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Motorists wait to enter a Fraser Health COVID-19 testing facility, in Surrey, B.C., on Nov. 9, 2020.DARRYL DYCK/The Canadian Press

Tony Singh, founder of the Fruiticana grocery chain, stood in one of his stores in Surrey, B.C., for about an hour last Friday. He observed just one customer who didn’t don a face-covering at the entry; he went up and reminded him to mask-up.

It was a bit easier to do on Friday, the day after B.C.’s Provincial Health Officer made masks mandatory in all indoor public spaces. Before that, Mr. Singh said he was concerned about his staff’s safety as 13 of the 15 B.C. Fruiticana stores are located in the Fraser Health region, the hardest hit by COVID-19 in British Columbia.

“We all have to go home to our own families, and we have children and older people at home. So it’s very stressful for our staff and for all of us to work day to day with all the COVID cases increasing,” Mr. Singh said in an interview.

John Trochta, a regional operations manager for utility FortisBC, said the high case counts have created new challenges for his workers in the field, maintaining the natural-gas supply across the Fraser Valley.

Mr. Trochta, who divides his time between the office and the field, said his workers are donning personal protective equipment, and have been supplied more company vehicles – equipped with soap and water dispensers – so they can travel alone to maintain physical distance as they keep the gas flowing for residential, industrial and commercial customers.

“Basically it just puts an added stress on the community, I think, and the customers we have, which puts an added stress on the individuals that are conducting that work that have that interaction with the customers,” he said.

Businesses and residents alike have reason to be on edge in the Fraser Health region as the COVID-19 cases rise. The high numbers of essential workers in “high-risk” businesses, multigenerational households and social gatherings in homes may all be contributing to Surrey and the surrounding region’s dubious distinction of being B.C.’s hot spot.

The Fraser Health region, which stretches into the Fraser Valley from the cities east of Vancouver, including Surrey, has the highest case counts in any of B.C.’s five other health care regions, with daily counts frequently two times or more higher than those in the Vancouver region.

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Since the first COVID-19 case was diagnosed in British Columbia, there have been 15,448 cases in Fraser Health. Last week, Health Minister Adrian Dix referred to Surrey – the largest city in the region, and second-most populous city in B.C. – as “ground zero” for COVID-19 in the province.

Fraser Health looks after more people than any of British Columbia’s other health regions, covering a vast territory about three times the size of Prince Edward Island and including 20 communities such as Surrey and Burnaby. It includes 12 acute-care hospitals and covers 1.8 million people. By comparison, Vancouver Coastal Health serves 1.25 million people including residents of Richmond and Vancouver as well as communities stretching north to Bella Coola.

As provincial officials Thursday announced sweeping new restrictions, including mandatory mask-wearing, they also released new case count numbers that highlight the challenges facing Fraser Health. Of 538 new cases, 309 were in Fraser Health compared to 178 in the Vancouver Coastal Health region.

On Friday, the numbers were 516 in B.C. overall. Of those, 294 were in Fraser Health and 148 in Vancouver Coastal Health. Seventeen were in the Vancouver Island health region, 31 in Interior Health, and 25 in the Northern Health region.

Anita Huberman, chief executive officer of the Surrey Board of Trade, said the red-zone designation is “embarrassing” for the city. “People outside our city will think we don’t take the virus seriously. Of course many of us do,” she said in an interview.

With the announcement last week that included wearing masks in all indoor public settings, the board issued a statement itemizing the rules, which include no socializing beyond the immediate household. It urged obedience to the rules and called for people to report urgent situations of non-compliance to Surrey bylaw officials or the Surrey RCMP.

Jordan Tinney, superintendent of schools for Surrey, said it’s hard to escape the reality of managing education in a city that leads in pandemic-virus counts. One school has closed, because of exposures, affecting 850 students and staff. As of Friday, 36 others had listed an exposure. The district has 131 schools for 75,000 students.

“There is a whole piece of me that sees everyday that life is normal and great things happening in schools, and all the simple examples of why schools are wonderful places,” Mr. Tinney said in an interview.

“But there is also the cloud that is COVID that never seems to lift, which is schools get going and there is an exposure letter.”

Fraser Health said Victoria Lee, its president and chief executive officer, was unavailable for an interview on the COVID-19 challenges facing the health authority.

However, Dr. Lee, Mr. Dix and Provincial Health Officer Bonnie Henry have all spoken of the pandemic dynamics at play in Fraser Health.

They say the region is home to many essential workers in such “high-risk” businesses as poultry and fruit processing plants, as well as trucking and health care. Also, officials have said cases are being fuelled by social gatherings in homes and elsewhere that have led to community transmission.

Public-health researcher Farah Shroff, with the University of British Columbia’s school of population and public health, said many front-line workers who work and serve in the Greater Vancouver area reside in Surrey because housing is more affordable there.

“Those socioeconomic factors are quite germane to the spread of droplet borne conditions such as COVID-19,” she said.

Also, there has been concern in Fraser Health about a preponderance of multigenerational homes, particularly in the South Asian community where people are in close quarters and infections can spread. Visible minorities accounted for more than half of Surrey’s population, led by people of South Asian descent. Among them, some still keep the culture practice of living in multigeneration homes.

On this issue, Dr. Henry said last Thursday that the virus “doesn’t recognize who we are, but it recognizes that when we’re in crowded situations indoors that we can pass on.”

Dr. Shroff said the South Asian population has a genetic predisposition to diabetes and heart disease, two of the conditions which put them at higher risk of having more serious level of COVID-19 complications if they contract it.

In past few months, she has been calling the government to collect race-based COVID-19 data which could help show whether South Asian Canadians are at greater risk of higher morbidity or mortality related to COVID-19.

“I believe the answer is going to be yes,” she said.

Delta North MLA Ravi Kahlon said the effect of this surge on the South Asian community has prompted efforts by community leaders, particularly faith leaders, to ensure safety protocols are in place.

“When you think of heroes during a pandemic, you have to look at the South Asian community. Truckers, front-line workers, people working in grocery stores, people working in care homes overwhelmingly are from South Asian community and living and residing in Fraser Valley,” he said.

Mr. Kahlon said there’s a lot of racism on social media, an issue he’s particularly concerned about, but overall, he thinks people understand the virus is a complex challenge and no one community is to blame.

“I don’t think it’s fair to point fingers at one community as the culprit when you have to acknowledge that not only are there challenges, but also we are the front-line workers that are dealing with the pandemic ,” he said.

Dr. Henry and Mr. Dix said extra resources have been deployed to Fraser Health, including contact tracers and environmental health officers on the case where transmission has flared in business settings.

Dr. Henry said sweeping provincewide measures, such as mandatory masking and curbs on social gatherings, would make a difference.

Speaking during a background briefing for reporters, an official pointedly said, “What needs to be done in Surrey needs to be done everywhere.”

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