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A COVID Surge is Coming and Here’s How to Stay Safe

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COVID cases have been declining in the U.S., which have people questioning if we’re still in a pandemic–we are, but experts are concerned about a potential surge this winter because of rising cases in European countries like the U.K., France and Italy.  “In the past, what’s happened in Europe often has been a harbinger for what’s about to happen in the United States,” says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “So I think the bottom line message for us in this country is: We have to be prepared for what they are beginning to see in Europe.”

Another thing experts are monitoring closely is new omicron variants popping up. “We look around the world and see countries such as Germany and France are seeing increases as we speak,” says Lauren Ancel Meyers, director of the UT COVID-19 Modeling Consortium at the University of Texas at Austin. “That gives me pause. It adds uncertainty about what we can expect in the coming weeks and the coming months.”

While it’s likely the U.S. will experience a spike in cases, it’s not for certain. NPR, reports, “That’s because it’s not clear whether Europe’s rising cases are related to people’s greater susceptibility to new subvariants they’ve not yet been exposed to. In addition, different countries have different levels of immunity.” Justin Lessler, an epidemiologist at the University of North Carolina who helps run the COVID-19 Scenario Modeling Hub says, “If it is mostly just behavioral changes and climate, we might be able to avoid similar upticks if there is broad uptake of the bivalent vaccine,” Lessler says. “If it is immune escape across several variants with convergent evolution, the outlook for the U.S. may be more concerning.” Read on—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.

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According to NPR, “The levels of virus being detected in wastewater are up in some parts of the country, such in Pennsylvania, Connecticut, Vermont and other parts of the Northeast. That could be an early-warning sign of what’s coming, though overall the virus is declining nationally.”

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“It’s really too early to say something big is happening, but it’s something that we’re keeping an eye on,” says Amy Kirby, national wastewater surveillance program lead at the Centers for Disease Control and Prevention.

NPR reports, “But infections and even hospitalizations have started rising in some of the same parts of New England, as well as some other northern areas, such as the Pacific Northwest, according to Dr. David Rubin, the director of the PolicyLab at Children’s Hospital of Philadelphia, which tracks the pandemic. “We’re seeing the northern rim of the country beginning to show some evidence of increasing transmission,” Rubin says. “The winter resurgence is beginning.”

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David Souleles, MPH, Director of the COVID-19 Response Team at the University of California, Irvine tells us, “The evidence of a potential surge can be seen by looking at our neighbors in the east and west, specifically Europe where case numbers are inching up. There have also been reports that we should expect a bad flu season, which will complicate COVID case monitoring since symptoms are similar. To prevent severe reactions to COVID and the flu, we need to be vaccinated and take other measures, including hygiene, good sleep, eating well, tracking case counts in your community, and being mindful of spreading the virus.”

A top-ranking Chicago doctor does expect an uptick in cases and told NBC, “I haven’t seen anything really scary yet on the horizon, but I do think we’re going to see a COVID surge. I would be the happiest person alive if we get to February or March and we haven’t seen even a small COVID surge, just because it’s respiratory season and the way that we see flu and RSV and everything else surge in the winter, I think we’re expecting at least some COVID surge,” Chicago Department of Public Health Commissioner Dr. Allison Arwady said. “The question is really what does that looked like with variants?”

African American little boy with his mother during PCR test of coronavirus in a medical labAfrican American little boy with his mother during PCR test of coronavirus in a medical lab
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In addition to worrying about COVID this winter, experts are also warning about the flu. Dr. Benjamin Alli, MD/ PhD Sakellerides professor and author of Not Just Covid, which comes out later this month, tells us, “This winter is expected to be especially brutal due to influenza (twin virus) and other respiratory illnesses that have been increasing in various areas – largely due to misinformation (controversy over continued use of a mask), and a decline of those in the healthcare industry wanting to continue on for various reasons, include stress, personal crisis, pay and more.”

