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Bruce Arthur: A COVID peak would be nice. But Ontario faces a winding, treacherous path back to health – Toronto.com

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Maybe this is a peak. Not THE peak: we’ve been over peaks before, as the pandemic has rolled over two long years. But wastewater data analyzed by the province’s independent volunteer science table appears to be showing a plateau. There are other indications that we may be finding a limit on BA.2, the dominant variant in Ontario right now.

It would be good news. Not an end; not deus ex machina. Toronto’s 67-year-old mayor just tested positive, for goodness’ sakes, after a day of in-person appearances. But a peak would beat the alternative, because Ontario sure wasn’t going to do very much to stop the spread of the virus on its own.

And you can already see the road ahead: mission accomplished, off we go. We were already partway in that mind space, from the government on down. And while that might work on an individual level, regrettably, that’s not how communicable diseases work.

“We’d be foolish to think” this is over, says Dr. Isaac Bogoch, an infectious diseases specialist at Toronto General and the University of Toronto. “While it’s wonderful that there’s arrows pointing in the right direction, that this wave may have crested, and while all waves come to an end and this one will as well, we still have to have a strong medium- and long-term vision.

“Because there will be more variants, there will be more waves, and we have to build resiliency in Ontario and of course elsewhere in Canada and really at a global level to to help protect us against future variants and future waves. Which are going to happen.”

Indeed. People will set their own individual risk level with little actual information — how fast does your personal immunity wane? — and for many, it’s defensible. And much of society seems to be snapping back to its default setting of not thinking about the vulnerable unless absolutely necessary. It would be harder to reinforce public health, plan wholesale booster campaigns to address waning immunity, create truly effective communication channels and strategic flexibility, any of that. A truly effective booster campaign would be accompanied by three-dose vaccination passports. And it would be easy to simply mandate masks in places where people like cancer patients or the immunocompromised have to go, like grocery stores or pharmacies.

But no, we’re probably going to veer toward pretending this is over.

“I think that if you’re the government, you’re quite happy about this, because the sky doesn’t appear to be falling and you don’t need to change direction,” says Dr. Andrew Morris, a professor of infectious diseases at the University of Toronto and a member of the table, and the medical director of the Antimicrobial Stewardship Program at Sinai-University Health Network. “Right now you’ll have the blowhards of the world who say I told you this wasn’t a big deal and everything was going to be fine. And then you’ll have people who say I told you there’ll be tons of cases, and they’ll say that they were right.

“But there’s a huge amount of uncertainty. I think overall some of this is promising, but I think that this is still going to carry with it a fair amount of unnecessary deaths. We’re now entering the phase where to some degree, we just have no idea about the hidden pandemic. Right now the pandemic is increasingly becoming hidden from analysis, and it’s going to make it very difficult to sway government, because certainly in the next while, they’re not going to care.”

That uncertainty is reflected in the latest round of science table modelling Thursday, and the summary is easy: projections are much higher since masks were made voluntary, with median forecasts of 3,000 for a hospitalizations peak — the January Omicron wave set the record with over 4,000 — and 500 in the ICU.

The confidence ranges, however, are massive — ICU alone ranges from 250 to 1,000, which is two different universes. We can only see what’s coming in the crudest terms — wastewater going up, going down, holding fast, and whatever happens in the hospitals. Everything is anecdotal. Surgeries might be cancelled again, or not. Deaths and hospitalizations will rise some more before they stop, and Long COVID — which was detailed in the modelling, and remains the sleeping giant of this thing — is a lottery we’re all playing. But nothing will be done to slow this down.

“In both Denmark and the U.K. and other countries they’ve had this ongoing rise of deaths, and the person on the street doesn’t recognize it; they’re just saying, OK, that’s just how it is,” says Morris. “So people who are in the U.K. right now, unless they’re in the health-care system, they’re just saying this is how life is, and we’ve got freedoms and we’re gonna live our life, and if I’m boosted the risk to me is relatively low.”

A cresting of the wave, while unambiguously good news, would likely only accelerate that idea. And meanwhile, this wave isn’t over. Wastewater is a jumpy and imprecise measure, and there’s a holiday long weekend coming. Hospitalization and ICU numbers aren’t done rising. And as the science table noted, we’re already matching the peak of health-care worker infections right now.

A peak would be a relief, honestly. Maybe this is the start toward a fallow period, into summer with better weather and enough residual immunity, after a wave that plummets as quickly as it came. It would be nice. It would beat the alternative.

