Newfoundland and Labrador's regional health authorities are preparing for its first cases of COVID-19 as the disease continues to spread — 90,000 confirmed cases so far, with more than 3,000 deaths.

While no cases have reached Atlantic Canada yet, Dr. Janice Fitzgerald, the province's acting chief medical officer of health, told CBC News preparations began as soon as the first cases broke out.

"I think it's almost certain that we will see cases. I think the health-care system is prepared to handle those cases as they come," Fitzgerald said.

"If people present with symptoms, and we're testing them, we actually ask them to isolate themselves until we have those tests back."

Fitzgerald said there are screening processes at points of entry into the province for people travelling from affected areas of the world, such as China, Iran and Italy. Those travellers have been asked to identify themselves upon entry.

Those who are screened, and show no symptoms, are asked to go into a 14-day quarantine. Fitzgerald said those who show symptoms will go through a "protocol" upon entry, but she did not say what that protocol is.

Anyone travelling from other parts of the world with confirmed cases of COVID-19 have been asked to monitor their personal health and call 811, the province's health line, if their health deteriorates.

Right now there have been patients tested for COVID-19 in Newfoundland and Labrador, but none were positive. Fitzgerald said all test results are being sent to the National Microbiology Laboratory in Guelph, Ont.

Front-line staff

The severe acute respiratory syndrome, or SARS — another type of coronavirus — outbreak in the early 2000s killed 44 people in Canada. At least one was a nurse, while other nurses tested positive and were subsequently quarantined for weeks.

Many front-line workers are concerned about what will happen with the COVID-19 outbreak.

"Only about 40 per cent of them feel that they are ready," said Debbie Forward, president of the Registered Nurses' Union Newfoundland and Labrador.

Registered Nurses' Union Newfoundland and Labrador is concerned about members' protection from cases of COVID-19. (Mark Quinn/CBC)

Forward says the concern is over a recommendation by the Public Health Agency of Canada that nurses and other front-line workers should wear an N95 mask — said to block 95 per cent of air particles — only while doing procedures with patients suspected or confirmed to have COVID-19.

She wants to see health-care workers wearing N95 masks even if it's in cases of simple contact with suspected COVID-19 patients. She said the nurses union is treating this outbreak as an occupational health and safety matter, where nurses should be demanding proper protective equipment from their employers.

Protection

Forward said front-line workers were not prepared well enough during the SARS outbreak almost 20 years ago.

"We don't want to make the same mistake again until we really understand this virus," she said.

"Then we need to make sure we provide, the system provides, maximum protection to decrease the chance of workers becoming infected and decrease the spread."

She said Ontario has the best system in place for preparing and protecting its medical workers in the country, thanks to lessons learned during the SARS outbreak, when the province's medical workers were hit the hardest in Canada.

Only about 40 per cent of nurses believe they are adequately prepared to deal with COVID-19 cases, says Debbie Forward, president of the union. (Mark Quinn/CBC)

In Newfoundland and Labrador front-line medical workers are being trained to follow "appropriate isolation procedures," according to Fitzgerald.

They're also being taught what equipment they will need while on the job.

Fitzgerald said the equipment includes a surgical mask with a face shield, gowns and gloves is what's needed, all of which she says is standard and available at all hospitals.

She said the N95 mask is recommended for aerosol-generating procedures and special procedures where ventilation is necessary.

Provincial Health Minister John Haggie told reporters Wednesday afternoon the risk of cases reaching the province is still relatively low.

On top of protective equipment being provided for nurses, Haggie said, negative-pressure isolation chambers in emergency rooms across the province have been checked to make sure they're in working order.

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