Transcript: Dealing with the New Coronavirus | Jan 31, 2020

Nam sits in the studio. She's in her early forties, with shoulder length curly brown hair. She's wearing glasses and a blue blazer over a black shirt.

A caption on screen reads "Dealing with the coronavirus. Nam Kiwanuka, @namshine, @theagenda."

Nam says IT IS NOW A GLOBAL
HEALTH EMERGENCY ACCORDING TO
THE WORLD HEALTH ORGANIZATION.
WITH US NOW ON HOW WELL
PREPARED WE ARE TO CONFRONT
2019-NCOV OR THE CORONAVIRUS,
DR. EILEEN DE VILLA, MEDICAL
OFFICER OF HEALTH FOR THE CITY
OF TORONTO, THE LARGEST LOCAL
PUBLIC HEALTH AGENCY IN CANADA...

Eileen is in her forties, with long straight brown hair. She's wearing glasses, a gray blazer and a mustard green scarf.

Nam continues AND DR. MICHAEL GARDAM IS
CHIEF OF STAFF AND AN INFECTIOUS
DISEASE SPECIALIST AT
HUMBER RIVER HOSPITAL.

Michael is in his late forties, bald, with a trimmed beard. He's wearing glasses, a blue suit and a white shirt.

Nam continues THANK YOU BOTH FOR COMING HERE.
I KNOW IT'S BEEN A VERY BUSY
WEEK FOR BOTH OF YOU.
SO WE'VE HAD EXPERIENCE WITH
SARS.
WHAT MAKE THIS IS CORONAVIRUS
UNIQUE, DR. GARDAM?

The caption changes to "Michael Gardam. Humber River Hospital."

Michael says THERE ARE A NUMBER
OF THINGS.
I THINK ONE IS THE VIRUS ITSELF.
WE KNOW RIGHT OUT OF THE GATE
THAT THIS VIRUS IS LESS DEADLY
THAN SARS WHICH IS GOOD TO KNOW.
AND WHILE THERE IS GROWING
EVIDENCE THAT IT MAY BE MORE
TRANSMISSIBLE THAN SARS WAS WE
ALSO CLEARLY KNOW IT IS NOT AS
TRANSMISSIBLE AS INFLUENZA IS.

Nam says HOW DOES ONE PERSON GET IT?
HOW DO YOU TRANSFER IT?

Michael says BASICALLY IT'S
TYPICALLY CLOSE CONTACT F I HAVE
THE VIRUS AND I'M COUGHING ON
EILEEN, I'M COUGHING ON YOU
THERE IS A GOOD CHANCE THOSE
PARTICLES COULD COME OUT OF MY
MOUTH, HIT YOUR FACE AND YOU
COULD GET IT THAT WAY.
THAT'S TYPICALLY HOW THESE
THINGS ARE SPREAD.

Nam says WE'VE NOW SURPASSED THE
10,000 MARK AND THE NUMBER OF
CORONAVIRUS INFECTIONS AND THERE
ARE DEATHS IN THE HUNDREDS.
LET'S TAKE A LOOK AT HOW THE
VIRUS HAS SPREAD.
WE HAVE A GRAPH THERE.

A slate appears on screen, with the title "Confirmed cases of coronavirus."

A line graph shows the increase in cases in mainland China, rapidly growing since January 24, and the slow increase in cases in other locations.

Nam says EILEEN, WHAT DOES THIS RAPID
GROWTH IN NEW CASES VIRTUALLY IN
ONE MONTH TELL YOU ABOUT THIS
CORONAVIRUS?

The caption changes to "Eileen De Villa. Toronto Public Health."
Then, it changes again to "The spread."

Eileen says WELL, I THINK IT'S
IMPORTANT TO NOTICE THAT, HE
WHY, YOU HAVE THE NUMBERS THERE.
BUT YOU'LL NOTICE THAT THE VAST
MAJORITY OF CASES ARE ACTUALLY
IN CHINA.
AND WHEN YOU LOOK AT THE GRAPH
VERY CAREFULLY, YOU'LL SEE THAT,
IN FACT, THERE HAS BEEN VERY
LITTLE IMPORTATION OR
EXPORTATION TO OTHER COUNTRIES.
AND, IN FACT, THE GROWTH IN THAT
CURVE IS NOT BEING SEEN.

Nam says HOW IMPORTANT IS THAT TO
CONVEY THAT INFORMATION?

The caption changes to "Eileen De Villa. City of Toronto."

Eileen says IT'S EXTREMELY
IMPORTANT.
IT'S IMPORTANT TO UNDERSTAND THE
CONTEXT AND FOR PEOPLE IN OUR
COMMUNITY HERE AT THIS TIME TO
RECOGNIZE THAT, YOU KNOW, THE
RISK REMAINS EXTREMELY LOW IN
OUR COMMUNITY.

Nam says MICHAEL, WE'VE HEARD
REPORTS FROM NON-GOVERNMENT
SOURCES SAYING THAT THE OUTBREAK
IS FAR WORSE THAN THE NUMBERS
WE'RE SEEING.
HOW ACCURATE ARE THOSE REPORTS?

Michael says I LOOK AT IT THE
OPPOSITE.
I SAY, IN FACT, THERE'S LIKELY
THAT WE HAVE MANY-FOLD MORE
PEOPLE INFECTED WITH THE VIRUS
WHO AREN'T ACTUALLY SICK WITH IT
OR MINIMALLY SICK WITH IT.

