there you have our numbers that have
given to you already we're now up to 18
with 15 active cases are three resolved
of course and you had some of the
immediate releases on some of the
earlier cases there's three others that
you didn't have I'll give you some a
little short version of what there's one
is a female in late 60s with a travel
history to Egypt and we came and we came
back on the 20th and was seen at
Mackenzie Health and 29th verses well
self isolating and New York Region is
following up those a female in their 70s
also travel history gypped also returned
on Tehran the 20th and there's a
roommate of another one so that was at
North York and Toronto Public Health of
course is following up on that case and
now there's a male 60s and that was a
history of travel to Iran and as a close
contact of another Ontario case and that
person returned at hunter on the 23rd of
February and that was a North York case
and again I would be Toronto Public
Health is doing the follow-up in that
regard and I think what you've seen in
that time is that when we expanded out
to our wider number of countries someone
asked me what as I expected increased I
was predicting we'd see about 20 to 30
so to see these numbers is for me
oddly enough as reassuring that tells me
that the system is working people are
coming forward people are being seen and
people are being assessed in that way
and that's that's the crux of our whole
way that's how we do it and we follows
up in a timely fashion we look at any
exposure histories we are in a strong
containment mode and we continue to do
so and you'll see some trends and
directions I'll talk about in a moment
that tells you what may or may not be
going on in that aspect there but the
key thing is that as we're looking at
those aspects there with the number of
travelers that are comfortable these
areas these are still small numbers
relatively speaking but important
numbers and ones that we applaud those
who are coming forward with a sense of
reassurance that they will be seen in a
timely way they'll repeat they will be
treated respectfully and they'll work
with them on their concerns about their
illness the panelists for their families
and exposures and we find them all very
much responsible in that
I think if you look at our data you'll
find interesting that for now so we can
have we've had no cases from who buyer
from China there are still people coming
from China still people come from Hawaii
and the government there continues to
see their numbers drop as they seem to
have been able to with quite draconian
steps carry out containment but it's
still early but they saw the direction
is is I think is reassuring and we're
going to see what they're going to do
with that our latest one of course is
Iran and talking to the public health
agency of Canada they were the country
itself was not aware of any issue until
after the 19th or the 19th of February
and so we're trying to have our person
from public agency of Canada has gone to
the Iran and they're checking out with
their systems and data much like what
happened with Japan and with China and
you'll see that now we've had a cluster
of cases from there and so that like for
example our testing has gone up we're
seeing about 30 or 35 a days 70 to 80
tests today being submitted not all with
personal under investigation there's
other ones too that Commission's want to
have assessed and we have 12 that are
waiting for tests all the rest of the
rule 975 are negative so we've had over
a thousand tests done through our system
there and that continues to perform well
I think in the aspect there is that when
you look at it we've had over 18 cases
for had our initial ones traveled to
China for have had a travel history to
Egypt and that's interesting because the
country itself doesn't report many cases
and we're aware the another country says
we also have a cluster and it's a 2 or 3
it with at the same time in the same
place it looks like there's an event
that all these people are at at the same
time by happenstance unfortunately for
some of the Canadian ones here and so
instead of a countrywide issue you have
an event issue and this is important to
have the epidemiology to understand that
and to determine that in the Iran
situation we're not too sure where the
details are in the country whether it's
the original epicenter of Qom and wider
we're trying to get some more details
from the epidemiological review in the
country with our expert who's gone there
the time to help and then assistance we
have to have no travel history
but don't relay it to close family
contacts and that's our thing as we're
seeing is that our cases with close
family contacts
are really close down in the contacts
they're not just casual family events
people walking by I think that's
important for the public to understand
they think they're walking by someone
that we go by on a street just like that
that's not the case and we're talking
about fairly close within a meter to the
person for an extended period of time
and this of course you're coughing
sneezing all over them which I'm not
sure anyone would appreciate and that
kind of aspect there and that's why we
have all these precautions so we're
continue to see that even with all our
ones we're doing the mandates on the
flights we continue to go after those
three or two seats of back to seats
