Daily brief
Dr. Robert Strang announced 46 new cases of COVID-19 on Monday bringing Nova Scotia’s total cases to date to 721. He also noted that 48 people have recovered from COVID-19 and there have been no additional deaths, which brings active cases in the province to 464.
The majority of the new cases were associated with Northwood, the long-term-care facility (LTCF) in Halifax that is the site of the province’s worst outbreak at the moment, along with East and North Dartmouth. Northwood confirmed independently on Monday that it now has 152 COVID-19 cases affecting 111 residents and 40 staff members. Northwood also said that an infusion of workers from elsewhere in the healthcare system has eased the strain on its facilities.
Dr. Robert Strang, NS COVID-19 Update 20 April 2020
Dr. Strang was asked again about the logic behind moving recovered patients, who may have immunity, out of Northwood to a hotel (which the province is in the process of doing) and he explained that they don’t know for sure these residents have immunity or how well their immune systems would protect them if they remained in a facility with active cases, but he also noted that moving people who had recovered decreases the possibility that you will simply transfer the virus to another facility.
He also clarified that if a patient at Northwood — or any other LCTF — needed to go to hospital and had no directive specifying they weren’t to go to hospital and it was judged clinically possible to move them, then they would be transferred to a hospital. That said, as noted yesterday, the COVID-19 unit from the Halifax Infirmary has been transferred to Northwood.
The Premier thanked the workers who have stepped up to assist at Northwood, including nursing students and the unions representing the province’s healthcare workers.
Asked if the health system had sufficient resources to provide the same assistance to another LTCF should that become necessary, Strang said they would do all they could with the resources they had, but noted that Northwood is “by far” the largest such facility in the province and that the outbreak underway there, which resulted from a high number of infections among staff members, was unique and that the other eight LTCFs with COVID-19 cases had their outbreaks “under control.”
(Unfortunately, I can’t tell you precisely which facilities and how many cases per facility, although Shannex has acknowledged cases at Harbourstone in Sydney, Bissett Court in Dartmouth and Maplestone in Halifax; while GEM Health Care Group has acknowledged cases at the Admiral Long Term Care Centre in Dartmouth. The Magnolia residential care home in Enfield and the R.K. MacDonald Nursing Home in Antigonish have also reported cases as has the Ocean View Continuing Care Centre in Dartmouth. In addition, the Northside Guest Home in Cape Breton acknowledged that one of its residents died in hospital of COVID-19. Those plus Northwood add up to nine but I can’t guarantee they are the nine that currently have active COVID cases. On the other hand, if 111 of the 127 residents affected are at Northwood, that leaves only 16 cases which, divided between eight facilities means an average of two cases per facility.)
Strang also emphasized that keeping the disease from spreading in the community is a way of preventing further outbreaks in LTCFs.
Asked if patients who have tested positive for COVID-19 at Northwood are still sharing rooms with those who have tested negative, Strang said this may still be the case for some patients but they were working to “get people out of this situation as quickly” as they can and have “strengthened infection control measures” in rooms where this is the case. He added that some who have tested negative may already be “incubating” the disease, which is why they are testing repeatedly now at Northwood.
Asked why Nova Scotia seemed to be the “epicenter” of the outbreak in Atlantic Canada and later if the outbreak in this province was “out of control,” Strang said that if you looked across the province, you saw “sporadic” disease activity with “no substantive community spread” in the Eastern (including Cape Breton), Northern, and Western Health Zones and even in the Central Zone, which has identified the most cases, these are largely due to two outbreaks — Northwood and East Dartmouth.
Strang said, that we actually appear to be on the “downward slope with our epidemiology” even in the communities of East Dartmouth but despite “signs of decreasing disease activity in general,” they need to continue to impose strong measures and focus on the two hotspots.
Numbers
Total new cases: 46
Total cases: 721
Total hospitalized: 11
Total in ICU: 4
Total recovered: 248
Total deaths: 9
Total long-term-care facilities (LTCF) affected: 9
LTCF residents: 127
LTCF staff: 61
Total positive and negative tests: 22,490
Age range of patients: under 10 to over 90
Emergency Alert
The premier was asked about the province’s failure to employ its emergency alert system (the one that apparently startled the daylights out of many of you, telling you to say home on the Easter Weekend) to warn people in the Portapique area about the armed and dangerous man who was on the loose from late Saturday night to late Sunday morning.
The premier said EMO would have had to have been asked to send the alert and it wasn’t.
Asked if he was concerned that the RCMP relied on Twitter to reach people — many of whom may have been elderly or without internet — the premier refused to “second guess” the decisions made by law enforcement.
The same question was asked of RCMP Chief Supt. Chris Leather during a press conference this afternoon and he first directed it to the communications person with him. who said Twitter was used because it was an unfolding situation, but added that they were in contact with the province the whole time (the premier had previously said the RCMP were in touch with Justice Minister Mark Furey).
Leather said he could not say why the alert wasn’t used but that he hoped to have an update by Tuesday.
The weekend’s events were also referenced in a question about the COVID-19 assessment centers in Truro and Springhill, which apparently had to close on Sunday while the RCMP conducted their manhunt.
Strang said both were back in operation by early afternoon on Sunday.
Prescription fees
A reporter noted that limiting prescription refills to 30 days to ensure the supply has forced consumers to pay more in dispensing fees. “Are you prepared to get involved here?” he asked the premier and the premier said:
“Yes.”
Lessons?
A RadCan reporter asked if this province might learn from what’s happened in LTCFs and put the necessary protocols in place to avoid such outbreaks in future.
The premier said there was “no question” that once the province had returned to something like normal, they would be looking — from a public health and a structural point of view — at how to improve LTCFs, which, he noted, are not so much facilities as “homes.”
But he also spoke favorably of the level of care provided traditionally to residents of Northwood.
Burnside
A prisoner at the Burnside jail has tested positive for COVID-19, reports Tim Bousquet, who says that in response to a question, a Justice Department spokesperson told him:
This individual has been in an isolated healthcare cell since admission to the facility, due to a pre-existing injury. As a result, this person has had minimal contact with staff and other inmates since they entered custody.
P.S.
I have been too distracted by unfolding events today to add any bonus content to today’s update but I promise I will have some for you tomorrow.
