Canada announces first confirmed ‘presumptive’ case of coronavirus in Toronto

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Canada has its first “presumptive” case of 2019-nCoV, the SARS-like virus that has already swept across China and found is way to the United States, Australia and Europe.

The patient is a Toronto-area man in his 50s who had recently travelled to Wuhan, the central Chinese city where the new virus was first identified less than a month ago.

The man is now in isolation at Sunnybrook Health Sciences Centre, public-health officials and Ontario’s health minister told a news conference Saturday evening. His condition is stable and he is expected to recover.

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David Williams, Ontario’s Chief Medical Officer of Health, said Canada’s health-care system had been girding itself for the arrival of new virus, which has killed at least 56 in China and sickened nearly 2,000 others.

“We've been waiting for our first case,” Dr. Williams said. With the amount of travel between China and Canada, he added, “I would be very surprised if this is the last case."

Despite warning that more cases of 2019-nCoV could turn up in Canada, Dr. Williams and his colleagues tried to reassure the public that the man now in isolation at Sunnybrook was unlikely to seed a wider outbreak.

"He really wasn’t in Toronto very long,” said Barbara Yaffe, the province’s associate chief medical officer of health. “He wasn't feeling well, I think he was at home, and the people who live with him are in self-isolation."

The man flew out of the city of Guangzhou on Tuesday – there are no direct flights from Wuhan to Canada – and landed at Pearson International Airport on Wednesday.

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He would have left Wuhan just before the city was effectively cut off from the outside world, with all outgoing flights and train rides cancelled. Chinese authorities have since expanded the quarantine to several more cities.

On Thursday, the day after the patient landed at Pearson, he and his wife called 9-1-1 and told the dispatcher that the man had a cough, a fever and had recently been to Wuhan. Paramedics wearing personal protective equipment picked him up from his home and took him to Sunnybrook, where he was put in a negative-pressure room designed to keep infections from spreading.

His wife has not developed any of the respiratory symptoms typical of the new virus, the officials added.

Using a rapid diagnostic test, Public Health Ontario’s laboratory confirmed on Saturday afternoon that the man had the virus from Wuhan.

Peter Donnelly, the president of Public Health Ontario, said Canada’s National Microbiology Lab in Winnipeg is also testing samples from the patient, using a slightly different method, to definitively confirm that Canada has its first case of 2019-nCoV.

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Dr. Donnelly said he was certain the national lab would reaffirm Ontario’s results, but until then, officials consider the case presumptively confirmed.

News of the case was so fresh on Saturday that Toronto Public Health officials said they were still in the process of determining the man’s movements in Canada and tracing his contacts.

They would not say what flight the man was on. However, they said he travelled home from the airport in a private vehicle.

“We have somebody who’s had very little external contact,” said Eileen de Villa, Medical Officer of Health for the City of Toronto. “We are now in the process, as the local public health unit, of undertaking the investigations, understanding the history of the ill individual, and all of the activities that that individual has undertaken since becoming ill.”

Dr. Yaffe said medical authorities are still ascertaining whether the patient was infectious on the flight.

She said the protocol is to work with the federal government in getting the flight information, and to identify people who were within three rows of the person. “Because they would be at risk, potentially,” she added.

Much is still unknown about 2019-nCoV, a virus from the same family as SARS, which is believed to have originated at a seafood and wild game market in Wuhan. The infectious disease doctors and public-health officials fighting the virus have confirmed human-to-human transmission, but it is too early to determine exactly how contagious the virus is – or how deadly.

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So far, 2019-nCoV seems to be passed through close contact, much like other respiratory viruses that can be spread through coughing and sneezing.

Andy Smith, the president of Sunnybrook hospital, emphasized how much better prepared Canada is for a new infectious disease than it was when SARS hit Canada in 2003, killing 44 people.

He called the prevention and control measures taken by paramedics, emergency-department staff and others in the hospital, “sophisticated” and “tremendous.”

In a statement, Federal Health Minister Patty Hajdu said that measures to mitigate the risk of introduction and spread of diseases like the new coronavirus in Canada are in place.

“While the risk of an outbreak of novel coronavirus in Canada remains low, I encourage Canadians to tell your health care professional if you have travelled to an affected area of China, and develop flu-like symptoms,” she said.

One major difference this time is that Chinese scientists sequenced the genome of the new virus quickly and shared it with the world, allowing Public Health Ontario and the National Microbiology Laboratory to swiftly develop their own tests to detect 2019-nCoV.

“The system is working,” Health Minister Christine Elliott said. “Ontarians can rest assured that the province’s integrated health care system today is far more prepared to respond to any potential health risks than in the past.”

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