Canadians and travellers: What to know about the Wuhan coronavirus

The Wuhan coronavirus has captured the world’s attention, even without the World Health Organization (WHO) calling for an international public health emergency.

The new coronavirus, which originates from Wuhan, China, is believed to have started in a food market, as health authorities work to gather more information and a better understanding of its severity. Human-to-human transmission has been proven possible, but all cases so far have involved people who were in China, while the spread has been linked to people who are close to one another, such as family members.

As of Sunday morning, over 50 fatalities have been reported, and over 1900 confirmed cases in countries such as Nepal, Vietnam, Singapore, Japan, South Korea, Taiwan, Thailand, France, Australia and the United States.

On Saturday, Canada reported its first confirmed “presumptive” case of the novel coronavirus. The man, who arrived in Toronto, was taken to the hospital, while further tests to confirm the illness are underway and should be available in the next 24 hours. Toronto officials are also interviewing those who in contact with the man, to ensure that they are not infected.

“The risk of an outbreak in Canada still remains low,” said chief public health officer Theresa Tam, in a news briefing Sunday morning.

“We wouldn’t be shocked if more cases are reported in Canada.”

As the world awaits more information about the Wuhan coronavirus, which causes severe respiratory problems, Canada is taking precautions. Those have started in major airports across the country, as health officials track a virus that has proven to already have deadly consequences.

What airport precautions can you expect

Upon arrival at Canadian airports, there is a three-part screening process. The first step involves making passengers aware of what symptoms are associated with the Wuhan coronavirus, such as a fever or having a cough. If passengers experience symptoms, they should immediately tell a border control agent, said Tam.

As of January 23, major airports in Vancouver, Toronto and Montreal airports have also featured signs that raise awareness, because of the likelihood that travellers from Wuhan will arrive at these destinations.

The second step involves electronic kiosks, where passengers are specifically asked if they were in Wuhan. On January 26, Tam said that the location question on the kiosks might change or broaden as more information becomes available about how many people are infected from different areas of China and worldwide.

The third step involves speaking with a border service officer, who will also be looking to identify people who appear sick. If that’s the case, quarantine services will be consulted, and all tests will ultimately end up at Winnipeg’s National Microbiology Laboratory.

“Airport screening is not going to prevent the introduction and the spread of a human adaptive virus,” said Allison McGeer, a professor at Dalla Lana School of Public Health, who specializes in airport screenings as an infectious disease consultant.

“Airport screening’s purpose is to notify people who might be at risk about what symptoms they should be looking for and what they should be reporting. It also eliminates a great majority of people from consideration, so we don’t unnecessarily take up time from the border security agents.”

How about those who are not feeling ill?

Asymptomatic people, even if they did arrive from China, won’t be tested. Instead, they’ll be given information in English, French and simplified-Chinese, to inform them about the flu-like symptoms they should be aware of within the next 14 days, which is the believed to be the incubation period.

People who do come from Wuhan and don’t experience any symptoms aren’t being tested, because the probability that Canadian health authorities will be able to detect the “virus is very low,” said Tam. It’s the same reason why incoming passengers are not having their temperatures taken, since it’s proven to be an ineffective method, but one that’s still being taken in Wuhan before passengers board flights.

The Canadian case was identified because the man had called health officials after leaving the airport, where he had received information on the symptoms. But Tam also said the man had reportedly showed flu-like systems on the flight.

“I think our system is working,” said Tam. “The person received the information that hey needed to enter the health system in a safe and responsible matter.”

Susy Hota, an associate professor at the University of Toronto’s Faculty of Medicine, who focuses on infectious disease prevention and control, points to the SARS outbreak in 2003, which was another coronavirus virus that led to 38 fatalities and over 250 cases in Canada alone. Canadian airports completed screenings but had “disappointing results” as they were not able to pick up one case that entered the country.

Compared to 2003, Canada is much more prepared to handle an infectious virus such as the Wuhan coronavirus, says Yoav Keynan, the scientific lead at the National Collaborating Centre for Infectious Diseases. Keynan points to the fact that our capacity to control an infectious discuses is much stronger, with more advanced laboratories and the establishment of the Pan-Canadian Public Health Network in 2005, which has led to better communication for a quicker turnaround.

Brian Conway, the medical director of the Vancouver Infectious Diseases Centre, also mentions that Chinese authorities have been much more transparent and proactive compared to the SARS outbreak, such as by not allowing any incoming flights to Wuhan, an action that was taken as they tried to prevent the spread of the disease.

“With the SARS epidemic, they were waiting to see what measures were necessary,” said Conway. “But now we’re applying the measures that we can, and then we can either pull back, or keep applying more pressure as more information becomes available on a day-to-day basis.”

Measures you can take to avoid contracting the virus

There still isn’t much information about how the latest coronavirus is transmitted, but so far it’s believed to be through droplets, says Tam. For that reason, it’s advised to stay away from people who are coughing, especially as a passenger at an airport.

The idea of wearing a mask has not proven to be effective, said Tam, because you’re putting your hands in close proximity of your face as you apply the mask. The only advisable period to wear a mask is if you’ve already contracted the coronavirus and you’re on your way to receive medical assistance.

Other good practices are similar to precautions doctors issue for any other flu, such as to avoid touching your mouth and face area, to wash your hands or to even keep a bottle of hand sanitizer nearby. If you’re feeling sick, it’s best to stay home, instead of going to work or school.

Conway also mentions that since China is closing off other cities and areas, such as Shanghai, which is over 800 kilometres away from the centre of the epidemic in Wuhan, it’s best to defer any travel plans to visit China anytime soon.

At this point, if you’re experiencing any symptoms and you have had any recent travels or have been in contact with people who were recently in China, it’s best to report yourself to health officials, instead of trying to control symptoms on your own.

“The decision whether or not to use Tylenol or other medications to suppress fever, the doctor in me says, ‘Oh, yeah, go ahead and do that make yourself feel a little bit better’,” said Hota. “But you know, from an epidemiological standpoint, we want to detect any new possible cases. There's not been a case in Canada yet, and we want to be prepared to deal with it appropriately.”

When will the epidemic become more severe in Canada?

Through the latest news briefing, Tam reiterated many times that the risk of an outbreak in Canada remains low.

Those who were seated in a two-metre radius of the Canadian passenger, who was identified to have the latest coronavirus, are now being interviewed, as well as flight attendants who worked in that area. Those who were on the same flight or at Pearson airport, but were not in close proximity, should not be “overly concerned,” said Tam.

While we await further test results, there have been no other confirmed cases of the coronavirus in Canada, as the man who was identified Saturday has also been moved into an isolated area.

Conway says it’s important to note that the world has yet to also confirm a secondary spread, meaning that the virus hasn’t spread to a person who wasn’t in China. It’s also one of the reasons why WHO has yet to declare an international public health emergency.

A secondary spread would represent a different stage of the epidemic, says Conway. In terms of travel, it would mean that incoming flights from an increasing number of destinations would face heavier screening precautions, because we wouldn’t know where the virus could be coming from.

At this point, McGeer wants Canadians to know that there isn’t a reason to be worried in their day-to-day lives.

”You don't have to worry about taking the subway or going to the movies or flying on planes inside Canada,” said McGeer. “If you want to worry about something, worry about influenza or driving your car.”