Health officials in Ontario confirmed three new cases of the novel coronavirus on Saturday, the highest number of positives reported on a single day in the province.
Two of the new cases are in Durham Region, the other in York Region. They are the first cases reported in the two regions.
The report comes a day after two more positives were reported in the province, bringing the overall total in Ontario to 11. Three of those patients have since recovered from the virus.
Most of the latest cases in Canada involved people who travelled through Iran, or who live with somebody who had visited there. Iran’s health ministry said Saturday that there are 593 cases in the country, with 43 deaths.
But earlier this week, the Star reported that the true number of coronavirus cases in Iran may be upwards of 18,000, according to a preliminary analysis by Canadian researchers.
“It’s a raging epidemic (in Iran) and the Iranian government appears to be in a state of denial,” University of Toronto epidemiologist Dr. David Fisman told the Star.
Experts have expressed concern that the extent of the outbreak in Iran is under-reported, and that uncontrolled transmission in the country could have profound consequences for limiting the global spread of the disease.
Despite the recent increase, Toronto medical officer of health Dr. Eileen de Villa said Saturday afternoon that residents should not panic and that there have been no reported cases of local transmission in Toronto.
So far, everyone in Canada diagnosed with COVID-19 — the disease caused by the novel coronavirus — has been infected while travelling, or lives closely with someone who became ill while travelling.
Each case has been carefully followed up, and everyone who may have been in close contact with those who are infected is notified, said de Villa.
“The best available evidence says that this virus is not airborne; you have to have close contact with the respiratory excretions of an ill person,” de Villa told the Star.
“So, walking through the same Loblaws or Costco is not a significant exposure.”
She said the city is preparing for the possibility that the situation may evolve to the point where people are being infected locally. For example, more testing is being conducted when people present with flu-like symptoms in hospital, or are admitted with respiratory issues.
“We’re asking people to stay up to date because we are regularly updating our information on our website and would really encourage people to rely on Toronto Public Health and other official credible sources of information,” said de Villa.
The York Region case involved a patient at Mackenzie Health hospital in Richmond Hill on Thursday.
After arriving in Toronto on Wednesday, the 34-year-old woman — who had a travel history to Iran — went to Mackenzie Health the next day with a dry cough, runny nose, shortness of breath and headache.
She was wearing a mask on arrival at the hospital, a news release said.
“Due to the low severity of symptoms and the condition of the patient, the patient was not admitted to hospital,” the news release said. “The patient is in self-isolation, per protocols, where she remains.”
She developed symptoms prior to her return and was symptomatic on the flight, York said in a news release.
The woman flew with her husband to Toronto with a layover in Denmark. She wasn’t wearing a mask during her travels back to her home.
York officials urged all passengers who travelled in the business class section of Qatar Airways flight QR483 and QR163 on Tuesday; travelled in business class on Air Canada flight AC883 on Wednesday; or was sitting on the upper deck on GO bus No. 40 eastbound on Wednesday at about 3:55 p.m. to contact York Region Public Health because they may have been exposed.
These people are asked to call 1-800-361-5653 Monday to Sunday between 8:30 a.m. to 8 p.m. for further assessment.
“It was only a matter of time before York saw a case of COVID-19 in York Region,” Dr. Karim Kurji, the region’s medical officer of health, told reporters at a news conference.
Kurji said public health officials are trying to identify passengers on the plane who were seated two seats ahead or behind the patient.
The risk level on the GO bus is lower than that of the plane because the period of travel is shorter, and there is a higher degree of ventilation and air movement on the bus.
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“We believe in aggressive contact followup. We have every confidence that we’ll be able to contain the exposure and we have isolated close to 600 individuals since the spread of the virus over the past few months,” Kurji said.
The virus has also mostly been brought in from outside and isn’t circulating within the community, Kurji said.
As of Saturday afternoon, people on the flights haven’t been tracked or contacted as officials do not have the flight manifestos yet, Kurji said.
The woman’s husband and toddler are also in self-isolation.
The process of self-isolation includes separating members of the family: they cannot share the same room, washrooms, utensils or general living space. If they need to be in contact, they need to be at least two metres away from each other, said Kurji.
“It’s quite difficult for a toddler who can’t see their mom,” Kurji said.
An internal hospital letter obtained by yorkregion.com assured MacKenzie Health workers that all protocols had been followed.
“Because of the protocols in place, there were no staff, patient or visitor exposures related to this case,” read the letter written by Dr. Danny Chen, physician lead in infection prevention and control.
“Staff and patient safety will always remain a priority at MacKenzie Health.”
In Durham Region, two patients at Lakeridge Health Ajax Pickering also tested positive.
A 51-year-old woman returned to Toronto from Iran on Feb. 22. On Friday, she went to an Ajax clinic while wearing a mask, with symptoms of a cough, body aches and chills.
Her 69-year-old husband, who had a cough but wasn’t recently in Iran, also tested positive for COVID-19 after accompanying his wife to the clinic.
Both were discharged home and put in self-isolation.
On Friday, Ontario health officials reported that a man in his 50s who had travelled to Iran had tested positive for the virus in Toronto. Later Friday night, officials reported that a Toronto man in his 80s with a travel history to Egypt had tested positive.
Meanwhile, the B.C. government has confirmed a new presumptive positive case in the Vancouver Coastal Health region.
Provincial health officer Dr. Bonnie Henry says the eighth case in the province is a woman in her 60s from Tehran, Iran, who travelled to B.C. to visit family and developed symptoms a few days after arriving.
That means there are 19 confirmed cases of COVID-19 in the country plus one presumed positive in Quebec.