forward and all the ones so far have
been negative and that's reassuring in
one way so we're learning more and more
about how this virus transmits and so
that's important regardless of that
we've asked some questions with our
agency and public health agency of
Canada and we've had meetings or the
weekend and we've asked to increase the
risk factor for Iran and they have
agreed to do that so it'll be moving
from a level three it's up to level
three now if you look at their webpage
and we going up to be similar to who by
so asking people who are coming from
Iran because we're not too certain and I
don't think the countries are certain of
the breadth and width of the spread
within the country at this time so
asking those people come back from there
they would self isolate they would have
be required when the kiosks are updated
at the airport to fill out the
questionnaire which has their contact
information and local public health
would locate them and work with them
over a 14 day period to either ascertain
if they have symptoms yes or no during
that time if they do eight symptoms to
get them tested much like we've done
with the WHO by residents during this
time as well so you can see there's a
transition and a modification of the
travel advisories and we have to keep
our my eyes on that because you see the
numbers in northern Italy you see the
numbers in South Korea South Korea tens
any more clustered around a large group
activity and we're trying to get their
assessment their analysis what does that
mean for us
and how does that affect we still
haven't had any cases well that's
related to those other areas
nevertheless we're vigilant and watching
for that so that in mind I'm not going
to go through all the global numbers you
know those and I'm saying before the
global numbers the total becomes less
important
as it does the change the rapidity of
change in different countries and what
does that indicate going on and how does
that pose as a risk for Canada because
we have many people traveling we know
that for example from Iran we have in
Toronto we have two weeks ago 500 people
and then 300 people so not
inconsequential so when we get those
numbers in and they're dropping those
numbers because the number companies
around are not flying in to Iran and
there's no direct flights from Iran into
Canada so therefore we have to ask them
to declare that that means when you get
all those notifications public health
has to follow up with all those people
that's more workload for public health
and yet foreign following-up say 40 or
50 questionnaires when you actually have
a person who was missed for day or two
and you have to do two or three hundred
calls you can balance out the workload
but that's the dynamic of Ontario Public
Health we have that ready and to go
that's why you saw York Region step up
there medical officer doing their media
briefings on that Durham will step up
and the other ones around there so we
have that resource available we're only
using three health units at the moment
not that I want everybody to do it but
they're prepared and ready and we have
regular teleconference with them to
handle all these situations in this
containment in the management that and
looking at all the risk situations
that's what it's about
so when we look at that we said what's
our next step in Ontario and we have
undertaken to look at our pandemic plan
and in our in our management system that
we have a model and a program that lays
out different aspects of surveillance
analytics logistics communications and
these are all manned by staff as it gets
into the potential of a wider issue
before it gets into wider issue you do
your planning ahead of time that's why
the deputy and the Minister announced
that we're putting forward a new command
type structure it's part of our pandemic
plan and the next phase is that we put
that together it's chaired by the Deputy
Minister of Health it reports the
Minister of Health I am at the table
with the Deputy Minister there other
deputy ministers of appropriate areas at
the table there's ethics officers at the
table there's various other key people
from the ministry at the table law a
legal council the table because if and
when you need to make decisions you need
command center that one is having all
the stuff feed into it at the right time
in the right way has the power and
authority to make decisions either the
authority of local medical officers my
authority is achievement officer health
the legal authority of the Minister of
Health or at times an emergency
operation center of the province if and
when necessary that's not because
there's a need right now but you always
want to have these things in place
before there's the need and that you're
planning for that and prepared for that
and so the deputy we've had our first
meeting already and as you see there's
number aspects there's the command table
I talked about we've had our use in
Ontario health five regional offices
with regional leads with public health
at that table it's like a microcosm of
the large command one because if we do a
large scale thing with something going
on those responses are often worked at
through regional models because a large
event never hits the province
homogeneous Lee at the same time and so
they recall to do that and report back
