Front Burner - In Brief: Breaking down Canada’s COVID-19 numbers

Episode Date: March 30, 2020

Early data is starting to give an indication of how Canada is doing in its fight against the spread of COVID-19. How deadly is the virus in Canada? How is the virus spreading across the country now? Who is most vulnerable to becoming seriously ill? And why are public health officials watching this week so closely? For answers, Jayme Poisson turns to CBC health writer Adam Miller on this episode of Front Burner.

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. Hi everybody, Jamie here. So we're going to talk to senior health reporter Adam Miller in a moment, but first some headlines from today. Justin Trudeau says Canadian businesses, including non-profits, that see a 30% drop in revenue will qualify for a 75% wage subsidy. Newfoundland and Labrador reported its first coronavirus death,

the first COVID-19-related death in Atlantic Canada. And across Canada, a domestic travel ban for those showing symptoms went into effect today. And on tonight's episode, we want to talk about how Canada is doing in its fight against COVID-19, a preliminary report card, if you will. With information and early data from public health officials, we are slowly starting to get an idea of how the virus is spreading and the severity of cases across Canada, though the data is not perfect. This is from Bernard. Hi, Adam. How's it going?

Hi, Jamie. Good. Thanks for having me. It's a pleasure. Thank you so much. So, look, for weeks, officials have been pushing the importance of social physical distancing. Now we've got some preliminary data from the Public Health Agency, and it suggests that about 63% of cases are based on community transmission, meaning experts don't know where somebody got infected. Is that alarming to you, that number? Yes, it's definitely concerning. You know, as you said, community transmission, it's the spread of COVID-19 with no known link to travel or previously confirmed cases. So that means that

for every confirmed case that we have from community transmission in Canada, there are an unknown number of cases that are likely going unreported across the country. We've seen that number steadily increase over the past couple of weeks. And last week, it grew to over half of all the cases in Canada too. So, you know, that's what Canada's chief public health officer, Dr. Theresa Tam, she called it a fundamental shift last week because before that, cases of COVID-19 related to travel were the main concern. People who either traveled overseas and returned to Canada or people who had come in close contact with someone who had traveled. Okay. And we should say, before we go any further,

this data that we have from the public health agency, it doesn't tell us very much about what's happening today, right now in Canada, right? Right. It's usually a day or two behind, and it's only about half or so of the number of reported cases in Canada. So we're dealing with incomplete data that's a little bit dated as well. So it's difficult, right? Okay. I want to talk to you about a few things, including the death rate. So you and I are talking around 2pm Eastern on Monday, and so far 77 people have died over the course of about nine weeks. And so Canada has a mortality rate that's hovered around 1%. Globally, the rate sits at around 4.5%, though this rate fluctuates. What does that mean for somebody listening right now?

Does that mean Canada is handling this crisis well? The case fatality rate is basically the rate at which COVID-19 kills the people who get infected with it. And yes, Canada sits at about 1% of reported cases, and that's relatively low. But given that about 63% of Canada's cases are from community transmission with no known source, it's likely that there's a lot more happening in the community that we don't see, and that can bring the case fatality rate down even further, especially if there's a lot of people who are experiencing mild symptoms or no symptoms at all. So the current estimate

from the WHO is that more than 80% of COVID-19 cases are mild compared with 15% severe and 5% that are critical and need ventilators. So there's likely a lot more people infected that we don't know of. And that's going to dramatically affect the case fatality rate. But considering the total number of deaths that we have right now, so 77 after nine weeks of this outbreak, what are you hearing from experts about how we're doing, essentially? Like, is this something that is good news, even though it's not good news, right? 77 people have died. But, you know, compared to what we're seeing elsewhere in the world.

You're right. I mean, the rates are very different between different countries. And what I'm hearing right now is that really it's too early to know how bad the situation is going to get here or where exactly we're at in our epidemic curve. And it makes it really difficult to compare us to other countries, right? Because the timing of the outbreaks in different countries happen at different times. The accuracy of other countries reporting, whether they have backlogs in testing or if they're doing widespread testing. The age of their population is really important. And the effectiveness of containment measures that they've taken, like physical distancing. So when we look

at countries that have been hit particularly hard, Iran has a case fatality rate of more than 7%, Spain is over 7.5%, and Italy is above 10%. Wow. Yeah. So other countries like South Korea and even the U.S. both have a case fatality rate of around one and a half percent. And Germany's at zero point five percent. But Germany's been testing like upwards of one hundred and fifty thousand people per week. And that's very key in understanding why it has one of the lowest case fatality rates in the world. So, you know, the fact that we're at about one percent, it's a good sign. But it's important to

remember that that rate is a snapshot of the outbreak in each country at a given time. We have an older population. South Korea has a younger population. I think only about 14% of their population is over the age of 65. Okay. That would affect their fatality rate. Italy has an older population. Yeah, exactly. They've got more than 23% of their population over the age of 65, which could partially explain why they have a higher case fatality rate there. We've got 17% of our population over 65. So we could see our case fatality rate rise or lower as the pandemic continues, but we really won't know for quite some time what the true rate is because of all these factors. Okay. So, I mean, really, and I know that this won't necessarily be a satisfying answer

