The B.C. government released new statistics on June 23 to bolster the case for moving to Phase 3 of reopening, now that Covid-19 cases have been reduced to a manageable level.
Phase 3 permits non-essential and recreational travel to other parts of the province as the summer season gets underway. In reality, people have been doing this kind of travel for weeks anyway as there never was a legal ban on non-essential travel in the province – just a recommendation.
The numbers for B.C. are good right now. But as more and more summer tourist traffic fills the streets of Osoyoos, we need to remain vigilant.
Other countries have brought the virus under control only to see renewed outbreaks, sometimes worse than the original infection. Some U.S. states, especially in the south and west, opened up prematurely and are now seeing the virus raging out of control.
As of yesterday, Friday, June 26, B.C. has experienced 2,878 total confirmed cases over the course of the pandemic from which 174 people have died and 2,545 have recovered. Seventeen people are currently in hospital for coronavirus province wide including five in ICU.
There were 10 new cases reported, all in the Fraser Health Authority, which includes much of the Fraser Valley to the east of Vancouver. That area has seen the most recent new cases.
Here in the vast Interior Health Region, there have been 199 confirmed cases over the course of the pandemic from which two people have died and 196 have recovered.
The June 23 numbers show there were 99 cumulative cases in the Okanagan, including two new ones in the period between June 8 and June 21.
Compared to provinces like Quebec and Ontario, that means we’re relatively safe. And we’re seeing a much different situation here than in those U.S. states that began opening up in early May and are now seeing cases surge in record numbers.
But there is reason for concern on several fronts in B.C., even if we’re not yet at the point of alarm.
Here in Osoyoos, I would compare the Covid situation to an extremely dry landscape in fire season. At the moment, there’s little risk of a fire flaring out of control because there’s no spark, but it only takes one carelessly tossed cigarette butt.
We don’t have the population density or the extreme poverty that has contributed to outbreaks elsewhere. We do have several examples of congregate living or working in the South Okanagan that could spell trouble – long-term care residences, the Okanagan Correctional Centre near Oliver, and fruit packing plants where workers may not be able to physically distance.
The median age in Osoyoos, at 60, is the second highest in Canada after Qualicum Beach, meaning our population is especially at risk.
Now add a massive influx of visitors, often in carefree “vacation mode,” many from out of province, the Lower Mainland or even Americans supposedly en route to Alaska. That chance of a metaphorical tossed cigarette butt is high.
The two figures that caught my eye in the June 23 government report were that the Rt rate is currently hovering around one and contact rates since mid-May are roughly 65 per cent of normal. The Rt rate is the average daily number of new infections generated per case.
When the R (reproduction) number is below one, that means each infected person on average gives the virus to fewer than one other person and over time the number of infected people declines. When it’s higher than one, each infected person gives the virus to more than one person on average, causing the infection rate to grow.
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- This BBC article provides a more detailed explanation of R numbers.
As people adopt physical distancing and other control measures, the R number goes down. As people let down their guards, don’t wear masks or they congregate without social distancing, the number tends to go up.
As the government report notes, currently B.C. is at the threshold for a rebound in new cases.
Related to this is the contact rate of around 65 per cent. If the contact rate rises to 70 – 80%, we could see case numbers rise again to levels comparable with March and April or higher.
“Our models suggests (sic) that contact rates since mid-May are roughly 65% of normal, which is roughly the threshold for a rebound in new cases.” – Covid-19 in B.C.: Going Forward, B.C. Ministry of Health
In other words, we’re currently at the threshold of a rebound just as B.C. is moving into Phase 3 and travel within the province was already increasing at a significant rate.
The problem is that when the R number is high due to lack of physical distancing and other measures, the spread of the virus can become exponential. The spread can be choked off by reimposing some of the measures put in place in late March, but politically that’s very hard to do because people have bought into the message that it’s now safe to reopen. Closing again is like putting toothpaste back in the tube.
Some U.S. governors who reopened their states too aggressively have been surprised at how quickly the virus is spreading. Arizona, Texas and Florida, all led by Republican governors who downplayed the virus, are now being particularly hard hit. Those states, unfortunately, decided to reopen when cases were still rising, unlike B.C. and some European countries that only introduced reopening after a sustained drop in new cases.
Research is making it clear that many people are infectious just days after being exposed and often before they show any symptoms. So the focus by health authorities just on people who are symptomatic has been misguided and has probably contributed to the spread. Many people are infected by people not showing symptoms, which is why SARS-Cov-2 (novel coronavirus) is so much more dangerous than the original SARS.
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- See “In the W.H.O.’s Coronavirus Stumbles, Some Scientists see a pattern,” New York Times
- See “Infected but Feeling Fine: The Unwitting Coronavirus Spreaders,” New York Times
It’s often said that three T’s are crucial to preventing a resurgence – testing, tracing and trust.
Provincial Health Officer Dr. Bonnie Henry has earned the trust of British Columbians with her calm and factual information that has persuaded most people to follow her guidance without resorting to draconian lockdown measures. B.C. was wise to let her rather than politicians take the lead on addressing the public.
Tracing of contacts has no doubt played an important role in B.C.’s success so far at containing the virus.
But B.C.’s testing rate is among the lowest in the developed world and testing has been mostly limited to those already showing symptoms. This failure to conduct more widespread surveillance testing could seriously impair our ability to catch new outbreaks early.
B.C.’s testing rate as of yesterday was 3,158 per 100,000 population. This is lower than every province and territory in Canada with the exception of Nunavut, which has had zero cases. The Canadian average is 6,912 people tested per 100,000 population.
In total, B.C. has tested 160,145 people, whereas Alberta has tested 373,437 people despite having a smaller population. Why the difference in approach between the two provinces?
Canada once led the U.S. in testing per capita, but that has changed and the U.S. is now doing much more testing than we are, adjusting for our different populations.
Rhode Island leads with 21,577 tests per 100,000 population. Even Idaho, last place among U.S. states, has a testing rate of 4,591 per 100,000 – significantly higher than B.C.
Among major European countries, only France at 2,121 per 100,000 is doing less testing than B.C.
That’s not to say that B.C.’s lack of testing is alarming, particularly at the present when the number of active cases is very low. It would be more of a concern if tests were showing a 5% or higher positivity rate, which they are not.
The question though is whether the low rate of testing and focus on testing people only after they are symptomatic could allow a new outbreak to escape detection until it is too late.
B.C. has done well, but as the province itself admits, we are at a threshold just as summer travel is picking up.
I’ll try to get out and enjoy the summer, but I’ll remain prudent about physical distancing and hand washing, and when I can’t keep a safe distance, I’ll put on a mask.
We’re not out of the woods yet.
