COVID-19 'superspreaders' contributed to Saint John outbreak, says medical officer

A COVID-19 "superspreader" event contributed to a doubling of confirmed cases in the Saint John health region within a day, says the province's chief medical officer of health.

And there are some "superspreaders" involved in some of the 14 cases now in the region, Zone 2, with the seven new cases announced on Friday, said Dr. Jennifer Russell.

Public Health and the federal Department of Health don't define superspreader, but it's "a person who transmits an infectious disease or agent to an unexpectedly or unusually large number of other people," according to the Oxford dictionary.

Being at the peak of infectiousness and performing an activity, such as talking, singing or breathing heavily from exercise in a poorly ventilated, crowded space for a prolonged period, can contribute to superspreader events, according to infectious disease specialists.

About 300 people in Saint John are self-isolating.

"Many" of them are health-care workers, although Russell said she couldn't say how many during a news conference in Fredericton, when she announced the region will be bumped back to the stricter orange phase of COVID-19 recovery, as of midnight.

She also didn't reveal where the health-care workers are employed, but an outbreak has been declared at Shannex Tucker Hall, a 90-bed nursing home in the city's north end, after a single case was confirmed on Thursday.

Shannex confirmed on its website that it is an employee who tested positive but did not say whether it is a health-care worker. 

"We have no other active cases of COVID-19 at this time," the notice states.

More than 400 residents and staff from Tucker Hall and the other nearby Shannex facility, Parkland Saint John, were expected to be tested Friday and contact tracing is underway, Russell told reporters.

"We are expecting more cases to pop up," she said. 

"With the contact tracing that we've done and the type of contacts that we have found and those people who are self-isolating as a result, we expect many of them to become positive."

Return to red level possible

Premier Blaine Higgs warned he may need to move the region to the most restrictive red level "if we can't get the numbers under control quickly."

The Moncton health region, Zone 1, had 24 confirmed cases when it was rolled back to the orange level on Thursday and 21 cases when it previously returned to orange in October.

Although Saint John's case count is lower, Russell said the same triggers have been met. Those include a doubling of cases within six days, a certain number of health-care workers being involved, and the fact that people have not been following public health protocols, such as wearing a mask, maintaining a physical distance of two metres and keeping their close contact numbers low.

The health system is at risk and keeping people safe is at risk and lives are at risk.- Blaine Higgs, premier

"This is a virus that spreads exponentially if left unchecked," she said.

If the current 14 cases double each day, cases would hit nearly 500 in less than a week.

Of those, 20 per cent would be "very ill," 15 per cent would require hospitalization, five per cent would require intensive care, and "a certain percentage" of those will die, said Russell.

"So we know the math, we know the modelling, and we know how important it is that everybody do what they need to do immediately to get this under control so we can go back to the yellow phase as soon as possible," she said.

Higgs urged all New Brunswickers to take the situation seriously. 

"We have seen areas where there have been fundraisers, social events, household and other gatherings with way too many people, no social distancing and no face masks," he said.

"Too often people are gathering with one group at one night and completely a different group another night. This has led to the situation we are currently in."

Enforcement will be stepped up in the Saint John and Moncton regions, Higgs said.

Police officers, peace officers with the Department of Justice and Public Safety, Public Health inspectors and WorkSafeNB inspectors are in both regions to make sure the rules are being followed. People who refuse to comply with provisions of the mandatory order will face penalties.

"We will never catch everyone, nor will we try," Higgs said. "But we really want people to pay attention and help us here because the health system is at risk and keeping people safe is at risk and lives are at risk."

Saint John EMO activated

The City of Saint John has activated its Emergency Management Organization. EMO continues to monitor the situation and follow the province's advice and recommendations, it said in a news release.

Mayor Don Darling said he has been pleased with the "immediate and proactive action" taken by the community over the past few days, and the "support and understanding from residents."

"Now is the time to show how resilient we are, and how we can work together in the best interest of our community," he said in a statement.

"We have seen other areas of our province successfully move in and back out of the orange phase and we know we can do the same."

Darling encouraged residents to protect their mental well-being as well as their physical well-being by getting fresh air and exercise whenever possible, maintaining virtual connections, and checking in on neighbours, family and friends.

More possible exposures

Public Health announced three additional potential public exposures in Saint John on Friday:

• At Rocky's Sports Bar, 7 Market Square, between 10:30 p.m. on Nov. 13 and 12:30 a.m. on Nov. 14 and between 10:30 p.m. on Nov. 14 and 1:30 a.m. on Nov.15. (The bar had posted its own advisory on social media on Thursday.)
• At Big Tide Brewing Company, 47 Princess St., on Nov. 16, between 12:30 p.m. and 2 p.m.
• At Java Moose, 84 Prince William St., on Nov. 16, between 2 p.m and 2:30 p.m.

People who visited these locations during these periods should self-monitor for symptoms for 14 days afterward, the estimated incubation period for the respiratory disease.

If symptoms develop, they should self-isolate and take a self-assessment test online or call Tele-Care 811 to get tested.

Water Street Dinner Theatre posted its own advisory on Facebook, saying it was advised Thursday afternoon that someone who attended the Nov. 13 production "recently" tested positive for COVID-19.

"As a precautionary measure we have discontinued operations for 14 days at the direction of the department of public health," and cancelled performances scheduled for Nov. 20, 21 and 27, with hopes of resuming operations on Nov. 28, it said.

"We are working closely with public health officials to ensure that all guests in attendance that evening are notified of the possible exposure.⁣"⁣

On Thursday, Public Health advised anyone who visited the Five and Dime Bar, at 34 Grannan St., between 12:30 a.m. and 2:30 a.m. on Nov. 14, or Freddie's Pizza, at 27 Charlotte St., between 2:30 a.m. and 3 a.m., to self-monitor for symptoms for 14 days. 

The Saint John Sea Dogs also announced a staff member tested positive, resulting in at least five hockey games being postponed.

The infected individual, who had not travelled outside the Atlantic bubble since before Aug. 30, is sick and in isolation, the organization said in a news release Friday.

No one else has tested positive, but testing is ongoing, the release said.

All players are in confinement as well as "the majority" of staff.

2 nursing homes close to visitors

Two Saint John nursing homes — Loch Lomond Villa and Rocmaura Nursing Home — announced Friday they have closed to visitors as a precaution until further notice.

In a Facebook post, Loch Lomond CEO Cindy Donovan cited concerns about the ongoing COVID-19 outbreak in the Moncton area and "a number of possible exposures" in the Saint John region.

"Please understand that this decision was not made lightly," she wrote. "We hope these restrictions will be short-lived, but due to the vulnerability of your loved ones, we must do everything we can to keep COVID-19 out of our home."

Virtual visits will still be possible via Zoom or FaceTime in the interim, she added.

Rocmaura's executive director Sheana Mohra cited "the evolving situation in our province and our region" for the decision and thanked everyone for their support.

New cases

The seven new cases in the Saint John region include:

• One person aged 20 to 29.

• Three people aged 40 to 49.

• One person aged 50 to 59.

• One person aged 60 to 69.

• One person 70 to 79.

Two new cases were also confirmed in Moncton Friday — one person under 19 and one person aged 20 to 29.

New Brunswick has a total of 51 active cases. One person is in hospital.

Symptoms to watch for

Public Health says symptoms shown by people with COVID-19 have included:

• A fever above 38 C.

• A new cough or worsening chronic cough.

• Sore throat.

• Runny nose.

• Headache.

• New onset of fatigue, muscle pain, diarrhea, loss of sense of taste or smell.

• Difficulty breathing.

In children, symptoms have also included purple markings on the fingers and toes.