There may be many different paths to the new COVID-19 “normal” as provinces announce various plans to gradually ease social restrictions across Canada.
But all of them share one critical requirement: the ability to test widely for infection and then trace contacts, in order to isolate people who were exposed and break the chains of infection.
Are we ready? Has Canada fixed the testing backlogs and shortages that made headlines just a few weeks ago?
Infectious disease experts on the front line of Canada’s COVID-19 outbreak say no, but it’s a question that doesn’t have an easy answer.
‘Easy to say, hard to do’
Each province is responsible for its own testing policy, and in many cases individual municipal or regional health units are responsible for contact tracing.
“I personally am concerned about testing and tracing capacity,” said Dr. David Naylor, who was appointed to the leadership committee of the newly established COVID-19 Immunity Task Force announced by Prime Minister Justin Trudeau last Thursday.
Dr. Isaac Bogoch, infectious disease specialist at Toronto General Hospital, agrees.
“We’re not in a position yet where we’re doing enough diagnostic tests to reopen,” said Bogoch. “The crucial elements of reopening will be no barriers to diagnostic testing, and then we need an army of people to do contact tracing so we can identify positive cases and their close contacts,” he said on CBC News Network on Sunday.
“Easy to say, hard to do.”
If Canadians lack confidence in the testing system, it’s understandable.
In the first days of Canada’s outbreak many were shocked to learn that they could not get tested even though they had both symptoms and a travel history.
Soon after, Ontario, B.C. and several other provinces reported backlogs that forced some people to wait more than a week for test results.
Even after the testing chaos prompted Ontario’s frustrated premier to warn he would accept “no more excuses,” Ontario still hasn’t reached the level of testing promised almost six weeks ago.
In March, Ontario officials said they would be testing 20,000 people by mid-April. But for the past seven days the province has only done 12,500 tests per day, with a target of 14,000 tests per day by the end of this week.
British Columbia is only testing about 2,000 people per day, according to Dr. Bonnie Henry, the province’s chief medical officer of health.
“Partly that is because we are not seeing a lot of respiratory illness in the community right now,” said Henry. “We’re continuing to test anybody who goes to hospital with a respiratory illness or any other symptoms that we’re concerned about, and we have very broad symptoms that we’re talking about for the community.”
Canada’s Health Minister Patty Hajdu was asked about Canada’s COVID-19 testing capacity during a media briefing on Monday.
“I think, obviously, Canada can do better,” she said. “We’ve done a lot, and we’re very happy with the growth of testing that’s happening in the capacity of provinces and territories.”
WATCH | Epidemiologist explains why testing is key to reopening the economy
Hajdu added that the federal government has contracted a New Brunswick company to supply some of the desperately needed reagents — particular chemicals needed to conduct the tests.
“Now we have a local manufacturing source for that reagent, which is making it a lot easier to get that component of the testing done.”
LuminUltra is to supply the federal government with 500,000 RNA/DNA isolation kits per week.
CEO Patrick Whalen said the company will have shipped one million test kits to provincial labs by Thursday.
“We are providing this RNA isolation kit that is optimized to function on a specific extraction device, a robotics device that processes 96 samples at a time,” said Whalen, adding it’s designed to work on equipment that is commonly used in provincial health labs across Canada.
But there are other chemicals needed at different stages of the test, and the supply of those chemicals is also strained.
“We are ramping up our ability to produce the assay kits, as well — the step that comes after the isolation process — but we have not been called upon or asked to produce those for the provincial health labs yet,” Whalen said.
What about the Spartan Cube?
Ottawa’s Spartan Biosciences has been applauded for its rapid DNA analyzer, the Spartan Cube, that has been adapted to do COVID-19 tests. Health Canada approved the test two weeks ago, but it’s still not clear whether the test has added any capacity to the system.
CEO Paul Lem said he could not reveal precisely how many of the portable DNA analyzing machines Spartan has shipped to the federal government or the provinces, citing the need to protect proprietary information.
“Unfortunately, I can’t tell you,” Lem said. “We want to keep that competitive intelligence away from our competitors.”
He would only say the company has shipped “close to 100 or more.”
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Each cube can perform one test per hour, which would be a maximum of 24 tests per day per machine. Lem said the company is shipping thousands of the tests that are designed to be used with the company’s tiny testing machine. But he couldn’t say whether they are being used yet.
“Good question, I don’t know,” said Lem.
