NO EASING IN SIGHT EVEN IN ‘SAFER’ AREAS OF B.C.

Latent coronavirus risk forces Henry to refrain from regional reopenings

B.C. increasingly appears to have experienced two COVID-19 outbreaks, a more severe one in and around Metro Vancouver and a lighter one in the rest of the province.

Fraser Health and Vancouver Coastal, the health regions spanning Metro Vancouver and the Fraser Valley, have about 60 per cent of the B.C. population.

But as of this week, they had recorded 80 per cent of the roughly 2,500 confirmed cases of COVID-19 and 95 per cent of the 155 deaths attributed to the disease.

The Vancouver Island, Interior and Northern health regions have gotten off relatively lightly, with only onefifth of the documented cases and five, two and zero deaths, respectively.

The gap is equally evident in the number of active cases, which are diminishing everywhere but most dramatically outside Metro Vancouver.

The Vancouver Island health region had only one active case as of Friday, compared to more than 200 in Fraser Health and almost 100 in Vancouver Coastal.

In light of the disparity in active cases, should B.C. consider lifting restrictions in the regions that appear to have shaken off the outbreak?

But when I put that question to provincial health officer Dr. Bonnie Henry, she answered with a flat “no” — as precise an answer as she has given in recent media briefings.

“We do know that people move,” she explained. “We do know, as well, that with this virus, we are not catching everybody that has it. We know it is still in our communities. The cases that we have that have tested positive are a good indication.”

Which was not to say that testing is turning up much on Vancouver Island. The region is averaging several hundred tests a day. It hasn’t turned up a new case in almost two weeks, according to chief medical health officer Dr. Richard Stanwick.

Still Dr. Henry argues that “the philosophy that we need to have across the province for the coming period of time is we don’t want to give this virus those opportunities to start spreading to large numbers of people.”

So no waiving physical distancing, limits on social connections, the 50-person rule on crowd size or other Phase 2 restrictions anywhere in the province.

The stance is different from what Dr. Henry suggested back on April 9 when asked about the possibility of a phased regional exit from COVID-19 restrictions. Question: “Looking at regions outside the Lower Mainland that are reporting zero or single-digit cases now daily, would there ever be a day the province would consider perhaps relaxing or tailoring rules, depending on what’s happening locally?” Answer: “Absolutely. We’re looking at all kinds of options. We’re a very large province with quite different demographics and different geographic issues in many places where there’s single introductions. We will be tailoring it as best we can to what’s happening in the different areas that we know of, but that thinking is going on now, for sure.”

The thinking changed over the ensuing six weeks.

One factor may have been reflected in her response to the calls from rural and remote parts of the province for a ban on visitors. She rejected it as unjustified and not likely to be all that effective.

Another factor may have been evident in her reasons for not identifying the number of cases in specific towns or communities.

“Simply put, the risk is everywhere,” she declared. “It would be irresponsible to mention only a few communities and give people outside those areas a false sense that they are not susceptible or at lower risk.”

But I expect her overriding reason for not reducing the current level of vigilance is to reduce the chances of sudden and uncontrolled outbreaks, like the one unfolding at the Langley Lodge long-term care facility in the Fraser Health region.

The facility was removed from the list of stricken longterm care homes on April 25, after a brief outbreak consisting of a single case.

But four days later it was put back on the list after a second outbreak that has now become the second worst in the long-term care sector.

As of Tuesday, Dr. Henry was reporting 43 residents and seven staff had tested positive and eight residents had died. As of Friday, officials at the facility were reporting 16 dead, a toll exceeded only by the 20 residents who died at the Lynn Valley Care Centre in North Vancouver.

“We’ve seen over and over again that once the virus gets into the facility and once people have been exposed, we know that there’s going to be ongoing development of illness, particularly our elders and seniors,” Dr. Henry said this week.

“That illness can be very mild, then very suddenly and unfortunately lead to death very quickly.”

On another day this week she underscored the Phase 2 challenge of managing the outbreak while relaxing some restrictions:

“We know this virus hasn’t left. It is circulating in our community. That’s why we are doing this so cautiously and thoughtfully. And if we look at the modelling of what we have seen in other places, and what we have seen here in B.C., there is a potential for it to start transmitting quite rapidly in our community.”

On that basis, I wouldn’t look for her to relax any restrictions, regionally or otherwise, before the anticipated start of Phase 3 in the middle of June.

I expect her overriding reason for not reducing the current level of vigilance is to reduce the chances of sudden and uncontrolled outbreaks.