Nam says IN CHINA?

The caption changes to "Michael Gardam, @DrMichaelGardam."

Michael says YES, IN CHINA.
AND I ACTUALLY THINK THAT'S A
GOOD NEWS STORY.
WHAT THAT'S TELLING US IS THE
MORTALITY RATE MIGHT BE 0.2 OR
0.02 PER CENT.
WHEN YOU ARE LOOKING AT THAT
TYPE OF MORTALITY RATE YOU ARE
LOOKING AT SOMETHING LIKE
INFLUENZA MORE SO THAN SOMETHING
LIKE SARS.
YES, THE VIRUS MAY WELL HAVE
SPREAD FURTHER.
BUT AS WE GET MORE INFORMATION,
IT ACTUALLY MAKES IT LESS
SERIOUS IN TERMS OF PEOPLE
GETTING SICK WITH IT.

Nam says I KNOW YOU'RE BOTH IN
THE MEDICAL FIELD.
BUT THERE SEEMS TO BE A
POLITICAL UNDER TONE TO THIS.
IS THAT A FAIR STATEMENT TO
MAKE?

Michael says EVERY OUTBREAK I
HAVE EVER DEALT WITH THERE'S
ALWAYS A POLITICAL UNDER TONE.
SO EVEN THE W.H.O. IS ONE OF THE
MOST POLITICAL ORGANIZATIONS ON
THE PLANET.
SO WHEN IT'S MAKING
RECOMMENDATIONS OR IT'S
DECLARING SOMETHING A PUBLIC
HEALTH EMERGENCY, THERE'S ALWAYS
POLITICAL REPERCUSSIONS FROM
THAT.
RIGHT?
AND IF A COUNTRY DECIDES TO BAN
TRAVEL OR SOMETHING LIKE THAT,
IT MAY BE PARTIALLY DUE TO THE
VIRUS.
THERE MAY BE OTHER POLITICAL,
ECONOMIC REASONS WHY THEY'RE
DOING IT.
SO GOVERNMENTS USE THINGS LIKE
THIS FOR VARIOUS ADVANTAGES.
AND SO IT'S NEVER JUST ABOUT THE
DISEASE CONTROL.

Nam says DO YOU THINK THAT...
SORRY, GO AHEAD.

Eileen says AND I THINK THAT WHEN
WE'RE TALKING ABOUT A SITUATION
THAT INVOLVES MULTIPLE
COUNTRIES, YOU CAN'T HELP BUT
GET INTO SOME DEGREE OF
POLITICS.
SO I THINK THAT'S JUST PART AND
PARCEL.
AND CERTAINLY PUBLIC HEALTH
CONTAINMENT MEASURES OFTEN STEP
INTO THE REALM OF CONTROLLING
MOVEMENT... MOVEMENT OF GOODS,
MOVEMENT OF PEOPLE.
AND THAT INEVITABLY HAS A
POLITICAL ASPECT TO IT.

Nam says WHEN YOU ARE TALKING
ABOUT MOVEMENT, WE DO LIVE IN A
DIGITAL ERA AND MOVEMENT OF
INFORMATION OR MOVEMENT OF
CONSPIRACY THEORIES.
HOW DIFFICULT IS THAT FOR YOU TO
GET THE CORRECT MESSAGE OUT WHEN
WE HAVE PEOPLE ON SOCIAL MEDIA
SAYING THE OPPOSITE?

The caption changes to "Eileen De Villa, @epdevilla."

Eileen says WELL, I THINK YOU'RE
QUITE RIGHT.
WITH SUPPOSE MEDIA PLATFORMS
AVAILABLE AND IN WIDESPREAD USE
GLOBALLY, THERE IS THE POTENTIAL
FOR MISINFORMATION AND, IN FACT,
WE'RE SEEING QUITE A BIT OF
MISINFORMATION OUT THERE.
AS MICHAEL RIGHTFULLY POINTED
OUT, WE'RE DEALING WITH A NEW
VIRUS.
A NEW INFECTIOUS DISEASE.
AND I THINK THAT NEW, EMERGING
INFECTIOUS DISEASES, NEW HEALTH
RISKS TEND TO GENERATE MORE FEAR
AND ANXIETY THAN THE STANDARDS
LIKE INFLUENZA AS MICHAEL WAS
TALKING ABOUT.
WE KNOW THAT INFLUENZA HAS A
HEALTH RISK ASSOCIATED WITH IT.
BUT MOST PEOPLE DON'T THINK
ABOUT THAT.

The caption changes to "Connect with us: Twitter: @theagenda; Facebook, agendaconnect@tvo.org, Instagram."

Nam says BECAUSE IT'S
SOMETHING THAT'S BEEN AROUND FOR
A WHILE.