in and we have their operations center
still with with our meok and we have a
scientific table of Public Health
Ontario we have our ethics table with
University of Toronto bioethics we have
our sector for specific issues and we
have our collab table with all their
collaborative entities such as the Oh
may the OHA owna all those other ones
that have invested interest to be kept
informed of what's going on and we work
with them in a collaborative way in that
function and so we are now seeing that
we're stepping up to that level
therefore that preparedness because then
you start expanding those things that
were in one area they're having larger
and larger groups all reporting up if
and when necessary to give you a quality
effective efficient and timely response
to events as they occur as they hit on
the healthcare system
how are you going to handle things right
now how many patients are in the
hospital Kovac 19 none how many but in
the hospital is 12 in 19 in Ontario 1
how many deaths that we had with kovin
19 none and so those are important
things it's not that we're not
interacting with the global picture we
are and yet our citizens and our system
continues to respond in a way that we
would say to the Ontarians it's a
low-risk still with Ontario why because
of the ongoing vigilance and the amount
of resources and staff or
into monitoring surveying and following
out so I'm happy to take questions at
the moment and to deal with the
different components I've touched base
with today well they wouldn't know if
they had yet because they haven't put
the kiosk update so the federal
government has to put that way so we've
we've asked people on our media things
if you have come and you have concerns
that you would then notify public house
especially if you're self monitor and
identify signs or symptoms we're want to
step that forward and ask the people
from Iran if you're coming back in the
last 14 days you would go into self
isolation you would notify public health
and to assess that if you wanted to get
testing how would you do it how could
you go about doing it because there may
be some issues with language and we have
translators available to assist and make
it as accessible and mandible as
possible to help them in their
assessment personal assessment because
some they weren't somewhere wearing
aware they're exposed when they're in
the country now they're where they want
to know and they're concerned about
their health issues so we haven't we
don't know if they are yet in the future
when the kiosk is up and running and the
questionnaire is administered then
proactively we would know where the
individuals are where their contact
information is and those questionnaires
are then distributed to the respective
health department's health units you may
were those people at least on their
chart indicate that reside we've got
several people here who were in Egypt
and I think you said there may have been
an event there do you know like if
there's something that these people have
in common - they all attend I don't know
maybe it was a wedding was it that's our
working we have we've been asked by
Health Canada say because they're caught
they're their investigation with another
country has another group saying they
were also at something they all came
back on the same times you notice and so
we're trying to get that detail put
together and it may be very informative
in regards to that because right now we
have more cases than Egypt has okay but
what's the other country that's got a
cluster someone mentioned but I'm not
I'm not gonna be it was just casually
mentioned so I don't want to quote it if
I don't haven't got it correctly we're
doing that now
yeah we're asking all our between York
and Toronto Public Health can you go
back and ask those people and it's part
of the investigative epidemiology it
sounds like it was an event in Egypt so
just as you're asking individuals who
have had recent trouble from which
countries to put themselves in to say
that Oh sillies isolation so Iran and
then certain parts of China who I who my
problem that was there we've had to
historically there yes Iran's moved up
to the same level as who by at this time
until we get a sense from the country of
their understanding of how the breadth
and width of the impact on their country
is and get their data and the systems up
to run so we just don't know where at
the moment he asks when do we expect
that information to be put in there I
think the the chief protocol officer may
be making some announcement later today
on that it does take time to update
those systems in there and they get the
questionnaires administered so it's not
dumb it doesn't happen in an instant
can you expect too much concerned about
the cases in South Korea and Italy why
are you surprised that we don't
mr. Ferriero I am surprised and and
maybe encouraged in a couple of ways if
you look at the South Korean situation
the the government feels its it deals
with a couple of large gathering events
in there and they feel that they have
worked at that because a large over half
their cases come from a certain group
gathering and they're looking at that so
it may be contained in that way so
that's thus far they seem to be doing
okay on that one we have not had any
cases yet reported it is on our Lert
list it's on level two and North Italy
