As the number of reported cases of novel coronavirus continue to climb across the globe, even the slightest incident can spark rumours that run rampant on social media.
On Monday, a man was seen falling to the ground while waiting in line outside Richmond’s HK BBQ Master around noon.
The scene was caught on video and then shared on WeChat and Vanpeople, one of Vancouver’s largest Chinese language online forums.
Someone online suggested that the man might have novel coronavirus, and the rumour quickly spread.
HK BBQ Master was quick to state on its Facebook page that the man experienced a seizure due to a condition unrelated to any virus.
“What really happened was a man had withdrawals from substance abuse. He came with a group of friends to enjoy lunch and patiently lined up outside the store. Within three minutes of appearing at our store, that was when the withdrawal happened and caused him to experience seizures,” reads the posting on the restaurant’s Facebook page.
According to HK BBQ Master, one of the man’s friends was able to provide immediate medical care, and an ambulance arrived shortly to assist. The man is, reportedly, in stable condition now.
HK BBQ Master warned the public of the risk of spreading rumours and false information.
“Always be vigilant and aware when reading news on social media, and in general. Most try to raise readership with scandals, most report hastily without understanding details, (and) some post for likes and attention. The dangers of unknowingly reporting false information can cause harm to small family businesses like ours.”
The incident was also caught on the restaurant’s CCTV camera, and that footage has been shared on the restaurant’s Facebook page.
Reverend Berechiah Lee, a friend of the man who collapsed, said his friend had a sudden epileptic seizure while waiting outside the restaurant, but his condition improved after being taken to the hospital.
“This accident is unrelated to HK BBQ Master,” Lee added.
Canadians in several provinces face long lines for a swab to help diagnose COVID-19 as school and workplaces open. While new testing technologies could help, doctors say they won’t be a silver bullet.
The gold standard swab of the nose or throat can be uncomfortable. In contrast, a key promise of saliva tests is that people could collect saliva themselves so that fewer nurses and other health professionals would be needed at assessment centres, as staffing is one of the factors that can drive up wait times.
But that ideal won’t happen immediately. Currently in Canada, both saliva collection and testing remain a research project that regulators are closely evaluating.
There are three main barriers to overcome before saliva tests roll out widely.
Gobs of saliva vary in how fluid they can be, so collecting a high-quality sample can be a challenge even for something as non-invasive as spitting into a cup. The next hurdle for scientists is to get accurate and consistent results on the presence of the virus. Finally, clinicians need to determine how well the test results help them to correctly identify those with the disease.
Dr. Mel Krajden, medical director of the public health laboratory at the BC Centre for Disease Control, said health professionals face a quandary in finding the best ways to support a return to school, with all of its formative benefits for students, while protecting the oldest people at highest risk for severe consequences from COVID-19, such as grandparents or parents who are vulnerable because they have other health conditions.
Krajden said in his experience, saliva testing works better with COVID-19 patients in hospital than on people living in the community who’ve tried it as part of a research project. His Vancouver lab is working on a simpler approach to collection than the traditional nasal swab using a saline gargle that seems to work in older children.
On Thursday, British Columbia announced it’s introducing a new mouth rinse, gargle and spit test for students from kindergarten to Grade 12 to make it easier for children and teenagers to check whether they have COVID-19. But this new test is only offered to school age kids, and only in B.C.
“What we need to be thinking through is what is the best mixture of tests and how are they best supplied?” Krajden said. “You want to have the right balance between convenience and sensitivity.”
Unresolved questions about saliva tests
Health Minister Patty Hajdu said on Wednesday that Health Canada will not approve a test that endangers Canadians’ health because they are inaccurate or offer a false sense of security.
In Canada, the mobile Spartan Cube was recalled because of reliability problems with its swab for the lab-in-a-box PCR test (also known as a polymerase chain reaction test) that was billed as providing results in less than an hour. In the United States, wide-scale problems early on with another PCR test developed by the Centers for Disease Control and Prevention hampered containment efforts.
A different technology, a molecular test launched by Illinois-based Abbott that the company says can deliver positive results in as little as five minutes, was also subject to a recall. It aims to detect the virus during active infection.
The outstanding questions about saliva tests include: How good an alternative could they be to a nasal or throat swab, who would benefit — such as different age groups or those who show symptoms — and when would they be available?
For governments and clinicians globally and across Canada, the challenge now is to organize all kinds of testing to allow society to function while preventing transmission to those at highest risk of severe consequences.
For the majority of young people, COVID-19 is like a common cold, Krajden said. It’s older adults and those who are vulnerable because of other health conditions that can face serious infection or death.
Policy-makers urged to shift gears
Dr. Larissa Matukas, head of the microbiology division at St. Michael’s Hospital, Unity Health Toronto, said experts and policy-makers need to shift gears to understand where cases are multiplying and shut them down quickly by moving resources, including testing, to where there are signs of concern.
