Federal and provincial officials are starting to discuss how and when to start reopening schools and businesses but Prime Minister Justin Trudeau warned on April 14 the full-scale lockdowns most Canadians are living with right now will remain in place for at least several more weeks.
Similar discussions are happening around the world, as many countries are starting to show some positive signs of slowing the spread of COVID-19—even as experts warn limited testing in most places could be masking the real picture of the disease.
The World Health Organization is trying to inject some coordination into these decisions, releasing new guidelines Tuesday for what should be in place before easing restrictions.
“The way down is much slower than the way up,” Tedros Adhanom Ghebreyesus, Director-General of the WHO, said in a speech Monday. “That means control measures must be lifted slowly, and with control. It cannot happen all at once.”
The WHO guidelines outline six areas officials must consider if they are to look at resuming activities. Here is where Canada stands on each of them.
1. Is Transmission of the Virus Under Control?
Short answer: Were not testing enough to know.
What the experts say: Eleanor Fish, a professor of immunology at the University of Toronto, said testing must become much more widespread before we really understand the state of community transmission.
Alison Thompson, a public health professor in the Leslie Dan Faculty of Pharmacy at the University of Toronto, said it takes a significant amount of time between a confirmed infection and fully tracing a persons contacts and testing them, to know whether that confirmed infection has resulted in many more infections.
“We have to make sure it actually is levelling off, or that community transmission has actually ground to a halt, which can take quite a while,” she said.
If restrictions are removed too quickly, thousands of people with COVID-19, who may not know they are infected, could potentially spread it fast and wide, she said.
Thompson also said its time to stop thinking of the pandemic in terms of health versus the economy. If there isnt a healthy workforce the economy will continue to suffer, she said.
“We may see some short-term gains if we did ease up on some of these restrictions,” she said. “But in the long run if we end up with an out-of-control situation with COVID, the economy will take much, much longer to recover.”
2. Is the Healthcare System Equipped to Detect, Test, Isolate and Treat Every Case, and Trace Every Person Who Came Into Contact With a Positive Case?
Short answer: Not yet.
What the experts say: Timothy Sly, professor emeritus at Ryerson Universitys school of occupational and public health, said Canada has done “an abysmal job” at testing and tracing.
“We have a situation now essentially where were groping along in the dark in terms of finding out who in fact is virus positive and whos virus negative. Weve done an abysmal job at that,” said Sly, who specializes in epidemiology.
Sly pointed to an especially woeful rate in Ontario where Premier Doug Ford has vowed to perform 8,000 tests daily by Wednesday, up from about 5,000. Alberta is among Canadas testing leaders with about 7,400 tests conducted daily, which Sly said is still not enough.
Still, he acknowledged there have been hurdles beyond Canadas control that have handcuffed efforts—notably, global shortages of equipment including swabs and laboratory chemicals needed to process test samples.
Sly said Health Canadas recent approval of a rapid, mobile handheld testing device from an Ottawa company should help, as will a series of expanded testing criteria that various provinces have adopted in recent days.
Jianhong Wu, a distinguished research professor at York University who has led multiple national projects on SARS, pandemic influenza, and immunization evaluation, said there is a close relationship between contact tracing, testing, and social distancing.
“If you dont do well in one component, you need to significantly magnify your effort in other components,” he said.
Sly said provinces are largely trying to contact people exposed to a confirmed case by telephone, which is not sustainable given the soaring number of cases.
He pointed to countries such as South Korea, which have employed cellphone data to track possible contacts. He said that is much more effective, but it would raise privacy issues.
“People are going to be hollering and screaming about that but it does seem to work,” he said.
3. Are Outbreaks Minimized in Special Settings Like Health Facilities and Nursing Homes?
Short answer: No.
What the experts say: Risks remain dangerously high in hundreds of nursing homes across the country.
Quebec, where long-term care centres have been particularly hard hit, announced Tuesday that inspections have identified 41 seniors residences that require special monitoring because of a high number of COVID-19 cases. Premier Francois Legault on Tuesday appealed for people with experience in health care to help out in understaffed long-term care facilities.
Canadas chief public health officer, Theresa Tam, said Monday nearly half of the countrys deaths from the CCP virus have come from long-term care facilities, and she predicted the number will increase despite provinces efforts to fight the problem.
Twenty-nine residents in a 65-bed nursing home in Bobcaygeon, Ont., have died amid the pandemic. Another facility in Toronto recorded 22 deaths by Monday, while the Lynn Valley Care Centre in North Vancouver, B.C., has had 18 residents die. In many facilities workers are also getting sick in high numbers.
After the Lynn Valley Care Centre outbreak, British Columbia moved to stop staff from working in multiple facilities as a way to slow the spread of the virus. Ontario made the same move Tuesday.
Isaac Bogoch, an infectious disease specialist at the University of Toronto and the University Health Network, feels that strategy, along with limiting visits with seniors and infection-prevention methods, could go a long way in minimizing risks for possible subsequent waves of COVID-19 among the elderly.
Canada now has guidelines for helping to protect long-term care residents and workers, but Tam indicated this week the outbreaks are the biggest concern that has arisen in Canadas COVID-19 situation over the last two weeks.
4. Are There Measures in Workplaces and Schools to Prevent the Spread of the Virus?
Short answer: Not yet.
What the experts say about workplaces: In most provinces, only essential businesses like grocery stores and pharmacies can remain open. All others must operate with employees working from home. If they cant do that, they must close. Restaurants can generally only allow takeout or delivery.
Many businesses report being too focused on setting their employees up to work from home, and havent yet begun to think about what to do to reopen.
Provinces and business groups say its too early to speculate on which measures can be lifted. Any shift in approach would come at the advice of the chief medical health officer “and with extreme caution so as to avoid a resurgence of the virus as has been seen in other jurisdictions,” said Hayley Chazan, a spokeswoman for Ontario Health Minister Christine Elliott.
The Canadian Chamber of Commerce says it wants clear advice from public health authorities before restrictions loosen.
“We fully expect that there will unfortunately be an instance where an employee does test positive. What does that mean for the workplace? Does there have to be a total shutdown? A deep clean?” asked Mark Agnew, the chambers senior director of international policy.
Sector-specific rules will remain critical as the lockdown starts to lift, he said, noting that retailers, meat processors, and refrigerator technicians might all require different protocols around physical distancing and personal protective equipment.
What the experts say about schools: Kids, while less susceptible to the CCP virus, are well equipped to transmit it.
“Children are generally less compliant with effective hand hygiene, and they dont necessarily control their secretions,” said Dr. Nisha Thampi, infection prevention and control lead at Childrens Hospital of Eastern Ontario in Ottawa. “That presents an exposure risk to the staff as well as to other children.”
The Public Health Agency of Canada has stopped short of recommending specific changes schools could make to their operations, but did offer more general guidance for schools in February, before Canada began to really experience the impact of COVID-19. That included regular hand-washing and supervised use of hand sanitizer, education on proper “respiratory etiquette” such as covering coughs and sneezes, ramped-up cleaning and disinfection routines within school buildings, and reinforcement of “no sharing” policies.
Thampi said medical experts will also have to craft advice that strikes a balance between student safety and developmental needs.
“Children have always seen school as being a social environment,” she said, adding many are no longer getting that kind of stimulation in the era of physical distancing. “How can we be sensitive to that while also teaching them about infecRead More – Source