Virus spread slowing, but resurgence possible
Despite lack of data, outbreak clusters among vulnerable, Tam states
OTTAWA— Numbers don’t lie, but Canada’s top doctor fears COVID-19 data is deceptively encouraging.
Dr. Theresa Tam, chief public health officer, said Thursday that nearly three extraordinary months of economic shutdown and limitations on Canadians movements have slowed the spread of the coronavirus. But Tam warned Canadians that reckless reopenings could lead to an “explosive” resurgence of the disease.
“If we relax things too soon, there’s a very high likelihood of some sort of rebound or resurgence,” she said as she released the federal government’s latest data and future modelling projections Wednesday. They showed four provinces still battling the majority of outbreaks in this country, including the stubborn foothold of the disease in Quebec and Ontario, along with ongoing cases in Alberta and Nova Scotia.
And although Canada’s provinces and territories do not report race-related pandemic data, it’s clear from looking at where the outbreak clusters are that it is having a “disproportionate impact” on racialized and vulnerable Canadians, Tam said.
“COVID-19 has exploited social and economic vulnerabilities and inequalities across Canadian society, taking hold in settings and among communities that experience overcrowding, lower incomes and health disparities.”
Tam said the federal government now has “99 per cent” of case-based information from provinces and territories for lab-confirmed cases, but that doesn’t show the whole picture, which would include people who were infected and never got tested. It is also missing race- and ethnicity-based data.
Even without that, she said, a sobering reality for policy-makers has emerged: “While I think some of us who can stay at home are staying at home, there are many, particularly in the population most impacted by health inequities, who are out there doing the essential work.”
Tam said a lot of the workers who support long-term care or work in places like meat-packing plants are “in those populations who are in a lower socio-economic spectrum, they have more crowded housing and they are in some of the racialized populations.
“It’s a complex mix of health inequities, as well as the actual crowdedness of the workplace or the housing.”
Tam said national surveys of blood antibodies, which are currently in the planning stages, will eventually provide a clearer picture of how widely the virus spread.
Hardest hit in Canada so far are vulnerable populations in “congregate” settings, including long-term care and seniors homes, acute-care hospitals, daycares, correctional facilities, homeless shelters, meat plants and worker camps where there are also shared living spaces.
There have been more than 900 separate outbreaks in longterm care and assisted-living homes, amounting to 18 per cent of Canada’s confirmed cases. The data confirmed what the Star previously reported based on information collected by the National Institute on Aging: that 82 per cent of deaths countrywide are occurring in long-term-care homes.
Tam said the epidemic is playing out quite differently across the country.
Some provinces have effectively controlled the spread of the virus. No positive cases have been reported in Nunavut, while there’s been no community transmission in Prince Edward Island, the Northwest Territories or the Yukon.
Quebec and Ontario account for more than 90 per cent of new cases reported in the past two weeks, and the hot spots were in Montreal and the Greater Toronto Area.
But Tam stopped short of saying Ontario and Quebec should slow the pace of their phased reopenings, saying local public health authorities are best placed to make those calls, and Quebec, for example, has slowed reopenings in Montreal.
Since the coronavirus outbreak took hold in Canada in early March, public health authorities have closely watched the effective reproduction number of the virus — the average number of new infected people for each infected person — which is an indicator of how contagious a disease is. At one point it was up to nearly three. The goal was to get it down below one.
Thursday’s data showed Canada’s number has remained below one for nearly two weeks, suggesting the epidemic is under control. Tam said it must remain below one for three weeks in a row before any conclusions can be drawn.
“It doesn’t take very long for an outbreak to really gain some steam,” said Health Minister Patty Hajdu.
That’s why the need to build domestic capacity remains crucial, says Thunder Bay MP and emergency room doctor Marcus Powlowski, in the event there is a resurgence or second wave.
“So far” the health system has been able to cope, he said in an interview, “but we’re like in the second inning of the game that we don’t know has how many innings, so it’s not over yet. There certainly isn’t herd immunity and we don’t know — we’re a long way from herd immunity.”
In Thunder Bay, he said he’s “proud” of workers at the local Bombardier plant, which ordinarily makes rail and subway cars and buses. Up to 60 have switched to making ventilators. Bombardier called back 45 workers to work on a subcontract with a Toronto-based company, O2 Medical, to provide the Ontario government with 18,000 new ventilators. The first 500 are rolling off the assembly line this week.
As of Thursday, Tam said Canada had 93,441 positive cases and 7,543 deaths. Her modelling projects that in a best-case scenario, by June 15, Canada will see 97,990 cases, or with poor control measures up to 107,454 Canadians will become infected. Those models include a range of deaths from 7,700 to 9,400.