What do the bars of Montreal, the farms of southern Ontario and the Hutterite communities of the Prairies have in common?
They are all linked to recent coronavirus outbreaks.
Long-term care homes were originally hotbeds of the disease in Canada, but the number of new cases reported and ongoing outbreaks in institutions have recently declined, according to researchers at Ryerson University who have followed the outbreaks of LTC.
Now experts say that more recent epidemics share a few things in common: they are found in indoor environments where it is difficult to maintain physical distance or social events where people do not want to.
Here’s a look at some of the current outbreaks in Canada and what we can learn from them.
1. Montreal bars
Hundreds of people lined up outside a Montreal hospital this week.
They were there to get tested for COVID-19, after an outbreak was reported, linked to the city’s famous bar scene.
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Local health officials asked everyone who had visited a bar in Montreal since July 1 to get tested and, on Friday, they found at least 30 bar-related cases.
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“Bars are just a classic example of why I’m not very open to bars,” said Dr. Gerald Evans, chair of the infectious disease division at Kingston General Hospital.
“They contain all the ideal elements that one would expect in a situation that will greatly facilitate the transmission of the virus.”
These include crowds, an enclosed space with poor ventilation, and improper use of the mask – because people cannot drink a beer with a mask on, he said.
People also tend to spend an hour or more in the bar, which can increase their exposure.
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Then there is the beer. “Once you start drinking, your ability to think about standing within four to six feet of someone else falls,” he says, and other normal safety measures might also fall.
Robyn Lee, assistant professor of epidemiology at the University of Toronto, says other provinces, like Ontario, should keep Quebec’s experience in mind by reopening their own bars.
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“I think we’ll see the same,” she said.
“I think the rest of Canada is no different from Quebec when we open rooms that offer a high risk environment for transmission like these.”
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2. Festivals in Montérégie and Kelowna
Outside of Montreal, in the Montérégie region, a handful of house parties – one with over 100 people – also contributed to a local outbreak.
British Columbia officials also attribute 27 cases to private parties in Kelowna on Thursday.
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These are caused by the same types of problems as bars, said Lee: namely many unmasked people in an enclosed space.
“It’s the same kind of problem. You have a bunch of people in a small space, ”she said.
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People can move from room to room, talking to all kinds of different people, which presents problems, she said.
“I think part of the problem is also that this transmission happens when people don’t know they have COVID-19,” she said. Recent data suggests that 40-45% of people either have no symptoms or develop symptoms long after becoming infectious to others.
This means that they can do things like go to parties, because they feel good, but can accidentally pass the virus on to people they meet.
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3. Misericordia Hospital in Edmonton
The Edmonton Misericordia Hospital is in the middle of an outbreak, with more than 50 cases reported on Friday, both in patients and staff.
Alberta Health Services announced the creation of a task force to examine the outbreak and its origin.
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While he cannot comment specifically on the Misericordia outbreak, Evans said hospital outbreaks do occur from time to time.
“The minute you get lots and lots of COVID-19 patients, then of course you increase the likelihood of transmission because you just have a lot more people in there. “
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Most hospitals create special COVID-19 units, but you must carefully monitor staff as they enter and leave. And, over time, the use of PPE by staff could decrease, because “people are just getting enough of it,” he said.
Common areas, such as break rooms where people eat lunch, can also cause transmission between staff.
4. Migrant farm workers in Windsor-Essex County
“The Windsor-Essex area right now is zero. But at any time, it could be another community anywhere in Canada, ”Chris Ramsaroop, an organizer with the Justice for Migrant Workers group, told Global News this week.
Southern Ontario County has recorded more than 800 cases related to farm work, in an outbreak that has lasted for weeks.
Many farms in the region employ temporary migrant workers.
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Farm workers reside in shared, often cramped spaces where physical distance is “absent,” Ramsaroop said. They share bathrooms and are transported around the properties in groups.
This is bad news for the transmission of coronaviruses, Evans said. If multiple people share a room, then if one person has the virus, they will expose all of their roommates overnight.
“Everyone in this room will end up being exposed to some sort of exhibition,” he said.
That, added to conditions that leave workers reluctant to complain or seek medical attention for fear that their employers will withdraw their immigration permits, have contributed to the outbreak, according to Ramsaroop.
5. Hutterite communities in the Prairie provinces
A number of Hutterite communities have been linked to coronavirus cases in Alberta, Saskatchewan and Manitoba, according to health officials in those provinces.
Some cases appear to have been linked to a funeral in Alberta, but Alberta officials say the risk of spreading to the community as a whole is low and that those affected have been quarantined.
Communities cooperate with health officials, they say, and officials condemn any discrimination against such people.
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In close-knit communities where people come together to eat, work and pray together, they again increase the likelihood of spreading the virus, said Lee.
“When you are around another person with COVID-19, you are more at risk of getting infected with the virus. So it’s just a setting that is more likely to allow propagation. “
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As for the lessons from these epidemics, “I think the key is to make sure people are able to maintain physical distance,” Lee said.
This can mean encouraging outdoor activities as much as possible and reducing things like shared toilets in the workplace, she said.
“And then, educate the people of Canada about how transmission can happen when you don’t actually know you have symptoms.”
Even if you feel fine, you could still pass the virus on, so you need to take precautions, she said.
– with files from Rachael D’Amore, Kalina Laframboise, David Giles, Simon Little, Caley Ramsay, Kwabena Oduro and Quinn Campbell of Global News
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