The Globe and Mail - 13.03.2020

FRIDAY,MARCH13,2020| THEGLOBEANDMAILO CORONAVIRUS A

Despite assurances from public
health officials that coronavirus
tests are widely available, some
front-line physicians say they’re
having trouble getting patients
tested, creating potentially dan-
gerous gaps that could leave Can-
ada vulnerable to outbreaks.
Akeyproblemislackofconsis-
tent communication about who
qualifies for testing. For weeks,
federal, provincial and local pub-
lic health officials have been rely-
ing on a narrow list of countries
experiencing COVID-19 out-
breaks, such as China, Iran and,
more recently, Italy, to help deter-
mine which individuals could be
tested. The list has faced intense

criticism from numerous experts

who point out it doesn’t include

placessuchasGermany,Franceor

the United States, even though

those countries are experiencing

outbreaks of the coronavirus.

On Wednesday, the Public

Health Agency of Canada finally

removed the list of affected areas

from its website. Now, PHAC sim-

ply directs clinicians to the World

Health Organization’s list of

countries reporting COVID-

cases and advises them to base

testing decisions on advice from

provincial and local health offi-

cials.

But some doctors are con-

cerned the change in criteria is

not being communicated consis-

tentlyacrossCanada.MarioElia,a

family physician based in Lon-

don, Ont., said he wanted to order

a COVID-19 test on Thursday for a

patient who recently attended a

conferenceinTorontoandstarted

to experience respiratory symp-

toms. Dr. Elia called his local pub-

lic health unit, as he’s been in-

structed to do, but the nurse who

answered told him the woman

didn’tmeetthecriteriafortesting.

Dr. Elia said there was not much

more he could do than to advise

the woman to self-isolate at

home.

Dr. Elia fears this type of situa-

tion means cases of COVID-19 are

going undetected in Canada. He

compared the situation with the

U.S.,wherealackoftestinghasled

toseriousoutbreaksinnumerous

states, including at a long-term-

care home in the Seattle area.

“We’re not doing any better

than they are with testing,” Dr.

Elia said. “From a testing stand-

point, we really have nothing to

be gloating about here.”

Lucas Castellani, an infectious

diseases physician in Sault Ste.

Marie,Ont.,saidhe’sheardofsim-

ilar issues cropping up in other

areas.

“I’m hearing from colleagues

there’s these cases that could ac-

tually be potentially COVID that

we’re not testing because of the

criteria set by the current recom-

mendations by the Public Health

Agency of Canada.”

PHAC and Ontario’s health

ministry did not respond to ques-

tions about testing.

Dr. Castellani said an addition-

al problem is that Ontario has

been directing health workers to

use airborne precautions when

treating patients who may have

COVID-19. Airborne precautions

include the use of special N95 re-

spirator masks and negative pres-

sure rooms, which are typically

only available in hospitals, not at

family doctors’ offices.

Ontario’s Health Ministry has

decided to move to droplet pre-

cautions, which includes regular

surgicalmasks,gowns,glovesand

eye protection and no other spe-

cial equipment, which could help

increase testing outside of hospi-

tals.

Earlier this week, a Sudbury

man tested positive for COVID-

after attending a large conference

in Toronto. Penny Sutcliffe, med-

ical officer of health with Public

HealthSudburyandDistricts,said

she’s been directing health-care

workers in the area to shift away

from the outdated, narrow list of

countries experiencing COVID-

outbreaks in recent days, which is

why the man got checked for the

disease.

“Honestly, we wouldn’t have

identified[that]caseinourareaif

I had stuck to that case defini-

tion,” Dr. Sutcliffe said.

While Ontario, Manitoba and

other provinces are setting up

standalonetestingcentrestohelp

eliminate bottlenecks and reduce

pressure on emergency rooms,

Dr. Sutcliffe said smaller, more re-

mote areas likely won’t have ac-

cess to those facilities, at least in

thenearfuture.Thatcouldleadto

backlogs processing samples and

waitingfortestresults,inaddition

to issues getting patients tested.

“If you live in Chapleau or you

live further away, it’s extremely

challenging,andthat’sjustonthe

lab side,” Dr. Sutcliffe said.

Bonnie Henry, B.C.’s provincial

officerofhealth,saidtheprovince

has steadily broadened its testing

criteria, but that even still, ensur-

ingeveryonewhowantsatestcan

get one is a difficult task, which

will become even more so as the

case numbers continue to rise.

In the meantime, provincial

health officials are asking anyone

who develops symptoms, even

mild ones, to stay home.

