What Canada Needs to Do Now to 'Flatten the Curve' of Coronavirus

Will Canada close its borders? And is it time to roll out mass testing for COVID-19? Experts weigh in on how to tackle the pandemic.
Manisha Krishnan
Toronto, CA
March 13, 2020, 7:39pm
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Photo by Fred Chartrand/The Canadian Press

Canada’s response to the COVID-19 pandemic has escalated quickly in the past 24 hours, with Ontario closing all public schools, Prime Minister Justin Trudeau self-isolating after and his wife tested positive for the coronavirus, Parliament shutting down, major sporting leagues cancelling their seasons, and B.C. and Ontario advising residents against all non-essential travel.

So far, Canada has confirmed more than 150 cases of the novel coronavirus with one death. Most of the cases (80 percent) are from travellers. Medical professionals say the best route forward is to “flatten the curve,” meaning slow down the rate at which new people become infected, in order to avoid maxing out healthcare resources.

Trudeau announced $1 billion to respond to the outbreak. That includes funding to provincial and territorial health authorities for increased testing and medical supplies, a streamlined process for sick workers who need to access Employment Insurance, and money for researching vaccines.

But what else should the government be doing to flatten the curve? And are we responding quickly enough?

Should Canada close its borders?

The U.S. has already banned all incoming travel from Europe. Trudeau announced Friday he was considering closing the Canada-U.S. border and incoming international flights will be restricted to certain airports.

But doubts have been cast about the effectiveness of such measures. In a report, the World Health Organization (WHO) said that international travel restrictions have limited impact, particularly once a pandemic has already been introduced to a country. If it hasn’t been introduced, the WHO says a travel ban may delay that introduction and allow for other medical interventions to ramp up.

Dr. Abdu Sharkawy, an infectious disease specialist with the University Health Network in Toronto, said Canada should shut its borders, and that he expects Trudeau to do so “any minute.”

“That may seem extreme to some… but frankly I feel these sorts of measures are absolutely warranted,” he said.

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Sharkawy said while inconvenient, closing the borders sends a powerful message that people need to stop moving around because the virus is “extremely contagious.” He said Canada needs to prevent the massive outbreaks that took place in China and Italy. The Italian government has been criticized for being slow to implement social distancing measures.

“If we can do anything to prevent ourselves from being in close quarters with others and sharing this, we need to do it now,” he said.

Sharkawy said travel restrictions should be part of an overall strategy. “It’s somewhat naive and simplistic to suggest that travel restrictions cannot help,” he added.

But Dr. Issac Bogoch, also an infectious disease specialist at University Health Network, said he doesn’t think outright travel bans will work at this point, particularly in places like the U.S. where there’s already widespread community transmission of the disease.

Bogoch said people coming to Canada from high-risk areas such as China, Iran, and Italy are already expected to go into isolation for two weeks.

Bogoch did say that the U.S.’s slow response to the crisis—particularly its lack of testing—will negatively affect Canada.

Are enough Canadians being tested for coronavirus? Why isn’t Justin Trudeau being tested?

Between the National Microbiology Laboratory in Winnipeg, Manitoba, and testing in B.C. and Ontario, the two provinces with the most cases, more than 8,600 Canadians have been tested or approved for testing of coronavirus. But is that enough? In South Korea, one of the hardest-hit countries with nearly 8,000 cases, the government has rolled out drive-through testing using nose and throat swabs. More than 200,000 of the swab tests have been administered, according to Wired, and the number of new cases is on the decline. A chart from Maclean’s shows that Canada’s testing rate is about 226 per million, while South Korea’s is more than 4,000 per million. (The U.S. is around 26 tests per million.)

In Canada, some hospitals are setting up centres outside hospitals.

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Bogoch said Canada has scaled up its ability to administer diagnostic tests and has effectively eliminated restrictions on being able to get one.

“If a clinician suspects it there's nothing standing in the way of ordering a test,” he said.

Asked why Trudeau isn’t getting a test given that his wife has the coronavirus, Bogoch said the rules are the same for everybody whether you’re the prime minister or not and that Trudeau is following protocol by going into isolation and monitoring for symptoms.

But strains on the healthcare system are already showing. According to CTV News, doctors in BC are turning away patients who have symptoms and want testing because they don’t have enough face masks, which should be changed between each patient.

Sharkawy said its critical that people don’t flock to hospitals if they don’t need to, or just because they exhibit some flu symptoms. He said emergency visits should be limited to people who are experiencing physical distress with rapidly deteriorating conditions, shortness of breath, and those with chronic illness or compromised immune systems.

Should all schools shut down?

Public schools in Ontario are closed until April 5, and some universities, including the University of Toronto and Carleton, are moving all classes online. As a matter of policy, schools in B.C. are remaining open, although a few have shut down of their own accord.

Sharkawy said he doesn’t necessarily think a blanket ban across the country is warranted, because some regions, including Atlantic Canada, have very few cases.

Bogoch said he expects announcements about school closures will continue to unfold in the next few days. In his view, a major concern is getting “buy-in” from the public about the importance of social distancing (reducing contact with other people and avoiding large gatherings).

Do we need national sick days?

Doctors have been clear about stating that sick people should stay home and isolate themselves.

While Trudeau is making it easier to access Employment Insurance, giving sick people a bit of a safety net if they’re out of work, many people doing contract work likely won’t qualify. On top of that, paid sick days aren’t federally mandated, except for government jobs.. That means people who can’t take paid time off and are living paycheque to paycheque may feel pressured to keep working.

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NDP Leader Jagmeet Singh is calling for the government to give Canadians paid sick leave in response to the pandemic.

“Other countries have found a way to give people paid sick leave so they can stay home. Canada must do better,” he tweeted.

How close are we to a vaccine?

Canadian researchers have isolated the novel coronavirus (known clinically as SARS-CoV-2), the agent responsible for COVID-19, the Sunnybrook Research Institute announced early Friday. When scientists isolate a virus, they’re able to grow and manipulate it during experiments, ultimately learning its ins-and-outs a lot faster. In short: we’re one step closer to tracking down a COVID-19 vaccine.

But don’t expect a vaccine anytime soon. Most researchers expect a vaccine in about 18 months. One Canadian company announced on Friday that it developed a “vaccine candidate,” or a possible vaccine. (There are about 20 vaccine candidates globally.) For a vaccine to be market-ready, however, major tests need to take place to ensure it works and is safe to use—a process that takes months.

—with files from Anya Zoledziowski

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