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The latest on the coronavirus outbreak for June 18

The latest on the coronavirus outbreak from CBC News for Thursday, June 18.

 

British Prime Minister Boris Johnson, left, greets French President Emmanuel Macron while physical distancing. The visit was Macron's first trip outside France since the COVID-19 pandemic began. (Dan Kitwood/Getty Images)

Mandatory mask laws are spreading in Canada

Some communities across Canada have started making non-medical face masks mandatory on public transit — or even in businesses or indoor spaces — to curb the spread of COVID-19. Some doctors and epidemiologists are calling for such laws to be more widespread, writes CBC's Emily Chung, but others warn about the potential negative impacts and say the scientific evidence isn't strong enough to warrant such heavy-handed measures.

Currently, the Public Health Agency of Canada recommends that healthy people wear a non-medical mask or face covering in public places, especially crowded ones, when physical distancing — keeping a distance of two metres from other people — isn't possible to do consistently. Such places include stores, shopping areas and public transportation. The idea is that masks can reduce the spread of respiratory droplets you produce when breathing, talking, coughing or sneezing. The recommendation was put in place because of growing evidence that people can transmit COVID-19 through such droplets before showing symptoms. People with symptoms should stay home and not be in public places.

A national group of health-care professionals and epidemiologists called Masks4Canada and a group in Quebec have recently called for more laws making masks mandatory in certain circumstances. Masks4Canada wrote an open letter to federal health officials asking them to recommend such laws to lower levels of government for all indoor spaces outside the home, crowded areas — both indoors and outdoors — and public transit. The letter noted that despite recommendations, a recent poll showed less than half of Canadians are wearing masks when they go out in public. It cited computer simulation studies that showed more than 70 per cent of the population needs to wear masks in public to significantly reduce transmission. Some businesses, such as the Longo's grocery store chain, have already implemented policies barring customers without masks.

Most research on masks so far has involved medical settings or households with a person known to be infected, said Dr. Mark Loeb, a McMaster University professor who studies infectious diseases and recently reviewed the evidence on masks and the spread of respiratory illnesses. When it comes to wearing masks in the wider community, most studies published in scientific journals don't show a clear impact so far, possibly because of factors such as study size, he said. He said that the PHAC's advice on masks is pragmatic and "a wise thing to do." But he questioned whether the evidence on universal mask wearing is strong enough to make it mandatory in all public places, although, he said, mandating it on transit may be reasonable. Dr. Amy Tan, an associate professor of family medicine at the University of Calgary and a member of Masks4Canada, said we don't have the "luxury of time" to wait for that kind of evidence. "During a pandemic, you need to be looking at the emerging evidence and look at other levels of evidence to say there is more than enough science behind it."

Most mandatory mask regulations in Canada so far concern transportation situations where people may have trouble physically distancing. As well, at least two municipalities — Côte Saint-Luc, Que., and Wellington-Dufferin-Guelph in Ontario — are implementing mandatory mask laws, although most regulations include exceptions. Many jurisdictions seem to be making moves in the direction of making masks mandatory. For example, health officials in Ontario's Waterloo region are currently talking to business owners about what they would like to see in a mask or face covering policy. Kate Mulligan, who sits on the Toronto Board of Health but isn't part of any group advocating for masks, said she's been asking about potential mandatory mask policies. So far, she's been told by officials that the evidence doesn't yet support broader mask laws. "I expect that to change," said Mulligan, assistant professor at the Dalla Lana School of Public Health at the University of Toronto who studies health policy and equity. In the meantime, she suggests people follow public health recommendations to wear masks voluntarily where physical distancing is difficult.

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After three months of schools being shuttered in the Atlantic provinces, a CBC News survey of school boards found most students used online learning, but there’s no data on how much school work was done or how often students were online. 2:06

IN BRIEF

Canada tops 100,000 reported coronavirus cases

Canada's total number of confirmed and presumptive coronavirus cases surpassed 100,000 today after Ontario reported 173 new cases. As of 12:42 p.m. ET on Thursday, Canada had 100,146 confirmed and presumptive cases. Provinces and territories listed 62,442 of those cases as recovered or resolved. A CBC News tally of deaths based on provincial data, regional health information and CBC's reporting stood at 8,348 after being revised down by one when health officials in Ontario's Peel Region updated their figures.

