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Top doc talks NWT's path to phase three – and risk of returning to tighter restrictions

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1603COVIDnewsconference4.jpg Simon Whitehouse/NNSL photo Kim Riles, chief operating officer of the Stanton Territorial Hospital, Diane Thom, minister of health and social services, Kami Kandola, chief public health officer, Premier Caroline Cochrane, and Ivan Russell, manager, emergency measures with the Department of Municipal and Community Affairs. The four held a news conference at the Great Hall of the NWT Legislative Assembly on March 13.

Chief public health officer Dr. Kami Kandola said Wednesday the NWT has a path to the next stage of the Covid-19 recovery plan but warned the pandemic is actually worsening globally.

There have been no active cases in the NWT for weeks but new infections continue to be reported daily in other parts of Canada. Nunavut, which had been virus free until earlier this month, has its first presumptive case.

Kandola said there are a few scenarios that could lead to a return to stricter public health orders in an individual community, a region or the entire territory, even temporarily.

What would cause us some concern is when we start to see evidence of community spread and we don’t know where that source is.”

In addition to a breakdown in contact tracing, the other possible trigger for going back a phase are cluster outbreaks. Cluster outbreaks are where several cases of infection occur in one place within a short time frame and thus have the potential to overwhelm the health system.

In those cases, Kandola says restrictions are likely to be placed on specific communities or regions experiencing the outbreak. 

“If there are two or more communities in a region [experiencing community spread] the region gets isolated," she explained. "If it's just one community, the community gets isolated. If there are two or more regions [with serious outbreaks] then we would have to consider a territorial approach.”  

Even in those scenarios, she says “it wouldn’t be forever. 

“If we could try to decrease any secondary infection, once we feel that we’ve passed that high risk period we would go back to our regular phase.”

Kandola says that NWT is in a good spot, and that while there are no antivirals and no vaccines, the public health measures are all we have. These public health measures – physical distancing, wearing a mask, keeping social circles small, sticking to the outdoors as much as possible – are ways we can all contribute to slowing Covid’s spread. 

With all those in place, a measured approach for a reopening is the best approach so we don’t get thrown back into containment and can stay as open as much as possible with these public health measures in place,” she says. “As opposed to being in a scenario like the U.S, where you open too quickly and now you’re back into containment. The last thing I want is for us to go back into containment.”

As people in NWT continue to enjoy the summer, Dr. Kandola urges that as much as possible people try to spend their time outdoors. 

“The more and more we understand about Covid-19, [the more we see that] there’s a very significant decrease in risk with outdoors physical distancing,” she says. “When we’re outdoors in a safe manner the risk is a lot lower than in indoor settings.”

NWT right now is in phase two, a considerable way from March’s containment phase and even phase one, which we entered May 15. 

But for every measure Dr. Kandola takes to relax restrictions, she cautions “we are still in a state of pandemic, and that pandemic is actually worse off.

People have to understand we’re in a pandemic and the virus spreads quickly, it spreads easily, and it can spread when people have no symptoms,” she says. “Back in March when I first put in my travel restrictions order, internationally we weren’t seeing 200,000 cases a day and now we are, so we’ve actually eased up as the pandemic has worsened worldwide.”

Kandola points to the H1N1 and Spanish Flu pandemics for patterns in spread. In both cases, there was a small first wave during spring, a large outbreak in the fall, and then a subsequent smaller wave again the following spring. 

She says that Canada is expecting its second wave in the fall, as people head back to school, back to work and spend more time indoors where the risk of transmission is higher. With the enforcement of public health measures like social distancing and mask wearing, especially in densely populated urbanized areas, she hopes that NWT can continue to stay in phase two. 

“Our biggest risk is specifically travel right now,” Kandola says. “So if we see that second wave across Canada being decreased, that means we could stay in phase two as much as possible, and if we miss the second wave – we don’t have a large second wave – we could perhaps even open up to phase three.”

So if across Canada, provinces and territories are working hard to decrease localized spread that would be a good scenario for NWT,” she says.

Even in cases where travellers are bringing Covid into NWT, Kandola explains that as long as “they self-isolated 14 days, and through contact tracing we were able to pick up anyone who was exposed and isolate them, and minimize the threat of this travel case to any others that they meet at close contact, that wouldn’t cause us to go back a phase because that’s basically a travel related case that we were able to contain."