The Globe and Mail - 03.04.2020

FRIDAY, APRIL 3, 2020 | THE GLOBE AND MAILO NEWS | A

The federalgovernment is lagging some
provinces and other countries as it contin-
ues to hold back the modelling that shows
the best- and worst-case scenarios Canada
faces in the COVID-19 pandemic.
Governments around the world are rely-
ing on mathematical projections based on
available case data to understand how the
pandemic could spread, in order to guide
decision-making and ensure the right re-
sources are in place to handle the coming
surge in cases. Experts say releasing this
modelling and other data are critical to
building trust with citizens and helps gov-
ernments get buy-in for the unpreceden-
ted and restrictive policies.
“The more information that we can
share, the better,” said Steven Hoffman, di-
rector of the Global Strategy Lab at York
University in Toronto.
Last week, Prime Minister Justin Tru-
deau said hisgovernment would disclose
its modelling, but Ottawa has since played
down the need and delayed its release. The
result is Canadians are still in the dark
about what information Mr. Trudeau’s
government is basing its plans on.
At the provincial level, that’s changing.
British Columbia has already released its
modelling and Ontario will reveal its pos-
sible scenarios on Friday.
“It’s going to be a real sobering discus-
sion,” Ontario Premier Doug Ford said
Thursday. “It’s going to be stark.”
The province’s top doctor compared
pandemic modelling to a weather forecast

• it may predict a blizzard, but exactly how
  much snow fell comes from the data.
  New Brunswick and Alberta have also
  promised to release their models.
  Countries such as New Zealand and the
  United States have already released their
  planning scenarios. Models from the U.S.
  show the restrictions put in place are ex-
  pected to blunt the impact of the disease
  and limit deaths to between 100,000 and
  240,000. Withoutgovernment action, the
  models show deaths could have reached
  2.2. million.
  Last week, Mr. Trudeau said Canadians
  “deserve the best information we’ve got
  about what’s happening today and what
  tomorrow might bring.” His only update
  Thursday was the information is coming
  “soon.”
  He made his call for patience a day after
  federal officials played down the need for
  the models to be made public. “It’s not that
  helpful for us right now,” Canada’s Chief
  Public Health Officer Theresa Tam said,
  adding her agency’s focus is on getting the
  pandemic’s firstwaveunder control.
  Pressed repeatedly by journalists on
  Thursday about the delay, the Prime Min-

ister said “as we get those models more ac-

curate, we look forward to sharing them

with Canadians.”

The federal NDP is calling for the imme-

diate release of those models. “We can’t

fight this virus blindly,” B.C. MP Don Davies

said.

Last week, British Columbia took the

lead in Canada in disclosing the models it

is using to guide its pandemic response.

Provincial Health Officer Bonnie Henry

has also shared the protocols that will

guide how medical teams will make life-

or-death decisions, if critical medical

equipment such as ventilators are ra-

tioned.

Dr. Henry said transparency is critical to

ensuring the public embraces the sweep-

ing restrictions, including school and busi-

ness closings, travel bans and physical dis-

tancing rules.

“I just think if people can see it, they’re

much more likely to believe,” she said.

The B.C. models didn’t include projec-

tions on fatalities, but compared the po-

tential number of acute COVID-19 cases

with the number of intensive-care beds

the province has, which are equipped with

ventilators. In what health officials believe

is the most likely scenario, the models

show B.C. can meet the peak demand of

271 adults requiring ventilation.

Across all levels ofgovernment, former

federal health minister Jane Philpott is

calling for “radical transparency.”

Dr. Philpott, a family physician, staffing

a COVID-19 assessment centre in the Grea-

ter Toronto Area, and the incoming dean

of the faculty of health sciences at Queen’s

University in Kingston, said there are sev-

eral challenges with the data going into the

models, including consistency across juris-

dictions, limited testing and timeliness,

but that shouldn’t stop the information

from being released.

