On Tuesday afternoon, Mayor Darrin Canniff; Dr. David Colby, C-K medical officer of health; CAO Don Shropshire; and Lori Marshall, president of C-K Health Alliance, participated in an online question-and-answer session for the public. Here are their direct answers to the public’s most-asked questions regarding COVID-19 and self-isolation.
Q: This is a question that I think all three of you can contribute to. Dr. Colby, from a community perspective, (Shropshire) from an employer aspect, and (Caniff) from personal. How do we ensure people properly self-isolate when they have travelled?
Colby: This is difficult and it may change today, in fact, but we largely rely on the willingness of people to contribute to the common good, and do what we asked them to do. This is essential. We all have to co-operate.
As far as enforcement goes, the federal government is looking at making a criminal penalty for people who do not self-isolate after a trip outside of Canada. That is not the case. At the moment these remain very strong suggestions, but the consequences of not doing that is the cost of life.
Shropshire: From the municipality standpoint, as an employer, we’re exercising a number of changes to make sure people are safe. We’ve asked supervisors to track every one of their employees that have travelled outside of Canada. We’ve ensured that those people, when they come home, are directed to self-isolate for 14 days.
We’ve also provided additional information to all of our employees to maintain social distancing within their workplace and also in some cases with their family members. And we have ensured that everybody has ongoing information in support as to how to practice your hygiene measures so that they can continue to be safe at home and at work.
Caniff: I’ve been living with it firsthand. Some of my family left before there were warnings, and hindsight is 2020. If we knew then, they wouldn’t have went, but at the time if you weren’t travelling to Iran or Italy or China, it was fine to go.
So they came back. They’ve been self isolating, and I’ve been doing everything to stay away from them.
The children came back three days ago. They’re living in the basement and I don’t think I’ve seen them in the last day and a half. But they’re self-isolating, and I’m self-regulating on a daily basis. My wife’s nine days in, there’s no symptoms, etc. But living with that, and keeping my social distance, etc. is based on what public health has said. I’ve been consistently consulting with them to ensure that we’re meeting all standards on that.
Q: The self-distance, is that for people who have been in close contact with their family?
Colby: It’s pretty hard to maintain that type of thing with a normal family that would be affectionate with one another. Obviously, unless as the mayor gave his personal story earlier, that people are actually instructed to self isolate, then it’s very much discouraged. But the larger the group, the more the hazard.
Q: Lots of people are wanting to know, are they still able to go out to the neighbourhoods or walking and being able to be in open air as long as this outdoor space is empty? Is that still considered social distancing?
Colby: Absolutely. That’s considered social distancing. What we are trying to discourage is gatherings of people in close proximity. Enjoying the outdoors, especially as the weather clears up and gets warmer. That’s one of the great joys of living in a place where we have different seasons.
And I encourage people to do that. Get out and stretch your legs and be healthy. Just stay as far apart as you can practically and don’t associate in large groups. That’s what we’re trying to discourage, not people going outside. Enjoy Chatham-Kent.
Q: For sale sites, like say Facebook Marketplace where people can sell items to each other, where money can be transferred electronically, and products can be left outside for people to pick up on their own, do you still believe that this is something that people shouldn’t be doing during this time?
Colby: No, no reason at all. As much as possible, we would love to preserve normal commerce, in all aspects of society. It’s part of living. But we have to maintain social distancing. So that makes certain kinds of businesses very hard to undertake. And that’s why we have the measures that we do. For this kind of thing I don’t see any kind of potential hazard and no reason to discourage it.
Q: What about drive-thru?
Colby: The usual distance that people have, from their car window to the serving window – and a drive thru is quite substantial – would be at least a metre. There is limited potential for this to be transmitted through inanimate objects. So just washing your hands and using hand sanitizer, and that kind of social distance would mean that those types of interactions are really quite safe. And that may be the only way that we can patronise our favourite restaurants right now.
COVID-19: SAFETY AND TRANSMISSION
Q: Can you explain how the virus is different in its structure from other coronaviruses and what the COVID-19 test specifically looks for to differentiate it from the common flu?
Colby: Well, first of all, influenza viruses and coronaviruses are quite different. They’re both respiratory viruses, but they are not really the same at all. And the first part of the question structurally, you can’t see any difference between this coronavirus and other coronaviruses under powerful microscopes called electron microscopes. They look exactly the same, but they behave differently. The genome, the genetic code in this virus, is about 80 per cent, the same as the SARS virus, but there are differences. The SARS virus was more deadly, but not transmitted as easily. So it was about four times more deadly but it was harder to catch. This one passes very easily between people, which is why we’re taking these unprecedented steps of closing everything down and advocating social distancing. The test is extremely specific, again, based on that genetic code, and the uniqueness of that virus. It’s an excellent test, very sensitive, very specific, very good predictive value.
