Officials warn about large events as 7th COVID-19 case confirmed in York Region

'Unfortunately, we don’t have 100 per cent assurance that every traveller from a high-risk place, the newest being Iran, observes the 14-day period of self-isolation, even though we may call them frequently,” York medical officer of health says

Barrietoday.com
March 9, 2020
Kim Champion

As York Region public health yesterday confirmed the seventh positive case of COVID-19, medical officer of health Dr. Karim Kurji cautioned religious and community leaders to mitigate the risks associated with large-scale celebrations, such as the upcoming Persian and Baha’i new years, Easter, Passover, and others.

The region’s seventh case of the coronavirus, known as COVID-19, was confirmed about 4 p.m., March 6, and involves a 64-year-old Richmond Hill woman who arrived home from Egypt on March 2.

She is now in isolation and public health investigators have followed up so far with 60 of her casual contacts and 17 of her close contacts, eight of which are being handled by Toronto’s public health department.

“One of those close contacts has turned out to be negative, and we are still awaiting results on the others,” Kurji said, adding that York Region is working closely with its Toronto counterparts.

Two other York Region COVID-19 patients, one woman from Newmarket and a second woman from Richmond Hill, were both confirmed positive after travel to Egypt that has been linked to exposure while on a cruise ship.

York Region’s four other confirmed positive cases of the coronavirus have been linked to travel in Iran, which the federal government has recently added to the list of high-risk countries as there are indicators that suggest widespread community, or person-to-person, spread occurring.

One of York Region’s positive cases is now asymptomatic, Kurji said, and is expected to be cleared of the virus in the next day or two.

To date, York Region public health has investigated an additional 364 people for COVID-19 and all have come back negative, Kurji said.

There is no evidence of community transmission and the risk remains low, Kurji said.

Meanwhile, what York Region is experiencing is that residents are bringing the virus back from affected countries, said Kurji, adding that upcoming large-scale religious celebrations pose challenges and difficulties in containing COVID-19.

“The main risk comes from somebody breaking self-isolation and coming into a large event that one may have organized,” Kurji said. “This can happen because a person didn’t fully understand their responsibilities during self-isolation, language barriers, or other reasons.

“Unfortunately, we don’t have 100 per cent assurance that every traveller from a high-risk place, the newest being Iran, observes the 14-day period of self-isolation, even though we may call them frequently,” he added.

Kurji noted that given the strained resources in the health-care system, public health investigators may not be able to handle following up with contacts and case investigations of very large numbers of individuals.

“That would be a great strain on our resources, a strain on laboratory resources as far as testing goes, and also a large number of members of congregations may well have to go into self-isolation depending on what follows,” he said.

“Activities like singing, when an infectious individual sings, the droplets may go way beyond the immediate vicinity of that individual. Are you sharing food? If a sick person coughs on a buffet, it is possible that we may have a problem,” said Kurji.

The Ontario government has implemented a surveillance program with several Toronto-area hospitals, which now includes Mackenzie Health in Richmond Hill, where specimens tested for influenza are also tested for COVID-19.

In addition, the Public Health Agency of Canada has produced a risk-assessment tool for large-scale events that may have the potential for public health consequences if they are not planned and managed carefully.

That’s because large numbers of people in small areas can enable the spread of infectious diseases.

Examples of large-scale events include conferences, sporting events, and celebrating religious, national and international events.

Decisions about whether to proceed, restrict or postpone such an event should be based on a risk assessment undertaken by event organizers to reduce the risks posed by large-scale events that include:

• Reduce the numbers of participants
• Stagger the event over two or three days to keep the numbers low
• Keep the session short
• Avoid crowding and provide extra space for participants
• Replace buffet-style foods with packaged foods
• Consider asking vulnerable older adults to stay at home
• Communicate that those who are sick should stay home
• Communicate in advance that individuals under 14-day self-isolation must not attend
• Increase access to and the number of hand-washing stations
• Promote personal protective practices (hand hygiene, cough etiquette)
• Promote environmental cleaning (disinfect common areas)
• Offer alternative ways to participate in the event (virtual or live-streamed activities)
• Change the program to reduce activities that could contribute to spread, like singing or cheering
• Have a mechanism for public health to contact all participants after the event

As with other respiratory illnesses, COVID-19 can cause mild symptoms, including cough and fever. It can also be more severe for some people and lead to pneumonia or breathing difficulties, organ failure and even death.

Available information indicates that older people and people with a weakened immune system or underlying medical conditions are at a higher risk of developing severe disease.