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.
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.”
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VANCOUVER – Contract negotiations resume today in Vancouver in a labour dispute that has paralyzed container cargo shipping at British Columbia’s ports since Monday.
The BC Maritime Employers Association and International Longshore and Warehouse Union Local 514 are scheduled to meet for the next three days in mediated talks to try to break a deadlock in negotiations.
The union, which represents more than 700 longshore supervisors at ports, including Vancouver, Prince Rupert and Nanaimo, has been without a contract since March last year.
The latest talks come after employers locked out workers in response to what it said was “strike activity” by union members.
The start of the lockout was then followed by several days of no engagement between the two parties, prompting federal Labour Minister Steven MacKinnon to speak with leaders on both sides, asking them to restart talks.
MacKinnon had said that the talks were “progressing at an insufficient pace, indicating a concerning absence of urgency from the parties involved” — a sentiment echoed by several business groups across Canada.
In a joint letter, more than 100 organizations, including the Canadian Chamber of Commerce, Business Council of Canada and associations representing industries from automotive and fertilizer to retail and mining, urged the government to do whatever it takes to end the work stoppage.
“While we acknowledge efforts to continue with mediation, parties have not been able to come to a negotiated agreement,” the letter says. “So, the federal government must take decisive action, using every tool at its disposal to resolve this dispute and limit the damage caused by this disruption.
“We simply cannot afford to once again put Canadian businesses at risk, which in turn puts Canadian livelihoods at risk.”
In the meantime, the union says it has filed a complaint to the Canada Industrial Relations Board against the employers, alleging the association threatened to pull existing conditions out of the last contract in direct contact with its members.
“The BCMEA is trying to undermine the union by attempting to turn members against its democratically elected leadership and bargaining committee — despite the fact that the BCMEA knows full well we received a 96 per cent mandate to take job action if needed,” union president Frank Morena said in a statement.
The employers have responded by calling the complaint “another meritless claim,” adding the final offer to the union that includes a 19.2 per cent wage increase over a four-year term remains on the table.
“The final offer has been on the table for over a week and represents a fair and balanced proposal for employees, and if accepted would end this dispute,” the employers’ statement says. “The offer does not require any concessions from the union.”
The union says the offer does not address the key issue of staffing requirement at the terminals as the port introduces more automation to cargo loading and unloading, which could potentially require fewer workers to operate than older systems.
The Port of Vancouver is the largest in Canada and has seen a number of labour disruptions, including two instances involving the rail and grain storage sectors earlier this year.
A 13-day strike by another group of workers at the port last year resulted in the disruption of a significant amount of shipping and trade.
This report by The Canadian Press was first published Nov. 9, 2024.
The Royal Canadian Legion says a new partnership with e-commerce giant Amazon is helping boost its veterans’ fund, and will hopefully expand its donor base in the digital world.
Since the Oct. 25 launch of its Amazon.ca storefront, the legion says it has received nearly 10,000 orders for poppies.
Online shoppers can order lapel poppies on Amazon in exchange for donations or buy items such as “We Remember” lawn signs, Remembrance Day pins and other accessories, with all proceeds going to the legion’s Poppy Trust Fund for Canadian veterans and their families.
Nujma Bond, the legion’s national spokesperson, said the organization sees this move as keeping up with modern purchasing habits.
“As the world around us evolves we have been looking at different ways to distribute poppies and to make it easier for people to access them,” she said in an interview.
“This is definitely a way to reach a wider number of Canadians of all ages. And certainly younger Canadians are much more active on the web, on social media in general, so we’re also engaging in that way.”
Al Plume, a member of a legion branch in Trenton, Ont., said the online store can also help with outreach to veterans who are far from home.
“For veterans that are overseas and are away, (or) can’t get to a store they can order them online, it’s Amazon.” Plume said.
Plume spent 35 years in the military with the Royal Engineers, and retired eight years ago. He said making sure veterans are looked after is his passion.
“I’ve seen the struggles that our veterans have had with Veterans Affairs … and that’s why I got involved, with making sure that the people get to them and help the veterans with their paperwork.”
But the message about the Amazon storefront didn’t appear to reach all of the legion’s locations, with volunteers at Branch 179 on Vancouver’s Commercial Drive saying they hadn’t heard about the online push.
Holly Paddon, the branch’s poppy campaign co-ordinator and bartender, said the Amazon partnership never came up in meetings with other legion volunteers and officials.
“I work at the legion, I work with the Vancouver poppy office and I go to the meetings for the Vancouver poppy campaign — which includes all the legions in Vancouver — and not once has this been mentioned,” she said.
Paddon said the initiative is a great idea, but she would like to have known more about it.
The legion also sells a larger collection of items at poppystore.ca.
This report by The Canadian Press was first published Nov. 9, 2024.
