How Should We Fight Coronavirus in Saskatchewan (我们该如何应对萨斯喀彻温省的冠状病毒)?

How Should We Fight Coronavirus in Saskatchewan?

Abstract: On 18 March 2020 the Saskatchewan government declared a state of emergency in response to more confirmed cases of COVID-19 in the province. Many cases are linked to travel and public gatherings except for a few, with seniors a higher possibility to catch it. In order to curb community transmission, many strict measures have been taken. Restaurants are ordered to serve takeaways only, and schools are shut down. International travels by government employees will be prohibited and domestic ones restricted. Different models have been analyzed, and the Singapore Model and South Korean Model are recommended for study with their fast response, sufficient test kits, measures in advance and use of high technology to track patients and contacts while keeping businesses and schools open. The writer recommends taking precaution and screening measures at airports and all other public facilities and restricting non-essential travel. Face-masks, gloves and glasses are encouraged as the virus can stay in the air for 3 hours though panic shopping should be criticized and fined. It is high time to cooperate in solidarity and stop blaming or discriminating against each other as this is a global virus that many countries and many people suffer no matter what your status is. By gathering and allocating resources optimally, keeping the public informed and confident in what the government is doing, and making decisions based on facts, experience of others and reasoning, Saskatchewan can pass this dark tunnel and see the light ahead again.

Key Words: Coronavirus, precaution and screening, patient tracking, transparency and public confidence

1. Situation

On 18 March 2020 Saskatchewan declared a state of emergency in response to eight new cases of COVID-19 in the province (with a provincial total of 16)[1]. This is the beginning alert prompted to the writer to write this report.

On 17 March 2020, six new presumptive positive cases of coronavirus (also called COVID-19 later) were identified in Saskatchewan, bringing the total number of cases in the province to eight, adding to the original two in Saskatoon in their in their 60s who had recently travelled to Egypt and Oregon. One resident, a health care worker in their 30s, had a recent history of travel to Nigeria and Germany, as well as Alberta. The individual is recovering in northern Saskatchewan[2].

Two presumptive cases were in their 40s and live in the same household in Regina. One recently travelled to Vancouver for a dental conference at which an attendee was later confirmed to have COVID-19.  The two Saskatchewan residents were tested March 13 and are self-isolating while they recover.

The fourth new case was an individual in their 20s with a history of travel to Tennessee, U.S., who was tested in Regina and is now self-isolating and recovering in their home community.

The fifth was a man in his 60's, who had been recently in Arizona and was tested in Regina. They added the person is currently in hospital due to unrelated medical issues[3].

The sixth was a man in his 50’s, who traveled to Vancouver for the same dental conference as the 4^th mentioned above[4].

 

On 18 March 2020, eight new, presumptive positive cases of novel coronavirus were detected in Saskatchewan, bringing the current provincial total to 16 cases. According to the provincial chief medical health officer, one investigation had not yet demonstrated a link to travel, which could signal local transmission; one got infected by close contact with a previous case; the others got infected through travel either to Vancouver or somewhere else in North America. Of the 8 new people, 3 were in Saskatoon, 3 in Regina, 1 in Moose Jaw and 1 somewhere else in SK. Fifteen of the sixteen cases are currently well enough to self-isolate at home[5].

On 19 March 2020, four new presumptive cases[6] were related to travel including Dr. Woo, president of the Saskatchewan Medical Association, who contracted the virus at a curling bonspiel in Edmonton, and one was a close contact of a known case. On 20 March 2020 six new cases include two in their 20’s and two older people from Regina, as well as a couple from Prince Albert, all had traveled recently out of Canada except for one[7]. However, it seems that many cases may not be discovered due to the limit of test kits. As of 20 March 2020, 3093 tests had been performed[8]. On 21 March 2020, 17 new confirmed cases and one presumptive case were reported. Most of the cases were related to people travelling or attending group events including a dental conference, a funeral and a curling bonspiel in Alberta with 11 tested positive out of 22 attendees in SK. However, 3 people who had tested positive for COVID-19 did not travel, nor did it appear as if they had attended any mass events. The new jump in cases came from the province’s ability to confirm testing for COVID-19 at its Roy Romanow Provincial Laboratory (RRPL), located at University of Regina[9]. On 22 March 2020, there were 8 new confirmed cases, including a teenager[10]. On 23 March 2020, there were 14 confirmed new cases, including a child[11]. On 24 March 2020, there were 8 confirmed new cases, including one more case of unknown exposure, suggesting community transmission and need of more precautions[12]. On 25 March 2020, there were 14 confirmed new cases, with two of the newest cases involve patients 19 years of age and under, bringing the total in that age group to four. The highest numbers continue to be in Saskatoon, with 41accumulated reported cases[13]. On 26 March 2020, there were 9 confirmed new cases, with one additional case of local transmission[14].

