The B.C. government has released details of its pandemic co-ordination plan in the wake of 21 cases of the novel coronavirus in the province.
The government also said it continues to is the identification of COVID-19 and then containment through isolation of case-specific instances of viral infection, monitoring and responsive health care.
Health Minister Adrian Dix says the province is ready to use emergency powers to protect the population, health workers, and the health system’s capacity to help patients with other problems.
Dix says the B.C. government is also preparing for how it will function if large numbers of public employees get sick. The plan is to be ready to operate under an outbreak that lasts up to four months.
The plan is to be ready to operate under an outbreak that lasts up to four months.
The B.C. government has established a special committee of deputy ministers to deal with COVID-19 in the province. The committee will focus on public communication about coronavirus spread.
“I believe that we’re on the right track but we need to be vigilant,” BC Premier John Horgan said during a press conference on Friday.
On Thursday, the B.C. government announced eight new cases of COVID-19, bringing the province’s total to 21. Of the 21, four have recovered. One of the cases, a woman in her 80s, is in ICU at Vancouver General Hospital. Provincial Health Officer Dr. Bonnie Henry said her condition has improved.
Dix said the priority is delaying the onset of an epidemic until after the influenza season.
According to Horgan, the province has tested more than 2,000 people for COVID-19 and four new labs will now be testing for COVID-19.
One of the new cases announced Thursday, a woman in the Vancouver area, did not travel recently and has had no known contact with anyone diagnosed with the novel coronavirus. Its the first apparent community transmission of the virus in the province.
“It was not surprising to me,” Henry said about the community spread.
One of the other cases is a woman from Seattle who was visiting family in B.C.’s Lower Mainland. As of Friday, 11 people who tested positive for COVID-19 have died in Washington state. Ten people died in King County and one person died in Snohomish County.
“We are very connected around the world and this virus doesn’t recognize any of our geopolitical boundaries,” Henry said on Friday.
The provincial government has already said people travelling from China or Iran are being asked to self-quarantine for 14 days.
Horgan said he has been speaking with Washington state Gov. Jay Inslee and Deputy Prime Minister Chrystia Freeland about travel and border recommendations.
There are 53 COVID-19 cases in Canada: 21 in B.C., 28 in Ontario, two in Alberta and two in Quebec.
Containment and Pandemic Co-ordination Plan
- Continuing close collaboration with the federal government on border surveillance, advice and follow up for travellers.
- Keep as a priority to delay onset of widespread community transmission for as long as possible into warmer weather of late spring.
- Focus on enhanced screening, information, and testing for travelers at borders as required to meet spread to multiple countries.
- Testing, isolation and rapid flexible response from health system.
The government has a British Columbia Provincial Pandemic Coordination Plan and will be ready to escalate parts of the plan as necessary. The government is already going ahead with elements of the plan.
The plan includes initiating all-of-government cross-ministry co-ordination, increased internal and external communications and ensuring provincial government business continuity. Cross government minister and deputy minister committees are established to co-ordinate and quickly direct action/resources and increase response as required. The government is also ready to use emergency powers set out in Emergency Program Act and Public Health Act as required.
According to the B.C. government, action in four areas of the plan is underway and will expand as needed. The four areas are protecting population, protecting vulnerable citizens, protecting health workers, and supporting health-care capacity.
Under protecting the population the government focuses on:
- Increasing testing capacity through additional sites and equipment.
- Increasing proactive and targeted communication of potential risks for general population and more at-risk patient groups.
- Enact government continuity plans to prepare for possibility of high absence rates due to illness or if employees are absent to care for family.
- Focus on working with institutions and businesses to manage through a sustained three-to-four month outbreak: Work with and provide guidance for businesses, employers and unions on: implementing continuity plans; protecting staff; working from home; and allowing time away from work for quarantine/isolation of ill employees.
- Work with key business sectors to ensure business continuity and provide guidance/advice: grocery store chains to monitor and ensure supplies for daily living, and discourage inappropriate panic buying; work with food chains and other key suppliers to prepare and develop contingency plans; public transportation to reduce infection spread; tourism and in particular protocols for cruise ships in advance of the season, starting in British Columbia
- Provide guidance and ongoing support to municipalities; schools; and post-secondary institutions.
- Readiness preparation to quickly respond to events as required, including using emergency powers: a singular large public exposure; a widespread hospital exposure; a community-based organizational exposure (e.g., workplace, church); specific widespread localized community spread virus activity; supply chain issues; novel clinical presentation
Under protecting vulnerable citizens, the government focuses on:
- Specific messaging and protocols for vulnerable populations to prepare: take sensible steps to avoid infection; advise to support self-care and when/how to reach out for help; increase access to virtual care and appropriate access to medicines: focus on protecting our elderly citizens; focus on supporting patients with more complex medical conditions and/or chronic illnesses who will face increased risk.
