Nova Scotia hospitals closed their doors to most visitors and a new list of businesses was told to cease operations as officials announced Wednesday the province now has three confirmed and nine presumptive cases of COVID-19.
Five new cases were identified Tuesday, the province said. Four are travel-related and one is connected to an earlier case.
Dr. Robert Strang, the province's chief medical officer, told a news briefing the 12 affected people range in age from early 30s to mid-70s. All are in self-isolation and recovering at home, he said.
Strang said public health is working to identify others who may have come in close contact with them.
To date, the province has 1,141 negative test results, to go along with the nine presumptive cases and three confirmed cases. Presumptive cases are only confirmed after being sent to the National Microbiology Laboratory in Winnipeg.
Health Minister Randy Delorey said efforts continue to re-licence retired doctors and nurses to help bolster the health-care workforce. That includes more opportunities for casual and recent nursing graduates. More openings and services are being created at 811 and Delorey said dozens of nurses have either completed or are in training to help with the work.
The province is also enabling doctors to provide care via the telephone and video conferencing where appropriate to help promote social distancing. The province and Doctors Nova Scotia reached a funding agreement for the change so doctors will be paid to do telemedicine.
Delorey said most doctors are able to access the technology through existing medical record software, and the province would get something in place for those who cannot.
"Physicians who already have access to this technology may begin using it immediately," he said.
In another effort to reduce demand on primary-care providers and boost efforts to keep people from needlessly leaving their homes, Delorey said employers will no longer be allowed to require sick notes from any employees. The Health Department will also now allow pharmacists to provide permitted services virtually.
Hospitals end visitation
On Wednesday, the IWK Health Centre and Nova Scotia Health Authority announced a no-general-visitation policy.
Pediatric patients and women in labour will each be permitted one support person. Those people will be screened as they enter the hospital for any signs of illness.
A statement from the health authority said compassionate and supportive care exceptions would be made for patients at end-of-life and for substitute decision-makers, as required for plan of care.
"Multiple people waiting in hallways, family rooms or waiting rooms is not acceptable given requirements to social distance," the health authority said in a news release. "In the case of pediatric patients, an exception may be considered for two parents in consultation with care team."
On Tuesday, the health authority and IWK announced they would be suspending elective surgeries and a variety of other non-essential services as staff prepared to ramp up their pandemic plan.
More businesses to close
The provincial government has heightened protocols in previous days in an attempt to quell the spread of the virus. That includes closing schools and daycares, shutting down bars and casinos, restricting restaurants to only providing delivery and takeout services, and limiting public gatherings to 50 people or fewer.
On Wednesday, Premier Stephen McNeil said all gyms, spas, barbershops and salons, body art establishments and nail salons would also have to close.
That is also the case for service providers funded through the Community Services Department's disabilities support program, including social enterprises and day programs. McNeil said families affected would be supported with respite care through provincial group homes.
Now that the federal government has announced its aid package, McNeil said the province would soon announce programs of its own to help small businesses, workers and vulnerable populations. There's also work being done to address concerns about people struggling to pay their rent and to help the agricultural sector.
"We will be there for you as we make our way through this challenge," McNeil said.
Offering support to neighbours
As the number of cases of COVID-19 increase and Nova Scotians who have been out of the country are self-isolating, McNeil said he's concerned about reports of people trying to identify those who are not following protocols.
"This is the time that we need to be our best selves," he said. "We need to be kind, caring and compassionate."
Strang said no one should be concerned about who has or has not travelled or who should be self-isolating because everyone should be practising social distancing. Even those who self-isolate, if they're feeling well and not displaying symptoms, could be outside as long as no one else is around them, said Strang.
"It's why we're closing down so many things we're closing down," he said. "What's really important is that people are separating from each other."
Public health officials will only publicize information related to presumptive cases when it's necessary to find people for the purposes of testing, said Strang.
Watching the curve's growth
Strang said as more people return from March Break and from trips outside the country, he expects the number of cases of COVID-19 to increase. It's why it's important for everyone who's been away to self-isolate, he said.
His expectation is it would be another six to eight weeks before it's clear exactly how big the curve of positive cases becomes in the province.
"We know we're going to get more cases, we're trying to limit how rapidly that [curve] climbs and what the peak is."
McNeil said more closures could be announced in the coming days if public health officials decide they're required to limit the spread of the virus.
He said the province is in talks with the federal government about what provisions are being taken at the Irving shipyard in Halifax, which remains open and is one of the largest employers in the city.
The province also announced on Wednesday that 41 people serving intermittent sentences in Nova Scotia's four adult correctional facilities will be released on temporary absences until further notice, a measure allowed under the Nova Scotia Correctional Services Act.
On Sunday, Correctional Services closed its facilities to all visitors.
Public health officials reiterated that anyone who has been in close contact with someone who has travelled and is experiencing fever above 38 C and/or a new cough should complete the online questionnaire before calling 811.
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