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Canada hesitates to update public health guidelines on risk from coronavirus variants – CBC.ca

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The rapid spread of more contagious coronavirus variants across Canada has led some hard-hit regions to question whether national public health guidelines go far enough to protect Canadians — and they’re sounding the alarm over the dangers of just minutes of exposure.

Despite acknowledging the emergence of variants threaten to “rapidly accelerate” the spread of COVID-19, the Public Health Agency of Canada (PHAC) has not made any updates to its guidance for the public. 

Canadians continue to be told to stay at home as much as possible and follow basic public health guidelines such as mask-wearing, physical distancing and handwashing — but at a local level, regions facing rising variant cases are going even further.

In York Region, just north of Toronto, public health officials made headlines this week after releasing startling new information on individuals infected with the variant first identified in the U.K. that seemed to call into question federal guidelines. 

“Those cases were quite careful in many instances but seem to have the variant of concern nevertheless,” Medical Officer of Health for York Region Dr. Karim Kurji said in a statement to CBC News. 

“Some of these people who caught it were just doing essential visits and not for very much time, just a minute or two.” 

WATCH | What do variants change about the approach to COVID-19?

An infectious disease specialist and epidemiologist answer questions about COVID-19 variants including if people need to adapt precautions and how they affect testing. 5:55

York Region has seen a dramatic rise in the number of confirmed cases of the variant, also known as B117, with at least 39 to date.

It’s also stepped up efforts to control the spread of variants by opening isolation centres and lowering its thresholds for risk.

Kurji said York Region has had a more “conservative” definition of a close contact throughout the pandemic than other areas, describing it as just 10 minutes of interaction within two metres as opposed to the federal government’s 15-minute rule. 

“At the very beginning of the pandemic, these guidelines were not very clear,” he said. “So we established this rule and we have stuck with that.”

Public Health Ontario (PHO), an arm’s-length provincial government agency, also recently told health units across the province they should reduce their thresholds for classifying all COVID-19 exposures because of the emergence of variants. 

If a person infected with COVID-19 and a contact are both wearing masks, but the contact isn’t wearing eye protection, PHO said they should be considered “high-risk” if they were within two metres for at least 15 minutes. 

If neither of them is wearing a mask or eye protection — PHO said any amount of exposure time is risky, aside from briefly passing by each other. 

And if the contact isn’t wearing a mask but the infected case is, even if it’s a high quality medical mask, the risk of exposure is large no matter what. 

It’s a far cry from the federal government regulations that still recommend non-medical masks and define exposures in the COVID Alert app as 15 minutes within two metres. And the competing advice from different public health officials no doubt leaves Canadians confused as to what they should be doing to protect themselves.  

What should we do differently?

Experts say much like local public health units that are reassessing guidelines in light of the variants, Canadians should be rethinking risk based on the situation in their communities. 

“I think in this case the local health units have it right in the sense that you want to have an abundance of caution,” said Ashleigh Tuite, an infectious diseases epidemiologist and assistant professor at the University of Toronto’s Dalla Lana School of Public Health. 

“We know that we have a more transmissible variant that’s circulating, we’re still trying to figure out exactly what that means. We continue to hear that the precautions that have worked with the regular version of [the coronavirus] still work — but we may need to do them better.” 

Canada’s Chief Public Health Officer Dr. Theresa Tam puts on a mask at a news conference on Nov. 6, 2020. The Public Health Agency of Canada has resisted recommending the use of medical masks to lower risk of exposure, despite calls from experts like Dr. Anthony Fauci to up our mask game whenever possible. (Patrick Doyle/Reuters)

Tuite said the 15-minute exposure time and two-metre distance rules are “arbitrary,” and erring on the side of caution makes sense even in areas without widespread variants. 

“The new variants I think provide us with a reason to reevaluate those rules and I think that’s something that hasn’t necessarily been well communicated to the public,” she said. 

