Front Burner - 'More than just a blip': Canada’s COVID-19 cases on the rise

Episode Date: September 16, 2020

Coronavirus cases are on the upswing in Canada's four most populous provinces: Ontario, Quebec, Alberta and British Columbia. On Tuesday, Ontario reported 251 new confirmed cases: the fifth day in a row of more than 200 new infections. To put that in perspective, the last time that happened was in early June, when the province's restaurants, hair salons and places of worship were still locked down. Today, infectious disease specialist Dr. Isaac Bogoch on what these numbers mean, and what can be done to tamp them back down.

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 Josh Bloch. Another day, another set of alarming numbers. In Ontario on Tuesday, 251 new confirmed COVID cases, the fifth day in a row of more than 200 new infections.

To put that in perspective, the last time that happened in early June, the province's restaurants, hair salons, and places of worship were still locked down. We all know that a second wave of this virus is coming. We will take every step necessary, including further shutdowns. In British Columbia, active cases have reached an all-time high. We know what we need to do. Now is the time to do it. We need to hold our line. And in Quebec and Alberta too, confirmed coronavirus cases are on the rise. All this while kids are starting to go back to school and temperatures are starting to drop.

Today, Dr. Isaac Bogosh on what these numbers mean and what can be done to tamp them down again. This is FrontBurner. Hello, Dr. Bogosh. Hello. When you look out at the coronavirus landscape in Canada right now, what do you see? in Canada right now. What do you see? Yeah, unfortunately, we see a real rise in cases in BC, Alberta, Ontario, and Quebec. And you know, it's more than just a blip in the numbers. And we know there's day to day variations in the numbers. But this is a real steady rise in cases, you know, we're just grumbling along headed in the wrong direction. In addition, though, I think we're also seeing some positive news. That eastern bubble, the maritime provinces

are doing remarkably well. There's very, very little activity over there. So four provinces not headed in the right direction, and then the eastern provinces are doing fantastic. I mean, it's that steady increase in cases that seems to be a cause for concern. I mean, it's that steady increase in cases that seems to be a cause for concern. I mean, I know that Chief Medical Officer Dr. Theresa Tam warned that it is that slow and steady increase that is causing her concern. Although Canada is striving to maintain a slow burn, this is concerning. And I want to underscore that when cases occur, it is a reflection of what's happening in the community. Yeah, absolutely. And I can see why. I mean, we have excellent capacity now to make diagnoses. I mean, I appreciate that many of the testing centers have lineups, but if you compare that

to March or April of this year, it's so much better now. So when we see that steady rise in cases, we know that this is truly a problem. And I think the key thing here is now to focus on, all right, who's getting infected? Where are they getting infected? What's the context of how people are getting infected? And it's not too late to act. Can we do something about it to prevent this from rising and rising and then unfortunately having to reimpose some public health measures? At previous moments in the pandemic, we've had a pretty good sense of which populations were being worst affected. In the early days, it was people who had traveled to COVID hotspots, you know, people who had traveled to the US or Italy or Iran. And then of course, we saw the pandemic wreak havoc in nursing homes.

But with these new cases now, who is being most affected? It's interesting. We're seeing the new infections in people in and around their 20s. And that's posed a problem. What's really unfortunate is that's not new. We've known that since around June. And I think it's just a bit disappointing that we haven't really seen targeted public health efforts focused toward that age cohort. So we've had a few notable outbreaks associated with, for example, meatpacking plants and other occupational environments where people are working shoulder to shoulder. There's been a lot of focus on private gatherings and house parties and perhaps even weddings that have been taking place in people's homes. B.C. has announced a new plan to crack down on partiers.

Now effective immediately, sweeping new penalties for scenes like this. $2,000 fines for anyone organizing an event or hosting a party that exceeds the 50-person limit. And $200 tickets for attendees who refuse to leave or follow directions from police. And then, of course, we've heard about some very high-profile outbreaks associated with restaurants and bars. A night of karaoke is having a ripple effect in this Quebec City neighbourhood. At least 40 cases are directly linked to bar le cure-whac, but there are secondary cases too, including among children in schools. Right, and health experts have pointed to bars and restaurants and parties

and large gatherings, especially with young people. They've also warned that, or pointed out that, look, young people are more likely to be working lower paying jobs, jobs that you can't necessarily do from home. I was reading about a case where there were 60 cases that have been linked to a workplace in Mississauga. Yeah, exactly. And, you know, I've been sort of quietly discussing with some senior public health leadership to really provide more transparent information about these outbreaks. I think it's extremely important to know who's getting infected and where they're getting infected in the context about where they're getting infected.

