Surges in COVID-19 cases and hospitalizations across several provinces prompted warnings on Monday from public health experts, who said stricter measures and adherence to guidelines are needed in the days and weeks ahead.
Ontario reported 3,270 new cases of COVID-19 and 29 more deaths attributed to the novel coronavirus on Monday, while officials in Quebec reported 2,546 new infections and 32 more deaths.
One expert in Quebec said the province should impose a curfew to ensure people are in their homes at a certain hour — a move that was recently imposed in France. “The government bet on a partial lockdown to reduce the number of cases. It didn’t work,” Roxane Borges Da Silva, a professor at Universite de Montreal’s school of public health, said in an interview Monday.
She said the stricter measures could also include the closure of the manufacturing sector, which accounts for many COVID-19 outbreaks. “We don’t have room to manoeuvre. We have no choice but to put in place strict measures that will really work. We can’t afford to do more trial and error,” Borges Da Silva said.
Quebec and Ontario imposed partial lockdown rules over the holiday period in an effort to get the pandemic under control and ease pressure on their strained health-care networks. But health-care workers and public health experts continue to raise concerns over rates of infections and hospitalizations in both provinces.
Quebec reported 1,294 hospitalizations on Monday, including 188 patients in intensive care, while Ontario said 1,190 people were currently hospitalized, including 333 in intensive care.
Dr. Nadia Alam, a family doctor in Georgetown, Ont., northwest of Toronto, and past president of the Ontario Medical Association, said many people are feeling “pandemic fatigue.”
Alam said many Ontarians are following public health directives, but some, she said, do not have the social support they need to adhere to the regulations. Others, she said, are bucking the rules because they do not take the pandemic seriously.
The result is “a crisis in health care” and the exhaustion of health-care workers, particularly in long-term care homes and hospitals in Ontario, Alam said in an interview. “We’re stretched so thin. It’s a bit of a nightmare. The vaccine gave us all hope — and it is giving us hope — but right now are very difficult times.”
In Atlantic Canada, New Brunswick reported 17 new COVID-19 cases Monday, the highest number of single-day infections in the province since Nov. 21.
Nova Scotia reported six new cases — two from Sunday and four on Monday — while Newfoundland and Labrador reported its first new COVID-19 infection of 2021.
Health authorities in Saskatchewan reported 286 new cases of COVID-19 on Monday and two more deaths attributed to the novel coronavirus. The province said 180 people were in hospital, including 35 receiving intensive care.
Meanwhile, Canadian politicians at the federal and provincial levels are facing criticism for taking trips abroad despite advice to avoid non-essential travel. Frustrations have been especially high in Alberta, where at least six members of the province’s United Conservative government travelled outside the country during the holiday period.
On Monday afternoon, Premier Jason Kenney said he had accepted the resignation of the province’s municipal affairs minister and asked his chief of staff to step down. Four other party members also lost their committee and other parliamentary responsibilities.
“By travelling abroad over the holidays, these individuals demonstrated extremely poor judgment,” Kenney said in a Facebook post.
Dr. Alika Lafontaine, an anesthesiologist in Grande Prairie, Alta., and past president of the Indigenous Physicians Association of Canada, said it was “disheartening” to see politicians ignore travel advice. “I’m actually quite concerned that Albertans will take that as a signal that maybe the pandemic isn’t … as bad as it really is,” Lafontaine said in an interview Monday.
Alberta’s chief medical officer of health, Dr. Deena Hinshaw, said Sunday an estimated 400 new COVID-19 cases had been identified in the province on Jan. 2. Hospitalizations and intensive care admissions were stable, she said in a tweet.
Lafontaine said, however, that ICU admissions are not decreasing fast enough, adding that he feared the health-care system as a whole — and regional hospitals like where he works, in particular — could be overwhelmed. “At the stage that we’re at right now with hospitalizations, I think our system is on the verge of being overwhelmed if it does get worse,” he said.
That’s why public health guidelines need to be followed closely, Lafontaine said, adding that politicians should be setting an example. “We all have to treat this pandemic as the health crisis that it actually is, and that starts at the top.”
That was echoed by Dr. Donald Vinh, an infectious disease specialist and medical microbiologist at the McGill University Health Centre in Montreal, who said COVID-19 infections will only decrease if everyone follows public health measures.
“Collectively, we need to bend this curve down and we need to do it through intense adherence to public health measures, consistently, everywhere, by everyone,” Vinh said.
— With files from Sarah Smellie in St. John’s and Stephanie Taylor in Regina.
Jillian Kestler-D’Amours, The Canadian Press
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Provinces set back COVID-19 vaccinations as deliveries grind to halt – Peace Arch News – Peace Arch News
Some provinces were forced to push back vaccination for health-care workers and vulnerable seniors on Monday as deliveries from a major manufacturer ground to a temporary halt.
Canada is not due to receive any Pfizer-BioNTech vaccines this week as the company revamps its operations, and deliveries are expected to be slow for the next few weeks.
Prime Minister Justin Trudeau has stressed that the delay is only temporary and that Canada is expected to receive 4 million doses of the Pfizer vaccine by the end of March.