Saskatchewan COVID Cases

	Mar-12	Mar-13	Mar-14	Mar-15	Mar-16	Mar-17	Mar-18	Mar-19	Mar-20	Mar 21	Mar 22	Mar 23	Mar 24	Mar 25	Mar 26
Confirmed	0	0	0	0	1	2	2	8	8	25	33	66	72	86	95
Presumptive	1	2	6	6	6	6	14	12	18	19	19	1	0	0	0

Source: See Note vi, viii and ix, xi, xii & xiii.

Summary of COVID-19 Cases as of 22 Mar 2020

Region	Total Cases	Confirmed Cases	Presumptive Cases	Deaths
North	3	2	1	0
Central (excluding Saskatoon)	4	0	4	0
Saskatoon	21	17	4	0
South (excluding Regina)	5	3	2	0
Regina	19	11	8	0
Total Saskatchewan	52	33	19	0

Source: See Note ix.

Summary of COVID-19 Cases as of 26 Mar 2020

Region	Total Cases	Confirmed Cases	Hospitalization	Recoveries	Deaths
North	3	3	0	0	0
Central (excluding Saskatoon)	13	13	0	1	0
Saskatoon	44	44	2	1	0
South (excluding Regina)	7	7	0	1	0
Regina	28	28	3	0	0
Total Saskatchewan	95	95	5	3	0

Source: Adam Hunter and Guy Quenneville: Sask. COVID-19 case details expand after Premier Scott Moe pledges more transparency, CBC News, March 26, 2020, please click to view the article https://www.cbc.ca/news/canada/saskatchewan/sask-covid-case-detail-1.5511231.

Coronavirus Infection Rate per 100,000 across Canada as of 19 Mar 2020

Province	BC	AB	SK	MB	ON	QB	NL	NB	NS	PEI	YT	NT	NU
Rate	4.5	2.7	0.2	1.1	1.5	1.1	0	0.3	0.3	0.6	0	0	0

Source: Coronavirus: How COVID-19 is spreading across Canada by Patrick Cain, 20 Mar 2020, Global News, please take time to read the whole article by clicking the link: https://globalnews.ca/news/6700788/coronavirus-covid-19-canada-cases-data/.

Of the 1075 Canadian cases reported as of 20 March, 54% of cases are travellers and 10% are close contacts of travellers, and 29% of cases are 60 years old and over, and only 12 people in Canada have died of COVID-19. However, the data for travelers and close contacts are changed to 44% and 7%, while community setting has become also 44% as of 22 March 2020. Common symptoms of COVID-19 include respiratory symptoms: fever (58%), cough (81%), shortness of breath (26%), and breathing difficulties[15]. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death. Older people or those with chronic illnesses may be at higher risk. There is no specific treatment for disease caused by a novel coronavirus. However, many of the symptoms can and should be treated.

2. Arrangement

As of March 20, 2020, the Provincial Government has announced the following prevention and precaution measures[16]:

• All persons returning from international destinations, including the U.S., are required to self-isolate for 14 days upon return to Canada (not allowed to go to work, school and public areas such as churches, stores, shopping malls or restaurants, with truckers, airline, rail, and work crews that are required to work in order to maintain business continuity who are supervised by Infection Prevention and Control Officers or Occupational Health and Safety in the workplace exempted[17]) and breach to this may result in legal consequences including a fine of $2,000 or imprisonment of 6 months for a second offender or both 
• Mandatory self-isolation for any person flagged by the province as a close contact of a COVID-19 case
• All gyms, fitness centers, casinos and bingo halls, arenas, curling rinks, swimming pools, galleries, theatres, museums, all other recreational and entertainment facilities, all "personal service facilities" including tattooists, hairdressers, barbers, acupuncturists, acupressurists, cosmetologists, electrologists, estheticians, manicurists, medicurists, suntanning parlours, relaxation masseuses, body piercers, dentist offices (except for non-elective procedures like emergency or essential procedures) will be closed until further notice
• The closing of nightclubs, bars and lounges except for takeouts, as long as they respect the same two-meter distancing rule
• The closing of all restaurants, food courts, cafeterias, cafes and bistros except for takeouts respecting the same two-meter distancing rule, effective 23 March 2020 (in Regina effective immediately on 20 Mar due to the 5 people limit though the province said otherwise[18])
• Effective on 26 March 2020, face-to-face services to the public will be stopped from the following businesses: clothing stores, shoe stores, flower shops, sporting goods stores, adventure stores, vape shops, boats, ATV or snowmobile retailers, gift and book stationary stores, jewelry stores, toy stores, music stores, entertainment stores, pawn shops, and travel agencies[19]
• All public schools in the province will close indefinitely
• Child care centers within schools will be closed to the public and each room in other day care centers should have no more than 8 children
• No public or private gatherings over 10 people effective on March 26 (with the condition of some contact with international travelers removed, the number changed from 25, the private group added , except for families in the same household, and where critical public and business services are conducted yet practicing self-monitoring or supervision by Infection Prevention and Control Officers[20], and the more stringent number 5 in Regina, with some certain exceptions abiding by the two-meter rule[21])
• Closure of dental offices in the city except for emergency or essential procedures
• No visits to hospitals, clinics, community or continuing care facilities except for compassionate reasons as shown below (with a stricter requirement than just excluding recent domestic travelers with symptoms)
• All non-urgent/elective surgeries, procedures and diagnostics will be discontinued or rescheduled
• People are encouraged not to take buses, taxis or ridesharing and to not have visitors in the home
• International travels by government employees will be prohibited and domestic ones restricted
• Travelers returning from within Canada are advised to self-monitor for 14 days upon return
• For patients who are in critical care or high acuity units in SHA hospitals, visitors will be restricted to one at a time, unless extenuating circumstances exist

New virtual services, which will be supported through a new payment code for physicians, will enable patients to connect with physicians by telephone or secure video effective immediately. Provision of virtual care by telephone or video is just one strategy the provincial government is using to ensure residents have options for accessing health care.