She said models, by their very nature,

aren’t perfect but they are still important

to understanding where resources are

needed, what the worst-case scenarios are

and if Canada’s health-care professionals

are properly equipped.

“You have to be frank about the things

we are worried about and that we’re not

doing so well on,” Dr. Philpott said.

The information shared publicly needs

to go beyond modelling to include up-to-

date numbers on new cases, hospitaliza-

tions and deaths, as well as transparency in

the factors that go into government deci-

sions, Prof. Hoffman at York said.

What’s important is “promoting trust

and ensuring there’s a broad range of in-

formation” available, he said. Prof. Hoff-

man added the federalgovernment has

been ahead of some of the provinces in

this goal.

On the front lines, health-care workers

are also calling for more transparency.

Christine Sorensen, president of the BC

Nurses’ Union, said hospitals and long-

term care homes are rationing personal

protective equipment, and her members

deserve to know what is happening with

resupply efforts.

“We are asking thegovernment to be

more transparent, to be more honest

about what they are facing in the days and

weeks ahead,” Ms. Sorensen said.

Mr. Ford said he changed his mind

about releasing the models because the

public deserves to see the information that

he gets, adding it will be a “real wake-up

call” for people who still aren’t following

self-isolation rules.

Deena Hinshaw, Alberta’s Chief Medical

Officer of Health, said her province is pre-

paring to release its modelling, because it

will help “people understand how serious

the situation is” and why they need to fully

participate in efforts to reduce the spread

of the virus.

Quebec Premier François Legault and

provincial Director of Public Health Hora-

cio Arruda have refused to share Quebec’s

projections – but haven’t been shy to claim

success based on them.

This week Mr. Legault shifted position

on sharing a select version of the prov-

ince’s modelling, saying he asked the pub-

lic-health team to release a “most likely

scenario.”

“I understand people want to see what

we have,” Mr. Legault told reporters.

Nova Scotia said it hasn’t decided yet

whether to release its models when they

arecomplete. Newfoundland and Labra-

dor said its epidemic is weeks behind B.C.

and it doesn’t yet have enough data for its

models.

Manitoba said it is still working on its

models, but was unclear on whether they

would be released. Saskatchewan and

Prince Edward Island did not respond to

questions about releasing their models.

WithreportsfromLauraStoneinToronto

andLesPerreauxinMontreal

Ottawaholds backcoronavirusprojections

Canadiangovernmenthasyet

toreleasemodellingbasedon

availablecasedatathatcould

forecastpandemic’spotential

spread,withPMonlysaying

informationiscoming‘soon’

Federal Minister of Health Patty Hajdu looks on as Chief Public Health Officer Theresa Tam speaks during a news conference in Ottawa

on Thursday. Dr. Tam has said that releasing coronavirus projections to the public is ‘not that helpful for us right now.’

ADRIANWYLD/THECANADIANPRESS

MARIEKE WALSHOTTAWA
JUSTINE HUNTERVICTORIA

Anyone who lives in Canada
should have an intuitive sense of
why the battle to reduce the
spread of COVID-19 is so depend-
ent on everyone keeping their
distance from each other.
Just picture a group of people
standing at a bus stop on a typical
winter morning, every breath
forming a puff of fog in the frigid
air. Now move the scene indoors
and imagine those same overlap-
ping puffs made visible as people
exhale and speak in close prox-
imity. For a respiratory virus, the
situation presents a golden op-
portunity to jump from one host
to the next.
“Because you breathe all the
time ... the amount of virus that
gets in the air is overwhelmingly
greater from you breathing than
from coughing or sneezing,” said
Allison McGeer, an infectious dis-
ease researcher at Mount Sinai
Hospital in Toronto.
This reality is why the United
States is now reportedly consider-
ing a recommendation that peo-
ple cover their mouths with
masks, scarves or bandanas when
they enter stores and other set-
tings where they may be in close
proximity with others. The point
of the covering is not to keep the
virus out, but to help keep it in, or
at least keep it close. (The effec-
tiveness of the strategy may vary
greatly depending on the situa-
tion.)
What Dr. McGeer and her col-
leagues would like to know is
how long that exhaled virus sur-
vives in the air and how easily it
can infect others.
Growing evidence that people
who are not even aware they are
infected can transmit the virus
highlights the importance of the
two-metre rule for physical dis-

tance. The wide berth eliminates

the possibility of making direct

contact with someone who is in-

fected. It is also out of range of liq-

uid droplets that fly outward like

tiny virus-containing cannon-

balls when someone coughs,

sneezes or expels saliva in the act

of speaking.

