March 23, 2020
By Jim Harding
Officials across Canada are stressing that “we must flatten the curve” to avoid a healthcare crisis. Saskatchewan declared a State of Emergency after known COVID-19 cases doubled to 16, in one day. We went from 1 to 26 cases in a week. A few days later we were at 66. Across Canada known cases doubled to over 1,000 in just 3 days and are now over 2,000 in another 3 days. If this trend continues, we would find ourselves like Italy. With 1/25th the population, Italy has passed China for having the most deaths from this pandemic.
Flattening the curve will take more than asking Canadians to voluntarily self-isolate, especially if they travelled abroad. Asked about people just arriving home who feel all right going out in the community, Premier Scott Moe reacted, “This cannot be happening”.
We have been cavalier about the threat from travelling. Concerns about the economy slowed health emergency measures. All initial cases across Canada were travellers from outbreak countries. Only then did community spread occur. Canada was vigilant about returning Canadians from infected cruise ships, flying them to military bases for quarantine. But we have been lax about air travel and cross-border travel with the U.S.
Trump’s regime has been very slow to expand testing and maximize harm reduction. The U.S. is becoming an outbreak country.
China initially suppressed medical whistleblowers. But it then took actions across society in a coordinated way. South Korea, Japan, and Singapore have used mass testing to reduce the infection speed. Now that China is reporting no new cases, it prepares for a second wave from returning citizens, requiring negative tests before boarding domestic flights home.
Chinese nationals live all over the world; Italy has one of the highest Chinese populations in Europe.
Here, with snowbirds about to descend, after the federal advisory to immediately return home, people are simply being told to self-isolate for 14 days. Such self-regulation is very clumsy and could backfire. Some returnees have reported that this advisory didn’t even occur.
Canadians with symptoms will no longer be able to board flights home. But this virus spreads long before symptoms appear, which can be up to 2 weeks. Infected people won’t know they are infecting. Targeted information explaining why there must be mandatory self-isolation after travelling, with no shopping and visiting on the way home, simply must occur. So must tracking, testing if symptoms appear, and containment.
WHO is calling for more testing, everywhere.
Thorough testing is needed to protect front-line health and care workers.
Thirty-five deaths are linked to the Life Care Centre outbreak in Kirkland, Washington. The Centre for Disease Control (CDC) found 57 patients were infected and 25% had already died. The care staff “fueled” this outbreak. “They need the money. They don’t have sick leave. They don’t recognize their symptoms”, the CDC said. Many earn minimum wage and work in other care homes or retail. Staff lacked protective equipment. Staff were not systematically tested to contain the spread.
Health and care workers should not face economic pressure to work; conversely, those who don’t test positive should know it is safe for them and others to continue work. The federal aid package will help, but testing is still required. After China locked down, the spread grew within families. They used facilities for infected people not requiring hospital care, so they didn’t spread the virus. Treatment areas were completely isolated and monitored. Testing was required to make these adaptions.
We need to quickly learn from elsewhere. The town of Vo reported Italy’s first death. It became Covid-free. All 3,300 residents were tested. Asymptomatic people played a “decisive role” in viral spread. The regional Governor said, “We found 66 positives, who were isolated for 14 days, and after that 6 of them were still positive. And that is how we ended it.” While contagions are constantly evolving, stringent testing clearly helps flatten the curve.
Calling for physical distancing, and for returning travellers to voluntarily self-isolate, while limiting testing to those with symptoms and risk factors, is not likely to “break the chain of transmission”. It is good that 200 Saskatchewan doctors called for changing commercial practices to prevent infectious social interaction. Doctors who attended a curling bonspiel where the virus spread should be taking their colleagues’ advice.
In Saskatchewan the first 20 Covid-19 cases were located from about 2,000 tests. Testing symptomatic travellers and then tracing their contacts was a vital beginning. To get in front of this we have to do much more. Physical distancing is a must. Systematically testing for worker and patient protection, and more stringent screening, isolation and follow up of travelers, returning in the thousands as spring arrives, needs immediate attention.
Jim Harding is a retired professor of environmental and justice studies. He is a founding director of the Qu’Appelle Valley Environmental Association (QVEA.CA). He was a research director for Sask Health’s Alcoholism Commission and Prairie Justice Research at the University of Regina.