As Parliament resumed Monday, Trudeau faced a barrage of questions from MPs of all parties as they blasted the Liberal government for what they described as a botched approach to rolling out vaccines.
Both Trudeau and Procurement Minister Anita Anand repeated the government’s promise that by the end of September, all Canadians wishing to be vaccinated will have received their shots.
Trudeau added that the country is still receiving shipments of the Moderna vaccine.
Earlier Monday, Deputy Prime Minister Chrystia Freeland said there is “tremendous pressure” on the global supply chain for vaccines that the government has tried to mitigate.
“We are working on this every single day, because we know how important vaccines are to Canadians, to first and foremost the lives of Canadians and also to our economy,” she told a news conference in Ottawa by video.
Despite the vaccine delay, some provinces continued to report encouraging drops in the number of new cases and hospitalizations.
Ontario reported fewer than 2,000 cases, as well as fewer people in hospital. It was a similar story in Quebec, where hospitalizations dropped for a sixth straight day.
Newfoundland and Labrador also reported no new cases of COVID-19 for a third straight day.
There are now 34 confirmed cases of the B117 variant in Ontario and Toronto's top doctor says you should assume it is spreading – CP24 Toronto's Breaking News
There are 34 confirmed cases of the B117 COVID variant in Ontario and officials are now acknowledging that the strain may not just be more contagious but could also cause “more severe illness” in some people as well.
Chief Medical Officer of Health Dr. David Williams shared the latest data during a briefing on Monday afternoon. It is a big jump from last Thursday when officials were reporting just 15 cases of the so-called UK variant.
Of the 34 cases, 10 are in York Region, six are in Toronto, seven are in Simcoe, three are in Peel, three are in Durham and three are in Ottawa. Kingston and Midddlesex-London have also had single cases.
“The key issue is that with the aggressive nature of the UK variant in particular the reasons for being cautious and careful with masking and distancing are enhanced even further because it can be spread with breaches to those protocols in a very short period of time,” Williams warned. “We are going to have to be on our guard but the same measures that protect you from the other strain of COVID-18 will protect you from this one. But you have to do it consistently.”
Ontario has been screening positive samples from people who have returned from aboard for new variants as well as samples collected from large outbreaks.
Efforts, however, are now underway to conduct genomic sequencing on all of the positive samples from Jan. 20 to give officials a snapshot of how widely the variant might be circulating in Ontario but results are expected to take two to three weeks.
Speaking with reporters, Williams said that the variant was probably “moving around in Ontario” before it was discovered earlier this month and may now be “more prevalent than we think.”
For that reason, he said that a recent decline in case counts should be taken with somewhat of a “grain of salt” at this point as there remains a risk that transmission could ramp up again should the variant take hold.
“We don’t want to be casual and careless and open up too soon,” he said.
Just ‘assume’ variant is circulating de Villa
Officials have previously said that the B117 variant is at least 56 per cent more contagious but could be as high as 70 per cent more contagious.
At an earlier briefing on Monday afternoon, Toronto’s Medical Officer of Health Dr. Eileen de Villa said that residents should probably just “assume” that the variant is circulating widely at this point and act accordingly.
That, she said, means limiting your in-person contact with people outside of your household as much as possible.
“We can create barriers to variants spreading widely if we avoid situations where COVID-19 can spread,” she said. “You have heard before what I am going to say next. I hope you will take it to heart more than at any other time. This means keeping apart as much as possible and it means making as few exceptions for contact as we can.”
De Villa said that given the risk posed by the variant in congregate settings, Toronto Pubic Health has reached out to all long-term care homes, retirement homes and complex and continuing care facilities to get the to “review, audit and reinforce” their current infection prevention and control (IPAC) measures.
She said that there are also “heightened practices for case and contact management when there is reason to believe” a given case may involved the B117 variant.
“You know I am sympathetic to the sacrifices and to the strain of life in the COVID-19 pandemic but for now the time has passed for focussing on impositions, inconveniences or frustrations,” she said. “This current situation in the simplest terms is not good. For now we need to focus on things as they are and do everything we can to make sure that things don’t get worse.”
Day 42 after first COVID-19 vaccines and still no second dose in sight as Quebec steps into 'wilderness': experts – CTV Montreal
It’s been 42 days since residents of Maimonides Geriatric Centre in Montreal received their first doses of the Pfizer COVID-19 vaccine, and with no appointments scheduled to administer the second dose, Quebec is now heading into the “wilderness,” says a leading Montreal geriatrician.
Dr. Jose Morais, Chief of Geriatric Medicine at McGill University, emphasized that he thinks “these are difficult decisions,” and “from the public health standpoint, maximizing the distribution of the vaccine is the right thing to do,” to protect a larger number of vulnerable seniors and front-line health-care workers.
From what is known about vaccines and immunity, he also said it’s unlikely the protective effects of one dose will just abruptly disappear. They usually diminish more slowly, and it is possible the effects could last for three months.
But Quebec’s decision to delay the second dose up to 90 days so that double the number of vulnerable Quebecers can be immunized with a first vaccine is not risk-free, Morais said.
