Nova Scotia beats back COVID: but for how long?

On November 18, Nova Scotia’s success in beating back COVID-19 received international attention when The New York Times published a sunny assessment of life in the province.

Describing Nova Scotia as a “magical, virus-free world,” the writer noted the freedom she was enjoying. That included hosting a care-free dinner party where they toasted the chief medical officer of health, Dr. Robert Strang.

The author credited the success to geography, sacrifice and a reliance on epidemiology to help guide public policy.

That optimism was a common sentiment during the summer and fall in Nova Scotia. After joining much of the rest of Canada in a strict near-lockdown in March and requiring anyone coming into the province to self-isolate for two weeks, the province had by summer pushed new daily cases to at or near zero. In July, the four Atlantic provinces banded together to form an “Atlantic Bubble” in which residents could travel freely. With businesses open again, life seemed almost normal, and in September, students went back to school, seemingly with little risk.

But even before New Yorkers read about Nova Scotia’s success, the picture here was worsening.

You can also view a full-screen version of this chart.

On November 16, Nova Scotia announced its first two cases in schools. The next day, Premier Stephen McNeil said the province was facing a wake-up call.

“Covid is not just entering two of our schools, it is quickly creeping into a number of our neighbourhoods, particularly here in the central zone (of Halifax and West Hants),” he said. “It tells me we are not taking COVID seriously.”

The virus was on the loose again, and the fight to stop it was on.

The biggest sign of trouble was in Clayton Park, a suburb of Halifax.

“We had no community transmission for about five months and then we saw only cases linked to travel; then we started to see a few cases that weren’t linked to travel,” said Karina Top, an associate professor of community health and epidemiology at Dalhousie University.

“The reasonable conclusion from that, was that there had been people who hadn’t properly self-isolated and that had spread to others.”

Top said it was clear there was widespread community transmission once a second cluster was reported, as a result of two or more generations of transmission from the original travellers who didn’t isolate properly.

One sign of the growing problem was the increasing number of locations being publicized by the Nova Scotia Health Authority where people may have been exposed to COVID-19. Many of them were bars and restaurants in Halifax’s downtown, and provincial officials said young people congregating in social settings were a big part of the renewed spread. Scroll down on this map to see the progression:

Some of the restaurant and bar owners who had endured the long shutdown starting in March saw trouble coming and in November decided to switch to only offering takeout and delivery before they were told to do so.

The manager of Antojo Tacos + Tequila on Argyle Street in the heart of Halifax’s bar district, Lia Beveridge, found herself and her staff juggling hospitality and public safety.

“It was a very weird atmosphere because people were coming out of their homes and coming to our restaurant for an evening where they could escape,” she said. “You also have to make sure everyone is safe, clean everything like crazy and make sure everyone is wearing masks and people don’t move around so much.”

With cases climbing into the double digits and exposure warnings inching closer to her restaurant, Beveridge said her staff knew the inevitable. Antojo had to close.

And in stark contrast to industry pressure in other harder-hit provinces to keep restaurants open,
an industry group, the Restaurant Association of Nova Scotia called on the government to close Halifax restaurants, in an effort to gain control over community spread in the downtown core.

This map shows locations where there were potential exposures to COVID-19, starting at the end of October. The locations come from Nova Scotia Health Authority news releases. Click on the time icon to see an animation through time.

“Consumers started to lose confidence in going to restaurants overall,” said Gordon Stewart, executive director of the association. “If community spread did hit hard, the restaurants were just going to get hit a lot harder.”

It didn’t take long for the province to make it official.

“If we forgot how serious COVID-19 is, this is a stark reminder,” Strang said at a news conference on November 24. “We all need to work together to get ourselves out of this and we all need to start today, now.”

That day, Nova Scotia reported 37 new cases of the coronavirus, marking it the largest single-day increase since April 23. All but two were in the central zone.

The province announced new public health rules in Halifax Regional Municipality from Hubbards in the west to Porters Lake in the east, including clamping down on restaurants and bars, which could only open for takeout and delivery.

Fitness and recreational facilities, libraries, museums and gaming establishments such as casinos were also shut down. Retail businesses had to reduce the number of customers to 25 per cent of their legal capacity.

In doing this, Nova Scotia acted much more quickly than had some other provinces such as Ontario, Manitoba and Alberta.

“We have the advantage of being one of the last ones,” Strang said, “but if we look at where it’s happened they’ve instituted these tough measures later on in the course of the second wave. We do not want to be in the position that they are in where their health systems are overwhelmed, where public health is overwhelmed.”