Doctorswarnofgapsinvirustesting

Physicianssayofficials

aren’tconsistentlyclear

onwhoqualifies,which

mightleaveCanada

vulnerabletooutbreaks

CARLYWEEKS
HEALTHREPORTER

The federalgovernment said it is
“ready and prepared” to approve
a national package of economic
stimulus after Alberta Premier
Jason Kenney said a fiscal jolt
worth about $20-billion is ur-
gently needed.
Mr. Kenney discussed the pos-
sibility of provincial and federal
stimulus spending with Deputy
Prime Minister Chrystia Freeland
Thursday during a private meet-
ing in Ottawa in advance of a
planned first ministers meeting.
The gathering was later can-
celled after Prime Minister Justin
Trudeau announced that he was
self-isolating, while his wife,
Sophie Grégoire Trudeau, is be-
ing tested for the new coronavi-
rus.
The Alberta Premier said pro-
vincial measures will be an-
nounced in the coming weeks
and that Ms. Freeland told him
federal measures are also under
consideration.
“We need to design policies
that will really help liquidity and
cash flow for businesses that are
uniquely affected right now,” he
told reporters after delivering a
lunchtime speech in Ottawa. “In
Alberta, that would include the
energy sector, but also the tou-
rism, hospitality and leisure sec-
tors.”
Mr. Kenney said that other
countries affected by the corona-
virus – such as Britain – have al-
ready announced substantial
stimulus policies.
The Premier said stimulus of
about 1 per cent of gross domes-
tic product – roughly $20-billion

• is warranted in the current sit-
  uation. For context, Canada and
  other countries pledged to pro-
  vide stimulus worth 2 per cent of
  GDP in response to the 2008 fi-
  nancial crisis.
  Speaking with reporters
  Thursday afternoon, Ms. Free-
  land said she and Mr. Kenney
  discussed the needs of specific
  economic sectors and that she
  reiterated the federal govern-
  ment’s position that it is ready to
  provide fiscal stimulus if re-
  quired.
  “There has been already an
  impact on the global economy
  and on the Canadian economy.
  But it is fair to anticipate that
  there will be further economic

consequences,” Ms. Freeland said

Thursday. “And therefore, let me

assure all Canadians, as I assured

Premier Kenney, that our gov-

ernment stands ready to respond

to support the Canadian econo-

my, and we do have the econom-

ic firepower to do so.

“Canada has a triple-A credit

rating and the lowest debt-to-

GDP ratio in the G7. The Cana-

dian economy is strong. The gov-

ernment is ready and prepared

to act to support our economy.”

The government announced

$1.1-billion worth of coronavirus-

related measures this week and

said a federal budget will be re-

leased on March 30.

Finance Minister Bill Morneau

addressed the media late Thurs-

day after Canadian stocks

plunged more than 12 per cent.

Mr. Morneau said he and the

Prime Minister are in frequent

contact with provincial and in-

ternational counterparts and

strongly hinted that the budget

will include measures to stimu-

late the economy.

Mr. Morneau also said the

budget figures will be based on

an updated average forecast

from private-sector economists

so that the projections are as up

to date as possible.

“That’s going to help us to

make sure that we have a good

starting point,” he said. “From

there, what we’re going to do is

to use our fiscal strength to make

sure that our economy stays

strong in the face of this uncer-

tainty.”

Any fiscal measures – such as

tax cuts or new spending –

would be in addition to the re-

cent monetary stimulus provid-

ed by the Bank of Canada, which

cut rates by 50 basis points last

week. Canada’s central bank is

widely expected to cut again at

its next rate announcement in

April.

The federalgovernment said

Wednesday that in the event that

businesses face tight credit con-

ditions, it will stimulate the

economy through federal lend-

ing agencies such as the Business

Development Bank of Canada

and Export Development Cana-

da.

Scotiabank chief economist

Jean-François Perrault is also rec-

ommending fiscal stimulus in

the neighbourhood of 1 per cent

of GDP.

In a report released Wednes-

day, Mr. Perreault said Canadian

economic growth will fall below

zero in the second quarter and is

likely to fall below zero in the

third quarter unless fiscal policy

intervenes.

“A reasonably mild recession

appears likely unless timely and

targeted fiscal measures are de-

ployed in the very near future to

deal with the economic impacts

of the virus,” the report said.

Mr. Perreault, a former senior

Finance Department official, said

possible stimulus measures

could include expanding the GST

rebate program, contribution ho-

lidays for Employment Insur-

ance or Canada Pension Plan

premiums or temporary increas-

es to the Canada Child Benefit or

Old Age Security programs.

“Our recommendation is to

place a priority on approaches

that provide financial support to

those most likely to spend it –

less-well-off Canadians,” he

wrote.

Mr. Kenney isn’t getting unan-

imous backing for his call from

Conservatives though. Ontario

MP Pierre Poilievre said in a

statement Thursday that “too

much government spending is

one of the reasons the Canadian

economy was weak before CO-

VID-19. More government spend-

ing will not solve the problem it

helped cause.”

And Tory leadership candi-

date Peter MacKay sent an e-mail

to supporters with a link to a

fundraiser taking issue with the

$1-billion Ottawa has already

committed. The Prime Minister

“seems to think throwing some

more of your money at the prob-

lem will make it go away. It

won’t.” Mr. MacKay wrote in the

e-mail.