And that's not to shame and blame businesses. I mean, sometimes this is, you know, people could be doing everything right and there's an outbreak as well, even if you're trying your best and doing everything right. So it's not the name of a particular business because it can have tremendous negative repercussions

for that particular business. But it's more to talk about what industries are involved, what locations are involved. You don't need the address, but, you know, where is the outbreak? What sector is involved with the outbreak? Just some more details about where people are getting infected. And I think it's also important to appreciate the context to which people are getting infected. So for example, I mean, I work in a hospital. We wear personal protective equipment on the wards, including when we had enough patients,

we had a dedicated COVID-19 ward. But interestingly, I'm not talking about my hospital per se, but in some hospitals, there were outbreaks. And you'd think the outbreaks are going to be associated with the COVID wards. But in fact, there were outbreaks associated with break rooms and lounges where people would cluster together. So, you know, the context of where people are getting infected is extremely important if we want to mount an effective public health campaign and response. Boy, that resonates with me because I have to admit, I find it tricky to calibrate, you know, where the greatest risk is if I don't know where the outbreaks are.

I mean, are they happening in bars? Are they happening, you know, in restaurants? It would feel like it'd be more helpful to Canadians to know what kind of activities are higher risk. I completely agree. But having said that, we already know where this virus likes to be transmitted. And that is in indoor settings, when there's lots of people congregated in close proximity for prolonged periods of time. And it doesn't matter if it's a bar, a restaurant, a school, a place of worship, a house party, irrelevant. Those are the conditions.

If you've got a lot of people indoors in close proximity for a prolonged period of time, that's the perfect setup for this to be transmitted. And of course, we all are well aware since March of what we can do to mitigate that. Spread apart by two meters, put on a mask when you're in an indoor setting, keep your hands clean. And of course, if we can do whatever it is we're doing in an outdoor venue, that's significantly safer, significantly safer. So, I mean, if someone is interested in going to a bar and a bar is open in wherever it is they're living and you walk into the bar, you know, of course, all businesses are supposed to limit the number of people and spread people out, blah, blah, blah.

We've heard it all a million times. But if you walk into the bar and you see that there's a ton of people gathered together, OK, you know what? We know better by now. You know that's probably not the best place to go into. And you can turn around and find another bar to go to. So I think there's a lot of responsibility that lies on businesses and organizations that house people under one roof, be it a school, a place of worship, a bar, a restaurant,

or another business. But there's a lot of individual responsibility that we can take as well to make good choices. Are there a lot of cases where we just actually don't know where the cases are coming from, where they're not being effectively traced? Yes, there certainly are. And that's going to differ based on where the contact tracing is being done.

So we've seen some geographic variation in that. For example, in certain parts of Ontario, I'm biased because I'm standing in downtown Toronto right now, depending on where you are, there's about 30% to 50% of the new cases where it's not entirely clear where a person picked up this infection. Now, obviously, contact tracing is tough, right?

There's an art and a science to contact tracing. We've heard time and time again that it's very labor-intensive, it's resource-intensive, and there's certainly a skill to this. And now I will ask the health minister to speak to you. There was a gathering of 17 people in a restaurant. There are 31 cases currently. We will have to screen 330 clients who registered on that restaurant's log. Now imagine the workload.

Having said that, I think, I know they're doing the best they can, but you've got to wonder if with language and culturally sensitive contact tracing, I wonder if we can squeeze a little more juice out of that and have a little bit better, some better results and a higher proportion of cases where we know where people caught this. I think that might be very helpful. 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.

Hi, it's Ramit Sethi here. You may have seen my money show on Netflix. I've been talking about money for 20 years. I've talked to millions of people and I have some startling numbers to share with you. Did you know that of the people I speak to, 50% of them do not know their own household income. That's not a typo. 50%. That's because money is confusing. In my new book and podcast, Money for Couples,

I help you and your partner create a financial vision together. To listen to this podcast, just search for Money for Couples. You mentioned earlier that it's mostly 20-year-olds or thereabouts who are getting this. And I'm wondering if that makes this increase in a way less concerning, since they're less likely to get seriously ill. And we've seen that hospitalization rates and the numbers of deaths are staying relatively low. Not at all. I think it's a false sense of security when we hear that hospitalizations and

deaths aren't rising proportionally with the number of cases. And I think this for a couple of reasons. I completely agree with you, though, in that the younger age groups are just much less likely to get sick. Some will. We've cared for people in their 20s in the hospital, and some of them are really, really sick. But by and large, if we look at all 20-year-olds who get COVID-19, the vast majority of them will feel a little unwell for a short period of time, and the vast majority of them will make a full recovery, and that's going to be the end of that. The issue is that we know this is a very contagious infection, and it's not realistic to think that this infection is going to stick within one age cohort for long.

Because, of course, 20-year-olds will get together with other 20-year-olds. But 20-year-olds will also go and visit their mom and dad or their grandma or grandpa or visit other people in the community. And they can certainly transmit it to others. So it's just a matter of time before it starts to spread to others. starts to spread to others. There's excellent data demonstrating this from France and from Florida and from Spain where they really looked at different age cohorts affected over time.

For the second week of July Canadians in their 20s accounted for a quarter of those new cases. Health officials warn unless the spread of COVID-19 comes under control in young people keeping a second wave of infections to a minimum will be unlikely. Of course, if it does spread to other age cohorts, sadly, older age groups or people with underlying medical conditions are not going to be as fortunate. We know that they're just more

likely to get sick from this infection. And we are starting to see a slight uptick in the number of hospitalizations associated with COVID-19. Okay, well, I'm almost hesitant to ask this because I kind of dread the answer here. But for months, we've heard that so much about how this second wave was going to come in the fall. And I know that that term, the second wave, doesn't necessarily have a fixed definition. But in your view, is what we're seeing right now, the beginnings of a second wave? Yeah, it certainly could be. It really, truly could be. I don't know. And, you know, I hate to punt, but like, in all fairness, like, this is just a, we'll have to see how this goes kind of moment. But really, we'll have to see how this goes. And I guess fortunately, the ball's in our court, right? We control what

this is going to do. We totally have control. We meaning Canada and Canadians. So if we take this seriously, if we have good policy, if we have smart businesses and organizations that adhere to this policy to create a safe indoor environment for employees, students, clients, customers, if we take responsibility as individual citizens, if we all do our part, this will not evolve into a large second wave. If we don't, I mean, we don't have to look too far to see what happens, right? I mean, we don't have to look too far to see what happens, right? We saw Israel, for example, just saw a tremendous spike in cases, and they've actually moved to a country-wide lockdown. Benjamin Netanyahu announced the unpopular but perhaps unavoidable decision.

Health ministry executives and hospital managers have warned us that death rates are forcing the application of immediate measures. A part of the medical staff and the hospitals are overwhelmed. have warned us that death rates are forcing the application of immediate measures. A part of the medical staff and the hospitals are overwhelmed. France is seeing a very, very high spike in cases now, and it's not quite clear how they're going to manage that from a public health standpoint. But I suspect that they're going to make some significant changes to their policy shortly because they're just seeing over 10,000 new cases per day now. Masks are now compulsory in major French cities. Violators could pay a nearly $200 fine. But some Parisians remain remarkably blasé. Yeah, of course, we are a bit worried about the situation, but we also have to live like normally.

I mean, it feels like it couldn't be happening at a worse time for us with schools reopening, people being driven indoors by cooler temperatures and the wildfire smoke out west. So what are the concrete policies that you would like to see put in place now that could help bring the numbers back down? Yeah, it's a great point. So the concrete steps really should be reflective of what's happening on the ground. And if you have good quality data to guide you, they should be data-driven decisions based on what's happening locally. We often talk about public health is local. Well, this is exactly the case. So, for example,

if there are 20-year-olds who are at house parties getting this infection, great, here are some communication strategies and targeted public health messaging geared to 20-year-olds to help them make better decisions. Well, it doesn't seem like there's been a lot of targeted campaigns towards the demographic that is seeing this high rate of infection towards 20-year-olds. I mean, I know in BC they had Seth Robin and Ryan Reynolds doing PSA. I don't know how effective those are going to be. And, of course, it's terrible that it affects our most vulnerable.

