A Newmarket woman is one of four people who have tested positive for the new coronavirus known as COVID-19, York Region’s public health department confirmed in a Sunday, March 1 statement.
All four confirmed positive cases so far of the emerging virus in York Region were announced this past weekend on Feb. 29 and March 1 by the region’s medical officer of health, Dr. Karim Kurji.
The Newmarket case involves a female resident in her 70s who was in Egypt with the recently reported positive Egypt travel-related Toronto case.
She was tested and assessed at Southlake Regional Health Centre on Saturday, Feb. 29. Since her testing, she has been in self-isolation and York Region Public Health is working to conduct a risk assessment and follow up with the Newmarket woman’s contacts.
Meanwhile, at a news conference Saturday, Feb. 29 at the region’s administrative headquarters in Newmarket to discuss the details of the first COVID-19 case, Dr. Kurji said it was only a matter of time before York Region would see its first case of COVID-19.
“We have a community that has a lot of ties with many parts of the world and I think one of the great things about our community is they seem to be quite health conscious and diligent in taking measures to avoid any exposures to society,” Dr. Kurji said.
“I haven’t seen anything like that with respect to all 200 people we investigated (for possible infection). They have been extremely good. They get private vehicles from the airport, limit exposure to the community, and have acted correctly when they got home,” he said.
The first Iran-related travel case involves a Richmond Hill woman in her 30s, and now includes her husband. The couple travelled together with their toddler to visit family in Iran.
The woman developed symptoms prior to her return to Richmond Hill on Feb. 26. On Feb. 27, she was tested and assessed at Mackenzie Health hospital in Richmond Hill. She is in self-isolation and is recovering at home.
Dr. Kurji said the woman was exposed to her mother-in-law during the visit, who had cold symptoms.
The husband, who is in his 40s, was asymptomatic on all three flights the couple took, which included: Business class seating on Qatar Airways flights QR 483 and QR 163 on Feb. 25, with a layover in Copenhagen, Denmark; and an Air Canada flight AC 883 to Toronto’s Pearson International Airport on Feb. 26.
The family then, on Feb. 26, boarded GO bus #40 about 3:55 p.m. heading to Richmond Hill Centre station. They sat on the upper deck of the bus.
The husband was tested and assessed at Mackenzie Health hospital in Richmond Hill on Feb. 28. He had self-isolated prior to developing symptoms and has had no community exposure while symptomatic.
Dr. Kurji said self-isolation is a major process as an individual is not supposed to share bathrooms, must be in a room by themselves, keep at least a 2-metre distance from others, not share utensils, and wear a mask.
The Richmond Hill couple are well, Dr. Kurji said, adding that the husband had some symptoms that could be attributed to shovelling snow recently. COVID-19 can present itself with symptoms of myalgia, or muscle pain, he said.
The toddler will be tested, as well, Dr. Kurji said.
“You can imagine how challenging it is for the family when you have a toddler who can’t see their mom, so it’s a challenging circumstance,” he said.
York Region public health is asking anyone who was travelling on these same routes to contact them immediately as they may have been exposed to the positive case of COVID-19.
You can call the region’s Health Connection department at 1-800-361-5653 for assessment.
Dr. Kurji noted that as a result of the coordinated and collective efforts of the local health care and public health system, the Richmond Hill woman was quickly assessed and isolated.
The fourth local positive case involves a male in his 50s, a Toronto resident who is temporarily living in Vaughan.
He is the brother of one of Toronto’s recently reported cases who travelled to Iran. He did not develop symptoms until after his arrival in Canada. He also self-isolated and has had no community exposure. He was assessed and tested at Mackenzie Health hospital on Feb. 28.
With regard to exposure to COVID-19 involving the Richmond Hill woman who travelled with symptoms, Dr. Kurji said there are a number of areas where it could potentially occur.
“Let’s start with the plane, there were three flights the individual was on, and having had symptoms on the plane means this individual was infectious,” Dr. Kurji said.
“Now, generally speaking, what we normally do is try to identify individuals sitting two rows ahead, behind, and beside the individual. We contact them to take specific precautions, and that involves self-isolation. For other individuals, we would ask them to monitor for symptoms and signs (of the virus) for 14 days.”
York Region’s public health has requested a flight manifest of all aircraft involved so they can be contacted, interviewed, and educated about potential exposure and next steps.
“We believe in aggressive contact follow-up and this is the strategy that we use with respect to containing the spread of COVID-19, it is a strategy that worked with SARS, and we have every confidence that we would be able to contain the exposures,” said Dr. Kurji.
“We have been through almost 200 persons under investigation (as of Feb. 29) in York Region and we must have isolated close to 600 individuals, but we are very fortunate that the lab system today has a great turnaround time and we are able to reassure individuals,” he said.
The risk level on the GO bus is much lower than in a plane, Dr. Kurji said.
“There’s more ventilation, the period of travel is less, and that means exposure is limited, as well,” he said. “But those individuals should get in touch with us, as well, to understand the risks, know the symptoms and signs, and if there were unusual circumstances, we can act,” he said.
Dr. Kurji warned on Feb. 29 that it wouldn’t be unusual to possibly get additional cases in the coming days and weeks. Three new cases were confirmed a day after the first Richmond Hill case was announced.
“We honestly believe there is no virus circulating in the community as yet,” Dr. Kurji said, noting that all cases to date are travel-related.
COVID-19 is spread through droplets, through a cough or sneeze. Symptoms can include fever, cough and shortness of breath.