Health Canada’s media office was unable to say how many Cubes have been purchased and received so far, or whether any of those Cubes is currently being used to do COVID-19 tests.
Who to test
One key question as social restrictions are eased will be determining who is tested.
As B.C.’s Henry noted, that province is testing anyone with symptoms.
“We need to have a broader understanding of where cases and clusters are coming up in our communities,” Henry said.
Henry said there is no point in testing people without symptoms unless they are within a specific outbreak, such as in prisons or long- term care settings.
Hospitals want to be able to test every patient who is admitted, not just people who have symptoms of COVID-19.
That’s one reason some front-line doctors are saying it’s too early to ease restrictions.
“It’s trying to find that balance between opening things up and not opening up too much because we’d have such a surge of cases, we’d go right back to the concern we had a month ago,” said Dr. Michael Gardam, chief of staff at Humber River Hospital in Toronto.
“It’s an unbelievably tricky balancing act to try to figure out the way forward,” he said. “To be blunt, it was so much easier to shut things down than it will be to open them up.”
The other side of testing is the need for legions of contact tracers to track down everyone who was encountered by every person who tests positive. It’s a daunting undertaking.
“Contact tracing is really important,” said Henry. “It’s what helps us understand where people are that might have been exposed to the virus and maybe developing symptoms,” she said. “Because the incubation period is so long for COVID-19, that gives us the opportunity to find people and make sure they’re isolated before they can transmit to somebody else.”
B.C. has been building up its contact tracing capacity, Henry said.
“We’re looking at how we can use technology to facilitate that, but really there’s nothing out there that takes the place of having an individual connect with each of the contacts.”
The federal government put out a national call for COVID-19 volunteers that received almost 58,000 responses by the time it closed last Friday. The provincial and territorial governments can call upon those people as needed, said Andre Gagnon, a spokesperson for Health Canada.
But he said most of them won’t be working in contact tracing.
“The lists of volunteers have been shared with a number of jurisdictions, mostly to support long-term care. Each jurisdiction will be determining when and how they will be deploying volunteers.”
Strains from Europe and Eastern Canada account for most COVID-19 cases in B.C., genomic data shows – CBC.ca
Strains traced to Europe and Eastern Canada are by far the largest source of COVID-19 infections in B.C., according to new modelling presented by the provincial government Thursday.
Provincial Health Officer Dr. Bonnie Henry revealed the results of genomic tracing of different strains of the virus, showing that of those samples that have been sequenced, early cases linked to travel from China and Iran appear to have been well contained, leading to relatively few other infections.
But beginning in March, with an outbreak that began with the Pacific Dental Conference in Vancouver, infections with strains from Eastern Canada and Europe spiked dramatically.
“One of the people that we knew was positive and had attended that conference had previously been in Germany during his incubation period before he became ill,” Henry said.
Strains traced to Washington state have also been linked to a large number of cases, particularly in long-term care homes in the Vancouver Coastal Health region.
Henry explained that this kind of tracing is possible because the genome of the virus changes relatively quickly, but not as fast as diseases like influenza.
She also announced nine new confirmed cases of the virus on Thursday, for a total of 2,632 to date. No new deaths have been recorded, leaving B.C.’s total at 166.
The new cases announced Thursday include four people who have already recovered, people that Henry described as epidemiologically linked to previous patients who have tested positive.
This means these four people were close contacts of known cases and developed symptoms of COVID-19, but may not have had access to testing at the time.
There are currently 26 people in hospital, including six in intensive care. To date, 2,265 people have recovered from their illnesses, and there are now 201 active cases across the province.
Meanwhile, there has been a new community outbreak at the Beresford Warming Centre in Burnaby, where three people have tested positive for the virus.
Richmond has lowest caseload in Lower Mainland
For the first time, Henry also provided more detailed geographic data about COVID-19 cases in B.C., breaking them down by the 16 health service delivery areas.
The numbers show that in the Lower Mainland, Richmond has had the lowest percentage of cases, with just 444 per million residents, compared to 832 in Vancouver, 911 on the North Shore, and 1,241 cases per million in the area from Abbotsford to Hope in Fraser Health.
The numbers also show that Richmond had no new COVID-19 cases in the last two weeks of May, the only part of the Lower Mainland where that was the case.
As well, 83 per cent of B.C.’s new cases in the last two weeks of May were in just two health delivery areas — Fraser East and Fraser South.
