Sixth Case of COVID-19 Coronavirus in Vancouver called a Sentinel Event

Note: This article is an update to an earlier article about COVID-19 coronavirus in the Vancouver area that was posted on February 6th, 2020.

Provincial health officer Bonnie Henry announced Thursday, February 20th that a woman in her 30s who just returned from Iran this week is British Columbia’s sixth case of the novel COVID-19 coronavirus.  The woman was assessed at a hospital and is now in self-isolation at home in the Fraser Health region. Health officials won’t say which area she is in, but only that the Fraser Health region spans from Burnaby to Hope[1].

Note: The north shore (North Vancouver) is well known for its vibrant Iranian community, but so is Coquitlam, which is part of the Fraser Health region.

Health officials are now investigating details of the woman’s travel and working to determine whether other passengers on her flight home will need to be notified and tested.

This case is unusual in that the travel was to Iran, and not China or Singapore. Dr. Henry said that this is what is called a “sentinel event”, which is “a marker that something may be going on broader than what we expect[1].”

Earlier this week, on February 16th two Canadians returned to British Columbia from having been on the Westerdam cruise, and were asked by officials to put on protective face masks at Vancouver International Airport as an American woman who was on the cruise with them has tested positive for the COVID-19 coronovirus, and both she and her husband have been hospitalized with pneumonia [2,3]. The Global News headline for the story read “COVID-19 fears spike after woman let off cruise ship in Cambodia tests positive“.  The story’s opening paragraph reads, “The feel-good story of how Cambodia allowed a cruise ship to dock after it was turned away elsewhere in Asia for fear of spreading the deadly virus that began in China has taken an unfortunate turn after a passenger released from the ship tested positive for the virus [3].”

A week ago, a 5th case of COVID-19 had been identified in British Columbia in a woman in her 30s who travelled to the Shanghai area of China. “She was not in Hubei province and was not in an area where travel was restricted,” said Dr. Bonnie Henry, B.C.’s Chief Medical Health Officer. “She came home from Shanghai through YVR (the Vancouver International Airport) and then travelled by private vehicle to her home in the interior,” said Henry. The woman was tested on February 11th, and the lab returned a positive result on Thursday February 13th [4]. Global News reported that they think that the woman’s symptoms started around her time of arrival. Henry said, “We’re still working out the seating and looking at the flights“.  Global News also reported that “health officials are still working to contact everyone who sat within three rows of the woman to discuss what to do if they show symptoms”. Officials are not saying what flight the woman was on, or where she lives in the interior because “because they don’t want to unnecessarily alarm people“, Henry said [4].

It is also known that 5 million people left Wuhan before quarantine was set up in that city in preparation for the lunar New Year[5]. Where did they go? We know for sure that two people from Wuhan came to Vancouver during that time and that a woman in her 50s with whom they were staying contracted COVID-19 from them [6,7]. Since incubation period for the illness is believed to be up to 14 days and these individuals they were without symptoms while touring Vancouver sites, it is unknown how many individuals in the greater Vancouver area may have also been exposed to the coronavirus over the last few weeks by being in close contact with these three individuals. It is also unknown how many other people from the outbreak area may have come to Canada before the quarantine was in place. 

Some thoughts…

Medical officials are continuing to assure the public that the risks of getting COVID-19 are “low”, but “low” is a relative term.

Risk would certainly be “low” when compared to Wuhan where the coronavirus originated from (based on the sheer number of individuals infected there) and would also be “low” compared to those who were quarantined on the Diamond Princess off of the coast of Japan, but people in the Greater Vancouver area are very much on edge knowing that being within 2 meters (6.5 feet)  for any length of time of those who are contagious may put them at risk. Two meters is the distance between tables in  a restaurant, the distance between people in front and behind in a long line up at a checkout line, or at popular locations including the airport. Given that people can have no symptoms whatsoever and be contagious for 14 days has many people concerned.

