Daily briefing
Nova Scotia has recorded its first COVID-19-related death, a woman in her 70s with underlying conditions. The provincial press release said only that the death was recorded in the Eastern Health Zone, but during the question period at today’s briefing, it became clear she was a patient at the Cape Breton Regional Hospital.
In fact, Chronicle Herald reporter John McPhee asked Dr. Robert Strang to confirm that the woman had been treated on the third floor of the hospital and not in a dedicated COVID-19 unit, but Strang said if that information was true, it was more than he himself had and more than he would ever make public. The Post‘s Nancy King asked Strang to confirm the woman was a resident in a long-term care facility, but again, citing privacy concerns, Strang declined to offer more detail. Public Health, Infection Control and Occupational Health and Safety are investigating the hospital’s handling of the death and Public Health will contact and test anyone determined to have been in close contact with the patient.
Dr. Robert Strang, COVID-19 Update, 7 April 2020
The province has 17 new cases of COVID-19 for a total of 310 cases.
Numbers, please
Total new cases: 17
Total cases: 310
Total hospitalized: 11
Total in ICU: 4
Total recovered: 66
Total deaths: 1
Total positive and negative tests: 10,931
Age range of patients: under ten to over 90
Partying and privacy
Dr. Strang announced that mobile testing was being done in the Prestons and Cherry Brook which — along with East Hants, where a temporary assessment center has been established in Elmsdale — are suspected of being COVID-19 hotspots.
Both Strang and the premier took it in turn to scold the “reckless” people in the Prestons who have apparently been flouting the social-distancing and essential gathering rules. Strang said there have been COVID-19 cases in Halifax that have been traced to these communities — including some involving healthcare workers.
Here’s my problem: Strang has said repeatedly — in fact, he said it again on Tuesday — the he’s not releasing COVID-19 case numbers by community because he doesn’t want us looking at other communities and thinking it’s their problem, not ours.
But isn’t naming the communities in which you’re opening temporary assessment centers or conducting mobile testing (let alone scolding these communities during the daily briefing) going to have precisely that effect? Isn’t everyone in the province now looking at the Prestons and Elmsdale/Enfield in exactly the way Strang said he didn’t want us to? Doesn’t it have the effect of focusing our attention on them exclusively because we don’t know where any of the other cases are?
I think this slow-drip approach to releasing information could end up being more of a privacy issue than just releasing the community-level data.
For the record, here’s the breakdown of cases by Health Zone for April 7:
Uh-oh Costco
Did you see that picture making the rounds of social media showing people apparently flouting the social distancing rules outside the Bayers Lake Costco on Sunday?
Dr. Strang did, and he was not happy.
In fact, he was “baffled,” noting that this is “the kind of activity that actually easily spreads this disease.”
He also said that Occupational Health and Safety will be visiting all grocery and Big Box stores and working with them to make them as safe as possible but — and he apologized for sounding like a broken record — it us up to all of us to make sure these Public Health measures work and we make them work by following them.
Masks 7.0
The NSHA and the IWK Health Centre are now asking staff to wear masks whenever they’re in public spaces inside a hospital or coming in contact with patients and other staff.
As the CBC reported earlier today:
Dr. Brendan Carr, the NSHA president and CEO, informed health authority staff of the new policy in a video posted online on Tuesday.
Carr said the decision is based on evolving information that shows COVID-19 can be spread by people with the virus even before they show symptoms or if they are asymptomatic.
“We think that this will offer some protection both to the individual and can protect other people if we happen to have COVID and are unaware of that,” he said…
Staff will be given a procedure mask when they arrive for work that they are to use throughout their shift or until it becomes soiled.
Asked again about supplies during today’s briefing, Premier Stephen McNeil said that even with these new protocols, they had enough to last a month and more on order (including an order with Stanfield’s which has switched to the production of surgical gowns and is also supplying the federal government.)
Fines not dandy
CTV reports the Cape Breton Regional Police ticketed four people on Monday for violating COVID-19 related government orders.
Three separate individuals were fined $582.50 each for parking at Dominion Beach on Monday evening and failing to comply with the Emergency Management Act. Earlier the same day, another person was fined $1,000 for failing to comply with physical-distancing under the Health Protection Act.
To date, the Cape Breton Regional Police has issued eight COVID-19-related summary offense tickets.
NS Premier Stephen McNeil, COVID-19 Update, 7 April 2020
Ontario
When a reporter suggested to Dr. Strang — who had earlier compared us favorably to Ontario and Quebec in terms of our response to the virus — that our cases per 100,000 population rate was actually the same as Ontario’s, Strang said comparing confirmed cases didn’t give a full picture of the situation.
Strang said Nova Scotia has a “robust testing capacity” while Ontario has actually had to back away from testing.
Numbers published today by Macleans show both Nova Scotia and Ontario have 32 cases per 100,000 population — but they also show Nova Scotia has done 1,075 tests per 100,000 population whereas Ontario has done 536.
In fact, the CBC reported today that testing in Ontario had declined from 6,200 on April 1 to just 2,568 today. The only explanation offered was that the province’s assessment centers have been submitting only about 3,500 tests per day although Ontario has the lab capacity to complete 13,000 tests per day.
The same report noted that more than 500 healthcare workers have tested positive in that province, representing about 11% of all confirmed cases.
Antibodies
The Globe and Mail reports that Canadian blood transfusion experts are about to conduct a clinical trial of a potential COVID-19 treatment:
The study, which will involve 1,000 patients from across the country, will include at least 40 Canadian hospitals, and is being overseen by doctors from the University of Montreal, University of Ottawa, University of Toronto, McMaster and the University of British Columbia, among other schools.
The experimental treatment involves injecting antibody-rich plasma from patients who have recovered from the virus into those who are still infected. This approach has only been tried in small trials in China, Singapore, South Korea and the U.S. It is part of a global race to find a treatment for the disease, with researchers also focusing on antivirals and medications used to treat malaria.
Plasma, says the Globe, is a “straw-yellow” liquid component of blood (in case you want to color match your living room walls or your work-at-home wardrobe) and the theory is that people who have recovered from COVID-19 may have antibodies to fight the virus. (Strictly speaking, from what I’ve read, researchers don’t yet know if people who have had COVID-19 develop immunity, which may be why the treatment is being described as a “Hail Mary.”) The trial has come together at lightening speed and the lead doctor, Donald Arnold, a hematologist at McMaster University, says the goal is to get and analyze results just as quickly “so that we can start using this product if it’s truly effective, or realize it’s not and stop using it.”
U of T epidemiologist David Fisman called the trial “the most promising thing” he’d seen in a while and noted:
There is a long history of using antibody both for passive vaccination (we use it currently for hep A, chicken pox, others) and for therapy.
He suggested the treatment might be best used not on ICU patients but “upstream” to treat patients as they began to sicken or as a “passive vaccine…conferring immunity as a superpower on healthcare workers.”
Tonight’s Distraction
Shakespeare’s Globe Theatre in London is posting six videos of live productions on YouTube free of charge. There is a new production every second Monday at 3:00 PM ADT and it will stay up for a full two weeks.
As Adam Feldman explains in TimeOutIn:
The first offering is Shakespeare’s magnum opus, Hamlet, where a ghost and a prince meet and everyone ends in mincemeat; in a gender-blind modern gesture, the company’s artistic director, Michelle Terry, plays the title role.
