The presence of Covid-19 in a staff person at the Betel Home, a personal care home in Gimli, is of great concern, as are the symptoms of a respiratory infection in 9 residents. I am very concerned when I hear a report that only those who are symptomatic among the residents were tested for Covid-19.
It is now very clear that people can test positive for the Covid-19 virus before they are symptomatic. It is also now apparent that some people are infected with Covid-19 and test positive for the virus but are not symptomatic. The positive test means that the virus is present in the nasopharyngeal cavity and that the person can spread the virus to others. There is, as well, clear evidence that asymptomatic individuals with Covid-19 can spread the virus (1). A carefully researched study in the community of Vo in Italy in which everyone was tested showed the importance of identifying those who are asymptomatic and isolating them (2). In Iceland, testing suggests that up to 50% of people with Covid-19 may be asymptomatic (3).
Personal Care homes have a very high vulnerability to covid-19 as we have seen in Canada and as has been observed in other countries. It is not enough, in a personal care home environment to test only those who have symptoms. In order to be on top of what is happening in a personal care home where there has been a staff person or a resident with Covid-19, all staff and all residents need to be tested. This is vital to be sure that such individuals are isolated. It is also critical to be sure that all staff with Covid-19 are identified and are isolated. Only when all who are infected are identified and isolated is there a good prospect of being able to limit the Covid-19 outbreak in the personal care home.
1) Roche C et al. Transmission of 2019-nCoV infection from an Asymptomatic Contact in Germany. New England Journal of Medicine 382:970-971, March 5 2020. https://www.nejm.org/doi/full/10.1056/NEJMc2001468
2) Guardian: Scientists say mass tests in Italian town have halted Covid-19 there: A study in Vo, which saw Italy’s first death, points to the danger of asymptomatic carriers. https://www.theguardian.com/world/2020/mar/18/scientists-say-mass-tests-in-italian-town-have-halted-covid-19
3) Mihai, Andrei: Icelan’s testing suggests 50% of Covid-19 cases are aymptomatic. Diseases, Health and Medicine News March 26, 2020 https://www.zmescience.com/medicine/iceland-testing-covid-19-0523/