NBC reports, “Hospitals nationwide are preparing for another winter with Covid — the first one that’s also expected to include high levels of influenza and other respiratory illnesses that have simmered quietly in the background for the past two years. Flu cases are already rising in parts of the U.S., according to the Centers for Disease Control and Prevention. Pediatricians, too, are seeing a growing number of children sick with respiratory syncytial virus, or RSV, and enteroviruses. And despite a downward trend in Covid, tens of thousands of new cases are still being diagnosed every day.”

Cheerful Smiling Adolescent Patient Showing Vaccinated Arm With Sticking Patch On Her Shoulder After Getting Shot And Thumb Up Gesture.Cheerful Smiling Adolescent Patient Showing Vaccinated Arm With Sticking Patch On Her Shoulder After Getting Shot And Thumb Up Gesture.
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More people have gotten the vaccine, which will help with some immunity.

NPR reports, “We have a lot more immunity in the population than we did last winter,” says Jennifer Nuzzo, who runs the Pandemic Center at the Brown University School of Public Health. “Not only have people gotten vaccinated, but a lot of people have now gotten this virus. In fact, some people have gotten it multiple times. And that does build up [immunity] in the population and reduce overall our risk of severe illness,” Nuzzo says.

However, interest in the latest booster is really low. “Nearly 50% of people who are eligible for a booster have not gotten one,” says William Hanage, an associate professor of epidemiology at the Harvard T.H. Chan School of Public Health. “It’s wild. It’s really crazy.” The new booster became available over Labor Day weekend and fewer than 8 million people have gotten one. Since it is likely there will be a surge, Nuzzo reminds us that staying up to date on the boosters is vital. “The most important thing that we could do is to take off the table that this virus can cause severe illness and death,” she says. “There are a lot of people who could really benefit from getting boosted but have not done so.”

Nurse gives students a vaccination in school during coronavirus pandemicNurse gives students a vaccination in school during coronavirus pandemic
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Bernadette Boden-Albala, MPH, DrPH, founding dean of the UCI Program in Public Health says, “To prevent severe reactions to COVID and the flu, we need to be vaccinated and take other measures, including hygiene, good sleep, eating well, tracking case counts in your community, and being mindful of spreading the virus.”

Dr. William Li, physician, scientist, president and medical director of the Angiogenesis Foundation, and author of Eat To Beat Disease: The New Science of How Your Body Can Heal Itself explains, “The easiest way to be protected against serious illness from COVID is to get your bivalent vaccine. You might still get infected if exposed, but you won’t get as seriously sick, and unlikely to need hospitalization. The easiest way not to be exposed is to wear a good quality (N95/KN95) mask which is available anywhere.” And to protect your life and the lives of others, don’t visit any of these 35 Places You’re Most Likely to Catch COVID.

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B.C. promises weekly updates on flu deaths as 6 children confirmed dead this fall – CBC.ca

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B.C.’s provincial health officer is promising weekly updates on the number of children who’ve died after contracting influenza following confirmation that six deaths have already been reported so far this fall.

Dr. Bonnie Henry said the deaths this year include one child under the age of five, three between the ages of five and nine and two teenagers between the ages of 15 and 19.

“My thoughts are with families and communities impacted by the loss of a loved one,” Henry said in a statement.

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“Early findings indicate some of the children experienced secondary bacterial infections contributing to severe illness, which can be a complication of influenza.”

She added that deaths have been rare in “previously healthy children” and that infants and toddlers, children with chronic medical conditions, kids who need to take Aspirin or ASA for long periods of time and very obese children are most at risk.

“Parents of all children should seek care if your child experiences difficulty breathing or if your child’s fever goes away and comes back or persists longer than five days. This may indicate a possible bacterial infection,” Henry said.

She described the flu season so far as an “unusual season with unusual characteristics,” including an early and serious surge in cases. As a result, the B.C. Centre for Disease Control will be posting weekly updates on pediatric flu-related deaths on its website.

B.C. health officials have urged parents to have children vaccinated against the flu, citing a “dramatic increase” in cases of influenza A, a strain which can cause severe illness in children. 

Historical data provided by the B.C. Coroners Service showed the number of deaths this year to be well above previous flu seasons before the COVID-19 pandemic. 