is the same with the amount of travel
back and forth I would be expecting
cases than this the Italian government
has been quite successful to limit it to
northern Italy so far we are still
watching and waiting and a people feel
have come back and have signs or
symptoms and are concerned they might
have been exposed it's the same as all
those seven countries if you've been to
Singapore or Hong Kong and you think you
might have been exposed and you feel
signs and symptoms actually get back
please call Public Health and and go and
get assessed we would not discourage
that
big conferences starting to get canceled
are you advising people change their
behavior at all around handshakes
particularly all those maybe in jobs who
have to do it frequently we have just
said people during flu season we tend to
not encourage that things I don't know
if I'm if you're gonna shake my hand you
don't know what I did just before and so
long as I have hand sanitizer afterwards
whatever I mean I trust you you trust me
it depends and you're familiar in the
group working there we tend to say not
usually unless you're pretty sure or
you're going to be washing your hands
afterwards and not going to touch your
face and and and that kind of aspect
there so it's a it's a behavioral thing
that people do the elbow touch and
different routines especially because if
you're not sure especially if you're
traveling and you're in busy airports
and bait alignments and stuff you're
going to have to take your own
precautions because you can't be sure
the people in the crowd around and
behind you what were they're from what
exposure they've had so those are the
things about being diligent on your own
personal hygiene and behavior during
that time caring well small volumes and
get through customs security of the hand
sanitizer and that kind of stuff so
we're gonna have the hand wipes the
cloth ones so and then wash your hands
of course in the washing you have a
chance so I would generally say do
discourage that in some settings and as
you know the setting quite well and your
own methods of personal hygiene monitor
that as you said wash your hands
frequently all those things
systems taking some extra steps is that
something you would recommend more
transit systems look at or is this
something they should maybe be doing
every flu season we haven't restricted
the travel system we told people that
one if you're sick stay home
coughing your sleeve all those kind of
things of etiquette we've we've become
known around antero people doing this
Ontarians are known for that and we
haven't limited because especially with
Corona
unlike flu it's even more closer
Association so you'd have to be with
someone or with it for a certain period
of time fairly close which in some
subway settings you could be and you're
gonna have to there's no one like
someone standing next to and we're
starting hacking and coughing you can
see everybody just moves away and and
and and Ontarians are pretty pretty
strong now didn't they Suzy confront
someone with who's undertaking that
behavior so they've taken the message
pretty seriously so cough etiquette is
very important so we haven't done full
restriction we'd rather have people take
proper responsibility people because of
the question they're voluntarily but for
sure some people we hide the information
and the how would our house unit to
track down those people like oh I know
through our interview with another
person and she said she knew somebody
come from away even a family member
being it's a lot of the confirmed case
but but she didn't contact this our
health unit this person still in the
process convince that person to contact
this helps unit so how do you deal with
that situation well there are always
some individuals who may try and do that
we found so far most are not that way
usually affairs with who buying that if
you're showing your passport and it
shows that your place to resident the
customs officer will police ID said
where's the questionnaire and you push
it on the kiosk if you don't if you're
caught and you did not deny are you you
denied it then you will be in difficulty
with the customs officer the same just
say okay your flight was from there to
there did you travel anywhere else they
can easily on that massive day they can
see on your passport you went from this
country that kind of said it looks like
a few hours ago you're in some place so
where'd you travel from there so that's
what you train up the car the officers
they know what to look for and they say
well you were supposed to declare that
and so if people want to be deceptive
than that I guess they can try to be
that way but at the same time they may
do it at their own compromise that they
get quite ill and their family members
as well so then they're not being
responsible to themselves or they're not
really responsible for their family
members and that's the more concern
especially if you have some elderly
people in your household who you give it
to they may don't just get sick they may
die because it's that older group that's
at risk and you need to take that
seriously it's not matter being
deceptive there's no penalty if I can
get seen and assess because then you
know better
how does cope in 19 compared to the
common flu I mean when you take a quick
look at statistics we're talking thirty
