What do Montreal bars, southern Ontario farms and Prairie Hutterite communities have in common?
They’re all linked to recent coronavirus outbreaks.
Initially, long-term care homes were hotspots for the disease in Canada, but the number of new cases reported and ongoing outbreaks in the facilities have trended downwards recently, according to researchers at Ryerson University who have been tracking LTC outbreaks.
Now, experts say, more recent outbreaks share a few things in common: they are in indoor settings where it’s tricky to maintain physical distance or social events where people don’t want to.
Here’s a look at some current outbreaks in Canada, and what we can learn from them.
1. Montreal bars
Hundreds of people lined up outside a hospital in Montreal this week.
They were there to get tested for COVID-19, after an outbreak was reported, linked to the city’s famous bar scene.
Local health officials asked everyone who had visited a bar in Montreal since July 1 to get tested, and as of Friday, they had found at least 30 cases linked to bars.
“The bars are just a classic example of why I’m not big on bars opening up,” said Dr. Gerald Evans, chair of the division of infectious diseases at Kingston General Hospital.
“They have all of the ideal elements that that one would expect to have in a circumstance that’s going to greatly facilitate transmission of the virus.”
These include crowds, a closed-in space with poor ventilation, and poor mask use — since people can’t drink a beer with a mask on, he said.
People also tend to spend an hour or more in the bar, which can increase their exposure.
Then there’s the beer. “Once you start drinking, your ability to think about the fact that you’re standing closer than four to six feet from somebody else kind of drops off,” he said, and other normal safety precautions might drop as well.
Robyn Lee, an assistant professor of epidemiology at the University of Toronto, says other provinces, like Ontario, should keep Quebec’s experience in mind as they reopen their own bars.
“I think we will see the same thing,” she said.
“I think the rest of Canada is no different from Quebec when we’re opening venues that provide a high-risk environment for transmission like these.”
2. Parties in Montérégie and Kelowna
Outside Montreal, in the Montérégie region, a handful of house parties — one with more than 100 people — have also contributed to a local outbreak.
Officials in B.C. are also blaming 27 cases on private parties in Kelowna, as of Thursday.
These are caused by the same kinds of issues as bars, Lee said: namely a lot of unmasked people in an enclosed space.
“It’s the same kind of problem. You have a bunch of people in a small space,” she said.
People might move from room to room, talking to all sorts of different people, which presents issues, she said.
“I think part of the issue, too, is a lot of this transmission is happening when people don’t know they have COVID-19,” she said. Recent evidence suggests that 40 to 45 per cent of people don’t have symptoms or develop symptoms well after they become infectious to others.
This means that they might do things like go to parties because they feel fine, but can pass the virus on to people they meet.
3. Misericordia Hospital in Edmonton
The Misericordia Hospital in Edmonton is in the middle of an outbreak, with more than 50 cases reported as of Friday, among both patients and staff.
Alberta Health Services has announced a task force to look into the outbreak and how it occurred.
While he can’t comment specifically on the Misericordia outbreak, Evans said that hospital outbreaks do happen from time to time.
“The minute you get lots and lots of patients with COVID-19, then, of course, you increase the probability of transmission because you’ve just got lots more people in there.”
Most hospitals create special COVID-19 units, but you have to carefully monitor staff as they go in and out. And, over time, staff’s PPE use might slide, because “people just get tired of it,” he said.
Common areas, like break rooms where people eat lunch, can also lead to transmission among staff.
4. Migrant farmworkers in Windsor-Essex county
“Windsor-Essex area, right now, is ground zero. But at any moment, this could be another community anywhere in Canada,” Chris Ramsaroop, an organizer with the group Justice for Migrant Workers, told Global News this week.
The southern Ontario county has had more than 800 cases linked to agricultural work, in an outbreak that has gone on for weeks.
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Many farms in the area employ temporary migrant workers.
Agricultural workers reside in shared, often cramped spaces where physical distancing is “absent,” Ramsaroop said. They share bathrooms and are transported around properties in groups.
This is bad news for coronavirus transmission, Evans said. If several people are sharing a bedroom, then if one person has the virus, they will expose all their roommates overnight.
“Everybody in that room is going to eventually have some sort of exposure happen,” he said.
That, compounded with conditions that leave workers reluctant to complain or seek medical care, lest their employers withdraw their immigration permits, have contributed to the outbreak, according to Ramsaroop.
5. Hutterite communities in Prairie provinces
A number of Hutterite communities have been linked to coronavirus cases in Alberta, Saskatchewan and Manitoba, health officials in those provinces say.
Some cases appear to have been linked to an Alberta funeral, but Alberta officials say the risk of spread to the larger community is low and that affected people have been quarantined.
The communities are cooperating with health officials, they say, and officials condemn any discrimination against these individuals.
In close-knit communities where people gather to have meals, work and pray together, they are again increasing the likelihood of spreading the virus, Lee said.
“When you’re in close proximity to another person who has COVID-19, you’re at higher risk of being infected with the virus. So it’s just a setting that is more likely to allow for spread.”
When it comes to lessons from these outbreaks, “I think the key is ensuring that people are able to maintain physical distancing,” Lee said.
That can mean encouraging outdoor activities as much as possible and cutting down on things like shared washrooms in workplaces, she said.
“And then, educating the population of Canada just how much transmission can happen when you actually don’t know you have symptoms.”
Even if you feel fine, you might still pass the virus along, so you should take precautions, she said.
— with files from Global News’ Rachael D’Amore, Kalina Laframboise, David Giles, Simon Little, Caley Ramsay, Kwabena Oduro and Quinn Campbell
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