After 3 years of COVID-19, here's how Canada's 'endemic' future may look – q107.com
On March 11, 2020, the world came to a screeching halt when the World Health Organization declared the COVID–19 outbreak a global pandemic.
Schools across the world shut down, workplaces turned remote and the fast-spreading virus revealed the fragility of many countries’ health-care systems. Since then, the virus has claimed close to seven million lives, of which more than 51,000 were Canadians.
Fast-forward three years and COVID-19 hospitalizations and deaths are declining, more than 70 per cent of Canadians have contracted the virus at least once and effective vaccines and treatments paired with previous infection have allowed many to live somewhat normal lives again.
Some experts now say the pandemic is slowly transitioning to an endemic state — when a disease, like COVID-19, is consistently present, often within a particular area or region. Examples of this include the flu, malaria, ebola and hepatitis B.
“I think we are seeing that point,” explained Dr. Zain Chagla, infectious disease physician and associate professor at McMaster University in Hamilton.
“We are seeing death rates lower since the beginning of the pandemic, we’re seeing health care utilization slowing, we are seeing the population having immunity to this,” he said.
Dr. Theresa Tam, Canada’s chief public health officer, echoed this sentiment.
Speaking at a media conference Friday, she said Canadians should not expect a surge of COVID-19 in the upcoming months.
“We are now at a point in Canada where COVID-19 activity has reached a relatively steady state. In recent months there have been no distinct variant-driven waves,” she said. “Over the past six to eight months COVID-19 hospitalizations have been relatively stable despite the ongoing spread of Omicron subvariants.”
In light of the good news, Chagla warned COVID-19 will be around for “quite some time as it’s reached every corner of the Earth,” meaning there will be future challenges with infection and hospitalization – especially for older and immune-compromised Canadians – just like there is with influenza every year.
But if the virus is here to stay, at least in the near future, will society ever be able to recover when a persistent threat of a new variant remains just over the horizon?
New variants are likely to circulate, Chagla warned, but the impact may not be as profound as it was in 2020 or 2021.
“Many have been infected with Omicron or had a vaccine and because most of the population has seen the virus as well as a vaccine, it makes a higher barrier for health destabilization to happen,” he explained.
Danielle Rice, assistant professor at McMaster University in the Department of Psychiatry & Behavioural Neurosciences, said if there are more variants on the horizon, it may cause anxiety for some, but many people may have become accustomed to the consistent threat of a new variant of concern.
Rice, who is also a clinical and health psychologist in supervised practice at St. Joseph’s Healthcare, said people’s mental health has been “resilient” during COVID-19 and likely will continue.
“There have been challenges, such as folks that may feel distressed with the reality that we may be living with COVID-19, but on the other end are folks adapting to this new reality,” she explained.
“In general that’s how anxiety works, the more we are exposed to something, the less anxiety we face.”
New variants may emerge in the future, but testing for COVID-19 may not be as prevalent, Chagla said.
Instead, the message from health officials may be simply to stay at home if you are sick, he added.
“I think the guidance of staying home while sick is more effective from a long-term standpoint,” he explained. “Rather than saying, with one disease you isolate and another disease, you don’t isolate.”
At the end of January, Health Canada announced it was ending shipments of rapid antigen tests to provinces and territories.
Supply is not an issue as Ottawa and provincial health authorities have millions of rapid tests in their stockpile. However, demand appears to be waning, according to officials.
“It’s not surprising, just given the fact that we are starting to see this gradual transition out of the pandemic into a little bit more of normal life,” said Dr. Gerald Evans, infectious disease specialist at Queen’s University in Kingston, Ont.
“So it may be that a year from now or so, the rapid test may not be necessarily useful,” he told Global News.
As the virus has mutated over time, the emergence of new variants has also reduced the sensitivity of the antigen tests, said Evans.
But, Evans argued that cutting back on supply might make it difficult for people who want to continue testing themselves, and many may have to start paying for it.
If people end up having to buy them, Evans suspects most won’t be keen on spending out of their pocket.
