On Tuesday, March 24, Dr. Charles Gardner, medical officer of health for the Simcoe Muskoka District Health Unit (SMDHU) reported that there are four new confirmed cases in Simcoe Muskoka. Two of the cases were at hospitals in Simcoe County; details on the other two are pending.
Dr. Gardner also responded to several questions from media across the region, including the topics below.
Snowbirds returning to Canada
“Although we are concerned about community transmission, we are still concerned about people bringing this back with them from travel anywhere out of the country including the United States. Thirty per cent or so of travel-related cases in Ontario have been related to travel from the United States,” he noted.
It’s very important that people be aware that when they return to Canada they are to go into home isolation [a.k.a. quarantine] for 14 days and to seek assessment if they develop symptoms… It’s up to people to abide by this. We don’t have the capacity to enforce this with the numbers of people that come back.
It is a “dangerous thing [to ignore isolation orders and stop and get supplies on the way home] when they are in fact to completely abide by this requirement and to directly go home into isolation and stay in their home for the 14-day period,” he added
How the virus spreads
The novel coronavirus is spread by droplets from an infected person’s airway. Being close to an infected individual who is breathing in your direction within a two-metre distance, coughing or sneezing can allow for the virus to be breathed in or it can touch your eyes, nose or mouth. Once it has entered your body, it can propagate and cause the illness. “People need to be aware it’s that easy,” said Dr. Gardner.
It can also be contracted from surfaces. If droplets from someone coughing or sneezing fell on a table top or doorknob, for example, and someone else touches it and then touches their face—particularly eyes, nose or mouth. “So it’s really important that you do your best not to touch your face. It’s hard not to do,” he added. “And that you wash your hands frequently throughout the day. Handwashing has been shown to be the most effective thing that you could do.”
Because it is so easily spread, the health unit is asking people to, as much as possible, stay home.
“Keep your family members at home. If you do go out, you need to be emphasizing that physical distancing,” said Dr. Gardner. This of course is very hard on children, the idea of not being with other children, but it is necessary at this time. Children actually aren’t particularly prone to developing severe symptoms, but they are very good at spreading it to others, and so they can be a means by which this propagates in the community.”
People with mild cases could shed the virus for up to eight days. Those people need to remain in self-isolation for at least 10 days from the onset of symptoms, even if their symptoms resolve before that time. And if symptoms last longer than 10 days, they should remain in isolation for 24 hours after symptoms have resolved.
He reiterated that people who are vulnerable—people who are older than 60 or 70, and people with preexisting medical conditions—who acquire the infection are much more likely to have a severe outcome that requires hospital care or intensive care unit care, or even results in death.
For severe cases, it could take many weeks to recover.
“So it’s very serious,” said Dr. Gardner. “People need to take to heart that they still have to do that physical distancing and they still have to abide by the recommendations and requirements coming right now from the province and from public health.”
Number of tests conducted locally
Dr. Gardner said that the health unit is not notified about how many tests have been ordered for its district, but said that there is a significant amount of testing being done.
“My main concern actually is not only how many more tests are pending, but how many more potential cases are out in the community that have not been able to be assessed or perhaps have very mild symptoms and have not sought assessment,” he said. “It goes right back to the importance of the physical distancing that we need to be doing to safeguard ourselves, reduce transmission and flatten the curve.”
He added that the lack of confirmed cases in Muskoka to date doesn’t mean that there aren’t people in this area who haven’t been infected.
“We do need to know what’s going on in Muskoka,” he said. “The emergency departments certainly are doing testing. There aren’t assessment centres so that I think is a challenge and it will be a good thing once they are open because it will help increase the volume of testing that is in fact needed in Muskoka.”[More on assessment centres pending for Muskoka here: Muskoka awaits approval for two coronavirus assessment centres].
Gardner noted that there is a bottleneck in testing: “…there are many more tests being taken than the ability of the system to process at this time and so some other hospitals in the Greater Toronto Area are coming online with their laboratories being able to provide this service as well to be able to increase system capacity.”
Cases that are confirmed require full recovery and then two tests done 24 hours apart that each have a negative result before they are permitted to leave self-isolation, which adds additional volume to the testing system.
“All of this has happened over a relatively short period of time, a week-and-a-half or so,” said Dr. Gardner, “and we are just asking ourselves how best to facilitate their follow-up testing considering that people right now have a hard time getting testing via the assessment centres and emergency departments. We are seeking to work out an arrangement that will make it easier.”
Mental health impacts
“There are undoubtedly mental health impacts in this situation and I think that they will mount as time goes on as all of these changes continue to be in place and impact on people’s lives,” said Dr. Gardner. “Isolation is hard on people. The Canadian Mental Health Association has identified that and spoken in the media about the importance of a focus on people maintaining social connection [while remaining physically distant]…and they need to use the [technological] means at their disposal to maintain contact with each other. This will be a great challenge for us all going forward in time.”
He acknowledged that it will be particularly difficult for front-line workers as time goes on.
Read more from the Canadian Mental Health Association here.
Read more updates from the health unit on Huntsville Doppler at the links below. Also check our COVID-19 page for ongoing news and community information, including case details in Simcoe Muskoka to date.
For more information on the novel coronavirus in Simcoe Muskoka, visit SMDHU’s COVID-19 page.
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