NS COVID-19 Update for 8 May 2020

Daily Briefing

Dr. Robert Strang today announced two more deaths at the Northwood long-term-care facility (LCTF) in Halifax, bringing total deaths at the facility to 40 and total deaths across the province to 46.

Strang also announced one new case of COVID-19.

Doing the math, it seems there are only 44 known active cases outside Northwood and the single case at another LTC facility. The cumulative number for the Eastern Zone (which includes Cape Breton) remains at 50, but the province refuses to break this data down into resolved and active cases, although Strang — as you’ll read in a moment — says disease activity outside the Central Zone has been “very limited” in the last few weeks.

I understand this: public health is afraid if we found out there were very few (or no) active cases in Cape Breton, we would stop being as careful and the numbers would shoot up.

But I think people have proved they are responsible enough to handle the truth.

 

Numbers

Total new cases: 1

Total cases: 1,008

Total hospitalized: 5

Total in ICU: 2

Total recovered: 722

Total deaths: 46

Total long-term-care facilities (LTCF) affected: 2

LTCF residents: 156 (Northwood)

LTCF staff: 38 (Northwood) 1 (other LTC facilities)

Total positive and negative tests to date: 33,843

Age range of patients: under 10 to over 90

 

Schools

Nova Scotia’s schools will not re-open this academic year. At-home-learning will continue until June 5. The province hopes to reopen daycares on June 8, but will make a final decision closer to that date.

Teachers will continue to work until the end of June to finalize assessments and report cards.

On the bright side: “does not work well with others” is a criticism unlikely to figure in this year’s assessments.

 

Open for Business

Dr. Strang, who has been refusing for a couple of weeks to answer reporters’ questions about his plan to reopen the province, was much more forthcoming on Wednesday with the Halifax Chamber of Commerce and the Nova Scotia Business & Labour Economic Coalition. (According to Chamber President Patrick Sullivan, the meeting ran the gamut of interested Nova Scotian parties from A to B, including the Pictou, Yarmouth, Truro and CBRM chambers, the Halifax Partnership, the Centre for Women in Business, the Black Business Initiative and “many others.”)

I should say right now, the premier does not like this characterization of events, not one bit. In fact, he is very, very angry at reporters trying to “make hay” out of Strang’s presentation to the Halifax Chamber (which, I will bet you a medical-grade surgical mask was McNeil’s idea, not Strang’s) because the plan is based on Public Health Agency of Canada (PHAC) guidelines which are public, because he always gets criticized for not consulting and now he consults and he’s getting criticized anyway, because of course they’re consulting with their business “partners” about opening up the economy, because Strang is going to consult with everyone before the plan is finalized, because it’s one thing to criticize him but it’s quite another to cast aspersions on the abilities of Dr. Strang.

The CBC’s Michael Gorman pushed back on that last assertion, prefacing his opening question by saying that reporting on the leaked Chamber presentation is hardly casting aspersions on Dr. Strang’s abilities of a chief medical officer of health but McNeil, so far up on his high horse I’m surprised he was still within camera range, was having none of it.

Personally, I’m not surprised this government equates “making information public” with “talking to the Chamber of Commerce” because I was bellyaching about just that back in February when McNeil went on a “state of the province” tour of CoCs, stopping in Sydney to answer softball questions lobbed by the local chamber president. Some things have clearly returned to “normal” in this province faster than others.

And look at this list of “stakeholders” included in the presentation — Strang obviously realized there were some gaps because he encourage any groups who didn’t see themselves there to contact Public Health. All the non-business stakeholders are lumped together in one bullet point “Sport, Art and Cultural Organizations.”

Moreover, none of the explanations offered can change the fact that May 6 precedes May 8 and Strang gave the business community a sneak peek at the reopening plan on May 6 before he told the rest of us anything about it on May 8 and there was no need of that.

Gorman wanted to know if we would have seen the presentation at all today if the Wednesday version hadn’t leaked but McNeil was too busy being outraged to actually answer the question.

Whatever the case, Strang (I would say quite happily) walked everyone through what he’s got so far, which is based on the need to balance reopening the economy with controlling the disease while mitigating the impacts of the public health measures on people and businesses. (Nothing to it, right?)

The province will empower a “table” of deputy minister level “executives” representing various sectors to “steward the risk assessment” that will inform the great reopening. Risk will be measured according to seven criteria, including epidemic control, healthcare capacity, public health capacity, management of outbreak risks, workplace prevention, managing risk of bringing in new cases (which means provincial and federal border controls) and community awareness and engagement.

Strang says while we’re “very much at the end of the first wave” of the epidemic, the first criterion will be “low-to-no cases for two incubation periods” or 28 days. (He pointed to New Brunswick which identified a case this week after 16-17 days without one.)

Strang acknowledges that some regions may hit this milestone before the province as a whole does — here he admitted the health zones outside the Central Zone have had “very limited activity” in the past few weeks — but he doesn’t want to open the place up piecemeal, an idea District 4 Councilor Steve Gillespie was floating on Facebook Wednesday:

Strang said such a policy would raise a number of risks, the largest being the “inadvertent encouragement of travel between the regions.”