Eileen says A LONG TIME.
WE'RE USED TO SEEING IT EVERY
YEAR.
IT'S A FAMILIAR THING TO MOST
PEOPLE BECAUSE WE'VE KNOWN ABOUT
IT FOR QUITE SOME TIME.
THAT DOESN'T ACTUALLY TAKE AWAY
FROM THE FACT THAT IT IS QUITE
SERIOUS AND HAS SIGNIFICANT
HEALTH IMPACTS.
BUT THE NEW RISKS TEND TO GET
MORE ATTENTION.
I THINK YOU GET MORE FEAR AND
ANXIETY ASSOCIATED WITH THAT AS
A RESULT.
AND, THEREFORE, MISINFORMATION.
THAT'S WHY IT'S BEHOLDEN ON US,
LOCAL PUBLIC HEALTH AUTHORITIES,
PROVINCIAL, FEDERAL, ET CETERA,
AND IN CONCERT WITH OUR CLINICAL
PARTNERS TO MAKE SURE THAT WE'RE
PUTTING OUT CREDIBLE
INFORMATION.
AND I'M URGING PEOPLE TO
ABSOLUTELY GET UPDATES, INFORM
YOURSELF.
THAT'S ALL PERFECTLY
APPROPRIATE.
BUT WHEN YOU ARE DOING THAT, GO
TO THE CREDIBLE SOURCES OF
INFORMATION.
GO TO, YOU KNOW, RELIABLE
SOURCES.
DON'T JUST GO TO ANY, YOU KNOW,
SOCIAL MEDIA CHANNEL OR TRUST
WHAT FRANKLY NON-HEALTH
AUTHORITIES ARE SAYING.
BECAUSE THERE IS A LOT OF
MISINFORMATION OUT THERE.

Nam says DO WE UNDERSTAND YET
WHEN PEOPLE ARE CONTAGIOUS?
EILEEN?

Eileen says WELL, YOU KNOW, I
THINK THAT'S STILL... WE'RE
TALKING ABOUT A NEW VIRUS.
SO STILL TRYING TO UNDERSTAND
THIS VIRUS IN ALL ITS ASPECTS.
BUT WE CERTAINLY TALKED ABOUT
AND MICHAEL INDICATED THAT
PEOPLE WHO HAVE SYMPTOMS ARE
BETTER AT PUTTING OUT THE
PARTICLES, THE VIRUS PARTICLES
OUT THERE.
SO CERTAINLY BEING SYMPTOMATIC
WOULD BE ONE OF THE RISKS.

Michael says I WOULD AGREE.
WE DO KNOW A FAIR BIT ABOUT
OTHER RESPIRATORY VIRUSES AND
THERE IS NO REASON TO SUSPECT
THIS WOULD BE FUNDAMENTALLY
DIFFERENT.
THERE ARE SORT OF THE LAWS OF
BIOLOGY GOING ON HERE.
WE KNOW WITH INFLUENZA, FOR
EXAMPLE, THAT WHEN PEOPLE ARE
INFECTED FOR THE FIRST 12 HOURS
OR SO BEFORE THEY DEVELOP
SYMPTOMS THEY HAVE A SMALL
AMOUNT OF VIRUS IN THEIR NOSE.
BUT WHEN THEY START TO DEVELOP
SYMPTOMS THEY CAN HAVE 10,000
MORE-FOLD VIRUS THAT THEY ARE
SPREADING AND THEY HAVE SYMPTOMS
THAT ARE SPREADING IT AND IT CAN
GO ON FOR FIVE DAYS.
WHILE A LITTLE BIT OF VIRUS IN
YOUR NOSE COULD THEORETICALLY
MAKE IT CONTAGIOUS, THE RELATIVE
CONTRIBUTION OF PEOPLE FEELING
FINE SHEDDING A LITTLE BIT OF
VIRUS HAS TO PALE IN COMPARISON
TO PEOPLE WHO ARE ACTUALLY SICK
AND COUGHING ON OTHERS.

Nam says I WANT TO TALK ABOUT
WHERE THE VIRUS ORIGINATED.
AROUND WE'VE HEARD OF... THERE
WAS A LIVE ANIMAL MARKET IN
WUHAN, CHINA.
AND THAT'S TEAMED TO BE THE
EPICENTRE.
DO WE KNOW WHICH ANIMAL IS THE
SOURCE, EILEEN?

Eileen says I BELIEVE THAT'S
STILL VERY MUCH THE SUBJECT OF
INVESTIGATION AND FURTHER STUDY.
I THINK THAT'S GOOD ABOUT THESE
KINDS OF THINGS IS THAT WE'RE
SEEING A LOT OF INTERNATIONAL
COLLABORATION AND COOPERATION.
SO THAT WE CAN ADVANCE THE
SCIENCE ON THIS.

Nam says AND MICHAEL, WHAT
HAPPENED IN THAT MARKET THAT
RESULTED IN THIS NEW VIRUS?

Michael says IT'S BEEN KNOWN FOR
A LONG TIME THAT WHEN YOU HAVE A
REALLY DENSE CONFLAGRATION OF
PEOPLE AND ANIMALS IN ONE AREA
THAT THAT'S THE BEST SITUATION
TO HAVE.
YOU KNOW, VIRUSES OR PATHOGENS
JUMPING FROM ANIMALS TO HUMANS.
AND A LOT OF HUMAN PATHOGENS
CAME FROM ANIMALS.
AND CORONAVIRUSES ARE ANIMAL
VIRUSES.
THEY'RE WELL KNOWN IN BATS, FOR
EXAMPLE, WHERE SARS CAME FROM
ALTHOUGH THEY WERE TALKING ABOUT
SNAKES THE OTHER DAY.

Nam says DO YOU NEED TO KNOW
WHICH ANIMAL IT CAME FROM IN
ORDER TO GET A VACCINE?

