Doctor says stricter measures needed to protect Nova Scotians from COVID-19

A Nova Scotia family doctor is urging the province to implement stronger COVID-19 policies, and says it should not consider lifting the mandatory 14-day self-isolation requirement for Canadians visiting the province from outside Atlantic Canada.

Premier Stephen McNeil has mused about reopening the province to the rest of the country sometime this summer.

Dr. Ajantha Jayabarathan, who is also an assistant professor at Dalhousie University's medical school, noted that cases of COVID-19 have shown up in recent weeks in communities of three Western provinces that are bubbled.

"I'm gravely worried that the premier will contemplate such a thing, let alone say it. It seems reckless," Jayabarathan said.

"Why would you invite disaster into your midst? We know what is happening in the United States and everyone of those cases in the Western provinces arrived through travel. Why would you court danger particularly when we have so many gaps and holes in terms of our borders?"

CBC News has recently reported on cases where people coming from both Quebec and the U.S. did not receive any calls from authorities in Nova Scotia to ensure they were self-isolating.

On July 6, Premier Stephen McNeil said people entering the province from outside Atlantic Canada would have to fill out a form and provide contact information. He said the government would call every day to ensure they were following the rules.

But on July 17, Chief Medical Officer of Health Dr. Robert Strang said the province would be prioritizing calls, especially to those coming from the United States, due to "capacity issues."

Jayabarathan said the tracking system "clearly has a major crack and a gap."

Other COVID-19 precautions needed, says doctor

She said the province needs to implement other measures to help prevent the spread of COVID-19, including a mandatory mask policy in stores. She noted the World Health Organization (WHO) has recognized COVID-19 is spread through airborne transmission.

"If somebody has no symptoms, just the act of breathing is enough to create what they call a viral cloud," Jayabarathan said.

She said this makes it easy for people to spread COVID-19 in enclosed public spaces. Wearing a mask would help prevent that.

On July 18, Quebec became the first province to make masks mandatory in indoor public places.

Last week, Strang said wearing masks needs to become "much more of a habit for all Nova Scotians." However, he stopped short of making it mandatory, outside of on public transit beginning July 24.

"We're just not there yet. There's still more work to do, but people need to understand we are looking very actively at going further with a mandatory masking policy," Strang said.

Jayabarathan calls that "wishy-washy."

"Why would you not mandate that, particularly if you say you're serious about preventing a second wave [of COVID-19]. I don't understand it," she said.

A call for expanded testing

Jayabarathan also said COVID-19 testing needs to be ramped up. She noted essential workers who travel outside the Atlantic bubble are not required to self-isolate upon their return and they aren't tested either. She said this flies in the face of common sense.

In P.E.I., essential workers must be tested for COVID-19 or self-isolate for 14 days before they return to work.

Jayabarathan also worries the province is not acknowledging asymptomatic cases, where people have the virus but show no symptoms and therefore are not aware they are spreading it.

It's unclear what percentage of people who have contracted COVID-19 are asymptomatic, but studies have suggested the number ranges from five per cent to 80 per cent.

As of July 22, Nova Scotia has one known active case of COVID-19.

Jayabarathan said it's misleading for the province to say there is only case because there is no random testing for asymptomatic cases. Only people who display a symptom are currently tested.

She said they are tracking cases through postal codes, but not releasing that information prevents people in those communities from protecting themselves and others.

"I think [this] is very, very dangerous," she said. "You need to have a public that is informed. This is not fear mongering, this [is] reality. This is our lives."

What the province is saying

CBC News asked the Nova Scotia government whether it plans to start testing essential workers when they return to the province from outside the Atlantic bubble, and whether it plans to expand testing to people who do not have symptoms.

"Testing cannot replace the need for a 14-day isolation period when that is required," spokesperson Marla MacInnis wrote in an email.

However, she did not say whether the province will require testing essential workers.

"Nova Scotia's testing strategy has evolved and will continue to evolve," MacInnis wrote. "Our learnings from the initial wave of COVID-19 help inform how we respond to the disease now and in the future. Throughout the pandemic, we actively developed new testing initiatives, based on these learnings, to use our lab capacity in different ways."

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