five hundred deaths in Canada each year
we're talking about 18 cases in Ontario
the numbers don't don't seem to compare
here and people are worried he had to
put in perspective you know last week we
had 560 cases of influenza A 218 of
influenza B and somebody's and young
people and some got hospitalized and
some people died with influenza so
influenza is still making more impact
Ontario by far then Kovac 19 does that
mean we can be casual no we're being
vigilant because we don't have
in a vaccine like influenza so a lot of
our vulnerable population are not
protected so we're trying to encircle
that group if you may by doing all the
contact tracing and containment
so that group does not get exposed now
there are some people who came back who
we said in our data are over the age of
50 and they seem to be doing fine
fortunately on that case there so I
think you may raise a very good point we
look at other causes of mortality more
busy more people with problems with
whether it's drugs and different things
like that
these are making warm impact daily in
Ontario than kovat 19 yet we're not
going to be casual because we feel we
still have to be in that strong
containment mode and to keep monitoring
that it's k4 as you can but it's a good
point you phrased their testing to
change soon to put anybody who presents
with respiratory symptoms is that coming
to pass yet or is that not going to pass
we're working on that where we're doing
some pilot stuff and that we're going to
look at data they say certain hospital
where people were either seen or
admitted with respiratory and we do some
parallel testing with the Cova 19 to say
how are we missing any or not and doing
that there but certainly people with
with respiratory symptoms if they've had
travel history or they've been in
contact with groups and people like that
they felt they might have been exposed
they need to discuss that with your
health care provider or with whoever
doing the screen or with public health
so we're not saying those are not
important that that's part of the
history but you know I we've had some
people say I talked to so on the phone I
think I might have they may have had
Kovac 19 well that's obviously not
exposure it's the people just overly
apprehensive and we're seeing that a
little bit and we really like to go back
and tell the public that you really have
to be look at the data look at the facts
be informed be knowledgeable on that one
there and before you take may jump to
conclusions on situations if you have
questions talk to your public health
department talk to your physician talk
to your different health care
professionals on that and look at the
web pages and do your analytics but go
to real good sources don't go to any
source at all you want to make sure
they're reliable
cases that you're looking for before you
would recommend steps like limiting
travel on Trant and mass transit
canceling public events or would it have
to do more with if there if we come to a
point where there's community
transmission well there's the difference
there number of cases I mean if we get
with travel and we go up to 20 30 40 50
60 80 people and we still they're all
travel aid and we still do it on the
containment I would I'm not that worried
about that if we find that all of a
sudden those cases coming up that have
no travel history no contact with case
history and then there's a large event
then you would do something around that
basis there then you have start to see
the evidence of community widespread and
so your epidemiological link is not
there so you can't tell who transmitted
to who and where it's going then you
have to start to wall it off by limiting
large activities that if they seem to be
where the site is occurring much like
some countries have done and which which
China did so that would be when that
step would occur about a just I'm not
sure how to pronounce up that AEG is
it's one of the disinfectants that's
being used by a mass public transit
system or Metro links other transit
systems we've spoken to you say that
it's proven to just be moderately
effective of protecting against viruses
do you know anything about this I
haven't looked into that per se there's
lots of products out there that people
are using because it is droplet spread
some of them do stay on this the
environment for a short period of time
but these viruses do not last that well
outside one of the advantages of a
Canadian environment is that it's cold
and they don't last well on cold
environments so it's one of our one of
the pros of having a bad winter or a
cold winter in that sense but in that
specific question I haven't looked into
the agents and to assess their value and
quality in that perspective to worry
about there's some coverage on the
weekend about that English for a second
language school up at 98
an Eglinton and young area I know there
was some concerns expressed by people
that even if they don't go to the
language school and they work in that
building they have money they have mean
they may have touched the handrail they
may have touched an elevator button and
maybe stuck their finger in their eye or
whatever so how much and there were news
shots this weekend of that building
being scrubbed so how much do people
who've been through that building have
to worry about so far we haven't seen
that kind of spread occurring where you
