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Canada could avoid the worst of a 4th wave — but we're not out of the woods yet – CBC.ca

Published

3 years ago

July 24, 2021

This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.

Canada will likely face a fourth wave of the pandemic as the highly contagious delta variant continues to spread ahead of borders and schools reopening, but there’s growing optimism another surge won’t bring the country back to a crisis point.

Canadian immunologists, virologists and infectious disease specialists say we could fare better than in previous waves, with a lower rate of serious infections, due to the effectiveness of COVID-19 vaccines and the willingness of Canadians to get vaccinated.

But our rollout is plateauing and there are still huge swaths of the population that are unvaccinated — either by choice or due to a lack of access or eligibility — including millions of Canadian kids who are heading back to school in just over a month.

“We’re going to see rises in case counts at some point again,” said Matthew Miller, an associate professor of infectious diseases and immunology at McMaster University in Hamilton.

“Probably similar to last year, as we head into the fall and the cold weather arrives. But those bumps are hopefully just that — tiny hills, and not mountains like the earlier waves.”

People walk in downtown Montreal on June 3 after the city lifted public health restrictions. (Jean-Claude Taliana/CBC/Radio-Canada)

How bad will Canada’s 4th wave be?

The severity of Canada’s fourth wave will largely be determined by levels of COVID-19 immunity in the population from vaccines or prior infection, which can prevent community transmission from rising and stop severe cases from overwhelming hospitals.

Canada has had more than 1.4 million cases of COVID-19 so far, yet only 2.6 per cent of Canadians were found to have antibodies due to prior coronavirus infection in early 2021.

“The question is — is there sufficient population immunity? No,” said Raywat Deonandan, a global health epidemiologist and associate professor at the University of Ottawa.

“And the reason for that is because we measure population immunity by recovered cases and vaccinations.”

More than 80 per cent of eligible Canadians aged 12 and up have received at least one shot, and more than 60 per cent have had two. But that number drops to about 70 per cent with one dose and just over 50 per cent fully vaccinated when you consider the country’s entire population.

Although Canada has “nowhere near enough” immunity yet, Deonandan says we can “artificially create” adequate protection by using interventions like masking indoors to help with “building walls” around unvaccinated Canadians as COVID-19 becomes more seasonal.

“We’re seeing the arrival of the endemic phase of this disease in places around the world,” he said. “Because mostly they don’t have enough people vaccinated — it comes down to that.”

Maria Rey, 27, gets her first dose of the Pfizer-BioNTech COVID-19 vaccine at an overnight clinic at the International Centre in Mississauga, Ont., on May 16. (Evan Mitsui/CBC)

Delta threatens to drive COVID-19 surge

Another key factor in Canada’s ability to fend off a severe fourth wave is the spread of the more contagious, potentially more deadly delta variant, which is driving COVID-19 levels back up in countries around the world.

“We know from watching the U.K., for example, that delta is very, very capable of tearing through unvaccinated people very quickly,” said Dr. Dominik Mertz, an infectious diseases physician and associate professor of medicine at McMaster University.

“Any percentage of unvaccinated people in the population are leaving themselves at very, very high risk.”

The United Kingdom has seen a rise in COVID-19 levels in recent weeks, putting pressure on the health-care system. Israel has reinstated mask mandates in response to new outbreaks. And the U.S. has seen a surge in undervaccinated states driven by delta.

A new study in the New England Journal of Medicine (NEJM) this week found two doses of the Pfizer-BioNTech vaccine were 88 per cent effective against the delta variant, while two shots of the AstraZeneca-Oxford vaccine were 67 per cent effective.

But there are conflicting reports from the real world about vaccine effectiveness against delta, including new data from Israel’s health ministry that suggests the Pfizer shot is only 39 per cent effective against infections — but far better at preventing severe illness.

WATCH | Why the delta variant is different from others:

A respirologist breaks down what is known about the coronavirus delta variant, including what makes it different, how dangerous it is and whether vaccines protect against it. 4:26

Dr. Anthony Fauci, director of the U.S. National Institute for Allergy and Infectious Diseases, told CBC’s Power & Politics Friday that the U.S. still has a “substantial proportion” of the population that is unvaccinated and at highest risk from delta.

“That is absolutely something we need to correct, because when you are dealing with a variant like the delta variant that is so efficient in spreading from person to person, you are going to see a kind of surge in cases,” he said.

