VANCOUVER —
As Canada’s top doctor warned the country about a third wave of COVID-19 driven by variants and researchers urged governments to ramp up testing, B.C. health officials are downplaying the predictions and defending the province’s approach to testing and variants.
Canada’s chief public health officer Dr. Theresa Tam cautioned that with more-contagious COVID-19 variants now spreading in all provinces, “the current community-based public health measures will be insufficient to control rapid growth and resurgence is forecast.”
That resurgence could lead to a seven-fold increase in daily infections, according to modelling Tam presented in Ottawa.
During her briefing in Vancouver on Friday, B.C.’s deputy provincial health officer Reka Gustafson responded to questions about Tam’s modelling.
“Mathematical models are exactly that, and they take the parameters that we are seeing with these new variants and can give us potential scenarios,” Gustafson said. “They don’t predict what’s going to happen, and I think that’s really important to remember.”
“There is actually no indication from the behavior of the variants that we need to do anything that is different, and what we mean by that is that the mode of transmission of the new variants is very similar, the virus is just more efficient (in its) transmission … The things that we need to do to prevent the transmission of variants are the exact same things we do to prevent COVID-19, but we have less room for error.”
Tam and other experts have been taking a more aggressive tone in warning citizens that the mutations that make the virus more contagious and deadly can spread with alarming speed, as seen in Newfoundland and Labrador this month, requiring both careful monitoring and a willingness to make amendments to public health orders.
Adding further concern to the situation, a team of B.C. university researchers is urging governments to swiftly ramp up detection of the variants, lest they spread undetected.
“I’m very concerned about the higher transmissibility of these variants — we’re going to hit a wall in Canada when these variants start circulating in the community and we’re going to have to see much more strict regulations to bend the curve down with such a rapidly growing variant,” said UBC biomathematician and study co-author Sally Otto.
“We constructed a model that would predict by the time you find your first case, how many other cases would there be in the community? And the thing is, if we don’t look at a lot of cases, if we don’t do a lot of sequencing, there could be hundreds of cases by the time we detect a case in the community.”
B.C. was one of the first provinces to adopt a more efficient process for screening for variants, which is much more complex and time-consuming than a standard COVID-19 test, which provides a response within 24 to 48 hours.
Only after someone tests positive are specially selected samples sent to a B.C. Centre for Disease Control lab – one of only a handful in the country capable of further testing – for targeted PCR testing to search for a mutation the three main variants of concern have in common. If the mutation is detected, then full genome sequencing is done to determine which variant in particular has been discovered; the process takes almost a week.
“In order to really find it when it’s one or a few people, before it gets out and established within the community, we have to ramp up that testing pretty much every week or every other week,” Otto said.
That suggestion comes as B.C. testing rates remain relatively stagnant. While the health minister and provincial health officer had promised a capacity for 20,000 tests per day by the fall, actual tests have never come near that. The most tests performed in a single day was 15,213 on Nov. 27, around the height of the province’s second wave. Since then, daily tests have been largely under the 8,000 mark.
On a national scale, B.C. is also well behind on testing, especially compared to the other most populous provinces on a per capita basis. Canada-wide, there have been 614,953 tests for every million residents, but B.C. has only conducted 357,341 per million. Alberta is at 748,995 while Ontario and Quebec are virtually tied around 700,000.
“Our testing guidelines in British Columbia have actually quite a low threshold,” Gustafson said. “We actually have no indication that we’re missing large numbers of cases or even substantial number of cases.”
“One of the reasons may be that our testing is relatively low is that the measures that we’re taking that reduce the rate of COVID-19 actually reduce other respiratory illnesses as well, and because we generally test people with symptoms of respiratory illness, if we have less respiratory illness in the community, fewer people will be will be presenting testing,” she said.
When asked whether the province had any plans or benchmarks at which it would implement stricter restrictions, particularly in light of Ontario communities extending lockdowns as they hunt for variants, Gustafson suggested that wasn’t necessary.
“The mode of transmission, how long you’re infectious, the fact it’s spread through respiratory droplets – those have not changed (with the variants),” she said. “Which means, really, it’s really not a question of doing something different. It just makes us sure that we absolutely have to do our very best to follow those measures and to really do excellent case and contact management, which means that all contacts who were asked to self-isolate, actually need to self-isolate, need to adhere to those recommendations given by public health, because there’s less room for error.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
