Newfoundland and Labrador expanded public health restrictions in central Newfoundland Monday, as an outbreak that now involves community spread threatens a wider area.
All communities along the Trans Canada Highway from Gambo to Badger, as well as communities along highway Routes 320, 330, 340 and 350 — including Gander and Grand Falls-Windsor, the largest towns in the region — will move to Alert Level 4, effective immediately. The four regional highways provide passage to New-Wes-Valley, Gander Bay, Twillingate and Botwood.
"We're really hopeful that by putting [this order] in place, that we will not have to expand it and that by expanding it to this degree today, that this will help to keep things in check and be able to really, really help us control it to stop that transmission," Chief Medical Officer of Health Dr. Janice Fitzgerald told reporters at a briefing Monday morning.
Under Alert Level 4, the second-strictest level in N.L.'s pandemic management orders, essential businesses can remain open but restaurants cannot offer indoor dining. Bars, gyms, pools and arenas must remain closed. Funerals, weddings and other services are restricted to 10 people.
Five new cases were reported Monday. There are also 11 presumptive positive cases, and one probable case.
Four of the new cases announced Monday are associated with the cluster, which broke out last week in the Lewisporte area. One is a person between 20 and 39, one is a person in their 40s and one is a person in their 50s. The fourth case is a woman in the Eastern Health region who is over 70 years old. She is a close contact of a previously known case and connected to the cluster, according the a Department of Health media release.
The fifth new case is a person in their 40s in the Eastern Health region and is related to travel.
There are now 33 confirmed cases associated with the central Newfoundland cluster with several more awaiting results. Investigators have yet to pinpoint a source.
As part of the ongoing investigation public health is asking anyone who visited Subway on Hamlyn Road in St. John's on Sunday to arrange for COVID-19 testing.
The Health Department said people who visited the restaurant and currently have symptoms are required to isolate until 24 hours after their symptoms resolve and they receive a negative test result.
People who visited the restaurant and do not currently have symptoms are not required to isolate until they receive a negative test result.
"While awaiting their test result, they should monitor for symptoms and isolate should any symptoms develop," said the Health Department.
Three people have recovered from COVID-19 since Sunday, leaving 89 active cases in the province. There are four people in hospital due to the virus.
During Monday's emergency briefing, Fitzgerald said travel to and from the area should be limited to essential travel only.
To date, 141,787 people have been tested.
Virus spread through sports, gatherings
Fitzgerald said those who have travelled to the area now included under Alert Level 4 for the Victoria Day long weekend can return home, but should monitor for symptoms for two weeks and get tested if they show any symptoms of the virus.
The cluster is still evolving, Fitzgerald said, but there are signs that there was some spread of the virus through social gathering and sporting events.
She said schools in the area were closed for professional development days, which kept the virus from spreading in schools.
The Newfoundland and Labrador English School District is keeping schools in Alert Level 4 communities closed for Tuesday and Wednesday. A total of 36 schools are among those remaining closed. A full list can be viewed here.
"While public health has not expressly advised that in-class instruction be suspended at this time, this action is being taken from a district perspective to address any operational issues which may occur in terms of teaching and support staff being directly advised by public health to self-isolate," the NLESD said in a media release.
The school district said students can collect learning materials from their schools on Tuesday, and online instruction will be held on Wednesday. The district said it's expected that in-person instruction will resume on Thursday, and will issue an update on Wednesday.
Based on screening so far, the cases related to the cluster don't appear to be of the B117, B1351 or P1 variants, Fitzgerald said, but public health is waiting for testing to determine if the cases are of a variant first identified in India.
Health Minister John Haggie said testing is ongoing in Lewisporte, as well as in Gander and Grand Falls-Windsor on Monday. There is also an option to expand testing on Tuesday, he said, and public health and the health authority are exploring possible locations.
"The challenge is that their contacts are spread out over a large geographical area," Haggie said. "There's sporting events, there's family gatherings and there's social events that have led to a list of possibly 300 contacts."
He noted officials are dealing with a "young" cluster, with an average age of 38. Looking ahead, return-to-play plans submitted by sports associations may need tweaking, he added.
"I think the challenge sometimes isn't around the sport, it's around what goes on before and after the sport," Haggie said.
It's not known yet how many of those infected have received a dose of vaccine, Fitzgerald said.
"That's of great interest to us. If this does turn out to be a variant ... we're very interested in knowing how the vaccine might help prevent spread of that."
Long lines for testing in Lewisporte
The Department of Health reported 23 new cases Sunday, the highest single-day caseload in over three months.
Calls for increased community testing in the Lewisporte area also led Central Health to issue an advisory Sunday night, saying it had filled all current time slots and assigned those requiring a test to a wait list. The health authority said it would open more clinics later in the week to accommodate demand.
Kevin Barnes, mayor of Summerford, noted residents lined up for hours over the weekend for a swab at the sole clinic in Lewisporte, with some of them turned away without a test at all.
"It could have been done in different areas," he said. "We were caught off guard ... I don't think we were truly prepared for a situation of this magnitude in this area."
Barnes described an air of anxiety around town, and said most residents are staying close to home.
"They don't know the extent of it yet," he said.
Watch the May 24 briefing:
In Lewisporte, deputy mayor Krista Freake said the town as a whole "shifted well" to Alert Level 4 restrictions, with businesses closing or reducing capacity.
"People were quick to do that and are eager to do what's right to ... contain this virus," Freake said.
Public health officials are also asking anyone who worked at or visited a Loblaws pharmacy inside the grocery store at 252 Main Street in Lewisporte between 9 a.m. and 5 p.m. on Wednesday or Thursday, or between 9 a.m. and noon on Friday to arrange a test.
Public health said the possible exposure was found as part of its investigation into the cluster.