NS COVID-19 Update for 9 September 2020


Premier Stephen McNeil and Dr. Robert Strang, the province’s chief medical officer of health, held one of their now-quite-rare COVID-19 updates on Wednesday. The premier had nothing in particular to announce, other than congratulating teachers, staff and especially students for “having the courage” to return to school yesterday. (I have to allow myself an anecdotal aside: I drove to Sydney on Route 4 yesterday and passed a number of little groups of parents and children waiting for the school bus and I have to say, they looked some happy.)

The bulk of the talking today was left to Strang, who began by running through our most recent statistics — three active COVID cases, no new cases discovered yesterday and 801 tests completed by NSHA labs.

Dr. Robert Strang, COVID Update

Dr. Robert Strang, COVID Update September 9 2020.

He then went into detail about the one new case announced Monday. He said while he always tries to balance the public’s desire for details with the individual’s right to privacy, this particular case has already received a lot of public attention, so he felt the need to address it.

It seems the case announced on Monday involved a homecare nurse who had tested positive for COVID in May but whose case was considered to be resolved because 10 days after the onset of symptoms, the nurse’s acute symptoms had resolved. Then, four months later, the nurse developed new symptoms, although “recent tests are all inconclusive.”

Rather than waiting for the mystery to be resolved, Public Health is treating this as a new case and taking all necessary precautions, which includes assessing all the nurse’s clients to determine which ones require testing. Strang said whether a client is considered a “close” contact will depend upon the service provided by the nurse, who was wearing appropriate personal protective equipment (PPE) at all times.

Asked by the CBC’s Michael Gorman if they knew how the nurse had re-contracted the virus, Strang said that was one of the things under investigation.

He explained that a new infection would mean the nurse had been reinfected and, if subsequent investigations and lab tests confirm this, the case would be one of only a handful of documented reinfections. Strang said he couldn’t be sure off the top of his head, but believed there had only been two or three documented cases.

I looked it up following the press conference and found that the first documented COVID-19 reinfection was reported in Hong Kong on August 24. The case involved a 33-year-old man who was first infected in late March and then, again, four-and-a-half months later. According to STAT, news of the Hong Kong reinfection brought other researchers forward with their own reports — including one from Belgium, one from the Netherlands and another from Nevada.

Strang says should the Nova Scotia case prove to be an example of reinfection, it will have implications for how we think about immunity, which appears to last only about three months. Strang said this doesn’t come as a surprise, because it’s the case with most respiratory illnesses. It will also, he says, have implications for how we think about vaccines and how long they’re likely to be effective and — in general — about how we continue to live with COVID.

But Strang said it is also possible the test was somehow picking up “residual” virus from the nurse’s initial infection. For now, as noted, the case is being treated as a new infection and all the usual precautions are being taken.

Strang also noted that the Atlantic Provinces had recently been dubbed the “New Zealand” of North America although both he (and later the premier) cautioned us not to let it go to our heads.

The reference seems to be to this tweet by a University of Calgary developmental biologist:



Total new cases: 0

Total active: 3

Total cases: 1,086

Total hospitalized: 0

Total in ICU: 0

Total recovered: 1,018

Total deaths: 65

Total long-term-care facilities (LTCF) affected: 0

Total positive and negative tests to date: 81,175

Age range of patients: under 10 to over 90

Number of Epidemiologists in Dr. Strang’s department: 3



Strang said that after broadening the list of symptoms that should trigger a self-assessment or 811 call — and possibly a COVID test — in May, Public Health has cut the list back to better reflect “how COVID presents.”

Strang said the change was made based on their observation of cases and he is “comfortable” with the “much more refined” list of symptoms. People are now advised to do the self-assessment online or call 811 if:

…in the past 48 hours you have had, or you are currently experiencing:
  • fever (i.e. chills/sweats) or cough (new or worsening)
Two or more of the following symptoms (new or worsening):
  • sore throat
  • runny nose/ nasal congestion
  • headache
  • shortness of breath

Strang said they’ve learned the “threshold for testing” introduced in May was “unnecessarily broad,” and found them testing kids in daycare with runny noses when, “just a runny nose isn’t how COVID presents.”

If you’re not feeling well, said Strang, go home or stay home, do the self-assessment or call 811 which “has the expertise to determine if you need testing.”

(And no, the premier was not asked about compensation to make “staying home” or “going home” feasible for people without paid sick days.)



Strang gave an update on the situation in the province’s reopening universities and community college campuses, saying 3,200 students have entered the province from outside the Atlantic Bubble and are, for the most part, done with their self-isolation and COVID tests — 6,000 have been completed.

Three cases were discovered among the 3,200 students which Strang says “bodes well” and is “good news.”

He also said it was a testament to the measures in place that the disease didn’t spread beyond the three identified cases, because the students in question were self-isolating.

Strang thanked the province’s students for adhering to the rules and taking the required precautions before noting that a “small minority” are not doing what they’re supposed to be doing. Strang referenced weekend reports of a long line at a Halifax club — and pictures showing patrons failing to maintain social distance — saying they were “concerning” and asking students to think of the broader community. He also pointed to British Columbia where night clubs have been closed in response to a spike in COVID cases.

