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Alberta health officials must determine ‘largest factor’ fuelling new COVID-19 cases to slow spread

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As COVID-19 cases continue to rise in Alberta, so too does the number of cases that have an unknown source of exposure — meaning officials can’t pinpoint where the person came in contact with the novel coronavirus.

From Oct. 27 to Nov. 2, 67 per cent of the new cases confirmed had an unknown source, according to the Alberta Health website.

And of the province’s 6,110 active cases reported Tuesday, 53 per cent of those also had an unknown exposure, the website showed. No new data on Wednesday’s causes of exposure were available as of time of publishing on Wednesday.

According to chief medical officer of health Dr. Deena Hinshaw, the unknown exposure percentage of active cases that Alberta Health is working with is significantly lower, at roughly 40 per cent. She said Wednesday that’s because a public health investigation, including contact tracing, hasn’t happened yet, adding that in “many of those cases, we will be able to determine the source.”

Hinshaw called the number of cases where officials don’t know where the virus came from is “concerning.”

“We do know what the trends are in our own data and those trends match the transmission issues that we’re seeing in other provinces, which are social gatherings — they are times when people are spending time together in close contact, not wearing masks, not using distancing.

“The issues happen when individuals perhaps are not staying home when they’re symptomatic.”

Dr. Vanessa Meier-Stephenson, infectious disease physician and virologist at the University of Calgary, said the high number of cases with unknown sources makes for a “higher risk for potentially contracting the virus from various day-to-day activities.”

“It really does make it hard to implement the measures that would be necessary to quell that fire,” she said.

“The thing is, if we know it’s only occurring in groups, we can focus on trying to encourage people to stop having larger group gatherings.

If it’s only occurring in schools, then we can revisit what we’re doing at that. But that’s not the case.”

More virus in community leads to ‘increased risk for everybody’

The Alberta government last month introduced new mandatory restrictions on social gatherings in Calgary and Edmonton, limiting them to 15 people, however, it takes about two weeks to see whether those new measures have had an impact.

Premier Jason Kenney said Wednesday if the “significant wave” in cases doesn’t slow down, “they will pose a very serious challenge to the ability of our health care system to cope.”

“If the current trends continue, we’re going to have to move more people out of acute care beds, delay more surgeries and those actions will have negative downstream health consequences which we want to avoid,” Kenney said.

Meier-Stephenson said without knowing whether it’s truly gatherings that are causing the spikes in case numbers, it’s hard to know whether the restrictions will work and whether more robust ones should be enforced.

“The challenge for public health is to identify: what is the largest factor that’s contributing to these numbers?”

“The fact that we have more people with the virus in the community means… [for] every extra person, there’s that extra potential for another surface, another interaction to include the virus in there,” she said. “So it does it does make it to an increased risk for everybody.”

Meier-Stephenson said people need to get back to the basics of preventative health measures including hand-washing, wearing masks and most importantly, staying home when feeling sick and keeping groups small.

“I’m certain that any of us could could think back in the past several days or weeks — are there times when we let our guard down, we let things slip?” she said.

“We need to revisit that and and really pay attention to kind of what we’re doing with each of these measures.”

Meier-Stephenson admitted it’s “hard to keep that message at that intensity for so long,” adding that many people are feeling fatigued about the precautions and pandemic overall.

 

 

 

Source:- Global News

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AstraZeneca manufacturing error raises questions about vaccine study results – CBC.ca

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AstraZeneca and Oxford University on Wednesday acknowledged a manufacturing error that is raising questions about preliminary results of their experimental COVID-19 vaccine.

A statement describing the error came days after the company and the university described the shots as “highly effective” and made no mention of why some study participants didn’t receive as much vaccine in the first of two shots as expected.

In a surprise, the group of volunteers that got a lower dose seemed to be much better protected than the volunteers who got two full doses. In the low-dose group, AstraZeneca said, the vaccine appeared to be 90 per cent effective. In the group that got two full doses, the vaccine appeared to be 62 per cent effective. Combined, the drugmakers said the vaccine appeared to be 70 per cent effective. But the way in which the results were arrived at and reported by the companies has led to pointed questions from experts.

The partial results announced Monday are from large ongoing studies in the U.K. and Brazil designed to determine the optimal dose of vaccine, as well as examine safety and effectiveness. Multiple combinations and doses were tried in the volunteers. They were compared to others who were given a meningitis vaccine or a saline shot.

Before they begin their research, scientists spell out all the steps they are taking, and how they will analyze the results. Any deviation from that protocol can put the results in question.

None of the volunteers in the trial who received the half dose was under the age of 55. (Siphiwe Sibeko/Reuters)

Real or quirk?

In a statement Wednesday, Oxford University said some of the vials used in the trial didn’t have the right concentration of vaccine so some volunteers got a half dose. The university said that it discussed the problem with regulators, and agreed to complete the late-stage trial with two groups. The manufacturing problem has been corrected, according to the statement.

