Duration of physical distancing still unknown
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This article was published 03/04/2020 (1035 days ago), so information in it may no longer be current.
Whether Manitoba’s public-health orders were imposed early enough to effectively slow the spread of COVID-19 in this province is expected to become clear within weeks. But there isn’t enough data yet to understand how physical distancing is working here, or when governments will be able to ease restrictions, a leading infectious disease expert says.
"That’s the million-dollar question, is when will we be able to relax the measures? And I can’t answer that," said Dr. Yoav Keynan, scientific director of the National Collaborating Centre for Infectious Diseases and an infectious-disease physician at the University of Manitoba.
"Those are questions that people are working on, trying to figure out what are the exit strategies of this epidemic, but I think we’re … in early days. We have the advantage — I think (public health) responded early," he added.
"We are late to the party, so we will learn from good and bad experiences of other places."
Canadians are facing speculation they can expect several months of physical isolation (Prime Minister Justin Trudeau didn’t confirm reports earlier this week the federal government is planning to keep distancing measures in place at least into the summer, according to Global News) but Keynan said he wouldn’t make projections.
He did point to signs he and other public-health experts will watch for to better understand if distancing is working — and the number of confirmed cases in Manitoba isn’t one of them.
"They are interesting in understanding the big picture of transmission, but those are not the numbers that will determine if we’re successful or not," Keynan said.
Instead, it’s the number of hospitalizations that is critical; specifically, data on intensive care patients. Those numbers, indicators of the demand for ventilators, will guide officials’ response to the ongoing crisis. Increasing numbers of diagnosed cases could be a good sign, he said, because they can lead to a better understanding of how the virus is spreading, and ultimately how to stop it.
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Timeline of Manitoba’s COVID-19 response
March 12
The province announces
Manitoba’s first three
cases of COVID-19.
March 16
Hospitals, health centres,
and acute care centres
start limiting the number
of visitors. Recent
travellers and people with
symptoms are told they
shouldn’t visit those places.
Manitoba health-care
workers returning from
international travel are
told to report to their
occupational health office
before returning to work.
Canada halts most
international travel, and
Prime Minister Justin
Trudeau urges Canadians
abroad to come home. He
says other Canadians should
only go out for essentials.
March 17
Manitoba public health
officials recommend
cancelling all gatherings
of 50 people or more and
suspends visitors to
long-term care facilities
across Manitoba, except
for compassionate or
end-of-life reasons.
March 20
Manitoba declares a state
of emergency, allowing
public health officials to
issue orders. Gatherings
of more than 50 people
are banned, and many
businesses are ordered
to close. Limits are
placed on restaurants
and bars to reduce the
number of people who
could be inside. All licensed
child care centres are
ordered closed.
1
,
0
0
0
8
0
0
March 27
Manitoba’s first COVID-19
death is recorded.
6
0
0
4
0
0
2
0
0
0
4
5
6
7
8
9
1
0
1
2
1
4
1
6
1
8
2
0
2
2
2
4
2
6
2
8
3
0
1
4
5
6
7
8
9
1
0
1
2
1
4
March
2020
April
March 30
Gatherings of more than
10 people are banned;
grocery stores and other
retail businesses allowed
to remain open must
ensure customers stay at
least two metres away
from each other. The
order also applies to
public transportation.
March 31
Schools are to
closed indefinitely.
April 1
All “non-critical” businesses
are ordered to close, as per
a new public health order.
April 3
Manitoba’s second
COVID-19 death is
announced.
WINNIPEG FREE PRESS — SOURCE: MANITOBA HEALTH, SENIORS AND ACTIVE LIVING
Timeline of Manitoba’s COVID-19 response
March 12
The province announces
Manitoba’s first three
cases of COVID-19.
March 16
Hospitals, health centres,
and acute care centres
start limiting the number
of visitors. Recent
travellers and people with
symptoms are told they
shouldn’t visit those places.
Manitoba health-care
workers returning from
international travel are
told to report to their
occupational health office
before returning to work.
Canada halts most
international travel, and
Prime Minister Justin
Trudeau urges Canadians
abroad to come home. He
says other Canadians should
only go out for essentials.
March 17
Manitoba public health
officials recommend
cancelling all gatherings
of 50 people or more and
suspends visitors to
long-term care facilities
across Manitoba, except
for compassionate or
end-of-life reasons.
March 20
Manitoba declares a state
of emergency, allowing
public health officials to
issue orders. Gatherings
of more than 50 people
are banned, and many
businesses are ordered
to close. Limits are
placed on restaurants
and bars to reduce the
number of people who
could be inside. All licensed
child care centres are
ordered closed.
1
,
0
0
0
8
0
0
March 27
Manitoba’s first COVID-19
death is recorded.
6
0
0
4
0
0
2
0
0
0
4
5
6
7
8
9
1
0
1
2
1
4
1
6
1
8
2
0
2
2
2
4
2
6
2
8
3
0
1
4
5
6
7
8
9
1
0
1
2
1
4
March
2020
April
March 30
Gatherings of more than
10 people are banned;
grocery stores and other
retail businesses allowed
to remain open must
ensure customers stay at
least two metres away
from each other. The
order also applies to
public transportation.
