The superspreader events that governments let happen

Nora Loreto: Scientists warned about the danger of superspreader events in workplaces. But across Canada, politicians did little to address them—with catastrophic results.

Macleans.ca
April 19, 2021

When British Columbia’s provincial medical officer Bonnie Henry gave the green light for skiers to hit Whistler’s slopes last Feb. 5, the resort town was already dealing with a lot of COVID-19 cases. With about 12,000 permanent residents and many seasonal staff, Whistler had had 547 infections the month previous, a rate of 2,193 cases per 100,000 people.

Fast forward two months and British Columbia is now home to the world’s largest outbreak of the COVID-19 variant P1 outside of Brazil, where it originated. The Guardian reported that nearly a quarter of all cases in the province are linked to Whistler—a place where people live with multiple roommates, where social distancing is difficult and where front-line workers were expected to keep showing up to work. By April, Whistler’s COVID-19 infections had surpassed 1,500 people.

The outbreak at Whistler is many things: a cautionary tale of leaving tourism open, including welcoming tourists from other parts of Canada. It’s also the story of how young people found themselves classified as essential workers and were forced to keep working and living in conditions that were susceptible to rapid spread of COVID-19. But above all, it’s the story of a massive superspreader event, one that helped to propel British Columbia into its third wave and one that should have been foreseen and could have been avoided.

Scientists have warned about the danger of superspreader events from the beginning of the pandemic. Increasingly, scientists are understanding the site where everything began, the market in Wuhan, China as having been a superspreader event, rather than the source of COVID-19 itself. Superspreader events are so dangerous because COVID-19 is not spread equally by everyone. Research estimates that between two and 10 per cent of individuals are responsible for somewhere between 20 per cent to 80 per cent of all infections. Knowing that, social distancing, masking and isolation have become important tools to control spread.

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But individuals can only obey these rules to an extent. Canada’s largest superspreader events were in workplaces vulnerable to swift infection spread and where workers had little power to keep themselves completely safe. The rapid spread and mass death within long-term care facilities were effectively superspreader events, with the worst ones resulting in hundreds of primary infections and dozens of deaths.

Rather than seeing the impact that these infections had on driving community transition outside of their walls, politicians insisted that they instead could be isolated and protected from community transmission. In November, Ontario Minister of Health Christine Elliott promised to place an “iron ring” around residential care facilities to try and stop the spread. Cases exploded within residential care in the weeks and months that followed.

There have been thousands of superspreader outbreaks in Canadian workplaces, and some have been massive. Cargill’s High River beef factory had an outbreak that infected at least 950 employees. Dozens of other meat packing facilities have also had superspreader outbreaks, resulting in thousands of infections and at least 18 deaths across Canada. Shipping and transportation, construction, office work and other large congregant settings have been the sites of major superspreader outbreaks, though they were rarely talked about as such.

Instead, the superspreader designation tended to be kept for more social events: a wedding in Vaughan, where nearly 50 people got sick, a curling bonspiel connected to at least 54 cases. Spinco spinning studio in Hamilton, where 44 were infected. Or Quebec City’s now-famous Méga Fitness gym, which is connected to more than 500 primary and secondary cases, and at least one death.

But even these events happened at workplaces. Workers at Whistler were at increased risk of catching COVID-19. Banquet workers, food service workers, personal trainers and instructors are all at risk at weddings, funerals or fitness classes. And superspreader events have the potential to create even more superspreader situations. The Méga Fitness outbreak, for example, triggered at least 49 workplace outbreaks across Quebec City and helped to push infections to a record high. Schools were closed and tight social restrictions were re-introduced as a result.

It’s been long known that superspreader events are dangerous. In November, engineering professor at Carleton University Gabriel Wainer wrote in The Conversation that, “The pandemic has largely been driven by superspreader events.” Worried about a second wave, he argued that modelling could show policymakers how to avoid what makes superspreaders so dangerous: mapping airflow to reduce aerosol transmission, modelling the number of people in an enclosed room, and so on.

But governments did very little to try and tackle superspreader events. Instead, every government from Quebec to British Columbia, classified the largest congregant work settings in construction, manufacturing, resource extraction and many offices as essential, exempting them from closing when governments enacted strict measures. In allowing large congregant workplaces to operate, even in cases where their work was arguably not essential, like mining, construction and industrial manufacturing, COVID-19 continued to spread.

As COVID-19 cases tailed off after the winter holidays, aided especially by residential care residents and workers having access to vaccines, politicians from B.C. to Quebec became complacent. They opened businesses back up accompanied by pleading words from officials who begged the population to not ruin it this time.

Of course, COVID-19 can’t be resisted through politician’s good words or medical officers pleas. It can be resisted through policies that would restrict superspreader events from continuing. But just as a small number of individuals are responsible for a large amount of the COVID-19 spread, so too is this true for businesses. And fuelled by vaccine confidence, people returned to gyms, to ski resorts or restaurants, hoping that this time, another wave could be avoided.

On March 20, the Canadian Press published a warning from the head of the Sinai Health System-University Health Network’s antimicrobial stewardship program Andrew Morris. He argued that relaxing measures in Ontario likely would lead to superspreader events. Capacity in restaurants in regions with the most COVID-19 cases was increased from 10 to 50, and in Ontario’s orange zones, increased to 100.

At the same time, large congregant workplaces that were considered essential continued to operate as usual. This combination launched Ontario into its worst wave yet. A Cargill poultry plant in London closed on April 15, after 82 workers were infected. Cargill should not have waited so long to close down, but it wasn’t  compelled to close either.

Governments have allowed corporations to police themselves. From Amazon to Cargill, from Maple Leaf to Canada Post, large work settings have become the engines of COVID-19 spread in their communities. And the consequences have been deadly. In my research, I have found at least 71 workers have died from COVID-19 infections acquired through a workplace outbreak. This is count is undoubtedly low, as it’s based on information gleaned from news reports and obituaries. There is no agency publicly tracking workplace-related COVID-19 deaths in Canada.

On April 8, B.C. finally announced that it would institute an order that would fast-track workplace closures in the case of a workplace-linked outbreak of three or more employees. WorkSafeBC would be able to issue an order to close for 10 days or longer. But in Alberta, Saskatchewan, Manitoba, Ontario and Quebec, the measures don’t seek specifically to reduce infections in large congregant settings, despite the fact that the third wave is placing tremendous pressure on hospital systems.

At month 14, it’s unacceptable that there still isn’t consistent protocol to limit the possibility of superspreader events. Whistler was well on its way to being a disaster when Henry allowed it to open in February. Méga Fitness Gym’s owner Dan Marino had been a vocal opponent of anti-COVID-19 measures and who had flaunted public health orders the moment his gym opened for the first time since summer 2020.

These events were foreseeable and preventable. But without containing COVID-19 in the largest congregate settings, and allowing facilities to manage their own outbreaks, governments have outsourced one of the most important COVID-19 mitigation strategies that exist.