What is less certain is what

happens when the virus becomes

truly airborne and travels even

farther. In that case, a droplet

might be small enough for the

water it contains to evaporate in

mid-air, leaving behind a micro-

scopic residue called an aerosol,

which is light enough to be buoy-

ed by air currents.

Last week, researchers at the

University of Nebraska Medical

Center posted results that

showed they were able to detect

airborne traces of COVID-19 ge-

netic material at a distance grea-

ter than two metres from the

source. However, the work has

not been peer reviewed, and the

researchers stressed that they

have not demonstrated whether

the virus can remain viable under

such conditions.

A study published last month

in the New England Journal of

Medicine suggested that a virus

could survive after hitching a ride

on an aerosol, but it is not clear

how likely this is outside a labora-

tory setting.

“It may happen, but it’s cer-

tainly not the main route of infec-

tion that the virus will use to

spread,” said Caroline Duchaine,

a professor at Laval University

who specializes in biological

aerosols.

The reason, she said, is that as

it dries out in the air, the virus can

lose its spiky, protective enve-

lope. Its genetic contents may en-

dure, but they are no longer pack-

aged in a form that allows it to in-

fect a cell. She added that if CO-

VID-19 were primarily spread

through the air, its infection pat-

tern would more closely resemble

measles, a highly contagious vi-

rus that is known to survive in

aerosol form.

Other researchers say that the

jury is still out on how much the

new coronavirus can spread

through aerosols.

On Wednesday, a German-led

research team presented evi-

dence from nine patients who de-

veloped mild cases of COVID-19.

The patients had upper respirato-

ry infections and shed large quan-

tities of virus during the first

week. The study, published in the

journal Nature, may help explain

why the COVID-19 pandemic is

playing out differently than the

SARS outbreak of 2003, despite

the similarities between the two

viruses.

“I assume a high potential of

this virus to spread via aerosols,”

said Clemens-Martin Wendtner, a

co-author on the study and direc-

tor of infectious diseases and

tropical medicine at Klinikum

Schwabing, a hospital in Munich.

“We could detect virus in pa-

tients’ rooms,” he added. “Right

now virus culture experiments

are ongoing to prove or disprove

that virus is infectious.”

In Canada, Dr. Duchaine is

teaming up with Dr. McGeer and

other collaborators to study how

the virus fares in airborne form,

particularly in a hospital setting,

such as when a patient with a se-

vere case of COVID-19 is being in-

tubated. But the results, which

the researchers hope to have in

hand within a few weeks, may

also shed light on the question of

whether masks may be a useful

safeguard for reducing transmis-

sion after the initial wave of the

pandemic peaks.

Dr. McGeer stressed that be-

cause of limited supplies in Cana-

da and the urgent need for pro-

tective gear in hospitals, any dis-

cussion of mask use (apart from

what people may fashion for

themselves) should prioritize

those working with infected pa-

tients.

“We just don’t have a good pro-

jection of what’s going to happen

in May,” she said. “It would be re-

ally awful if we all used up masks

in the community now and didn’t

have any left for health-care

workers.”

Researchersseektounderstandhowvirustravelsthroughair

IVAN SEMENIUK
SCIENCE REPORTER

A man wearing ski goggles and gloves rides the subway in Toronto on Tuesday. Scientists want to learn how

long an exhaled virus can survive in the air and how easily it can infect other people.CHRISHELGREN/REUTERS