“And for those who are vulnerable, like the elderly and people with underlying conditions, the chances of their getting hospitalized increases.”

A nurse tends to a patient suspected of having COVID-19 in the intensive care unit at North York General Hospital in Toronto in May 2020. (Evan Mitsui/CBC)

Reopening borders, schools leaves unvaccinated at risk

Canada could also be at increased risk of exposure to delta due to the reopening of the border to U.S. travellers next month and international travellers in September, along with the return of school, which could put unvaccinated Canadians at higher risk of COVID-19 exposure.

“It absolutely will. In addition, the greater travel that we’re doing inside the country is going to increase the risk of variants,” said Dr. Allison McGeer, a medical microbiologist and infectious diseases specialist at Toronto’s Mount Sinai Hospital.

“We should not be surprised if the delta variant starts to increase quite substantially and we should not be surprised if we have to go back to some level of travel and other restrictions.”

The single biggest cohort of unvaccinated Canadians are children under 12, who are not yet eligible for COVID-19 vaccines despite ongoing clinical trials. Experts say the reopening of schools in September could put them at higher risk.

“It’s important that we start reporting our percentage vaccinated, including kids, because that’s our actual number,” said Alyson Kelvin, an assistant professor at Dalhousie University and virologist at the Canadian Center for Vaccinology and the Vaccine and Infectious Disease Organization.

“Considering we want to have herd immunity be above 85 per cent, we’re not going to get there without kids.”

Wearing masks to prevent the spread of COVID-19, elementary school students walk to classes in Godley, Texas, on Aug. 5, 2020. (LM Otero/Associated Press)

Until children under 12 are eligible for vaccination in Canada, Kelvin says those who have less effective immune responses from COVID-19 vaccines — including older Canadians and the immunocompromised — will continue to be vulnerable.

“Children can’t be vaccinated and variants such as delta are more highly transmissible — and there seems to be case reports of increased disease severity in kids when they do get infected,” she said. “That’s something that we need to be watching going forward.”

Future variants pose unknown threat

One unknown threat Canada faces is the possibility of more transmissible variants emerging in the weeks and months ahead that could be worse than delta, as COVID-19 continues to ravage undervaccinated countries around the world.

Canada was hit hard by the alpha variant at a time when our vaccination campaign had not yet picked up steam, and new and more dangerous variants have repeatedly appeared in countries that continue to be hit hard with each passing wave.

“Definitely we’ll see other variants. If they will be more severe or a variant of concern is another question,” said Kelvin. “But it is an interesting trend that … there seems to be an increase in transmissibility with each as time goes on and we see new variants.”

That’s not typically something that is seen with other circulating viruses like influenza, said Kelvin, meaning the unpredictability of this virus leaves its future an open question.

Miller says COVID-19 will likely become endemic in Canada and around the world, returning each year like the flu, and our ability to control it is contingent on our ability to get more people vaccinated.

“It’s going to keep evolving for decades, presumably. It’s not going anywhere. But we have astoundingly successful vaccines,” he said. “The truth is, there is light at the end of the tunnel. This will end as all things end.

“But if you’re not vaccinated, you’re definitely — at some point — going to get infected.”

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With grief lingering, Blue Jackets GM Waddell places focus on hockey in wake of Gaudreau’s death

Published

7 hours ago

September 16, 2024

Anne Joseph

BUFFALO, N.Y. (AP) — Hearing the familiar sounds of clacking sticks and pucks banging off the boards and glass while watching Columbus Blue Jackets prospects from the stands of a cold rink on a warm late-summer afternoon was not enough to wash away the lingering residuals of grief for Don Waddell on Saturday.

That, the Blue Jackets’ general manager acknowledged, will take more time than anyone can guess — weeks, months, perhaps an entire season and beyond.

What mattered is how spending the weekend attending the Sabres Prospects Challenge represented a start to what Waddell called among the first steps in refocusing on hockey and the future in the aftermath of the deaths of Columbus star Johnny Gaudreau and his brother, Matthew, who were struck by a suspected drunken driver while riding bicycles on Aug 29.

“We got to play hockey,” Waddell said. “We’re not going to forget about Johnny and his family, the Gaudreau family.”