Michael says NO, THAT DOESN'T
IMPACT ANYTHING.
IT'S REALLY JUST THE
UNDERSTANDING, THE EPIDEMIOLOGY.
ONCE YOU HAVE THOSE ANIMALS AND
HUMANS IN CLOSE CONTACT IT'S A
MATTER OF PROBABILITIES.
AT WHAT POINT, WHAT EVENT
PEOPLE, HOW CLOSE WERE THEY, ET
CETERA.
AND THEN IT COULD POTENTIALLY
JUMP INTO HUMAN POPULATIONS.
YOU ALSO NEED TYPICALLY SOME
MUTATIONS IN THE VIRUS THAT ARE
JUST HANGING OUT AND JUST BY
HAPPENSTANCE HAPPEN TO JUMP INTO
A HUMAN AND THEY CAN START TO
PROPAGATE.

Eileen says AND I WAS SAYING
THAT, YOU KNOW, THINKING THAT
WHILE THE EPIDEMIOLOGY IS
INTERESTING, TO KNOW, AND THAT'S
WHY IT'S HELPFUL TO DO THESE
STUDIES.
PERHAPS FROM A PUBLIC HEALTH
PERSPECTIVE IT'S ALSO IMPORTANT
TO UNDERSTAND SOURCE SO THAT WE
CAN THINK ABOUT PREVENTIVE
STRATEGIES TO THINK ABOUT THE
FUTURE.

Nam says HOW PREPARED AS A
COUNTRY ARE WE TO DEAL WITH THE
CORONAVIRUS?

The caption changes to "Preparedness."

Eileen says I THINK HERE IN
ONTARIO, GIVEN OUR EXPERIENCE
WITH SARS THERE WERE MANY
LESSONS LEARNED.
CERTAINLY MICHAEL AND I CAN
COMMENT ON THOSE FOR AN EXTENDED
PERIOD OF TIME.

Michael says YEAH.

Eileen says SUFFICE IT TO SAY
THAT THERE WERE MANY, MANY
LESSONS LEARNED AND MANY OF
THOSE LESSONS HAVE BEEN PUT INTO
PRACTICE ON AN ONGOING BASIS AND
CERTAINLY IN RESPECT OF
RESPONDING TO THIS SITUATION
THAT WE'RE IN RIGHT NOW.

The caption changes to "Watch us anytime: tvo.org, Twitter: @theagenda, Facebook Live, YouTube."

Nam says MICHAEL, WHAT WERE THOSE
LESSONS?

Michael says THERE WERE MANY OF
THEM.
BUT JUST THINKING BACK TO SARS.
AT THAT TIME IN 2003, PUBLIC
HEALTH DIDN'T HAVE A WAY OF
REALLY EASILY COMMUNICATING WITH
CLINICIANS.
SO YOU WOULD HEAR ABOUT IT
BECAUSE YOU KNEW SOMEBODY NOT
BECAUSE THERE WAS A WAY TO DO
THAT.
WE WERE NOT ADEQUATELY SCREENING
FOR PEOPLE WHO HAD FEVER AND
COUGH.
WE WEREN'T NECESSARILY ISOLATING
THEM.
OUR STAFF WERE NOT TRAINED TO
WEAR THE APPROPRIATE PERSONAL
EQUIPMENT.
WE DIDN'T NECESSARILY HAVE STOCK
PILES OF IT.
WE COULD GO ON AND ON AND ON.
SO THE MEASURES WE TOOK DURING
SARS, THOSE AREN'T NORMAL
MEASURES.
THOSE WERE MEASURES BECAUSE WE
WERE AFRAID THIS WAS GETTING
AWAY ON US AND WE WERE DOING
WHATEVER WE COULD TO CONTROL IT.
NOT DISSIMILAR TO WHAT CHINA IS
DOING NOW BUT ON A MUCH SMALLER
SCALE.
WE LEARNED ALL THOSE LESSONS.
NOW WE HAVE THE EQUIPMENT.
PEOPLE HAVE BEEN APPROPRIATELY
TRAINED.
THERE IS NOTHING... I KEEP
GETTING ASKED WHAT ARE YOU DOING
DIFFERENTLY TODAY.
AND THE ANSWER IS NOT A WHOLE
LOT WE'VE BEEN DOING THIS FOR
THE PAST DECADE.

Nam says YOUR HOSPITAL WAS BUILT
AFTER THE SARS OUTBREAK.
WHAT DO YOU HAVE THAT MAKES YOU
MORE EQUIPPED TO DEAL WITH CASES
LIKE THIS?

Michael says I THINK
FUNDAMENTALLY THE OLDER
HOSPITALS WE HAVE IN ONTARIO AND
OTHER PARTS OF CANADA, I OFTEN
SORT OF BLEAKLY JOKE THAT
THEY'RE KIND OF DESIGNED TO
SPREAD INFECTIOUS DISEASES.
WE HAVE PEOPLE IN FOUR-BEDDED
ROOMS THEY DON'T NECESSARILY
HAVE THE LATEST VENTILATION.
THEY'RE CROWDED.
THERE'S NOT ENOUGH PLACE TO
STORE THINGS.
SO NEWER HOSPITALS WHEN THEY'RE
BUILT WERE TYPICALLY TAKING INTO
ACCOUNT ALL THOSE THINGS.
WE HAVE A LOT OF NEW SINGLE
ROOMS.
NEW HOSPITALS IN ONTARIO HAVE TO
HAVE AT LEAST 8 0 percent SINGLE ROOMS.
WE NEED MORE PLACES TO STORE
THINGS.
WALKING THE FLOORS OF HUMBER
RIVER, IT'S ACTUALLY SHOCKING
THE DIFFERENCE IN TERMS OF HOW
MUCH SPACE YOU HAVE.
BUT HUMBER TOOK IT FURTHER THAN
THAT.
HUMBER WAS BEING DESIGNED AT THE
TIME SARS WAS OCCURRING.
AND SO WE ACTUALLY HAVE SPECIAL
VENTILATION SYSTEMS.
WE HAVE 100 percent FRESH AIR
VENTILATION SO THE AIR ISN'T
BEING RECIRCULATED IN THE
BUILDING.
WE CAN CONTROL DIFFERENT
BUILDINGS AND DIFFERENT WINGS
WITH VENTILATION.
IT'S REALLY QUITE REMARKABLE HOW
IT WAS BUILT.