“We are in unknown territory. We may be taking undue risks for these particular people because the science supports giving it up to six weeks, 42 days, and the WHO (World Health Organization) has looked into this data and this is what they suggest,” the geriatric specialist said.
Benoit Masse, a public health researcher at Universite de Montreal agreed with the assessment made by Morais.
“Yes, there are potential risks with delaying the second dose beyond six weeks. Unknown risks,” he said.
Canada’s National Advisory Committee on Immunization (NACI) also recommended a six-week delay in a report issued on Jan. 12, because that specific waiting period between doses has been proven to work in clinical trials for Pfizer and Moderna vaccines.
It advised the strategy only be deployed in response to a perfect storm: a rising number of cases, strain on hospitals and a limited supply of vaccines.
In a Jan. 21 update on the province’s decision to delay second shots as long as 90 days, the Quebec Public Health Institute (INSPQ) noted in French, that “no maximum interval between doses is specified,” by the NACI and that “the proposal to not exceed 42 days is therefore not based on data of decreased efficacy after this time period.”
That means the decision to not exceed 42 days was also made by the NACI, because there is currently no data to back it up, as Morais and Masse explained.
Quebec’s immunization committee does conclude administering a second dose is necessary to assure long-term protection, and that the timing of the second dose could be advanced if studies eventually show efficacy wanes after the first dose.
FAMILIES IN LIMBO
As they mark day 42 on the calendar, family members of the long-term care residents at Maimonides remain in the dark about the timeline.
Joyce Shanks, whose father lives at the facility, said the families did not get a response “to the original legal action that we took.”
The Maimonides Family Advocacy Committee is accusing the government of breach of contract.
Lawyer Julius Grey sent an open letter to the premier and health minister more than two weeks ago.
Nor have they heard anything from the West-Central Montreal health authorities (CIUSSS) about the second dose, said Shanks.
“They are toeing the government line. We have nothing specific to go on about the vaccine,” she said, adding “we are exploring every legal opportunity.”
When CTV asked the West-Central Montreal CIUSSS if it has set a date for the second shot to be administered, a spokesperson directed us to Quebec’s health ministry. A Quebec health ministry spokesperson, in turn, invited us to “reach out to the West-Central Montreal CIUSSS with that question.”
But the government is likely recalculating its timeline for the umpteenth time now that most of the province’s doses have been administered – and because Pfizer has delayed shipments of its vaccines to Canada, it is putting public health officials in an even more precarious position.
That was confirmed Monday when the health ministry told CTV that because of the “important” reduction in the number of Pfizer doses they had expected to receive over the next two weeks, they “must review the vaccination calendar, notably for the RPAs,” which are private seniors’ residences.
Above all, the vaccine shortage and dosing strategy have now pushed Quebecers waiting for the booster shot well past the goal lines – three weeks past the vaccine manufacturer’s recommendations, and past the 42-day emergency interval laid out by the NACI.
The decision to give the second dose any time past Pfizer’s 21-day schedule or Moderna’s 28-day recommendation has divided scientists and clinicians around the world, particularly in Canada and also in the U.K, where a 12-week dosing interval has also been approved.
“Even us, we are torn apart between these two scenarios,” revealed Morais, who works at two MUHC hospitals as well as the Jewish General Hospital.
“I have a colleague who decided to take no vaccination. He said if I didn’t receive the second dose within 42 days, why bother taking the first vaccination?” Morais said.
In an email exchange with CTV, public health expert Masse acknowledged that Quebec is walking a tightrope as he spelled out the province’s predicament.
“The benefit of delaying the second dose is (almost) immediate. We protect more people with a first dose, as we are in a large outbreak that we are barely able to control. We are talking about saving lives and hospitalizations in the short term,” he wrote.
Once immunity starts to kick in though and then builds – at 14 days after the first dose, according to a study in the New England Journal of Medicine – even some protection can mean the difference between a survivable illness and one that’s fatal.
However, if the risk turns out to be real – that the vaccine’s protective effects decline quickly or the effectiveness of the first dose turns out to be considerably weaker than expected – then Masse said we could “end up with no net gain overall or worse, an overall increase in death and hospitalizations.”
Masse argued, though, that it’s likely the intensity of the second wave will ease in the coming months and only if there is a rapid decline in the efficacy would we “undo all the benefits we can get right now by vaccinating the maximum number of people.”
Also, getting one dose of the vaccine, even two doses doesn’t mean anyone should stop following all recommended hygiene and distancing measures in the short-term. No one knows yet if the vaccines approved in Canada, will prevent transmission of the virus.
Finally, Masse offered the following assignment, suggesting people ask themselves what they’d do if they have two parents who are both 80 years old (as he does).
“If you give me two doses of a vaccine right now, what do I do? Vaccinate only my mother and keep the one dose in the freezer – or, vaccinate both my mother and father right now?”
In the current climate, when case numbers and community transmission are still high, “I choose the latter without hesitation. In the context of a huge outbreak, I want to protect both of them,” the public health researcher said.
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