Coronavirus is more widespread than numbers suggest — so act like it

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Dr. Vera Etches says Ottawans have to assume they could be in contact with, or even have, the virus

When it comes to the spread of COVID-19 in Ottawa, the situation might almost seem encouraging.

And it is tempting to take solace from some bona fide good news. After a spike last Sunday in new cases of people testing positive for COVID-19, the numbers have tapered off in the past few days. Only one new case was identified on each of Monday and Wednesday, while no new cases were reported on Tuesday.

As well, most of the 14 people who have tested positive so far have reported mild symptoms. Even the person in their 60s who has been hospitalized with the illness is not in intensive care.

But Ottawa's chief medical officer of health is warning residents not to fall prey to complacency. The unsettling reality is that there are probably hundreds of people in the capital right now unknowingly infected with the novel coronavirus.

"There is a high likelihood it's here in our community and so we need to act that way," Dr. Vera Etches told CBC.

"It's not like the risk has gone away. I expect more cases because we have more and more returning travellers and we probably have transmission in the community that we haven't been able to detect yet."

Numbers skewed to travel-related cases

All the local cases are travel-related — the virus did originate in China and is now moving across the globe — but the way in which health care officials are screening may skew the numbers toward travellers in a way that doesn't fully capture the real shape of the COVID-19 situation.

We can't find all of those hundreds of cases. We can't test for all of those. We don't know who they are.
- Dr. Vera Etches, chief medical officer
The confirmed cases we've seen in the last eight days are the result of illness that is linked to travel over the past couple of weeks. There was a risk to travellers then, and as more people are returning to Canada, "that risk continues and grows," said Etches.

However, people with mild, flu-like symptoms who have no connection to travel are generally not being tested. It is not feasible to test everyone who has a cough or slight fever. Still, some of these untested individuals may, in fact, be infected with the virus.

Right now, health workers are largely testing people with mild symptoms and who've travelled in the last two weeks or been in close contact with someone who has tested positive. At the Brewer Park arena assessment centre, more than 1,500 people who presumably fit that criteria have been tested since last Friday.

"We can't find all of those hundreds of cases," said Etches. "We can't test for all of those. We don't know who they are."

That's why staff are beginning to screen anyone who comes into a hospital for possible coronavirus symptoms — in particular a fever, cough and shortness of breath. "Anyone could have been in contact with someone in the community and become infected," she said.

'Imagine' you've come in contact with the virus

Etches wants people to "imagine that you could have come in contact with the virus." Act like you might be infectious, especially around older adults, who are at greater risk if they fall ill with COVID-19.

That means self-isolating not only for 14 days after returning to Canada or when you're feeling unwell, but limiting most social interaction for everybody.

"The less the better," said Etches.

For example, if you need another family to watch your child while you go to your essential job, then fine. Otherwise "play dates are kind of optional."

Etches said she realizes that the extreme limiting of social interaction, which will likely be needed in coming weeks, can be daunting and difficult.

"It's something we all have to help each other with," she said, adding that even her own family was already feeling "testy."

"But it's important," she said. "You look at the facts — that the fatality rate for people over 80 is 20 percent — and we just we just don't want to see that."

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