Ottawa Citizen - - Np - SHARON KIRKEY


With new con­firmed COVID-19 in­fec­tions surg­ing across the U.S. South, Dr. David Fis­man says a rea­son­able ex­pec­ta­tion would be that Amer­ica “is in for a hel­la­cious cou­ple of weeks" in terms of deaths.

“This has been so badly mis­han­dled from the get-go in the United States. It’s hor­ri­ble to watch,” said Fis­man, head of the di­vi­sion of epi­demi­ol­ogy at the Univer­sity of Toronto’s school of pub­lic health.

But nei­ther should Cana­di­ans imag­ine that we are so “epi­demi­o­log­i­cally dif­fer­ent,” said Si­mon Fraser Univer­sity dis­ease mod­el­ling ex­pert Caro­line Colijn. “If we re­open too much we will see rises in cases, too.”

While Prime Min­is­ter Justin Trudeau said on Mon­day a re­view of the fed­eral re­sponse to COVID-19 will help pre­pare for a po­ten­tial sec­ond wave, the first wave hasn’t passed.

In Canada, daily new cases and deaths are fall­ing, hos­pi­tal ad­mis­sion rates are down and re­cov­er­ies are in­creas­ing, ac­cord­ing to a new fed­eral mod­el­ling up­date re­leased Mon­day. And while there’s been a steep de­crease in trans­mis­sion among the elderly, there’s been a rel­a­tive in­crease among 20- to 39-year-olds.

“It’s still right here with us, like em­bers in a dry for­est,” said Colijn, whose mod­el­ling has helped in­form B.C.’s re­sponse to the pan­demic.

We’ve slowed the curve with se­vere ac­tions, not with im­mu­nity, she said. “When we stop the wa­ter by stop­ping our dis­tanc­ing mea­sures and other pub­lic health con­trol, those sparks can light up,” ig­nit­ing large new out­breaks.

Flare-ups are al­ready oc­cur­ring: in Kingston, Ont., where more than 3,000 peo­ple were tested over the week­end fol­low­ing an out­break at a nail sa­lon that has so far in­fected six staff, six clients and 13 of their close con­tacts; in Cal­gary, where a clus­ter of 45 in­fec­tions at a high­rise condo prompted pro­vin­cial of­fi­cials on the week­end to up its COVID-19 clas­si­fi­ca­tion for the city’s East Vil­lage; and in On­tario’s Wind­sor-Es­sex re­gion, where more than 180 farm work­ers tested pos­i­tive over the week­end.

Case counts in the U.S. are swelling to record daily highs in south­ern and western states. In Los An­ge­les and six other Cal­i­for­nia coun­ties, bars were or­dered shut after health of­fi­cials said booze makes peo­ple less likely to com­ply with phys­i­cal dis­tanc­ing and manda­tory face mask­ing. In Florida, bars and beaches in sev­eral coun­ties have closed for the Fourth of July hol­i­day week­end. Six­teen states are see­ing ris­ing cases.

De­spite the bleak de­vel­op­ments, the cri­sis seems “dif­fer­ent than what we saw two months ago,” U.S. Vice Pres­i­dent Mike Pence, leader of the White House coro­n­avirus task force, said on Fri­day. In Florida and Texas, half of con­firmed new cases are in un­der-35s, which Pence said was, at some level, “en­cour­ag­ing news,” be­cause younger peo­ple ap­pear less sus­cep­ti­ble to se­ri­ous out­comes.

Pence said fa­tal­i­ties and hos­pi­tal­iza­tion rates are de­clin­ing and that more test­ing is gen­er­at­ing more cases. “We’re in a much bet­ter place” than the worst mo­ments of the pan­demic two months ago, he said.

It’s true that more test­ing re­veals more cases, Colijn said. But even in younger adults COVID-19 can be se­vere. They can also spread the virus to the elderly and other vul­ner­a­ble groups.

Hos­pi­tal­iza­tions also lag con­firmed in­fec­tions — it takes time be­tween the on­set of symp­toms and be­ing so ill you need a hos­pi­tal, Colijn said. And deaths lag hos­pi­tal­iza­tions.

It takes an es­ti­mated three to six weeks to de­tect a change in trans­mis­sion. “Only now would we be start­ing to see the im­pact of re­open­ing in May and June,” Colijn said.

We should be ready for a “re-clos­ing” if we see a surge in cases, and pre­pared for surges in hospi­tals, she said. “We should un­der­stand that it takes time to see changes, we won’t know right away and we risk in­fect­ing peo­ple now who will need care in a few weeks time” if we don’t con­tinue phys­i­cally dis­tanc­ing.

“Stay­ing phys­i­cally away from each other, con­sis­tently, works and it is the only thing we know works,” Colijn said. Masks help, hand-wash­ing helps, “but we don’t know how much. To my knowl­edge, there is nowhere in the world that masks and contact trac­ing as the only in­ter­ven­tions have worked to keep COVID-19 at bay while so­cial ac­tiv­i­ties and con­tacts were near nor­mal.”

Fis­man said there’s an op­por­tu­nity for Canada to learn “from the mis­takes of oth­ers.”

“The rel­a­tive lack of deaths and se­vere cases and hos­pi­tal traf­fic isn’t a func­tion of the dis­ease sort of de­cid­ing to not be that big a deal any­more,” he said.

“It’s di­rectly a re­sult of our ac­tions,” such as dis­tanc­ing. “A very ac­tive ef­fort is mak­ing things not hap­pen,” he noted.

“Ob­vi­ously, the other con­cern is that this is our nex­tdoor neigh­bour,” Fis­man said. With con­firmed cases now ex­ceed­ing 2.5 mil­lion, and more than 125,000 re­ported deaths, the U.S. has the largest COVID epi­demic in terms of rec­og­nized cases in the world “by a lot.”

Even with the bor­der closed to non-es­sen­tial travel, se­ri­ously high rates of dis­ease in the U.S. could po­ten­tially in­flu­ence the epi­demic here given that our economies are so in­ter­twined, Fis­man said.

“We’re dealt a tough hand, here. The bor­der is fed­eral ju­ris­dic­tion, and it prob­a­bly means the fed­eral gov­ern­ment needs to step up in terms of get­ting very se­ri­ous about how we han­dle screen­ing trav­ellers com­ing into Canada, how we deal with quar­an­tine of trav­ellers, and mon­i­tor­ing peo­ple to make sure they don’t break (the 14day) quar­an­tine and how we try to think cre­atively about how we try to keep the dis­ease from be­ing in­tro­duced, with truck­ers com­ing across the bor­der, back and forth,” per­haps with saliva tests.

“It’s worth re­mem­ber­ing that, even back in Fe­bru­ary, we saw this grum­bling start to th­ese epi­demics, where we were im­port­ing cases and im­port­ing cases and we did not have an ex­po­nen­tial growth,” Fis­man said.

“And then in early March it sud­denly ex­ploded.”


Peo­ple wait in line at a free COVID-19 test­ing site in Hous­ton on Sunday. Texas Gov. Greg Ab­bott shut down bars and scaled back restau­rant din­ing late last week as cases climbed to record lev­els after the state em­barked on one of Amer­ica’s fastest re­open­ings.


The num­ber of COVID cases has spiked in the U.S., es­pe­cially in the south and west, as re­stric­tions were lifted.

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