Friday, February 28, 2020

Containing Novel Coronavirus : Global Pandemic

"This is about containing the virus, this is about isolation of the virus, not isolation of people. It has nothing to do with discrimination whatsoever. It's a global fight against this virus. Let's contain it if we can."
"If you transmit it to somebody, who will this person be? Those will be your close family members, the person who greets you at the airport, hugs you. Your wife, parents, kids, very close friends."
"We [group of 23 Chinese-Canadian doctors] are a step ahead of the policy ... but we believe it's the right thing to do."
Dr.Stanley Zheng, family physician, Toronto
Volunteers on WeChat have facilitated "no-touch" pick-ups from the airport for people flying in from China, meaning they arrange for a running car to be waiting in the pick-up zone. Jennifer Gauthier/Reuters

This family doctor practising in Toronto, along with a group of 22 other Chinese Canadian doctors in Toronto have urged, through an open letter, that anyone returning to Canada from a trip to China be instructed to self-quarantine; enter a voluntary, 14-day quarantine. This recommendation is a critical step beyond what now constitutes public health policy. As far as Dr. Zheng and his colleagues are concerned, tougher measures are required to control the emerging infectious outbreak.

The federal government should, according to the contents of the letter, take steps to ensure such isolation is mandatory for not only people returning to Canada from visits to China, but should include other COVID-19 hot spots like South Korea, Iran and Italy, all with significant outbreaks. The fly in that ointment, of course, is that with the rapid spread of the coronavirus and its demonstrated ability to proliferate as it has done in Italy, Iran and South Korea, before long visitors arriving from just about anywhere in the world may bring the virus with them.

Canada and the United States also bear the risk of becoming one of those countries, and should the status of global pandemic be bestowed upon the global outbreak by the World Health Organization, it may become imperative that all countries close their borders in an effort to contain the virus internally while halting additional influxes from abroad. There are now 50 countries of the world known to identify instances of the novel coronavirus in their populations.

A woman wears a surgical mask in Vancouver amid fears over the COVID-19 coronavirus. Seven of Canada’s 13 cases are in British Columbia. Arlen Redekop/Postmedia

 In Canada, health authorities are urging people to take action to prepare for a worst-case scenario of a possible lock-down of cities similar perhaps to what has taken place in China where Hubei province with its hugely populous cities, including its capital Wuhan, with a combined total close to 60-million people have been quarantined; people instructed to remain where they are, no one permitted to leave or to enter the cities.

Canada's chief public health officer has advised businesses, governments and individuals to prepare for a pandemic.That individuals stock up on necessities such as non-perishable foods and prescription medications. Above all, health authorities advise to do the simplest and most effective of routine hygienic practices; wash hands, frequently and thoroughly to aid in a bid to stop transmission of the virus.

Out of China comes news that infectious disease authorities there reveal that 14 percent of patients who recovered from the virus continued to test positive after recovery and it is unknown whether they remained contagious. Scientists have concluded that this disease represents a dangerous mix of lethal, communicable and difficult to detect, with a long incubation period where people showing no symptoms could be infecting others for days or weeks before becoming symptomatic.

A member of the Japanese house of representatives, in Tokyo, adjusts her face mask during a session on 27 February. Photograph: Masatoshi Okauchi/REX/Shutterstock

Toronto has now identified its first COVID-19 case traceable to Iran. The Canadian Pandemic Influenza Preparedness: Planning Guidance for the Health Sector represents a document "that outlines how jurisdictions will work together to ensure a coordinated and consistent health sector approach to pandemic preparedness and response". It sounds reassuring but only when it becomes necessary to bring it to action will we know if it is effective.

Should it become necessary, the plan is to advise people not to gather in large groups. It might become necessary, as Japan has now done, to close all schools even though the spread of the virus within child populations has not yet been identified. What is generally seen as impractical and potentially costly is to close down borders given the obvious detrimental effects on trade and food shipment along with "significant negative social, economic and foreign policy consequences".

COVID-19 is known to cause only mild illness for most people infected, even though a small proportion of people become severely ill. The death rate is counted between two and four percent in Wuhan the epicentre of the infection, and 0.7 percent elsewhere in China and around the world. For older people it is more fatal, along with people having pre-existing medical conditions and/or compromised immune systems; there the death rate leaps to nearly 15 percent for those over 80.


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