Editor’s Note: This story was published before the World Health Organization declared novel coronavirus a pandemic and Canada’s chief health officer labelled the virus a “serious public health threat.” For the latest coronavirus news, click here.
As the novel coronavirus continues to spread across Canada, “community cases” are on the rise — and such cases may indicate a shift in how COVID-19 affects the country moving forward.
“Rather, it’s detected in someone who has no travel history and who isn’t associated with someone who has a travel history.”
This is relatively concerning for public health officials because it means the virus is in the community and “no one knows where it has come from or even how widespread it is in the community,” Hoption Cann said.
“That’s why public health agencies are working so hard to prevent community transmission as it is much harder to control its spread.”
On March 5, Canada’s first community case was reported, involving a Vancouver-area woman who caught the virus without having recently left the country.
Then on Tuesday, B.C. provincial health officer Dr. Bonnie Henry announced the province wasn’t sure where one of its newest cases was acquired and that another, a man in his 40s, seems to have caught the virus in the community.
This matters because it could indicate that the virus is circulating in Canada.
“It is these community cases that give us some degree of concern and grief, but being able to detect them is really important,” Henry said.
“As soon as we detect them, we can start that detailed investigation to find out where they might have come in contact, and it helps us uncover where other chains of transmission are in our community.”
This change in how coronavirus originates is “concerning, but not unexpected,” said Hoption Cann.
“We have seen this occur in many other countries now with the virus spread to well over 100 countries worldwide. The approach is similar though: quarantine the individual with the illness and follow-up and test any contacts.”
The difference between travel-related cases and community cases
Before last week, all confirmed cases of COVID-19 in Canada were travel related.
That means they were “brought into the country,” according to Kerry Bowman, bio-ethicist and assistant professor in the faculty of medicine at the University of Toronto.
“What’s really different with community transmission is it’s here and moving within the community.”
The challenge occurs when the person diagnosed with COVID-19 has been going out in public while carrying the virus. It can become difficult to find “every case where transmission may have occurred,” said Hoption Cann.
Once the virus transitions to community transmission mode, COVID-19 becomes that much harder to contain.
“It only takes a small number of individuals to infect a large population … however, one may be able to slow the spread of the disease. As this is likely a seasonal virus, one may be able to slow down the spread of this virus until, with changing weather conditions, the transmission of the virus declines on its own.”
Until now, most Canadian cases of COVID-19 were able to be traced, allowing the public to be aware of where the person had gone within their community.
“Contact tracing may sound to some people like a needle in a haystack, but in many cases, it’s worked quite effectively. I don’t think we should be giving up on contact tracing at this point,” said Bowman.
However, this process likely wouldn’t be feasible if there were several hundred confirmed cases of COVID-19 across the country.
“I don’t want to be too negative, but the day will come where you can no longer do stuff like that,” Bowman said.
WHO declared coronavirus a pandemic on Wednesday, and as such, public health officials recommend that people practice social distancing.
The U.S. Centres for Disease Control (CDC) defines it as “remaining out of congregate settings, avoiding mass gatherings, and maintaining distance (approximately six feet or two metres) from others when possible.”
Canada’s public health agency’s guide for provincial and local health authorities defines social distancing as steps to “minimize close contact” with people in the community, such as “quarantine or self-isolation at the individual level” along with broader steps such as avoiding crowds.
So far, it has a chart with different recommendations for people with varying risks. For instance, for someone who’s had “close, unprotected contact” with a COVID-19 case, the recommendation is voluntary home quarantine.
Canada’s chief medical officer, Dr. Theresa Tam, has also advised social distancing for those travelling during March break. On Monday, public health officials advised Canadians to avoid cruise ship travel because close quarters on a ship are environments amenable to the rapid spread of the virus.
Experts say social distancing is akin to a strong suggestion for now.
“Essentially it means to try and prevent a congregation of large groups of people together in circumstances that might facilitate transmission,” said Dr. Gerald Evans, chair of the Division of Infectious Diseases at Queen’s University.
This can include cancelling large meetings or shutting schools and colleges.
“The important thing to remember is it’s not quarantining people, it’s not forbidding them to be out and about,” Evans said. As a medical expert with experience in pandemic planning, he said social distancing “works well when introduced early.”
“So if the epidemic gets hold and you get a lot of community spread, then social distancing begins to lose its effectiveness,” he said.
After B.C. announced the country’s first COVID-19 death on Monday — a man in his 80s with underlying health conditions at a North Vancouver care home — the province’s health officer, Dr. Bonnie Henry, emphasized it is up to the public to help stop the spread of the virus.
The new coronavirus was first identified in Hubei province, China, in December 2019 and spread rapidly. While the outbreak has begun to level off in China, it seems the virus has found a foothold in a number of countries around the world, and it continues to spread.
Confused about COVID-19? Here are some things you need to know:
Health officials say the risk is very low for Canadians, but they caution against travel to affected areas (a list can be found here). If you do travel to these places, they recommend you self-monitor to see whether you develop symptoms and if you do, to contact public health authorities.
Symptoms can include fever, cough and difficulty breathing – very similar to a cold or flu. Some people can develop a more severe illness. People most at risk of this include older adults and people with severe chronic medical conditions like heart, lung or kidney disease.
To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. And if you get sick, stay at home.
Visit full COVID-19 coverage on Global News.
—With files from Global News’ Maryam Shah & Maham Abedi