In the rest of the province, the only sub-region with a significantly higher percentage of COVID-19 cases was north Vancouver Island (comprising areas north of Qualicum Beach), with 483 cases per million residents compared to 92 cases in central Vancouver Island and 112 cases in south Vancouver Island.
Men account for more deaths and hospitalizations
The figures presented by Henry also show a trend that has been noted in most other parts of the world.
While slightly more women and girls have tested positive for COVID-19 in B.C., men and boys have been much more likely to have serious cases of the disease.
About two-thirds of COVID-19 patients who have been hospitalized were male — a proportion similar to those in intensive care and those who have died.
“We’ve talked about the biological reasons why this might be, but we do not have all the answers yet,” Henry said.
Meanwhile, people over the age of 70 are much more likely to die from the virus, even though people between the ages of 30 and 60 account for the majority of infections.
Other data presented Thursday suggest that since businesses and services began reopening on May 19, British Columbians have managed to keep their social contacts to between 30 and 40 per cent of what they were before the pandemic.
“That’s what we want to see,” Henry said.
She also said that modelling suggests that the partial reopening of schools that began on June 1 should have minimal impact on the spread of the virus, as long as adults maintain social distancing and those who are ill commit to self-isolating.
B.C. is now testing between 1,500 and 2,000 people for COVID-19 every day, and the percentage of those tests coming back positive has fallen in recent weeks. Anyone with symptoms can now get tested, and Henry said the province has the capacity to ramp up the testing rate if necessary.
If the curve of infection remains relatively flat, Henry said, she is hopeful that travel within B.C. will be safe by late June or early July.
If you have a COVID-19-related story we should pursue that affects British Columbians, please email us at email@example.com.
Coronavirus cases in Canada continue steady decline, death toll increases by 139 – Global News
New novel coronavirus cases in Canada have been dropping for the past several days, with Ontario and Quebec continuing to account for the vast majority of new cases and deaths.
Canada saw 637 new lab-confirmed cases of COVID-19 reported on Thursday, slightly lower than 705 a day earlier and 994 a week earlier, bringing the country’s caseload to more than 93,500 cases.
The national death toll rose by 139 deaths, for a total of more than 7,600.
New modelling data revealed Thursday that Canada could see up to 9,400 deaths by mid-June.
Quebec remains the hardest hit province, with 55 per cent of the country’s cases and more than 60 per cent of Canada’s fatalities. The province reported 259 new cases and 91 deaths on Thursday — a drop from last week’s numbers, which hovered in the 500 range.
More than 52,000 cases have been reported overall, with over 17,000 recoveries. Nearly 4,900 people have died.
Ontario reported 356 new cases and 45 new deaths, bringing its figures to nearly 29,500 cases and more than 2,300 deaths.
British Columbia saw no new deaths on Thursday and five new cases, as well as four “epidemiologically-linked” cases — people who are symptomatic or have had close contact with a COVID-19 case, but haven’t been tested.
Global News has only included the five lab-confirmed cases in its official tally.
Coronavirus: Team sports to gradually resume in Quebec
B.C. has seen more than 2,600 cases and 166 deaths, along with more than 2,200 recoveries. The number of people in hospital in the province has hit an 11-week low.
Alberta reported 15 new cases and one new death Thursday. More than 7,000 people have been diagnosed with COVID-19 and 146 people have died. More than 6,600 people are considered recovered so far.
Saskatchewan reported just one new case and saw its active COVID-19 cases drop below five per cent. The province has seen nearly 650 cases so far, including more than 600 recoveries and 11 deaths.
New Brunswick reported one new case as well as its first COVID-19-related death on Thursday.
Coronavirus: Toronto starts preparations for the return of patios
The province’s first death related to the coronavirus is linked to the ongoing outbreak in the Campbellton region — a cluster that has been traced back to a doctor who contracted the virus in Quebec and did not self-isolate upon his return.
The man who died was an 84-year-old resident of a long-term care home in Atholville, N.B.
Nova Scotia reported one new death, bringing its tally to 1,058 cases and 61 deaths, as its active case total continued to go down. The majority of its death toll is linked to one long-term care home in Halifax.
No new cases
Three provinces didn’t report any new cases or deaths on Thursday, while two territories that have seen all their COVID-19 cases resolved have not seen any new ones. Nunavut is the only region in Canada that has not reported a positive case.