Teachers and staff can work from home or in schools as scheduled during the class cancellations.  For the rest of the scheduled school year, the Ministry of Education will work with School Divisions and Saskatchewan Teachers to implement a supplemental curriculum program through distance and alternative learning methods.  While this supplemental curriculum will have no impact on final grades, it will ensure that students seeking to continue learning will have the resources necessary to do so.

It is urged for people ONLY to call HealthLine 811 if they have symptoms and need to be assessed. It is not encouraged to call just to see how busy the line is - this impacts others trying to call who require help.

Premier Scott Moe said, "we can all do our part to reduce the risk to ourselves and others by washing often, practicing social distancing, staying home if we are not feeling well and seeking medical advice to determine if we need to be tested." Sneezing or coughing into a tissue is another thing to note.

3. Reasons for New Measures:

On Sunday, March 15, the Chief Medical Health Officer indicated that school closures would be based on a number of factors including:

• Evidence of sustained transmission within the community

• Rapid increase of local cases

• Transmission without a known link to travel or confirmed cases

There continues to be inadequate evidence that all of the above three criteria have been strictly met. However, experts believe that the novel coronavirus can be spread by a person who is not showing any symptoms, though such transmission is considered rare. A preventative and proactive approach of school closures beginning on March 20 means reducing the risk of COVID-19 transmission though evidence shows children have a lower risk of getting the virus though many countries like Singapore and South Korea still keep the schools open.

4. Comparisons of Models Coping with Coronavirus[22]

1) The English Model

With limited resources, the public is not encouraged for large-scale testing and doctor visits. It is recommended that the elderly limit their actions, establish herd immmunity, and eventually make the virus get weaker or die. The British government now wants every Briton over the age of 70, the most vulnerable age group, to stay at home for around three months. Prime Minister Johnson has also urged "non-essential contact" with others and all unnecessary travel to stop. Yet pubs, restaurants, schools and entertainment venues remain largely open. After researchers at Imperial College London projected that around 250,000 people in Britain would die if "chains of transmission" for the virus weren't immediately slowed or broken, Johnson dramatically changed his tactics.

2) The Singapore Model

This model focuses on the government tracking every new crown patient and all contacts, while light patients mainly rely on self-isolation and only go to hospital in severe cases, and keep living and working as normal as possible, demonstrating vigilance and rapid response with testing, isolating the sick, tracing contacts, quarantining those exposed and providing reliable information to the public. The country has an excellent health system; strict virus testing, tracing and containment programs; a small population; and citizens who are largely accepting of what the government orders to them to do. Singapore has about 200 cases and no deaths, and its rate of recoveries has outpaced infections. Singapore has allowed businesses and some universities to stay open but with very strict guidelines about the size of gatherings (25 or under). Singapore has also managed to keep its schools open throughout. They take prudent steps at prevention, but they haven't entirely shut the country down with rich experience fighting SARS.

3) The Japanese Model

This model does not advocate large-scale testing, except for those with symptoms, and the system is highly dependent on citizen self-discipline. Japan has imposed travel restrictions and encouraged social distancing while keeping restaurants and bars and other businesses open and not locking down the cities.

4) The Israeli Model

The Jews have a born sense of crisis. Equipped with a highly advanced medical system, a great population of educated people with a high attachment to solidarity, and a widely connected monitoring system, they have been very successful in controlling the incoming disease. The border is closed to all foreigners. Internal security service digital tools are used to keep track of sick Israeli citizens. Developments are being made to create a “special shield and separate ventilation” to protect ambulance drivers transporting coronavirus patients, and develop advanced software to improve efficiency of lab checks for testing kits[23]. Though it deviates from the agency's typical operations, but the goal is still in line with its overall mission of saving lives.

5) The German Model

Authorities in Germany have adopted relatively strict measures, including closing all schools and day-care centers. Events with more than 50 people have been banned. Museums, movie theaters, gyms, swimming pools and nightclubs have also been temporarily shuttered, and overnight stays at hotels becomes illegal unless necessary and not for tourist purposes. The borders with Austria, Switzerland, France, Luxembourg and Denmark have also been closed[24].