Last week, Canada’s national vaccination advisory body advised high-risk individuals to get another COVID-19 booster shot, starting this spring.
The National Advisory Committee on Immunization’s (NACI) recommendations said an additional vaccine shot may be offered for people at a higher risk of severe illness, such as the elderly, those living in long-term care homes, and Canadians who are immunocompromised.
Chagla explained that focusing on boosting the high-risk population is likely the approach Canadian health officials will keep using in the future.
“We are starting to see a switch (of booster campaigns) to really focusing on highest risk and focusing less on lower risk populations,” Chagla said.
Although vaccine rates are dropping among the lowest-risk population, he noted it’s still too early to say if Canada will soon recommend an annual COVID-19 booster.
In January, the U.S. Food and Drug Administration (FDA) asked its scientific advisors to consider simplifying COVID-19 vaccination to encourage most adults and children to get a once-a-year shot to protect against the virus.
Under this proposal, Americans would no longer have to track how many shots they’ve received or how many months it’s been since their last booster.
Canadian health officials have not indicated whether they are considering a similar proposal, but in a statement to Global News, Health Canada said NACI “continues to monitor evolving evidence, including evidence on the potential need or benefit of booster shots, and will update recommendations as required.”
As Canadians start heading into a new COVID-19 chapter, one where federal health officials are moving towards treating the virus like a “regularly occurring disease,” experts warn not to forget about the vulnerable population.
“Going into this pandemic phase … for most people that means going back to normal. But it’s important that resources for the highest-risk populations are maintained,” Chagla said.
“If we’re going to cut back on testing, we really do need to make sure testing is still there for the high-risk population. And if we’re going to cut back on vaccinations, vaccinations need to be easily accessible to those people that need to get them.”
She explained that pre-pandemic, society made sure to focus on protecting infants, the elderly and the immunocompromised from getting infected during the cold and flu season.
It will be the same battle moving forward with COVID-19.
“These are some transferable skills that are actually now able to take to the COVID-19 pandemic, potentially going to this endemic situation,” she said.
— with files from Teresa Wright and Global News’ Saba Aziz
© 2023 Global News, a division of Corus Entertainment Inc.
COVID-19 hair loss: Experts weigh in on PRP therapy – CTV News
The list of ways a COVID-19 infection disrupts the body’s natural functions is long and diverse, and, as Viktorya Skrypnyk’s clients have come to learn, includes hair loss.
Skrypnyk is a registered nurse who owns and operates VBeauty Spa, a medical aesthetic clinic in Toronto. The last two years have sent a parade of people through the doors of her clinic struggling with hair loss they say began after a COVID-19 infection.
“Lately, I do see that there’s people that are coming in that have no history of hair loss in the family, no history of alopecia that are developing these symptoms of alopecia within last few years,” she told CTVNews.ca on Friday. “Most of them are saying that they generally noticed an increase in the year loss specifically after acquiring COVID.”
Multiple published studies have shown COVID infections can trigger a type of hair shedding called telogen effluvium (TE). With TE, thinning typically occurs around the top of the head.
When clients suffering from TE come to Skrypnyk, it’s usually for a treatment she offers known as platelet-rich plasma (PRP) therapy. Before the pandemic, Skrypnyk estimates 70 per cent of her PRP therapy clients were men. Now?
“Lately I’ve noticed, after COVID especially, it’s been more popular among women,” she said.
WHAT IS PRP THERAPY?
Platelet-rich plasma therapy is a form of regenerative medicine that uses a patient’s own blood cells – specifically platelets – to accelerate healing in a specific area of the body.
Plasma is the liquid portion of blood; the medium that carries red and white blood cells and platelets through the body. It’s made mostly of water and proteins. Platelets are blood cells that aid in blood clotting and contain a naturally-occurring substance called growth factor, which stimulates cell growth and wound healing.
In PRP therapy, a patient’s blood is collected and spun in a centrifuge to concentrate the platelet component of the blood. The patient’s own platelet-rich plasma is then injected into an area of the body that needs help with growth or healing, like an injured muscle or, in some cases, a scalp losing hair.
