Was Canada quick enough to curb COVID-19? Experts say there was community spread as early as March 1
|Toronto Star 25 Mar 2020 at 19:56|
Did Canadian health officials act fast enough to curb community transmission of COVID-19? This week’s growth in positive tests, from people infected earlier in March, suggests they did not.
While infectious disease experts say it is believed Canada had community transmission as early as March 1, governments did not bring in “physical” or “social” distancing guidelines until the middle of March, and emergency orders to close businesses until the tail end of March.
In Ontario, Premier Doug Ford even encouraged people to enjoy themselves on March break holidays on March 12, which shocked experts in the infectious disease field. In Quebec, health officials in Montreal have recently begun contact tracing of people suspected of spreading the infection on public transit as early as March 6. Across the country there has been growing concern of spread of the disease at conferences, including a mining conference and a dental conference early in the month. A Toronto synagogue was closed for cleaning over fears of COVID-19 transmission from a visitor on March 9.
“Certainly for the entire month of March we have had local transmission going on,” said Dr. Michael Gardam, an infectious disease expert and chief of staff at Humber River Hospital in Toronto. Gardam is a veteran of other outbreaks, including SARS (2002 to 2004).
The question of whether Canadian officials acted in time reveals a tension between concrete evidence of local transmission and educated deductions based on how outbreaks typically spread and how COVID-19 was known to be spreading internationally.
Public health officials say they need firm evidence — confirmation of close contact between a known positive case and another person who has tested positive — before they can announce local transmission. Compounding the problem is that this particular disease, experts say, can “shed” the virus before symptoms present, during, and for roughly a week after. A person with COVID-19 could transmit the disease for roughly a month.
Here’s the timeline in Canada.
According to the World Health Organization’s own records, a Canadian federal official contacted the WHO on March 1 to inform the agency that Canada, like China, Italy and other countries, had confirmed local transmission (as distinct from an infected traveller returning home and testing positive).
Neither the WHO or Canadian officials will say which part of Canada made that report on March 1, but experts say it likely came from a cluster of cases in a nursing home in B.C.
To put that March 1 date in perspective, the Toronto Maple Leafs had the night before defeated the Vancouver Canucks 4-2 and were looking forward to a winning record in the last weeks of the season. The phrases “social distancing” and the now preferred “physical distancing” were not part of everyday jargon and at all levels of school in the country it was business as usual.
Over the next 10 days, leading up to March break across Canada, media reports show a rising level of concern, but the focus was still on travel. Would you get COVID-19 by travelling, and was it still safe to take a trip with the family on March break?
At this point, no public health agency in Canada had stated publicly that it had confirmation of local transmission of the virus, beyond the original B.C. report.
But there were signs that the virus was out there.
In Toronto, the Beth Sholom Synagogue closed for cleaning on March 9 after a lay leader who had been to a Washington D.C. conference became sick and tested positive for COVID-19. Other members of the synagogue went into self isolation, as did a Toronto councillor, who had a conversation with the lay leader previously, on March 5.
Around this time, a Sudbury man tested positive and it was believed he may have contracted the virus at a March 2-3 mining conference in Toronto.
And according to B.C. health officials it is now known that about 20 people tested positive after attending a March 5-7 dental conference in Vancouver. One dentist who attended the conference has since died. B.C. health officials have not said if the man died of COVID-19 but the man’s friends have told the media that he was very healthy prior to the onset of symptoms.
By the time Ford made those comments, public health officials were sounding alarms and suggesting travel might not be wise. But still, the public was being told by health officials that community transmission was at a low risk.
By the night of Thursday, March 12, it began to change. First Western University in London, the University of Toronto, Dalhousie University in Halifax and universities across the country closed and made plans to go online. Elementary and secondary schools, at the direction of provinces, followed suit, telling people students would not be coming back after March break
Still, stores and malls were open. Starbucks and other coffee vendors instituted a policy preventing people from using their own mugs. People sat at tables in restaurants as they always had.