B.C.’s top doctor recognizes ‘we don’t always get it right’
Dr. Bonnie Henry, British Columbia's provincial health officer, admitted at a press conference on Thursday that as the province adjusted guidance around schools as COVID-19 evolved, there was a lack of consistency across B.C.
“I think it’s important to recognize that we don’t always get it right, right off,” Dr. Henry said. “When we started sharing information about school exposures, our communications across the province were not fully aligned.”
“We are working through those kinks and continue to refine our approach, and I am confident now that our communication approach is aligned in all health authorities across the province.”
B.C.’s provincial health officer also defined exactly what constitutes a school exposure.
“A school exposure is when a single person is confirmed positive for COVID-19 [and] has been in the school during their infectious period,” Dr. Henry explained.
She went on to say that many health authorities are determining when a cluster is present in a school environment, which would be two or more people in school are confirmed positive.
“Every time there is a school exposure, public health contact tracing kicks into gear,” B.C.’s provincial health officer stressed.
Dr. Henry confirmed that B.C. has not seen an “exponential increase” in COVID-19 cases. Instead, the province has been experiencing a “linear increase” that has “slowed down.”
B.C.’s provincial health officer did continue to stress that there is still ongoing transmission in the community and people need to be cautious.
“It sneaks up on us,” Dr. Henry said. “We can have explosive outbreaks if we’re not on our guard.”
Halloween that is ‘scary for the right reason’
Dr. Deena Hinshaw, Alberta's chief medical officer of health, announced the province has release recommendation on how to safely celebrate Halloween in a way that is “scary for the right reason.”
The guidance includes only trick or treating with your family or cohort, and in your home community, avoiding touching high-contact items like doorhandles and railings, and handing out candy on your driveway or lawn.
Dr. Hinshaw also highlighted that parents and children should try to choose a costume that allows for a non-medical mask to be worn, and people handing out candy should be wearing a mask as well.
Candy should be prepackaged and the use of a “candy slide,” “candy catapult” or another non-touch method can be considered for handing out candy.
The province has also created posters for people in Alberta to post at their house if they are in fact participating in trick or treating this year.
Ontario changes COVID-19 screening guidance for children, students
The Ontario government has made changes to its COVID-19 school and child care screening guidance.
The first set of symptoms children should be screened for are fever and/or chills, cough, shortness of breath, decrease or loss of smell or taste. Students and children with any of these symptoms must stay home, consult with a health care provider and receive an alternative diagnosis or a negative COVID-19 test.
The second set of symptoms children should be screened for are sore throat, stuffy/runny nose, headache, nausea, vomiting and/or diarrhea, fatigue, lethargy, muscle aches or malaise. A student or child with one of these symptoms needs to stay home for at least 24 hours, until their symptoms have improved.
Students and children with two or more of these symptoms must stay home, consult with a health care provider and receive an alternative diagnosis or a negative COVID-19 test. Abdominal pain and conjunctivitis (pink eye) are no longer symptoms listed on the screening documents.
However, at a press conference on Thursday, Dr. Barbara Yaffe, Ontario’s associate chief medical officer of health, highlighted that schools and daycares should not require a negative COVID-19 test, or even a doctor’s note, for a child to return to a school or child care settings.
“Just doing a test, on its own, is not going to necessarily help the situation,” she said. “If the parent has consulted the [healthcare provider], the child is feeling better, they should be able to go back to school.”
Dr. Dirk Huyer, Ontario’s chief coroner and executive lead of the COVID-19 Testing Approach, stressed that the parent, the healthcare provider and the child work together to figure out the reason for these symptoms.
“There are a number of things that can cause fever and chills, and there should be an evaluation,” Dr. Huyer said. “Just going to get a test doesn’t allow that continued involvement of the healthcare provider and the parent.”
Ontario’s associate chief medical officer of health said the province consulted with both B.C. officials and Public Health Ontario about COVID-19 symptoms present in children. Dr. Yaffe revealed that up to 17 per cent of children with COVID-19 in Ontario had a runny nose when the infection started but it is also a “very common” symptom for other illnesses or infections.
She also said at least 20 per cent of children with COVID-19 are completely asymptomatic.
“The B.C. approach is more that, they are basically saying, we know we cannot keep COVID completely out of the schools, so why are we looking for all these symptoms,” Dr. Yaffe said. “We are saying no, we want to find it if it’s there, if we can.”
The symptoms students should be screened for in B.C. are fever and chills, cough, shortness or breath, loss of sense of smell or taste, or nausea and vomiting. Anyone with one of these symptoms (excluding fever) should stay home for 24 hours from when the symptom started.
“If the symptom improves, you may return to school when you feel well enough,” the B.C. guidance reads. “If the symptom persists or worsens, seek a health assessment.”
Any student with two of more of these symptoms in B.C., or a fever, should get a health assessment from a primary care provider and “should not return to school until COVID-19 has been excluded and your symptoms have improved.”
B.C. officials also indicate that a doctor’s note should not be required to confirm anyone health status.
‘It’s not just a repeat of Stage 2’
As officials in Ontario continue to express concern about COVID-19 cases in province, Dr. David Williams, Ontario’s chief medical officer of health, said the province will not be returning to Stage 2, as it existed earlier in year.
“It’s not just a repeat of Stage 2, [there] may be some things that are similar to Stage 2 but it’s applied with a much more methodical metric,” Dr. Williams said. “Going at it in a way that is backed up by local data and what the local medical officer of health sees.”
He added that there may be broad measures implemented across the province but also targeted rules for “hot spots” for COVID-19 spread in Ontario, primarily Toronto, Peel and Ottawa at this point. Dr. Williams also specified that some businesses or services forced to shut down operation in the future could be things that haven’t been closed since Stage 1.
With regards to restaurants and questions around possibly closing indoor dining, both Ontario Premier Doug Ford and the chief medical officer of health identified that most of the cases in these settings are between workers, not involving patrons, including before and after work, and in back rooms.
“Some are being less than stringent about the public health measures with their staff when they’re not in with the patrons,” Dr. Williams said. “Just because a few are not adhering, it doesn’t mean everyone should be punished.”
Ford added that “there has to be a justification” to close restaurant operations, especially when there are some areas of the province that have less than five COVID-19 cases.
Ontario’s chief medical officer of health stressed that provincial health authorities are not recommending that schools close at this point in time.
Some of the metrics that are being evaluated in any changes to the existing public health measures include the composition of the population (dense urban centre, rural areas with a spread out population), weekly and monthly trends in cases, effective reproductive number, testing issues and local outbreaks.
Ontario enhances salaries for personal support workers
The Ontario government announced Thursday that a $461 million investment is being made to temporarily enhance wages for personal support workers (PSWs).
“We know the wages of PSWs do not reflect the critical role they have played throughout this pandemic, in addition to their ongoing care of our loved ones,” Ford said in a statement. “Today's temporary investment will bridge that gap and ensure this vital profession receives the appreciation and respect it deserves.”
The wage increase is effective Oct. 1 and will apply to more than 147,000 workers. PSWs in long-term care, home and community care will received $3 more per hour. This amount also applies to workers in children, community and social services providing personal direct support services for the activities of daily living.
Eligible workers in public hospitals will receive an additional $2 per hour.