N.L. adds 4 new COVID-19 cases as dozens told to isolate

There are four new cases of COVID-19 in Newfoundland and Labrador on Friday, including one connected to the Eastern Health region cluster announced Thursday.

Another new case in Eastern Health is travel-related. Both cases in the region are under 19 years old.

The Eastern Health cluster now has five cases, and Chief Medical Officer of Health Dr. Janice Fitzgerald said the health authority is still investigating to try to locate the source.

"Eastern Health is also contacting anyone who is a close contact of these cases, and we now have approximately 160 individuals who have been contacted by public health are in self-isolation as a result of being identified as a contact of individuals in this cluster,"she said.

The two other cases are in the Central Health region: one is a man between 40 and 49 years oldand is travel-related.Thatman, a resident of Newfoundland and Labrador, returned to the province from work in Nunavut.

The other case in the CentralHealth regionis a man between 20 and 39 and is connected to recent cases related to a Marine Atlantic ferry.He is self-isolating and contact tracing is underway.

Fitzgerald said the Marine Atlantic case is not unexpected, adding the investigation is ongoing. She asked anyone who travelled on the MV Blue Puttees between Dec. 29 and Jan.16 to contact 811 for testingif they had not already done so, even if they were not symptomatic.

There have been a total of three COVID-19 positive caseslinked to the ferry service. According to Marine Atlantic, all three people are Marine Atlantic employees who worked on the MV Blue Puttees. All threewere on the vessel when it made the crossing on Jan.16.

The vessel recently returned to service. Fitzgerald said anyone considered at risk had been in isolation, including Friday's new case.

The province has 13 active cases, and 79,289 people have been tested to date.One person is in hospital

Watch the full Jan. 29 update:

Fitzgerald said there remains a suspected case connected to a daycare in the Eastern Health region, but it has not yet been confirmed.

Asked about the delay in confirmation, Fitzgerald said she couldn't answer due to privacy reasons.She did, however,define what asuspected case is.

"A suspect case is a case that is symptomatic and linked in some way epidemiologicallyto a confirmed case. Suspect cases are tested, and then depending on the test result, if they're a positive test result, then they become a confirmed case themselves. If they're a negative test result then they're still a suspect case," she said.

"The way that we treat a suspect case doesn't change with their test result. We're still watching their contacts closely, we'll still test their contacts."

Figuring out the protocols

With a confirmed case of COVID-19 among her staff,the owner of a St. John's furniture store says her team is taking every public health precaution to keep people safe in the face of the latest cluster of the virus in the province.

Susan Drover didn't open SAM Design on Freshwater Road to the public on Wednesday morning, after a staff member informed her a person on their team had been exposed to another case of the virus.

"To be honest,Iimmediately panicked. My brainIdidn't know what to do," Drover, the owner of SAM Design.

The news came as "a complete shock," she said, and she needed to take a few minutes to process it.

"Itook fiveminutes to calm my brain down and realize that Ineeded to really step into control of what was happening," she told CBC Radio's St. John's Morning Show onFriday morning.

"Imade a fewphone calls and then when Irealized that it was a pretty, pretty serious situation, Icalled the staff back and said, 'OK, you guys are all going to go home. We're going to sort this out.'"

As of Friday morning, Drover said there wasone confirmed case of COVID-19 among her staff, with that person self-isolating. Close contacts among her team are also self-isolating, with everyone having been tested for the virus.

While it took several phone calls and sources to figure out the protocols, "we're just following public healthguidelines as to what to do, step by step by step by step," she said.

Fitzgerald said if public health officials feel there is a concern with a business itself, theywill advise the business on what to do, such as isolation for those involved.

OtherwiseFitzgerald said, general public health guidelinesremainin place, such as cleaning frequently touched surfaces, keeping employees home if they're unwell, providing hand sanitizer for staff and customers, and screening employees when they come in.

The store is now undergoing a deep clean before reopening to the public with a small team of staff who had no exposure and modifications in place.

"Public health has deemed us not to be a risk ot the public and Ithink that was a really, really important point for me, because Iwas really nervous to think, well, has this exposed any of our customers," Drover said.

The rumour mill

Asked why the Department of Health hasn't identified businesses that have had confirmed exposures,Fitzgerald said if there are public safety risks then information will be provided.

"We are constantly trying to balance privacy with public health and safety, and there are situations where we have to be especially cognizantof that," she said.

"At the moment our investigation hasn't brought us to a place where we feel we need to make those kinds of declarations."

Fitzgerald said the first criterion in deciding to alertthe public is determiningwhether a person who was inside a space was infectious at the time.

"So if somebody was in a place five days before they became symptomatic, they weren't infectious and so that's not at risk," she said. If it's determined someone was infectious while in a public place, "then you look at what they did there, how close were their contacts there, were they wearing a mask, how long were they in the place. That helps you to determine the risk of the public in that particular place," she said.

If the risk is low, she said, there's no danger to public safety and there's no need to make an announcement. If the risk is significant there will be an announcement.

Fitzgerald said the new cluster could be connected toanasymptomatic carrierorsomeone who had mild symptoms and didn't get tested because they didn't think it was anythingtoworry about. It could also be connected to someone who had been in the province, was sick and left again.

Source unknown

Drover said the SAM Design case is related to a cluster of cases announcedThursday in the Eastern Health region.

So far, public health's investigation hasn't turned up a source for the cluster of four connected cases, whichFitzgerald has called "worrisome," and said Thursday could originate as far back as New Year's.

Finding thesource requires an intense combing-through of past contacts and movements of these cases, according to aformer medical officer of health.

"When you're looking at this, you're going back as far as you think it's necessary to try and find a source. So that's what'shappening now, there's a lot of effort being put into this investigation," said Dr. Catherine Donovan, who is also a professor in Memorial University's medical school.

There may be a cluster, but there's only one unknown source involved, said Donovan, with it being too early to tell if there is community spread.

"The evidence so far would suggest that it is fairly confined and there may very well be a source that we just don't know about yet," she said Friday morning.

In the face of uncertainty and worry, Donovan said the best thing for the public to do is follow the established health guidelines, including handwashing, mask-wearing and keeping contacts low.

"If we're doing all those things, we shouldn't be so concerned. If we're not, we should be having a look at what we're doing and how we can better protect ourselves and others," she said.

The cluster may not necessarily be connected with a level of complacency in a province that has seen few cases in recent weeks, but Donovan acknowledged people's patience with continued pandemicpractices is wearing thin and urged vigilance in the months prior to widespread vaccination.

"People are tired, but we really need to persevere throughthis," she said.

Read morefrom CBC Newfoundland and Labrador