Chief medical officer of health COVID-19 update - September 28, 2020

Thank you. Good afternoon everyone.  

As you can see, I am providing my part of today’s update from home.

I felt well on Thursday, but on Friday I developed a sore throat.

As I have said many times, it’s important to stay home when sick and get tested, even if the symptoms are mild.

As a result, I was tested over the weekend and have a negative COVID result.

Despite this, I don’t want to pass on whatever it is that I have to others, so am working from home until my symptoms resolve.

I acknowledge that I have the privilege of working a job that can be done remotely, which not everyone has.

I know that staying home is not easy, and that many Albertans face difficult financial or other choices. 

Most of us have worked with sore throats or runny noses many, many times.

However, during COVID, that is not a risk that I or anyone else should take. Do not risk exposing others if you are sick.

This is part of our new normal, and I recognize that staying home is inconvenient.

However, it is also part of how each of us can protect our family, friends and coworkers.

Turning to today’s update, I would like to review the weekend numbers and the outbreak at the Foothills Medical Centre, and then talk briefly about herd immunity.

There are currently 63 people in hospital in Alberta, including 15 in intensive care.  

This number has risen somewhat in the last week, due in part to the outbreak at the Foothills Medical Centre.

However, these numbers are still well within our health system’s capacity.

We continued to identify cases in all parts of the province.

The total number of cases grew by 60 on Friday, while our lab conducted more than 16,000 tests. This lower number is the net difference between Thursday and Friday after adjusting for previously clinically reported cases.

On Saturday, the lab again conducted over 16,000 tests and we identified 184 additional cases.

Finally, 162 new cases were identified yesterday, while more than 18,500 tests were conducted.

There are currently 1,549 active cases in the province, which is 52 more than on Friday.

Turning to schools, as of today, AHS has confirmed that 20 schools that previously had alerts have had no transmission, and students and staff are all now back in class.

There are active alerts or outbreaks in 113 schools, which is about 5% of the schools in the province.

There are currently 210 active cases in total at all of these schools.

This includes 47 schools which are on outbreaks, including 6 which are currently on the watch list.

As always, I want to remind everyone that although two confirmed cases in a school may qualify as an outbreak, this does not mean the school is unsafe.

In fact, of all these alerts and outbreaks, there are only 9 schools where in-school transmission has likely contributed to one or more of these cases.

However, we are being cautious, and ensuring swift measures are taken even when only a couple of cases are identified.

Sadly, I must report that there have been 4 additional deaths from COVID-19 since Friday.

I know that people who have lost loved ones during this pandemic to COVID or to any other cause have had to grieve in different ways than we are used to.

My thoughts are with everyone who is grieving the loss of a loved one now.

One of the deaths reported over the weekend was a patient at the Foothills Medical Centre.

This outbreak continues to be a significant concern, and a great deal of work is going into preventing any ongoing spread.

Two additional units are now under outbreak protocols.

One is a transitional medical unit, where a case linked to an outbreak unit has now been identified.

The other is a short stay unit which is not linked to the other outbreaks, but has a single case whose source is unclear.

Although the source of this single case could be community transmission, as a precaution, the unit has been put into outbreak protocols.

This outbreak now has 53 cases in total on all units that are affected, including 26 patients.  Sadly, four deaths have now occurred.

AHS is working hard to support patients and staff, and I have been assured that outbreak protocols are in place on each affected unit.

While aggressive measures are being taken, due to the long incubation period of this virus, it is likely that we will continue to identify additional cases in the days ahead.

What is critical is to prevent any further onward spread or exposures, which is the focus of AHS’ effort.

As an added safety measure, visitation to the entire site has been temporarily limited to end of life or pre-approved essential visitors only.

AHS has also rescheduled 39 surgical procedures slated for today at the Foothills Medical Centre.

All postponed surgeries are being rescheduled as quickly as possible, with many of them already rebooked within the next seven days. 

There is also an outbreak at Millwoods Shepherds Care Centre that is of concern.

There are currently 19 cases linked to this outbreak. Sadly, two of the deaths over the weekend occurred in residents at this facility.