“There’s nothing magical about that distance that was based on science, that’s based on sort of what we know about how airborne pathogens are spread. But I think the science has evolved, or at least our thinking has evolved.” 

PHAC was slow to update its guidance on the spread of the coronavirus through the air. It only mentioned the risk of transmission from aerosols — or microscopic airborne particles — for the first time in November

The federal agency has also resisted recommending the use of medical masks to lower risk of exposure, despite calls from experts like Dr. Anthony Fauci to up our mask game whenever possible. 

Tuite said it’s “unhelpful” for PHAC to tell Canadians who may not be closely following the science that variants are more transmissible than previous strains, but also not instruct them to do anything differently. 

“When you look at Canada’s response as a whole, clearly, there are many, many different things that we should be doing better,” said Dr. Leyla Asadi, an infectious diseases physician at the University of Alberta in Edmonton. 

“We should be having better public health restrictions in place, we should be having better public health messaging, we should be using more rapid tests, we should have more paid sick leave and wraparound services — all of those things.” 

A laboratory technologist at the B.C. Centre for Disease Control holds a genome cartridge while performing genomic sequencing of the the SARS-CoV-2 virus. (Ben Nelms/CBC)

Asadi said the reason Canada is doing so “poorly” in these areas, is simply because we’re not being “aggressive enough” in our response. 

“I think people fundamentally would appreciate having strong leadership from federal public health authorities,” she said. 

“I don’t think the science has necessarily changed. We don’t need new science I don’t think, I think we know these things already. We just need to make sure that it’s not just the people on Twitter and the health authorities that know it.”

Federal response

Federal health authorities said during a technical briefing Tuesday there were no plans to update current public health guidelines due to variants, but that could change as more information becomes available.

“The state of the science and our understanding of these variants is continuously growing,” said Dr. Guillaume Poliquin, head of the federal National Microbiology Lab in Winnipeg.  

“As data becomes available, public health decision-makers review the data and will re-evaluate any public health decisions based on data.”

WATCH | Alberta aims to reduce risk of new variant spread by adjusting quarantine rules:

By introducing the possibility of quarantine periods of up to 24 days for people who’ve been exposed to someone infected by COVID-19, the province of Alberta expects to reduce the risk posed by the arrival of coronavirus variants, says respirologist Dr. Samir Gupta. 2:04

Asadi said the average Canadian who may still be wearing a cloth mask and thinking two metres of distance is sufficient, may not be getting the information they need to avoid risk of exposure. 

“It makes me sad when I feel like the necessary information isn’t getting to precisely the people that it needs to get to,” she said. 

Risk guidelines ‘patchy’ across Canada

Dr. David Fisman, an epidemiologist at the University of Toronto’s Dalla Lana School of Public Health, said there has been enough scientific evidence released in recent months to warrant updating public health guidance on the risk of exposure, even before the emergence of variants. 

A recent report from the U.S. Centers of Disease Control and Prevention looked at COVID-19 transmission in the National Football League last fall, and found infections were occurring in exposures of less than 15 minutes

“So that’s before the variants are an issue. So it’s not a variant thing, it’s a COVID thing,” he said. “Maybe what’s motivating people to make these changes is the variant has freaked them out a little bit.” 

A shopper wears a mask as he passes a government sign on a bus stop in London, England. The more infectious coronavirus variant first detected in the U.K. is now in Canada. (Kirsty Wigglesworth/The Associated Press)

Fisman said there are still a lot of unknowns with variants. While it’s been proven B117 is more transmissible than previous strains, it’s not entirely clear what that means in terms of how people are likely to get infected. 

“That doesn’t tell us that they infect people after shorter exposure, it doesn’t tell us that there’s greater propensity to create aerosols,” he said. “So a lot of this stuff is by definition to be determined.” 

Fisman said additional precautions taken in places like York Region exemplify the “precautionary principle” of erring on the side of caution when faced with a lack of scientific evidence — a key lesson from the 2003 SARS epidemic. 

