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How an Edmonton curling tournament became a hotspot for the COVID-19 outbreak in Canada

How an Edmonton curling tournament became a hotspot for the COVID-19 outbreak in Canada
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A little more than two weeks ago, as the World Health Organization declared a pandemic, and Canadian experts scrambled to understand the scope of the COVID-19 outbreak, the Granite Club in Edmonton was preparing to host dozens of doctors and medical professionals for the most Canadian of events: a curling bonspiel.

The annual tournament, held this year between March 11 and 14, has now become one of the hotspots for the COVID-19 outbreak in Canada, with a cascade of infections among doctors and other health-care workers, and with public health agencies across the country scrambling to find people — patients, co-workers — who were in contact with them.

In previous years, says an old event report on the Alberta Medical Association website, doctors mixed tartans with St. Patrick’s Day costumes. The point is to have fun, even if you weren’t much of a curler, it says.

By Sunday, March 15,  the world had changed: Alberta Premier Jason Kenney announced classes were cancelled; the 19 cases in Alberta had nearly tripled to 56, and the province now had COVID-19 cases that had spread from within the community.

Tom Koch, a medical geographer at the University of British Columbia, and author of Cartographies of Disease, said the early outbreaks, such as the bonspiel, showed us a virus that moved in ways and speed that nobody had yet understood. “This virus has fooled us from the start,” Koch says.

As of March 27, at least 24 of the roughly 72 attendees of the bonpsiel have tested positive for COVID-19, including three in Red Deer, Alta., who saw patients before self-isolating. Also included among those testing positive are Dr. Allan Woo, the head of the Saskatchewan Medical Association, and an unidentified 60-year-old in Peterborough, Ontario.

It does not appear —  yet — that the virus can be traced further, to either patients or other health-care workers, from the bonspiel.

This event, as well as an earlier dental conference in Vancouver, that saw nearly 15,000 attendees, and has been connected to a few dozen cases in various provinces, — and perhaps the death of a North Vancouver dentist who attended (B.C. officials refuse to confirm cause of death) — raise a serious question: Should health professionals have known better than to gather in large groups in as a pandemic was unfolding?

The National Post contacted several physicians believed to have been organizers or attendees of the bonspiel; most did not reply to the Post’s inquiries, and none agreed to an interview. Said one Edmonton physician, who had previously been involved with the bonspiel — the Post could not confirm whether he attended this year’s event — who answered the phone at home: “Yeah, that’s a non-issue, the media’s just blown it totally out of proportion.” Then he hung up.

It’s difficult to remember how different the world was a mere two weeks ago. Alberta, for example, had banned gatherings of more than 250 people, but children in the province were still scheduled to attend school, parents were going to their offices.

Within days, everything changed. By March 16, the Canadian government moved to bar foreigners from entering Canada; on March 17, Alberta banned gatherings of more than 50 people. By March 20, non-essential travel to and from the United States ended.

Koch cautions about blaming doctors for not knowing about a virus which, at that point, not even infectious disease specialists fully understood. “If it was a matter of truck drivers and waitresses, we would not be so interested,” he says.  “They (the doctors) were just the poor schmucks that got caught early.”

The bonspiel’s Patient Zero, as far as health officials have figured out, seems to be a doctor from Saskatchewan. His or her identity is unknown, but this doctor had been to Las Vegas, before returning to Canada and heading to the bonspiel.

They were just the poor schmucks that got caught early

The first known bonspiel COVID-19 case — the one that brought the event and the outbreak to the public’s attention — was Dr. Allan Woo, an orthopaedic surgeon, who is also the president of the Saskatchewan Medical Association. On March 19, he announced in a statement that he tested positive, and that he suspected he’d caught COVID-19 at the annual bonspiel. “As I write this, I am reminded that physicians are not invincible,” Woo wrote in his statement. The Post was unable to reach him further comment.

Since then, several others have been caught up in the bonspiel outbreak. Later that same day, on March 19, Dr. Deena Hinshaw, Alberta’s chief medical officer of health, told reporters they’d just become aware of the event, and the COVID-19 case. At that point, Alberta had 146 positive cases. None of them, linked to the bonspiel, Hinshaw said. “We are taking this very seriously and again we’ll be making sure that we follow up individually with attendees,” said Hinshaw.