He then reflected on the speech Johnny Gaudreau’s wife, Meredith, made during the brothers’ funeral on Monday, by urging those in mourning to move forward as she will while focusing on raising their children.

“Everybody knows that Johnny wants them to play hockey,” Waddell said. “And everybody’s rallying around that.”

The resumption of hockey in Columbus began last week, when most Blue Jackets players returned to their facility to be together and lean on each other at the urging of Waddell and team captain Boone Jenner. And it will continue on Thursday, when the team opens training camp, exactly three weeks since the Gaudreaus were killed.

“Tragic. Senseless. But now we got to focus on trying to get our team ready to play hockey this year,” Waddell said. “We all mourn and heal differently, but I think as a team being together like that is going to be critical for them to get moving forward.”

Tragedy is no stranger to Waddell or the Blue Jackets.

Waddell was general manager of the then-Atlanta Thrashers in 2003 when Dany Heatley lost control of his car and struck a wall, with the crash killing passenger and teammate Dan Snyder. In 2021, Blue Jackets goalie Matiss Kivlenieks died during a July Fourth fireworks accident.

Waddell placed the emphasis on himself and coach Dean Evason — both newcomers to Columbus this offseason — to guide the team through what will be an emotional season.

“Now, do I think there’s going to be some dark days? I won’t be surprised,” Waddell said.

Reminders of the Gaudreaus’ deaths remain apparent, and reflected in Buffalo on Friday night. A moment of silence was held in tribute to the brothers before the opening faceoff of a game between the Blue Jackets and Sabres.

Afterward, Columbus prospect Gavin Brindley recalled the times he spent with Johnny Gaudreau in Columbus and as teammates representing the United States at the world hockey championships in the Czech Republic in May.

“He was one of the biggest mentors for me at the world championships,” Brindley said. “I couldn’t tell you how many times we hung out with Meredith, pictures on my phone. It’s just so hard to look back and see that kind of stuff.”

The NHL and NHL Players’ Association are providing the Blue Jackets help in the form of grief counseling, crowd security at vigils and addressing hockey issues, such as potentially altering the league’s salary cap rules to provide Columbus relief from having to reach the NHL minimum payroll because of the void left by Gaudreau’s contract.

“The Blue Jackets, I don’t think anybody’s focused from an organizational standpoint, from a hockey standpoint as to what comes next, because I think everybody’s still in shock,” NHL Commissioner Gary Bettman told The Associated Press last week. “I don’t think anybody’s focused right now other than on the grieving part, which is understandable.”

Much of the burden has fallen to Waddell, who has been in discussions with the NHL and the NHLPA and dealing with outreach programs with the Blue Jackets’ partner OhioHealth, while also overseeing preparations for training camp and gauging his prospects in Buffalo.

There’s also his roster to attend to, which he said has two openings at forward, one involving Justin Danforth, who may miss the start of the season because of a wrist injury. Waddell didn’t have to mention the second opening.

Tiring and emotional as it’s been, Waddell found comfort being in his element, a rink, and looking ahead to the start of training camp.

“The guys are in really good shape. We’ve done a lot of testing already and they’re eager to get going,” Waddell said. “We have a reason to play for. And we’ll make the best of it.”

The Blue Jackets later Sunday signed veteran winger James van Riemsdyk to a one-year contract worth $900,000.

“James van Riemsdyk has been a very consistent, productive player throughout his career,” Waddell said. “Bringing him to Columbus will not only provide depth to our group up front, but also valuable leadership and another veteran presence in our dressing room.”

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AP Hockey Writer Stephen Whyno in New York contributed to this report.

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PSG says defender Nuno Mendes target of racial abuse after a French league game

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7 hours ago

September 16, 2024

Anne Joseph

PARIS (AP) — Paris Saint-Germain defender Nuno Mendes was the target of abusive and racist comments on social media after a French league game.

The club condemned the abuse and expressed its “full support” Sunday for the Portugal left back, who was targeted following PSG’s 3-1 win against Brest on Saturday.

Mendes, who is Black, shared on his Instagram account a racist message he received.

During the match, Mendes brought down Ludovic Ajorque in the box for a penalty that Romain Del Castillo converted to give Brest the lead.

“Paris Saint-Germain doesn’t tolerate racism, antisemitism or any other form of discrimination,” the club said. “The racial insults directed at Nuno Mendes are totally unacceptable … we are working with the relevant authorities and associations to ensure those responsible are held accountable for their actions.”