That does seem to have been the experience in the US State of Georgia, which eased its restrictions before neighboring States did, and in the week after reopening, saw a 13% increase in people entering from other states.

Strang’s presentation stresses that “core personal measures,” like washing hands, not touching faces and ensuring physical distance, will remain in place throughout the outlined phases, the first of which could involve opening daycares, some non-essential businesses, allowing more outdoor activities, resuming non-urgent healthcare services, permitting “small” essential cultural gatherings (like funerals) and increasing the size of permissable gatherings from 5 to 10 people.

The slide-show notes, however that these five elements would be proposed:

…only if specific conditions can be met that would lower the risk of transmission (e.g., by reducing contact intensity and number of contacts)

To understand how difficult this will be in a daycare setting, we have only to look to Quebec, which has released safety measures for workers and children in elementary schools and daycare services — like maintaining physical distancing of two metres “at all times” and avoiding sharing any items (including “pencils, toys, copybooks”) — that critics say will be all but impossible to enforce.

The draft reopening plan suggests each time a restriction is eased here in NS, the effects will be monitored for two COVID-19 incubation periods —  28 days — to ensure there is no sudden spike in cases. If there is, restrictions could be re-imposed.

Phases 2-4 are low on detail, but basically involve opening low-risk to highest-risk businesses and allowing larger and larger gatherings. Interestingly, Strang said what will really matter is a business’ plan — so a high-risk business with a robust plan for keeping its customers safe might open earlier than the presentation would suggest.

The final phase is dependent on the availability of a vaccine or, should a vaccine prove illusive (which a vaccine may very well prove), treatments for COVID-19. During Friday’s briefing, Strang raised the possibility of “herd immunity” through natural transmission of the disease but cautioned we don’t even know for sure yet that a person who’s had COVID-19 will develop immunity.

Here’s today’s presentation:

COVID-19-planning-for-a-new-normal

 

NSHA

In related news, the CBC’s Michael Gorman reports that the NSHA doesn’t see its operations returning to normal any time soon.

Gorman quotes health authority CEO Brendan Carr:

It will be a gradual process, with the immediate focus on the patients who were displaced as a result of COVID-19 preparation, said Carr, and all of the work will happen in consultation with Chief Medical Officer of Health Dr. Robert Strang and public health officials.

“The best case will be that over the next period of months, we’re going to be able to advance along a very careful plan that Dr. Strang and his team will outline,” Carr said in a telephone interview.

Carr and IWK VP of medicine, Dr. Doug Sinclair, both say reducing the backlog of surgeries (which existed pre-pandemic) will take time, but Carr suggests some of the systems introduced to deal with COVID-19 — like having people call 811 to schedule an appointment to go to an assessment center instead of going directly there — could be used to control the numbers in emergency departments.

Speaking of which, the NSHA published the craziest list of closures yet yesterday. As I said on Facebook, I’m not sure how this can be considered useful information — are you supposed to print it out and hang next to the phone so you can consult it should you take ill or injure yourself?

ADDITIONAL TEMPORARY CLOSURES

Thursday, May 7

• Glace Bay Hospital’s emergency department reopens at 7 a.m. It also closes at 4 p.m. and reopens on Friday, May 8 at 7 a.m.
• Northside General Hospital’s emergency department is closed until further notice to direct resources to other health needs during COVID-19.
• Eastern Memorial Hospital’s emergency department is open from 7 a.m. to 7 p.m. and closed overnight.
• New Waterford Consolidated Hospital’s emergency department is closed for facility maintenance. It will reopen when work is completed.

Friday, May 8

• Glace Bay Hospital’s emergency department reopens at 7 a.m. It also closes at 4 p.m. and reopens on Saturday, May 9 at 7 a.m.
• Northside General Hospital’s emergency department is closed until further notice to direct resources to other health needs during COVID-19.
• Eastern Memorial Hospital’s emergency department is open from 7 a.m. to 7 p.m. and closed overnight.
• New Waterford Consolidated Hospital’s emergency department is closed for facility maintenance. It will reopen when work is completed.

Saturday, May 9

• Glace Bay Hospital’s emergency department reopens at 7 a.m. It also closes at 4 p.m. and reopens on Sunday, May 10 at 7 a.m.
• Northside General Hospital’s emergency department is closed until further notice to direct resources to other health needs during COVID-19.
• Eastern Memorial Hospital’s emergency department is open from 7 a.m. to 7 p.m. and closed overnight.
• New Waterford Consolidated Hospital’s emergency department is closed for facility maintenance. It will reopen when work is completed.

Sunday, May 10

• Glace Bay Hospital’s emergency department reopens at 7 a.m. It also closes at 4 p.m. and reopens on Monday, May 11 at 7 a.m.
• Northside General Hospital’s emergency department is closed until further notice to direct resources to other health needs during COVID-19.
• Eastern Memorial Hospital’s emergency department is open from 7 a.m. to 7 p.m. and closed overnight.
• New Waterford Consolidated Hospital’s emergency department is closed for facility maintenance. It will reopen when work is completed.

