Cut down on close contacts to curb COVID-19 spread, experts say amid rising numbers in Winnipeg

Public health experts in Manitoba and Ottawa are warning the public to reduce the number of people they have close contact with, as the number of contacts reported for people with COVID-19 rises in the province and across the country.

"It's just giving the virus more and more of an opportunity to spread.… It's definitely concerning," said Cynthia Carr, a Winnipeg-based epidemiologist and founder of EPI Research.

"As community members, we are the wildcard in all of this. There's clarity on how this virus spreads, how we give it opportunity to spread. The closer we are together for longer periods of time, the more opportunity that virus has to spread."

Recent cases of COVID-19 reported in Winnipeg have been associated with "large numbers of close contacts," the province said in a news release Tuesday. Close contacts are those who have been within two metres of a person with COVID-19 for longer than 15 minutes.

In April, when pandemic restrictions were in place, the head of Winnipeg's contact tracing unit said new cases of COVID-19 had an average of about three close contacts per case. 

But that number has ballooned for recent cases, "and that means we're having additional people who are exposed to the virus, and contact tracing becomes more complex," Manitoba Chief Public Health Officer Dr. Brent Roussin said Monday.

In one instance, a single case in the Winnipeg health region reported a total of 50 people as close contacts, according to the most recent provincial surveillance data.

That's among the highest numbers of contacts for a single Manitoba case so far, Roussin said at a Monday news briefing. He said he couldn't provide more detail on the circumstances of the case.

Roughly 14 per cent of close contacts of Manitoba cases of COVID-19 have developed the disease, he said.

The province is now seeing "exposures at … bars, some restaurants, just in gatherings in homes," said Roussin.

"There are circumstances where people are symptomatic and being out and about and not getting tested for days and days after symptoms start."

Canada at a 'crossroads': public health chief

Manitoba public health officials aren't alone in urging the public to follow health advice.

On Tuesday, Dr. Theresa Tam, Canada's chief public health officer, warned there could be a major resurgence of COVID-19 unless Canadians take action to reduce the number of people they have close contact with.

New modelling from the Public Health Agency of Canada released Tuesday predicted up to 155,795 cases and up to 9,300 deaths by early October if the current trajectory of the epidemic continues.

Canada is at a "crossroads," Tam said, but further lockdowns can be avoided if Canadians limit their contacts.

"All of us have the future in our hands," said Federal Health Minister Patty Hajdu in a Tuesday media briefing in Ottawa.

Dr. Prabhat Jha, a professor of global health in the University of Toronto's faculty of medicine, said the demographics of COVID-19 have shifted nationwide, with new cases being driven primarily by people aged 20 to 39.

"The current sets of new infections, right throughout the country, are occurring in younger people. The vast majority are below age 40," he said. "That's attributable to close contacts, particularly in parties or in indoor spaces without distancing or masks."

So far, the rise in cases across Canada hasn't triggered a parallel spike in hospitalizations and deaths, Jha said. If those can be contained, major lockdowns can be avoided.

"I know it's very difficult to be patient [enough] to do so, but see what happens next week in Manitoba in relation to the increase in cases this week," he said. "In the meantime, be cautious and careful."

Prairie Mountain experience shows public's power

It makes sense Manitobans are reporting more close contact lists in recent weeks compared to earlier in the pandemic, Carr said, thanks to loosened pandemic restrictions provincewide.

"The reality is with schools reopening, with daycares, with people ... wanting to get out and go to bars and restaurants, there's just more opportunity for people to be together," she said.

Fatigue from long-lasting restrictions could also play a role, she said, although she's encouraged by what she perceives as increased mask use among the general public.

Just as a growing number of contacts can fuel a spike in cases, tightening the number of contacts can contain spread, she said.

She pointed to the recent experience in the southwestern Prairie Mountain Health region — where cases dropped sharply after tighter restrictions were imposed following a spike in cases over the summer — as proof Manitobans can step up to the plate, and public health measures can work.

"There's a possibility for exponential increase or exponential decrease," she said. 

"In a blink, Prairie Mountain Health was accounting for half of all active cases, and then … it seemed like in no time those cases went down very quickly," said Carr. 

"It can be confusing for people, but it reinforces for people how quickly we can get on top of this."