In addition to a growing outbreak of COVID-19 in Iran, also of concern is the recent emergence of hundreds of cases of COVID-19 in Seoul, South Korea — as both of these countries have strong ties to local communities, and neither country is currently restricting travel.

Distance Consultations

Over the past decade that I have provided services via Distance Consultation, they had become increasingly popular with local-area clients as it saved them travelling time, booking time off work, or arranging childcare. As events related to coronavirus have unfolded, many local clients are glad to have the ability to consult with me remotely, especially given my experience doing so. 

You can find out more about Distance Consultations by clicking on the tab above.

More Info?

If you would like more information about the services that I provide, please have a look under the Services tab or in the Shop. If you have service-related questions, please feel free to send me a note using the Contact Me form above, and I will reply as soon as I can.

To your good health!

Joy

You can follow me on:

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Copyright ©2020 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.

References

  1. Globe and Mail, Andrea Woo, B.C. hit with sixth case of coronavirus after woman returns from Iran, https://www.theglobeandmail.com/canada/british-columbia/article-bc-hit-with-sixth-case-of-coronavirus-after-woman-returns-from-iran/
  2. CBC News, Austin Grabish, As Canadians return home from Westerdam cruise, health officials urge them to self-isolate, February 16, 2020 https://www.cbc.ca/news/canada/british-columbia/westerdam-cruise-canadians-return-home-1.5466131
  3. Global News, Sopheng Cheang, Eileen Ng, Grant Peck (Associated Press), COVID-19 fears spike after woman let off cruise ship in Cambodia tests positive, February 17, 2020, https://globalnews.ca/news/6559821/cambodia-cruise-ship-coronavirus-positive/
  4. GlobalNews, Stuart Little, B.C. identifies 5th presumptive case of COVID-19, woman who travelled near Shanghai, https://globalnews.ca/news/6552744/british-columbia-covid-19-update/
  5. CTVNews, Erika Kinetz, Where did they go? Millions left Wuhan before quarantine. February 9, 2010, https://www.ctvnews.ca/health/where-did-they-go-millions-left-wuhan-before-quarantine-1
  6. CityNews 1130, Paul James and Kathryn Tindale, Health officials track coronavirus in Metro Vancouver, risk remains low, posted Feb 5, 2020 11:31 am PST, last Updated Feb 5, 2020 at 11:32 am PST,  https://www.citynews1130.com/2020/02/05/virus-expert-tracking-infected/
  7. National Post, Richard Warnica, Fifth suspected coronavirus case in Canada is B.C. woman who had ‘close contact’ with Wuhan visitors, Posted February 4, 2020 and 11:33 PM EST, https://nationalpost.com/news/canada/fifth-suspected-coronavirus-case-in-canada-is-b-c-woman-who-had-close-contact-with-wuhan-visitors
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(Updated Feb.17) Health Officials Tracking Coronavirus Exposure in Metro Vancouver

Note: This post is based on two articles about the spread of coronavirus to the Vancouver area; one which is a was published by the National Post on Tuesday, February 4, 2020 and the other that was published on the News 1130 website on Wednesday February 5, 2020, and represent my thoughts on the subject.] Please see the most recent updates, below.

Secondary Coronavirus Case in Vancouver

This past Tuesday, February 4, 2020 BC’s provincial health officer, Dr. Bonny Henry announced that a woman in her 50’s who had not been to China recently but who had relatives visiting from Wuhan, China the past several weeks had tested positive for the coronavirus, and is now in hospital [1] in the Vancouver area.  Based on several reports, her relatives left Wuhan prior to the lock down of the city resulting from the coronavirus epidemic, but since incubation period for the illness is believed to be up to 14 days, they were without symptoms while recently touring Vancouver sites. The woman with whom they were visiting has since contracted coronavirus, but it is currently unknown how many individuals in the greater Vancouver area may have also been exposed to the coronavirus over the last few weeks.

