Ontario infectious disease doctor says B.C. has 'plateaued,' urges slow, steady reopening

One of the first Canadian infectious disease specialists to spot the COVID-19 crisis coming early this year says B.C.'s public health performance is the talk of Ontario.

Dr. Michael Gardam, chief of staff at Humber River Hospital in Toronto, is a veteran of respiratory outbreaks, notably the SARS outbreak in Ontario in 2003. 

He says the steady drop in the number of deaths and hospital admissions in this province is good news — putting B.C. in a good place to loosen restrictions.

Gardam is confident that British Columbia has crested the peak of the initial wave of COVID-19 infections. Most new cases are now linked to known outbreaks and hospital admissions have decreased since early April.

3 weeks ahead of Ontario

"Not only have you plateaued but you are coming down the other side. You are probably three weeks ahead of Ontario and Quebec," Gardam said.

"That's all I ever hear about in Toronto, is B.C. When it comes to public health issues it's sadly always in a good way for B.C. [and] always in a bad way for Ontario," he said.

B.C. health officer Dr. Bonnie Henry signalled on Monday that the slowing transmission rate and increased testing were putting the province in a good position to start lifting restrictions.

"We are getting close to that time where we can start to open up," Henry said during her April 27 briefing.

But Gardam warns, as restrictions ease, it's important people aren't too aggressive with reopening businesses, parks and resuming large gatherings.

"We have not stopped this from spreading. Those potential cases are still there," he said.

Gardam says each province has a different situation, so unique approaches make sense.

But he said Canadians can expect health strategies to shift as businesses reopen, activities resume, and people are no longer isolated.

He said protecting vulnerable groups by testing and contact tracing has been effective in places like New Zealand and Australia.

Gardam said Ontario has now tested more people per capita than B.C., and broader testing becomes more important as restrictions ease.

"We haven't done this in the history of the world, so nobody knows what the right answer is," said Gardam.

No regular flu

But he's angered by those who see COVID-19 as nothing more than an over-hyped flu.

"This is not a regular flu," said Gardam.

Gardam says people who believe that are "dead wrong" and "infuriating."

Gardam said COVID-19's mortality rate is "orders of magnitude" more than influenza, even factoring in all the asymptomatic cases of both the viral culprits.

He was one of the first to spot the danger after seeing an alert about an outbreak in China.

There's no official global system to scan social media to monitor potential disease outbreaks. But there are volunteer-run systems that post alerts. ProMED, run by the International Society of Infectious Diseases, is one watched by experts.

Gardam saw an alert in late December that described a "pneumonia of unknown etiology" in Wuhan, China.

'That's one hell of an infectious bat'

At first Gardam wasn't alarmed, but that changed as reports kept coming in. Despite assurances from the WHO that there was little initial evidence of human-to-human transmission, Gardam said his instincts kicked in.

"As cases kept coming, I thought this must have been one hell of an infectious bat," he said.

"It's like 'OK, is this going to have legs? Or is it going to stop?'"

He says it's never easy and often dangerous to be the first person who sees something like COVID-19 starting.

"We are never ready for it," he said.

He gives the example of the doctor in Wuhan — 34-year-old Dr. Li Wenliang — who died after trying to alert people to the danger.

"He was trying to blow the whistle on something that people hadn't recognized yet."