You know, BC, that's home to some of the coolest older people on earth. I mean, David Suzuki, he lives there. My mom. Or Paul Rudd also has a PSA that's been going viral as well. Oh my God. Like, welcome to my world. So fam, let's real talk. Masks?

They're totally beast. So slide that into your DMs and twitch it. I mean, I don't know i honestly don't know what to say we've known that since june i'm sure there's communication experts out there that are chomping at the bit to unleash smart intelligent effective campaigns geared toward you know 20 year olds who are getting this infection. There's a way to do it. And it's I'll tell you the way not to do it is to have, you know, like a boring middle aged physician like myself wag his finger and saying, you know, don't party like that. That's not going to be effective. We know that. I'm not going to preach at you like some celebrity. This is a combo where I talk and you shut up and wear your mask.

Hello? Oh, hi, Billie Eilish. You know, there's also policies that can be made as well. We know 20-year-olds, for example, are going to get together one way or another. If it's not in a bar, it might be at a house party or wherever. But can we provide people with strategies so that they get together in a safe manner? This is like a harm reduction approach. So, for example, messages that are age-appropriate, language-appropriate, culturally appropriate, saying, you know what, you're going to get together, but why not get together outside?

Or why not, you know, don't go into that crowded bar. Go have a drink outside with your friends and, you know, keep those groups small. The other thing, too, is you can make local changes to facilitate that. So, for example, we heard about Vancouver that was considering making some changes to public parks to allow alcohol consumption in those venues. And, like, that's a smart approach. I mean, it doesn't have to be for forever. I appreciate that a lot of people might not like that. But, like, at the end of the day, this is probably the biggest public health emergency to hit Canada in a century. So

I think it's completely reasonable to take these harm reduction approaches and set people up for success. That's just one example. But, you know, we've heard about, for example, several religious groups that might be disproportionately affected and many, many times in places of worship. Okay, can we provide language and culturally appropriate messaging to those various groups to really ensure that they have a safe place to worship? Can we engage the community and engage community leaders to help deliver that message? Like, there's a lot of ways that you can do this correctly, but I think the key thing is doing it locally.

One last point is that we can be proactive. We can learn from our mistakes. We can learn from the experience of others. We know that there's certain places that are at greater risk of having these outbreaks, like for example, bars and nightclubs. And certainly I know some people will say, well, why example, bars and nightclubs. And certainly, I know some people say, well, why don't we just close them all? That's obviously one strategy. Another strategy

would be, let's look at our policy there. Let's see how we can strengthen it to ensure that outbreaks are less likely to occur at those venues. And, you know, like Dr. Bonnie Henry did, she noticed that there was an unacceptable number of outbreaks at banquet halls and nightclubs, and she closed them. You can tell she's obviously terrific at what she does and is aware that the restaurants and bars are prone to this, and she tightened the restrictions on those. Issuing orders is not something that we do lightly.

It is our last resort. But as our cases are climbing, we need to make some changes to reduce the risks of these environments. So, you know, right move. I think that's certainly the right approach. As long as it's data-driven, evidence-based, and also takes into account, you know, likely scenarios, I think we're going to be doing something right. Dr. Bogosh, it's always great to speak with you. Nice to chat. Before we say goodbye today, a bit of Raptors news. Yes, their season may be over, but there's still much to look forward to.

The team signed Raptors head coach and NBA coach of the year, Nick Nurse, to a multi-year contract extension. Nurse had just one year left on his original deal. He was the head coach last year when the team won their first NBA championship. And he guided the Raptors on a 15-game winning streak this past season. That's the longest single-season winning streak for any Canadian NBA, NHL, MLS, CFL, or MLB team. We'll be watching to see if Raptors general manager Masai Ujiri is re-signed next. He's got one more season on his contract, and is one of the most sought-after executives in the game. That's all for today. Thanks for listening to FrontBurger.