COVID-19, Canada? Not to Worry!

"We have scenarios where there are more people requiring ICU beds than there are acute care beds [all hospital beds] in Ontario at peak."
"We see in Italy that G7 countries can have total collapse of health systems under the strain of this, even early in the epidemic."
"[If we add modest control it would take] aggressive social distancing and large scale quarantine] to reduce [numbers of people affected by coronavirus]. That's still a huge number of people ill, and critically ill people are a large fraction in this disease."
"I'm not going to share more specific numbers because I think they will scare people to no particular end."
Dr.David Fisman, professor in epidemiology, Dalla Lana School of Public Health, University of Toronto

"[Ottawa] is very alive to the fact that some provinces are indicating they have deficits [dwindling medical supplies of face masks, eye shields, other protective equipment]."
"We are gathering that information and we have said all along that we will be there as the federal government to support them with the resources they need, whether those are financial resources or practical resources."
Federal Health Minister Patty Hajdu

"You're working at 120 percent capacity and now you have this on top of  your normal work."
"We need to scale up the testing of these viruses. It's taking far too long in some centres to get the results."
"They're [front-liners] worried because they've only seen the beginning and they think that if there is a pandemic it's going to be extraordinarily difficult to manage the capacity of the needs of our patients coming through the system."
"What are you going to do with those patients that are already in hospital? Are you going to ask them to leave? What happens if it's a patient [who needs] home care, and there's no capacity?"
Paul-Emile Cloutier, president, CEO, HealthCareCan 

Pedestrians wear protective masks as they walk in Toronto on Monday, January 27, 2020. THE CANADIAN PRESS/Frank Gunn

The novel coronavirus called COVID-19 which began its deadly presence in Wuhan, China and caused Beijing to isolate the entire province of some 60 million people, has now spread to over 100 countries, infecting over 110,000 people worldwide, and resulting in over 3,800 deaths. China's isolation of entire cities and its alacrity in building instant new hospitals dedicated to the control and care of thousands of coronavirus-stricken people has resulted in the current situation where Beijing has reported to the World Health Organization that the situation is under control.

The number of new cases has been diminishing steadily over the past week. Ironically enough, some of the new cases that have been identified belong to Chinese citizens returning home from vacations abroad to Iran and Italy, bringing the novel coronavirus back with them from two of the hardest-hit countries to date outside China (besides South Korea). It remains to be seen whether China will discover it is being re-infected with a new, more stringent and deadlier strain of the virus that originated in China but regenerated abroad.

Canada still has a relatively modest number of people diagnosed with coronavirus and most of them brought it with them from trips to China and Iran and Italy, and a good number returning from infected cruise ships. But given the swift spread of this virus and its consequences, experts in  virology at University of Toronto have come up with a scenario where they predict that from 30 to 70 percent of Canadians could end up stricken with the virus, potentially requiring makeshift hospitals and quarantine centres to relieve an overburdened public health system.

At the best of times, Canada has a critical shortage of hospital beds available. This is flu season time where shortages become acute, and with the prospect of hospitals filling up further with coronavirus patients, added emergency measures will be required which a disease-transmission model that researchers from U.of T. developed. In Canada 71 known confirmed and presumed cases of the virus have arisen, with one death. Six cases have been linked to a cruise ship which had on an earlier cruise been implicated in virus transmission.

Paramedics leave the Lynn Valley Care Centre, a seniors care home which housed a man who was the first in Canada to die after contracting novel coronavirus, in North Vancouver, B.C., March 9, 2020. Jennifer Gauthier/Reuters

A second repatriation of Canadians on a virus-infected ocean liner is underway. In Alberta, doctors complain of a "lack of forward thinking", and lax communication on emergency planning, while nurses in British Columbia warn they are already short-handed, amidst concerns relating to dire shortages of needed protective supplies. Supplies of hospital gowns, gloves, masks, oxygen, drugs, ventilators and laboratory capacity of virus testing all representative of concerns relating to hospitals' capacity to cope with an emerging pandemic.

A new study recently published in The Lancet, based on 191 patients from two hospitals in Wuhan the outbreak epicentre, found that people continued to shed the virus for longer periods than expected; on average 20 days in survivors and up to 37 days -- not the mere 14 days that were previously assumed to be sufficient, meaning that isolation will have to be more prolonged to be effective. Shedding relates to pathogen spreading capacities.

"The extended viral shedding noted in our study has important implications for guiding decisions around isolation precautions and antiviral treatment in patients with confirmed COVID-19", reported the Chinese researchers. Rooms, wards and entire floors in hospitals will be required to be set aside to separate the presence of those infected with the coronavirus from other patients. "I'm not saying you need to build new hospitals", cautioned Mr. Cloutier whose position is representative of hospitals and other medical facilities country-wide.

Dr.Fisman, from his perspective as a epidemiologist, stresses that planners should prepare for makeshift hospitals -- recognizing virtually zero hospital spare bed capacity -- with designated hospitals for coronavirus patients and registries of health care workers who have had the virus and recovered, who can work safely with patients. "The risk to the general population within Canada is still low, but this could change rapidly" warned Theresa Tam, Canada's chief medical officer.

And more reason for Canadians to have confidence in their leaders in the health care community has emerged with the news that millions of face masks that had been stockpiled to protect health care workers during a future epidemic, have expired.

Preparations underway Monday for disembarkation at the Port of Oakland, Calif., of the Grand Princess cruise ship carrying passengers and crew who have tested positive for coronavirus. Kate Munsch/Reuters