Are schools driving Alberta’s COVID-19 spread or are they the victim of it? Dr. Hinshaw believes the latter
The reopening of schools has been highlighted as a potential driver of recent COVID-19 surges in other parts of Canada and around the world, but Alberta’s chief medical officer of health doesn’t believe they are causing the high rate of new cases in this province.
“I do not see evidence in Alberta of schools driving that increasing community transmission,” Dr. Deena Hinshaw said.
“It does seem to be the reverse, with community transmission causing increased pressure in schools.”
Alberta continues to see record-high levels of COVID-19 cases among school-aged kids, but that is not unique to their demographic. Virtually every age group in Alberta has recently seen its highest rate of new cases on record, as the province experiences its largest surge in virus spread to date.
Researchers and physicians in other jurisdictions have been warning that schools may be a significant driver of COVID-19 spread, after numbers surged shortly after classes resumed.
The timing of Alberta’s latest surge is consistent with what you would expect if schools were driving an increase in spread, says Malgorzata Gasperowicz, a developmental biologist and independent researcher who has been tracking Alberta’s COVID-19 data closely.
Gasperowicz had previously warned in October that, given the trajectory in Alberta’s COVID-19 spread at the time, the province could be seeing 1,000 cases per day by Nov. 11. Alberta nearly reached that level on Nov. 7, when the province reported 919 new cases of the disease.
She noted that, after plateauing for some time throughout the summer, the disease spread suddenly accelerated in mid-September to a pace where new cases were doubling every 2½ weeks.
“It sort of switched into this faster growth around Sept. 17, which is 16 days after the schools reopening,” she said.
She cautioned that this correlation does not imply causation. In other words, it doesn’t prove schools are driving the spread, but it doesn’t rule it out.
“For me, that shows we cannot dismiss schools as a contributor to the spread,” Gasperowicz said.
Schools and COVID-19 surges in other places
Quebec experienced a similar surge of COVID-19 cases in September, and some physicians in that province have been drawing a link to the resumption of in-person classes.
“Schools were the driver to start the second wave in Quebec, although the government did not recognize it,” Dr. Karl Weiss, president of the Association des Médecins Microbiologistes Infectiologues du Québec, told the Montreal Gazette last week.
More physicians recently spoke out about the situation to CBC Montreal, noting many schools are old and have poor ventilation. Quebec has also had relatively loose requirements for students wearing masks.
Still, Quebec’s public-health director, Dr. Horacio Arruda, maintains schools are not the main cause of the province’s recent surge. He says the cases among school-aged kids are more of a reflection of transmission in the broader community.
Globally, the reopening of schools has also been connected to increases in viral-transmission rates, according to University of Edinburgh researchers who analyzed data from 131 countries and published their findings in The Lancet, a prestigious medical journal.
On Tuesday, Manitoba announced a provincewide “code red” situation due to rapid growth in COVID-19 cases. The province ordered the closure of non-essential retail stores, gyms, movie theatres, salons and churches, as well as a shutdown of recreational facilities and sports activities. Social gatherings of any kind will also be banned as of Thursday.
Manitoba schools and child-care centres will remain open, however. Despite hundreds of cases among students and staff, there have been only a small number of confirmed transmissions directly within the school system, said Manitoba’s Chief Provincial Public Health Officer Dr. Brent Roussin.
Case growth and origins
In Alberta, cases of COVID-19 have been rising quickly among older kids and teens, but not quite as fast as among the 20-to-29 age group, on a population-adjusted basis.
On average over the past week, there have been about 18 new daily cases per 100,000 people aged 10 to 19, compared with about 23 new daily cases for people in their 20s.
Case growth has been significantly slower among kids aged five to nine, at about 10 new daily cases per 100,000 children in that age range.
There’s also the source of infection to consider, which can be difficult to determine.
But Alberta Health says the data points more heavily toward non-school settings than in-school transmission.
From September to mid-October, Hinshaw said just six per cent of COVID-19 cases among school-aged kids were found to be acquired in school.
Alberta Health also said last week that slightly more than half of active cases — across all age groups — were of unknown origin. That figure has been increasing lately, as contact tracers struggle with the sheer volume of newly infected patients.
All this makes pinpointing the primary drivers of the recent surge in cases a difficult task.
“Everything is tangled together,” Gasperowicz said.
She noted there could also be a “data acquisition bias” when it comes to kids, in particular.
“A big percentage of children are asymptomatic, so we don’t test them,” she said. “So there could be invisible spread.”
From all the available evidence, though, Hinshaw believes schools, themselves, are not a primary driver of Alberta’s latest surge.
She says there are “many factors” that have changed since the summer that are likely contributing to the spread.
“With the fall and cooler weather, people are spending more time indoors,” Hinshaw said. “There’s less of those opportunities, perhaps, for socializing outside that we had in the summertime. And, of course, there are other activities that start up in the fall in addition to school. There’s other, recreational-type activities that people are engaging in.”
Health unit suspends 1,900 students for incomplete immunization records – Windsor Star
More than 1,900 elementary school students in Windsor and Essex County have been suspended for out-of-date immunization records, the Windsor-Essex County Health Unit said Monday.
Parents must provide the health unit with an up-to-date immunization record for the suspension to be lifted and the student to return to school. Immunization clinics are available at both health unit locations in Windsor and Leamington on Monday and throughout this week, while immunization records are accepted in-person between 8:30 a.m. and 4:30 p.m. Monday to Friday at both locations.
Students who were suspended but attend and receive vaccinations at the health unit clinics, or who update their records with the health unit, will receive a notice and can return to school the same day.
Proof of immunization can also be submitted online at immune.wechu.org. Primary care providers can also send immunization records to the health unit at 519-258-7288.
The Immunization of School Pupils Act requires local health units to maintain and review vaccination records for all students and to enforce school suspensions if records are incomplete. These routine immunizations are often administered by primary care providers, but records must still be updated and on file with the health unit.
The review of student immunization records began in December 2022, when more than 12,000 students received notice their records were not up to date.
Earlier this month the health unit warned 3,200 students faced suspension for incomplete records; ultimately 1,908 were suspended on Monday, according to health officials.
Visit wechu.org/getimmunized for information and clinic times.
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.
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