March 31
Schools are to
closed indefinitely.
April 1
All “non-critical” businesses
are ordered to close, as per
a new public health order.
April 3
Manitoba’s second
COVID-19 death is
announced.
WINNIPEG FREE PRESS — SOURCE: MANITOBA HEALTH, SENIORS AND ACTIVE LIVING
Timeline of Manitoba’s COVID-19 response
1
,
0
0
0
March 20
Manitoba declares a state of emergency, allowing public health officials to issue orders. Gatherings of more than 50 people are banned, and many businesses are ordered to close. Limits are placed on restaurants and bars to reduce the number of people who could be inside. All licensed child care centres are ordered closed.
March 16
Hospitals, health centres, and acute care centres start
limiting the number of visitors. Recent travellers and people with symptoms are told they shouldn’t visit those places. Manitoba health-care workers returning from international travel are told to report to their occupational health office before returning to work. Canada halts most international travel, and Prime Minister Justin Trudeau urges Canadians abroad to come home. He says other Canadians should only go out for essentials.
8
0
0
6
0
0
March 30
Gatherings of more than 10 people are banned; grocery stores and other retail businesses allowed to remain open must ensure customers stay at least two metres away from each other. The order also applies to public transportation.
4
0
0
2
0
0
0
4
5
6
7
8
9
1
0
1
2
1
4
1
6
1
8
2
0
2
2
2
4
2
6
2
8
3
0
1
4
5
6
7
8
9
1
0
1
2
1
4
March
2020
April
March 12
The province announces
Manitoba’s first three
cases of COVID-19.
April 3
Manitoba’s second COVID-19
death is announced.
March 27
Manitoba’s first
COVID-19 death
is recorded.
March 17
Manitoba public health
officials recommend
cancelling all gatherings of
50 people or more and
suspends visitors to
long-term care facilities
across Manitoba, except
for compassionate
or end-of-life reasons.
March 31
Schools are to
closed indefinitely.
April 1
All “non-critical” businesses
are ordered to close, as per
a new public health order.
WINNIPEG FREE PRESS — SOURCE: MANITOBA HEALTH, SENIORS AND ACTIVE LIVING
:wfpremovefromapp
Right now, although two people have died of the virus, the physical distancing measures and other public-health recommendations are still buying time in Manitoba. It’s time that researchers are using to pursue clinical trials and study lessons learned in other parts of the world as they try to make sure our health-care system and ventilator supply are not overwhelmed by seriously ill COVID-19 patients, as has already happened in other countries. Canada had more time to tailor its emergency response, and "Manitoba even more so," Keynan said.
"Because we are learning from our colleagues and friends in Ontario and B.C. and Quebec, and the early information-sharing has been fantastic." Manitoba’s geographic location in the middle of the country may have been another advantage.
"Most of the initial cases are travel-related, and provinces that have more connectivity with southeast Asia and Europe had earlier arrival of the COVID. So I think our central location has provided some buffering here," Keynan said.
With schools closed, many businesses shuttered, once-bustling neighbourhoods quiet, and the economy and human interaction in flux around the world, public health isn’t the only factor in deciding how long physical distancing measures should go on. There have been suggestions widespread social distancing would need to last for 18 months to be effective, according to a report for the World Health Organization released by the Imperial College of London in mid-March. But Keynan said that doesn’t mean restrictive measures will remain in place for the next year and a half. Public health officials don’t take physical distancing restrictions lightly, he said.
"There are many considerations on the economic, emotional and mental-health impact of the long closures. Those are definitely factored in. But the point is, putting those measures in late doesn’t work. I think Manitoba has been very proactive in measuring the pros and cons, with a degree of uncertainty of course, because it’s a new virus for all of us."
Coping with the uncertainty is an issue in itself, said Ivy Bourgeault, director of the Canadian Health Workforce Network and professor at the University of Ottawa. Officials need to be looking at "unintended consequences" of the distancing measures, she said, including their effects on the wellbeing of health-care workers, isolation of older and vulnerable people, and women in violent relationships.
A narrow focus on capacity in the health-care sector doesn’t take into account the human cost of health-care work in the midst of this pandemic, Bourgeault said.
"We’re in the forest right now, and we’re just focused on the trees, and so I think some of us need to take a longer-term view and lend our expertise to that longer-term view," she said.
"I’m trying to figure out, how do we create positive legacies that create more resilient systems so this doesn’t happen again?"
katie.may@freepress.mb.ca
Twitter: @thatkatiemay
Katie May
Reporter
Katie May is a general-assignment reporter for the Free Press.
History
Updated on Friday, April 3, 2020 7:11 PM CDT: Removes jumbo image
Updated on Friday, April 3, 2020 8:02 PM CDT: Edits to graphic
Updated on Saturday, April 4, 2020 12:18 AM CDT: Updates ai2html and adds back JS