According to statistics from Johns Hopkins University in the United States as of 24 March 2020[25], there were 32,723 confirmed cases of coronavirus disease (COVID-19, Wuhan pneumonia), and 152 died in Germany. The mortality rate in Germany is only 0.5%, which is lower than that of neighboring countries (with France hitting 4.3% and the United Kingdom 5%), and far lower than the severely infected Italy (at 9.5%). According to data released on 23 March 2020 by public health authority the Robert Koch Institute, the average age of those diagnosed with this coronavirus in Germany, was 45 years old, and the average age of death was 82 years old.

Experts believe that the following may be the reasons for the low mortality rate. The first is the inspection capability. Christian Drosten, Germany's foremost virus expert and director of the Charité Virus Institute in Berlin, developed reagents in January, allowing 47 laboratories across the country to establish early the testing capability. Health Minister Jens Spahn recently revealed that Germany can test up to 200,000 people per week, and that the detection capacity continues to expand. As long as the patient has symptoms such as dry cough, fever, and dyspnea, and has recently been in a high-risk area such as Italy or has been in contact with an infected person, the doctor can judge if a test is necessary, and the cost will be borne by the health insurance company. Drosden therefore speculated that Germany may be the country with the highest number of people tested, and the difference between the number of people tested and the actual number of infected people is not large, which is conducive to the government's planning of corresponding epidemic prevention measures. Another possible cause is medical resources. Even with the statistics in 2017, Germany has 28,000 beds for critically ill patients, with an average of 34 per 100,000 people, which is three to five times the number of European neighbors. In response to a possible increase in the epidemic, Germany is planning to double its number of beds. Germany's critical care medicine is more advanced than most countries as well, and doctors are particularly experienced in treating severely ill patients with respirators.

6) The South Korean Model

This model emphasizes large-scale exact testing to rule out presumptive cases and strict monitoring once found positive. Restaurants are also open and there is no lockdown. In the interview by BBC on 22 March 2020, South Korean Foreign Affairs Minister Kang Jyung-wha mentioned that they have an open and transparent wired system connected with phone apps to monitor every case and inbound and outbound traffic so as to minimize the spread, lower the mortality rate and maintain public confidence. Another good point is that they are very quick to produce the reagent and the equipment for the test. According to data on March 17, there were 82 deaths in South Korea, with a mortality rate of only 0.99%, which is far below the global average. Through efforts, their daily increase of cases has dropped from 909 to 98[26]. Why is this happening? This is because South Korea's control measures are very simple and effective - free testing by the entire population and open and transparent epidemic information as well. It can be said that these two simple methods are difficult for some countries in Europe and the United States. This also results in many minor symptoms in the United States, or suspected cases not being tested, in which case it may be more likely to cause a large infection[27].

7) The Chinese Model

This model lays emphasis on a full shutdown, strict prevention of death, and control to all entries. China enacted sweeping measures that forced people inside for weeks, banned all forms of public gatherings and mobilized almost 20,000 medical staff from all over the country to Hubei. At the virus's peak, 120 million school kids were taught online. One excellent idea is that they isolated the sick in large stadiums and other venues for observation and treatment. Now China has no more increases in domestic cases. Another thing Canada should learn is their efficiency. It was not an easy task to build an emergency infectious disease hospital in just 9 days which covers a total area of 50,000 square meters with a floor space of 33,900 square meters, involving over 6,000 constructors in shifts, and nearly 1,000 large-scale machinery and vehicles working at site around the clock, demonstrating their ability of mobilizing resources, coordinating and on-site trouble shooting[28]. For a n emergency hospital of 500 beds to be built in Western countries, it may take 2 years.

8) The US Model

This model relies on how the government and private sector cooperate to obtain and allocate resources, manage staff and determine the scope and methods of self-restriction while trying to expand the scale of tests to meet the need.

How Countries Responded to COVID-19

Nation	Travel Restrictions	Social Distancing Encouraged	Restaurants/Bars Officially Closed	Widespread Testing	Lockdown
Britain	√	√	×	×	×
Singapore	√	√	×	√	×
Japan	√	√	×	×	×
Israel	√	√	√	√	√
Germany	√	√	√	√	×
South Korea	√	√	×	√	×
P. R. China	√	√	×	×	√
US	√	√	√	×	×

Source: See Note viii with some revisions from recent updates.

While the above models different models may be effective for their own countries, it does not mean any model may be automatically suitable for Canada even if they have shown very good results of control. The author put forward the following factor of consideration for the choice among different models: a) government credibility and capacity to command resources; b) ability to leverage on hi-tech; c) the public’s tendency to follow rules; d) availability of medical resources; e) the government’s speed of response to cope with emergencies; f) the ability for businesses to sustain losses of business closedown and interruption of trade.

