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Cape Breton patient initially tested negative for COVID-19

Dr. Robert Strang, Nova Scotia's chief medical officer, wears a medically themed tie at the province's COVID-19 briefing on Wednesday, April 8, 2020. - Communications Nova Scotia
Dr. Robert Strang, Nova Scotia's chief medical officer, wears a medically themed tie at the province's COVID-19 briefing on Wednesday. COMMUNICATIONS NOVA SCOTIA PHOTO


SYDNEY, N.S. — The province’s first confirmed COVID-19 death initially tested negative for the illness and was treated in a non-coronavirus unit of the Cape Breton Regional Hospital, the province’s chief medical officer confirmed Wednesday.

The first death, a woman in her 70s with underlying medical conditions, died in hospital in the Eastern Zone as a result of complications related to COVID-19 on Monday.

“The test came back negative and therefore people felt the person wasn’t infected. The test was repeated due to a change in the individual’s status, which came back positive,” Strang said.

“As a result of that my understanding is there has been a directive at the health authority that anybody that has suggestions of respiratory illness, that COVID precautions need to be maintained around that individual, even if an initial test may come back negative,” Strang added.

Medical factors contributing to false negative tests include low viral load in the upper airway where the swab is taken and if there is more advanced disease in the lungs, he added.

Strang said the general test that is being used in the community is very accurate. He said it could also be that someone, if tested based on having some potential symptoms and is found to be negative, may later test positive because they were subsequently exposed.

A number of health-care workers who came into contact with the woman who subsequently died, in advance of stepped-up use of personal protective equipment in non-COVID-19 units, were asked to self-isolate.

Strang said exposed workers must be tested to ensure they are not infectious. He said they are looking at ways to bring them back to work sooner than the typical 14-day isolation period, with measures around regularly monitoring temperatures and daily screening.

“Having to pull numbers of people out of a workforce, whether it’s in a hospital or a long-term care facility creates significant strain on our healthcare system and challenges the ability to deliver essential care,” he said, adding they also have to ensure the safety of others.

“The test came back negative and therefore people felt the person wasn’t infected. The test was repeated due to a change in the individual’s status, which came back positive,” Dr. Robert Strang.

In his remarks, Strang said Public Health officials may follow up on reports throughout the day but are not prepared to confirm them for the daily afternoon briefings with Premier Stephen McNeil. He said each report of a possible death must be fully investigated before being confirmed.

“We don’t want unnecessary unvalidated rumours about somebody having COVID-19 or even someone dying of COVID-19 circulating around,” he said.

Strang said Tuesday that Public Health was working to identify anyone who may have been put at risk, whether it be another patient or a healthcare worker including testing and isolating individuals, if necessary.

Strang explained there is an electronic communications system and every positive test is assigned to a lead Public Health nurse.

“We understand when did that individual become sick and, during that time that they could have been infectious, and we’re now going through that 48 hours before they became sick. We work very carefully to see where were they, who did they interact with, whether it was a business they were working in, whether they had gone into a healthcare facility, whether they were a resident of a long-term care facility and then we make assessments about who are the people that we would consider who meet our definition of having been a close contact,” he said.

Those close contacts are then tested and steps are taken to minimize their chances of passing the illness onto others, Strang said.

As of Wednesday, Nova Scotia has 342 confirmed cases of COVID-19. Thirty-two new cases were identified Tuesday. There are 11 confirmed cases in hospital, with five in intensive care.

The QEII Health Sciences Centre's microbiology lab completed more than 700 Nova Scotia tests on Tuesday and is now operating 24 hours.

The list of symptoms being screened for has expanded. If you have two or more of the following symptoms, visit https://811.novascotia.ca/ to determine if you should call 811 for further assessment: fever, new or worsening cough, sore throat, runny nose or headache.

To date, Nova Scotia has 11,346 negative test results, 342 positive COVID-19 test results and one death. Confirmed cases range in age from under 10 to over 90.

There are 22 primary assessment centres in Nova Scotia: 21 operated by Nova Scotia Health Authority (NSHA) and one operated by the IWK Health Centre, temporary primary assessment centres are operating in two communities

Two mobile assessment centres are being established by NSHA to do community-based testing. Emergency Health Services operates two field assessment units: one in Halifax Regional Municipality and one in Cape Breton Regional Municipality.

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