Dr. Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare Hamilton and an associate professor at McMaster University, said the lack of movement on public health guidelines from the federal government has left it up to local authorities to make decisions on risk. 

“They’re going to make decisions based on where they see,” he said. “They do risk assessments on more than just what the rules provide — the rules are supposed to be a guideline to them.” 

Alberta changed its self-isolation rules this week for those infected with variants. It’s now calling for quarantining of contacts for up to 24 days in some cases in response to the added threat of infection they pose.

“This risk assessment is getting very patchy and it’s really confusing,” Chagla said. “But it doesn’t mean that you have to create new rules out of nowhere.” 

He said it’s important that public health units are flexible in their assessment of risk, but the lack of coordination at a national level leaves a lot of room for confusion.

“You would like some centralization based on the science and we’re hearing different things across the country in terms of quarantine and what an exposure risk is,” he said. 

“Are people going to really adhere when again the rules keep changing left and right?”  

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Canada's inflation rate rises to new 30-year high of 4.8% – CBC News

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The Consumer Price Index increased at an annual pace of 4.8 per cent in December, as sharply higher prices for food led to the cost of living going up at its fastest rate since 1991.

Statistics Canada reported Wednesday that grocery prices increased by 5.7 per cent, the biggest annual gain since 2011.

The price of fresh produce is being walloped by two things, the data agency said: “Unfavourable weather conditions in growing regions, as well as supply chain disruptions.”

The price of apples has increased by 6.7 per cent in the past year, and oranges by almost as much — 6.6 per cent. 

The U.S. is the major supplier of oranges to Canada, and because of bad weather and a plant disease called citrus greening, the major growing region of Florida is on track to produce the smallest number of oranges since 1945. 

That’s causing the price of frozen concentrated orange juice to skyrocket on commodities markets.

“If you’re an orange juice drinker, it means your prices are going to be going up at the store,” analyst Phil Flynn, with Chicago-based commodity trading firm Price Group, told CBC News. “The cost of orange juice has almost doubled here in the last few months, and that’s going to be passed down to the consumers.”

Other types of food are going up quickly, too. The price of frozen beef has gone up by almost 12 per cent in the past year, while ham and bacon are up by about 15 per cent.

Kendra Sozinho, a manager at the Fiesta Farms grocery store in Toronto, says costs from suppliers are going up faster than she’s ever seen “We’re seeing almost every single supplier increasing their pricing whech then increases our pricing,” she told CBC News in an interview. “I’ve been here for 20 years and I’ve never seen a jump like this.”

WATCH | Grocery store manager explains why prices are going up:

Grocery costs going up

53 minutes ago

Duration 0:38

Kendra Sozinho at Fiesta Farms in Toronto says consumers are seeing higher prices because grocers are dealing with sharply higher prices themselves. 0:38

Economist Tu Nguyen with consultancy RSM says food price increases could be set to get even worse in the coming weeks and months because of new rules forbidding unvaccinated truckers from entering the country.

“The current bout of inflation is driven by supply chain disruptions, pent-up demand and inflation expectations,” she said. “While pent-up demand is expected to ease as pandemic spending winds down, supply chain and inflation expectations remain paramount challenges.”

Prices for oranges and orange juice are set to rise because of bad weather and a citrus disease in Florida, which supplies most of Canada’s oranges. (Bruna Prado/Getty Images)

Expect a rate hike soon  

Food is far from the only thing becoming more expensive.

Shelter costs have risen by 5.4 per cent in the past year, faster than the overall inflation rate. And unlike the global forces at play pushing up food prices, the factors driving up shelter costs are all Canadian-made, TD Bank economist James Marple said.

“The one exception to the global nature of the current inflationary environment, is housing inflation, which is both domestically driven and, outside of increased incidents of extreme weather driving up insurance prices, directly related to the Bank of Canada’s policy stance,” he said.

