Front Burner - Before the storm: Is Canada ready for COVID-19?

Episode Date: March 13, 2020

From U.S President Donald Trump suspending most travel from Europe, to major sports leagues suspending their seasons — efforts to slow down the COVID-19 pandemic are ramping up. Infectious disease specialist Dr. Isaac Bogoch talks to host Jayme Poisson about whether Canada is doing enough.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hello, I'm Jamie Poisson. Around the world, efforts to slow down the COVID-19 pandemic are ramping up. From U.S. President Donald Trump suspending most travel from Europe. The European Union failed to take the same precautions and restrict travel from China and other hotspots.

To Sophie Gregoire, Prime Minister Justin Trudeau's wife being tested for COVID-19 and both of them being in self-isolation. But out of what he's calling an abundance of caution, the prime minister has decided to self-isolate as well until they have the results of Sophie Gregoire Trudeau's COVID-19 test. Schools in Ontario are closing for two weeks after March break. We are planning for every single scenario possible. There are also an increasing number of large public events being cancelled. CARES, the organization that put on the Junos, announced that all Junos events were cancelled. The NHL officially announcing that it has suspended play this season. The NBA has announced it is suspending all gameplay until further notice. There is a lot going on. So today on FrontBurner, we're going to pull back a bit. I've got infectious disease expert

Isaac Bogosh with me. We'll talk about Canada's public health response to the growing concerns around COVID-19 and what we can learn from the successes and failures of other countries around the world. I should note, Isaac and I spoke before the Ontario school closures were announced. This is FrontBurner. Isaac, thank you so much for joining me. I know that we're reaching you today in Abu Dhabi, where you've been helping give advice to help protect vulnerable populations from COVID-19. Yeah, that's what I'm doing here. There's a large migrant population, and we're just looking at strategies to prevent how the infection can spread through vulnerable populations like that. Okay, well, thank you so much for making the time to talk to us.

Lots and lots of news over the last 24 to 48 hours. The Prime Minister and his wife are currently in isolation. We saw the NHL and the NBA both announced that they are suspending their season. And, you know, I want to talk to you first about those big announcements. You know, what good does that do to put these large events on hold? I think there's a few things that have really happened that really put this in center stage in Canada. And, you know, up until now, this has been something that's been happening on the other side of the world, but it didn't really feel real, I think, for Canadians. And now our prime minister

is in home isolation and the NHL is cancelled for the time being. Like this strikes very close to home for many Canadians. And I think people are aware that it's here and that, you know, it's time to be prepared. And, you know, it's interesting because for the last two months, you know, there have been countless physicians and public health specialists and, you know, people who hold office in Canada talking about this is coming, this is coming, we need to prepare, we're preparing. And now it's here and it's starting to feel quite real, I think, for most people in Canada. We have heard commentary, people who believe that we should be shutting it down, right? I think some

people might be wondering right now if they should be going to work or they should be working from home or if schools and universities should be canceled. And how do you think public health officials are weighing that? Yeah, I think this is really important to consider very carefully. I firmly believe that social distancing measures can significantly limit the rapid rise in cases. And the reason we want to do that is because for the most part, most people will be okay and will be able to recover at home. But of course, we know some people will need hospitalization. And sadly, some people are going to need even more resources like an intensive care unit. With rapid upswings in cases, we will reduce our hospital and healthcare capacity. So with social

distancing measures, all this does is it blunts those rapid upswings in cases and our hospital system, our healthcare system is able to cope with the number of patients coming in. This is also connected to this idea that we keep hearing about flattening the curve, right? That is exactly what we're talking about. So I think the question I have for you is, in Canada right now, are we seeing the right kind of advice when it comes to social distancing? Now, public health officials, you and I are talking Thursday afternoon. There hasn't been clear advice for employers to have their employees work from home. We haven't yet received clear advice on large gatherings. So Quebec's premier has certainly come out and essentially said that gatherings over 250 people should be banned. Yeah. So we're starting to see these messages, right?

We really are. And, you know, I really do think that these conversations are happening, maybe not as much as they should be, but certainly schools are having these conversations. Businesses are having these conversations. There's no one size fits all solution. So what works for one school system might not work for another school system. Certainly what works for one company might not work for another company. But really now is the time to make a plan. Actually But really, now is the time to make a plan. Actually, a month ago was the time to make a plan. But now is the time to start really making a plan and enacting that plan. These are just measures to really prevent large groups of people

from congregating in close quarters. And it really does work. does work. We've seen the U.S., Italian and Chinese governments take rigorous measures. Here in Canada, we're still waiting, unfortunately, for a plan to protect our border and prevent large public gatherings. We already have enhanced screening in place for people arriving from countries where there is, where there has been a larger outbreak. We already have. I want to talk to you a little bit about the borders. So on Wednesday night, Donald Trump announced travel restrictions.

