Should you be worried about the release of the first Canadian coronavirus patient from hospital?

TORONTO -- The man who was diagnosed as Canada’s first confirmed case of coronavirus was discharged from a Toronto hospital Friday morning.

While the news may be jarring to some residents, CTV News' Infectious Diseases Expert Dr. Neil Rau says that there is little to worry about.

Q: How significant is it that the patient has been released?

A: I expected that we would ultimately release someone and that this is not really a big deal. People can’t stay in hospital forever just because they have an infection like this. They can isolate themselves at home and it shouldn’t be a problem.

Q: How long are people with coronavirus contagious?

A: What we don’t know is how long people stay contagious for and there’s a lot of research interest in monitoring such patients with daily tests to check the level of virus—when you take a swab from the nose—to see how many days it takes for that to go away. So there’s varying guidance on how long people remain contagious for, but I’ll give a ball park: Maximum is probably seven days, but we don’t exactly know yet.

Q: Was the W.H.O’s global health emergency declaration justified?

A: It’s justified but it’s mainly to help under resourced countries address this. I think there’s still an optimism that we can contain this if everybody does the right thing and some of the poorer countries that don’t have resources, don’t have the ability to do that. So if we didn’t have an emergency declaration, they wouldn’t be able to do it.

Q: How is the virus spreading in China?

A: The theory is that this virus is spreading only from people who are very sick who are in contact with close contacts. There is some emerging information that came out in the New England Journal yesterday suggesting that people with mild disease could actually be quite contagious or even those without symptoms maybe could be contagious. This may cause a lot of people to be scared, but it’s actually a form of good news.

The reason I say this is if someone has mild disease and they can spread it there might be a lot of disease that’s gone on under the radar that is not serious and that’s not causing serious infection, serious enough to bring someone to hospital.

So, maybe we’ve only identified the tip of the iceberg, the most serious cases, and there’s a whole ocean of mild disease out there. The other side of it though is that if people with mild disease can spread, it’s going to be very difficult to fully control the spread of this virus using the efforts we’re doing now. We may have to live with it and face the consequences, which may not be that bad anyway.

Q: What do you make of the way in which the Ontario government has handled the coronavirus?

A: I think we’re doing the right thing, for now. We’re assuming the worst case scenario. We are prepared as if this is a SARS-like virus. But if this turns out to be transmitted more like a typical respiratory virus like the flu, then maybe we need to rethink the strategy and maybe we can even relax the strategy—we’re not there yet.

Q: What is your message to Torontonians looking to purchase surgical masks in the wake of the coronavirus outbreak?

A: I think there’s an epidemic of fear and wearing a mask is pointless. There’s no way you can wear a mask continuously and have it be effective. You’ll start touching your face and nose and this and that. It’s not going to work. 

Q: Should I be worried?

A: This threat, if it’s really widespread in the community, is not a big threat. It’s another respiratory virus just like any other. If it’s not widespread in the community and it is a more dangerous virus like SARS, then really the problem stays contained to health care facilities and where people are the sickest and we can control it anyway. So, this is why quarantine isn’t very effective either.

This is why, frankly, people avoiding all travel to China is an overreaction as well. I mean, airlines are cancelling flights mainly for business reasons so they don’t want to fly empty airplanes because people are freaked out. But it doesn’t mean the virus has become meaner or that the disease is really that terrible.