But this isn’t the last wave, or the last variant, no matter how much any of us would like to think it is. It’s not fun, but it’s true.

Bruce Arthur is a Toronto-based columnist for the Star. Follow him on Twitter: @bruce_arthur

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Europe, US on alert after new monkeypox cases emerge – Al Jazeera English

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US, Spain and Portugal announce cases of rare viral infection, two weeks after UK identified its first case.

Health authorities are on alert for the spread of monkeypox, a rare viral disease first reported in the Democratic Republic of Congo in the 1970s, after new cases emerged in Europe, and the United States confirmed its first infection.

Portugal said on Wednesday it had identified five cases of monkeypox, Spain said it was testing 23 potential cases, and the US state of Massachusetts announced it had found a case in a man who recently travelled to Canada.

The United Kingdom was the first to confirm a case of monkeypox earlier this month. It has now detected seven cases and is working with the World Health Organization (WHO) to investigate the virus’s spread after being unable to make a link between the initial case, in a man who had travelled from Nigeria, and the more recent ones.

Health authorities suspect some of the infections may have occurred through sexual contact – in this instance among gay or bisexual men – with four of the UK cases identified among people who visited sexual health clinics after developing the rash associated with monkeypox.

“No source of infection has yet been confirmed for either the family or GBMSM clusters,” the WHO said in a statement in Wednesday. “Based on currently available information, infection seems to have been locally acquired in the United Kingdom. The extent of local transmission is unclear at this stage and there is the possibility of identification of further cases.”

Monkeypox, which is similar to human smallpox, typically begins with a flu-like illness and swelling of the lymph nodes, followed by a rash on the face and body. Most people recover from the illness, which is endemic in parts of central and western Africa and usually the result of close contact with infected animals, within a few weeks, but it can be fatal.

The five Portuguese patients, out of 20 suspected cases, are all in a stable condition, according to the country’s health authorities. They are all men who live in the region of Lisbon and the Tagus Valley, they added.

Health authorities in Madrid said the cases discovered in Spain appeared to be linked to sexual contact.

“In general, its transmission is via respiratory drops but the characteristics of the 23 suspected infections point to it being passed on through bodily fluids during sex relations,” they said in a statement, without giving further details.

“All of them are young adult males and most of them are men who have sexual relations with other men, but not all of them,” Elena Andradas, head of public health in the Madrid region, told Cadena Ser radio.

US health officials said the Massachusetts man who developed monkeypox went to Canada to see friends at the end of April and returned home in early May. He is currently being treated in hospital.

Jennifer McQuiston from the US Centers for Disease Control and Prevention (CDC) said while it was the only case the CDC was aware of, “I do think we are preparing for the possibility of more cases”.

The agency is in contact with its counterparts in the UK and Canada as part of the investigation, but McQuiston said no link had been established so far.

There are two types of monkeypox virus: the West African clade and Congo Basin (Central African) clade. The case-fatality ratio for the West African clade has been documented to be about 1 percent, and up to 10 percent for patients with the Congo Basin clade.

The WHO said that while smallpox vaccination has been effective against monkeypox, the end of mass vaccination programmes for smallpox meant people under the age of 40 or 50 no longer had that protection.

The UK has previously reported cases of monkeypox – all linked to travel to Nigeria – as has the US. An outbreak there in 2003 was traced to pet prairie dogs that had been housed with small animals imported from Ghana that were found to have the virus.

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Federal corrections must improve workplace for parole officers’ mental health: report

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OTTAWA — A new report calls on federal corrections to ease caseloads, improve workplace policies and give added resources to parole officers in order to mitigate current strains on their mental health.

The report, led by public safety expert Rosemary Ricciardelli and released by a union, says that federal parole officers are experiencing extremely high levels of workplace stress and compromised mental health.

These 1,600 parole officers across Canada feel overwhelmed by their caseloads, are exposed to violent and traumatic material in client files, and need mental health supports, the report said.

Working either in an institution or in the community, parole officers are tasked with preparing imprisoned people to reintegrate back into communities, and address issues that brought that person to jail, according to the report.

Ricciardelli, currently a research chair in safety, security and wellness at the school of maritime studies at Memorial University of Newfoundland, said she found the well-being of parole officers moved in tandem with the well-being of their clients.

“If they were worried or concerned about a client’s ability in re-entry, or if a client has specific needs, or anything, their mental health became more compromised,” said Ricciardelli, who has extensive experience in criminal justice system research.

Parole officers are grappling with wanting to do more but being unable to because of their caseload, Ricciardelli added.