Monday, May 11

• Glace Bay Hospital’s emergency department reopens at 7 a.m. It also closes at 4 p.m. and reopens on Tuesday, May 12 at 7 a.m.
• Northside General Hospital’s emergency department is closed until further notice to direct resources to other health needs during COVID-19.
• Eastern Memorial Hospital’s emergency department is open from 7 a.m. to 7 p.m. and closed overnight.
• New Waterford Consolidated Hospital’s emergency department is closed for facility maintenance. It will reopen when work is completed.

Tuesday, May 12

• Victoria County Memorial Hospital’s emergency department closes at 6 p.m. It reopens on Wednesday, May 13 at 8 a.m.
• Glace Bay Hospital’s emergency department reopens at 7 a.m. It also closes at 4 p.m. and reopens on Wednesday, May 13 at 7 a.m.
• Northside General Hospital’s emergency department is closed until further notice to direct resources to other health needs during COVID-19.
• Eastern Memorial Hospital’s emergency department is open from 7 a.m. to 7 p.m. and closed overnight.
• New Waterford Consolidated Hospital’s emergency department is closed for facility maintenance. It will reopen when work is completed.

Wednesday, May 13

• Victoria County Memorial Hospital’s emergency department reopens at 8 a.m.
• Strait Richmond Hospital’s emergency department closes at 6 a.m. It reopens on Thursday, May 14 at 8 a.m.
• Glace Bay Hospital’s emergency department reopens at 7 a.m. It also closes at 4 p.m. and reopens on Thursday, May 14 at 7 a.m.
• Northside General Hospital’s emergency department is closed until further notice to direct resources to other health needs during COVID-19.
• Eastern Memorial Hospital’s emergency department is open from 7 a.m. to 7 p.m. and closed overnight.
• New Waterford Consolidated Hospital’s emergency department is closed for facility maintenance. It will reopen when work is completed.

Thursday, May 14

• Strait Richmond Hospital’s emergency department reopens at 8 a.m.
• Glace Bay Hospital’s emergency department reopens at 7 a.m. It also closes at 4 p.m. and reopens on Friday, May 15 at 7 a.m.
• Northside General Hospital’s emergency department is closed until further notice to direct resources to other health needs during COVID-19.
• Eastern Memorial Hospital’s emergency department is open from 7 a.m. to 7 p.m. and closed overnight.
• New Waterford Consolidated Hospital’s emergency department is closed for facility maintenance. It will reopen when work is completed.

Friday, May 15

• Glace Bay Hospital’s emergency department reopens at 7 a.m. It also closes at 4 p.m. and reopens on Sunday, May 17 at 7 a.m.
• Northside General Hospital’s emergency department is closed until further notice to direct resources to other health needs during COVID-19.
• Eastern Memorial Hospital’s emergency department is open from 7 a.m. to 7 p.m. and closed overnight.
• New Waterford Consolidated Hospital’s emergency department is closed for facility maintenance. It will reopen when work is completed.

 

Unemployment

The CBC is also reporting that 50,000 jobs were lost in Nova Scotia in April, reflecting the economic impact of the COVID-19 measures. Unemployment in the province rose to 12% in April from 9% in March.

Four out of five jobs lost in April were in the services sector, where 13,000 wholesale and retail trade jobs disappeared. Accommodation and food services lost 11,000 jobs.

Construction and manufacturing accounted for almost all of the jobs lost in the goods-production side of the provincial economy. Employment in each fell by 4,700 jobs.

The real story, of course, is in the details — how many of these workers qualified for EI? How many for CERB?

On a related note, McNeil was asked why he didn’t follow PEI’s example and include the cashiers and delivery people he had thanked for their service among the essential workers who qualify for the $2,000 pandemic bonus. (McNeil is limiting the NS program strictly to healthcare workers.)

McNeil responded by, first, thanking the cashiers and delivery workers for their service and then explaining he didn’t include them because healthcare workers were initially left out of the wage top-up program and he wanted to focus on the people on the frontlines without “plexi-glass” between them and the public. (I can’t even with this — how many delivery people carry plexi-glass around with them? And are cashiers so very safe behind theirs that we don’t have to acknowledge the chance they’re taking anymore?)

Asked if the province would be prepared to offer more financial help to businesses that won’t be able to open anytime soon, McNeil said he had first focused on businesses closed by the Public Health order but also acknowledged that they “took away others’ customer base” and would look to “capitalize on the federal dollars out there while using our “precious public dollars” to help fill in the gaps. (Federal public dollars being, apparently, less precious.)

On a final related note, the premier said no provincial staff had been laid off, although there had been “adjustments in seasonal hires” and departments are “not replacing people at the rate they were.”

 

New Brunswick

Asked, essentially, why we can’t be more like New Brunswick, Dr. Strang said there are a number of factors that have influenced the course of the disease in this province versus our neighbor to the west, the two most important being our international airport and our large urban area. He noted that the disease is more prevalent in big cities and the HRM is the biggest urban area in the Atlantic provinces.

Asked if he was considering giving the people at the border powers to “enforce restrictions,” McNeil said if there were a problem that required law enforcement, he would turn to the police, before reminding everyone that there are people who are permitted to cross the border for work.