COVID-19 Newsletters March 19 – 26, 2020

MARCH 26, 2020 6:00 pm


  1. The number of cases in Canada is 4018 (1,646 on March 24).
  2. This major increase may in part be due to a change in reporting policy in Quebec:
    • Previous cases were not considered “confirmed” until lab results were verified by Quebec’s National Public Health Lab in Montreal.
    • Now, cases are classed as “confirmed” from the moment the local hospital test is read as positive.


There has been some coverage in the press regarding two potential modes of transmission. Some may border on sensationalism and/or speculation.

  1. Excretion of the virus in the stool: Some patients have been found to excrete the virus in their stools. The exact risk of transmission by this method is not known but is likely low. This does again highlight the need for two measures:
    1. Vigorous hand washing regularly, after using the bathroom, and before eating
    2. Regular cleaning and disinfection of common bathrooms at least twice per work shift, with attention to the toilets, handles, doorknobs, faucets and vanities
  2. From a package received: In theory, an infected person could contaminate a shipping box, and, again in theory, the virus could remain alive on a surface for a few days.

According to the World Health Organization (WHO):

  • The likelihood of an infected person contaminating commercial goods is low
  • The risk of catching the virus that causes COVID-19 from a package that has been transported and exposed to different conditions and temperature is also low
  • If any doubt remains: Disinfect the parcel with disinfectant and/or use gloves to handle


Travellers returning to Canada from international destinations must abide by the 14-day quarantine.

MARCH 25, 2020 6:00 pm


  1. The number of cases in Canada is 3,409 (1,646 on March 24).
  2. There have been 35 deaths to date.
  3. Data from China reveals that more than 80% of COVID-19 cases are “mild”, which may in fact be an underestimate of the percentage of “mild” cases. People with mild symptoms may not present to healthcare professionals for testing, and thus would not be recorded as “cases”.
  4. The “risk to Canadians” has been upgraded to “high”. The Government of Canada Website points out that:
    • “The risk will vary between and within communities”, and
    • “This does not mean that all Canadians will get the disease”.


  1. COVID-19 on clothing: COVID-19 has been found on clothing, but it is not known with certainty for how long the virus can survive on clothing, nor how contagious the virus is on clothing.
  2. Synthetic fabrics (i.e. Spandex, Polyester) may retain the virus for longer than natural fabrics (i.e. cotton, wool). Again, this is speculative at this time.


  1. Remove clothing in the laundry room. If the items cannot be laundered immediately, place them in a separate bag.
  2. Do not shake the clothing: This may spread virus into the air.
  3. Wash the clothing with regular laundry detergent at the highest temperature recommended for the item.
  4. Other family member’s laundry can be washed at the same time.
  5. Wash hands when leaving the laundry room.
  6. Use of a laundromat is safe, as long as social-distancing and hand-washing precautions are observed.

MARCH 24, 2020 3:00 pm


  1. The number of cases in Canada is 1,646 (1,432 on March 23.
  2. The risk to Canadians has been upgraded to “high” with an increasing number of cases.
  3. The Government of Canada Website points out that:
    • “The risk will vary between and within communities”, and
    • “This does not mean that all Canadians will get the disease”.


  1. In the stool: COVID-19 can be excreted in the stools of patients, but at this point, it is not known how dangerous this is to others.
    • This highlights the importance of regular cleaning and disinfection of common bathrooms, including toilets, faucets, vanities and doorknobs.


  1. Italy: The number of daily new cases has dropped in the last two days since the peak day of March 21, two weeks after a national “lockdown” was instituted on March 11. It remains to be seen if this decline represents a firm “trend”.
  2. South Korea: The number of daily new cases has been declining since the peak of Feb 29 – Mar 03. An aggressive COVID-19 testing policy began in late January – including the now-famous “drive-thru testing”. This was followed by strict quarantine measures in early February.
  3. It is still early, but taken together, it would seem that both countries started to experience a decline about 3 weeks after “drastic” control measures were instituted.


  1. There may be some ground for optimism that cases in Canada will begin to decline by mid-April, based on the latest measures adopted over the last few days in Canada.


  1. Loss of smell is reported by many patients as an early sign of infection.
  2. Employers may be faced with the burden of employees having to care for elderly parents or family at home. The World Health Organization (WHO) has published this guide for home care of COVID-19 patients, which employees may find useful.