Experts say the relatively small number of people in the low-dose group makes it difficult to know if the effectiveness seen in the group is real or a statistical quirk. Some 2,741 people received a half dose of the vaccine followed by a full dose, AstraZeneca said. A total of 8,895 people received two full doses.

Another factor: none of the people in the low-dose group were over 55 years old. Younger people tend to mount a stronger immune response than older people, so it could be that the youth of the participants in the low-dose group is why it looked more effective, not the size of the dose.

A laboratory technician works at the mAbxience biopharmaceutical company in Garin, Argentina, which has agreed to make the AstraZeneca vaccine if approved. Details of the preliminary trial are to be published in medical journals. (Natacha Pisarenko/The Associated Press)

Another point of confusion comes from a decision to pool results from two groups of participants who received different dosing levels to reach an average 70 per cent effectiveness, said David Salisbury, and associate fellow of the global health program at the Chatham House think tank.

“You’ve taken two studies for which different doses were used and come up with a composite that doesn’t represent either of the doses,” he said of the figure. “I think many people are having trouble with that.”

Oxford researchers say they aren’t certain and they are working to uncover the reason.

‘The Goldilocks amount’

Sarah Gilbert, one of the Oxford scientists leading the research, said the answer is probably related to providing exactly the right amount of vaccine to trigger the best immune response.

“It’s the Goldilocks amount that you want, I think, not too little and not too much. Too much could give you a poor quality response as well,” she said. “So you want just the right amount and it’s a bit hit and miss when you’re trying to go quickly to get that perfect first time.”

Details of the trial results will be published in medical journals and provided to U.K. regulators so they can decide whether to authorize distribution of the vaccine. Those reports will include a detailed breakdown that includes demographic and other information about who got sick in each group, and give a more complete picture of how effective the vaccine is.

Moncef Slaoui, who leads the U.S. coronavirus vaccine program Operation Warp Speed, said Tuesday in a call with reporters that U.S. officials are trying to determine what immune response the vaccine produced, and may decide to modify the AstraZeneca study in the U.S. to include a half dose.

“But we want it to be based on data and science,” he said.

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COVID-19: B.C. ready for vaccine distribution by January, says provincial health officer – Gananoque Reporter

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371 people have died from COVID-19 since March, including a record 13 reported on Wednesday

Rapid COVID-19 testing is on its way in B.C. and the province will be vaccine-ready by January, the provincial health officer said Wednesday.

Dr. Bonnie Henry reported a record day for COVID-19 deaths in B.C. with 13 deaths between noon on Tuesday and noon on Wednesday, with 738 new cases.

Henry said the federal government had given the province 131 ID Now rapid-test machines that can provide a result in less than 15 minutes, and 27,000 test kits. B.C. also has 500,000 COVID-19 antibody tests.

“We are expecting more of the tests to arrive, both the machines and the test kits, in the coming months,” Henry said. “And we will be looking at how to best deploy them across the province to rapidly detect outbreaks.”

Henry said these rapid tests still required a nasopharyngeal swab, which was uncomfortable for the person being tested.

These were not same test used by the film industry in B.C. or by the NHL during the playoffs.

Henry said the downside of a rapid test was that it could not detect COVID when the person had no symptoms.

“Right now, we’re limited in how we can use these,” she said.

“They are also only licensed for use in people who are symptomatic – so people who have symptoms. And we know that even in that case, they’re not as sensitive. They’re not as able to pick up the virus as the regular NAT tests that we do on an ongoing basis that go to the lab.”

She said a promising development was a self administered swab that would go into the nose, but not all the way back to the throat. Rapid testing still requires a health-worker to insert the swab, she said.

Henry said the bright light in this second wave of B.C.’s COVID fight was that vaccines were in sight.

Two vaccines have received emergency use approval – Pfizer and Moderna – and both have deals in place to supply the Canadian government.

She said a B.C. COVID-19 vaccine program has been created and she was confident the B.C. Centre for Disease Control would be ready to distribute either the Pfizer or Moderna vaccine in January 2021.

“We know, for example, that the Pfizer vaccine will come in frozen trays of 975 doses and it has to be reconstituted,” Henry said.

The federal government has not revealed how the vaccines will distributed to the provinces.

“But we expect and what we’re planning for is first week of January, week 1 of 2021, to be ready to deliver the Pfizer and Moderna vaccines. And we will have phases after that.”

COVID-19 cases in Fraser Health were underreported between Nov. 17-24 by 255 cases due to data transfer errors, Henry said.

The reporting gaps between the laboratories and the health authority during those days were detected on Tuesday.

Some days were under-reported and some were over-reported, with and overall 255 cases not reported. The new data will appear on the B.C. Centre for Disease Control website within two days, Henry said.

Fraser Health has been a COVID hotbed in B.C., accounting for around 70 per cent of cases.

There have been 108 deaths so far in November, mostly in Fraser Health.

