Canada’s ‘inevitable’ second wave of COVID-19 cases

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TORONTO — No one knows when a fresh surge of COVID-19 cases will emerge in Canada, but experts agree numbers are poised to rise and could very well explode in surveillance blindspots.

One need only look to South Korea, where infections spread anew through Seoul’s nightclubs and bars, to see how quickly containment successes unravel when undetected cases spark flareups.

Of course, nightclubs remain closed in Canada, but the infection risk of a vast array of public spaces is being tested for the first time in coming weeks — retail stores, golf ranges, bar patios and some offices among them.

A “tried and true” principle with any respiratory virus is that infection risk is lower outside and in larger spaces where germs can dissipate, says Dr. Camille Lemieux, medical lead for the COVID-19 assessment centre at Toronto’s Western Hospital.

That’s opposed to small, confined areas with poor ventilation, but the speed of this novel coronavirus to find human hosts is what’s most concerning, says Lemieux.

“The one thing about COVID that I think has a lot of people stymied is the rapidity with which it spreads when it gets a foothold,” says Lemieux, also chief of family medicine at the University Health Network in Toronto.

Even with containment, the virus is circulating in the community thanks to a small percentage of people with mild and no symptoms who don’t even know they are sick, adds Dr. Gerald Evans, medical director of infection control at the Kingston Health Sciences Centre.

Evans says “second waves are inevitable” as regions open up, using the term loosely to mean any uptick big or small. He cautions against suggesting one sector of public life — such as the tennis court — is safer from the virus than others.

“If people start congregating around campfires and other things in parks, and then large groups of golfers are getting together and hanging out, that could facilitate transmission,” says Evans, also chair of the division of infectious diseases at Queen’s University.

If Evans were to guess, he says a Canadian resurgence is very likely to start among younger adults who resume social activities, suggesting they’re more likely to risk exposure and will have been largely shielded from infection.

“They have been in literal isolation now for months,” Evans notes.

“So, when we start to open restaurants, and we start to open social venues, I think what we saw in Korea is a distinct possibility of what might emerge here.”

This may sound obvious but wherever it happens, it’ll be precisely where we are not looking, says Lemieux, which is why ramped-up testing and contact tracing measures are critical as millions of Canadians consider increased exposure.

She stressed the need for aggressive surveillance that can quickly respond to any signs of resurgence.

“The only way we can do that is by allowing broad-based testing of the public,” says Lemieux, a vocal critic of testing rates in Ontario.

“We really need to be on a seek-and-destroy kind of strategy right now where we’re actually actively going and looking for pockets of transmission of the virus.”

As with case numbers, relaxed measures vary from province to province — licensed daycares can reopen Tuesday in New Brunswick, some classroom activity has already resumed in Quebec, while hair salons and restaurant patios recently opened in Manitoba.

Evans suggests Ontario should have waited another “two to four weeks” before allowing a slew of reopenings set for Tuesday, which include construction sites, dog grooming, and some brick-and-mortar stores.

It’s clear though, that political and medical leaders are wary of possible setbacks: Premier Doug Ford urged businesses to only open if they were absolutely ready and asked residents to continue limiting their outings, while on Friday the Ontario Medical Association encouraged those who venture out to wear a mask.

Patrick Saunders-Hastings, an epidemiologist and consultant with the management consulting firm Gevity Consulting Inc., says a phased approach should allow public health to recognize and respond to warning signs before an exponential increase occurs.

And because the infection rate is on the decline, provinces should be able to stamp out threats posed by every new case.

“We are better able to conduct that sort of ‘test, trace and isolate’ framework than we were earlier on in this outbreak,” Saunders-Hastings suggests.

When it comes to labour risk, larger businesses have greater capacity than small ones to enforce public health guidelines and even augment them with their own contact tracing and staff education efforts, he says.

“We see a great degree of diversity in the types of strategies that are being looked at — whether it’s screening for fevers, whether it’s the use of phone applications to conduct contact tracing on site and adherence to social-distancing,” says Saunders-Hastings, adding that ongoing physical distancing rules mean most offices will only be able to bring back 20 to 40 per cent of employees.

