Public health protocols could change as restrictions ease in Nova Scotia, says Strang

Nova Scotia's chief medical officer of health says there is a very real risk of people being lulled into a false sense of security as the province's COVID-19 curve flattens.

Dr. Robert Strang made the comments Monday, the first day since March that the province announced no active cases of the coronavirus.

Many people continue to follow public health directives, including physical distancing, gathering restrictions, regular handwashing and coughing etiquette, but Strang said he's also seeing evidence of people who are not.

"We need everybody to understand that the way we keep our economy and our communities open is for everybody to practise all those public health measures," he said in a telephone interview.

Those measures will continue to change and evolve based on epidemiology, said Strang. One possible example is the use of masks.

Although the World Health Organization and Public Health Agency of Canada recommend people wear masks in public, Strang noted the WHO recommendation targets areas with known or suspected community transmission, and both recommendations are then adjusted based on local epidemiology.

In Nova Scotia, where the risk of someone having COVID-19 is low, Strang's office recommends people consider wearing a mask when they're in public around people where physical distancing isn't possible, such as on the bus or at the grocery store.

That recommendation could change, however, as the province considers further easing of restrictions by opening up Nova Scotia to travellers from other provinces.

"The real risk now for Nova Scotians is the reintroduction of COVID into the province," said Strang.

"What we've talked about is actually not waiting for perhaps more cases to occur, but having a stronger recommendation around masks at that time, because that would build another layer of prevention as more people come into the province."

Atlantic bubble could come soon

Last week, Premier Stephen McNeil and his counterparts talked about the prospect of an Atlantic bubble forming soon, which would allow people to pass through the four Atlantic provinces without having to self-isolate for 14 days. McNeil also said he'd like to see the province open to the rest of the country by mid-July.

Although nothing has been settled, Strang said he thinks the Atlantic bubble is the right place to begin. That kind of a change would need to be observed before further changes could be made, he said.

Strang said the opening of borders is being discussed regularly with his counterparts across the country, and would partly depend on the situation in Quebec and Ontario, where COVID-19 continues to prove stubborn in certain areas.

"No decisions have been made at all around timing or even definitive commitment to do anything around border restrictions," he said.

The job for public health officials continues to be finding the balance between how to open things up, but in a way that doesn't take on unnecessary risk, said Strang.

Learning to live with COVID-19

People need to accept there's a strong likelihood there will be more cases of COVID-19 in the province. The real issue, said Strang, is whether those are sporadic cases that public health can quickly recognize and isolate, or if it's something more significant.

"If you have wide community spread, then you also have the risk of reintroduction into higher-risk settings like long-term care homes or a homeless shelter," he said.

If a few cases of the coronavirus do emerge, it doesn't mean the system has failed or that everything needs to be immediately shut down again, said Strang.

Rather, people need to learn to live with having some level of the disease in their community, something that can be achieved by following public health protocols and maintaining the increased capacity that's been built into the system in the last three months through screening at 811, lab testing and follow-up monitoring by public health staff.

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