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What Canadians need to know about COVID-19 before gathering over the holidays – CBC.ca

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This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.


Canadians considering gathering with loved ones over the holidays this year need to come to terms with some harsh realities. 

The country faces a perfect storm: record rates of COVID-19 amid a growing sense of pandemic fatigue at a time when we typically travel to see loved ones and spend time together indoors.

But COVID-19 is insidious, an unwanted guest that can slip in unnoticed and wreak havoc despite our best efforts to control it. 

“We have to ask ourselves honestly, must we socialize? And the answer is probably no,” said Raywat Deonandan, a global health epidemiologist and associate professor at the University of Ottawa.

“There is no way to eliminate risk except not to do it in the first place.”

But we’ve learned a lot more about how COVID-19 spreads since it first emerged at the beginning of this year, which can help inform us on where we’re most at risk. 

Confusion over holiday guidelines

There’s understandably a lot of confusion about what sorts of holiday gathering might be reasonable to consider this year, especially since depending on where you live in this country the rules and recommendations differ.  

The official advice from Canada’s chief public health officer is to avoid large gatherings, non-essential travel and to keep things as small as possible within your household. 

Certain provinces, like Ontario, recommend skipping extended family gatherings altogether and taking precautions like self-isolating for 10 to 14 days for those travelling home from away, including colleges and universities.

While others, like Quebec, have put a lot of faith in their population by allowing gatherings of up to 10 people for four days over the holidays after a seven day period of self-imposed quarantine.

But Deonandan says we can’t necessarily rely on people to completely self-isolate on their own — that requires not leaving home for groceries, essential items or even to walk the dog. 

WATCH | Dr. Theresa Tam advises no large gatherings or non-essential travel

Canada’s chief public health officer, Dr. Theresa Tam, says it’s clear that Christmas this year is not going to be like other years. She recommends against any gatherings but has some advice if people choose to forgo the public health guidelines. 0:48

“You’re also going to have outliers who have infectious periods longer than two weeks,” he said.

“If enough people do this, you’re going to get a sufficient number of people who do not fall under that umbrella who are indeed infectious and who start outbreaks.” 

Silent spread a ‘key driver’ of outbreaks

While we weigh whether it’s even possible to gather safely with friends and family in a pandemic, it’s important to keep in mind the unseen dangers we could be inviting in — even in parts of the country that have low rates of COVID-19.

“The problem with this virus is that it’s like many other viruses,” said Dr. Allison McGeer, a medical microbiologist and infectious disease specialist at Toronto’s Mount Sinai hospital who worked on the front lines of the SARS epidemic in 2003. “You shed virus before you get sick and some people who get infected don’t develop symptoms.” 

“That’s why what has worked is everybody wearing masks and everybody maintaining social distance, because you can’t tell who the next infected person is going to be.”

McGeer says viruses like influenza, chickenpox and measles typically present symptoms in the body before people are infectious — but the virus behind COVID-19 is different. 

The U.S. Centers for Disease Control and Prevention released updated scientific guidance this week that acknowledged asymptomatic or presymptomatic individuals account for more than half of all COVID-19 transmissions. 

“Silent transmission is one of the key drivers of outbreaks,” said Seyed Moghadas, a professor of applied mathematics and computational epidemiology at Toronto’s York University. 

“There is an incorrect notion in the general population that if someone feels fine then they are not infected. A person can certainly be infected, infectious, and feel completely fine.” 

Seyed Moghadas at York University says because of high rates of asymptomatic COVID-19 infections, silent transmission is one of the ‘key drivers’ of outbreaks. (Evan Mitsui/CBC)

Moghadas, the lead author of a study published in the journal PNAS on the silent spread of COVID-19 that was cited in the CDC guidelines, says this underscores how difficult the virus is to control, a challenge “magnified” in close quarters.

In Nova Scotia, which has successfully contained the spread of COVID-19 throughout the pandemic despite the bursting of the Atlantic bubble this week, catching those silent spreaders before they unknowingly infect others is key. 

Dr. Lisa Barrett, an infectious disease specialist at Dalhousie University, has partnered with public health authorities in a pilot project to use rapid COVID-19 tests on people without symptoms in high-traffic areas of Halifax. 

It’s only been a few days, but what they’ve found was surprising. 

On the first day they tested 147 people and found one asymptomatic case, the second day they tested 604 more and found another one, and on the third day they did 804 tests and found five more. 

“We recognized that there are a lot of people out there, even if they’re doing the right thing, that don’t know they’re infected, don’t know they’re infectious and could be spreading to other people,” said Barrett.

“When there’s community spread of a virus that has a long period of time when you can be infectious without symptoms, you have to test broadly in the community or you have no idea what’s going on.” 

‘A negative test is not a license to socialize’

One novel approach to avoid meeting with loved ones while unknowingly infectious that has emerged is to get a COVID-19 test beforehand to pre-emptively detect it. 

But the timing of that test is incredibly important and there’s a lot of room for error, so it may be a less effective strategy than it first appears.

A new study in the journal Science looked at 1,178 people infected with COVID-19 and more than 15,000 of their close contacts to determine when people were most infectious. 

It found most of the transition — 87 per cent — happened in a fairly wide window of time, up to five days before or after symptoms appeared, while 53 per cent was in the pre-symptomatic phase.

“It’s possible to be early in the disease cycle such that you won’t detect any viral presence. But in two days suddenly you’re infectious and now we’re screwed,” said Deonandan, at the University of Ottawa.

“So a negative test is not a license to socialize.”

Still, Deonandan says there will be people who are going to socialize anyway, so it’s better they do so with precautions in place like testing and self-isolating than nothing — even if those precautions aren’t perfect.

Whether you celebrate Christmas, Hanukkah, Kwanzaa or the winter solstice, Canadians are being told to consider meeting virtually, avoid risky indoor gatherings without masks and instead find ways to connect while still physical distancing.

“I think the pitch to people is that yes, we’re used to having time off school and we’re used to seeing everybody,” said McGeer. “But this is the year to delay.” 

WATCH | Tam on the holiday season and how the pandemic won’t go on forever

Canada’s Chief Public Health Officer Dr. Theresa Tam talks to The National’s Andrew Chang about the holiday season and getting to the end of the COVID-19 pandemic. 6:31

“The best advice this year is maybe not to go too far from home,” said Barrett. “Is it worth it to lose control of the virus?”

“We’re hanging on by a thread here. Please don’t let that thread break.” 


To read the entire Second Opinion newsletter every Saturday morning, subscribe by clicking here.

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Health Canada approves updated Novavax COVID-19 vaccine

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

The protein-based vaccine, called Nuvaxovid, has been reformulated to target the JN.1 subvariant of Omicron.

It will replace the previous version of the vaccine, 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.

Earlier this week, Health Canada approved Moderna’s updated mRNA COVID vaccine.

It is still reviewing Pfizer’s updated mRNA vaccine, with a decision expected soon.

This report by The Canadian Press was first published Sept. 19, 2024.

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

Note to readers: This is a corrected story. A previous version erroneously described the Novavax vaccine as an mRNA shot.

The Canadian Press. All rights reserved.

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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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