5. Reflections on the Measures

1) Teachings from the Models and Other Provinces’ Practice

The writer admires the Singapore Model and the Israeli Model, and urges the government officials to consider the following things before they decide on any measures: 1) the cost to be spent and the resources to be used in fighting the plague, both direct and indirect (including medical workers, protection equipment and hospital beds), both visible and invisible like the opportunity cost; 2) measures taken quick enough to prevent the spread which include test kits available and made use of (the number of tests done in Alberta is 6.58 times that of Saskatchewan though its population is only 4 times that of SK, which is obtained by dividing the Alberta tests number of 20360 as of 20 Mar 2020[29] by the number in SK mentioned previously, partly proving Alberta has been conducting among the highest number of tests per capita worldwide); 3) the speed to cure patients as we need to do things in advance (note that Albertans started to see patients who had recovered from COVID-19 with three individuals reported so on 20 Mar 2020[30]); 4) the future impact to the economy, especially some of the key industries; 5) the use of technology in treating patients without direct contact and tracing those infected and releasing information about location, age and the footings of the patient as urged by FSIN while not compromising privacy protection in general; 6) measures taken to keep the public informed and confident (in Alberta, for example, a more detailed breakdown of positive cases by region, age and sex is reported to the public though the reporting across Canada is not consistent[31]).

2) Observations

Proper precaution should be taken in Saskatchewan with the rapid spread of the coronavirus pandemic in Canada. However, when some travelers passed through international customs in Saskatoon recently, they were shocked to see that the border officers did not have any protection including gloves or masks despite their direct one-on-one interaction with each traveler, nor performed any hand cleaning between interactions. Secondly, at customs no temperatures were being monitored, health questionnaire taken, proper step by step information about how to self-isolate given out to the public, nor written self declarations filled about their health condition. Thirdly, international travelers should automatically self-isolate for two weeks no matter whether they come back by plane or not. Fourthly, travelers and non-travelers should have no physical contact and a minimum of two meters separation (note that Switzerland says people in groups of fewer than five must stay at least two meters apart, or face a fine[32]), and the international entry and the domestic entry should be treated with quarantine facilities of different degrees, which is not observed. COVID-19 is not a “slightly worse” flu and it is dangerous to assume that fact. The current death rate of the Italian coronavirus is 7%, much higher than the flu’s 0.1% mortality rate. Last but not least, the government should try to foster confidence among the public and balance the fight against the pandemic and the economic development (examples can be borrowed from Singapore and South Korea). Panic shopping should be discouraged, and may be fined for malicious speculation purchases. The writer has observed that even toilet paper is run out in many shopping centers, which will cause inconvenience for consumers; send a speculation signal to the public causing both panic and short supply, and in turn shoot the price higher; and also cause huge waste as some products have a valid date (note that 55 million N95 face masks in Ontario have been wasted as they pass the valid date after the government bought them during the SARS crisis[33]). Presently, Walmart in East Regina has carried out a new policy which limits the quantity a customer can buy an item of high demand to one, and this should be applaused.

3) Protocol to Be Followed

(1)Avoidance

a. Travel Ban

Travel ban should be carried out except for essential ones or ones engaging important trade of essential commodities, medical or food supplies or medical teams. Conferences should be delayed or held online.

b. Cancellation of Big Events

This involves any gathering of more than 25 people.

(2)Protection

a. Immune System Boost

Residents should be encouraged to maintain a good life style including a good diet, exercises and proper take-in of Vitamins and minerals. Ginger and tea should be promoted.

b. Screening

This is important both to protect medical workers and senior patients and to deter the spread of the virus. In Alberta, each essential visitor must be verified and undergo a health screening prior to entering a hospital or a senior’s facility, including a temperature check or doing a questionnaire. Facilities in Alberta have security staff or a greeter to conduct this screening and verify the visitor is designated.

c. Equipment

Face masks and gloves are advised to be worn as the virus can stay in the air as the researchers found that infectious viruses could remain in the air for up to three hours when they used a nebulizer to blow coronavirus into the air.[34].

(3)Final Cure

a. Root Cause Finding

The COVID-19 virus, although not as lethal as SARS, has proved much more pervasive. In three months, COVID-19 has killed more than five times as many people as SARS[35]. The virus appears to have originated in the Huanan Seafood Wholesale Market of Wuhan, a city of 11 million people in central China, with 2/3 of the patients having shopping experience there. Nevertheless, the very first patient identified had not been exposed to the market, suggesting the virus may have originated elsewhere and been transported to the market. On Feb. 22, a report by the Global Times, a Chinese state media publication, suggested the Huanan seafood market was not the birthplace of the disease citing a Chinese study published on an open-access server in China.  There are many speculations on the cause of the virus. The novel coronavirus also shares 80% of its genes with the previous SARS virus and 96% of its genes with bat coronaviruses[36]. Furthermore, genomic comparisons suggest that the SARS-Cov-2 virus (which causes COVID-19) is the result of a recombination between two different viruses, one close to RaTG13 and the other closer to the pangolin virus. For recombination to occur, the two divergent viruses must have infected the same organism simultaneously. Two questions remain unanswered[37]: in which organism did this recombination occur? (a bat, a pangolin or another species?) And above all, under what conditions did this recombination take place? Vineet Menachery, a virologist at the University of Texas Medical Branch, says the virus does have differences in the key areas that you would expect will influence its ability to infect humans[38]. Many cases found in Italy, Iran and Japan had no travel history in China or any contact with the Chinese people. Also, strange pneumonia appeared in Lombardy of Italy even last November, long before the Wuhan outbreak[39]. Some experts have grouped the virus into 5 family members: A, B, C, D and E, with A and B the parents, C the son, and the rest children of C and all of the family members can be found in the US[40]. Furthermore, CDC in the US mentioned once that many previous cases of the flu may be coronavirus, which was proved by related reports[41]. Wherever it originated, it is vital for us to tackle the global problem and eradicate the root together, instead of blaming each other.

b. Vaccine Development

A vaccine is needed to both curb the spread and to prevent it from returning. However, Dr. Soumya Swaminathan the chief scientist of WHO, said that the “risk is always there, and I think the population needs to understand that and feel confident that mechanisms are being put in place to study some of those things.”[42]Our job should be to reduce the risk as much as possible and let the public make an informed decision.