“We usually withdraw the platelets and re-inject them back into the hairline, specifically where there’s a lot of hair loss,” Skrypnyk said.
PRP meets the definition of a drug under Canada’s Food and Drugs Act, but isn’t covered by provincial health insurance plans. At VBeauty Spa, a treatment typically costs $600, though other clinics may charge more or less.
According to an entry by doctors Neera Nathan and Maryanne Makredes Senna in the Harvard Health Blog, most of the research on PRP for hair loss has looked at its use to treat androgenetic alopecia, also known as hormone-related baldness. Androgenetic alopecia affects both men and women, resulting in balding at the crown and front of the head in men, and balding that begins with a widening of the part in women.
“There is not enough evidence to make conclusions about the effectiveness of PRP for other types of hair loss, like telogen effluvium, alopecia areata or forms of scarring hair loss,” Nathan and Senna wrote.
YOUR MILEAGE MAY VARY
A person can elect to receive PRP therapy for any type of hair loss, but Dr. Jeff Donovan cautions it should only be considered as a second- or third-line treatment for most patients and most types of hair loss.
“PRP is very popular, but the overwhelming message that I would have is that there is no hair loss condition for which PRP is the first-line option,” Donovan told CTVNews.ca in a phone interview on Friday.
Donovan is a dermatologist and member of the Canadian Dermatology Association who specializes in hair loss. Like Skrypnyk, he sometimes treats patients using PRP therapy. However, he rarely uses it to treat the type of hair loss most commonly linked to COVID-19 infections – telogen effluvium – and he never prescribes it as a first-line treatment.
For one thing, he explained, TE normally resolves on its own after four to eight months, as long as the condition that triggered it has resolved. It often doesn’t respond to the typical hair loss treatments.
“Telogen effluvium is a hair loss condition that happens due to a trigger,” Donovan told CTVNews.ca on Friday. “The treatment for telogen effluvium involves treating the trigger, not a bandaid with some other treatment plan.”
If a patient’s TE was triggered by low iron, treatment would involve restoring their iron levels, he said. Likewise, TE triggered by a thyroid condition, or a condition like anorexia nervosa, should resolve after the underlying condition has been treated.
In rare cases, Donovan will recommend PRP therapy for a patient suffering from TE for which an underlying cause can’t be pinpointed. More often, he’ll recommend it for patients suffering from other types of hair loss, but even then, only after exhausting other treatment options.
“When we speak about treatment for hair loss, we must speak about what is the first line treatment, what is the second line treatment and what is the third line treatment,” he said. “These are treatment ladders according to evidence-based medicine.”
For a client with alopecia areata, a type of hair loss that results in circular bald patches, Donovan said the first-line treatments are topical steroid injections and topical minoxidil, which is the active ingredient in Rogaine. For genetic hair loss or androgenetic hair loss, Donovan would first recommend oral and topical minoxidil as well as topical and oral anti-androgens.
Among clients who do end up using PRP therapy, Donovan said between 20 and 40 per cent will see mild benefits, such as a slower rate of hair loss or some modest growth. In order for PRP therapy to provide long-term benefits, however, Donovan said clients typically need to return for treatments three times per year, indefinitely.
Like Skrypnyk, Donovan has noticed more people seeking out PRP therapy for TE in the past year or two. However, he cautions against shelling out for the treatment before speaking to a doctor.
“Due to the popular nature of PRP and the marketing that goes into PRP, there has been an increase in the number of patients demanding that therapy,” he said. “However, that is not necessarily reflective of the benefit of the treatment. Nor is it reflective of how these conditions should be managed based on current scientific evidence.”
Instead, Dovovan said anyone who has hair loss concerns should start by seeking a diagnosis from their usual health-care provider, who can screen for underlying triggers and suggest treatments.
“In my practice, I really prefer when patients come after having tried several therapies,” he said, “because then I get a sense of how well the hair is responding to certain types of treatments.”
'Worrisome' deadly fungus spreading through US at alarming rate – Sky News
A drug-resistant and potentially deadly fungus is spreading rapidly through US health facilities, according to a government study.