An article on News 1130 published Wednesday, February 5th stated that “medical officers are tasked with tracking down anyone who may have been in contact with carriers of the (coronavirus) virus” [1]. The article went on to elaborate that “anyone who would be in close range of about two meters (~6.5 feet) of an individual who’s infected and spends a significant amount of time in that space would be at highest risk for picking it up”, said infectious disease expert Susy Hota of the University of Toronto’s Faculty of Medicine. She added that “There’s no guarantee that they will pick it up, in fact, most people won’t“. Not mentioned is the risk associated with the more common way of catching viruses, such as by someone contagious sneezing into their hand and then touching surfaces we then touch, such as public restroom door knobs.

Dr. Michael Gardam, who is an infectious disease specialist at Toronto’s Humber River Hospital was reported in the National Post article to have said, “We’re all worried about the potential of this becoming a problem in Canada. I don’t think this is going to be a short-term thing,” he said and added “because of the nature of how it’s spreading and what’s happening in China, we could unfortunately be dealing with this story for the next two years[2].”

The National Post highlighted that what makes this most recent case of coronavirus in Vancouver significant is that the person had not travelled to China. Dr. Isaac Bogoch, an infectious disease specialist at the University of Toronto was reported to have said, “That’s called secondary spread. That’s a problem[2].”

The story published on News 1130 web page elaborated that medical officials in the Vancouver area “want to reach out to the close contacts of that individual” which they explain tend to be household members, or those who interact very commonly with the individual(s). “Each person contacted will be assessed for early symptoms (of coronavirus) and given information on how to react if symptoms develop”.  Susy Hota of U of T’s Faculty of Medicine was reported to say “while tracking of those people will be underway, the risk of other people being infected remains low“.

Final thoughts…

“Low” is a relative term. Risk would certainly be “low” when compared to Wuhan where the coronavirus originated from, based on the sheer number of individuals infected there, and would also be “low” compared to those currently quarantined on cruise ships off the coast of Japan and Hong Kong, but it is unknown how many people in the Metro Vancouver area were within 2 meters of this woman and her relatives for any significant amount of time while they were in Vancouver over the last several weeks. These individuals had no symptoms of having coronavirus at the time, but based on the known two-week incubation period before people manifest symptoms, people that were within 2 meters of them for an extended period of time may currently be contagious.  It would seem, in my understanding that this could include those seated at an adjacent table in a restaurant, standing nearby in a crowded shop for significant amount of time, or waiting in the same check-out line at a store.

There is a high degree of concern about coronavirus among the people I speak with on a daily basis; with most concerned that they may be at risk of contracting the virus, or now wondering if they have already been exposed to it, and have not yet manifested symptoms.  While health officials continue to encourage people that the risk of getting coronavirus in Metro Vancouver is “low”, people remain concerned about what is not known.

Since I already had over a decade of experience providing Dietetic services via Distance Consultation, and almost two-thirds of my clients already chose to meet with me remotely, it seemed to makes good sense at this time for me to provide all services in this manner. 

You can find out more about Distance Consultations by clicking on the tab above. 

Please see updates on this story, below. 

More Info?

If you would like more information about the services that I provide, please have a look under the Services tab or in the Shop. If you have service-related questions, please feel free to send me a note using the Contact Me form above, and I will reply as soon as I can.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/lchfRD
Facebook: https://www.facebook.com/BetterByDesignNutrition/
Instagram: https://www.instagram.com/lchf_rd
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UPDATES: 

(February 8, 2020): While not directly related to the current situation in Vancouver, this new story indicates how this virus is spreading without any direct or secondary connection to China. Five British nationals have been diagnosed with the new coronavirus at a French ski resort, and apparently caught it from a British national who had recently visited Singapore and had attended a business meeting from January 20 to 23 which had business delegates from around the world. None of the UK nationals had visited China [3], so this would not be “secondary spread” of the virus, as in Vancouver, but tertiary spread. Vancouver is a major city and Canadian Pacific port hub, with ships arriving daily. It is concerning that coronavirus is now being transmitted in other countries from those who have not visited China.