Nam says YOU WANTED TO SAY
SOMETHING?

Eileen says YEAH, AND I THINK
OVER AND ABOVE THOSE
IMPROVEMENTS WE'VE SEEN IN THE
HOSPITAL SETTINGS, WE HAVE
BETTER LABORATORIES.
WE HAVE AN AGENCY, PUBLIC HEALTH
ONTARIO.
SPECIFICALLY SET UP TO HELP
PROVIDE GUIDANCE AND SCIENCE TO
PUBLIC HEALTH PRACTITIONERS AND
TO HEALTH CARE PRACTITIONERS.
WE HAVE BETTER COMMUNICATIONS
EXISTING BETWEEN THE VARIOUS
PLAYERS AT THE LOCAL LEVEL, AT
THE PROVINCIAL LEVEL AND AT THE
FEDERAL LEVEL.
AND BETWEEN PUBLIC HEALTH
PRACTITIONERS AND HEALTH CARE
PRACTITIONERS WE HAVE MORE
ROBUST INFORMATION SYSTEMS TO
SUPPORT THE SHARE OF INFORMATION
BETWEEN THE VARIOUS PLAYERS THAT
ARE ENGAGED IN THE RESPONSE.
SO THERE REALLY HAS BEEN QUITE A
BIT OF WORK HERE.
AND AS MICHAEL RIGHTFULLY POINTS
OUT, THESE ARE SYSTEMS THAT ARE
ACTIVELY IN PLAY ON A DAILY
BASIS, INCLUDING INFECTION
PREVENTION AND CONTROL
STANDARDS.
HERE IN THE CITY OF TORONTO, WE
ESTABLISHED A GROUP WITHIN
TORONTO PUBLIC HEALTH CALLED THE
COMMUNE CAB DISEASE LIAISON
UNIT.
SO WE'RE IN ACTIVE CONVERSATION
ON A DAILY BASIS WITH HOSPITALS
HERE IN OUR CITY ON ALL MATTERS
THAT HAVE TO DO WITH INFECTION
PREVENTION AND CONTROL.
THESE ARE MAJOR IMPROVEMENTS
RELATIVE TO WHAT EXISTED BACK IN
2003.

Nam says MICHAEL, CHINA WAS ALSO
THE EPICENTRE FOR SARS.
AND CASES ARE SOARING THERE
AGAIN.
WHY ISN'T THERE THE KNOWLEDGE
AND PREPARATION WE HAVE IN
CANADA THERE?

Michael says I WOULDN'T SAY THERE
ISN'T THE KNOWLEDGE.
I THINK EVEN IF YOU LOOK AT THE
PICTURES COMING OUT OF SOCIAL
MEDIA IT ISN'T THAT PEOPLE HAVE
PERSONAL PROTECTIVE EQUIPMENT...
THEY MAY BE RUNNING OUT OF IT...
BUT THEY WOULD BE FOLLOWING THE
SAME PRACTICES WE'RE FOLLOWING
HERE.
ONE THING IT'S IMPORTANT TO
REMIND PEOPLE OF IS YOU ALWAYS
IDENTIFY OUTBREAKS IN HINDSIGHT.
RIGHT?
THE FIRST CASE OF SOMETHING YOU
NEVER IDENTIFY IT.
AND IMAGINE RESPIRATORY OUTBREAK
IN A CROWDED MARKET IN CHINA
DURING FLU SEASON PROBABLY
HAPPENS ALL THE TIME, RIGHT?
SO YOU'RE TRYING TO SORT THROUGH
ALL THE NOISE TO ACTUALLY
DISCOVER SOMETHING NEW.
AND THEN BY THE TIME THAT THIS
WAS IDENTIFIED, WHICH WASN'T
THAT LONG, VERY SOON AFTER WE
HAD THE VIRUS IDENTIFIED WE
ALREADY HAD A TEST FOR IT.
AND, YOU KNOW, CHINA'S ACTUALLY
BEEN DOING VERY SIMILAR THINGS
TO WHAT WE DID DURING SARS IN
TERMS OF THEIR CONTROL MEASURES.
IT'S JUST TRICKY.
WHEN YOU'RE THE FIRST PLACE THAT
HAS SOMETHING...

Nam says AND IT'S ALSO DURING FLU
SEASON.

Michael says DURING FLU SEASON.
AND THESE THINGS TEND TO GET
AWAY WITH YOU BEFORE YOU START
CONTROL MEASURES.

The caption changes to "Flu season."

Nam says EILEEN, BEFORE THE NEWS
OF THE NEW CORONAVIRUS BROKE WE
WERE DEALING WITH A NASTY FLU
SEASON.
HOW IS THE FLU PRESENTING IN
CANADA THIS WINTER?