for a lot of people listening, but there's just a lot that we don't know right now. Yes. I mean, I think that given that we've ramped up our testing in the past couple of weeks, we're going to have a better picture soon of the true number of cases in this country. And, you know, things like our case fatality rate and community transmission are going to have a better picture soon of the true number of cases in this country. And, you know, things like our case fatality rate and community transmission are going to become more clear. But as we see that rate of community transmission continue to rise, it again signals that there's like a lot more cases out there than we know of. And we're also not testing everybody like some countries are. So, you know, if it were possible for us to be testing as consistently as countries like Iceland or Germany, and Iceland had found that, you know,

of all the people that they had tested, half of them had no symptoms of COVID-19, even though they tested positive. So numbers could be way different if we get to that level. But it's going to take some time before we know the true number of people infected. And that's why, at least for now, containment measures like closing borders, physical distancing, these are so important right now. Because if we're able to contain our population and stop people who don't know that they have it from spreading it, we've got a much better chance of flattening the curve. Right. And just very briefly, I know one of the reasons why we haven't been testing widely is

because we can't get our hands on test kits or the components that make up a lot of these test kits. Has that changed? Is that changing? Yeah, well, I know that the government is trying to source more testing kits. We've definitely ramped up. I think we're doing well over 100,000 tests per week, which is great. Initially, we were only looking at people who had symptoms or who were connected to people who had traveled. But now we're starting to loosen that a bit and we're catching more cases. I think provinces like Quebec are catching more cases. That's why they have seemingly higher numbers right now.

They also had an earlier March break, which might explain some of that. So I think we're heading in the right direction. And we will, you know, as we continue to ramp up more, we're going to source more equipment and, you know, obviously get a better picture than we have had in the past. Yeah. Right. And obviously, we could do an entire podcast just on this testing question alone. But I do want to talk to you about some of the other data that was released this weekend, because it does give us a clearer picture of who is being affected by this. And so it obviously is not surprising that people over the age of 60 have the highest rate of hospitalizations. But who else is getting seriously ill in Canada?

Like, what does the data tell us about that? Dr. Tam, Canada's chief public health officer, came out this weekend and made a real point of emphasizing that younger people can experience severe illness as well, and even hospitalization. I think the percentage of hospitalized patients under the age of 40 is currently around 12% in this country. That's really significant, right? Because I think a lot of younger people have this misconception

that it's not going to affect them or as long as they're not relatively unhealthy, it's not going to be a problem. But that's clearly not the case. You know, of course, older age groups make up a higher proportion of serious cases, but it can affect young people indiscriminately as well, even if they're healthy. That's why it's so important for young people to take things like physical distancing seriously, because if they're not, they could be spreading it without knowing it to each other or more vulnerable populations because they may not even be experiencing symptoms. Right. And I've seen some reports come out of New York that are horrendous. And I've seen some reports come out of New York that are horrendous. So even if this isn't putting you in the hospital, if you're a younger person, this isn't putting you in the hospital. People who are getting very bad symptoms here, like, are essentially reporting that they had trouble breathing for a week, a week and a half.

That they were having a hard time even walking to the bathroom. So this sounds like it can be awful, an awful, awful experience, you know, even if you are a completely healthy 33-year-old with no comorbidities. I know we mentioned before it's been nine weeks since the first case of COVID-19 was recorded in Canada. And over the weekend, of course, Dr. Theresa Tam, she did her daily press conferences, and she iterated that this week is going to be very important to see a trend line. To end today, tell me a little bit more about what she's going to be watching for. This is a crucial time right now, because we're going to start seeing the cases tied to March break and the repatriation of hundreds of thousands of Canadians start to show up. I think Dr. Tam is going to be closely watching Quebec, Ontario and Alberta, because those are some of the regions that have been experiencing a higher number of cases to date. What she's really looking for, though, is if there's a decrease in the number of new confirmed cases,

sort of the growth rate of new cases. And that's something that British Columbia announced on Friday. You know, they had said that the effects of physical distancing, the BC provincial health officer, Dr. Bonnie Henry, said that physical distancing cut the province's growth rate of new cases to just 12% a day. She said that without physical distancing, that number would probably be twice that size at 24%. So that's some really solid evidence in favor of physical distancing, that number would probably be twice that size at 24%. So that's some really solid evidence in favor of physical distancing, but we need to make sure that people continue to take it seriously across the country. If we see similar drops in growth rates in Ontario, Alberta,

and Quebec, we'll know that we're on the right track to flattening the curve. But if we don't see those rates drop, public health officials may need to adjust their strategies. So it's such a critical time right now. And I think we're all really interested to see how this week plays out so we know where we're heading and if we're on the right track. Okay. Well, Adam, we're going to keep in touch with you to see what happens. Thank you so much. Thanks for having me.

with me. 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. All right, that's all for tonight. Stay tuned for our episode tomorrow morning. We're talking about rent and what options are available for people who simply can't pay.