Ontario and Quebec, which have seen the vast majority of cases, have seen some progress in beating back the disease as seen by new case numbers. On Thursday, there were 120 new cases in Quebec and Ontario reported fewer than 200 cases for a fifth day in a row. Long-term care homes have been an area of major concern in the country, with several facilities in Quebec and Ontario facing such severe staffing issues that the provincial governments requested help from the Canadian Armed Forces. Nunavut remains the only jurisdiction in Canada with no confirmed cases of COVID-19, but Yukon, the Northwest Territories and Prince Edward Island have to date had no deaths attributed to the virus.

The global pandemic has caused massive strain on health systems and economies worldwide — including in Canada, where provinces struggled to ramp up testing in early days and worried about shortages of critical protective gear and trained staff. Public health officials responded to growing case numbers with public health measures aimed at slowing the spread of the disease, but widespread closures came with significant economic strain for governments, businesses and families as organizations closed their doors. As daily new case numbers decline, provinces have been taking steps toward reopening after months of closures and strict health measures aimed at fighting the virus, for which there is no proven cure or treatment. Dr. Theresa Tam, Canada's chief public health officer, has warned that there is no place for complacency around public health measures, and urged people to keep up hand hygiene and physical distancing.

Read more about what's happening in Canada

Voluntary countrywide contact tracing app coming soon, Trudeau says

Prime Minister Justin Trudeau said today he hopes Canadians will download a new app on their cellphones that will alert them if they've come into contact with someone who has tested positive for COVID-19. "It will be up to individual Canadians to decide whether to download the app or not, but the app will be most effective when as many people as possible have it," Trudeau said.

The federally backed project has been spearheaded by the Canadian Digital Service, a federal initiative, and the Ontario Digital Service, with help from volunteers from the tech firm Shopify. It incorporates Bluetooth technology provided by Apple and Google. The app will undergo a security review by BlackBerry. The technology works by having people who test positive upload their results anonymously to the app, using a temporary code provided to them by a health-care provider, according to a federal release. Other users who have the app and who have been near someone who has tested positive will then be alerted that they've been exposed and a notification will encourage them to reach out to their local public health authorities. The prime minister said Ontario will start testing the app first, but he's hoping to get other provinces on board and to make it available countrywide in July.

Public health officials have been championing the practice of tracking people who may have come in contact with an infected person in order to get them tested and isolated. Alberta has been using its own app called ABTraceTogether for weeks now. That has some people worrying about a patchwork of apps across the country that could lead to confusing messaging, low uptake numbers and inconsistent data. Trudeau stressed that the new app will be completely voluntary and the federal privacy commissioner has weighed in on its development. Today's announcement likely will also receive scrutiny from privacy advocates, who have raised concerns about how much data these emerging technologies collect and how that information is stored. "At no time will personal information be collected or shared, and no location services will be used," Trudeau said. "The privacy of Canadians will be fully respected."

Read more about the contact tracing app

Quebec's COVID-19 triage protocol is discriminatory, disability advocates say

The potential for mistakes and discrimination against people with disabilities is likely if Quebec doesn't revise its COVID-19 triage protocol, advocates warn. The triage protocol is a set of worst-case scenario guidelines designed to help doctors decide which patients get access to critical care beds and ventilators if the health-care system is overwhelmed by cases, advocates warn. Several of the exclusion criteria — the factors that help a medical team decide which patients are ineligible for life-saving intervention — are discriminatory, in the view of the Quebec Intellectual Disability Society (SQDI), an umbrella group representing organizations across the province.

In addition to excluding patients who have suffered a heart attack or a severe and irreversible neurological event like a stroke, the criteria excludes anyone who has a severe cognitive disability as a result of a progressive illness that leaves them unable to perform daily activities without help. People with an advanced and irreversible neuromuscular disease, such as Parkinson's disease, would also not be entitled to intensive care in the event that there was a shortage of resources, said Samuel Ragot, a policy analyst and adviser for the SQDI. With a second wave of the virus likely, Ragot said, it's urgent the province act now and remove any discriminatory criteria. The SQDI has launched a website, along with a petition; so far, nearly 4,800 people have emailed their member of the National Assembly and the premier to raise their concerns about the protocol.