Eileen says WE'RE HAVING A BUSY
FLU SEASON, YOU'RE RIGHT RIGHT
IN CANADA.
AND WHEN I LOOK AT OUR DATA, THE
MOST CURRENT AVAILABLE DATA IN
TORONTO, IN TERMS OF
LAB-CONFIRMED CASES WE'RE
DEFINITELY HIGHER THAN WE HAVE
BEEN IN THE PREVIOUS SEASONS.
SO WE'RE HAVING A BUSY FLU
SEASON.
HENCE, WE'RE REMINDING PEOPLE
THAT, LOOK, IT IS COLD AND FLU
SEASON.
PLEASE CONTINUE TO PRACTICE
THOSE GOOD HYGIENE PRACTICES
THAT WE TELL PEOPLE EVERY SINGLE
SEASON.

Nam says IS THERE A CONCERN THAT
BECAUSE WHAT HAPPENED IN CHINA
IS HAPPENING DURING THE FLU
SEASON THAT EVEN HERE WE'RE
HAVING A FLU SEASON THAT SOMEONE
MIGHT PRESENT WITH A FLU BUT
IT'S ACTUALLY LIKE THE
CORONAVIRUS?

Eileen says WELL, AS IT TURNS
OUT, WHEN YOU LOOK AT WHAT MAKES
GOOD SENSE IN TERMS OF GOOD
INFECTION PREVENTION AND CONTROL
PRACTICE AT AN INDIVIDUAL LEVEL,
WHAT MAKES SENSE TO PREVENT COLD
AND FLU MAKES SENSE TO PREVENT
ALL RESPIRATORY VIRUSES:
WASHING YOUR HANDS WITH SOAP AND
WATER ON A REGULAR BASIS, TRYING
TO AVOID TOUCHING YOUR FACE...
AND THAT SOUNDS SO SIMPLISTIC.
BUT PEOPLE TOUCH THEIR FACES A
LOT WITHOUT EVEN REALIZING.

Nam says I HAVE TO ADMIT THAT IN
OTHER FLU SEASONS I WASN'T
REALLY PAYING ATTENTION AT HOW
MUCH I TOUCHED MY FACE.
AND NOW I'M PAYING A LOT MORE.
AND I'M ALWAYS TOUCHING MY FACE.

Eileen says SO IF THAT'S ONE OF
THE THINGS THAT EMERGINGS FROM
THIS PARTICULAR SITUATION THAT
MAY NOT BE THE WORST THING IN
THE WORLD IS TO HAVE PEOPLE
RECOGNIZE THAT THERE ARE SOME
VERY SIMPLE MEASURES THAT PEOPLE
CAN DO AT ALL TIMES, HAND
WASHING, COVERING THEIR COSTS
AND GETTING THE FLU SHOT. THESE
ARE ALL GOOD THINGS TO BE DOING.

The caption changes to "Keep calm and carry on."

Nam says I KNOW THIS IS A SERIOUS
CONVERSATION BUT I DO HAVE A BIT
OF A LAUGH... IT DOES HAVE
SOMETHING TO DO WITH
CORONAVIRUS. THIS IS FROM THE
SATIRICAL NEWS WEBSITE,
THE BEAVERTON AND THEY WROTE...

A quote appears on screen, under the title "Fact resistance." The quote reads "Public health officials in Toronto have confirmed its first 50000 cases of being a misinformed %$&*@ as xenophobic conspiracy theories and tales of false cures continue to spread across social media.
'Becoming a complete moron during an infectious disease outbreak is far more viral than we first thought,' said Doctor Jeanne Smith of Toronto Public Health. 'Fact resistance is abnormally high.'
Patients are usually asymptomatic until they open their mouths or start tweeting."
Quoted from Alex Huntley, The Beaverton. Jan 28, 2020.

[LAUGHTER]

Nam says I KNOW THAT'S FUNNY BUT AS THE
FIRST GLOBAL HEALTH EMERGENCY
IN THE AGE OF SOCIAL MEDIA, THE
CORONAVIRUS, HOW DO YOU DEAL
WITH THAT IN PUBLIC HEALTH,
EILEEN?

Eileen says I THINK WE DEAL WITH
IT BEST BY MAKING SURE WE PUT
OUT INFORMATION ON A REGULAR
BASIS AND TRYING TO COMMUNICATE
AS CLEARLY AS POSSIBLE WITH OUR
POPULATION.
AND HELP THEM PUT RISKS IN
CONTEXT.
ALSO, GIVING PEOPLE INFORMATION
AROUND WHAT THEY CAN DO, WHAT
ACTIONS THEY CAN TAKE TO PROTECT
THEMSELVES ARE FUNDAMENTAL.
SO I CAN'T SAY IT ENOUGH.
WASH YOUR HANDS.

Nam says ALL THOSE GOOD PIECES OF
ADVICE: WHEREBY YOUR HAND,
COVER YOUR COUGH, DON'T TOUCH
YOUR FACE OR AVOID DOING SO AND
GET YOUR FLU VACCINE EVERY YEAR.
I DON'T THINK WE CAN SAY THAT
ENOUGH.
A LOT OF ASIAN PEOPLE HAVE BEEN
SHARING STORIES OF PEOPLE SAYING
RACIST THINGS OR AVOIDING THEM.
THE SAME THING HAPPENED TO THE
CHINESE COMMUNITY DURING SARS.
SO NOT THAT IT NEEDS TO BE DONE
BUT MAYBE THIS IS AN OPPORTUNITY
TO DO THIS: LET'S QUELL THOSE
NOTIONS.
IS THERE ANY HIGHER RISK IN THE
CHINESE CANADIAN COMMUNITY THAN
ELSEWHERE?