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Slovenia’s Tadej Pogacar wins Grand Prix Cycliste de Montreal

Published

7 hours ago

September 16, 2024

Anne Joseph

MONTREAL – Tadej Pogacar was so dominant on Sunday, Canada’s Michael Woods called it a race for second.

Pogacar, a three-time Tour de France champion from Slovenia, pedalled to a resounding victory at the Grand Prix Cycliste de Montreal.

The UAE Team Emirates leader crossed the finish line 24 seconds ahead of Spain’s Pello Bilbao of Bahrain — Victorious to win the demanding 209.1-kilometre race on a sunny, 28 C day in Montreal. France’s Julian Alaphilippe of Soudal Quick-Step was third.

“He’s the greatest rider of all time, he’s a formidable opponent,” said Woods, who finished 45 seconds behind the leader in eighth. “If you’re not at your very, very best, then you can forget racing with him, and today was kind of representative of that.

“He’s at such a different level that if you follow him, it can be lights out.”

Pogacar slowed down before the last turn to celebrate with the crowd, high-five fans on Avenue du Parc and cruise past the finish line with his arms in the air after more than five hours on the bike.

The 25-year-old joined Belgium’s Greg Van Avermaet as the only multi-time winners in Montreal after claiming the race in 2022. He also redeemed a seventh-place finish at the Quebec City Grand Prix on Friday.

“I was disappointed, because I had such good legs that I didn’t do better than seventh,” Pogacar said. “To bounce back after seventh to victory here, it’s just an incredible feeling.”

It’s Pogacar’s latest win in a dominant year that includes victories at the Tour de France and Giro d’Italia.

Ottawa’s Woods (Israel Premier-Tech) tied a career-best in front of the home crowd in Montreal, but hoped for more after claiming a stage at the Spanish Vuelta two weeks ago.

“I wanted a better result,” the 37-year-old rider said. “My goal was a podium, but at the same time I’m happy with the performance. In bike racing, you can’t always get the result you want and I felt like I raced really well, I animated the race, I felt like I was up there.”

Pogacar completed the 17 climbs up and down Mount Royal near downtown in five hours 28 minutes 15 seconds.

He made his move with 23.3 kilometres to go, leaving the peloton in his dust as he pedalled into the lead — one he never relinquished.

Bilbao, Alaphilippe, Alex Aranburu (Movistar Team) and Bart Lemmen (Visma–Lease) chased in a group behind him, with Bilbao ultimately separating himself from the pack. But he never came close to catching Pogacar, who built a 35-second lead with one lap left to go.

“It was still a really hard race today, but the team was on point,” Pogacar said. “We did really how we planned, and the race situation was good for us. We make it hard in the last final laps, and they set me up for a (takeover) two laps to go, and it was all perfect.”

Ottawa’s Derek Gee, who placed ninth in this year’s Tour de France, finished 48th in Montreal, and called it a “hard day” in the heat.

“I think everyone knows when you see Tadej on the start line that it’s just going to be full gas,” Gee said.

Israel Premier-Tech teammate Hugo Houle of Sainte-Perpétue, Que., was 51st.

Houle said he heard Pogacar inform his teammates on the radio that he was ready to attack with two laps left in the race.

“I said then, well, clearly it’s over for me,” Houle said. “You see, cycling isn’t that complicated.”

Australia’s Michael Matthews won the Quebec City GP for a record third time on Friday, but did not finish in Montreal. The two races are the only North American events on the UCI World Tour.

Michael Leonard of Oakville, Ont., and Gil Gelders and Dries De Bondt of Belgium broke away from the peloton during the second lap. Leonard led the majority of the race before losing pace with 45 kilometres to go.

Only 89 of 169 riders from 24 teams — including the Canadian national team — completed the gruelling race that features 4,573 metres in total altitude.

Next up, the riders will head to the world championships in Zurich, Switzerland from Sept. 21 to 29.

Pogacar will try to join Eddy Merckx (1974) and Stephen Roche (1987) as the only men to win three major titles in a season — known as the Triple Crown.

“Today gave me a lot of confidence, motivation,” Pogacar said. “I think we are ready for world championships.”

This report by The Canadian Press was first published Sept. 15, 2024.

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