6. Conclusion

Coronavirus has already come so rapidly that Saskatchewan is now in a state of emergency. By gathering and allocating resources optimally, keeping the public informed and confident in what the government is doing, by making decisions based on facts, experience of others and reasoning, Saskatchewan can pass this dark tunnel and see the light ahead again.

我们该如何应对萨斯喀彻温省的冠状病毒？

摘要：2020年3月18日，萨斯喀彻温省政府宣布进入紧急状态，以应对该省更多确定的COVID-19病例。除少数案例外，许多案例都与旅行和公共聚会有关，而老年人则更有可能患上这种疾病。为了遏制社区传播，政府已采取了许多严厉的措施。餐馆被命令只提供外卖，学校也被关闭。政府雇员禁止进行国际公务旅行，国内旅行也被限制。本文分析了不同的冠状病毒应对模型，推荐研究新加坡和韩国模型，因为它具有快速响应、充足的检测试剂、提前采取措施以及使用高科技跟踪患者和联系人、同时保持企业和学校开放的优势。作者提议在机场和所有其他公共场所采取预防和检查措施，并限制不必要的出行。由于这种病毒可以在空气中停留3个小时，作者鼓励使用口罩、手套和眼镜，而对抢购进行批评和罚款。现在是团结合作并停止互相指责或歧视的时候了，因为这是一种全球性病毒，许多国家和人民都会遭受痛苦，无论你是否穷富以及是否有地位。通过最佳地收集和分配资源，让公众了解政府的行为并充满信心，通过在事实、他人的经验和推理基础上做出决策，萨斯喀彻温省可以越过这条黑暗的隧道，重新看到前方的光明。

关键词：冠状病毒，预防和筛查，患者追踪，信息透明和公众信心

---

[1] Saskatchewan Government: COVID-19: Saskatchewan Declares State of Emergency, Imposes Additional Measures to Protect Saskatchewan Residents, 18 March 2020, please click the link: https://www.saskatchewan.ca/government/news-and-media/2020/march/18/covid-19-state-of-emergency.

[2] Newsletter from Ken Cheveldayoff, MLA, on March 16, 2020, except for otherwise mentioned; Saskatchewan Government: COVID-19: Eighth Presumptive Positive Case Recorded, also view https://www.saskatchewan.ca/government/news-and-media/2020/march/17/covid-19-case-8.

[3] David Giles: Saskatchewan reports 7th presumptive case of coronavirus, Global News, 16 March 2020, please read the full article by clicking the following webpage link: https://globalnews.ca/news/6685561/confirmed-presumptive-cases-covid-19-saskatchewan-coronavirus/.

[4] Guy Quenneville and Haiti Netter: COVID-19 in Sask: Province announces 8th case, CBC Saskatoon, March 17, 2020, please read the full article by clicking the following webpage link: https://www.cbc.ca/news/canada/saskatoon/covid-19-saskatchewan-tests-1.5500068.

[5] Austin Davis: Sask. declares state of emergency after eight new coronavirus cases, Regina Leader-Post, 18 March 2020, please also read the whole story by clicking the following link: https://leaderpost.com/news/saskatchewan/covid-19-live-updates-03-18/?from=groupmessage.

[6] Michaela Soloman: Four new cases of COVID-19 in Sask, CTV Regina, please read the article https://regina.ctvnews.ca/four-new-cases-of-covid-19-in-sask-1.4859971.

[7] Guy Quenneville: COVID-19 in Sask: Premier threatens international travelers who don't self-isolate with arrest, fines, CBC Saskatoon, 20 March 2020, please also read the whole article https://www.cbc.ca/news/canada/saskatoon/saskatchewan-coronavirus-1.5504240.

[8] Saskatchewan Government: Cases and Risk of COVID-19 in Saskatchewan, 20 Mar 2020, https://www.saskatchewan.ca/government/health-care-administration-and-provider-resources/treatment-procedures-and-guidelines/emerging-public-health-issues/2019-novel-coronavirus/cases-and-risk-of-covid-19-in-saskatchewan.

[9] Mickey Djuric: Coronavirus: Saskatchewan reports 18 new COVID-19 cases, province totals 44, Global News, 21 March 2020, please take time to read the whole story by clicking the link: https://globalnews.ca/news/6713523/coronavirus-saskatchewan-new-cases/.

