The coronavirus pandemic, once concentrated in older adults in Quebec and Ontario, is moving west and appearing in younger groups.
On April 15, Quebec and Ontario accounted for nearly 84 per cent of new daily cases. On Aug. 15, 23 per cent of new cases were in B.C. and another 23 per cent in Alberta. Ontario and Quebec had 24 and 18 per cent respectively.
This is representative of a new trend: While new daily case numbers in central Canada seemed to have generally stabilized recently, Western Canada’s keep growing.
Dr. Lynora Saxinger, an infectious disease specialist at the University of Alberta, said “it doesn’t really look like it’s slowing at this point,” in her province.
“I think it’s too soon to say that this appears to be the start of the second wave in British Columbia or Alberta,” said Dr. Isaac Bogoch, an infectious disease specialist at Toronto General Hospital. But, he thinks it’s cause for concern.
In Alberta, much of the outbreak appears to be focused on Edmonton, which accounts for more than half of the active cases in the province. Edmonton now has more than twice as many active COVID-19 cases than Toronto – 636 as of Aug. 17.
In B.C., which was very recently thought of as a success story, Fraser Health Region has had the most new cases recently. The health region covers Surrey, Delta, Abbotsford and Burnaby.
To Bogoch, the main culprit is young people.
“It’s 20-year-olds,” he said. “We’ve seen this tremendous shift from having a large number of cases in long-term care facilities to people in their 20s who are getting this infection either through social gatherings, or perhaps through other mechanisms – for example at work.”
On Friday, the Public Health Agency of Canada released data showing that since early July, the highest incidence of COVID-19 across Canada has been reported among people aged 20-39.
Stephen Hoption Cann, a professor of population and public health at the University of British Columbia, said that private indoor gatherings are a major driver of B.C.’s spread. “Obviously they’ve been trying to keep the message out, that people need to social distance. I think a lot of people just aren’t listening to that,” he said.
“People have arranged private parties and things like that where they’re going beyond their social bubble.”
Saxinger agrees that social bubbles seem to have expanded lately.
“It really reads to me, in summary, like more people are in contact with more people and that the infection never has gone away,” she said. “And as soon as we start seeing more people contacting more people, we see cases go up.”
While hospitalizations are low in Alberta for now, she worries that in a few weeks, they will start to go up again. Typically, hospitalizations lag cases by two to four weeks, she said. Young people, which account for a majority of new cases, are less likely to have severe illness, but they can spread it on to other more vulnerable people.
Many recent cases across Canada have been linked to public places. A recent Global News investigation, using data compiled by the Institute of Investigative Journalism (IIJ) at Concordia University, found that 505 cases between July 4 and Aug. 11 were linked to places like restaurants, bars and retail stores.
This data is likely incomplete though, as the federal government does not provide detailed statistics on where people got infected. B.C. regularly issues alerts to people though, of possible exposures, and they tend to name restaurants, clubs and airplanes as culprits.
Saxinger thinks that while there have been outbreaks linked to specific events – like one recently at an Edmonton church – there are still a lot of unexplained cases in Alberta where investigators aren’t sure where someone got the virus.
This is trickier for public health authorities to track and contain, and indicates that the virus could be widespread in the community, she said.
Saxinger expects cases in Alberta to continue to rise, in contrast to much of the pandemic, where they were relatively low. “The fact that cases in Alberta were low for a long time might play into it,” she said. “I think having the infection seem to be out of sight, out of mind, might be playing a role in changes in behaviour.”
When people don’t see the threat or aren’t continually reminded of the danger, she explained, they tend to slowly go back to their old ways of life.
Part of the solution has to be more effective public health messaging to reach young adults, Bogoch said.
One strategy could be a harm-reduction approach. “I think it’s unrealistic to think that we can prevent people in their 20s from getting together in social gatherings,” he said.
So, you try to mitigate the harm. “A harm reduction approach is ensuring that that happens in the safest way possible,” he said, which could include emphasizing outdoor gatherings in smaller groups, which would have a lesser risk of transmitting the disease.
Saxinger thinks there is one big takeaway from Western Canada’s recent experience with the virus:
“If you give it an inch, it takes a mile.”
— With files from Max Hartshorn, David Lao, Andrew Russell and Kerri Breen, Global News
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