Health official says COVID-19 numbers can help or hinder the situation

Releasing information about COVID-19 (Coronavirus) in the Grey-Bruce region has to strike a balance between what is helpful and what can be overwhelming.

That's the word from Grey Bruce medical officer of health Dr. Ian Arra (above), who is in charge of the daily situation reports released by the Grey Bruce Health Unit, regarding the confirmed cases of the virus in this area.

“The general feedback we've received is that people want simple numbers, nothing too complicated,” he told the Kincardine Record, in a phone interview Wednesday. “The new confirmed cases we've seen daily have been about two or three, on average, which is evidence of flattening the curve of the pandemic.”

He and his team have been considering the release of “doubling-time” numbers which indicate how quickly the virus spreads. For example, in early March, there were five cases, and four days later, there were 10; therefore, the doubling-time was four days.

“In Canada, in early March, that number was four days,” said Arra. “Now, it's 10-plus days which is excellent. Here, in Grey-Bruce, we have 80 cases which is double the 40 we had about 10-15 days ago. That's a good situation.”

With regard to “recovered cases” which are included in the daily report, Arra said they are “a warm fuzzy for the public.”

“That is a meaningless number,” he said. “It means something only if it indicates a person going back to work in a nursing home or hospital.”

A recovered case, said Arra, means the person tested positive and quarantined for 14 days. “There is immunity in a person who recovers, but we don't know how long it will last because the virus might change.”

For example, he said, there are other diseases on the spectrum, such as measles, which once you have had it, you have a lifetime immunity to it. Others, such as pertussis (whooping cough) have a limited immunity. And then, there's influenza for which you can be immunized but the virus changes its shape periodically.

“With influenza, there's something called drifting which means there are small changes to the virus,” said Arra. “But then every 10-15 years, there is a shifting which means the virus changes drastically. That's what happened with H1N1, we had a major issue because the influenza vaccine would not work at all.”

He said the same concern exists with COVID-19. “There is evidence of immunity but then the virus could change its shape.”

TESTING EVERYONE IN SENIORS' HOMES

As for testing, Arra said the Ontario Ministry of Health and Long-Term Care pushed for increased testing, especially for residents and staff in retirement and long-term care homes – whether they were symptomatic or not.

“That was a good idea,” said Arra. “People were beginning to mistrust the system, so this offered a sense of ease for the public. However, it was not so good to test those who were asymptomatic because it diluted the validity of the test, causing 'false-positives'.”

He said the one spike in positive cases earlier this month in Grey-Bruce, stemmed from testing everyone at Maple View Nursing Home in Owen Sound, with the result of 14 confirmed cases of COVID-19 in the one-day test.

Of note, he said, most of those who tested positive for COVID-19 at Maple View had mild symptoms. None was taken to hospital and four days ago, eight residents had recovered. The home could be out of outbreak by Friday (May 1).

At Sepoy Manor Retirement Home in Lucknow, four people who showed no symptoms were tested and one came back positive which prompted the outbreak at the home, said Arra. “That forces me to ask, can I trust that test? That person was tested a second time and it came back negative. Now, we have to do a third test to confirm it.

“People think the testing is some kind of 'silver bullet' but that simply is not the case.”

As for Brucelea Haven in Walkerton, the two confirmed cases were in staff members, said Arra, but due to ministry guidelines, the nursing home was considered in outbreak.

So, is he concerned with three seniors' homes in outbreak in Grey-Bruce?

Arra said his concern is not the positive test results, but what was happening two weeks prior to that when the person was first infectious.

“If I get a positive test today, April 29,” he said, “I'm thinking that the disease has a dormant period of seven days. The person gets tested and the results take four to five days. That's 14 days, so that person has been infecting other people since April 15.

“It's not 'the sky is falling' but there is a great potential for infection.”

He said that's why the testing for seniors' homes takes 24 hours instead of four to five days, and cases are isolated as soon as their test results show positive for COVID-19.

When asked about whether it's time to lift some of the restrictions and allow people to return to their work and businesses, Arra said there are a lot of layers to that decision.

“We make recommendations from public health,” he said, “but there are other stakeholders at the table who are making decisions based on social needs and business and economic issues. We are working on a three-month plan, based on information from the John Hopkins Medical School which we have adapted to our local needs.”

Arra said lifting restrictions would have to be two-fold: gradual and unified.

“It would have to be a gradual restriction release,” he said. “Allow a couple of sectors to open and measure what happens. And it would have to be a unified process across the province. Otherwise, if we open only in Grey-Bruce, where we have low numbers and no deaths, we could be inundated with people coming from infected areas to vacation and go shopping.

“If the province pushes ahead and opens certain businesses, we should follow suit.”

And finally, what does Arra think of cottagers coming to this area from the larger urban centres?

“My concern is the 'Us versus them' - 'cottagers versus residents' - attitude we are seeing,” he said. “My message is for people to stay put, that's visitors and residents. If you have arrived in Grey-Bruce, stay where you are.”