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Panting, spewing droplets, poor ventilation: What makes gyms a superspreading risk – Chemainus Valley Courier

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A recent COVID-19 outbreak at a southern Ontario fitness studio is illustrating how certain indoor settings can provide a perfect storm for superspreading events.

The studio, a downtown Hamilton SPINCO location, has been connected to 69 cases of COVID-19 as of Wednesday, despite screening customers, operating at 50 per cent capacity and keeping the recommended two-metre radius around bikes.

So how did so many cases originate there? And does it raise concern about how the novel coronavirus can spread in a gym setting?

“Certainly this event makes you wonder that,” said Dr. Matthew Oughton, an infectious disease expert at Jewish General Hospital and McGill University in Montreal.

“I can see where this could lead to perhaps gyms having serious restrictions placed on them if they want to avoid similar superspreading events.”

Ontario and Quebec recently reintroduced closures at gyms in virus hotspots, including Toronto, Montreal and Ottawa, for a four-week period to help limit spread.

And Dr. Barbara Yaffe, Ontario’s associate chief medical officer, said Wednesday authorities are reviewing guidelines for fitness studios across the province after the Hamilton outbreak.

Oughton says gyms and fitness studios have a few strikes against them when it comes to tailoring them for the pandemic.

They’re operating almost exclusively indoors, which makes for poorer ventilation, and patrons aren’t usually masked when engaging in strenuous exercise.

High-impact activity also leads to heavier breathing, which means droplets are being expelled from peoples’ mouths at an accelerated rate — and being propelled further distances.

Dr. Andrew Morris, a professor of medicine at the University of Toronto, likens it to throwing a ball. The harder you throw, the further it goes.

“We still don’t have a perfect understanding of this,” he said. “But we do know that when people are exercising vigorously, the volume and distance of what comes out of their mouth and their lungs is dramatically different than when somebody is speaking (in a normal way).”

If people are shouting, cheering or singing — which often happens in a spin class where music is blaring and instructors spew out encouragement to keep participants’ intensity up — that can make things worse.

“And if you mix that in with a space that may not have proper ventilation, there is risk for a lot of spread to occur,” Morris said.

READ MORE: No new COVID rules for B.C. gyms as Ontario fitness studio sees ‘very large outbreak’

Dr. Ilan Schwartz, an infectious disease expert with the University of Alberta, says spin classes may pose more risk than other group settings because of the bikes themselves. In theory, the rapidly spinning wheels could aerosolize droplets by flinging them further distances.

“I haven’t seen any studies of this, but theoretically it makes sense,” he said.

“I think going to the gym isn’t necessarily high-risk, unless individuals are close together and there’s poor ventilation. But there might be specific circumstances that could make it higher-risk, where something with fast, moving parts (or) a rapidly moving fan can generate aerosols as well.”

But Morris says the real danger comes when people are spewing out droplets in a poorly ventilated space.

The prolonged length of time spent in a spin class, typically one hour, and the number of people in the room will also impact risk.

Not all fitness classes will present the same dangers, he added.

A low-impact yoga class where hearts aren’t racing and breathing is kept under control seems safer than a high-impact spin class, but not if it’s crowded and poorly ventilated.

A dance class, where participants are crisscrossing into airspace previously occupied by others, can be risky as well in the same environment.

“Assuming that room has relatively poor ventilation, that’s the kind of setting where yes, you’d be concerned about the potential for transmission,” Oughton said. “But if you had the exact same room with an excellent HVAC system, or the same room where windows were kept open … those are the kinds of things you could do to reduce the risk.”

Morris says finding ways to make these activities safer is always better than banning them.

Masks, while uncomfortable when working out, can be worn in most instances, he said. Improving ventilation and limiting numbers of people even further can also help.

“If we’re going to be successful, we can’t keep telling people they can’t have these things,” Morris said. “We need to be able to point to something and say ‘this is the better choice.’”

Schwartz says frequent hand-cleaning and the sanitization of equipment should also be kept in mind, even if surface transmission isn’t as concerning as it was earlier in the pandemic.

“And for now I think it’s probably a good idea to avoid spin classes,” he added.

Oughton foresees people taking their workouts outdoors in new ways over the winter if gyms and fitness centres are deemed too risky.

That could mean dusting off the skates or ski boots.

“I think this is going to re-emphasize the safety and the necessity of being able to get some activity and fresh air outside,” he said.

“Hopefully we find new appreciation for outdoor winter sports that we can all enjoy.”

Melissa Couto Zuber, The Canadian Press


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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 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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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

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