[10] Michaela Solomon: 8 new cases of COVID-19 in Sask., total at 52, CTV News Regina, 22 March 2020, https://regina.ctvnews.ca/8-new-cases-of-covid-19-in-sask-total-at-52-1.4863521.

[11] COVID-19 Update: 14 new confirmed cases in Saskatchewan, Humbolt Journal, 23 March 2020, https://www.humboldtjournal.ca/news/covid-19-update-14-new-confirmed-cases-in-saskatchewan-1.24104382.

[12] Thomas Piller: Coronavirus: Saskatchewan reports 6 new COVID-19 cases, bringing total to 72, Global News, 24 March 2020, please also read the whole story by clicking the link: https://globalnews.ca/news/6726305/coronavirus-saskatchewan-covid-19-cases-march-24/.

[13] David Giles: 14 new COVID-19 cases in Saskatchewan, total reaches 86, Global News, 25 March 2020, https://globalnews.ca/news/6732583/covid-19-cases-saskatchewan-coronavirus-march-25/.

[14] Saskatchewan Government: Nine New Confirmed COVID-19 Cases in Saskatchewan, 26 March 2020, please also take time to read the whole article by clicking the following link: https://www.saskatchewan.ca/government/news-and-media/2020/march/26/covid-19-update-march-26.

[15] CultMTL: There are 1,075 COVID-19 cases across Canada, 20 Mar 2020, please also read https://cultmtl.com/2020/03/cases-province-canada-covid-19-coronavirus-map/; Government of Canada: Epidemiological summary of COVID-19 cases in Canada, 22 March 2020, also view:

https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals/epidemiological-summary-covid-19-cases.html.

[16] Austin Davis: Sask. declares state of emergency after eight new coronavirus cases, Regina Leader-Post, 18 March 2020, please also read the whole story by clicking the following link: https://leaderpost.com/news/saskatchewan/covid-19-live-updates-03-18/?from=groupmessage; Newsletter from Ken Cheveldayoff, MLA, on March 16, 2020; Guy Quenneville: COVID-19 in Sask: Premier says international travelers must now self-isolate or face legal consequences, CBC Saskatoon, 20 March 2020, please also read the whole story by clicking the following link: https://www.cbc.ca/news/canada/saskatoon/saskatchewan-coronavirus-1.5504240.

[17] Saskatchewan Government: Government Clarifies Allowable Business Services, Limits Gatherings to 10 Person Maximum, 25 March 2020, please also read the whole article by clicking: https://www.saskatchewan.ca/government/news-and-media/2020/march/25/allowable-business-services.

[18] Mickey Djuric: Saskatchewan municipalities can’t make up their own coronavirus regulations: province, Global News, 22 March 2020, please also read the whole story by clicking the link: https://globalnews.ca/news/6716266/coronavirus-saskatchewan-municipalities-regulations/.

[19] Michaela Solomon: Here's a list of businesses that have to stop providing public-facing services in Sask., CTV New Regina, 25 March 2020, please also click the link to check the list: https://regina.ctvnews.ca/here-s-a-list-of-businesses-that-have-to-stop-providing-public-facing-services-in-sask-1.4868161.

[20] Saskatchewan Government: Nine New Confirmed COVID-19 Cases in Saskatchewan, 26 March 2020, please also take time to read the whole article by clicking the following link: https://www.saskatchewan.ca/government/news-and-media/2020/march/26/covid-19-update-march-26.

[21] Saskatchewan Government: Government Clarifies Allowable Business Services, Limits Gatherings to 10 Person Maximum, 25 March 2020, please also read the whole article by clicking: https://www.saskatchewan.ca/government/news-and-media/2020/march/25/allowable-business-services.

[22] Kim Hjelmgaard: These countries are doing the best and worst jobs fighting coronavirus, USA Today, 17 March 2020, please also read the whole article by clicking the following link: https://www.msn.com/en-sg/news/world/these-countries-are-doing-the-best-and-worst-jobs-fighting-coronavirus/ar-BB11pRo6?li=BBr8Cnr; Nicholas Kristoff: The Best-Case Outcome for the Coronavirus, and the Worst, 20 March 2020, New York Times Sunday Review, please click: https://www.nytimes.com/2020/03/20/opinion/sunday/coronavirus-outcomes.html.

[23] Israel’s top secret military intelligence unit breaks cover to tackle coronavirus, Arab News, 22 March 2020, https://www.arabnews.com/node/1645291/middle-east.

[24] Kim Hjelmgaard: These countries are doing the best and worst jobs fighting coronavirus,

USA TODAY, 17 March 2020, please also take time to read the comparative article by clicking: https://www.usatoday.com/story/news/world/2020/03/17/coronavirus-how-countries-across-globe-responding-covid-19/5065867002/.

[25] The Possible Cause Analysis of the Low Mortality Rate of Wuahn Pneumonia in Germany (in Chinese), Radio Taiwan International, 25 March 2020, please read the article by clicking the link: https://www.rti.org.tw/news/view/id/2056920.