Researchers from the Centres for Disease Control and Prevention (CDC) reported the fungus, a type of yeast called Candida auris or C. auris, can cause severe illness in people with weakened immune systems.
The number of people diagnosed, as well as the number who were found through screening to be carrying C. auris, has been rising at an alarming rate since the fungus was first reported in the US in 2016.
The fungus was identified in 2009 in Asia, but scientists have said C. auris first appeared around the world about a decade earlier.
Dr Meghan Lyman, chief medical officer of the CDC’s mycotic diseases branch, said the increases, “especially in the most recent years, are really concerning to us”.
“We’ve seen increases not just in areas of ongoing transmission, but also in new areas,” she said.
Dr Lyman also said she was concerned about the increasing number of fungus samples resistant to the common treatments for it.
Dr Waleed Javaid, an epidemiologist and director of infection prevention and control at Mount Sinai Downtown in New York, said the fungus was “worrisome”.
“But we don’t want people who watched ‘The Last Of Us’ to think we’re all going to die,” Dr Javaid said.
“This is an infection that occurs in extremely ill individuals who are usually sick with a lot of other issues.”
Is The Last Of Us’ real ‘zombie’ fungus an actual threat?
The fungus, which can be found on the skin and throughout the body, is not a threat to healthy people.
But about one-third of people who become sick with C. auris die.
The fungus has been detected in more than half of all US states. The number of infections in the US increased by 95% between 2020 and 2021.
Species of fungus discovered in Scotland
Fungal infections ‘increased significantly’ during COVID pandemic
The new research comes as Mississippi is facing a growing outbreak of the fungus.
Since November, 12 people in the state have been infected with four “potentially associated deaths”, according to the state’s health department.
More dead birds found in Caledon could be linked to bird flu
Possible cases of bird flu have been found in Caledon as potential outbreaks of the virus are popping up in Brampton and across southern Ontario.
The City of Brampton issued a warning about two possible avian flu incidents on Friday after dead birds were found in the area of Professor’s Lake and Duncan Foster Valley South.
Now the Town of Caledon says a number of dead birds have also been found in a pond near Coleraine Dr. and Harvest Moon Dr. and that the deaths may be related to bird flu.
The Town has closed a trail in the area out of precaution and says testing is being conducted by the Canadian Wildlife Health Cooperative to determine the birds’ cause of death.
Peel Public Health says that while avian influenza is a threat to birds, the risk to humans is very low.
“Most cases of human avian flu have been traced to handling infected poultry or their droppings,” said Dr. Nicholas Brandon, acting Medical Officer of Health for PPH. “Residents are asked to follow the recommended guidance to limit the spread of avian flu and protect the health and safety of residents and pets.”
Peel Public Health is recommending residents and pet owners are asked to take the following precautions:
- Keep animals away from any waterfowl or fecal matter
- Do not feed or otherwise interact with the waterfowl
- Keep cats indoors
- Keep dogs on a leash (as required under the municipal by-law)
- Do not feed pets (e.g., dogs or cats) any raw meat from game birds or poultry
- Pet birds, if not normally kept indoors, should be restricted to the indoors
- Bird feeders should be removed or washed with soap and water frequently to reduce the chance of bacterial or viral contamination
The cause of the birds’ death in all three of the cases in Peel has not been confirmed but Brampton Animal Services is actively monitoring the areas.
If the birds test negative for Avian Influenza a full necropsy will be conducted to determine the cause of death, the City of Brampton said on Friday.
Last week the Toronto Zoo shut down some of its bird enclosures after an avian flu case was detected at a southern Ontario poultry farm.
A highly pathogenic type of H5N1 avian flu has been tearing through Canadian flocks since early 2022, killing millions of birds and infecting a record number of avian species.
The Canadian Food Inspection Agency detected a case at a commercial poultry operation southeast of Hamilton on Tuesday, the second reported Ontario site in a week after a lull in detected cases going back to the end of December.
With files from The Canadian Press
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