When the triage protocol was drafted, health-care officials in Quebec wanted to avoid the heartbreaking, life-or-death decisions many doctors in Italy, and later, New York, were being forced to make when they had to ration care and equipment. "A triage protocol is to prepare for a catastrophe. You only use it in an emergency, as a last resort. You don't use that if the resources are still available," said Marie-Eve Bouthillier, a professor of clinical ethics in the faculty of medicine at the University of Montreal. She was tasked by the province with coming up with a plan in one week, so she gathered together a working group of more than 40 experts, including intensive care specialists, emergency physicians, nurses, lawyers, ethicists and patients to draw up the protocol. "It's a medical decision. It's not at all a decision based on the value of the life of someone living with cognitive impairment or any other physical disability," said Dr. Joseph Dahine, an intensive care specialist at Laval's Cité de la Santé who was part of Bouthillier's working group. Bouthillier said she has asked the Quebec Health Ministry to post the protocol on its website this week.

Read more about the triage protocol

THE SCIENCE

Is public transit safe to use amid the pandemic?

CBC News readers, viewers and listeners have sent in countless questions about the COVID-19 pandemic, including this one. If you have a question of your own, reach out at covid@cbc.ca.

As for the issue at hand: The experts CBC News spoke to said there's risk whenever you leave your house, but especially when you're in an enclosed space with people outside your household. But there are ways to make public transit safer.

Robyn Lee, an infectious disease epidemiologist at the University of Toronto, said maintaining physical distance and observing good hand hygiene can reduce the risk of transmission. She also suggested taking transit during off-peak hours. "Fewer people travelling at rush hour will make it easier for those who have to be at work at 9 a.m. to safely physically distance," she said, "and for those who can start work outside peak hours, this would allow them to better physically distance on their commute to work as well."

And if there's an option to avoid using transit in general, it might be worth considering — especially while the weather permits, said Dr. Sumon Chakrabarti, an infectious diseases physician at Trillium Health Partners in Mississauga, Ont. "If there is any leg of the journey that can be done outside, like walking or biking, where possible, do this," he said. Various transit authorities are also trying to reduce the risk by implementing precautionary measures, like creating physical distancing between seats, installing Plexiglas for drivers and recommending or mandating masks for passengers. "To keep transit safe, this will take co-operation of all of us," said Lee.

AND FINALLY...

Sackville, N.B., nursing home residents treated to first live music performance in months

Ventus Machina, a woodwind quintet based in Dieppe, N.B., performed for the residents of the Drew Nursing Home in Sackville, N.B., on Wednesday. (Pierre Fournier/CBC)

Residents of a Sackville, N.B., nursing home were treated to their first live music performance in months on Wednesday, when the woodwind quintet Ventus Machina set up in the courtyard to play a midday concert. The Drew Nursing Home usually has musicians performing regularly, but COVID-19 restrictions brought those performances to an end months ago.

Residents Barb and her husband JJ Leadbetter were thrilled to have live music after having so little to do for so long. "We really needed some live music, we really did," said Barb. "We were getting so tired of looking at ourselves." Members of the group seemed as excited to play to a live audience as the residents were for live entertainment. "To have those faces there and to feel that we've made a difference, that's amazing," bassoonist Patrick Bolduc said.

Karin Aurell, the group's flautist, said she has a family member in isolation at the local hospital and has become all too familiar with "window visits." "We're just trying to do a little bit toward making their day a little brighter." Ventus Machina played at a nursing home in Port Elgin and at the Sackville Memorial Hospital on Wednesday as well, and the quintet plans to perform in Riverview, Dieppe, Moncton and Saint John in the coming weeks. Aurell said the group received a small grant from the province to perform, which has helped to make up lost income from cancelled performances.

Read the full story about the performance

​​Send us your questions

Still looking for more information on the outbreak? Read more about COVID-19's impact on life in Canada, or reach out to us at covid@cbc.ca.

If you have symptoms of the illness caused by the coronavirus, here's what to do in your part of the country.

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With files from CBC News, The Canadian Press, The Associated Press and Reuters

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