Meanwhile, Ms. Freeland said

she had a “very open” conversa-

tion with U.S. Secretary of State

Mike Pompeo Thursday, where

they discussed Canada’s public-

health system and the measures

that the Canadian government is

taking to combat the virus. How-

ever, she did not say if Ottawa

would follow in the footsteps of

the Trump administration’s deci-

sion to ban most travel to the

U.S. from 26 European countries,

“When it comes to the Cana-

dian border, we have already

heightened measures in place for

monitoring travellers from parts

of the world where there is a

greater outbreak of the coronavi-

rus. Those measures are in place

right now at our air, land and sea

borders,” Ms. Freeland said. “The

situation with the coronavirus in

Canada and in the world is devel-

oping quickly. It is constantly

changing and we are monitoring

that situation hour by hour and

day by day.”

Anne McLellan, who served as

health minister during the SARS

outbreak, said in an interview

Thursday that Mr. Trump’s travel

ban has created more panic and

more confusion.

“And there is no evidence that

it actually deals with the prob-

lem,” she said.

On another front, Canada’s

banking regulator – the Office of

the Superintendent of Financial

Institutions – announced Thurs-

day that it has asked about 360

of its Ottawa-based employees to

work from home while an OSFI

employee is being tested for CO-

VID-19. The office said services

will not be affected.

With reports from Michelle Carbert

and Janice Dickson

Ottawasettogreen-lightnationalstimuluspackage:Freeland

DeputyPrimeMinisterChrystiaFreeland,seeninOttawaonThursday,metwithAlbertaPremierJasonKenney,

whodiscussedthepossibilityofprovincialandfederalstimulusspending.SEANKILPATRICK/THECANADIANPRESS

BILLCURRY
MARIEKEWALSH
KRISTYKIRKUPOTTAWA

“Although I’m experiencing un-
comfortable symptoms of the vi-
rus, I will be back on my feet
soon,” she said.
The rapidly evolving pandem-
ic gripped Parliament Hill on
Thursday, forcing Mr. Trudeau to
cancel in-person meetings in Ot-
tawa with the premiers and In-
digenous leaders in favour of vir-
tual meetings, and MPs and sen-
ators discussed suspending the
houses of Parliament.
Other parliamentarians, in-
cluding International Trade Min-
ister Mary Ng and Natural Re-
sources Minister Seamus O’Re-
gan, are also in self-isolation out
of precaution.
Some Conservative leadership
candidates have cancelled their
public events.

The Prime Minister will have

meetings over the phone with

premiers and Indigenous leaders

on Friday.

Mr. Trudeau’s discussions

Thursday included speaking

with U.S. President Donald

Trump, British Prime Minister

Boris Johnson and Italian Prime

Minister Giuseppe Conte. All of

those discussions centred on CO-

VID-19, his office said, and Mr.

Trudeau also called into the spe-

cial cabinet committee meeting

on the disease.

A brief summary of Mr. Tru-

deau’s call with Mr. Trump said

the two leaders “welcomed the

close co-ordination between

Canada and the United States in

managing this challenge, includ-

ing as it relates to the Canada-

U.S. border.”

The Prime Minister’s Office

said in Mr. Trudeau’s call with

the Italian leader, he “expressed

solidarity with Prime Minister

Conte and all Italians as they

take extraordinary measures to

contain and respond to CO-

VID-19’s health, social, and eco-

nomic impacts.”

“They agreed on the impor-

tance of international co-ordina-

tion in response to the virus,”

the statement said.

Nothing will necessarily

change in government if the

Prime Minister does get sick, Lori

Turnbull, director of the school

of public administration at Dal-

housie University, said Thursday.

However, if Mr. Trudeau be-

came incapacitated, Prof. Turn-

bull said, it wouldn’t lead to a

power vacuum because there are

mechanisms in place to ensure

the continuity of government.

She called it a “rare, if ever” used

process where cabinet would ap-

point an acting prime minister.

Given Chrystia Freeland’s role

as Deputy Prime Minister, she

said, Ms. Freeland would be the

likely candidate.

NDP Leader Jagmeet Singh

said Thursday he is self-isolating

because he feels unwell. On a

doctor’s advice, he is limiting his

contact with the public until he

feels better, but the doctor does

not believe his symptoms are

consistent with COVID-19, he

said.

As of Thursday evening, MPs

and senators were discussing a

possible suspension of the legis-

lative sitting.

Health Minister Patty Hajdu

recommended avoiding large

gatherings.

Conservative leadership can-

didates have been organizing

events across the country as they

race to raise money and attract

new supporters.

The candidates have taken

varying approaches to their cam-

paigns.

Conservative leadership can-

didate Peter MacKay suspended

all public campaign events

Thursday and Erin O’Toole said

he would cancel all of his as of

Friday.

Other candidates are forging

ahead. MP Marilyn Gladu’s cam-

paign has not cancelled any

events, but said it would reassess

that decision on a daily basis.

Governor-General Julie

Payette’s office said “out of an

abundance of caution” it is limit-

ing public events and activities

and is looking at rescheduling

ceremonies.

Trudeau:FederalHealthMinisterrecommendsavoidinglargegatherings

FROMA