Experts keep close eye on U.S. COVID surge
CANADIAN HEALTH EXPERTS CONCERNED AS CASES SURGE AMONG YOUNG PEOPLE ACROSS THE BORDER
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.”