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OTTAWA, Ont. —

With a growing number of cases of COVID-19 in Canada, public health officials are broadening their approach to containing the rapidly spreading virus.

The number of cases in Canada now sits at 27 —18 in Ontario, eight in British Columbia and one in Quebec — and a surge of new cases over the weekend and on Monday from individuals who have travelled to Iran, or had close contact with someone who did, has caused Canadian officials to change the Iran travel health notice to Level 3.

This means Canadians are being asked to avoid all non-essential travel to Iran.

China is also still at Level 3, as are northern Italy and the South Korean cities of Daegu and Cheongdo, while other countries that have seen pockets of spread at the community level, such as Italy, South Korea and Japan, remain at Level 2, which advises travellers to exercise a high degree of caution.

Dr. Theresa Tam, Canada’s chief public health officer, said officials are asking travellers from Iran to identify themselves upon arrival in Canada, contact local public health officials within 24 hours, monitor for symptoms of coronavirus disease and self-isolate at home for 14 days.

“Our domestic response continues to focus on containment to prevent and delay the spread of the virus in our communities by detecting cases early, isolating and caring for patients, and rigorously tracing contacts,” Tam said.

“At the same time, we are preparing the health system and society to respond to the possibility of widespread illness and the need to reduce the impact on our populations.”

Tam said to date in Canada nearly 2,900 individuals have been tested for COVID-19, and until now testing has been focused on persons presenting with symptoms and a history of travel to an affected country, or close contact with someone who has.

Health officials will expand testing to detect cases of COVID-19 beyond those parameters in order to detect any spread at the community level.

Tam said the Canadian health-care system, individuals and communities need to be prepared for the potential future deployment of public-health measures meant to interrupt transmission of the virus at the community level, such as the suspension of large-scale gatherings, and the closure of schools and workplaces.

Canada’s pandemic influenza plan, which was tested and refined following the 2009 H1N1 pandemic, remains Canada’s basis for planning.

“As our outbreak planning and response is a shared responsibility, the Government of Canada is working in very close collaboration with provinces and territories,” Tam said.

In the meantime, Tam said, Canadians can continue to do their part to protect themselves and others by frequent handwashing, always covering their mouth and nose when sneezing and coughing, and staying home when sick.

“By taking these simple measures you can contribute to slowing the spread of respiratory viruses, protect the most vulnerable such as older populations and those with underlying medical conditions and reduce the impact on our health systems.”

On Monday, World Health Organization officials expressed concern about the rise of cases of community spread in other parts of the world as the instances of new cases in China continue to decline.

“In the last 24 hours, there were almost nine times more cases reported outside China than inside China,” WHO director-general Tedros Adhanom Ghebreyesus said at a news conference.

Outside of China, South Korea has the highest number of known cases of COVID-19, at just over 3,700, representing more than half of all reported cases outside of China.

But Ghebreyesus pointed out the cases in South Korea appear to be coming from the five known clusters of the virus rather than the community.

“That’s important because it means surveillance measures are working and their epidemic can still be contained,” he said.

Iran, which has only 593 cases but 44 deaths, is of immediate concern to global health officials, as significant spread has been reported at the community level.

A WHO team arrived in Iran Monday to deliver supplies and support the government in its response.

Ghebreyesus said that if this were an influenza epidemic, officials would have expected to see widespread community transmission across the globe by now, and efforts to contain it or slow it down would not be feasible, but thankfully that is not the case for COVID-19.

“Containment of COVID-19 is feasible and must be the top priority for all countries. With early, aggressive measures, countries can stop transmission and save lives,” he said.

Even with significant concerns regarding spread outside China, causing the WHO to increase the global risk level to very high, the organization is still not calling it a pandemic.

“We’re monitoring the situation every moment of every day. WHO will not hesitate to describe this as a pandemic if that's what the evidence suggests,” Ghebreyesus said.

As of Monday, there were approximately 87,100 cases of COVID-19 confirmed globally. Just under 80,000 of those were in China and 7,200 were reported elsewhere. There have been approximately 3,000 deaths attributed to COVID-19 worldwide.

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