choice is not between implementing another lockdown or letting COVID-19 run unimpeded.
“Instead, we must make it as easy and safe as possible for Albertans to live with this virus for the foreseeable future,” she said.
One day before Halloween, Alberta reported 622 new cases of the virus, a new daily record. It pushed the number of active cases in the province to a record 5,172.
Fraser Health outbreaks push active COVID-19 infections in B.C. to all-time high of 2390 – Powell River Peak
B.C. has never had more people actively battling COVID-19 infections, as new government data showed a total of 2,390 people suffering with the virus that has spurred a global pandemic.
That’s 46 more people suffering with the illness than was the case yesterday and it comes as 272 people were newly identified as infected in the past 24 hours. With 10,420 tests conducted, the day’s positive-test rate was 2.6%.
The hotspot for new infections remains the 1.8-million-resident Fraser Health region, which includes much of the eastern and southern Lower Mainland, including 20 communities, such as Burnaby, Coquitlam, Surrey, Delta, Langley, Abbotsford and Chilliwack, but not Richmond or Vancouver.
Only about two-thirds of the new cases are from Fraser Health today, however. That’s down from the average in the past week, which had seen about three-quarters of all new cases located in the Fraser Health region.
Here is the breakdown of all 14,381 detected COVID-19 cases in B.C., by health region, with new cases identified overnight in brackets:
• 4,664 in Vancouver Coastal Health (76);
• 8,219 in Fraser Health (183);
• 256 in Island Health (no change);
• 741 in Interior Health (seven);
• 412 in Northern Health (six); and
• 89 people who reside outside Canada (no change).
The number of COVID-19 patients in hospital fell by six to 78, with 25 of those people having infections serious enough to be in intensive care units.
The vast majority of those infected are self-isolating at home. Health officials are keeping tabs on a record 6,003 people because those individuals have come into contact with others who are known to be carrying the virus.
The vast majority of COVID-19 patients recover: 11,670, or more than 81%.
One new death was recorded overnight, pushing the provincial death toll from the disease to 263. That leaves 58 patients unaccounted for, and health officials have told BIV that it is likely that they left the province without alerting authorities.
“There has been one new community outbreak, at Suncor Firebag Oil Sands,” provincial health officer Bonnie Henry, and Health Minister Adrian Dix said in a joint statement. “There continue to be exposure events around the province.”
One hospital in Fraser Health, Surrey Memorial Hospital, has had an outbreak for weeks. That health authority earlier this week declared that the outbreak at Delta Hospital is over.
There are three new outbreaks at seniors’ homes and healthcare facilities:
• Hawthorne Seniors Care Community in Port Coquitlam;
• CareLife Fleetwood in Surrey; and
• Queen’s Park Hospital: Unit 3C NMSK 2.
Three such outbreaks have been declared over:
• Fort Langley Seniors Community in Fort Langley;
• Sunset Manor in Chilliwack;
• The Village in Langley.
Fraser Health yesterday declared that the outbreak at Good Samaritan Victoria Heights, in New Westminster, is over, and the province confirmed that news today.
Other seniors’ long-term care and assisted living facilities in B.C. that have active outbreaks, include:
• Gateway Assisted Living for Seniors in Surrey;
• Mayfair Terrace Retirement Residence in Port Coquitlam;
• Louis Breyer Home and Hospital in Vancouver;
• Revera Lakeview long-term care home in Vancouver;
• Evergreen Baptist Care Society in White Rock;
• Queens Park Care Centre in New Westminster;
• Three Links Care Centre in Vancouver;
• Royal Arch Masonic Home in Vancouver;
• Haro Park Centre long-term care facility in Vancouver;
• Banfield Pavilion 4 West in Vancouver;
• Peace Portal Seniors Village in Surrey;
• Rosemary Heights Seniors Village in Surrey;
• Zion Park Manor in Surrey;
• Laurel Place in Surrey;
• Amenida Seniors Community in Surrey;
• Baillie House in Maple Ridge;
• Fellburn Care Centre long-term care facility in Burnaby;
• St. Michael’s Centre long-term care facilityin Burnaby;
• Fair Haven Homes Burnaby Lodge in Burnaby; and
• Agassiz Seniors Community in Agassiz.
“As we all enjoy Halloween tomorrow, make it about the treats and not the tricks,” Henry and Dix said.
“Respect homes that are choosing not to participate this year and give everyone the space to stay safe, both indoors and outdoors.”
Family Thanksgiving dinner linked to 13 cases of COVID-19 in Renfrew County – CTV Edmonton
Three weeks after Thanksgiving weekend, a family dinner is Renfrew County is being linked to 13 cases of COVID-19.
Acting Medical Officer of Health Dr. Robert Cushman tells CTV News Ottawa between 15 and 20 people attended an intergenerational Thanksgiving dinner over the holiday weekend.
Dr. Cushman says it appears someone at the dinner was asymptomatic or didn’t pay attention to the symptoms.
The Renfrew County and District Health Unit says 13 positive cases are linked to the Thanksgiving dinner, including two new cases Thursday. Not all 13 positive cases attended the dinner.
“What you see is the spread, now into the third group from those at the dinner,” said Dr. Cushman, noting there is now second and third generational spread of the virus.
Two family members who tested positive for COVID-19 were high school students.
“Luckily, no further spread yet (at schools), thanks to excellent public health precautions at the school,” said Dr. Cushman.
Seventy students at the school were tested for COVID-19, while 90 students returned to school on Friday after being asked to self-isolate for 14 days.
Dr. Cushman says four outstanding students who developed symptoms on days 14 and 15 are now being retested, and will remain in isolation.
The Renfrew County and District Health Unit is also investigating a COVID-19 outbreak at the Canadian Nuclear Laboratory at Chalk River. Six people have tested positive for COVID-19.
“This virus is very wily,” said Dr. Cushman, noting CNL has solid public health measures in place.
Costco Black Friday 2020 — Costco Black Friday Ads And Deals – Delish.com
Researcher predicts 4,000 daily new COVID-19 cases in Alberta by mid-December if measures not taken – CBC.ca
COVID-19: Okanagan resort closes temporarily after staffer tests positive – Revelstoke Review
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