The growing number of COVID-19 cases in the province without a known source of infection means the virus could be spreading through Alberta communities unchecked, an infectious diseases specialist warns.
“It dramatically lowers the efficiency of contact tracing,” said Craig Jenne, an associate professor at University of Calgary in department of Microbiology, Immunology and Infectious Diseases.
“If we don’t know where you got it, it’s difficult to notify other people who also may have been exposed.”
Not only are the higher rates making the virus more difficult to track, it will make it more difficult to identify which restrictions would be most effective in controlling it, Jenne said.
The numbers should serve as a wake up call to Albertans, he said.
“It makes it very difficult for us to have an accurate picture of where the virus is spreading in the community. What are the sources that are driving this? These are big problems.”
Currently the source of two-thirds of the COVID-19 cases in Alberta is unknown.
Of the 3,768 new cases reported in Alberta between Oct. 27 and Nov. 2, the source of infection could not yet be identified in 2,548, 67 per cent of cases, a percentage that is rising.
In mid October, 43 per cent of Alberta’s newly-confirmed cases had an unknown source, with 37 per cent of active cases having an unknown source.
But Dr. Deena Hinshaw, the province’s chief medical officer of health, has said the true percentage of unsolved cases is closer to 50 per cent.
Rate concerning, Hinshaw says
During a news conference Wednesday, Hinshaw said the rate of unknown transmissions is concerning but the data should be examined with caution.
Newly-reported cases have yet to be investigated, Hinshaw said. The number of unsolved cases could shrink from 67 per cent as contact tracers begin investigating each case in earnest, she said.
For example, of the 6,110 active cases in the province Tuesday, only 53 per cent were of unknown origin.
“Because the volume of cases we’re seeing every day has been rising, and when we get a new case, an investigation has yet to take place,” Hinshaw said.
“Many of those cases, we will be able to determine the source.”
Health Minister Tyler Shandro told reporters Wednesday the proportion isn’t a concern.
“It’s just a matter of people getting their tests before the contact tracers have spoken to them,” Shandro said.
The increasing rate of unknown cases comes at critical time with more people in hospital and in ICU for the disease than ever.
‘Critical juncture’
Adjusted for population, Alberta now has the second-highest number of active COVID-19 cases off all provinces.
Hinshaw has said the province is at a “critical juncture” in its bid to reverse the trend and suggested that a growing carelessness around COVID restrictions could exacerbate the problem.
While health officials can’t pinpoint the source of all the new cases, there is a clear trend behind the spike in new transmissions, Hinshaw said.
“We do know what the trends are in our own data and those trends match the transmission issues that we’re seeing in other provinces which are social gatherings,” she said.
“They are times when people are spending time together in close contact, not wearing masks, not distancing, not saying home when they’re symptomatic and those are the things we’re really focused on.”
Hinshaw warned if efforts to reverse the trend through voluntary measures fail, further restrictions could be imposed and soon.
“We’ll be watching very closely over the coming days to see if we’ve been able to start turning the corner with our current restrictions or if more restrictions are necessary.”
Meanwhile, Alberta Health and the province is promising to reverse the trend by speeding up test turnaround times and bolstering its team of contact tracers. The contact tracing team, a workforce which has already doubled in size since the pandemic hit, will expand again.
More contact tracers on the way
Alberta’s staff of disease detectives will grow from 800 to 1,100 within the next few weeks.
“We are working to reduce the number of unknown cases as soon as possible,” Tom McMillan, Alberta Health spokesperson, said in a statement.
“This is primarily being done by reducing wait times for testing and test results and speeding up contact tracing,” McMillan said. “We have seen wait times lower in recent days as a result of shifts to our strategy and AHS is hiring more contact tracers to expand their dedicated teams.”
Contact tracing is a laborious but critical step in slowing the spread of the virus. Once a person tests positive for COVID, a team of public health begin the work of tracking their movements and close contacts.
“These folks are working, like all of our public health folks, working really long hours,” Shandro said.
Those who may have been infected are informed, tested and often asked to quarantine. The process can involve a few simple phone calls or be complex and protracted, depending on how many people the infected person has come in contact with.
“The system is working seven days a week,” Shandro said.
“If I could speak on behalf of our contact tracers, they wish that Albertans could follow the public health guidance so there would be less pressure on them but it’s also why we’re continuing to hire contact tracers.”
‘No excuse’
Jenne said increasing the number of contact tracers and faster testing will help.
Jenne said the job of contact tracers has become more difficult in recent months, he said.
“These are big problems, but they’re also suggesting that people are perhaps having too many contacts in the community.
“What is perhaps even more disturbing is we are seeing increased reports of people not being forthcoming with their known contacts as well.”
Even so, the success of Alberta’s fight against COVID-19 will hinge largely on individual decisions, he said.
“COVID fatigue, it’s real and it’s understandable,” he said. “But it’s also not an excuse.
“We have to do what we can now to not put ourselves in a situation where the public health officials have no option but to bring in restrictions.”
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.
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.
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.