Between 2015 and 2019, B.C. recorded two to three influenza-related deaths in people aged 18 or younger annually. In 2020, the province recorded one death, while none were recorded in 2021.

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At least five B.C. children died from influenza last month, as mortalities spike

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At least five children died last month in British Columbia from influenza as a rise of early season respiratory illnesses added strain to the beleaguered healthcare system.

The figure marks a departure from the average of two to three annual flu deaths among children in the province between 2015 and 2019, data from the BC Coroners Service shows.

“Public health is monitoring the situation closely and is reminding people of the steps they can take to protect themselves, their children and their loved ones against the flu,” the B.C. Centre for Disease Control said in a statement.

“It is important to know that death associated with influenza in previously healthy children continues to be rare.”

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The centre said it is aware of a sixth reported flu death among children and youth under 19, but it was not immediately clear why the sixth wasn’t included in the coroners’ figures.

Provincial Health Officer Dr. Bonnie Henry said the children who died included one who was younger than five years old, three who were between five and nine, and two adolescents who were between 15 and 19.

“Early findings indicate some of the children experienced secondary bacterial infections contributing to severe illness, which can be a complication of influenza,” Henry said in a statement Thursday.

The deaths in British Columbia suggest figures could tick up across the country given the common challenges facing health systems this respiratory season. Alberta has also recorded the deaths of two children with influenza so far this season.

Before the COVID-19 pandemic, an average of five to six kids died per flu season across Canada, data collected from 12 hospitals across the country shows.

The national data was collected between 2010 and 2019 by IMPACT, a national surveillance network administered by the Canadian Paediatric Association. It was included in a research paper published in March in “The Lancet Regional Health — Americas” journal that also found no deaths from the flu among children in either 2020 or 2021.

No one from either IMPACT or the B.C. Centre for Disease Control was immediately available for an interview.

On Monday, Henry said that after two years of low flu rates, mostly due to COVID-19 pandemic restrictions, the province is seeing a “dramatic increase” in illness and it arrived sooner than normal.

She urged parents to get their children vaccinated against the flu.

On Thursday, British Columbia’s Health Ministry announced a “blitz” of walk-in flu clinics that will open across the province Friday through Sunday. Flu vaccines are free to all kids aged six months and older in B.C.

The B.C. Centre for Disease Control said getting the shot is particularly important for those at risk of severe outcomes, including those with chronic medical conditions like heart, lung, kidney or liver disorders and diseases, those with conditions that cause difficulty breathing or swallowing, those who need to take Aspirin for long periods of time and those who are very obese.

The BC Coroners Service said its data is preliminary and subject to change while investigations are completed.

The cases include those where influenza was identified as an immediate, pre-existing or underlying cause of death, or as a significant condition.

Henry said updates on pediatric influenza-related deaths will be posted weekly as part of the respiratory surveillance summaries on the B.C. Centre for Disease Control website.

This report by The Canadian Press was first published Dec. 8, 2022.

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Cough and cold medication shortage to end next year, pharmacists association says – The Daily Press

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Children’s Tylenol returning slowly to retail outlets in town

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Parents with sick kids might be able to take a break from crushing adult Tylenol and mixing it with apple sauce if they hurry quickly to a local pharmacy.

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Children’s Tylenol (acetaminophen) in liquid form began arriving at retail outlets in late November, but in such limited quantities that pharmacists are keeping them behind the counter and limiting them to one bottle per customer.

A Shopper’s Drug Mart pharmacist The Daily Press spoke with on Tuesday wouldn’t say how much they’d received but advised to hurry while quantities last. A Rexall pharmacist is only selling children’s Tylenol to parents with sick kids, not to those just preparing for a rainy day.

Adam Chappell, owner and pharmacist at Parma Right in The 101 Mall, told The Daily Press he was expecting nine retail-sized bottles of children’s Tylenol last Wednesday, which he also planned to keep behind the counter and limit to one bottle per customer.

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He predicts that more will become available, but that there will be extended shortages in the short term. Pharmacies are being allocated small amounts by the manufacturers, to spread out supply.

The shortage makes it difficult for parents to control fevers in their children, leading to more doctor visits, he said.

“We had more public health measures in place with COVID, so we had 1½ to two years where we really didn’t see much influenza or common cold,” said Chappell, whose independent pharmacy opened in November.

“So now we’re seeing everything all at once because we’re now socializing more. It’s that time of year, so we’re starting to see more influenza, cough and colds and COVID is still circulating. I think it’s a combination of higher use and some lingering logistical issues.”

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Shelves sit half empty in the adult cough and cold section at the Shopper’s Drug Mart at 227 Algonquin Blvd. E. on Tuesday. The shortage is expected to end between January and March of 2023, said Jen Belcher with the Pharmacists Association of Ontario. The timing would coincide with the end of the cold and flu season.NICOLE STOFFMAN/The Daily Press
Shelves sit half empty in the adult cough and cold section at the Shopper’s Drug Mart at 227 Algonquin Blvd. E. on Tuesday. The shortage is expected to end between January and March of 2023, said Jen Belcher with the Pharmacists Association of Ontario. The timing would coincide with the end of the cold and flu season.NICOLE STOFFMAN/The Daily Press jpg, TD

A children’s drug shortage began in the spring and worsened in the summer when an early onset of flu and respiratory syncytial virus was made worse by COVID-19, which presents as a cold. Parents began stocking up.

When local manufacturers could not keep up with demand, Health Canada arranged to import supply from the United States and Australia, whose first shipment in early November went straight to hospitals, in part because the labels were not bilingual, Postmedia reported.

Health Canada has authorized 500,000 bottles of imported children’s acetaminophen for retail to arrive in December, and domestic supply is starting to recover, Jen Belcher with the Ontario Pharmacists Association told The Daily Press in a telephone interview.

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“The demand really hasn’t abated, and manufacturing really hasn’t been able to keep up from a straight capacity standpoint, rather than a supply interruption with a lack of ingredients,” she said, when asked to respond to a claim by the German pharmacist’s association.

That organization asserts pandemic lockdowns in China are blocking exports of the raw ingredients used for medications, Postmedia reported Nov. 16.

If lockdowns in China continue, however, she conceded it could interrupt the ingredient supply in the long-term.  There is also a global reliance on India for the raw ingredients used in over-the-counter medication.

Canadian manufacturers can tap various international suppliers if approved by Health Canada, Belcher said.

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Children’s Advil (ibuprofen), an anti-inflammatory, continues to be in short supply in pharmacies, but available in hospital. Neither Belcher nor Chappell has heard reports of Health Canada planning to import it for retail outlets.

Adult Tylenol and Advil remain plentiful.

Chappell recommends that parents speak to their pharmacist to determine a dosage of adult pills based on the child’s weight and symptoms. They can be crushed and added to yogurt, apple sauce or chocolate syrup.

If parents can wait a few days for the package to arrive, they can order a supply for their child from a compounding pharmacist, who is qualified to make custom medications including liquid formulations. There are several compounding pharmacists in Sudbury, but none in Timmins.

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Adults in Timmins who have come down with a cold or flu lately may also have been surprised to see empty shelves in the adult cough and cold section of their local pharmacy.

“When it comes to cough and cold medication for both adults and children, we’re not seeing an imported supply of those. Those are short and have been for quite some time due to this high level of demand, small amounts have been trickling through the supply chain but it hasn’t been enough to keep up with demand,” said Belcher.

She expects the adult cough and cold medication shortage to end sometime between January and March, 2023, just in time for the end of flu season.

A quick check of the adult cough and cold section of four downtown pharmacies on Tuesday showed partially empty shelves, but there was still a variety of medication to choose from.

Belcher said pharmacists have lots of experience finding alternatives for patients, if necessary.

“While the over-the-counter medications in short supply are the most visible representation of the challenges to our supply chain, pharmacy teams have been managing very high levels of drug shortages, some critical, where there are really few or no alternative options,” she said, adding that up to 20 per cent of the team’s day is spent managing shortages.

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