Ottawa preps for first COVID-19 cases

Health officials in Ottawa have been ramping up their efforts to track and contain potential cases of COVID-19, the respiratory illness caused by the new coronavirus, as the disease spreads.

There have still been no positive cases of coronavirus reported in Ottawa. 

Even so, officials with Ottawa Public Health (OPH) and the Ottawa Hospital have been on alert since January, preparing for the first positive case in the capital and what should happen if the number of cases grow.

OPH says it's preparing to set up special assessment centres using community paramedics as a way of diverting people with questions about coronavirus from hospitals, as those facilities are likely to face increased demand during an outbreak.

"The emergency departments are busy. It's not the best place to send people who are well. There are sick people there," said Dr. Vera Etches, medical officer of health for the city.

Darryl Wilton, president of the Ontario Paramedic Association, said paramedics are in an excellent position to treat people.

"What we don't want is a cluster of infected patients showing up in a place like a hospital and spreading it to everyone else in the waiting room," Wilton said.

The 'worried well'

Dr. Andrew Willmore, medical director for the department of emergency management at the Ottawa Hospital, said many patients won't contract severe cases of the virus, which has symptoms similar to flu.

Willmore said the "worried well" have already started to appear in emergency rooms, but so far hospitals have been able to manage the increased demand.

"We really want to make sure that the folks who are feeling well enough to be at home have [somewhere] they can go other than the hospital, to save that for the patients that really need to be here," he said.

Dr. Kathryn Suh, associate director of the infection prevention and control program at the hospital, says staff are being equipped with yellow gowns, gloves, special respirators and plastic face shields.

Patients with symptoms who have a reasonable connection to other coronavirus cases would be put into negative pressure isolation  — meaning a room that ventilates outdoors rather than circulating air back into the hallway — and a swab would be taken for testing, Suh said.

The hospital has 90 isolation rooms and will be moving patients around so that those with COVID-19 are contained.  

"We have some reserves for the first patient that comes that requires that isolation bed. We are keeping those areas available," Willmore said. 

"Sometimes patients are in an isolation room because they're private rooms, but they don't require isolation."

Willmore said the Ottawa Hospital is well stocked with face masks and ventilators, and also has access to additional supplies through its partners.

Both Willmore and Suh said people concerned about coronavirus should call OPH first.

Public health calls increasing

On Tuesday, public health nurses fielded several calls some from people concerned about whether they'd been exposed to coronavirus. The number of calls have almost tripled from early to late Februrary — from 60 calls weekly to more than 160 — and continue to increase.

Etches said in addition to monitoring for cases related to travel, OPH is starting to test people who present with respiratory illnesses to see if COVID-19 has entered the city undetected.

Etches said public health nurses will retrace the steps of anybody who tests positive in an effort to contain the risk of exposure.

"We are doing intensive case and contact management. That's our plan," Etches said. "We account for every minute of their day to understand if they may have exposed anybody else."

Etches said a team of between 20 and 30 is currently monitoring the situation, but more staff can be brought in from OPH's 200 nurses, or total staff of 500, if volumes increase.

The plan for schools

OPH also has a plan in place to stem outbreaks in schools.

Etches said if a child showed up to school coughing and then tested positive, health officials would remove them from class before deciding if the whole school needed to be closed.   

"We would work with the school to make sure we understand where the child has been in the school, which classrooms could be affected," she said. 

"[We'd also be] making sure that we clean the environment and then providing the right information to the families who might have been affected."

Etches said any decision on shutting down a school or workplace or restricting public gatherings — as has happened in other countries with coronavirus outbreaks — would involve consulting her provincial and federal counterparts.