Politicians weigh in

Conservative finance critic Pierre Poilievre placed the blame for high inflation squarely at the foot of the federal government, noting that as a country with abundant energy and food resources, Canada should have a built-in advantage when it comes to keeping a lid on prices.

“The biggest increases for consumer products have been those that we source right here at home, not those that depend on foreign supply chains,” he told reporters in Ottawa.

“Home price inflation is a home-grown problem,” he went on, arguing that record government spending under Prime Minister Justin Trudeau is to blame for inflation. “The more he spends, the more things cost,” Poilievre said.

The Prime Minister, for his part, rejected that claim and said his government has a plan in place to face the inflationary challenges that many countries are facing.

WATCH | Trudeau talks about record high inflation:

Trudeau says inflation is a ‘global challenge’

2 hours ago

Duration 1:34

Prime Minister Justin Trudeau says inflation is a challenge facing many countries and his government has a fiscal plan in place to get past it. 1:34

Lending rates were slashed to record lows in the early days of the pandemic to stimulate the economy. But two years of rock bottom mortgage rates have proven to be jet fuel for Canada’s housing market, causing many policy makers to suggest the time has come for the Bank of Canada to hike its rate to cool things down.

After Wednesday’s inflation report, investors think there’s about a 75 per cent chance of a rate hike as soon as next week, when the bank is set to meet. 

“Inflation is likely to come down over the next year, but getting it there will require tighter financial conditions and rate hikes by the Bank of Canada,” Marple said. 

Semiconductor shortage persists

And an ongoing lack of semiconductor microchips continues to drive up the price of just about anything with a microchip in it.

That includes durable goods like washing machines and other household appliances, the price of which have gone up by 5.7 per cent in the past 12 months. New car prices are up by even more — 7.2 per cent. 

If there was one area of relief for consumers, it was gas prices, where the price to fill up at the pump fell by 4.1 per cent during the month. That’s the biggest monthly drop since April 2020. But compared to a year ago, gas prices are still 33 per cent higher than they were in December 2020.

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Coronavirus: What's happening in Canada and around the world on Wednesday – CBC News

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The latest:

New Brunswick’s health minister is asking the public for assistance as the province struggles with a growing wave of COVID-19 that has sparked concern over the strained health-care system.

“We need your help,” Dorothy Shephard, the province’s health minister, said in a statement. “Whether you are retired, non-practising or unlicensed — if you have experience that can help, please reach out to us.”

The health minister said the Omicron variant is causing both increased hospitalizations and staff absences, which is “putting pressure on all aspects of our health-care system.”

Health officials in New Brunswick on Tuesday said three more people who had COVID-19 had died, bringing the number of recorded deaths in the province to 192. The province also said a total of 113 people were hospitalized with COVID-19, including 15 in intensive care. The province, which is one of many jurisdictions in Canada that now restrict access to PCR testing, also reported an additional 330 lab-confirmed cases.

The province said it was looking for people to fill both paid and unpaid roles, noting in the statement that training and personal protective equipment would be provided.

New Brunswick’s call for help came as Prince Edward Island announced tight new restrictions — including closing gyms and restaurant dining rooms — and extended remote learning until the end of January as officials try to slow the spread of COVID-19.  

As of Tuesday, the island had eight people in hospital being treated for COVID-19, including four in intensive care. The province also reported an additional 407 lab-confirmed cases.

Nova Scotia on Tuesday reported one additional COVID-19-related death. Health officials said in a statement there were 73 people in hospital “who were admitted due to COVID-19 and are receiving specialized care in a COVID-19 designated unit.” That figure includes 15 people being cared for in intensive care units, the province said.

The update came as the province reported an additional 415 lab-confirmed cases of COVID-19. 

“Now is the time to buckle down,” Premier Tim Houston said in a statement. “I ask all Nova Scotians to do everything you can to keep COVID-19 out of our health-care system, long-term care facilities and our communities.”

