From 3-layered masks to medical travel, N.W.T. health officials answer your COVID-19 questions

The N.W.T.'s Chief Public Health Officer Dr. Kami Kandola and territorial medical director Dr. Sarah Cook took your questions about COVID-19 live Thursday morning on CBC's The Trailbreaker.

Since the last Trailbreaker call-in radio show, new cases were confirmed at the Gahcho Kué diamond mine near Yellowknife, and in Inuvik. 

As of Wednesday, the territory had a total of 10 cases of COVID-19. All people infected have recovered, Kandola said on Thursday morning. 

In her weekly update on Wednesday, Kandola said new cases were "inevitable" in the territory, and that public health measures are more important than ever as the pandemic "continues to accelerate" across Canada.

Latest update on how COVID-19 is transmitted?

On Wednesday, the Public Health Agency of Canada recommended Canadians start wearing three-layer, non-medical masks with a filter layer to prevent the spread of COVID-19 as they prepare to spend more time indoors over the winter.

Canada also quietly revised its guidelines on how COVID-19 spreads, to include the risk of aerosol transmission, which acknowledged the airborne threat of the coronavirus.

Cook explained that update means it's not just droplets from breathing, sneezing or coughing that could carry the virus, but also tiny, microscopic particles that stay airborne for longer and can travel further. That might change the way the risk is perceived, though there is still a lack of clarity on how high that risk is right now, Cook said.

Doctors have always been aware and careful of different procedures that creates aerosols like intubation or types of dental work.

"If the evidence continues to show that there is transmission possible or likely through aerosol, then it does change how we need to behave."

Cook said it means that there's a higher risk of having transmission in an enclosed space particularly, especially if it's not well ventilated.

Reducing isolation time for medical travel patients?

When it comes to someone making repeated visits to Edmonton for medical treatment, there can be a lot of isolation involved every time they return home.

But Cook says the question about how that can be reduced revolves around whether testing can be used to reduce self-isolation time — which in short, is no.

"We certainly understand the very significant burden on patients who are traveling to Edmonton for medical travel and then having to come back, often cyclically, particularly for cancer patients, it's incredibly challenging," Cook said.

But since the incubation period of the virus can be anywhere between two to 14 days, a test upon arrival back to the territory doesn't guarantee the person is not infected.

"Even if every time someone came back they had a test, let's say they were exposed to the virus in the airport or in the airplane. That test is not likely to come back showing the virus, even though they may be harbouring the virus," Cook said.

With Alberta's growing COVID-19 cases, will N.W.T. patients be turned away?  

No. Cook says there's an agreement between the N.W.T. and Alberta where patients from the territory are treated as part of the Edmonton-zone catchment and cases are triaged based on need, not geography.

"One of the things that has been confusing, I think, for our patients is that not all physicians or clinics in Alberta know about this formal relationship. And so what we have seen is that some of our patients are being told that their procedures or elective appointments are being cancelled," Cook said.

If that happens, Cook says "it's really important" people contact their health care provider in the N.W.T. to help navigate that issue.

Is self-isolating in small communities going to be an option soon?

Kandola says the territory is currently looking at the public health order in place and allowing more flexibility.

"We are actively looking at scenarios," she said, such as the question described. Kandola says if there's an exigent circumstance, people can apply for a compassionate exemption in the interim.

Cook says what's being worked on is how to provide support for people, especially in smaller communities, who are wanting to isolate at home but can't because they live with multiple others.

"Certainly in the smaller cabin communities that don't have health-care providers in the community at all times, there is a bigger challenge in terms of the safety of people who may be coming back to those communities," Cook said.

She says it is safer for people to be in the regional hubs where it's easier to access support and connect with physicians.

Is the surge in cases across the country almost done?

Kandola says not yet and with Christmas holidays on the horizon, it may increase further if people are not following protocols. She says that's because there will likely be an increase in people travelling, plus the Christmas holiday are longer than other holidays, like Halloween, and people will likely be spending more time indoors together.

"We have not reached the peak. The world has not reached the peak," Kandola said, adding second waves tend to be larger than first waves.

"We'll have to continue to monitor."

Cook says even if a vaccine becomes available in early 2021, it's important to remember that it will likely first roll out to high-risk people like the elderly, those living in communities with less access to health care (such as Indigenous communities) and essential workers.

"We all wish that we could, you know, predict the time when all of this craziness will stop and we can return to our normal lives," Cook said. "But we just simply can't." 

Missed the live call-in show? Watch it here: