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

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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.”


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.

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Bitcoin hovers near 6-month high on ETF hopes, inflation worries

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Bitcoin hovered near a six-month high early on Monday on hopes that U.S. regulators would soon allow cryptocurrency exchange-traded funds (ETF) to trade, while global inflation worries also provided some support.

Bitcoin last stood at $62,359, near Friday’s six-month high of $62,944 and not far from its all-time high of $64,895 hit in April.

The U.S. Securities and Exchange Commission (SEC) is set to allow the first American bitcoin futures ETF to begin trading this week, Bloomberg News reported on Thursday, a move likely to lead to wider investment in digital assets.

Cryptocurrency players expect the approval of the first U.S. bitcoin ETF to trigger an influx of money from institutional players who cannot invest in digital coins at the moment.

Rising inflation worries also increased appetite for bitcoin, which is in limited supply, in contrast to the ample amount of currencies issued by central banks in recent years as monetary authorities printed money to stimulate their economies.

But some analysts noted that, after the recent rally, investors may sell bitcoin on the ETF news.

“The news of a suite of futures-tracking ETFs is not new to those following the space closely, and to many this is a step forward but not the game-changer that some are sensing,” said Chris Weston, head of research at Pepperstone in Melbourne, Australia.

“We’ve been excited by a spot ETF before, and this may need more work on the regulation front.”

 

(Reporting by Hideyuki Sano in Tokyo and Tom Westbrook in Singapore; Editing by Ana Nicolaci da Costa)

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China’s plunging construction starts reminiscent of 2015 downturn

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China’s September new  construction starts slumped for a sixth straight month, the longest spate of monthly declines since 2015, as cash-strapped developers put a pause on projects in the wake of tighter regulations on borrowing.

New construction starts in September fell 13.54% from a year earlier, the third month of double-digit declines, according to Reuters calculations based on January-September data released by the National Bureau of Statistics on Monday.

That marks the longest downtrend since declines in March-August 2015, the last property malaise.

When the sector recovered in 2016 after authorities loosened their grip on purchases and development, tens of thousands of real estate firms borrowed heavily to build homes.

But as regulations tightened again this year, many of them have started to face a liquidity crunch, which was then worsened by sharply weaker demand due to tighter restrictions on speculative purchases.

Property sales by floor area dropped 15.8% in September, down for a third month, according to Reuters calculations based on the statistics bureau’s data.

The slowdown in the sector was also underscored by a 3.5% drop in property investments by developers in September, the first monthly decline since January-February last year at the height of the COVID-19 pandemic in China.

“All the data are poor,” said Zhang Dawei, chief analyst with property agency Centaline.

“Financing is hard, sales are tough, so of course, there has been no enthusiasm to build. For the first time in history, developers are encountering two blockages – blockages in sales and blockages in financing.”

The potential collapse of highly indebted real estate firms such as China Evergrande Group have raised concerns about systemic risks to the broader economy. The real estate sector accounts for a quarter of China’s gross domestic product.

Authorities will try to prevent problems at Evergrande from spreading to other real estate companies to avoid broader systemic risk, Yi Gang, governor of China’s central bank, said on Sunday.

On Friday, a central bank official said the spillover effect of Evergrande’s debt problems on the banking system was “controllable.”

“There is a likelihood that housing policies may loosen in the fourth quarter, and that would ease the pessimism in the property transaction data,” said Yan Yuejin, director of Shanghai-based E-house China Research and Development Institution.

On Friday, representatives from 10 Chinese Property Companies met government regulators to ask for an “appropriate loosening” on policy restrictions, financial news outlet Yicai reported.

China’s real estate shares have fallen 22% so far this year. On Monday, they were down 2.6% as of 0300 GMT.

In the first nine months, property investment rose 8.8% from a year earlier, slowing from 10.9% growth seen in January-August.

Funds raised by China’s property developers grew 11.1%, slower than the 14.8% rise seen in the first eight months.

(Editing by Jacqueline Wong)

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Saks Fifth Avenue ecommerce unit aims for IPO at $6 billion valuation – WSJ

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The ecommerce business of luxury department store  Saks OFF 5TH is preparing for an initial public offering and targeting a $6 billion valuation, the Wall Street Journal reported Sunday, citing sources.

The company is interviewing potential underwriters this week for an  IPO that could take place in the first half of next year, according to the report.

 

(Reporting by Sheila Dang; Editing by Daniel Wallis)

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