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A recurring fear looms over newly reopened bars and restaurants, lurking over crowded aisles, clinking glasses and face-to-face banter enlivened by alcohol.
Are we sleepwalking toward an American-style coronavirus crisis?
As Canadian establishments reopen, it’s a worry voiced even by some people with a financial stake in the hospitality business.
Two Montreal restaurateurs said they were aghast at behaviour they witnessed after businesses resumed operating several weeks ago.
“Frustrated. Angry. Disheartened,” is how Stephen Leslie, owner of Tavern on the Square and Monkland Tavern, describes his reaction to seeing other establishments defy safety guidelines, with too many tables and too little PPE for staff.
“You just can’t help but think that what’s going on to the south of us — Texas, Florida — how they’ve been forced to re-close is going to happen to us here if we don’t follow the rules.”
A patron enjoys a glass of wine at the bar of Lemeac restaurant on the first day after restrictions were lifted on restaurants in Montreal, on June 22. (Christinne Muschi/Reuters)
Ilene Polansky, owner of Montreal restaurant Maestro SVP, said disrespectful clients littered; stumbled into her; did not distance; refused to wash their hands; and stormed off when she declined to group tables together.
“They said, ‘One-star review for you. We’re never coming [back] here,'” Polansky recalled.
“It’s sad that I have to tell people to follow the rules.”
The post-reopening spikes inevitably raise questions about whether Canada is simply a few weeks behind a neighbour that reopened sooner.
In the U.S., a new wave of the virus is battering virtually every region, with cases rising in most states; record spikes in several of them; and hospital bed shortages in Florida and elsewhere.
To gauge whether the early signs in Canada point to a scenario similar to the one flaring up through the U.S., CBC News consulted three infectious disease experts, four public health officials, and national, state and provincial data.
One of Canada’s best-known public health experts said she lost sleep over the decision to reopen bars in B.C. — but she’s now confident in their ability to clamp down on outbreaks quickly before they spiral out of control.
“We’ve had our restaurants and bars open for the last month now, and we haven’t had major outbreaks,” Bonnie Henry said in an interview with CBC News. “It’s not been perfect, and we’ve had to revise things.”
Henry said B.C. reopened establishments in a “manageable” way that allowed people to socialize safely, with smaller capacities, strict physical distancing and hygiene protocols, and a COVID-19 safety plan in place.
“The first thing people said when we had the exposure event in a couple of the nightclubs in Vancouver was, ‘Oh, shut them down.’ But that doesn’t help,” she said, adding officials worked with the industry to minimize risk to patrons and staff.
“It just drives people underground, where we won’t hear about cases because they’re afraid to talk about it.”
‘You can’t eat and drink with a mask on’
When trouble hit the United States, it initially struck with stealth — as a series of anecdotes, unheeded warnings, contradictory news headlines, and videos of safety guidelines being ignored.
Within days the headlines took an unambiguously bleaker turn. Arizona reported its highest one-day increase in cases. Then the cases kept growing, and growing, then doubling, tripling, quadrupling.
California is among the many states experiencing a surge in coronavirus cases. Pictured are cars lined up at a drive-thru testing site at Dodger Stadium in Los Angeles on Thursday. (Lucy Nicholson/Reuters)
Now Canada is also reopening what experts describe as some of the highest-risk environments — bars and restaurants.
People are indoors, in close contact, sharing food and drinking while proven infection-control measures — like physical distancing, hand hygiene and mask wearing — are also much harder to maintain.
“You can’t eat and drink with a mask on,” said Dr. Matthew Oughton, an infectious disease specialist at the Jewish General Hospital and an assistant professor at McGill University in Montreal.
The spread of COVID-19 among bar-goers who aren’t displaying symptoms is another major risk factor.
“The risk is that you could be feeling totally fine and ready to go for a night out,” he said. “And your dining partner might be infected, or you might be infected and yet not know it.”
Oughton said the biggest challenge for public health officials is catching those outbreaks from bars and restaurants early enough to stop them from “snowballing” into larger threats to the community.
He said they need to focus on isolating positive cases and contact tracing to ensure the virus doesn’t spread in the community unchecked after an outbreak.
“We are sitting in a forest that is bone-dry and there are lots of places where sparks might flare up,” Oughton said.
“So you can stomp out the first spark, you can stomp it the second spark, what worries me is if there’s 100 different sparks starting 100 small brush fires, can you actually stomp it all of them in time?”
WATCH | B.C. and Quebec hurry to trace new COVID-19 clusters
Authorities in B.C. and Quebec are racing to contain a new cluster of COVID-19 cases linked to bars and social gatherings. 2:04
But the statistic to watch, according to one U.S. epidemiologist: the percentage of people testing positive for coronavirus, and which direction it goes.
That’s a metric Jennifer Nuzzo follows closely as a leading indicator of where case totals are headed.
If it starts to move down, that’s good news; if it moves up, that’s a red flag that more cases are being missed, more people are unwittingly spreading the virus, and there’s a growing chance it might spiral out of control.
“I pay a lot of attention to positivity,” said Nuzzo, an epidemiologist at Johns Hopkins Bloomberg School of Public Health.
“If it starts to pick up, that’s, I think, a worrisome development.”
The goal set by the World Health Organization is to keep positive test rates below five per cent.
By that standard, the U.S. is in brutal shape. A whopping 33 U.S. states had rates higher than the WHO benchmark on Thursday, with several just above or just under 20 per cent.
Canada has far lower positivity rate than U.S.
That’s exhibit A in the difference between Canada and the U.S..
U.S. states were indisputably in worse shape when they reopened indoor social establishments:
Arizona’s positivity rate was around six per cent when it allowed restaurants and some bars to reopen on May 11 — and has surged to a recent peak of 26.9 per cent, according to figures compiled by Johns Hopkins. The Texas rate hovered above five per cent this spring during the weeks it reopened, and is now at 16 per cent. Florida reopened restaurants in most places on May 4 and bars on June 5, a period during which test-positivity rates were between two and five per cent — and then started surging to a peak near 20 per cent.
U.S. states reopened with little regard for such metrics, said Dr. Abraar Karan, a physician and public health researcher at Harvard Medical School who is aiding the Massachusetts pandemic response.
He said the U.S. could have avoided a spike in cases from reopening if it had simply taken its own advice: in May, the U.S. Centers for Disease Control and the White House published careful step-by-step guides to reopening based on scientific benchmarks.
“The thing is, none of those were actually implemented at the state level across the United States,” Karan said.
Right after the White House published those guidelines, however, the president of the United States was essentially brushing them off, calling on states to reopen in a series of all-caps tweets like, “LIBERATE MICHIGAN!”
That illustrates another difference between the countries: politics.
Bar patrons attended a reopen-Florida maskless rally and dinner in Windermere, Florida, this week, illustrating the political debate over pandemic precautions even as cases surge in the U.S. (Octavio Jones/Reuters)
Even now, the governor of Georgia is preventing cities from imposing masks.
And while the numbers are shifting, as the U.S. grapples with this ongoing wave, data collected by Google from people’s smartphones showed Canadians doing far more physical distancing than Americans in the winter and spring.
“What happened in the States is that they did a fast reopening, before they even came close to settling down their first wave. So what’s going on now is not a second wave, it’s a continuation of the first wave,” Oughton said.
“Whereas it’s very safe to say that in Quebec — and, in fact, across Canada — we really have largely controlled it.”
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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