[26] South Korea's new daily COVID-19 cases fall to 98, CNA International Version, 22 March 2020, https://www.channelnewsasia.com/news/asia/coronavirus-south-korea-new-covid-19-cases-12564406.  

[27] South Korea's epidemic unexpectedly subsides, while European and American experts look silent when they visit it (Chinese), Half-month Observation, 24 March 2020, please click to view:

https://military.china.com/retie/37506543.html.

[28] Alwihda Info: China’s Huoshenshan Hospital a race against epidemic (in Chinese), People’s Daily, 2 February 2020, please take time to read the whole story by clicking the following link: https://www.alwihdainfo.com/China-s-Huoshenshan-Hospital-a-race-against-epidemic_a82317.html.

[29] Alberta Government: Cases in Alberta, 20 Mar 2020, please see the data by clicking the link: https://www.alberta.ca/covid-19-alberta-data.aspx; List of Canadian provinces and territories by population, accessed on 20 Mar 2020, please take time to compare the population by clicking: https://en.wikipedia.org/wiki/List_of_Canadian_provinces_and_territories_by_population.

[30] Chief medical officer of health COVID-19 update – Alberta’s chief medical officer of health provides an update on COVID-19 and the ongoing work to protect public health, 20 Mar 2020, https://www.alberta.ca/release.cfm?xID=69885C2DA6F38-D1BC-FC71-BCFF3E4DABF01AF6.

[31] Adam Hunter and Guy Quenneville: Sask. COVID-19 case details expand after Premier Scott Moe pledges more transparency, CBC News, 26 March 2020, please click to view the article https://www.cbc.ca/news/canada/saskatchewan/sask-covid-case-detail-1.5511231.

[32] Katrin Bennhold and Melissa Eddy: Germany Bans Groups of More Than 2 to Stop Coronavirus as Merkel Self-Isolates, New York Times, 22 March 2020, please click the following link: https://www.nytimes.com/2020/03/22/world/europe/germany-coronavirus-budget.html.

[33] Allison Martell and Moira Warburton: Ontario stockpiled millions of face masks after SARS. As COVID-19 nears pandemic status, they're all expired, National Post, 9 March 2020, please read: https://nationalpost.com/news/world/ontario-stockpiled-millions-of-masks-after-sars-they-all-expired-as-covid-19-nears-pandemic-status.

[34] Coronavirus Resource Center: How long can the coronavirus stay airborne? 20 March 2020, https://www.health.harvard.edu/diseases-and-conditions/coronavirus-resource-center.

[35] Ewen Callaway & etc: The coronavirus pandemic in five powerful charts, Nature, 19 March 2020, https://www.nature.com/articles/d41586-020-00758-2.

[36] Jackson Ryan: Coronavirus explained: All your questions about COVID-19 answered, CNET, 24 March 2020, please click the following link to view the whole article if you have time: https://www.cnet.com/how-to/coronavirus-explained-all-your-questions-about-covid-19-answered/.

[37] Coronavirus origins: genome analysis suggests two viruses may have combined, the Conversation, 18 March 2020, please take time to read the article by clicking the link: https://theconversation.com/coronavirus-origins-genome-analysis-suggests-two-viruses-may-have-combined-134059.

[38] Emma Yasinsky: Scientists Scrutinize New Coronavirus Genome for Answers, the Scientist, 23 January 2020, please take time to read the article by clicking the following link: https://www.the-scientist.com/news-opinion/scientist-scrutinize-new-coronavirus-genome-for-answers-67006.

[39] Liu Zhen: Coronavirus: ‘strange pneumonia’ seen in Lombardy in November, leading Italian doctor says, South China Morning Post, 22 March 2020, please click the link to view the article: https://www.scmp.com/news/china/society/article/3076334/coronavirus-strange-pneumonia-seen-lombardy-november-leading.

[40] Larry Romanov: COVID-19: Further Evidence that the Virus Originated in the US, Global Research, March 11, 2020, please take time to read the article by clicking the following link: https://www.globalresearch.ca/covid-19-further-evidence-virus-originated-us/5706078; Fuhao: The Origin of Coronavirus May Be in the US (Chinese), Zhihu, 28 March 2020, please check the article: https://zhuanlan.zhihu.com/p/109836766.

[41] CDC director says some coronavirus-related deaths have been found posthumously, CNN, 11 March 2020, please take time to read the director’s testimony by clicking the following link: https://edition.cnn.com/world/live-news/coronavirus-outbreak-03-11-20-intl-hnk/h_1319f66f92245a2fe4ec63fe91ab66c9; Yasemin Saplakoglu: Confusion and chaos surround coronavirus testing in the US, Life Science, 11 March 2020, please also take time to read the article https://www.livescience.com/coronavirus-testing-chaos-us.html.

[42] World Health Organization: “Global Vaccine Safety Summit”, WHO.int, December 2 – 3, 2019, https://www.who.int/news-room/events/detail/2019/12/02/default-calendar/global-vaccine-safety-summit. Dr. Swaminathan’s remarks can be viewed in the video for the hours “14h – 15h15” on December 3, 2019, from about 24 minutes to about 32 minutes in.