Another four cases of COVID-19 in Ontario were reported Thursday, but Ontario’s top doctor says there’s no need to hoard hand-sanitizer or other home supplies as the best defence against the virus is proper washing with soap and water.

“I’m not sure why toilet paper is the biggest thing, but it seems to be one of the things that people like at this stage,” chief medical officer of health Dr. David Williams said, as the number of cases in the province jumped to 24.

New cases are popping up across Canada. Eight were reported in British Columbia Thursday evening, including the first instance of community transmission in that province. One more case was reported in Quebec and the first presumed case was announced in Alberta.

The latest Toronto case revealed Thursday night is a person who travelled to Las Vegas for an international conference. According to an internal email sent to staff in the University Health Network, the person went to the Emergency Department at Toronto Western Hospital Wednesday with respiratory symptoms.

“All protocols were followed and the patient was assessed and sent home to self-isolate,” said the email, from Gillian Howard, the vice-president of public affairs and communications at the University Health Network.

“The patient is now at home and being monitored by Toronto Public Health,” she continued. “We are continually reviewing our processes to ensure that we are current with the situation as it changes.”

Another of the new Ontario cases involves a Waterloo Region woman in her 50s who recently returned from Italy, where there is a huge outbreak in the north around Milan, and becomes the first case from that country in Ontario. The second is a man who had recently been to Iran.

Peel Region’s public health revealed the third new case late Thursday afternoon — a Mississauga resident who was on a Grand Princess cruise ship that travelled from San Francisco to Mexico between Feb. 11 and Feb. 21.

A 71-year-old California resident who died earlier this week was on the same voyage, prompting Gov. Gavin Newsom to declare a state of emergency. The ship is now floating off San Francisco after its scheduled trip to Hawaii was postponed while passengers are tested. According to Global Affairs there are 235 Canadians on the ship’s manifest.

The unidentified Mississauga resident returned to Canada on Feb. 28 and developed symptoms the next day. He did not go to hospital until Wednesday and was later sent home to remain isolated, said Dr. Jessica Hopkins, Peel’s medical officer of health.

“To protect the health of the public and prevent community spread, Peel Public Health has immediately launched an investigation to identify potential sites of exposure within our community and any individuals who may have come in close contact with the case during their period of communicability,” she added in a statement.

Williams said shoppers concerned about the potential course of the new coronavirus need to “be reasonable,” given relatively low risk levels here so far. And he offered help from public health officials if people in self-isolation run low on anything.

“We will assist them in any way we can, so they should not feel desperate they’ll run out of something,” he told reporters, noting friends and neighbours can also be called upon to make deliveries.

Clean hands are important, he said, but there’s no need to go overboard with hand sanitizer when an old-fashioned alternative is better.

“Hand sanitizer is meant to be around in mobile places where you don’t have access to a sink and soap,” Williams said.

“We know that hand sanitizer is not as effective as a thorough hand washing with soap and water ... if you’re bringing back big containers to your house to use in the household, why are you not using your sink and your soap and your water?”

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The main thing people should be stocking up on are things that are hard for others to arrange, such as prescription renewals, providing the quantities are not so large the drugs will pass their expiration date before being used, Williams said.

The new cases of COVID-19 from Italy and Iran were assessed and tested in hospital before the patients were sent home to self-isolate.

The woman who had been in Italy went to Grand River Hospital in Kitchener upon her return Tuesday with “mild symptoms” that had been evident on the plane, Williams said. Waterloo Region public health officials have the flight manifest and are notifying passengers who sat within two rows of her that they may have been exposed, and tracing other contacts.

The man in his 60s who flew back from Iran on Saturday went to the emergency room at Sunnybrook hospital on Tuesday. Toronto public health workers are tracing his contacts and movements.

Williams said he expects more cases from Italy, the European country that’s been worst hit by the new coronavirus that originated in China three months ago and has never been seen in humans before. A recent cluster of cases who had recently returned from Egypt have been traced to a cruise on the Nile River where another passenger “must have been infected,” Williams added.

Ontario’s public health lab is now doing about 220 tests a day, triple the rate of a week ago, as COVID-19 sees significant spikes in dozens of countries. There have been more than 100,000 infected and at least 3,000 killed, mostly in China.

To look for wider person-to-person spread of the bug in Ontario, medical officials have recently tested 270 patients with other illnesses in health care settings in recent days but none have tested positive.

That type of testing will continue to detect any “community spread” for which public health officials have been preparing given the fast-growing number of cases and deaths in Italy, Iran, South Korea and Washington state in the U.S.

While there is no need to begin cancelling or curbing “mass gatherings” at this time, Williams said health officials are preparing information sheets for organizers of large public events to help with safety precautions. That will be released in the coming days.

He cautioned against travels to any “hot zones” for the new coronavirus, particularly for the elderly or anyone with underlying health conditions like heart disease, diabetes or respiratory challenges, saying there would be “considerable risk.”

The Toronto Catholic District School Board is considering a motion to require “enhanced cleaning and disinfecting procedures” in schools, install more hand sanitizer dispensers and to discourage “food sharing” among children.