The pandemic day ‘seared into my memory’
Dr. Bonnie Henry was one of the early faces of the COVID-19 pandemic. As British Columbia’s provincial health officer, she was hailed for her decisive action — and even had a pair of Fluevog shoes made in her name. Her sister, Lynn, is the publishing director of Knopf Canada. The siblings teamed up to record the events of that first month in a book: “Be Kind, Be Calm Be Safe: Four Weeks That Shaped A Pandemic,” out on March 9. As we mark a year since COVID-19 first sent us into lockdown, Dr. Henry remembers one of the most important days at the pandemic’s beginning.
February 20 was the next day to be seared in my memory. Midway through that morning I received a call from the lab: we had another positive case, but this time the only travel had been to Iran.
Iran!? We were all shocked. Iran hadn’t reported having any cases, but we knew that information coming out of the country was limited. The relationship between Canada and Iran had been strained for a long time, and had recently broken further after the shooting down in Tehran of a passenger airplane carrying 169 people, two-thirds of whom were Canadian or had ties to Canada. My first thought was that this must be a false positive or a contamination — or perhaps even a MERS infection that had cross-reacted. But the lab had already considered these possibilities and tested for MERS as well as for the other circulating coronaviruses. The results came back negative, even while the sample was COVID-19 positive on all three mark- ers, and with a low cycle threshold (meaning lots of virus). The lab also sent the sample for whole-genome sequencing to determine whether it was the same as the viruses we’d seen in people who’d been in Wuhan — or different enough that it would help us understand how long it had been circulating in Iran. We were learning that this virus mutated slowly, but that over time even small changes in the RNA as it passed from person to person allowed us to track its movement. The genome results came through in hours: this strain of the new virus was indeed different from those we’d seen here before.
This was what’s known in public health as a sentinel event: an important marker that the virus had spread more widely than we knew globally, and also an indicator that its spread in Iran was happening on a large scale. As our public health teams sprang to work investigating the story of this new case, I reported these concerning new findings to our country’s chief public health officer as well as the Public Health Agency of Canada, who urgently passed it on to the WHO.
Our press briefing that day was longer than usual as I explained the significance of this sentinel event. There were, understandably, many questions, but one was paramount: Why had the person been tested in the first place? Given our limited testing capacity, like our colleagues across the country we’d given priority to those with known risks for COVID-19 — people who’d travelled to areas where we knew the virus was circulating or who’d had contact with someone who had travelled and was ill. Iran was not one of those areas. The woman who tested positive had visited family there during the New Year celebrations and then flown home through Tehran to Istanbul to Frankfurt. She’d become ill with an influenza-like illness several days after her return home to B.C. and was sick enough that she went to the local emergency department to be assessed. The doctor who saw her was initially sure she had influenza, but because she’d travelled on so many flights, and almost as an afterthought, had asked for a COVID-19 test as well. In short, we’d picked up the case partly through luck and partly thanks to our preparedness messaging: we’d told clinicians to maintain a low index of suspicion and to test if they believed the virus was at all a possibility. To paraphrase Louis Pasteur, luck favours the prepared. Excerpted from Be Kind, Be Calm, Be Safe: Four Weeks that Shaped a Pandemic. Copyright © 2020 by Dr.