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2,000 COVID-19 cases missing from Toronto's map of hot spots – CBC.ca

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More than 2,000 confirmed COVID-19 cases are missing from the map the City of Toronto released last week that shows infections by neighbourhood, CBC News has found.

The detailed geographic information about the spread of the novel coronavirus was released last week by Toronto Public Health, marking the first time such data has been made available in Ontario during the pandemic. It shows infections based on where patients live.

But in a review of published data, CBC News found the count on the map comes up short.   

On Thursday morning, the map showed 9,623 positive COVID-19 cases distributed over 140 neighbourhoods. That’s 2,029 cases short of the official 11,652 total count for that day.

That means roughly one out of every five cases is missing in the city’s own geographic analysis. Similar proportions of missing data were found in the map and case counts from previous days.

The data gap was not mentioned in any of the local health authority’s statistics or on its webpage until CBC pointed it out. 

Muhammad Junayed, right, gets instructions for being tested for COVID-19 from a health-care worker at a pop-up testing centre at the Islamic Institute of Toronto. (Nathan Denette/The Canadian Press)

An extra row identified as “Missing addresses/postal code,” totalling 2,029 cases, has been added to the city’s downloadable spreadsheet showing the number of cases assigned to each neighbourhood.

Toronto Public Health blames the missing data on reports sent by testing labs. The public health authority says some forms only have a name and an address, while others don’t have a patient’s postal code or phone number, leaving health authorities scrambling to fill in gaps.

“Sometimes, they are not putting enough contact details, and in the legislation it doesn’t specify that you must include XYZ details of the individual,” said Dr. Vinita Dubey, Toronto’s associate medical officer of health, referring to the provincial law that requires medical labs to report positive results of certain tests to local health authorities. 

“It just requires that it be reported, so that’s where some of the missing information and gaps occur.”

Delays possible

Dubey said it’s “very unlikely” that the missing data had an impact on contact tracing, but that there could have been delays as her staff had to retrieve missing contact information before they could connect with a patient who tested positive. 

Toronto Public Health said that so far, it has been able to complete contact tracing for a patient within 24 hours in 88 per cent of cases. 

The issue of information transfer between laboratories and public health units was raised last Friday in a report to city council and the Toronto Board of Health by Toronto Medical Officer of Health Dr. Eileen de Villa. 

Dr. Eileen de Villa said that ‘case and contact management is a complex and time-consuming process,’ in a statement on Wednesday. (Rozenn Nicolle/Radio-Canada)

“Laboratories’ reports are received all together in one large fax, sometimes containing hundreds of individual lab results, which must be taken apart for further processing,” de Villa wrote. 

She called for changes in laboratory procedures and the provincial law.

Missing hot spots

Beyond potential delays in contact tracing, the missing geographic data might have another impact. 

Toronto’s current map distribution suggests that some of the city’s poorest and most diverse neighbourhoods — predominantly in the northwest and northeast areas — have had the highest number of cases so far and might be most vulnerable to the novel coronavirus. 

As Ontario is ramping up testing, resources like mobile testing clinics, staff and personal protection equipment will be focused on those hardest-hit areas of the city. 

But with 2,000 cases missing, one researcher familiar with Toronto’s map data said health authorities could be missing out on other vulnerable communities. 

Kate H. Choi, an associate professor in the department of sociology at Western University in London, Ont., said Toronto has been ahead of the curve in terms of COVID-19 data collection, so she was “really, really surprised” when she was told how many of the city’s confirmed cases were missing from its map.

Kate H. Choi is an associate professor of sociology at Western University. (Kate Choi)

She said part of the issue might also be that some populations are less likely to be able to provide a precise address or a postal code, including homeless people, migrant workers or nursing home residents. 

“We may be missing COVID-19 hot spots or certain vulnerable populations may be missing from the narrative about COVID-19 in Toronto.” 

Alternatively, some Torontonians might feel a false sense of security after assuming their neighbourhood is low-risk based on the map, said Choi. It’s also possible that resources and staff could fail to be deployed to hospitals in unknown hot spots, which could lead to more transmission of the virus.

“Those 2,029 individuals are someone’s loved one,” said Choi. “They are also 2,029 people who could be your neighbours. They could be residents in an area where there are a lot of asymptomatic carriers and unfortunately, that may mean they could bring COVID-19 to your doorsteps.”

WATCH | Toronto releases a map showing the city’s COVID-19 cases:

The City of Toronto has released the postal code data about where COVID-19 patients live in the city. Some fear it could stigmatize communities, but the information can help officials decide where to conduct more testing. 2:00

Choi stressed that more research on the age, gender and other characteristics of the missing 2,029 cases is needed to fully understand the impact and risks of this data gap.

Toronto Public Health has also repeatedly said that the map shows where patients infected with COVID-19 live and not where they acquired the infection. 

Gap won’t be fixed for weeks

Toronto Public Health said it does not have the resources to go looking for the 2,029 missing postal codes at the moment.

“Some of them were early on in our outbreak and so it would require going back to some of these cases in February and March. That work won’t be done until we either have less cases or have reached the end of the first wave,” said Dubey. 

This is the second data gap uncovered by CBC in less than a week. On Monday, it was revealed that Ontario hospitals had failed to flag 700 positive COVID-19 tests to public health officials because of a mixup. 

In a statement to CBC, Ontario Health has said the impact of the error “may not be fully understood for some time.”

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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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