Henry said that of the 7,616 active cases of the disease, 294 people were in hospital including 61 in intensive care.

Health Minister Adrian Dix said B.C. hospital beds were 72.3 per cent full, while 66 per cent of intensive care beds are occupied.

Henry said there had been no new health-care facility outbreaks. There are 57 active health-care outbreaks, with 52 in long-term care homes. There were no new community outbreaks reported in B.C., while the Royal Columbian Hospital in New Westminster has been declared over.

Henry said her office was reviewing its tougher COVID-19 restrictions as the Dec. 7 expiry loomed.

“We are looking at every option that we have. We’ve never had a lockdown in that sense here in B.C., and we are looking at the important things that we can do to make a difference where transmission is happening.

“We are going through all of the options over the next ten days to two weeks. So by Dec. 7, we will know what we need to do from here.”

dcarrigg@postmedia.com


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Manitoba's COVID-19 vaccine task force is waiting on Ottawa: provincial health minister – CBC.ca

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Manitoba’s health minister says a team of public servants, minus the province’s top doctor, has been enlisted to get a COVID-19 vaccine into the arms of as many people as possible.

But Cameron Friesen said the provincial task force is restrained by circumstances beyond their control.

“There is only so much advanced planning that we can do until we are in need of the detail that only the federal government can provide,” Friesen told reporters Wednesday.

As the first batch of COVID-19 vaccines is slated to arrive by early 2021, Manitoba insists its task force devoted to the coveted shot in the arm is doing everything possible, before then. 

The province said the task force is preparing for the needs of each vaccine candidate, such as freezer capacity, by identifying the resources Manitoba already has and those it still requires.

Manitoba Health Minister Cameron Friesen said the province has a task force equipped to ensure a smooth rollout of the COVID-19 vaccine. (John Woods/The Canadian Press)

The group is speaking with key stakeholders, participating on national vaccine committees and ensuring the province has the means of tracking new vaccines from inventory to uptake, the government said in an email. 

The task force will also make decisions on vaccine priority groups, as well as the logistics of receiving, storing and distributing it.

“This work involves significant risks, it involves significant contingency planning,” Friesen said.

“But those things, we will be ready for. We need the federal government, though, to say what’s happening.”

Friesen went on to cite the United States’ COVID-19 task force, named Operation Warp Speed, and implied that Canada’s effort might be lagging behind.

“It seems that we have a slow-lane approach to vaccine, at least expressed thus far from the federal government,” Friesen said.

Ottawa has deals in place to buy the vaccine and distribute them to provinces and territories, but Friesen said over the past week that Manitoba doesn’t know much in terms of vaccine, distribution and storage planning. 

He said a phone call Tuesday involving his federal counterpart, Patty Hajdu, didn’t alleviate his concerns.

Premier Brian Pallister told a national audience on CBC’s Rosemary Barton Live Sunday that Manitoba needs national criteria to ensure fairness in distributing a vaccine. He added that vulnerable people and health-care workers are expected to be first in line.

WATCH | Manitoba’s premier says vaccine rollout should be equitable:

Brian Pallister cautions against ‘piecemeal’ plans for access to COVID-19 vaccines and wants a standard in place across all provinces and territories. 1:28

The province said in an email Wednesday that Manitoba has received an estimate on the number of available vaccine doses from the federal government, but would not reveal what that number is. 

Other provinces, including Saskatchewan and Ontario, have revealed an estimated dosage.

Manitoba’s task force will be comprised of staff from various government departments, including Health, Seniors and Active Living, Finance, and Central Services.

Dr. Brent Roussin will not be at the table, Friesen confirmed.

“Our chief provincial public health officer is very busy with his assigned duties, so therefore, we cannot task him also with this,” Friesen said, “but we have expertise here. We have taken a whole-of-government approach.”

The NDP’s health critic said Roussin’s voice shouldn’t be missing from the table.

“I was surprised to hear that Dr. Roussin wouldn’t be taking the lead in terms of what the vaccine’s going to look like once it reaches Manitoba and how that those decisions are going to be made,” Uzoma Asagwara said.

They added that the province should focus less on blaming Ottawa and more on preparing.

“We know it ends up with us being in a position to react instead of being proactive,” Asagwara said. 

“Where they’ve made many mistakes during this pandemic,” Asagwara said of the government, “this is an opportunity to get it right.”

Doctors Manitoba wants to be consulted

Doctors Manitoba, which represents physicians in the province, has yet to be consulted by provincial officials on vaccine rollout. President Dr. Cory Baillie hopes that will change.

“At this point, we’d like to ensure that physicians are involved in deciding who receives the vaccine first and ensure that physicians are involved in giving the vaccine,” he said.

“We know that physicians have built up trust with their patients and we think building on that trust is going to be very important in order to ensure maximum uptake in the population of the coronavirus vaccine.”

Friesen has previously said the vaccine distribution plan will be guided, in part, by the annual flu vaccination campaign, with some notable distinctions.

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