In Newfoundland and Labrador, health officials on Tuesday reported two additional deaths and said COVID-19 hospitalizations in the province stood at 14, with three people in critical care. The province also reported an additional 295 lab-confirmed cases of the illness caused by the novel coronavirus.

-From CBC News, last updated at 7:20 a.m. ET


What’s happening elsewhere in Canada

A man has a paper checked by an SAQ employee at an outlet in Montreal on Tuesday. In an effort to curb the spread of COVID-19, vaccine passports will be mandatory to enter liquor and cannabis stores. (Graham Hughes/The Canadian Press)

With lab-based testing capacity deeply strained and increasingly restricted, experts say true case counts are likely far higher than reported. Hospitalization data at the regional level is also evolving, with several provinces saying they will report figures that separate the number of people in hospital because of COVID-19 from those in hospital for another medical issue who also test positive for COVID-19.

For more information on what is happening in your community — including details on outbreaks, testing capacity and local restrictions — click through to the regional coverage below.

You can also read more from the Public Health Agency of Canada, which provides a detailed look at every region — including seven-day average test positivity rates — in its daily epidemiological updates.

In Central Canada, Ontario health officials reported an additional 60 deaths on Wednesday, as the province’s health minister held a COVID-19 briefing alongside the province’s top doctor.

Health Minister Christine Elliott reported a total of 4,132 hospitalizations, with 589 in ICU. A total of 5,744 additional lab-confirmed cases were reported in Ontario on Wednesday, which was the first day back in classrooms for many students after a winter storm delayed the shift to in-person education.

Dr. Kieran Moore, Ontario’s chief medical officer of health, said Wednesday that for the first time in weeks, the number of people in the province’s hospitals and intensive care units is “increasing at a slower pace.”

Elliott said she sees a glimmer of hope, but cautioned that February will pose a challenge — especially for hospitals.

Quebec’s COVID-19 update on Wednesday showed 88 additional deaths. Hospitalizations stood at 3,425, with 285 people in intensive care units. The province also reported an additional 6,123 lab-confirmed cases.

“In all likelihood, the number of cases has already peaked,” Dr. Luc Boileau, Quebec’s interim public health director, told reporters on Tuesday. “We’re starting to see the rise in hospitalizations slowing down, which is a very good sign, even if the situation in hospitals remains very fragile.” 

In the North, the chief public health officer in the Northwest Territories on Tuesday said restrictions on gatherings were being extended until the end of the month. A statement from Dr. Kami Kandola said additional recommendations are being made for Inuvik and Fort Smith, including a call for work-from-home where possible, because of community transmission.

In the Prairie provinces, Manitoba on Tuesday reported three additional deaths in its COVID-19 update. The total hospitalizations stood at 620, with 48 in intensive care. The province also reported an additional 847 lab-confirmed cases.

In Saskatchewan, there were no additional COVID-19-related deaths reported on Tuesday. According to the province, the total number of hospitalizations increased to 189, with 18 people in intensive care units. The province also reported an additional 1,089 lab-confirmed cases.

Meanwhile, Alberta’s chief medical officer of health said COVID-19 hospitalization rates are rising to levels not seen in the province since mid-October when the health-care system was grappling with the fourth wave. Dr. Deena Hinshaw said the surging number of cases driven by the highly infectious Omicron coronavirus variant are starting to be reflected in hospital admissions.

As of Tuesday, the province’s COVID-19 updates showed a total of 1,089 hospitalizations, with 104 people in intensive care units. The province also recorded nine additional deaths and 3,279 additional lab-confirmed cases.

“It is important to recognize that any COVID-positive admission has an impact on our acute-care capacity,” Hinshaw said, as she outlined changes to how the province will report data on COVID-19 patients. “The bottom line is that our acute-care system remains under serious pressure and COVID-19 continues to pose a risk of severe outcomes to many Albertans.” 