AHS is working closely with the operator to support them and ensure that the proper outbreak protocols are being implemented.

AHS staff are onsite and meeting virtually to provide direction, consultation and support. This includes a quality monitoring visit, which is standard practice for all sites on outbreak.

Testing is being offered to all residents and staff.

And I’ve been assured that all necessary steps are being taken to limit future spread.

With these outbreaks in mind, I want to talk about herd immunity.

I have heard several comments and questions lately about this topic recently that I’d like to address.

For those who aren’t familiar, herd immunity is what happens when there are enough individuals with immunity in a population to prevent an infection from spreading widely.

The percentage of immune individuals needed to make this happen changes depending on the specific infection. 

For COVID-19, estimates of this percentage range from  50 to 60%....

…and serology studies in Canada have estimated that we are only at about 1% or less of our population who have been infected.

What I have heard sometimes suggested for COVID-19 is that because younger people are generally at low risk of experiencing severe outcomes…..

...we should protect older Albertans, but otherwise let the virus spread as quickly and freely as possible so that we can build up a collective immunity to it.

This suggestion, however, does not take into account the drawbacks of this approach.

It is true that COVID-19 is rarely fatal in young people.

In Alberta, the risk of death for a person diagnosed with COVID-19 in Alberta is

• about 18% for those over 70,
• less than half a percent for those between 40 and 69,
• and vanishingly small for those under the age of 40.

It is also true that public health measures that have been in place to prevent COVID-19 spread have risks and health impacts of their own….

…..and we need to do our best to keep in place only the measures that are needed.

However, let me explain why I believe a herd immunity strategy is not the right approach.

First and foremost, it’s important to remember that COVID-19 is able to spread rapidly and we are all interconnected.

Adopting a herd immunity approach would have a serious and deadly impact on our population.

Even if we could put perfect protections in place for those who live in congregate settings like long-term care while letting the virus spread freely elsewhere, we cannot simply dictate where and how the virus will spread.

The more community transmission that we see, the greater the risk of it spreading to older and at-risk Albertans.

In Alberta, about 30% of those over 80 who have been diagnosed with COVID-19 and who live in long-term care have died.

For those over 80 living in the community it is 18% – lower, but still very high.

The lives of people with chronic conditions and our elders are very important.

Adopting an approach focused on herd immunity would place many older Albertans or those with underlying medical conditions at risk, and lead to many more deaths across our province.

Our only protection from COVID-19 is each other and we all share the responsibility of protecting our communities and our fellow Albertans.

The second reason that this approach is not right for Alberta is that death from COVID-19 is not the only severe outcome.

In Alberta over the past seven months, one in every 67 people between the ages of 20 and 39 diagnosed with COVID has needed hospital care.

That rises to one in 18 for those aged 40 to 69 and one in 4 for those aged 70 and over.

If we let the virus spread freely, our health system could be overloaded in caring for COVID patients, which would challenge our ability to provide all the other health services that we need.

Babies are still being born, car crashes are still occurring and our health system still must support Albertans in countless other ways.

We have seen this overload happen in other countries. We do not want it to happen here.

Finally, it’s important to remember that we still don’t know if being infected with COVID-19 actually confers any robust or long-lasting immunity.

This means the costs of widespread transmission – the deaths and the risks to so many Albertans’ health – could be for nothing.

We would put our elders and those with chronic conditions at risk, increase the burden on our acute care system, and still may not get the collective protection that this approach was designed to achieve.

Given that, what is our best path forward?

First, we must rely on science.

A great deal of research around the world is underway to find effective treatments and a safe and effective vaccine for COVID-19.

Ultimately, one or both of these is an end game that returns us to the world we want to live in.

Second, as we wait for treatments and vaccines to be discovered…..

……we need to find a balance between preventing the harms of COVID and preventing the harms that strict restrictions can have on the rest of our health.

This balance is delicate and dynamic.

It will need to change based on what we see and learn.

And we can only accomplish this together.

Our collective action is the key to protecting one another both from the risks of the virus and risks of strict restrictions.

We are all in this together, and that’s a good thing because we are strongest together.

Thank you and we are happy to take any questions you may have.