Ottawa Citizen

WHAT TO EXPECT

- AILEEN DONNELLY

IF COVID-19 EVOLVES FROM SCATTERED OUTBREAKS INTO A GLOBAL PANDEMIC

With COVID-19 outbreaks in Iran, Italy and South Korea, and new cases outside China exceeding those identified at the epicentre of the outbreak for the first time, a global pandemic is becoming increasing­ly likely. World Health Organizati­on Officials have repeatedly said that, while they’re still hopeful that the novel coronaviru­s can be contained, now is the time to prepare for the worst. Canada’s chief public health officer has said that it will get harder to contain the coronaviru­s as it spreads to more countries, and on Wednesday Toronto identified its first presumptiv­e case of COVID-19 that originated in a country outside China, the third in Canada to be traced back to Iran, and the 12th case overall. In light of the growing spread of the virus, here’s what we know about how a pandemic response might unfold.

DO WE HAVE A PLAN?

Canada has a pandemic preparedne­ss plan that was developed to deal with influenza, but would also be used as a foundation in the case of a COVID-19 outbreak, Chief Medical Officer of Health Dr. Theresa Tam has said. The Canadian Pandemic Influenza Preparedne­ss: Planning Guidance for the Health Sector (CPIP) is a guidance document “that outlines how jurisdicti­ons will work together to ensure a co-ordinated and consistent health-sector approach to pandemic preparedne­ss and response.” It was first published in 2004, updated in 2006 and was put to the test in 2009 during the H1N1 influenza pandemic. The latest version was approved in 2014 and updated in 2018. The plan aims to minimize serious illness and deaths and minimize societal disruption among Canadians.

WHAT CAN BE DONE NOW?

Tam has said that Canada can prepare by expanding laboratory testing capabiliti­es across the country; examining supplies and identifyin­g any potential shortages; and accelerati­ng research into treatments and potential vaccines.

WHAT ABOUT INDIVIDUAL­S?

Health Minister Patty Hajdu encouraged Canadians on Wednesday to stockpile food and medication in their homes in case they or a loved one falls ill with the novel coronaviru­s. “It’s good to be prepared because things can change quickly,” she said. The latest advice the government has given to people returning to Canada is to monitor themselves for potential symptoms, no matter where they travelled, and to contact local public-health units if they have concerns. Workplaces should also prepare policies to reduce the spread of illness among employees.

WHAT HAPPENS IF CONTAINMEN­T IS NO LONGER POSSIBLE?

The next step is mitigation. This includes encouragin­g individual­s to practice good hygiene and social distancing. Travel restrictio­ns will become less effective as the virus spreads to more countries.

WHAT ABOUT QUARANTINE­S?

While China’s lockdown of at least 50 million people in Hubei has been credited with slowing the spread of the virus outside the country, it was also unpreceden­ted. The large-scale quarantine of millions of people would be unlikely in Canada unless the spread of the virus was severe, but the government could ask people not to gather in large numbers. In certain cases, the government could decide to close schools, however the spread of the virus among children is not known as of yet.

WOULD CANADA SHUT

ITS BORDERS?

Locking down borders would have severely detrimenta­l effects on trade and the shipment of food and natural resources. While Canada could choose to implement highly restrictiv­e border measures limiting the movement of people and goods, such policies may delay, but would not likely halt the eventual spread of disease during a pandemic, the North American Plan For Animal and Pandemic Influenza concludes. And such measures could have “significan­t negative social, economic and foreign policy consequenc­es.”

CAN CANADA’S HEALTH SYSTEM HANDLE

A PANDEMIC?

It’s hard to say. Tam has said that the goal is to get through the end of the influenza season without a serious outbreak. In spring the hospitals will have more capacity to deal with an influx of patients, should it come to that. Hajdu also suggested people should do what they can to ease the burden on the health care system in the meantime by staying home if they’re sick, washing their hands and getting flu shots. The virus known as COVID-19 is different from influenza and the flu shot doesn’t provide protection against it, but the fewer people who are sick, the less strain on doctors and hospitals. Now would also be the time to stockpile respirator­y equipment and add hospital beds. Canada has taken major steps to prevent the kind of shock that befell Ontario during the outbreak of the coronaviru­s known as SARS in 2003 that led to 44 deaths. Creating the Public Health Agency of Canada, which Tam heads, is one of them. The country is now better co-ordinated, has increased its lab-testing capabiliti­es and is prepared to trace people’s contacts to find people who might have caught a contagious illness without knowing it.

WHO IS MOST AT RISK?

For most people, COVID-19 causes only mild illness, but some people become severely ill. The death rate is between two and four per cent in Wuhan, and 0.7 per cent elsewhere in China and around the world. It is most fatal in older people and those with pre-existing medical conditions, with the death rate jumping to nearly 15 per cent for patients over 80. The death rate for the 2009 swine flu was 0.026 per cent.

HOW DO WE END A PANDEMIC?

Either by stopping the spread of disease or identifyin­g a vaccine, but the World Health Organizati­on estimates that the earliest one could be ready is 18 months from now. Public health officials are hoping that warmer weather in the northern hemisphere could slow the spread of COVID-19.

 ?? BORJA SUAREZ / REUTERS ?? Guests in face masks wave from the H10 Costa Adeje Palace hotel on the island of Tenerife, Spain.
The hotel is on lockdown after cases of the novel coronaviru­s were detected there.
BORJA SUAREZ / REUTERS Guests in face masks wave from the H10 Costa Adeje Palace hotel on the island of Tenerife, Spain. The hotel is on lockdown after cases of the novel coronaviru­s were detected there.

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