While industrial settings such as meat plants have already suffered COVID-19 outbreaks, he cautions against assuming where the next workplace outbreak could occur, noting adherence to safety guidelines can falter anywhere.

Existing prevalence of COVID-19 infections offer little guidance, too, says Evans, noting it’s tempting to assume infection risk is lower in his city of Kingston, Ont., than Toronto.

He fears what might happen if big-city dwellers hit the road for a day trip, bringing the virus to a region highly susceptible precisely because counts are low.

“If the virus were to be reintroduced either from, say, Toronto or Montreal where there’s more activity, then there is a larger population that could get it so a second wave would look potentially worse here.”

Cassandra Szklarski, The Canadian Press

42 COMMENTS

  1. Everything is opening too soon.. economic downturn is one thing. The recovery will be a flat line and there won’t be a scale. It will tip heavy as no return when a lot of people are sick. We don’t have the industry, production etc that say China has. They can build an entire hospital in a day. We are not set up the same.

  2. I still dont understand why you cant get your dog a hair cut when its appointment only..you could talk behind plexiglass (like cashing out at walmart or getting your pizza from auroras)put your dog in a cage and walk out..the groomer can then step around the shield and get your dog..same for pick up…BUT I can go shop with 150 people at a time in walmart where NOBODY is following distancing let alone the arrows on the floor…absolutely does not make sense…fix the so called rules or scrap them all together

  3. They have to keep pumping out the B.S., and controlling people’s lives and taking away rights and priviliges, it’s all part of the Globalist Agenda.

    • Rob Gioia updated it twice today they really want panic. This is the doing of Algoma public health guaranteed. Have they mentioned domestic abuse overdose rise, suicide mental health it’s all part of Algoma public health it’s starting to paint a picture they only care about covid19 for some strange reason

    • Than they pressure the media which is on board with the liberals to pump up the volume.
      In my opinion Canadian media is one step away from the National Enquirer

    • Rick Deevey oh they don’t tell us how it’s effecting our mental health we all are locked up and suffering how bout tell us some news on the lateral consequences

    • Rick Deevey here’s some things they can post articles on

      Residential evictions
      The amount of homeless after this.

      Incraceration and how the system will ever recover and if they should entertainment addiction treatment in jails.

      How many people will suffer from alcohol addiction and require treatment from this.

      How will small business recover and how much of the products sold in corporate big box are from China.

      How about how Chinese Canadian citizen are be threatened and harassed on Canadian soil by China and nothing’s reported.

      How bout if all government offices are closed are the staff laid off or are they still receiving full pay.

    • Rick Deevey there’s news for you .
      No investigative news because of Billion Aires linked to the government have it censored .
      Sure Covid19 is a awfully big deal. but what is really going on and at what cost would be real news

    • We are tired of isolation. The virus can only move if we move it and is waiting for us to be tired of isolation. Risk all you want but don’t share your risk with the rest of us. Those in healthcare deserve our diligence. There is still plenty to do safely 🙂

    • Jeff Dupre it is not the flu. And I never knew anyone that died from a flu. Yes it kills people but this is new and different and worse and killing people that we know and love. Outbreaks in LTC in an already stressed healthcare system. Go ahead and get this if you think it is so safe.

    • Jeff Dupre please remember that we have access to a seasonal flu shot. NO ONE on this planet has any known immunity to covid. This is NOT like the seasonal flu at all. When Canada begins the seasonal flu (mid September ) plus the second wave covid deaths – then you will see the numbers of deaths spike. Please take this seriously.

    • Ivana Filice I social distance all u can do yes I worry to about how this can go but what else can we do be safe is the secret so many don’t even do that.

    • Jeff Dupre Jeff remember hearing about the military health professionals that were deployed into the nursing homes in Ontario and Quebec to assist with covid cases – 5 of them now have covid ! And you can bet your bottom dollar they were super careful. Wear a mask / wash your hands / clean your groceries with soap and warm water / physical distance / strengthen your immune system with vit c and zinc and vit D and get fresh air and exercise. And enjoy golfing

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