People across the Quinte Region and beyond continue to have questions about the ongoing COVID-19 pandemic. How is it impacting our area? What else can we do to stop the spread? Who are the most vulnerable? How long until life goes back to normal? Quinte News sat down for a phone call with Hastings Prince Edward Medical Officer of Health Dr. Piotr Oglaza, to get some of those answers and more, with the crisis moving through its second full month. As of the time of our interview on the morning of Thursday April 16, the two counties had 27 confirmed cases of the virus and 252 probable cases.
QN: Given the local numbers, how would you assess the handling of things by the community (residents, businesses, frontline workers) in general?
PO: We’re certainly doing a good job with physical distancing. Even though there may be some people who aren’t quite following the new rules that we have, the vast majority of people are listening and following the new social norms, which is reassuring and promising. We do see fewer people out and about and we do notice that resulting in fewer infections. The numbers we see in terms of new cases represent our actions from two weeks ago, so the longer we go with physical distancing and other precautions we’re putting in place as a society in general, we’ll potentially see fewer and fewer cases in the community. Right now the biggest concern from my perspective is the risk of outbreaks in long-term care homes. This is something that’s on everyone’s mind right now and we have to make sure to protect that vulnerable population.
QN: That’s definitely where a lot of the focus seems to be right now. Do you have any update on how it’s going at those two facilities locally with outbreaks (Hastings Manor in Belleville and Hallowell House in Picton) and what’s the key to controlling the situation at facilities like that?
PO: The key to control any outbreak in any facility is to make sure that everyone is in “outbreak mode”. That means we need to isolate people and cohort them. We need to put all the confirmed cases in one part of the facility, since they already have the disease and then have those who might have been contacted but aren’t confirmed, be housed in a separate area. Then we’d have to put the people who are susceptible but not yet identified as contacts also in another separate area and then cohort staff as well. These efforts are also augmented by the recent provincial government announcement around staff only working in one facility. We want to make sure that if someone is working in a facility where there may be an outbreak, they only work there and that prevents the inadvertent passing of the virus. These are very labour-intensive and important measures and our facilities do their best. It can be quite costly in terms of staffing and resources, but that’s where the priority is right now. We have to minimize the risk and limit those outbreaks from happening.
QN: We’ve been getting lots of questions to our newsroom about testing (i.e How many tests have been completed? How many tests are being done currently? How many cases have been resolved?). Are you able to share any insight into that and is that something Health Unit may look at releasing eventually, once there is more information?
PO: The main challenge with providing the denominator for testing is that it’s not just one agency ordering new tests. The tests can be ordered by primary health care providers, assessment centres or long-term care facilities, for example. So at any given time we may not have an accurate number. The ballpark I can give is to date we’ve done somewhere in the neighbourhood of 800 tests in our area. Of these tests, only 27 were positive, so that gives us one comparator we’re looking at called the “case positivity rate”. That’s how many positives we get out of all the tests we’re ordering as a community. Our number is somewhere around 3.8% or 3.9%, which is lower than the provincial average. That also indicates that we are testing appropriately by testing people who already are at higher risk of having COVID-19 and when we test them, not all of them are positive. That lower positivity rate indicates we are casting our net wide and make sure we don’t miss someone who could potentially be a case. When we look at the total number of cases here, it’s a smaller number than we see in other jurisdictions, but keep in mind our population is only a fraction of somewhere like Toronto, so our numbers are a reflection of that. We’re testing a sufficient number of people at this point to say that we are detecting cases at a similar rate to the rest of the province. There are plans to expand the availability of testing across the province and we are also looking at that.
QN: Is there one major concern you seem to hear from the public more than others, when they call the HPE Public Health Hotline?
PO: It’s changing based on whereabouts in the outbreak we are. If there are new orders or restrictions there are always questions about interpretations, like which workplaces were essential or not, but mostly when our lines are open and we hear from the public, it’s about their own symptoms. Anyone with symptoms that could be a result of COVID-19 can call our public health intake line and they would be assessed by our team. If they meet the criteria for testing, or being a probable case, they would be given advice on what to do next.
QN: A couple weeks ago you in your Facebook discussion you talked about shopping safely and whether or not you need to wipe down groceries before you bring them home. Has anything changed when it comes to things like that?
PO: I wouldn’t say anything has changed; the same precautions would apply. There are simple basic infection controls people can take and that would provide the most benefit like staying two metres apart, washing your hands and avoiding touching your face. On top of that if people are concerned, they might wipe their packaging with disinfectant, but again that offers diminishing returns. What we see is the vast majority of infections are person-to-person contact with frequently touched surfaces. The food packaging is not a frequently touched surface the same way a door or a railing is, so the benefit of wiping that doesn’t give as much benefit as those other measures. We also need to be careful because we don’t want people spraying food with chemicals, that’s not necessary. Washing fruit and vegetables like we normally would is more than sufficient to protect ourselves.
QN: We’ve heard some stories of people being kicked off of local school tracks, where they’re trying to walk or exercise. Do you see any potential to open those facilities, or should they be considered the same as other outdoor recreation facilities that people should be staying away from?
PO: This goes back to the whole point that our society is taking a lot of steps and restricting what we usually used to do. Keeping people from congregating in those spaces is one of the measures we have. Once decisions are made about how the outbreak is going in the province in general, some restrictions may start to loosen, and those types of facilities may start to reopen. But at this point it’s a very critical juncture. We want to maintain the gains that we’ve made and by opening up too early we’re risking potentially more transmission happening and things reverting back. We’ve done a fairly good job at keeping the curve flat and while the next frontier in the fight against coronavirus is in long-term care homes we also need to make sure our gains in the community are maintained. The key to that is the physical distancing, so I would be cautioning people from thinking that we are able to return completely back to normal. This is something that has to be done very thoughtfully and those decision are made at the provincial level.
QN: Given the fact we haven’t seen a massive surge in hospitals here and our numbers do seem relatively low, compared to some other places, there have been a lot of calls from people to start lifting some rules and get back to normal. What’s the response to those people at this point?
PO: I wouldn’t want to rush it. What I do want to happen next is to follow provincial guidance on expanding testing. If we see more testing done in the community, we will potentially see decreases in the case positivity rate, which would mean we’re testing a lot of people that don’t have COVID-19 and that’s good news. We want to make sure our gains in terms of flattening the curve and not seeing surges in new cases are maintained and that would be the point where we can start thinking about loosening restrictions. But it can’t be done in isolation or in one community and not the rest, it has to be a province-wide approach. I would look for guidance from our public health colleagues at the provincial level and the ministry, who have a view of the entire province. Locally I would be reassured to see more testing, but fewer cases and also to manage and stop any outbreaks at long-term care homes. There are a lot of moving pieces here, but in terms of the main question of “when will we see restrictions loosening?”, I think it might be premature, even though some of the things we’re seeing in our community are reassuring.
QN: Is there anything else you’d like to pass along?
PO: The main thing would be to emphasize anyone who is experiencing symptoms of COVID-19, that could be the classic cough or fever, or combination of other less common symptoms, they can call HPE Public Health, Telehealth Ontario, or their health care provider. If they call public health they’ll be asked some questions and then given some guidance in terms of what to do with regards to isolation, while some individuals will be offered testing. Hopefully with that increased testing we’ll get more of a fulsome picture of what’s happening in the community.