Strang said he’s been asked how students are to self-isolate with roommates and basically said they should do the best they can, maintaining distance, cleaning frequently, not sharing a bathroom if possible.

Later in the conference, Tim Bousquet of the Halifax Examiner asked Strang why he was offering no guidance on sex for students and Strang (after taking a drink of water) said that Dr. Theresa Tam had gone there (advising Canadians to wear masks during sex, thereby becoming the butt of social media jokes for a couple of days, although the Ally Centre of Cape Breton says she’s right) but that he didn’t necessarily think he had to and that frankly, from a public health perspective, he was more concerned with large groups of students socializing than with two people having sex.


Exposure advisory

Strang was asked about an NSHA COVID exposure advisory notice issued earlier this week, warning people who had been in the Fitness Centre at the Canada Games Complex in Halifax on certain days and at certain times that they may have been exposed to the virus.

Strang said that while public places like gyms and fitness centers are asking screening questions (“Do you feel unwell? Have you traveled outside the Atlantic Provinces in the past 14 days”) they’ve had “a number of cases like this,” where they want to alert “even those with a modest chance of exposure.”

Strang says such advisories are issued only in cases where they can’t contact all people who may have been in close contact with the infected individual.


Opening up

The CBC’s Michael Gorman suggested the Atlantic Provinces’ reputation as the “New Zealand of North America” depended on our isolation, and asked the premier how that played into his thinking on opening up to the rest of Canada. (McNeil has said he’d consider doing so before the other Atlantic Provinces, if necessary.)

McNeil said our epidemiology “will be a big part” of the decision to reopen, noting that we’ve had 28 days with low infection rates and that the influx of 3,200 students has been “so far, so good” (the students are all self-isolating, of course). Both, he says, give “some level of comfort” about people coming in from other parts of the country but as far as opening up to the rest of Canada, “We’re not there yet.”


Rotational workers

Alicia Draus of Global Halifax asked Strang if he was considering following the examples of the other Atlantic Provinces in his treatment of returning workers. Draus pointed out that returning workers in New Brunswick are required to self-isolate for just seven days, while Newfoundland requires seven days of self-isolation and a negative COVID test and PEI requires workers to self isolate until they are tested (and test negative).

Strang says his department is looking at various ways of loosening restrictions but underlined that work camps, like those in Alberta, remain “potentially higher risk environments” for COVID. He says he will be providing guidance on the subject of modifying the isolation period for rotational workers in the “very near future.”



A reporter asked about Halloween and Strang said that was a “family decision,” but that he saw no reason why it couldn’t be practiced safely and his department was not looking at putting restrictions on Halloween although it was crafting safety messages.

Strang then added that where Halloween has become “very much an adult” social event, all his cautions about following public health protocols in bars applied.

The premier said he had a nephew who was probably going to dress up as Dr. Strang for Halloween and Strang, for his part, said he’d dress as the COVID virus and be the “scariest thing around.”



Asked whether he had any plans to increase the size of gatherings, which were last modified in June, Strang said they were looking at possibly increasing the number of people permitted to gather without social distancing — now set at 10 — to allow for sports, theater and arts activities, but that no decison has been made yet.

In fact, he said, he had a “long discussion with his team” this morning about which restrictions would be tightened should the epidemiology deteriorate.


Second wave

Asked why he’d told the province’s Health Committee Nova Scotia was in a “good position” to deal with a second wave of COVID, Strang said it was because of the way we handled the first wave and because of the increased capacity in our Public Health system, from 811 staffing, to assessment centers (26 primary and “eight or nine” temporary at universities), to COVID test processing — our labs can complete 1,500 tests per day with “plans to go beyond that if necessary.”


Contact tracing app

Asked by CTV’s Natasha Pace if Nova Scotia would use COVIDAlert, the contact-tracing app that has been adopted by Ontario and Newfoundland and Labrador, Strang said he’s waiting to see what Ontario’s experience will be, noting that one problem that has already emerged is that of loose parameters triggering unnecessary alerts and creating “too much follow-up” for Public Health in Ontario.


Under pressure?

Asked by Tim Bousquet of the Examiner if there is any tension between himself  and the premier when it comes to balancing public health concerns with economic and political concerns, Dr. Strang said he faces tensions just in terms of balancing public health considerations because each restriction imposed to prevent COVID has its own set of health harms.

But as far as his dealings with the premier, he says he has “never felt tension.”

Every time I’ve talked to him he’s put the health of Nova Scotians first.


Cooperate & Isolate

The premier ended today’s press conference by warning us against becoming “arrogant” about our low COVID numbers. “We have all worked hard to get here” he said, but we “can’t stop now,” and we “don’t want to shut business down again.”

He then took a moment to anthropomorphize the virus, which “loves” it when we gather in groups or fail to self-distance but “hates” it when we follow public health protocols, before asking students and visitors from outside the Bubble to:

Please cooperate and isolate.

Do I see another t-shirt opportunity?