“The virus could possibly go about 2 metres away and land on surfaces. There are controversies about how long the virus could last on surfaces, but a majority of people feel it’s less than nine days,” he said. “Theoretically, it is possible for somebody to touch those surfaces and touch their mucus membranes, the eyes, nose and mouth, and become infected,” Dr. Kurji said.
York Region Public Health is actively following up on all close contacts of these positive cases. Individuals that were not in direct or close contact with these individuals are not considered at risk of becoming infected.
The risk to York Region residents of COVID-19 continues to remain low and there is no evidence of community spread within York Region.
York Region Public Health continues to collaborate with local hospitals, emergency services and other health agencies to ensure prompt reporting and follow up of all individuals who may require testing for COVID-19.
Residents can take the following steps to protect themselves from this new and emerging disease:
- Avoid touching your eyes, nose or mouth with unwashed hands
- Wash your hands frequently and thoroughly, including between your fingers, under your fingernails and your wrists. If soap and water are not available, use an alcohol-based hand sanitizer
- Cover your cough or sneeze using a tissue or into your elbow or sleeve, being sure to cover your mouth. Put used tissue in the garbage and wash your hands after or use alcohol-based hand sanitizer
- If you are sick, stay home from work or school until your symptoms resolve. If symptoms get worse, you may need to seek medical attention. Call your health care provider first, when possible
- Avoid close contact with anyone showing symptoms of respiratory illness such as coughing and sneezing
- Increase cleaning and disinfection frequency of high-touch surfaces such as toilets, sink tap handles, doorknobs, countertops, light switches and other shared items using regular household cleaners
- Avoid sharing personal items that come into contact with saliva such as toothbrushes, eating utensils drinks/water bottles and towels
Today, March 2, World Health Organization director-general, Dr. Tedros Adhanom Ghebreyesus, provided a briefing on COVID-19.
Here is his statement in full:
The number of cases in China continues to decline.
Yesterday, China reported 206 cases of COVID-19 to WHO, the lowest since the 22nd of January. Only 8 cases were reported outside Hubei province yesterday.
Outside China, a total of 8739 cases of COVID-19 have been reported to WHO from 61 countries, with 127 deaths.
In the last 24 hours there were almost 9 times more cases reported outside China than inside China.
The epidemics in the Republic of Korea, Italy, Iran and Japan are our greatest concern.
I would also like to inform you that a WHO team arrived in Iran this afternoon to deliver supplies and support the government in the response.
I would like to use this opportunity to thank Crown Prince Sheikh Mohammed bin Zayed Al Nahyan of the United Arab Emirates for his support in making this mission possible.
A WHO staff member in our Iran country office has now tested positive for COVID-19. He has mild disease.
The Republic of Korea has now reported more than 4200 cases and 22 deaths, meaning it has more than half of all cases outside China.
However, the cases in the Republic of Korea appear to be coming mostly from suspected cases from the 5 known clusters, rather than the community.
That’s important because it indicates that surveillance measures are working and Korea’s epidemic can still be contained.
Knowing and understanding your epidemic is the first step to defeating it.
Korea’s situation also underlines that this a unique virus with unique features. This virus is not influenza.
We are in unchartered territory. We have never before seen a respiratory pathogen that is capable of community transmission, but which can also be contained with the right measures.
If this was an influenza epidemic, we would have expected to see widespread community transmission across the globe by now, and efforts to slow it down or contain it would not be feasible.
But containment of COVID-19 is feasible and must remain the top priority for all countries.
With early, aggressive measures, countries can stop transmission and save lives.
We appreciate that people are debating whether this is a pandemic or not. We are monitoring the situation every moment of every day, and analyzing the data.
I have said it before and I’ll say it again: WHO will not hesitate to describe this as a pandemic if that’s what the evidence suggests.
But we need to see this in perspective. Of the 88,913 cases reported globally so far, 90% are in China, mostly in one province.
Of the 8739 cases reported outside China, 81% are from four countries.
Of the other 57 affected countries, 38 have reported 10 cases or less, 19 have reported only one cases, and a good number of countries have already contained the virus and have not reported in the last two weeks.
We know people are afraid. We know they have many concerns and questions.
Is the virus spreading in my community?
Will my kids be okay?
Will my parents be okay?
Is it safe to hold an event?
Should I travel?
The answers to these questions will vary depending on where you live, how old you are, and how healthy you are.
Individuals, families and communities should follow the advice provided by local health authorities and local health professionals.
WHO will continue to provide evidence-based guidance to help countries and individuals to assess and manage their risk, and make decisions.
There is no one-size fits all approach. Different countries are in different scenarios.
More than 130 countries have not detected any cases yet.
Some just received their first cases yesterday.
Some have clusters of cases, with transmission between family members and other close contacts.
Some have rapidly expanding epidemics, with signs of community transmission.
And some have declining epidemics, and have not reported a case for more than two weeks.
Some countries have more than one of these scenarios at the same time. For example, China had community transmission in Wuhan, but relatively small numbers of cases in other provinces.
Other countries have a similar pattern.
WHO is advising countries on actions they can take for each of the “three Cs” scenarios – first case, first cluster, first evidence of community transmission.
The basic actions in each scenario are the same, but the emphasis changes depending on which scenario a country is in.
Our message to all countries is: this is not a one-way street. We can push this virus back.
Your actions now will determine the course of the outbreak in your country.
There’s no choice but to act now.