Twenty six European countries, not including the UK, for some reason, will not be able to fly to the United States. People not goods. He had to clarify that afterwards. This would be a month long starting on Friday. How effective is this? So it's funny because like I literally had gotten off a plane in Brussels and turned on my phone and that announcement was made. And I was about to get on a plane to come to Abu Dhabi. And right across from me was a plane going to New York. And people, you could tell everyone was, you know, the airport is pretty empty these days and there's very few people traveling. But everyone was trying to get on that plane to New York. You could tell that was a going to be a packed flight and no other flight in the in the airport was even close to capacity. These are unprecedented times. And, you know, I think one of the things is

when we're starting to ban travel, if the goal is to slow down the epidemic, that's the goal. But, you know, you have to wonder how successful that's going to be when you already have a significant number of cases in your country and a significant burden of local transmission already. You know, the optics may look good to some. It looks like senior leadership is doing something. But in very practical terms, I think once you're starting to have this degree of local transmission, starting to ban flights, probably, got to be careful with my words, probably is not going to have the most impact. Like the cat's out of the bag is basically what you're saying.

Yeah, yeah, that's exactly it. A half dozen of these new cases in Ontario stem from U.S. travel. Dr. Barbara Yaffe, she's the associate chief medical officer of health. We'll listen in to see what she has to say. So we have 54 active cases. There's been quite a jump over the last 24 hours. We had 17 new cases reported, and about seven of those had traveled to the United States. So that's something that's a new pattern that we're seeing.

They have a ton of cases right now, and I want to talk to you about why their cases might have spiked in a moment. But first, you know, a Quebec MP is calling for us to shut our border with the United States. I know, you know, this idea that you can't fly to the United States from Europe, but there are a lot of concerns that now people are just going to fly through Toronto or Ottawa. Should we be considering these measures? I'm personally not a fan of shutting down borders. I think they tend to do more harm than good. I don't think it's going to really change any of the outcomes we have. I think we also need to appreciate how interconnected we are

and how important that border is. There could be significant, you know, human and economic repercussions for closing that border. And if that border is closed, we also have to think about will it really have any meaningful impact? Sadly, if the United States has a problem, Canada has a problem. And of course, we know the United States has a big problem. You know, they really dropped the ball. There's no other way to put it. They really did a terrible job scaling up their diagnostic tests. As the number of cases grows, there's a new warning tonight. The U.S. does not have enough coronavirus test kits to meet the current demand. And this has led to a significant number of cases in the United States

that probably shouldn't have happened. That ended up being a major problem for them, which sadly is turning into a major problem for us. And so you still don't think that closing the border with them would help us? I don't really think so. I mean, it's one of those things where, you know, really think so. I mean, it's one of those things where, you know, you can just start making a growing list of countries you're not going to allow through to your country, and that list rapidly becomes impractical. In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization. Empowering Canada's entrepreneurs through angel investment and industry connections.

I want to talk to you about this idea that the U.S. bungled testing. That they didn't test fast enough, that there were faulty tests in the beginning. Are we doing better here? How do we compare when it comes to testing? The testing in Canada was really good and still continues to be high caliber testing. And, you know, this was scaled up rapidly. And, you know, initially we had guidelines that suggested, you know, we're going to first test people coming from Wuhan and then China and then a few other places. And now really the pendulum has swung towards just testing

people that, you know, clinicians suspect may have this infection. So we've really done a good job at scaling our diagnostic testing up and also adapting our policies to reflect this evolving epidemic. I'm not trying to pat ourselves on the back. I just think that, you know, in general, the federal level and at the provincial level, that was done well. And, you know, when we think about public health initiatives, diagnostic testing is one of the major pillars. If you don't know how much of the infection is in your country and where it is, it's hard to mount a public health response. I take your point that we're doing a lot better than the United States, but I understand we're still lagging behind countries like South Korea when it comes to testing. Do you think that we're doing enough?

Yeah, I mean, we have to remember that our epidemic is way behind South Korea's. I mean, they've been dealing with this far longer than we have. And, you know, if we're going to learn a lesson from anyone, it would be the South Korea lesson, where they had a rapid scale-up of diagnostic testing. They provided diagnostic testing outside of hospital environments so that they didn't clog up emergency departments and hospital beds for people that just aren't sick enough to be in hospital. We're going to take a look at an innovative technique that South Korea has come up with for expediting trying to detect coronavirus infections. Drive-through coronavirus testing. Temperature? I'm instructed to stay in the car the whole time.