(February 9, 2020): It is now known that 5 million people left Wuhan before quarantine was set up in that city [4], in preparation for the lunar New Year. Where did they go? We know for sure that 2 came to Vancouver, and it is unlikely that they were the only ones. It is unknown how many more people from the outbreak area came to Canada before the quarantine was in place.

(Feb 11, 2020): Spread of the novel coronavirus (dubbed Covid-19) is suspected to be linked to an outbreak at a single shopping mall near Beijing, China and none of the 33 people that worked or shopped there had history of travel to Wuhan.

(Feb 14, 2020): A fifth case of Covid-19, the novel coronovirus has been identified in British Columbia in a woman in her 30s who travelled to the Shanghai area of China. “She was not in Hubei province and was not in an area where travel was restricted,” said Dr. Bonnie Henry, B.C.’s Chief Medical Health Officer. “She came home from Shanghai through YVR (the Vancouver International Airport) and then travelled by private vehicle to her home in the interior,” said Henry. The woman was tested on Feb. 11th, and the lab returned a positive result on Thursday February 13th [6]. Global News reported that they think that the woman’s symptoms started around her time of arrival. Henry said, “We’re still working out the seating and looking at the flights“.  Global News also reported that “health officials are still working to contact everyone who sat within three rows of the woman to discuss what to do if they show symptoms”. Officials are not saying what flight the woman was on, or where she lives in the interior because “because they don’t want to unnecessarily alarm people”, Henry said [6].

(Feb 17, 2020) Two Canadians who returned to British Columbia yesterday (Sunday) from having been on the Westerdam cruise were asked by officials to put on protective face masks at Vancouver International Airport as an American woman who was on the cruise with them has tested positive for the Covid-19 coronovirus, and both she and her husband have been hospitalized with pneumonia [7,8]. The Global News headline for the story read “COVID-19 fears spike after woman let off cruise ship in Cambodia tests positive“.  The story’s opening paragraph reads, “The feel-good story of how Cambodia allowed a cruise ship to dock after it was turned away elsewhere in Asia for fear of spreading the deadly virus that began in China has taken an unfortunate turn after a passenger released from the ship tested positive for the virus” [8].

 


Copyright ©2020 BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.

References

  1. CityNews 1130, Paul James and Kathryn Tindale, Health officials track coronavirus in Metro Vancouver, risk remains low, posted Feb 5, 2020 11:31 am PST, last Updated Feb 5, 2020 at 11:32 am PST,  https://www.citynews1130.com/2020/02/05/virus-expert-tracking-infected/
  2. National Post, Richard Warnica, Fifth suspected coronavirus case in Canada is B.C. woman who had ‘close contact’ with Wuhan visitors, Posted February 4, 2020 and 11:33 PM EST, https://nationalpost.com/news/canada/fifth-suspected-coronavirus-case-in-canada-is-b-c-woman-who-had-close-contact-with-wuhan-visitors
  3. Global News, Marine Pennetier, 5 UK Citizens Contract Coronavirus at French Ski Resort, February 8, 2020, https://globalnews.ca/news/6525402/5-uk-coronavirus-resort/amp/
  4. CTVNews, Erika Kinetz, Where did they go? Millions left Wuhan before quarantine. February 9, 2010, https://www.ctvnews.ca/health/where-did-they-go-millions-left-wuhan-before-quarantine-
  5. New York Times, Coronavirus Update: Quarantine ordered as cases are linked to shopping centre,  https://www.nytimes.com/2020/02/11/world/asia/coronavirus-china.html
  6. GlobalNews, Stuart Little, B.C. identifies 5th presumptive case of COVID-19, woman who travelled near Shanghai, https://globalnews.ca/news/6552744/british-columbia-covid-19-update/
  7. CBC News, Austin Grabish, As Canadians return home from Westerdam cruise, health officials urge them to self-isolate, February 16, 2020 https://www.cbc.ca/news/canada/british-columbia/westerdam-cruise-canadians-return-home-1.5466131
  8. Global News, Sopheng Cheang, Eileen Ng, Grant Peck (Associated Press), COVID-19 fears spike after woman let off cruise ship in Cambodia tests positive, February 17, 2020, https://globalnews.ca/news/6559821/cambodia-cruise-ship-coronavirus-positive/
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Five Pounds or Fifty Pounds of Fat – in very real terms

