Health
About 77 per cent of COVID-19 victims have at least one comorbidity, officials say – CTV Toronto
CALGARY —
While the majority of patients who have died from COVID-19 have had at least one comorbidity, or chronic condition, Alberta’s top doctor says it doesn’t mean that when a compromised individual catches the disease they could die.
Dr. Deena Hinshaw, Alberta’s chief medical officer of health, said Thursday that Alberta has always provided details on “severe outcomes” of the virus, including any comorbidities the patients have had.
About two weeks ago, the province introduced more specific information about whether or not comorbidities existed in the deaths currently being reported on a daily basis.
Alberta Health said the additional information, which includes the official date of death, was being released because of requests from the public and the media about those deaths.
However, Hinshaw says just because someone has one of the chronic conditions listed, it does not definitively mean they will die if they contract COVID-19.
“The presence of any chronic condition is not a death sentence and should not be,” she said. “Whether or not an individual who passed away had a chronic condition or not does not mean that that death was any less tragic.”
She also said Alberta has a risk assessment tool designed to help those with chronic conditions to understand their own risk.
“That’s a tool that we have updated over time as more information has become available – both through our own data in Alberta, as well as publications around the world,” she said.
Tom McMillan, assistant director of communications for Alberta Health, tells CTV News that Alberta has the “most in-depth and transparent” reporting of cases in the entire country.
“No other province shares as comprehensive and detailed data as we post online,” he said, adding Alberta Health is constantly looking for ways to provide additional data.
“We were the first province in Canada to offer a comprehensive online dashboard and were also the first to release ongoing data on severe outcomes, cases by age group and gender and other case characteristics.
“We have committed to providing Albertans with as timely and detailed information as possible while still protecting patient confidentiality.”
All three of the Albertans in their 20s who have died from COVID-19 had comorbidities, but the province has not released any more specific information due to privacy concerns.
Hinshaw also said that comorbidities do “disproportionately impact” those individuals, but every Albertan needs to do their part and follow all health rules to prevent the spread of COVID-19.
“It is up to every single one of us – whether or not we have a chronic condition – to be a part of the solution, and to be a part of protecting everyone in our society.”
Provincial data shows about 77 per cent of Alberta’s 575 deaths due to the disease have had at least one comorbidity.
(Source/Alberta Health Services)
Health
Day 42 after first COVID-19 vaccines and still no second dose in sight as Quebec steps into 'wilderness': experts – CTV Montreal
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.
CALCULATED RISKS
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.
Ontario adjusting vaccine rollout to address shipment delay
File photo courtesy of © Can Stock Photo Inc. / vetdoctor)
January 25, 2021 1:42pm
With a dwindling supply of COVID-19 vaccines in Ontario, the government has made changes in how the remaining doses will be distributed.
Premier Doug Ford provided an update on the vaccine rollout Monday afternoon at Queens Park, announcing that vaccine distribution will be adjusted with a goal of making sure all residents of long-term care facilities get a shot by February 5. The previous target date was February 15.
The adjustment ensures that the province’s most vulnerable population, such as long-term care residents, high-risk retirement community residents, and Indigenous elder care homes, have access to both required doses of the vaccines.
The change also means that, until more of the Pfizer vaccine arrives in Ontario, essential caregivers and health care employees may have to wait a little longer to get their shots.
“I know this will mean that some people may have to reschedule their vaccine appointments, but it is critical that our most vulnerable seniors receive the protection they need as soon as possible,” said Ford.
Doses of the Moderna vaccine will be redistributed to 14 of Ontario’s public health units to make sure long-term care homes are getting the vaccine as needed.
The government says once shipments of the vaccine are resumed, rollout will proceed at once. Up to 40,000 Ontarians a day can be vaccinated under the current system, with the ability to increase the capacity pending new shipments.
Also on Monday, Ontario extended its state-of-emergency declaration to Tuesday, February 9, unless extended or amended. Orders under the Reopening Ontario Act will continue to be enforced.
Health
Six cases of new UK variant of COVID-19 confirmed at Roberta Place LTC home in Barrie – Newstalk 1010 (iHeartRadio)
Simcoe-Muskoka health officials say another case of the U.K. variant of COVID-19 has been confirmed in the region.
The person infected – who did not travel abroad – was reportedly in close contact with someone who contracted the virus during the recent outbreak at Bradford Valley Care Community.
