Lessons from the gym epidemic in Quebec, one of the largest COVID-19 dissemination events in Canada

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Lessons from the gym epidemic in Quebec, one of the largest COVID-19 dissemination events in Canada



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We still don’t know exactly how it started – a runner on a treadmill, or maybe someone lifting weights – but an outbreak at a Quebec gym has become one of the biggest COVID spread events. -19 registered in Canada.
ThemThis isga Fitness Gym, tucked behind a busy highway in an industrial section of the provincial capital, has become a major source of contagion for the B117 variant first identified in the UK, which now accounts for 70% of all cases in Quebec .

The gymnasium was closed on March 31 as the city was closed again. To date, 222 people have been infected at the gym, another 356 linked cases involving outbreaks at 49 workplaces and a 40-year-old man has died.

But officials have yet to provide key details about the outbreak that can help educate the public, including whether it was triggered by the more contagious and potentially more deadly variant and whether it was driven by aerosol transmission – or by microscopic airborne particles.

The epidemic is now the subject of an epidemiological investigation, but some of the specifics of the spread of the virus remain confidential, said Mathieu Boivin, spokesperson for the local health authority.

The health authority said the gymnasium violated at least three public health orders before it closed. Gym staff reportedly did not ask customers if they were suffering from symptoms of COVID-19, customers were not two meters apart, and employees were not wearing required personal protective equipment.

Gym owner Dan Marino did not respond to requests for comment. In a Facebook post, he defended his efforts to comply with public health regulations.

Dr. Isabelle Bertrand, an emergency physician at Hôpital Saint-François d’Assise in Quebec City, began to see the direct consequences of the outbreak earlier this month.

One of his patients was a man who contracted the virus from his son, who contracted it while training at the gym.

Some hard-hit regions of Quebec still allow indoor fitness classes across Canada, or have done so until recently, despite the known increased risk of transmission of variants of the coronavirus. (Ivanoh Demers / Radio-Canada)

Now, she says, it’s harder to know how her patients got the virus, as it is spreading more widely in the community at an accelerated rate that she has compared to a “pyramid scheme.” Bertrand said his emergency department continued to “get busier and busier.”

“We’re almost at a point where we worry again,” she said.

An “astonishing” epidemic and more transmissible variants

The outbreak isn’t the only reason Quebec City recently increased the number of cases, but health experts say it was a key factor.

Raymond Tellier, an infectious disease specialist, medical microbiologist and associate professor of medicine at McGill University, called the epidemic “overwhelming.”

“This is the kind of setting where, if you don’t have adequate ventilation and have too many people, you could indeed have an aerosol-related spread event,” he said. “This one is remarkable. ”

It is also not the first major outbreak of its kind linked to a fitness center in Canada.

Another major event in a city center Hamilton, Ont., Spin studio in October, at least 85 people were infected with COVID-19.

Similar to the Quebec epidemic, Hamilton’s Spinco saw 54 people infected with COVID-19 in the studio, which then infected 31 others in households, schools, daycares, healthcare facilities and other workplaces. .

Another outbreak at Spinco, a spinning studio in Hamilton, Ont., Infected dozens of people in October 2020. (Bobby Hristova / CBC)

In the United States, the Centers for Disease Control and Prevention published a study on an outbreak at a Chicago gym in August that saw 55 people infected among 81 participants. Masks were rarely worn during exercise by clients – some of whom showed symptoms of COVID-19.

The difference between these epidemics and the one in Quebec is that the most transmissible variants of the coronavirus did not circulate widely in the community at the time as they are now.

One year later, politics are still lagging behind science

Professor Linsey Marr, an airborne virus transmission expert at Virginia Tech, said it was surprising that these types of outbreaks are still occurring a year after the start of the pandemic, given the growing body of research on aerosol transmission leading to wide spread events.

She said the Quebec epidemic had all the hallmarks of a “classic” spreading event: crowded indoor space, poor mask adhesion, and exercise activities that cause heavy breathing and increase the risk of transmission. by aerosol.

We can’t expect the public to follow all of the latest science… if they see the gym is open, they’re going to assume it’s safe.– Prof. Linsey Marr, air bone virus expert at Virginia Tech

“We can’t expect the public to follow all of the latest science so they’re going to live their lives probably based on what’s open and what’s not,” she said. “And if they see that the gym is open, they’re going to assume it’s safe. ”

Marr said the situation also underscored that public policy had not evolved to reflect scientific evidence that COVID-19 mainly spreads through the air rather than surfaces.

“People tend to hang on to the first thing they hear, which is wiping off your groceries, a year ago,” Marr said. “But I think we really need a campaign to just make people clear how the virus is spread and then policies that match that. ”

WATCH | The surge of COVID-19 in Quebec results in more restrictions:

Quebec is imposing more and more restrictions on COVID-19 as the number of cases increases, especially in Quebec where the variants have taken control. Quebec, Lévis, Gatineau and Beauce face tighter controls while Montreal and Laval return to a curfew at 8 p.m. 2:02

Since then, the gymnasiums have been closed in Quebec. They were also closed last week in Montreal and Laval as part of restrictions aimed at preventing the kind of surge already underway in the capital.

But some hard-hit areas still allow indoor fitness classes across Canada, or have done so until recently, despite increased risk of transmission from variants.

Manitoba moved to reopen gyms and indoor fitness classes in early February, the same day he recorded his first case of B117, and has so far kept them open despite being at the start of a third wave of the pandemic.

Alberta reopened gymnasiums in late January despite a rapid increase in variant cases, but announced last week that the province go back to the restrictions of step 1, which included their closure.

British Columbia Enabled Indoor Fitness masks required only when not working until the end of March, when he set up a three-week “circuit breaker” style lockout who have seen gyms closed, but individual fitness classes are allowed.

WATCH | Inside some of the hardest hit hospitals in Canada during the third wave of COVID-19:

More patients are fighting for their lives in Ontario’s intensive care units than at any time during the pandemic. CBC News enters Toronto’s Scarborough Health Network to see the impact. 7:34

“There is pandemic fatigue as the variants arrive, and also too much anticipation of the vaccination,” Tellier said.

“We must not let our guard down too soon and that is what is happening right now. “

Tellier said the recent rapid change in public health restrictions in the hardest-hit areas of Canada is in direct response to the spread of the variants – but it remains to be seen if these measures will have an impact.

“Governments thought they could open up a bit, which is exactly what people wanted too, but it doesn’t work,” he said.

“Over the next two to three months we have to come to terms with the fact that life is not returning to normal yet and we have to be very careful – even more than before due to the greater transmissibility of these variants. unhappy, but that’s what it is. ”

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