It’s been 101 years since the Spanish Flu swept through Canada, killing 55,000, including an estimated 259 in Greater Victoria. Not only was that flu particularly deadly, but it was also able to benefit from a world without a coordinated global health infrastructure designed to halt pandemics; by the time doctors knew what the flu was or how to prevent its spread, it was already too late.

As of this writing, Canada is working to contain a new virus known as novel coronavirus (2019-nCoV). The virus appears to have jumped the species barrier last December at a seafood market in China’s Hubei province. As of Thursday morning, it has infected 28,000 people and killed 565, largely in Hubei.

Victoria is only a short ferry ride from one of two known Canadian regions hit by the outbreak, as well as the site of the first known U.S. case, which occurred just outside Seattle. With Canada having activated its official response plan for biological events and Victoria pharmacies already running out of face masks and hand sanitizer, The Capital assembled a picture of what the response to novel coronavirus is looking like at the local level.

With no vaccine or treatment, the virus can only be contained

When Southern Vancouver Island was struck by a measles outbreak in April, the response of the Vancouver Island Health Authority was an immunization drive. But novel coronavirus is so new (the first known cases showed up less than two months ago) that there is no vaccine and no known antiviral treatment. As a result, the only way to curb its spread is containment; identifying people with the virus and putting enough space around them so that they can’t spread it to others.

Containment is humanity’s oldest form of disease prevention, but that doesn’t necessarily mean it’s a primitive response. For instance, Canada sees only a few hundred cases of tuberculosis each year, as compared to the 10 million cases that annually occur around the world. One of the primary reasons for this is good old-fashioned containment – Canadian health officials are very good at isolating new tuberculosis cases before they can infect others.

Today the @WHO determined that the novel #coronavirus is a public health emergency of international concern. The measures recommended by the WHO have already been put in place in Canada, and our health care system is prepared. The risk to Canadians remains low. pic.twitter.com/Ly8AxJMxLv — Patty Hajdu (@PattyHajdu) January 30, 2020

When it comes to 2019-nCoV, Canadian researchers have joined the global hunt for a vaccine. But with a solution as much as three years away, local efforts for the time being are all focused on identifying people with the virus and stopping them from getting near anyone else.

Coronavirus’ symptoms are identical to any number of infections, complicating detection

The BC Centre for Disease Control, the agency coordinating the provincial response to coronavirus, is advising frontline healthcare officials to be on the lookout for the following symptoms of 2019-nCoV infection: Fever, cough and difficulty breathing. Unfortunately, these symptoms also describe dozens of other wintertime infections, from pneumonia to the common cold. The BC CDC’s lab would be overwhelmed if all of these cases were tested for 2019-nCoV. As a result, healthcare professionals across Canada are only testing patients who are showing these symptoms and also reporting that they’ve travelled to Hubei or have been in close contact with others who have.

BC’s first confirmed case was a Vancouver man who had just returned from a visit to Wuhan, the capital of Hubei province. The second, a woman in her 50s, caught the virus after being in close proximity to family from Wuhan.

Teams of nurses are on call to laboriously track everywhere an infected person might have gone

The foot soldiers of an infectious disease outbreak are teams of public health nurses performing what is known as “contact tracing”; labouriously tracking down anyone who might have gotten infected by a confirmed case.

In Victoria, contact tracing was on prominent display during the city’s April measles outbreak, when the Vancouver Island Health Authority was trying to track down hundreds of people who may have ridden buses, attended classes or simply shared the same mall as a measles carrier. In large part due to contact tracing, that particular outbreak burned itself out before anybody was seriously injured or killed.

Air Canada Suspends Flights to Beijing, Shanghai: https://t.co/TUyvgtHEpi

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Air Canada suspend ses vols à destination de Beijing et Shanghai : https://t.co/hLoYPrG2L8 — Air Canada (@AirCanada) January 29, 2020

Contract tracing is a bit easier with 2019-nCoV because it’s not as infectious. So far as is known, it’s only possible get novel coronavirus by being within two meters of an infected patient; any further and you’re too far away to be hit by any infected water droplets emitted by a sneeze or cough. This is in contrast to the measles, which can leap across distances of up to 30 meters.

Still, contact tracing can be an incredibly daunting undertaking. In Snohomish County, WA, the site of the United States’ first confirmed case, staff at the Snohomish Health District poured an estimated 1,000 hours into tracking down every possible person the patient might have infected, including fellow guests at a group lunch the patient had attended, or the waiting room of a clinic where he had first sought medical attention.

Contact tracing is precisely what Vancouver Coastal Health is doing with its two 2019-nCoV cases. And should a confirmed or suspected case show up in Victoria, the Vancouver Island Health Authority would similarly be mobilizing teams to track down anyone who might have gotten within two metres of them.

Of course, contact tracing can only go so far. In Hubei, the virus has already spread so widely that Chinese authorities are needing to take much more drastic measures such as the locking down of entire cities and transportation networks. But in Canada’s case, public health authorities are still able to catch carriers of the virus when they’re only one or two degrees of separation from Wuhan. The singular goal of Canada’s public health response is to keep it that way.

