A 2nd wave, phase 2 and more testing: N.W.T.'s top doctors answer your questions

Nearly two weeks after the territory entered the first phase of its reopening plan, the N.W.T.'s top doctors answered questions from listeners about the pandemic and the territory's response.

N.W.T. Chief Public Health Officer Dr. Kami Kandola and territorial medical director Dr. Sarah Cook joined host Loren McGinnis on CBC's The Trailbreaker for a one-hour call-in show on Thursday. Here are some of the highlights.

2nd week of Phase 1 – how's it going?

As some businesses start to reopen, Kandola said you'll see a limited amount of people allowed in, hand-sanitizer and both staff and patrons wearing non-medical masks.

"It's really important to develop the practice of wearing your non-medical mask," Kandola said. She recommends keeping one in a plastic or brown paper bag and putting it on when going into stores or while you're in a waiting room – places where physical distancing isn't possible. She also reminded residents as the weather warms up, to maintain physical distancing.

Testing capacity – where's it at?

Cook said the territory has two GeneXpert rapid testing systems at Stanton Hospital in Yellowknife. Staff have begun using them and more are expected to arrive, with the territory potentially looking at putting one in Inuvik.

Cook ruled out placing one at airports because it requires a certain level of lab equipment and expertise. The GeneXpert can analyze a test in about an hour. But it's being used sparingly because of a lack of cartridges that the machine needs to operate.

"It's not just us, it's everyone across the country dealing with this shortage," Cook said.

"It's definitely a big challenge," she added. "Having rapid results and then being able to rapidly contact trace is really, really key to the public health effort."

The majority of tests are still going to Alberta, with a turnaround time of three to four days, depending on which community the swab is coming from. There's no shortage of swabs, Cook mentioned.

She said the territory is fortunate to have this window where it does not have any active cases, adding the strategy right now is to stockpile cartridges so the health system is ready for any next cases.

Why aren't we testing people without symptoms?

Often people ask why are we not testing asymptomatic people — those without symptoms. Some provinces in Canada have started to target high-risk groups in an effort to catch infections in places they are most likely to arise. Saskatchewan has expanded its testing to include anyone working outside the home.

But the N.W.T. is only testing asymptomatic health care workers who have travelled in from outside the territory.

"Random tests for people without symptoms is really of a limited value because it's hard to interpret the results," Cook said. She said that's because of the very high false negative rate.

If the test comes back negative, it doesn't necessarily mean anything, she explained. That person could be pre-symptomatic and come positive tomorrow or the next day.

"We don't know at what point during those 14-days the virus will start to shed and become positive," she said.

What about testing people to see if they've already been exposed?

A serological test could potentially do that, but is not widely available yet in Canada. "We hope that it will be in some point but it's not now and it's not in the near future," Cook said.  There's still limited data to interpret those tests, for example, how many people will actually create antibodies, how many develop immunity — or don't.

When will phase 2 start?

If conditions continue the way they are, with no community transmission, Kandola said the territory is on track to roll out the second phase of its reopening plan as early as June 12  — two full incubation periods, or four weeks, after the first phase began.

Phase 2 would allow dine-in restaurants and movie theatres to reopen with limited capacity and outdoor gatherings of up to 50 people.

"We will be relaxing measures for indoor gatherings but it will be done safely with physical distancing," she said.

What about a 2nd wave?

When looking at how pandemics behave — the Spanish flu, for example — Kandola said typically there are several waves, and the second wave is usually larger than the first. "In the summer, as we relax measures, we still need to plan for the fall," she said.

When the weather gets colder and people spend more time indoors with poor airflow, Kandola said it's ideal for a cluster outbreak.

"So we anticipate a scenario like that in the fall," she said.

"We still have to maintain public health measures, in terms of actively trying to quarantine as much as possible for 14-days for people coming across the border."

Miss the call-in show? Watch the full segment here.