think would be logical I know there's
some of the other countries have gone
with spraying the streets and everything
I think it really gets down to law that
contact tracing person-to-person in that
the happenstance of a1 virus on the one
piece of furniture in something you need
a bit of a dose to make an impact on you
and how it's going to introduced I would
sound likely but the fact they're clean
the place I would not discourage that
either that's just being diligent and
taking your steps there and the same as
Toronto Public Health did a full
investigation of anyone they thought was
of any risk and talk contacted them
personally
and so that was part of dr. two villas
team's investigation and made sure that
it was contained within level of risk
and satisfaction about the test kits
that we were using here in the province
some of such compared from the CDC to
the WTO's test kits there's a bit of
inaccuracy with the CDC's can you just
tell us a bit about what we're using
here well I'm not sure I mean having
investigated how accurate the CDC one is
I assume there must be a must be of good
quality we spend a lot of time as we
have dr. Vanessa Elam was here in the
early days with because we had the
genomic sequencing with our National
microbiological laboratory working in
partnership with our other senators such
as be CDC and with Quebec with their
Insp hew and we did a lot of
cross-referencing back and forth that's
what we took very much care of going
from our determine of the two allele to
a three allele system and going very
much with high sensitivity and high
specificity so we feel very confident
our testing now have you done cross
references CDC I have to bring something
like dr. Allen back to answer that
question but I mean I think we haven't
had any critter
his voice to us about CDC's testing so I
wouldn't want to be able to make any
comment on that
I feel very confident can anyone we've
worked hard to get that up to standard
and and did all the cross-referencing
and Quality Assurance and we continue to
do so so we will still share ours anyway
it's not because we need animal to say
the National microbiology laboratory to
say right they want to get copies of
ours would cover theirs and they keep
comparing to make sure we're not missing
anything so I can only speak to the
integrity of the Canadian system if we
get more and more cases right now there
it's all public health because they're
all outpatients there's no impatience at
all and so I mean yeah health Ian's
could help eachother they had to if the
workload gets overwhelming for one
health unit we have that capacity to
that and we're prepared to assist them
that way so it's mostly a public health
endeavor right now part of the command
control system is that if and when we
need that and then we would make
decisions on that and we'd say you know
with that's part of thing when the
system starts to get stressed you asked
for certain the healthcare system to
modify either with they're moving
patients out to other centers to make
room for beds more isolation type stuff
maybe cut back on elective surgery
different things you with and when you
need it part of the reason why you don't
do it too soon you can put all in place
but health issues go on and there's
still people out there that need surgery
they still people needing care and if
you put restrictions on too soon you
think sometimes do more harm than good
and you want to make sure you do it in
the right time of the right way to the
right extent that's why you have a
command table that looks at all that
because these decisions are not made
lightly because other things that we
said like influenza they're not stopping
and the care of our Ontarians in general
is of critical importance about math and
gloves there were reports in the US
like not enough inventory can you assure
us that here where we should be okay
with all the protection gear that
medical well we're spending a long time
look at that because the issue of
dealing with is a global shortage
because of the overall demand sometimes
we're concerned that the misuse and
wastage of it by sometimes public
sectors and things so we're trying to
look at a number of aspects of Education
stewardship working with our various
working groups with institutions working
with our unions and different groups
saying how can we do this best because
if you go through it too quickly when
you need it you won't have it but then
you should have it when you need it and
so our baltha and we're also at the
federal level with a logistics committee
that's looking at a national procurement
and the same thing is that they have a
national stockpile it doesn't mean every
part in Canada needs the same amount all
the same time and you may have to move
it around one where the issues are and
you'll be willing to share if we don't
have a big need we have some extra and
province X is going through a big issue
and it needs some more in 95s
we'd be asked to share same as we'd
expect from them and that's a that's a
national response so all this is taking
place with different companies and are
they ramping up their productions some
are doing that so it's it's a dynamic
process that we have are spending a lot
of time on of course because we have
enough we want to make sure we will have
enough and we're going to continue
working at that