‘Too soon to let our guard down’: How Canada has avoided a surge of COVID-19 cases in hospitals

Canada has not seen the anticipated surge of COVID-19 circumstances in hospitals that many feared would overwhelm the health-care system and result in a spike in deaths, however consultants say stress-free bodily distancing measures anytime quickly may put that in jeopardy.

There are almost 30,000 presumptive and confirmed cases in Canada, however Chief Public Well being Officer Dr. Theresa Tam acknowledged “cautious optimism” Wednesday as the speed of recent circumstances went from roughly doubling each three days to each 10 days. 

“We have carried out very well. If you happen to examine to the place Italy’s been and the place New York Metropolis is – we’re not there,” mentioned Dr. Michael Gardam, an infectious illness specialist and chief of workers at Humber River Hospital in Toronto.

“And daily that goes by, it is much less and fewer seemingly we’ll get there.” 

However whereas Canada has handed the grim milestone of 1,000 deaths from COVID-19, with Tuesday marking the deadliest day to this point with 147 deaths recorded, hospitals and intensive care models have to date efficiently managed the scenario.

“We have had a gradual, regular enhance in hospital admissions and a really gradual, regular enhance in ICU admissions,” mentioned Gardam, a veteran of SARS and H1N1 who has adopted this outbreak carefully. 

“So all that means that we have positively flattened the curve and we’re at a degree the place, presumably within the subsequent week, we’ll see these numbers beginning to go down.” 

How has Canada averted a surge?

Virtually half of Canada’s COVID-19 deaths have been in nursing and retirement houses, Tam mentioned earlier this week, that means the scenario will seemingly worsen as a lot of these sufferers die earlier than making it to hospital. 

“Even because the numbers of circumstances slows down the variety of deaths, sadly, are anticipated to extend,” Tam mentioned at a media briefing in Ottawa on Monday. 

Canadian hospitals took an “all fingers on deck” method to making sure they’d have the ability to take care of a surge in sufferers, mentioned Dr. Isaac Bogoch, an infectious illness doctor at Toronto Common Hospital. 

That included stopping elective surgical procedures and different procedures, growing laboratory capability for testing, reallocating workers to the entrance traces and increasing ICU beds. 

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“Fortunately, to this point, we’ve not actually required that a lot of this surge capability,” he mentioned. “However in fact, we all know that it is nonetheless too quickly to let our guard down.”

Dr. Lynora Saxinger, an infectious illnesses professor on the College of Alberta, mentioned in an electronic mail that Canada could have additionally averted the worst case eventualities different international locations have skilled from COVID-19 largely by likelihood. 

“I believe it’s seemingly a mix of well timed public well being actions and luck in not having giant superspreader incidents previous to these limits, as we have now seen in international locations the place the actions of a single affected person had been accountable for 1000’s of infections,” she mentioned. 

Saxinger referenced “Patient 31” a 61-year-old lady in South Korea who uncovered over 1,000 folks to the virus after attending non secular providers at a department of the Shincheonji Church of Jesus within the southeastern metropolis of Daegu.

“Definitely something that will increase the potential for contact between contaminated folks, who is probably not all that sick, and inclined folks, which is mainly everybody who has not been contaminated, could make this flip for the more severe. At any time.” 

Saxinger mentioned bodily distancing measures are “completely crucial” to regulate the epidemic of the coronavirus in Canada, and that lifting these measures must be carried out in a approach that’s “very cautious.”

Is Canada nonetheless vulnerable to a surge? 

Regardless that the curve flattening out, Canada remains to be reporting greater than 1,000 new COVID-19 circumstances per day — circumstances that can seemingly should be handled in hospitals and ICUs and pressure the well being care system. 

“Slightly than a flood, we’re getting a gradual stream, and it is extraordinarily essential to not get complacent right here and to actually make sure that our bodily distancing measures and the general public well being measures which can be in place are maintained in place,” Bogoch mentioned. 

“What we actually wish to see is a discount within the variety of new circumstances per day. Then and solely then can we begin to chill out a bit bit on the hospital aspect and recognize that we’ll have the suitable sources to take care of the sufferers which can be coming within the entrance door.”

Canadian hospitals have been making ready for a surge of COVID-19 circumstances for months by taking an ‘all fingers on deck’ method, says Dr. Isaac Bogoch at Toronto Common Hospital. (Luca Bruno/The Related Press)

The charges of deaths and hospitalizations may additionally proceed to rise even after each day case numbers have flattened out due to the delayed snapshot we have now from the information as a result of it may possibly take as much as 14 days earlier than signs of COVID-19 can current. 

“Right this moment’s knowledge displays what occurred a few weeks in the past,” mentioned Dr. Srinivas Murthy, an infectious illness specialist and medical affiliate professor in pediatrics on the College of British Columbia. 

“So we actually have to present it time for us to actually perceive what the illness trajectory is in any area.” 

Murthy mentioned a surge may nonetheless occur in Canada as a result of “unpredictable” approach by which they come up — similar to an outbreak at a long-term care facility or a big cluster of circumstances due to folks flouting bodily distancing measures. 

“Surges are all the time seemingly, the truth is, not simply potential,” he mentioned. “We’re simply hoping that it would not happen.” 

A health-care employee walks with a affected person exterior of Mount Sinai Hospital in downtown Toronto on April 6. Dr. Srinivas Murthy mentioned a surge may nonetheless occur in Canada as a result of “unpredictable” approach by which they come up. (Evan Mitsui/CBC)

Calgary emergency division doctor Dr. Joe Vipond mentioned that whereas the surge of circumstances in hospitals and ICUs may have been worse at this level in Canada, the scenario can be fully “risky.” 

“It could actually flare up once more immediately if we chill out our guard and so we have now to maintain all of our measures in place till we cease seeing circumstances and that may very well be some time,” he mentioned. 

“We do not actually know the place we’re going. And so I believe that the worst factor we are able to do is begin to suppose ‘Nicely, I am glad we missed that.’ As a result of what we actually needs to be considering is, ‘I am so glad we have had this additional time to arrange.’ 

“And if it is not as dangerous as we thought on the finish of all of it – have fun that. However we’re too early to start out celebrating now.”

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