Coronavirus could infect 35 to 70 per cent of Canadians, experts say
If there is a pandemic, makeshift hospitals and quarantine centres could be needed to shore up a health system that has virtually no give, experts say
SHARON KIRKEY
Updated: March 10, 2020
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The coronavirus could hit 35 to 70 per cent of the Canadian population, making “a huge number of people ill,” many critically, and makeshift hospitals and quarantine centres could be needed to shore up a health system that has virtually no give, experts predict.
According to a disease-transmission model developed by University of Toronto researchers, the virus’ overall attack rate in Canada, without public health interventions, could exceed 70 per cent. That number drops sharply, by about half, “if we add modest control,” said epidemiologist Dr. David Fisman, one of the model’s creators, but it will take “aggressive social distancing and large scale quarantines” to reduce it further, he said.
“That’s still a huge number of people ill, and critically ill people are a large fraction in this disease,” Fisman said in an email. “I’m not going to share more specific numbers because I think they will scare people to no particular end.”
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Still, front-liners are worried, Cloutier said. “They’re worried because they’ve only seen the beginning and they think that if there is a pandemic it’s going to be extraordinarily difficult to manage the capacity of the needs of our patients coming through the system.”
Fisman’s team has experience dealing with SARS, H1N1 and Ebola and recently reported that the outbreak in Iran was far larger than originally reported. Among other data, their model estimates basic reproduction numbers — how many other people one infected person is likely to infect — as well as the number of mild and asymptomatic cases that are flying under the radar, believed vastly higher than reported case counts.
“China’s epidemic was controlled through massive quarantine, enforced via threats of death penalty, and with lockdown of 750,000 people at peak,” Fisman said.
In Canada, modest public health control efforts would mean finding and isolating around 50 per cent of mild cases through testing, but no social distancing or quarantine.
More aggressive measures would be the kind of countrywide lockdowns now occurring in Italy, which have left streets in the capital Rome and other cities deserted, as well as school closures and banning of mass gatherings and sporting events.
A new study finds that older people, as well as people with sepsis or underlying clotting problems, are most likely to die from the virus.
Published in The Lancet, the study, based on 191 patients from two hospitals in Wuhan, the epicentre of the outbreak, also found that people shed the virus for longer than expected, an average of 20 days in survivors, and as many as 37 days. Prolonged shedding suggests people may still be capable of spreading the pathogen.
“The extended viral shedding noted in our study has important implications for guiding decisions around isolation precautions and antiviral treatment in patients with confirmed COVID-19,” the Chinese researchers reported.
We have scenarios where there are more people requiring ICU beds than there are acute care beds
In hospitals, rooms, wards and potentially entire floors will need to be set aside because the infected can’t be kept in ordinary rooms like any other patient, Cloutier said. “I’m not saying you need to build new hospitals,” he said. In China, where the virus has infected more than 80,000, a 1,000-bed hospital was panic built in just 10 days.
But if the virus spreads widely in Canada, “what are you going to do with those patients that are already in hospital,” Cloutier said.
“Are you going to ask them to leave? What happens if it’s a patient (who needs) home care, and there’s no capacity there?”
With virtually zero spare bed capacity, Fisman, of the U of Toronto, said planners should
prepare now for makeshift hospitals. There should be designated hospitals for coronavirus patients and registries of healthcare workers who have had the virus and recovered who can now work safely with patients.
Studies suggest 80 per cent of cases in China are mild. Those who die take 25 days to die on a ventilator. Those who survive are off ventilators after two weeks, but then spend another two weeks hospitalized.
— With files from the Canadian Press
If there is a pandemic, makeshift hospitals and quarantine centres could be needed to shore up a health system that has virtually no give, experts say
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