Michael says THIS HAS NOTHING TO
DO WITH WHAT ETHNICITY YOU ARE.
IT HAS TO TO WITH WHERE YOU'VE
BEEN.
RIGHT NOW IF YOU LOOK AT THE
EPIDEMIOLOGY, LIKE I'VE BEEN
SAYING THIS IS CHINA'S PROBLEM.
THIS IS A PROBLEM WITHIN THE
BORDERS OF CHINA.
WE DON'T WANT IT TO BECOME THE
WORLD'S PROBLEM.
THIS IS NOT ABOUT PEOPLE WHO
LIVE IN CHINA TOWN.
THIS HAS NOTHING TO DO WITH
THAT.

Nam says THIS IS HAVING REAL LIFE
REPERCUSSIONS BEYOND THE HEALTH
OF TORONTONIANS, RIGHT?

Eileen says AND I THINK, YOU
KNOW, TO ADD FURTHER TO THAT,
YOU KNOW, AS MUCH AS PEOPLE
THINK THEY'RE TRYING TO PROTECT
THEMSELVES, PROTECT THEIR HEALTH
AND PROTECT THE HEALTH OF
OTHERS, IT'S ACTUALLY NOT
HELPFUL.
RIGHT?
WHAT IS HELPFUL IS GOING TO
CREDIBLE SOURCES OF INFORMATION
AND, YOU KNOW, INFORMING
YOURSELF THAT WAY.
AND THAT'S WHAT WE'RE TRYING TO
DO IS MAKE SURE THAT THE RIGHT
SOURCES OF INFORMATION, THAT
FACTS ARE GETTING OUT THERE...
NOT MISINFORMATION.

Nam says WHAT ABOUT MASKS?
I HAVE SEEN A LOT OF PEOPLE ON
PUBLIC TRANSIT WITH MASKS.
DO THEY HELP?

Michael says NO.
THE THING WITH MASKS... MASKS
HAVE BEEN STUDIED, BELIEVE ME.
AND THERE IS NO GOOD EVIDENCE AT
ALL THAT WALKING AROUND DOWNTOWN
WEARING A MASK DOES ANYTHING FOR
YOU.
IN FACT, GIVEN THE CLOSE NATURE
OF CONTACT YOU NEED FOR
TRANSMISSION IT ACTUALLY DOESN'T
MAKE SENSE WHY IT WOULD WORK FOR
YOU.
SO WEARING A MASK AROUND IS NOT
HELPFUL.
THE ONLY TIME WHERE A MASK HAS
ACTUALLY BEEN SHOWN TO BE
HELPFUL IS THAT IF I AM SICK AND
HAVE I TO COME TO A MEETING WITH
YOU, MY WEARING A MASK WILL HELP
PREVENT YOU CATCHING IT FROM ME.
SO THE ONLY PEOPLE RIGHT NOW WHO
SHOULD BE WEARING MASKS ARE
HEALTH CARE PROVIDER WHO IS ARE
IN THE DIRECT LINE OF FIRE OF
CARING FOR PATIENTS WHO ACTUALLY
HAVE THESE SYMPTOMS.
WEARING THEM IN THE GENERAL
PUBLIC IS NOT HELPFUL.

Eileen says IF I CAN WITH THAT,
AS MUCH AS MICHAEL IS OFFERING
TO PROTECT YOU AT THIS
HYPOTHETICAL MEETING BY WEARING
A MASK, FRANKLY FROM A PUBLIC
HEALTH PERSPECTIVE IF HE IS SICK
HE SHOULD STAY HOME.

Nam says THAT'S GREAT ADVICE.
BUT MOST BUSINESSES THEY EXPECT
YOU TO COME TO WORK OR YOU HAVE
"X" AMOUNT OF SICK DAYS, RIGHT?

Eileen says I CAN APPRECIATE
THAT.
BUT AT THIS STAGE OF THE GAME,
WHERE POSSIBLE, IF YOU ARE ILL,
THE BEST ADVISE WE CAN OFFER IN
TERMS OF PREVENTING THE SPREAD
OF DISEASE, WHETHER WE'RE
TALKING ABOUT INFLUENZA OR ANY
OTHER RESPIRATORY VIRUS, BEST
ADVICE: STAY HOME IF YOU'RE
SICK.

Michael says WE'VE BEEN GIVING
THAT ADVICE FOR THE LAST 17
YEARS THAT HAS NOT CHANGED.

Eileen says THAT HAS NOT CHANGED.

Nam says IT DOES SEEM LIKE THE
TEMPERATURE IS A BIT HIGHER.
I WAS SHARING WITH YOU THAT I
TAKE PUBLIC TRANSIT.
EVEN FOR ME AS A RATIONAL... I
THINK I'M A RATIONALE PERSON.
WHEN I DID HEAR SOMEONE COUGH I
WAS A BIT ON ALERT.
HOW DO YOU CONVEY THIS
INFORMATION TO PEOPLE WHO ARE
SCARED ABOUT SOMETHING THAT IS
NEW WITHOUT PATRONIZING
THEM BY TRYING TO UNDERSTAND
MAYBE WHERE THAT FEAR IS COMING
FROM?