Gyms and other exercise facilities are being allowed to gradually reopen in British Columbia, a move the province’s top doctor describes as a “cautious step” in lifting COVID-19 restrictions. Dr. Bonnie Henry said proof of vaccination will be required to use gyms, which will operate under capacity limits.

Henry said other restrictions that went into effect in December will remain in place because of the high rates of transmission and the number of people needing hospital care. Bars and nightclubs will stay closed and capacity limits for restaurants, theatres and stadiums will remain in place until Feb. 16.

The province on Tuesday reported a total of 854 COVID-19 hospitalizations, including 112 in intensive care. The province also reported nine additional deaths and 2,032 lab-confirmed cases.

-From CBC News and The Canadian Press, last updated at 11:15 a.m. ET


What’s happening around the world

WATCH | China’s COVID-19 testing threshold could keep some athletes from Olympics: 

China’s COVID-19 testing threshold could keep some athletes from Olympics

14 hours ago

Duration 2:54

With just days before hundreds of athletes, coaches and staff depart for the Beijing Winter Olympics, CBC News has learned that China’s COVID-19 testing threshold is so high, it may prevent some athletes from competing — even if they’ve been previously cleared of the virus. 2:54

As of early Wednesday morning, roughly 334.4 million cases of COVID-19 had been reported worldwide, according to Johns Hopkins University’s coronavirus tracker. The reported global death toll stood at more than 5.5 million.

In Europe, France has registered 464,769 new COVID-19 infections over the last 24 hours, official data showed on Tuesday, the highest-ever recorded tally since the start of the pandemic.

In the Asia-Pacific region, the United Nations is preparing for distanced relief operations in Tonga to avoid a COVID-19 outbreak in the Pacific island nation that is reeling from the impact of a volcanic eruption and tsunami, an official said.

In Africa, Namibia’s pandemic-ravaged tourism sector launched a campaign to encourage its employees to get inoculated as vaccine hesitancy threatens to derail the sector’s revival.

Meanwhile, South Africa reported 3,658 additional cases of COVID-19 on Tuesday and 100 additional deaths, though officials noted 30 of the deaths occurred in the previous 24 to 48 hours.

In the Americas, the U.S. government’s new COVIDTests.gov website, set up for American households to order four free COVID-19 tests amid the Omicron variant surge, is up and running ahead of its official launch on Wednesday, the White House said.

In the Middle East, Iran on Tuesday reported 19 additional deaths and 4,060 new cases of COVID-19.

-From Reuters, CBC News and The Associated Press, last updated at 7:25 a.m  ET

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Coronavirus: Omicron peaking in some provinces – CTV News

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The Omicron-fuelled fifth wave of the COVID-19 pandemic appears to be peaking in some provinces, while others say the worst is likely still to come.

The Saskatchewan Health Authority says it is bracing for a tide of COVID-19 hospitalizations and absenteeism among workers until mid-February, while Alberta says hospitalization rates are rising to levels not seen since mid-October.

The growing number of COVID-19 cases and hospitalizations in Prince Edward Island has prompted the province to reduce gathering sizes and close gyms and restaurant dining rooms until at least the end of the month.

Even as they both set new records for hospitalizations, officials in Ontario and Quebec say the daily rate seems to be decreasing slightly, although they caution the health-care system remains under tremendous pressure.

There are 3,417 COVID patients in Quebec hospitals, while Ontario has 4,183, including 580 people in intensive care.

B.C. recorded 1,975 cases of COVID-19 with 854 people in hospital, as the province’s top doctor described her decision to allow the reopening of gyms and other fitness facilities Thursday as a “cautious step” in lifting COVID-19 restrictions.

Dr. Bonnie Henry said a proof-of-vaccination card will still be required to use gyms, and the facilities will need to operate under capacity limits and provide seven metres square for every person who is exercising.

This report by The Canadian Press was first published Jan. 19, 2022.

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