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There are 14 new confirmed cases of COVID-19 in Nova Scotia announced today, bringing the total to 207. Five people are in hospital, but 21 have fully recovered. See the Examiner’s charts tracking the progress of the disease, and the response to it, here.
Dr. Robert Strang, the province’s chief medical officer of health, said that 92% of the cases can be linked to travel or to previous cases. One person who has tested positive is being a labelled a definite case of community spread, but while contact tracing continues, other cases appear to be community spread as well.
“We’re seeing signals that make me increasingly concerned that we do have the beginnings of community spread here in Nova Scotia,” said Strang.
Magnolia
Yesterday, my colleague Jennifer Henderson asked Strang for more details about the outbreak of COVID-19 at the Magnolia residential care home in Enfield. Today, Strang provided a bit more information.
Three staff and two residents at the facility have tested positive for COVID-19. No other residents or staff have become ill.
There was “an educational event for staff” and a “family gathering on March 11 at that facility that brought out-of-province visitors,” said Strang. “So it’s a complex investigation with lots of interactions between staff and residents and the community.”
What Strang hasn’t addressed is if the staff involved are Continuing Care Assistants (CCAs). That’s important to know because CCAs typically work at more than one location — they might work at a nursing home part time, and also part time in another facility or as a home health worker, for example — and therefore might have been a vector for the disease to enter multiple sites.
Masks
Strang spoke of the “growing evidence” of the effectiveness of the general public wearing masks to help limit the spread of the disease.
“The Public Health Agency of Canada is looking at that, and as soon as they can, they’ll be providing a review of all the evidence and … we’ll use that to guide further action,” said Strang.
However, Strang noted that there are “global and national supply challenges around masks, and it’s very important that surgical grade masks are preserved and used for health care workers and other essential workers.” He added that if the public chooses to wear masks, they should not be these.
Earlier today, five public employee unions representing health care workers issued a joint statement calling for more distribution of personal protection equipment, including masks, among health care workers. The statement insists that:
All health care workers who are within two metres of suspected, presumed or confirmed COVID19 patients shall have access to appropriate PPE. This will include access to; surgical/procedure masks, fit tested NIOSH-approved N-95 respirators, gloves, face shields with side protection (or goggles), impermeable or, at least, fluid resistant gowns.
The statement was issued via a press release that said the demands are “similar to protocols that have recently been adopted by the provincial government and employers in Alberta and Ontario”:
On Monday, the protocol was sent to Premier Stephen McNeil, Health & Wellness Minister Randy Delorey, Chief Medical Officer Robert Strang, as well as Dr. Brendan Carr at the NSHA and Dr. Krista Jangaard at the IWK.
So far, government and employer representatives have not agreed to sign the document.
While Strang did not mention the unions’ statement, he did address it:
There are national guidelines developed by experts in infectious control that guide infectious control measures in Nova Scotia, and they include directives, or guidance on, what types of masks and other personal protective equipment are required to keep health care workers safe. We know that because COVID-19 is spread by droplets, and it is not airborne spread, that there are only specific circumstances in a health care environment where an N-95 mask is required.
Now, especially when we have these supply challenges globally and nationally, it’s very important that we use masks as appropriate. And the pressure to use N-95 masks [and] higher levels of personal protective equipment where the evidence does not say they are necessary, quite frankly, puts us into the possibility where in a few weeks time, when we get more Nova Scotians in hospitals, we may not have the supply of N-95 masks that are necessary in circumstances where there’s no disagreement at all that N-95 masks are necessary.
More on testing numbers
I asked Strang about my confusion about testing numbers. Recently, he said that tests were being processed in the lab with results returned on the same day, and yet the number of tests conducted daily he cites in the daily briefings is considerably higher than the numbers issued by the Department of Health.
To explain further, each day, the Department of Health issues a press release providing the total number of people tested by the end of day the day before. For example, today the release read “To date, Nova Scotia has 8,234 negative test results and 207 confirmed cases,” or a total of 8,441 total tests through Wednesday. Yesterday, the release read, “To date, Nova Scotia has 7,446 negative test results and 193 confirmed cases,” or 7,639 total tests through Thursday.
If you subtract yesterday’s total from today’s total, you get 802 tests, which was presumably the number of tests completed Thursday. But today Strang said “over 1,000 tests” were completed yesterday. And today’s Health Department release said “almost 900” tests were completed yesterday.
I’ve been trying to get a coherent explanation for that discrepancy all week, to no avail. However, in response to my question today, Strang brought a welcome degree of clarity to the issue:
I think you need to understand that we can’t match up directly, because some tests are indeterminate and have to be repeated. [And] the lab has been supporting St. Pierre and Miquelon — if they get tests, they come into us. A couple of weeks ago Moncton got into trouble and we supported Moncton temporarily. We did the same with Happy Valley-Goose Bay, being good neighbours, so what we’re reporting in Nova Scotia is not indicative of everything that’s going through the lab.
Good answer! I wish someone had simply said that Monday; it would’ve saved me a lot of grief.
It’s good to be good neighbours, and the complexity of indeterminate tests makes sense. And while I get that Strang has been focussing on lab capacity and showing how that capacity is increasing — which is clearly a good thing — for my purposes, what’s worth tracking is the total number of Nova Scotians tested and what the results were. So that’s how I’ll frame my tracking of this moving forward.
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The Premier obviously understood the danger of this pandemic earlier than many others. The provincial budget has a cushion in excess of $350 million for unexpected expenditures. The House of Assembly session was short, probably in preparation of clearing the decks for COVIC-19. We have been following this outbreak since a late January message from China and with updates since then.
Tim, I firmly believe you can,t test enough, but of course resources are limited, I think the crucial numbers will be how many are hospitalized/serious/critical and while it had not been said there can certainly be those who would choose to die at home or a long term care facility. And my2 cents worth on masks, sure save the gold standard N95 for health care in soecific settings but you dont really need a study to realize even a cotton kerchief offers some “potential” benefit for spread.