Michael says I THINK SETTING
OURSELVES AS AN EXAMPLE, I TAKE
PUBLIC TRANSIT ALL THE TIME.
I TAKE THE STREETCAR, I TAKE
PUBLIC TRANSIT.
I DON'T WANDER AROUND WEARING A
MASK.
IF YOU SEE ME WEARING A HAZ-MAT
SUIT BUT RIGHT NOW I'M NOT DOING
THAT AND NONE OF US ARE.
I THINK LEADING BY EXAMPLE
SAYING THAT WE'RE NOT DOING THAT
AND IT JUST DOESN'T MAKE GOOD
SCIENTIFIC SENSE WHY YOU WOULD
WORRY ABOUT THAT.
AND YOUR COMMENT ABOUT RIDING
THE SUBWAY, RIGHT?
PEOPLE COUGH ON THE SUBWAY ALL
THE TIME AND I CAN ASSURE YOU
BEFORE WE HEARD ABOUT THIS
CORONAVIRUS PEOPLE WERE COUGHING
MORE ON THE SUBWAY BECAUSE OUR
PEAK OF FLU WAS BETWEEN
CHRISTMAS AND NEW YEAR'S.
BUT NOBODY NOTICED IT.
THEY'RE NOTICING IT NOW BECAUSE
OF THE HEIGHTENED FEAR OF THE
CORONAVIRUS.
BUT THOSE PEOPLE COUGHING DON'T
HAVE THE CORONAVIRUS.

Eileen says I HOPE WHEN YOU SEE
US ON THE SUBWAY WHAT YOU WILL
SEE US DOING IS APPROPRIATELY
COVERING OUR COUGH AND SLEEVE
AND USING ALCOHOL AND HAND
SANITIZERS.
THAT'S THE KIND OF BEHAVIOUR YOU
WILL BE SEEING FROM PEOPLE LIKE
US.

Nam says RESEARCHERS ARE WORKING
AROUND THE CLOCK I IMAGINE IN
LABS TRYING TO WORK ON THIS NEW
VIRUS.
WHAT ARE THEY LOOKING FOR?

The caption changes to "The lab race."

Michael says THERE ARE A COUPLE
OF THINGS.
FIRST OF ALL, THEY WANT TO GET A
SENSE OF HOW SIMILAR THE
CORONAVIRUS IS TO OTHER VIRUSES.
WHAT ARE THE FACTORS IN THIS
VIRUS THAT ARE ACTUALLY CAUSING
ILLNESS IN PEOPLE.
AND THEN THEY WANT TO LOOK AT
THINGS LIKE ARE THERE PARTS OF
THE VIRUS THAT WOULD BE GOOD FOR
A VACCINE.
LOTS OF INFORMATION ABOUT THE
WORLD RUSHING TO GET A VACCINE.
YOU MIGHT BE ABLE TO COME UP
WITH A REASONABLE MOLECULE FOR
THAT WOULD BE A GOOD VACCINE BUT
THAT DOESN'T MEAN YOU HAVE TO
GIVE IT TO PEOPLE.
IT HAS TO GO THROUGH MULTIPLE
TRIALS AND REALISTICALLY WE'RE
LOOKING AT A YEAR-PLUS BEFORE
SOMETHING WOULD BE AVAILABLE.
OF COURSE, WE DON'T KNOW A YEAR
FROM NOW WHETHER THIS WILL BE A
FLASH IN THE PAN LIKE SARS WE
DON'T EVEN KNOW IF A YEAR FROM
NOW WE'LL NEED A VACCINE.
LOTS OF EXCITEMENT ABOUT
VACCINES BUT I AM NOT SURE
THAT'S SOMETHING WE SHOULD BE
HANGING OUR HAT ON RIGHT NOW.

Eileen says I WOULD AGREE.
IT DOES TAKE QUITE A BIT OF TIME
TO DEVELOP A VACCINE AND THERE
WOULD NEED TO BE SOME TESTING
ASSOCIATED WITH THAT.

Michael says YOU WOULD HAVE TO
KNOW THAT IT WORKS.

Eileen says RIGHT.
YOU WOULD HAVE TO KNOW THAT IT
WORKS AND THAT IT'S APPROPRIATE
FOR USE.
THERE ARE A LOT OF STEPS BEFORE
YOU GET TO A VACCINE THAT'S
READY FOR PRIMETIME.

Nam says WE THANK YOU SO MUCH FOR
YOUR TIME.
I KNOW IT'S BEEN A VERY BUSY
WEEK AND WE APPRECIATE THE
INFORMATION THAT YOU HAVE SHARED
WITH US TODAY.
THANK YOU VERY MUCH.

Michael says THANKS FOR HAVING
US.

Eileen says THANK YOU.

The caption changes to "Producer: Sandra Gionas, @sandragionas; Producer: Cara Stern, @carastern."

Nam says THAT WAS DR. EILEEN
DE VILLA, MEDICAL OFFICER OF
HEALTH FOR THE CITY OF TORONTO
AND DR. MICHAEL GARDAM, HUMBER
RIVER HOSPITAL'S CHIEF OF STAFF.
THANK YOU SO MUCH.

The caption changes to "Subscribe to The Agenda Podcast: tvo.org/theagenda."

Michael says THANKS.

Eileen says THANK YOU.

Watch: Dealing with the New Coronavirus