Q: Is there any timeline for how long the virus is active on a grocery item? Some items could have been handled by numerous people before ending up in my cart. Is wiping the grocery cart with Lysol wipes effective or should we be wearing gloves when we go to the grocery store?
Colby: I really appreciate that question. Viruses are not living things. They’re basically programs that redirect our cells to make viral proteins. Very interesting infections, but by-and-large, the main way that these viruses are transmitted is by direct contact with people and through droplet transmission, which is mainly through coughing, and that’s only within two metres. It is not airborne; it does not go long distances over air.
The question was really about surfaces. So if someone coughs and exposes surfaces to respiratory droplets, then the virus is there. But mainly, it’s the hands that transmit it to the face and to the respiratory tract. So the viruses that are on surfaces don’t last very long. This is a fragile virus; it deteriorates quite quickly under environmental conditions. So if someone coughs secretions onto a surface and that surface is contacted soon, then there is the potential but the dynamics of what we’re seeing by the way that this is transmitted doesn’t support that surfaces are the main way at all. So a little bit of extra disinfection for surfaces that are touched often is certainly a good idea. But it’s more important to wash your hands. Stay away from sick people, stay away from crowds, keep the social distancing. And that way the transmission will be interrupted.
Q: For those businesses that are considered essential that need to stay open and with hand sanitizers being in limited supply, what would you suggest they do to help keep their employees safe?
Colby: Again, social distancing is very important. Rearrange your workflow so that and the way you do business, so as to keep people apart. And we mustn’t forget the value of plain hand washing. That is every bit as good as hand sanitizer, maybe not as convenient, but washing your hands often is a fundamental strategy to prevent you from getting infected.
Q: What can we do with these little stores that are selling things like masks and trying to take advantage of people? I know seniors would buy these, and we can’t let that happen?
Caniff: As far as the federal government says you can’t be doing that during a crisis situation. If anyone experiences that and sees it, there’s a full toll-free number to call and report – 1-800-348-5358. You can report that and the federal government will investigate people’s claims.
Colby: I would just like to take the opportunity to say that you don’t need to wear masks when you’re outside. Masks are intended to contain the infection in people that are probably already infected, and people that are well don’t need to wear masks for their everyday activities.
We are encouraging people to stay home and stay safe. That’s a hallmark of social distancing, physical distancing. But we don’t need to wear masks. There’s a shortage of them right now and we need to reserve them for health professionals.
Q: What are the symptoms:
Colby: The symptoms of COVID-19 infection are fever, sore throat, and dry cough. That’s how it starts. And for the majority of people that’s about all it’ll be, including that kind of feeling that you’re unwell that we get with just about any kind of infection, that’s certainly going to happen. But almost everyone can be managed at home and that is the place for them. That is the best place. Don’t visit your doctor’s office if you’re not very sick. On the other hand, if you’re ill, you’re having shortness of breath, you can’t eat or drink or have any other severe illness, that’s what our acute care medical system is for.
Q: If someone has the symptoms, what should they be doing?
Marshall: What we are recommending is that people first start with the online self-assessment tool and that can walk you through and give you a better understanding of whether or not you need to reach out further. And then the next step we would take would be contacting either Public Health or your own primary care provider – so your family doctor or your nurse practitioner who takes care of you, they know you best – to have a conversation with you, and would then make a recommendation about whether or not you need to come to the Assessment Centre at the hospital. And then if you come you will be assessed there.
We’ve got a process to bring you in, get a little bit of information. Please bring your health card if you’re coming to the Assessment Centre. Then people are being asked to go back to their cars and wait to be brought in to be assessed.
Today, the majority of people that have come to the Assessment Centre are then going home. A few have ended up coming over to the emergency department being admitted and taking all appropriate precaution from that side of things. But for the most part, most individuals that we’re seeing at this stage can certainly be managed at home and with some isolation.
Q: When will C-K start more aggressive testing?
Colby: As soon as testing kits and facilities become available. COVID-19 is springing up all over the world and we live in a multi-national society and personal protective equipment, testing kits and everything are sourced from international sources, some of which have been disrupted because countries are all undergoing this at the same time.
Some of our equipment is made in Italy where they’re having a terrible time sourcing things and they’re not manufacturing things right now. So Public Health Ontario that runs our laboratory services are doing their absolute best and they’re doing a great job to increase their capacity. But there’s not enough to go around right now and we’re doing the best with what we have.
This is being worked on by both the provincial and federal levels. We are not out of swabs. We are not out of protective equipment but we have to be very careful with it right now. And as soon as we’re able to get more, we’ll do more.