Saskatchewan’s chief medical officer of health, Dr. Saqib Shahab, also said on March 19 that an investigation into the bonspiel was underway in his province. “Details are sought about where each of the participants were, did certain people sit together as a group and mix more than others, and based on that a determination will be made shortly — in a day or two — does this involve all people who attended?” Shabab said.

*****

By Saturday, March 21, there were positive tests. Shabab, Saskatchewan’s top doctor, told reporters in a teleconference that 11 of the 22 health-care workers who attended the bonspiel had tested positive. He called the news, which affected doctors in Saskatoon, Regina, Prince Albert and elsewhere, “sobering.”

“We are not immune to this virus in social settings, and this is a stark reminder for all of us of the care we need to take immediately in any gatherings,” Shabab said.

It can take up to 14 days for those who’ve been infected with COVID-19 to begin showing symptoms. This means that, at the outer margins, attendees of the bonspiel might not begin showing symptoms until Saturday, March 28.

Some people got lucky.

In Drumheller, a town northeast of Calgary, two doctors had decided not to attend the event. Dr. Rithesh Ram and Dr. Veronique Ram had planned to go, reported the Drumheller Mail the Drumheller Mail, but stayed home, given the outbreak.

“Initially, I was sad and wondering if I made the right decision for not going,” Rithesh Ram told the paper. “Hearing that my friends and colleagues are now in isolation and awaiting results of COVID-19 testing made this crisis even more real.”

This week, the Saskatchewan government declined to give any further updates on these cases.

The National Post asked if there were any further cases, or if there had been any transmission to patients from the affected individuals. Additionally, the Post also asked if the other 11 non-positive workers were self-isolating, or if they were at work. “We can’t comment on if/how patients are being treated, nor can we comment on who has gone back to work,” said an email from Colleen Book, a health ministry spokesperson.

Other jurisdictions have also remained tight-lipped, citing privacy rules.

Three doctors from Manitoba who attended the event have been in self-isolation since last week, said Doctors Manitoba, which represents physicians in the province; it’s unknown whether they’ve caught COVID-19.

One health-care worker in Manitoba has tested positive, said Manitoba’s top doctor, Dr. Brent Roussin, but the province has declined to say whether or not that person was a curler. “Public Health is not able to identify any individuals, as that could result in the release of personal health information,” said health ministry spokesman Gord Leclerc in an email.

One case connected to the bonspiel is as far afield as Peterborough, Ont. On March 25, the local public health unit confirmed to the Post that a man in his 60s had tested positive for COVID-19 after attending the bonspiel. A spokeswoman declined to say whether or not he was a medical professional, but noted that nurses are reaching out to two of the man’s close contacts.

Physicians are not invincible

In Alberta, the government took the extraordinary step of identifying where some of the affected doctors were, because they had gone to work early last week, before they were aware they’d fallen ill.

On March 24, Hinshaw, Alberta’s chief medical officer of health, said 12 of the 47 health-care professionals who were known to have attended tested tested positive. Three of those who fell ill were doctors in Red Deer.

This kicked off a further tracing exercise. Initially, Alberta researchers thought the doctors had been in close contact with 58 patients and a further 97 health-care workers. By March 26, the numbers had shifted: the investigation showed that 27 health workers and 59 patients were at risk of having been exposed.

“These are all self-isolating now as a precautionary measure and monitored by health officials,” said the province’s health ministry. To date, none have tested positive, the ministry confirmed. There are no indications from other provinces that anyone, yet, has died or been hospitalized as a result of the bonspiel.

In fact, the Alberta government believes it wasn’t the bonspiel itself that caused the outbreak. Rather, it was a banquet. “We suspect the virus was spread at a buffet where serving spoons were handled by many people,” Hinshaw told reporters.

The health ministry declined to say where the event was held, given there was no ongoing public health risk.

Back in Edmonton, the curling club has shut its doors. The board of directors said the decision had been made because of the coronavirus outbreak, not because of the bonspiel. In a statement posted to its website, the club said all employees who had worked the three-day tournament were in self-isolation — just in case.

Our most powerful weapon is that we know what it is and we can learn from people who have already suffered through it

Looking back at how politicians reacted, how the public felt and what was normal just a week ago makes the change even more abrupt

We may dodge a big bullet here. ... But we may well end up in a situation where we have to make some very tough ethical decisions
Read more on National Post
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