“I’m not sure that’s actually happening right now,” Matukas said.
“We should be shifting to a very aggressive finding of individuals, testing those who are symptomatic or testing those who’ve been in close contact with those who’ve been diagnosed with COVID and then isolating those individuals to really stop all the chains of transmission,” she and her co-authors wrote in an editorial last week in CMAJ.
Matukas said the first step is finding cases by improving access to diagnostic nasal or throat swabs or having a health-care professional evaluate symptoms.
“Unfortunately, there’s been this drive, particularly in Ontario, to reach a particular number of tests per day indiscriminately of who is actually being tested,” she said.
Other, equally important parts of containment have been neglected, Matukas said, such as governments communicating a clear need for all people with symptoms compatible with COVID-19 to get tested immediately and to self-isolate while they wait for the test result.
Dr. David Williams, Ontario’s chief medical officer of health, said Thursday that people who haven’t been in contact with a case, aren’t connected to an outbreak, haven’t received a notification from the COVID Alert app and don’t have symptoms “might want to defer your visit” until the demand for tests falls.
‘New technologies are always welcomed’
The level of disease in a particular community also makes a difference in misdiagnosing COVID-19 — another accuracy wrinkle to overcome in adopting quick, at-home saliva-based antigen tests for use in Canada.
“All new technologies are always welcomed,” Matukas said. “They always need to be evaluated in an objective, independent evaluation, and that’s the purpose of not just Health Canada, but that’s my job.”
As a medical microbiologist, Matukas carefully evaluates every diagnostic test introduced to ensure it meets the performance characteristics patients need in hospital. As part of her evaluation, new technologies are compared with a standard way of testing as a reference.
Lab workers need to do the same quality-assurance steps to check tests and equipment from all manufacturers. The goal is to ensure they perform well under real-life conditions, not just optimal ones.
Antigen tests that are used to identify mid-infection as the microbe multiplies, such as rapid tests for strep throat, is another technology under evaluation to help detect people likely infected with COVID-19 in schools, long-term care homes or other high-risk environments.
Krajden, of the BCCDC, said more data is needed to determine when it makes sense to deploy antigen tests to quickly inform decisions.
Matukas said people living in long-term care will continue to be a priority for diagnostic testing.
Living in an area with a high prevalence of the disease, taking part in certain activities — such as waiting tables, driving a cab or attending a large gathering — and not using personal protective equipment also contribute to the risk.
On the other hand, scolding people for breakdowns that can’t be controlled could drive some people underground and make it harder to detect cases, Matukas said.
Unfortunately, new and active COVID-19 case counts continue to climb to new heights in B.C.
There are also two new healthcare outbreaks, six flights and two Metro Vancouver stores confirmed cases, and 10 schools have reported cases.
Meanwhile, a new and more comfortable means of collecting test samples is being introduced in B.C. for children.
At a news conference in Vancouver, B.C. provincial health officer Dr. Bonnie Henry announced some unfortunate news: B.C. set a new record with 165 new cases today (which includes two epi-linked cases). The previous high was 139 cases on September 10.
The number of active cases continues to ascend. At the moment, there are 1,705 active cases (up 91 cases from yesterday’s 1,614 active cases), which is also a new record.
Hospitalized cases are slightly down to 57 people today in hospital (three less patients than yesterday), with 22 of those patients in intensive care units (one less than yesterday).
Of these patients, B.C. Health Minister Dix said that there are 26 in Vancouver Coastal Health, 23 in Fraser Health, seven in Northern Health, and one in Island Health.
The number of people being monitored by public health also continues to decrease—down from 2,966 people yesterday to 2,949 people today.
Unfortunately, one new death was announced, bringing the total number of fatalities to 220 people who have died from COVID-19-related causes during the pandemic.
A total of 5,719 people have recovered from the virus.
During the pandemic, B.C. has recorded a cumulative total of 7,663 cases, which includes 3,937 cases in Fraser Health, 2,714 cases in Vancouver Coastal Health, 489 in Interior Health, 241 in Northern Health, 196 in Island Health, and 85 people who live outside Canada.
Unfortunately, there are two new healthcare outbreaks. Both are in acute care units in Fraser Health, one at Delta Hospital and the other at Peace Arch Hospital in White Rock.
Fraser Health declared the Delta Hospital outbreak on September 16, stating that two patients tested positive in one unit, which has been temporarily closed to admissions. Enhanced cleaning and contact tracing is underway.
Accordingly, there are 16 active outbreaks in healthcare (11 in longterm care facilities and five in acute care facilities), with a total cumulative number of 802 cases (478 residents and 324 staff) involved in healthcare outbreaks during the pandemic.