Whether one loses 5 pounds of fat or 50 pounds of fat, I think it is very helpful to visualize just how much that is. Yes, five pounds of fat is much larger than most people realize!

This past week, I purchased a life-sized model of 5 pounds of fat from a well-known nutrition supplier; the same supplier I have purchased life-sized food models from, which I used to use a lot in my practice.  When I received it, I was quite surprised how much room it took up and just how heavy it was.

Here is a photo of the life-sized model 5 pounds of fat on a scale, with my left hand for a size reference:

5 pounds of fat on a scale, with adult hand as reference – © BBDNutrition

Here is a photo of it on an ordinary steno chair:

5 pounds of fat on a steno chair – © BBDNutrition

…and here is 5 pounds of fat being held in my hand:

5 pounds of fat in adult hand – © BBDNutrition

Finally, here is 5 pounds of fat being carried as one would carry an infant:

holding 5 pound of fat – © BBDNutrition

Five pounds of fat is a lot! Sure there is the initial water-loss at the beginning of weight loss, but here I’m talking about fat.

Fat takes up a fair amount of room around one’s waist, or worse inside one’s abdomen or organs. If someone has 20 pounds of fat to lose, that is four of those fat models distributed over their body; legs, belly, arms, neck, back and face and perhaps some in their liver.

I had 55 pounds of excess fat before beginning my journey.

Comparing these two full length photos, it is easy to see how I had the equivalent of one of those fat models over the length of each leg, one distributed between each arm, one distributed over my neck and face and 2 spread out around my waist and hips and some no doubt, in my liver and pancreas. But still, I can’t actually imagine where I was carrying 11 of those, all told!

The fat in my abdomen must have been more than I imagined, as it was wreaking metabolic havoc on my body.  I had very high blood pressure and had type 2 diabetes for 8 years.  You can read the entire story (including lab test results) under “A Dietitian’s Journey” on my affiliate low carb web site by clicking here. Keep in mind that I chose to follow a therapeutic low carbohydrate diet, but there is no one-sized-fits-all diet that is right for everyone.  

Whether you have 5 or 10 pounds of fat to lose, or like me ⁠— a whole lot more, it is really only done a pound or so at a time.  If you have significant amount of weight to lose,  I can not only help you do that, but since I’ve been through it myself, I can encourage you and coach you through it. I provide services across Canada (except PEI) via HIPAA-compliant video conferencing, and most extended benefits providers reimburse for licensed Dietitian services.

More Info?

If you would like more information about the services I offer, please have a look under the Services tab or in the Shop for more information. If you have service-related questions, please feel free to send me a note using the Contact Me form above, and I will reply as soon as I can.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/lchfRD
Facebook: https://www.facebook.com/BetterByDesignNutrition/
Instagram: https://www.instagram.com/lchf_rd
Fipboard: http://flip.it/ynX-aq

Copyright ©2020  BetterByDesign Nutrition Ltd.

LEGAL NOTICE: The contents of this blog, including text, images and cited statistics as well as all other material contained here (the “content”) are for information purposes only.  The content is not intended to be a substitute for professional advice, medical diagnosis and/or treatment and is not suitable for self-administration without the knowledge of your physician and regular monitoring by your physician. Do not disregard medical advice and always consult your physician with any questions you may have regarding a medical condition or before implementing anything  you have read or heard in our content.

Please follow and like us: