New Brunswick officials announced 20 new cases of COVID-19 Saturday, bringing the province to 57 active cases.
The new cases include 12 in the Moncton region (Zone 1), seven cases in the Campbellton region (Zone 5) and one case in the Fredericton region (Zone 3).
Three people are in hospital. One is in intensive care.
Dr. Jennifer Russell, the province's chief medical officer, said nine of these cases are related to the outbreak at the Manoir Notre-Dame in Moncton.
"This is not the start of the holiday weekend that any of us were hoping for," she said.
Single-day high for New Brunswick
The 20 new cases is a single-day high for the province since the start of the pandemic, surpassing 17 new cases on Wednesday.
The new Moncton region cases are an individual between 20 and 29, two people between 60 and 69, two people between 70 and 79, four people between 80 and 89 and three people over 90.
Three of those cases remain under investigation while the others are linked to the special care home.
In the Campbellton region, the new cases announced are an individual under 19, an individual between 20 and 29, an individual between 30 and 39, an individual between 50 and 59, two people between 60 and 69 and an individual between 70 and 79. Those cases are connected to a regional outbreak and remain under investigation.
The new case in the Fredericton area is an individual between 50 and 59 and related to travel outside of the Atlantic bubble.
Public Health says all the new cases are self-isolating.
Case at Dalhousie elementary school
Education Minister Dominic Cardy said a second case in a New Brunswick school since the start of the pandemic has been confirmed. That case is at Académie Notre-Dame, an elementary school in Dalhousie, which remains open under strict guidance from Public Health.
The first case in a school was confirmed on Thursday at Sugarloaf High School in Campbellton. That school will be closed on Tuesday and Wednesday as part of a prior decision to help students adapt to online learning.
Cardy said mask use will now be required — both indoors and outdoors — for all students in grades K-12 at schools in Campbellton and Moncton health regions.
Exceptions will be made for physical education, and while students are eating or working alone quietly at their desk. Those with medical reasons will also be exempt.
All school sports and extracurricular activities are now cancelled.
"This is a time which I think we all hoped would not reach us here in New Brunswick, after a long summer where we had a respite from a disease that's ravaging the world," Cardy said.
He would not say how many people at the two schools are self-isolating, citing privacy reasons.
Rising cases in Moncton, Campbellton regions
The spike in cases follows the decision Friday to force two regions back to the orange recovery phase in response to community transmission of COVID-19.
The changes for the Moncton region and the Campbellton region took effect at midnight.
That was following an outbreak at the Manoir Notre-Dame involving 19 people, while Sugarloaf High School confirmed a positive case.
Public Health said there is no indication of a link between the Moncton outbreak and 13 cases in the Campbellton region, but contact tracing is ongoing.
Russell said the source of the outbreak in the Manoir Notre-Dame is "associated with travel," while the source of the Campbellton cases is under investigation. At least one case is travel-related.
She asked New Brunswickers to reduce their close contacts to allow for quicker contact tracing, now that the province has risen to 57 active cases.
"That is very, very hard to stay ahead of," Russell said. "So we really need your help to keep that number low."
The Igloo Beverage Room in Moncton posted on Facebook Friday that one of its employees has tested positive for COVID-19. The pub and restaurant said it has closed and the individual was a kitchen employee not directly involved in food preparation.
The new cases Saturday bring the province to 258 confirmed cases of COVID-19, with 199 recovered. The province conducted 908 tests on Friday for a total of 84,081 tests since March.
Orange zone restrictions
Face masks are now mandatory in most outdoor and indoor public places in the Campbellton and Moncton regions, Russell said Saturday.
The change is a further tightening of the province's decision to make masks mandatory in most indoor public spaces that began Thursday.
Premier Blaine Higgs said Friday that residents in the two affected regions will need to stay within two-household bubbles in their orange zone. But he said bubbles can extend to include immediate family and caregivers.
Outdoor gatherings must be limited to 10 people or fewer, while some indoor events, including weddings, funerals and religious services are permitted with 10 or fewer.
Food, retail, and beverage businesses can continue to operate under COVID-19 operational plans, but "close contact personal services," such as barbers and hair stylists, must close.
Gyms, fitness facilities and recreational centres, casinos, amusement centres, bingo halls, arcades, cinemas and large live performance venues will also have to close.
The province daycares and schools from kindergarten to Grade 12 can remain open under strict guidance.
Russell said the two regions will remain in orange until case numbers decrease.
The rest of New Brunswick remains under the yellow recovery phase.
Russell advised New Brunswickers to avoid all non-essential travel in and out of the Campbellton and Moncton regions.
"We know there are students at post-secondary institutions in those zones who want to go home for Thanksgiving dinner this weekend," she said. "We are asking you and everyone not to travel in or out of those zones at this time."
Health services reduced
The Vitalité Health Network has scaled back services at the Campbellton Regional Hospital as a "precautionary measure."
Some services have also been temporarily reduced at the St. Joseph Community Health Centre in Dalhousie and the Stella-Maris-de-Kent Hospital in Sainte-Anne-de-Kent.
In the Moncton region, patients with non-urgent symptoms are asked to avoid visiting the emergency rooms at the Moncton Hospital or the Dr. Georges-L.-Dumont University Hospital Centre.
The ERs in all affected hospitals remain open for those with urgent or critical care needs, according to Horizon and Vitalité.
Vitalité also announced an end to visits at the Campbellton Regional Hospital, the Stella-Maris-de-Kent Hospital and the Dumont centre.
There is an exception for the obstetrics, pediatrics and palliative care units, and for patients who will receive medical assistance in dying.
Horizon Health confirmed a staffing shortage at the Moncton Hospital as 16 ER nurses and a phlebotomist have been self-isolating since Thursday.
This is creating a "challenging staffing situation" and longer wait times are expected, Horizon said in a statement.
Vitalité also confirmed it has employees in self-isolation who are close contacts of cases or tested positive for COVID-19. There are 20 employees from the Campbellton region and five from the Moncton region in isolation.
Anyone exhibiting mild or moderate symptoms of COVID-19 should complete the online self-assessment by visiting www.gnb.ca/coronavirus or call Tele-Care 811.
Public Health officials have asked anyone who has visited those Moncton locations between specific dates and times to self-monitor for symptoms and, if they have those symptoms, to call 811.
Those dates and times for Costco are: Oct. 1 from 4 p.m. to 8 p.m., Oct. 2 from 12:30 p.m. to 9 p.m. and Oct. 5 from 8:30 a.m. to 5 p.m.
For St.-Hubert restaurant: Oct. 3 from 11:15 a.m. to 4:30 p.m. and Oct. 4 from 11:15 a.m. to 3:30 p.m. and 4 p.m. to 8 p.m.
For McDonald's on Morton Avenue in Moncton: Between 8 a.m. and 12 p.m. from Sept. 28 to Oct. 5.
What to do if you have a symptom
People concerned they might have COVID-19 symptoms can take a self-assessment test on the government website at gnb.ca.
Public Health says symptoms shown by people with COVID-19 have included: a fever above 38 C, a new cough or worsening chronic cough, sore throat, runny nose, headache, new onset of fatigue, new onset of muscle pain, diarrhea, loss of sense of taste or smell, and difficulty breathing.
In children, symptoms have also included purple markings on the fingers and toes.
People with one of those symptoms are asked to:
Stay at home.
Call Tele-Care 811 or their doctor.
Describe symptoms and travel history.