Manitoba says it has seven active cases, out of a total of 287 lab-confirmed cases. That number includes seven deaths so far. The province says it has no COVID-19 hospitalizations at the moment.
Newfoundland and Labrador is left with two active cases out of 261 total cases, including three deaths.
Globally, the virus has caused more than 1.8 million cases and close to 389,000 deaths, according to data tracked by Johns Hopkins University.
© 2020 Global News, a division of Corus Entertainment Inc.
State Department says U.S. will reassess intelligence-sharing with Canada if it lets Huawei into 5G – CBC.ca
The United States is prepared to reassess its intelligence-sharing arrangement with Canada if Huawei is given the green light to take part in building Canada’s 5G networks, a State Department spokesperson said today.
The federal government still has not announced its decision on whether the Chinese telecom giant will be allowed to participate in building Canada’s next-generation wireless networks, despite more than a year and a half of assessing the question.
“We in the U.S. government have made it very clear to all of our friends and allies around the world that if Huawei is allowed into a country’s national security systems, we will have to protect our intelligence-sharing relationship,” Morgan Ortagus, spokesperson for the U.S. State Department, told CBC News today.
“We’ll have to make an assessment if we can continue sharing intelligence with countries who have Huawei inside their most sensitive technology, in their most sensitive national security areas.
“We think that the Canadian government will make their own sovereign decisions and what’s best for Canada’s national security.”
Watch: Prime Minister Justin Trudeau on Huawei and 5G
The prime minister didn’t say today when Canadians can expect a decision on Huawei and 5G, or whether he’s willing to risk injuring the relationship with Canada’s closest ally by allowing the Chinese telecom giant to participate in the networks.
“Every step of the way, we have listened to our security agencies, our intelligence agencies, worked with our allies,” Trudeau said in response to a reporter’s question today. “We will make the right decision for Canadians to both keep Canadians and businesses safe while at the same time ensuring competitiveness in our telecom industry.”
Some private companies aren’t waiting for Ottawa to make a decision. Bell and Telus announced yesterday that they would not be working with Huawei as they pursue their 5G plans. Instead, both are opting to use equipment from European companies Ericsson and Nokia.
Washington has long argued that Huawei poses a national security threat because the Chinese government has the power to compel private companies like Huawei to hand over sensitive information. Huawei’s critics say they fear the company would conduct espionage on behalf of Beijing.
U.S. tries to clip Huawei’s wings
Contacted by CBC News, Huawei’s VP for corporate affairs in Canada said State’s “threats” are consistent with “the Trump administration’s preference for bullying and coercing rivals and allies alike. “
“Huawei has operated in Canada for more than a decade without a single security incident related to our equipment. Not one,” said Alykhan Velshi. “We look forward to the Government of Canada making an evidence-based decision on Huawei’s role in Canada’s 5G rollout.
“This decision should be made by, in, and for Canada, not Donald Trump’s Washington.”
In recent weeks, while much of the world has been focused on the pandemic’s rising death toll, Washington has announced new measures aimed at curbing Huawei’s global influence.
On May 15, the U.S. Department of Commerce changed its export control rules to restrict “… Huawei’s ability to use U.S. technology and software to design and manufacture its semiconductors abroad.”
The move is meant to make it harder for Huawei to obtain the supplies it needs, to significantly raise its operating costs and to force the company to rely on goods that may be less reliable and more vulnerable.
As a middle power, Canada often has found itself taking collateral diplomatic damage from tensions between U.S. and China, as both superpowers fight to become the global leader in technology.
That damage started ramping up in December of 2018, when Canada arrested Huawei CFO Meng Wanzhou on a U.S. extradition request.
Beijing immediately demanded her release and executed swift retaliatory actions. Two Canadians — Michael Kovrig and Michael Spavor — were arbitrarily detained in China; they’ve been held for more than 500 days. Beijing took trade action as well, halting large purchases of Canadian canola and, for a time, Canadian pork.
Ortagus condemned China’s imprisonment of the two Canadians. She said U.S. Secretary of State Mike Pompeo has brought this issue up regularly during high-profile meetings with his Chinese counterparts.
“The United States, we’re taking a lot of actions, doing everything we can behind the scenes with the Canadian government,” she said.
Asked if the United States might deploy sanctions to pressure China to release the two men, Ortagus said “we’re not going to preview any public actions that we may take.”
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