Edmonton's case numbers are the worst they've ever been and — without added caution — rates of community infection could rapidly escalate, warns an infectious diseases specialist.
The capital region is experiencing a surge in COVID-19 cases and Dr. Lynora Saxinger — an associate professor of microbiology and immunology at the University of Alberta — says Edmontonians should be concerned.
"The numbers, they're pretty bad," Saxinger said Tuesday.
"They're the worst numbers we've seen in Edmonton and my concern is that it's just the beginning of an upswing."
The province recorded 982 active cases in the Edmonton health zone on Monday, up from 851 in Thursday's update.
The Edmonton zone now makes up 55 percent of Alberta's total of 1,783 active cases. The area has just over a quarter of the province's population.
In contrast, when Edmonton declared a temporary local state of emergency this spring, there were 195 cases of COVID-19 in Alberta, 43 of which were in the Edmonton zone.
During her regular briefing on Monday, chief medical officer of health Dr. Deena Hinshaw said a review of Alberta's current active caseload revealed that 11 per cent of those infected were attending work or social gatherings while symptomatic.
Hinshaw described the trend as alarming and suggested that harsher regulations could be adopted to contend with the increase.
She said her office is in talks with local public health and municipal officials to figure out if new restrictions for the Edmonton region are warranted.
The city is expected to provide an update on those talks during a news conference Wednesday, but a statement from city spokesperson Geoffrey Driscoll said no decisions have been made about what new measures could be put in place.
Saxinger said she is growing increasingly concerned about an apparent rise in community transmission, and the presence of the virus in almost every pocket of the city.
She said provincial and municipal governments should consider increased regulation to limit large indoor gatherings and encourage people to stay home when symptomatic.
In the meantime, Saxinger said people need to limit their contact with others. The next few weeks will be critical in reversing a surge in cases which threatens to put the province in the throes of a second wave.
"People are continuing to socialize in a more summer-like pattern as we move into the fall and we really have to dial that back pretty abruptly and pretty carefully," Saxinger said Tuesday.
"Even if we start doing everything great right now, the cases could continue to go up for the next week or two weeks so we really have to get this reined in pretty quickly."
'People should be getting more nervous'
Saxinger said the reopening of the economy in midsummer created a false sense of security around transmission. And after more than six months of COVID health messaging, people are getting exhausted.
"The numbers in Edmonton are terrible, but I actually find that people aren't aware of that as much. People have stopped watching as closely," she said.
"When you see others taking a more relaxed approach, it sort of snowballs and more people start to be more relaxed when objectively, there is no reason to relax right now.
"In fact, I think people should be getting more nervous and behaving accordingly."
Saxinger spoke at length with CBC about the surge in cases.
Here is that conversation, edited for clarity and length.
Q. What are your thoughts on the surge in cases in Edmonton?
I was watching the numbers and they were kind of hovering around 150 to little above 150 for quite a long time, and I was uncomfortable with that number. I think the discomfort is much, much more now that we've seen the weekend numbers come through because it does seem to be a significant jump.
Q What do you think could be driving the increase in Edmonton's case numbers?
There has been a suggestion from colleagues in other hospitals that we are seeing more cases from the inner city and that can be hard to track people because they don't have a fixed address. And then another place that has been highlighted by the chief medical officer was people who were going out, either to work or to socialize, when they're symptomatic but waiting for their test results. And that should be a big concern as well, because that should be totally preventable.
Q. A health review revealed that 11 per cent of Edmonton's active cases were attending work or social gatherings while symptomatic. Are we doing enough?
I found it a little shocking. We need to make sure our messaging is crystal clear that if you have symptoms you should not be going out. And if you choose to have a test, you stay home until you get your results. And it seems like that has been fairly consistent messaging but it seems like it's starting to slip a little bit.
And the other thing I'm interested in, some people are really in financial hardship right now and might not be able to afford to stay home and is there anything we can be doing to help with that problem.
Q. Are you concerned about possible outbreaks in workplaces?
A lot of workplaces have good policies and procedures in places, but we know that this virus is very opportunistic and it will exploit whatever weakness it finds, and workplace-based outbreaks have been a feature since we first started having cases. So people need to keep their guard up.
Q. How concerned should Edmontonians be about the current case numbers?
They're the worst numbers we've seen in Edmonton. I'm not sure where the peak will be or how long it will last, but all the things that we do from now on could hopefully minimize the peak and start to turn it around. But it's going to be very crucial for people to be careful around the holidays.
Q. What would you like to see in terms of increased regulation or restrictions?
I think the messages have to be smaller groups, smaller bubbles and reduce your number of contacts. And if we aren't able to get there without actually making the restrictions part of a public health mandate, then we have to do that again. I don't think we can really avoid [regulation] if things don't come under control.
Q. What kind of regulations or restrictions should be adopted first as the case numbers increase?
One of the things that is hard for people to manage is when official guidelines appear to be more open to larger gatherings of people indoors, but we are telling them not to do it. So I think some increased consistency in the messaging, so the rules go with the message a little better, would probably help people understand. I would be looking at the gathering numbers and I would also be looking at higher-risk businesses as well
There is a possibility that if everyone gets back in the mode that it will level off without having to do that.
Really focus on keeping to your own network and not crossing networks and making some of the social interaction you want to do virtual instead of in-person would probably help a lot.