Meanwhile, Dix also said that B.C. conducted a record number of tests during the pandemic on September 16: a total of 7,674 tests.
Loblaw has reported two of its stores in the Lower Mainland have staff who have tested positive.
An employee who tested positive last worked at the Westgate Centre location of Shoppers Drug Mart (20395 Lougheed Higway) in Maple Ridge on September 3.
Meanwhile, a staff member at the Real Canadian Superstore (7559 King George Highway) in Surrey, who tested positive, last worked there on September 11.
The B.C. Centre for Disease Control (BCCDC) has added two international and four domestic flights confirmed with COVID-19:
September 11: Aeromexico 696, from Mexico City to Vancouver;
September 11: Lufthansa 492, from Frankfurt to Vancouver;
September 11: Air Canada 8328, from Vancouver to Winnipeg;
September 11: WestJet 133, from Calgary to Vancouver;
September 12: WestJet 711, Toronto to Vancouver;
September 13: WestJet 711, Toronto to Vancouver.
For affected row information, visit the BCCDC webpage for public exposures.
Anyone at these locations or on these flights should monitor themselves for 14 days after the date of visit or flight date. If you develop symptoms, immediately self-isolate and contact 811 for testing information.
As announced yesterday, provincial health authorities have begun reporting potential exposure incidents at schools.
Fraser Health reported eight exposure events in schools.
One was at an exposure incident at Delta Secondary on September 11.
Two were at private schools: Khalsa School (elementary school at Old Yale Road location) on September 1 and 4, and Khalsa Secondary School in Surrey on September 9 and 10.
Five incidents were at public schools in Surrey:
Johnson Height Secondary from September 8 to 11;
Panorama Ridge Secondary on September 8;
Sullivan Heights Secondary on September 8;
William Watson Elementary on September 10;
Princess Margaret Secondary on September 11.
Interior Health listed Stanley Humphries Secondary School in Castlegar had one student on September 11 who has tested positive.
Northern Health listed École Frank Ross Elementary in Dawson Creek with an exposure event from September 10 to 11.
There weren’t any exposure incidents at schools reported in Island Health or Vancouver Coastal Health.
A new made-in-B.C. method of collecting samples for testing—one of the first of its kind in the world—is being introduced for testing school-aged children.
As an alternative to collecting samples from the nose with swabs, children and youth swish and gargle sterile salt water before spitting it into a tube, or by using a swab to collect a sample from their nose.
The nose swab is used for younger children or those who are unable to follow the swish, gargle, and spit instructions.
The BCCDC adds that children can practice at home how to swish, gargle, and spit.
Henry said that this new method will be more efficient because it doesn’t take as long to do as the nasal swab test.
However, due to limited supplies, she said they are focussing on children because “we know right now it’s going to be very critical for children if they start showing symptoms of COVID-19 and they’re in a school setting, many of them will need to get tested so it’s a way to try and facilitate that and make that easier right now.”
She said that this collection method needs to be done at a health centre assessment centre. In addition, she explained that the test itself remains the same but this is a different means of collecting samples.
The Renfrew County District Health Unit has confirmed a fourth staff member from Fellowes High School has tested positive for COVID-19.
RCDHU had deemed this person a probable case which factored into the decision to close the school on Sept. 16. This individual did not have any further exposures beyond the classes that have already been identified for testing and the staff member who became symptomatic last week has not been at school this week, according to a release issued Thursday evening.
The good news is that RCDHU has received negative test results for some staff and for all but two of the students in the original class that was exposed to the staff cases; these two tests have yet to be reported.
This afternoon RCDHU tested 98 individuals, 83 staff and 15 students. Almost all the staff from the school was tested along with most of the students considered to be at highest risk. There will be further testing tomorrow, for the remaining staff and students that could not attend today.
RCDHU will continue to update the school community and the public daily. In the meantime, RCDHU asks everyone to rigorously observe public health precautions as follows:
Limit your social activities and keep your bubble small.
Practice physical distancing (maintaining 2 metre distance).
Wear a mask when physical distancing cannot be maintained.
Clean your hands frequently with soap and water or an alcohol-based hand rub.
Cover your mouth and nose with a tissue when you cough or sneeze, then clean your hands.
If you don’t have a tissue, sneeze or cough into your sleeve and then clean your hands.
Avoid touching your eyes, nose or mouth, unless you have just cleaned your hands. • If you are ill, stay home.
Avoid contact with people who are sick.
Get your flu shot.
Use the COVID Alert App.
For all other information, visit RCDHU’s website at https://www.rcdhu.com/novelcoronavirus-covid-19-2/ or call 613-735-8654. For COVID-19 testing dates and times visit the Renfrew County Virtual Triage Assessment Centre (RCVTAC) website at www.rcvtac.ca for the testing schedule or call RCVTAC at 1- 844-727-6404 to book an appointment for testing.
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