- Increasing communication to family physicians and medical specialists to support their ability to care for their patients. Introduce emergency fee schedule as needed to support care.
- Action to protect seniors in long-term care, assisted living, and home and community care. Activate outbreak protocols: reduce people coming into facilities; screen visitors; vigilance for illness of residents and health-care workers.
Under protecting health workers, the government focuses on:
- Actively remind and maintain best practice for health-care workers in hospitals, community and primary care settings.
- Implement standardized preparedness plans at local level to support health-care workers to respond to a wider/more sustained outbreak.
- Provincially manage and co-ordinate supplies capacity, and manage supply chain for hospital, community and primary care.
- Implementing plans for bringing additional health care capacity to bear on hospital or community sites that come under stress: program redeployment of staff; local redeployment of staff; provincial redeployment of staff – establish list of health-care workers who could be rapidly redeployed and ensure adequate management capacity for a sustained period; working with professional colleges for privileging and/or registration.
- Established Emergency Operation Committees across health authorities and examining local health system capacity (e.g., primary care, ED (emergency department), hospital, ICU/ventilator) at regional/community levels to assess ability and plan to respond at a local level to a community-wide outbreak.
- Implementing functional protocols to be ready to create capacity as needed in hospitals for: discharging low-risk patients; deferring scheduled surgeries and procedures (in-patient and day patient surgeries); identifying capacity for new care spaces within hospitals; and ensuring bed/
equipment capacity to operationalize.
- Ensuring readiness to implement ED and hospital-wide protocols to safely triage and separate anyone presenting with respiratory illness. If volumes significantly increase, implement differential pathways for patients with respiratory illnesses presenting at B.C.’s 115 EDs to reduce hospital-acquired infection.
- Preparing to separate wards/ICU beds to keep respiratory patients away from all other patients and cohort staff for patient care.
- Established inventory of ventilator and extracorporeal membrane oxygenation machines across province to support deployment as needed.
- Actively monitoring medicine supplies.
The B.C. government said analysis of COVID-19 data from China, the novel coronavirus appears less severe than SARS and MERS but is more contagious. It is more severe than influenza but less contagious.
The government said approximately 81% of COVID-19 cases are mild. Fourteen per cent are severe, 5% are critical and there is a 2.3% case fatality rate in China. Outside of Hubei, the case fatality rate is 0.9%.
The case fatality rates also differ by age.
- Age 0-9: 0% case fatality rate
- Age 10-19: 0.2% case fatality rate
- Age 20-29: 0.2% case fatality rate
- Age 30-39: 0.2% case fatality rate
- Age 40-49: 0.4% case fatality rate
- Age 50-59: 1.3% case fatality rate
- Age 60-69: 3.6% case fatality rate
- Age 70-79: 8.0% case fatality rate
- Age 80+: 14.8% case fatality rate
And the fataility rates also change with comorbid conditions (existing simultaneously with and usually independently of another medical condition).
Without a comorbid condition, the case fatality rate is 0.9%.
However, patients with comorbid conditions have a higher fatality rate:
- Cardiovascular disease: 10.5% case fatality rate
- Diabetes: 7.3% case fatality rate
- Chronic respiratory disease: 6.3% fatality rate
- Hypertension: 6% fatality rate
- Cancer: 5.6% case fatality rate
Children experienced almost entirely mild illness, according to the B.C. government.
Henry said data from China shows quarantine in Hubei province, where the city of Wuhan (the centre of the COVID-19 outbreak), is located did help slowing down the spread of the novel coronavirus.
Four teams of researchers at the University of BC and others at Simon Fraser University and the University of the Fraser Valley are among 47 groups across Canada sharing a portion of $20 million in federal funds announced today for COVID-19 research.
The 20-million dollars is in addition to $7 million announced earlier by Ottawa, and researchers at a total of four B.C. universities will benefit.
The University of BC says it’s portion amounts to just under $3 million and will be divided among teams researching everything from who gets sick and how, to a mobile virtual health care app for those in self-isolation and an examination of the mental health consequences of enforced quarantine.
Federal Health Minister Patty Hajdu says the funds are not meant push Canada to the front of the race to find a vaccine, instead she says the money will ensure this country is at the ‘ground level” of COVID-19 research and is in a position to contribute to — and share the benefits of — any vaccine developed.
The World Health Organization said Friday all countries should make containing the outbreak of COVID-19 their top priority.
According to the Johns Hopkins University Center for Systems Science and Engineering, the total number of confirmed cases of coronavirus infection has now reached 101,587.
With files from The Canadian Press