When people are released from prison into the community, parole officers are supposed to understand any potential risks that person poses and how those can be managed, said David Neufeld, national president for the Union of Safety and Justice Employees.

“The fact is that parole officers, if they are not mentally or physically well, it makes it very difficult to do the work that they’re doing. Most Canadians don’t understand that every single day, parole officers encounter graphic files, working with files that document incidents of violence,” Neufeld said.

The high levels of stress parole officers face on the job makes their work more challenging, particularly from the accountability and responsibility that comes with assessing risks in determining whether someone is ready for release into the community, he said.

“They are first responders. They are the front line to ensure public safety. And in order to do that, they do compromise themselves,” added Ricciardelli.

“They’re protecting public safety in a way that we just don’t appreciate. And it’s going to take a toll.”

The correctional system has been under strain since 2014 when Stephen Harper’s Conservative government tasked departments with reducing spending in order to meet its savings targets, said Neufeld.

When it came to parole officers, the Correctional Service of Canada re-evaluated the work parole officers do and reduced the number of staff required to do the work, raising caseloads for staff, he said.

Prior to 2014, one parole officer was assigned to 25 imprisoned people in medium- and maximum-security prisons.

After the cuts, officers had to manage 28 to 30 cases in those same types of prisons. In minimum-security prisons, officers are assigned to 25 cases, said Neufeld.

Alongside the increased caseloads, the work has become more complex to appropriately manage cases for racialized Canadians and Indigenous Peoples, women and those with mental health needs, he added.

The study is based on in-depth interviews with parole officers employed by Correctional Service Canada across the country, conducted between August and September 2020.

Correctional Service Canada takes the issues raised by parole officers in the report very seriously, according to spokesperson Marie Pier Lécuyer in a statement Wednesday.

The agency is actively reviewing options to ensure resources and distribution of cases are “appropriate” and will continue to work with the union, said Lécuyer.

Staff have access to employee assistance, a stress management program and information sessions on mental health, she said.

All new parole officers are required to take mental health preparedness training, and the agency will resume mental health refresher training for all parole officers “once the COVID-19 pandemic is over,” Lécuyer said.

This report by The Canadian Press was first published May 18, 2022.

This story was produced with the financial assistance of the Meta and Canadian Press News Fellowship.

 

Erika Ibrahim, The Canadian Press

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Unexplained hepatitis cases rise to 429 across 22 countries, WHO says – The Irish Times

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Cases of unexplained hepatitis have risen to at least 429 in 22 countries, according to the World Health Organisation (WHO).

The number of countries reporting at least five cases has doubled since the last WHO briefing in April, from six to 12. Nine of these countries are in Europe.

A further 40 possible cases of acute liver disease are awaiting classification, officials told a press conference in Geneva on Tuesday.

Six children have died and 26 have required transplants, according to Prof Philippa Easterbrook of the WHO’s global hepatitis programme. About 75 per cent of cases are in children aged under five years.

Although the cause remains unclear, scientists are still investigating whether the cases were caused by an adenovirus activating an inflammatory response, possibly after a previous Covid-19 infection.

In Ireland, one child has died after being treated for the disease, and a second has received a liver transplant, the Health Service Executive reported last week.

Six probable cases of children with hepatitis of unknown cause have been detected in Ireland since the UK issued an alert in April.

The six children were aged between one and 12 years of age. All were hospitalised.

Covid-19 cases

Meanwhile, Covid-19 cases rose in four out of six regions of the world last week, according to WHO secretary general Dr Tedros Ghebreyesus. With testing and sequencing programmes being reduced in many countries, he said it was increasingly difficult to know “where the virus is and how it’s mutating”.

Officials expressed concern about virus outbreaks in North Korea, where state media has said there are about 1.4 million suspected cases, and Eritrea, which has yet to start vaccinating its population.

High levels of transmission of the coronavirus among unvaccinated people, such as in North Korea, creates a higher risk of new variant, a WHO official said.

“Certainly it’s worrying if countries . . . are not using the tools that are now available,” said WHO emergencies director Mike Ryan in response to a question about the outbreak in North Korea.

“WHO has repeatedly said that where you have unchecked transmission there is always a higher risk of new variants emerging,” he said.

Maria Van Kerkhove, WHO technical lead on Covid-19, said the notion that the Omicron variant of Covid-19 is mild was false and this narrative needed to be corrected. Omicron, in all its sublineages, can cause anything from asymptomatic infection to death, she pointed out, though vaccination provides protection. – Additional reporting: Reuters

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