MARCH 22, 2020 4:40 pm


  1. The number of cases in Canada is 1,302 confirmed cases with 19 deaths.
  2. B.C. has the most cases (424), followed by Ontario (377) and Alberta (226).
  3. “Community spread” is developing: 41% of the cases in Canada have had no foreign travel, nor contact with a known case.
  4. Severity of Disease: Data to date indicates that many cases are relatively mild, with 91% of patients able to be treated at home.
  5. Some patients may be unaware that they may have contracted Coronavirus, thus attributing their mild symptoms to other conditions.


  1. Patients with minimal symptoms, perhaps not even realizing that they might have Coronavirus, can still transmit the disease to others.
  2. How “easily” people with very minimal or no symptoms can transmit the disease is still unclear.


The mainstays for the workplace remain:

  1. Maintaining a “social distance” of 1-2 meters in the workplace.
  2. Enforcing a vigorous, frequent hand-washing program.

We will keep our clients informed as new data on transmission becomes available.


  1. Fear: It is human nature for people to fear and vastly overrate risks that they do not understand, such as Coronavirus, as opposed to familiar risks they do understand, such as the risk of a traffic accident.
  2. People in quarantine may develop symptoms such as anxiety, irritability, depression, powerlessness, rage, and in extreme cases, symptoms similar to Post-traumatic stress disorder (PTSD).
  3. The psychological effects of this Coronavirus quarantine on performance when employees return to the workplace is not known. In the interim, employers and colleagues can help the social isolation, financial stresses and stigmatization quarantined employees feel by:
    1. Maintaining “virtual” contact with employees (telephone, email, etc) in quarantine
    2. Helping employees access whatever financial supports are available.
    3. Assuring an as-welcoming-as-possible atmosphere when they return to work.


  1. A U.S. lab has developed a rapid Coronavirus screening test that can be done by less-trained personnel in 45 minutes. The previous screening test had to be sent to a central lab, and testing took 24 hours, with patients in Canada sometimes waiting 3-4 days for the results.
  2. No word on when (or if) this test will be available in Canada.


The mainstays of Workplace Coronavirus prevention remain social distancing and a vigorous, frequent hand-washing program. This is imperative as the “community spread” of Coronavirus is increasing.

MARCH 19, 2020 4:30 pm


  1. The number of cases in Canada is 736 confirmed cases with 9 deaths.
  2. The elderly and chronically ill account for most deaths, especially those hospitalized or in institutions. Employers may have to deal with increased absenteeism by employees caring for elderly/sick parents.
  3. Workplace coronavirus precautions are of vital importance: “Community spread” is starting to be seen in Canada, i.e. cases in persons who have not travelled or been in contact with a confirmed case.


There is still much that we do NOT know about how, and how easily, COVID-19 is transmitted.

  1. Droplets: The highest risk of transmission is still considered to be by person-to-person spread by “droplets” that are expelled when an infected person coughs or sneezes. These droplets may be inhaled by another person standing less that 1 metre away.
  2. Surfaces: Droplets may land on nearby person’s clothing, countertops, office machines, etc. A person may touch the surface, and then touch their face, eyes or nostrils and become infected.
  3. Late breaking research in the U.S. shows that the virus may remain detectable for up to 2-3 days on plastic or stainless steel surfaces. This is longer than had been previously thought. However, the risk of this mode of transmission is unclear.
  4. Shared Bathrooms: The risk of transmission between people using a shared bathroom is not known for sure, but is unlikely to be a main factor in the spread of the disease.
  5. MedExtra will continue to update our clients as soon as data on transmission becomes available.


The mainstays for the workplace remain:

  1. Hand washing: Proper technique is important. Regular and vigorous handwashing with soap and water for at least 20 seconds, especially after using the bathroom and before eating.
  2. Alcohol-based hand sanitizers: These are unavailable in most areas at this time.
  3. Work-separation distance: 1-2 metres is recommended.
  4. Regular cleaning and disinfection: High-touch frequency surfaces, including phones, doorknobs, computers, photocopiers, countertops.
  5. Homemade disinfectant: If commercial disinfectants, i.e. Lysol, are unavailable, a 9:1 mixture of water-household bleach appears effective.


  1. WHO Proper Hand washing video.
  2. WHO Proper Hand sanitizer video


A clinical trial evaluating an investigational vaccine for COVID-19 has begun in the USA; Volunteers will receive two injections 28 days apart. The trial will last 6-8 weeks.