Since January 14, six residents and three staff members there, have tested positive for COVID-19.
Health officials are investigating to see if the other cases are also tied to the U.K. variant.
They also reported that this seventh person in the region infected with the new strain of the virus, works at a retail outlet in Simcoe County. Officials did not provide the name of the store, but say it offered curbside pickup only. We have also earned that two other people associated with the retailer tested positive for the coronavirus.
As NEWSTALK 1010 first told you yesterday, the region confirmed six cases of the new U.K. variant at another long term care home – Roberta Place, in Barrie, Ontario. The home has been reeling from a deadly outbreak in recent weeks.
The Simcoe Muskoka District Health Unit said genome sequencing on six COVID-19 samples from Roberta Place Retirement Lodge have been identified as the highly contagious variant.
Officials with the local health unit announced earlier this week that they had found a variant at the home and were conducting tests to determine what it was.
On Saturday, NEWSTALK 1010 learned that 127 of the 129 residents at the home, as well as 84 staff, have tested positive for the virus. At least 32 deaths have been reported there, up from 29 reported Friday.
“The rapid spread, high attack rate and the devastating impact on residents and staff at Roberta Place long-term care home has been heartbreaking for all,” Charles Gardner, medical officer of health for the Simcoe Muskoka District Health Unit, said in a statement Saturday.
“Confirmation of the variant, while expected, does not change our course of action. We remain diligent in doing everything we can to prevent further spread.”
Speaking to the media Saturday afternoon, Gardner noted officials have no reason not to believe all the residents are infected with this new variant.
Known variant strains of the virus were first detected in the U.K., South Africa and Brazil.
An outbreak at Roberta Place was first declared on Jan. 8.
With nearly half of the the facility’s employees now self-isolating at home with the virus, additional help has been brought in from local hospitals and the Red Cross.
Meantime, CBC News is reporting that an employee, who brought COVID-19 to Roberta Place will not face charges. In a tweet, the CBC says the medical officer of health confirms that a staff member did travel, but there’s no evidence that the employee failed to quarantine, noting that person was asymptomatic when they returned to work.
The health unit, in partnership with the Royal Victoria Regional Health Centre, said it accelerated its immunization program on Friday and vaccinated all eligible residents and staff.
Officials said they planned to immunize residents at the other retirement homes throughout Simcoe Muskoka over the weekend.
As of Jan. 16, eligible residents of all long-term care facilities in Simcoe Muskoka have also received their first dose of immunization against COVID-19.
Ontario reported 2,359 new cases of COVID-19 on Saturday and 52 more deaths related to the virus.
That was down marginally from Friday’s figures of 2,662 new cases and 87 more deaths. There was also a slight drop in the number of people hospitalized with COVID-19, with 1,501 reported on Saturday – 11 fewer than Friday.
Health Minister Christine Elliott said Saturday there were 708 new cases in Toronto, 422 in Peel Region, 220 in York Region, 107 in Hamilton and 101 in Ottawa.
Since the province’s report on Friday, nearly 63,500 tests had been completed and 11,161 doses of a COVID-19 vaccine administered in Ontario.
As of Saturday, a total of 276,146 doses have been administered in Ontario.
On Saturday the Ontario government also announced it’s expanding its “inspection blitz” of big-box stores to ensure they’re following COVID-19 guidelines this weekend.
The workplace inspections, which started in the Greater Toronto and Hamilton areas last weekend, will now stretch out to Ottawa, Windsor, Niagara and Durham regions.
Officials want to ensure workers and customers at the essential businesses are properly protected from COVID-19 during the provincewide shutdown.
The blitz was developed in consultation with local health units and also covers a variety of other workplaces, including retail establishments and restaurants providing take-out meals.
The province’s labour ministry says more than 300 offences officers, as well as local public health inspectors and municipal bylaw officers, will conduct the inspections.
Corporations can now be fined $1,000, and individuals can be fined $750 or charged for failing to comply with the orders.
Labour Minister Monte McNaughton said the province is confident that the majority of workplaces in Ottawa, Windsor, Niagara and Durham are following orders.
“However, if we find that businesses are putting the safety of workers and customers at risk, our government will not hesitate to take immediate action,” McNaughton added in a statement.
“The only way to reduce the spread of COVID-19 and end the provincewide shutdown is for everyone – owners, customers and staff alike – to follow the proper guidelines.”
With files from The Canadian Press
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