Thank you to the restaurants and bars that have already made the hard choice to close to dine-in and to @RestAssocNS for this. Let’s do our best to support them: gift cards, take-out and a promise to return when we can. https://t.co/d902Xh29Kj

— Mayor Mike Savage (@MikeSavageHFX) November 24, 2020

Halifax councillor Waye Mason said he wasn’t surprised community spread would increase in his district, which includes the busy downtown bar scene.

“I was sad that we were not able to keep it from happening but not surprised, because those are the environments where you’re going to see it breakout.”

But Mason said 18- to 35-year-olds, who had been blamed for much of the spread, also started to become part of the solution.

Closing establishments where spread was likely was part of the province’s game plan, but so was an aggressive push to identify people with a COVID-19 infections, including those showing no symptoms.

The fact COVID-19 can be spread asymptomatically has made it a stealthy opponent.

Pop up rapid COVID testing for folks with no symptoms. It’s been a few days, Halifax! Swing by 🙂 12-5:30 pm. After all that increased contact over the holidays, time to confirm you’re neg 🙂 pic.twitter.com/UNt188TAUt

— Lisa Barrett (@LisaBarrettID) January 3, 2021

Young people flocked to the new pop-up testing sites, including ones using rapid testing techniques. The rapid tests are less accurate and need confirmation with a lab test but allow for speedy identification of those who may be infected.

“Students from all the universities were going to get rapid tests at (Dalhousie University’s) Sexton Campus,” Mason said. “It’s clear to me that more of them are concerned about their health and the wellbeing of others than they are worried about where the next party is going to be.”

Katie Redmond was one of those students.

On her way home from the gym, Redmond said she passed by a growing line near the Halifax Central Library. She noticed the sign offering rapid tests and decided to join.

After provincial wide rapid testing was introduced on November 21, McNeil said the first two weeks of rapid testing proved to be a success as the province conducted more than 7,000 rapid tests, finding 22 potential cases of COVID-19 from asymptomatic individuals.

When it came to waiting 45 minutes to get her test, Redmond said her family was her motivation.

“My parents have been pretty paranoid with me living downtown,” she said. “Most of the cases are in my age range but it was kind of just more so to give my family peace of mind.”

The upsurge also meant the end of the Atlantic Bubble and for Redmond, that meant no travel home to Newfoundland for the holidays.

Improvements

As November turned into December, it seemed the efforts were paying off. The number of cases of COVID-19 was on the decline and by the second week of December the daily number was in the single digits. At the same time, more cases were popping up in areas outside Halifax, and while exposure warnings had earlier been mostly in HRM, scattered potential exposures were showing up in parts of the province not included in the HRM restrictions.

On December 16, the province announced some of the restrictions in central region would be rolled back as of December 21 and since then there has been a further easing. Restaurants and bars are open province-wide, but must close by 11.

For the closed businesses, it was a necessary but difficult time.

“Mental health wise, it’s very stressful. You also don’t know if you’re going to get it, said Beveridge, who wanted to avoid putting her employees in harm’s way.

The first and second wave of restrictions have left her restaurant just covering its costs.

For Mason, it was a question of balancing public morale with public safety.

“If you don’t let people have some opportunities to get out of the house and do something to enrich their normal life, more and more people will break the rules because eventually they will just get frustrated, tired, and depressed. So, you’ve got to relax the rules when you can and ramp them back up again when you can’t, that’s the way it’s going to be.”

Since the start of 2021, the province has continued easing restrictions and in recent days case numbers have remained in the low single digits. The province has begun vaccinations, and a prototype community clinic was to open today at the IWK Health Centre. Ten more clinics, all for those 80 and older, will open throughout March.

Most of the new cases are again related to travel, though last week there were cases in Beaver Bank and New Minas of unknown origin and Nova Scotians have watched nervously as case numbers have climbed alarmingly in neighbouring provinces, first in New Brunswick and most recently in Newfoundland and Labrador.

“We’re not as safe as the numbers suggest,” said Top. “The outbreak in Newfoundland…a province which had very low cases since last spring, as well as the ongoing outbreak in New Brunswick, show us how quickly this virus can get out of control even when we are monitoring it closely.”

New Brunswickers wishing to come to Nova Scotia have had to self isolate for two weeks after arrival since January 9, and those from Newfoundland since February 10. With faster-spreading variants that in some cases may be resistant to current vaccines spreading in Canada, no one is letting their guard down.

As the first month of the new year drew near a close, Strang credited factors such as geography, lessons from other provinces, swift actions when necessary and a slow and cautious reopening for the continuing low case numbers.

And while the province may no longer be a virus-free world, it’s again getting favourable attention for its efforts.

“Just this morning I was sent an article from a German publication” said Strang in late January, “touting Atlantic Canada’s response to COVID and what a model it is.”

About the author

Travis Devonport

Travis is a freelance journalist and event photographer based out of Halifax, Nova Scotia.