Is it okay? Yes, okay. I fill out a questionnaire to see whether I have any symptoms or if I'm in a higher risk category of people. They really took the initiative on practicing social distancing techniques at the individual level and at the institutional level. And, you know, of course, they got hit just like lots of other countries got hit with this infection. But they didn't have these huge swings in peaks of cases, in numbers of cases. And right now, their numbers of new cases is actually declining. So they're really the poster child of how to manage this COVID-19

epidemic. Now, let's think about Canada for a second. Well, we certainly have scaled up diagnostic testing at the provincial health labs. Number two, we are now starting to see non-hospital based diagnostic testing available in many provinces. We're starting to see public health in certain areas will go and provide testing in the home. We're seeing standalone COVID-19 clinics pop up that can do diagnostic testing and management. And these are all arrows pointing in the right direction. The question is, number one, can we scale that up enough in the next really week to three weeks? And number two, will Canadians as individuals and will Canadian institutions facilitate these social distancing measures that are truly necessary to limit the spread of this infection. I feel like you just asked my follow-up question.

Do we have the capacity to do that? Do you think that that's coming? It's not capacity. It's do we have the will to do it? I mean, of course we have the capacity to do it. We can find a way. I also want to talk to you about our health care system. So I take your point that what we're going to what we're trying to do is flatten this curve to ensure that we don't have this massive spike in cases. But, you know, we already have a health care system that is working at capacity. A CBC investigation into this issue in Ontario revealed that overcrowding has become so common in this province.

People are receiving care in hallways and conference rooms routinely day after day. The Ministry of Health Issues monthly reports on wait times. The latest figures are from January. They show patients admitted to hospital spent on average 18.3 hours in the ER before getting a bed on a hospital ward. When you say that we don't, that we do have the capacity, like, do we actually have the capacity to deal with even a moderate spike in cases? I think we do to deal with, as you point out, a moderate spike in cases. But I completely agree with you. I mean, we will certainly run into trouble if we have a significant spike in

cases. There's no doubt about that. But if we flatten the curve, as we're saying, I think we can handle a moderate spike in cases. But that doesn't mean it's business as usual in the hospital. We have to remember that. Like, even with a moderate spike in cases, this might lead to the cancellation of non-essential services in a hospital environment. So, for example, elective surgery, like if the case number became high and if hospital beds were needed, you know, this is the time where, you know, elective surgeries would get cancelled for making space in a hospital. This is where, you know, if one hospital was really full to capacity, people would get rerouted to other hospitals. Same with, you know, if intensive care unit resources were limited in one place, we would reroute them to another place that has resources

available. But really, truly, it's up to us as Canadians to roll up our sleeves and do the work here. I can't stress this enough. Now is the time to roll up our sleeves and do the work here. I can't stress this enough. Now is the time to roll up our sleeves and do what needs to be done, which is enact local policies that promote social distancing so that we prevent these rapid upswings in cases and we allow our healthcare system to really deal with a manageable volume of patients.

So then I wonder if that's where we could end today with you sort of looping back to where we started this conversation around messaging and social distancing. So I understand that the situation is different in different parts of this country, and people have to look at what's happening in their communities. Let's say you're in Toronto or Vancouver, two centers that have the most cases right now. You as an infectious disease specialist, what is the advice that you would give businesses, schools, cities that are operating transit? What should those people be doing right now? So basically, this is at the this is at the organizational level. So I think we have to they have to really be mindful of a few things. One is that they have to really be flexible

in these in this setting. And and certainly should if if the work allows to promote people from working remotely and working from home. That's one. The next thing is sick days. I mean, now is not the time to be nitpicky and stringent and say, oh, you know, you only have blank numbers of days off and really putting people in an impossible position, people who truly need their paycheck to meet their basic needs. You know, we don't want those individuals to come in. We don't want anyone to come in if they're sick. So policies around this time to really ensure that people who are not well do not come in to work. And really, I think we need a lot of flexibility and adaptability as this epidemic unfolds, because we're going to need buy-in from these

organizations that employ or house lots of people. And oftentimes, I think we might even need to change the rules along the way to really adapt to how the epidemic is unfolding. Okay, Isaac, thank you so much, as always. Anytime, happy to chat. Okay, so many hours after Isaac and I talked yesterday evening, as announcements of more and more closures came, so did the results for Sophie Trudeau's COVID-19 test. She has tested positive for the virus. According to a statement,

she is feeling well and her symptoms are mild. She will stay in isolation for the time being, and as a precautionary measure, the Prime Minister will also do so for 14 days. He is not being tested right now because he has no symptoms. The statement says he's in good health and following advice from public health officials. Because he has no symptoms, doctors say there is no risk to people who have recently been in contact with him. Trudeau will continue his duties tomorrow and is set to address Canadians then. That's all for today, but we are continuing to follow this story very closely. Please stay tuned.