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Happy Sunday everyone! Canadians who arrived on Friday, Feb 7th on the two flights from Wuhan have 5 days left out of their 14 days of quarantine at Canadian Forces Base (CFB) Trenton. Those who arrived Feb 11th on the third flight from Wuhan, have 9 days left of their 14 day quarantine at CFB in Trenton. So far all continues well with everyone. Please see here the COVID-19 situational report #23 dated Feb. 16, 2020, received from the Ministry of Health’s Emergency Operations Centre (EOC). The number of confirmed cases reported to us today by the EOC, in Canada, is eight, with three persons in Ontario and five in British Columbia. All are recovering at home in self-isolation. In Ontario, at this time, there is 1 person under investigation with lab results pending. RNAO wants to stress the need not to let your guard down, and continue to protect yourself and educate others to regular respiratory protection practices - see WHO here. The silver lining of COVID-19 is that hopefully we can also reduce flu and common cold transmissions. We continue to hear that supplies disappear and that is a risk to all, should we need them. Please continue to remind colleagues that personal protective equipment (PPE) are to be used only when there is a need, as per the EOC guidelines. Health care providers facing immediate supply needs regarding PPE can email the ministry at EOCLogistics.MOH@ontario.ca. A reminder to all to be up-to-date on EOC information: http://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/2019_guidance.aspx. Situation Report 27 from the WHO updates that worldwide, there are 51,857 laboratory-confirmed (1278 new) cases of COVID-19 and 1669 deaths (143 new), mainly in China. (These are laboratory-confirmed cases; you may have seen larger numbers reported elsewhere since Hubei province has changed their reporting criteria for cases, resulting in a large spike in case count numbers for China according to the new definition). No new countries reported cases of COVID-19 in the past 24 hours. A third death of a COVID-19 patient has been reported outside of China; this individual was a tourist from China visiting France. Studies to assess the epidemiology and clinical characteristics of COVID-19 cases in different settings are critical to furthering our understanding of this virus and associated disease. Several early investigation master protocols or master forms are available from WHO for countries to use. More information can be found here. For those requiring advanced technical information, the WHO has a website with technical guidance. RNAO policy corner: Initial efforts to understand the behavior of the COVID-19 virus by researchers in Singapore suggest it is different from Severe Acute Respiratory Syndrome (SARS) and has more similarities with H1N1. Like influenza, COVID-19 is infectious when symptoms are mild, the researchers found. Because of this transmission mechanism, COVID-19, like influenza, can spread quite quickly, as people with mild symptoms may let their guard down. The other difference between COVID-19 and SARS is the severity, since the fatality rate in China for COVID-19 is lower than SARS. Outside of Hubei province in China, it is even lower, so mortality rates are lower than SARS. The fatality rate of SARS globally during the 2002-2003 outbreak was 9.56 per cent, as compared to a 2.14 per cent fatality rate for COVID-19 so far. The SARS outbreak led to 774 deaths out of 8,098 cases, according to WHO figures, while COVID-19 has so far killed at least 1,380 people out of about 64,400 cases (using the Hubei case definition). A study by the WHO based on 17,000 patients found that 82 per cent had mild symptoms, 15 per cent severe symptoms and 3 per cent had critical symptoms. The key message from this is not to let our guard down and insist on respiratory hygiene for persons with symptoms of a cold, flu and the like; and to follow EOC guidelines for testing when a travel history to China or other affected regions exits. We are here to hear from you and your teams should you be experiencing any challenges – please send your emails directly to me at dgrinspun@rnao.ca. You can also access the health provider hotline and website regarding questions about the outbreak, protocols, preparedness, and more. The toll free number is 1-866-212-2272, and the health provider website, updated regularly with useful resources, can be accessed here. An important reminder that the health provider website and the toll free number are for you – as a health professional – and not for members of the general public. The ministry’s public website on the COVID-19 exists to inform the general public – encourage your family and friends to access this public website. We also have information for the public on our website at www.rnao.ca which we update daily. The WHO has provided an excellent link for you to share with members of the public here. THANKS to all our health professionals in Ontario – especially the ones working at CFB Trenton, to those working in the cruise ships, and the over 13 million healthcare workers in China who are dedicating their expertise and compassion to the people in China – you inspire us! Doris Grinspun, RN,MSN, PhD, LLD(hon), Dr(hc), FAAN, O.ONT
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