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Canada is flying blind with Omicron as COVID-19 testing drops off a cliff – CBC News

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Canada has lost sight of the true size of its pandemic, with the number of people infected with COVID-19 now a mystery, as the highly infectious Omicron variant overwhelms testing capacity across the country.

Omicron is causing a never-before-seen surge in COVID-19 that has prompted provinces to reinstate curfews and gathering restrictions, shutter bars and restaurants and move schooling back online in a desperate attempt to mitigate the impact on hospitals.

Yet those case levels are about to drop off a cliff — not because of the flood of new public health restrictions across the country that haven’t yet taken effect, but because health officials have simply stopped testing the majority of Canadians for COVID-19. 

So how do we track the impact Omicron is having across Canada? And how will we know whether public health restrictions are working if officials aren’t collecting accurate data?

“Omicron is moving so quickly that it has become pretty much impossible to pin down the full extent of spread in real time,” said Dr. David Naylor, who led the federal inquiry into the 2003 SARS epidemic and co-chairs the federal government’s COVID-19 immunity task force.

“PCR testing capacity is overwhelmed,” Naylor said. “Rapid antigen tests [RAT] are inconsistently available. Those with positive RAT results often have no way to register them let alone confirm them.”

A doctor administers a COVID-19 test at North York General Hospital in May 2020. Case levels are about to drop off a cliff because the majority of Canadians aren’t being tested for COVID-19 due capacity issues. (Evan Mitsui/CBC)

Watch hospital admissions closely 

Public health experts and epidemiologists agree COVID-19 hospitalizations and intensive care unit (ICU) admissions have replaced case numbers as some of the most important metrics for understanding Omicron’s impact on the health-care system and severity of illness it causes. 

“It was always what was going to happen,” said Dr. Allison McGeer, a medical microbiologist and infectious disease specialist at Toronto’s Mount Sinai Hospital who worked on the front lines of the SARS epidemic in 2003. 

“We were always going to switch from cases to hospitalizations as a measure of how well we were doing.” 

But even those numbers can be skewed with Omicron. Data shows while the variant is highly contagious, vaccines still offer protection against serious illness and those infected are less likely to wind up in hospital than people with the Delta variant. 

That may lead to a shift in focus to hospitalizations, because the biggest concern with Omicron is that it’s spreading like wildfire and leaving more people exposed to potentially serious outcomes that could strain the health-care system. 

A recent report from Public Health Ontario found that while the risk of hospitalization and death was 54 per cent lower for Omicron than Delta — the fact that it is infecting so many more people may actually lead to an overall increase in hospitalizations. 

WATCH | Canadian hospitals brace for rising COVID-19 admissions, staff shortages:

Staff shortages, rising COVID-19 admissions add strain on Canadian hospitals

2 days ago

Duration 4:22

Hospitals across Canada are bracing themselves for rising admissions as Omicron-related staff shortages add extra pressure to the variant’s wave. 4:22

Omicron is also better at dodging immune protection from vaccines and prior infection than previous variants, dealing a massive blow to the effectiveness of COVID-19 vaccines against infection — but not necessarily against severe illness

A new preprint study from the Institute for Clinical Evaluative Sciences (ICES) in Toronto, which has not yet been peer reviewed, found two doses does not provide adequate prevention against Omicron infection and three doses was just 37 per cent effective — but the vaccines still protected well against hospitalizations

And as case counts creep into the tens of thousands, many provinces have scaled back testing and reimposed restrictions while officials estimate the true number of people infected could be in the hundreds of thousands per day in the coming weeks.

“It’s going to be a mess. We have, once again, waited too long,” said McGeer.

“It’s really looking like the sheer numbers are going to stress, honestly, not just the hospitals but the ICU … and in the next two or three weeks from now, the hospital system is going to be really, really stressed again.” 

WATCH | Why symptoms of COVID-19 are changing with omicron:

COVID-19: What are the new symptoms?

2 days ago

Duration 5:41

Infectious diseases specialists Dr. Danielle Martin and Dr. Zain Chagla answer questions about COVID-19, including how to recognize and respond to new and evolving symptoms. 5:41

Monitor test positivity rate

Another useful metric for examining the burden of COVID-19 across Canada is the test positivity rate — which doesn’t measure the number of individual cases but the percentage of tests that come back with a positive result. 

Canada’s national test positivity rate has sat at an astonishingly high 25 per cent over the past week, meaning one in four Canadians who have been tested are positive.

“Test positivity is going to probably be the only thing that matters,” said Dr. Alexander Wong, an infectious diseases physician at Regina General Hospital and associate professor of infectious diseases at Saskatoon’s University of Saskatchewan.

“It’s going to be really key to get an understanding of where provinces and territories are at with regards to their peaks.” 

When that rate starts to come down, we’ll get a better understanding of whether our Omicron-driven wave has peaked, but Wong said it’s important to keep in mind that even that number can be affected by access to testing. 

“In Saskatchewan, which is probably the least advanced relative to all other Canadian jurisdictions with regards to Omicron, even our testing capacity is pretty much overrun at this point,” he said. “And that’s just going to continue to worsen in the coming days.” 

Naylor said the test positivity rate is also affected by changes in test-seeking behaviour, meaning the number of people testing positive and the total number of cases are now both compromised due to a lack of access and a desire to even get tested. 

People wait in line for a walk in PCR COVID-19 test site in Toronto on Dec. 22, 2021. Canada’s national test positivity rate sits at an astonishingly high 25 per cent over the past week, meaning one in four Canadians who have been tested are positive. (Chris Young/The Canadian Press)

“We aren’t able to test the majority of people anymore who are symptomatic. We stopped testing those who have been exposed. We have significantly reduced any type of asymptomatic testing,” said Dr. Dominik Mertz, an infectious diseases physician and associate professor of medicine at Hamilton’s McMaster University.

“The case numbers become even more meaningless.” 

Look to sewage for virus presence

One other tool for understanding the extent of COVID-19 levels in the community is through wastewater testing, which examines sewage for the presence of the virus to determine how much is circulating within the population at a given time. 

While not a perfect assessment of the specific number of cases or the severity of disease, wastewater testing can help specific regions understand when the risk of exposure is high. 

“It can really show trends quite well,” said Sarah Dorner, a water quality expert and  professor at Polytechnique Montréal. “So if you’re really seeing rising numbers, it’s very much associated with rising cases.

“And that’s really what’s important in the current context because right now whatever’s in the wastewater is what’s happening in your community.” 

Dorner said such trends allow policymakers to determine when to act and to alert the population on where to protect themselves most from transmission. 

“It’s low-cost, high-impact and high-accuracy,” said Raywat Deonandan, a global health epidemiologist and associate professor at the University of Ottawa. 

“It won’t be as timely and won’t be as personal but in many ways it gives a better sense of the true impact of a disease on the community because it’s getting everyone — not just those who got tested.”

A researcher tests wastewater in a sewer outside Risley Hall, a residence at Halifax’s Dalhousie University, as part of the wastewater testing project in Nova Scotia. (Submitted by Graham Gagnon)

Wastewater surveillance has been used sporadically in countries around the world to monitor COVID-19 levels throughout the pandemic, but has been slow to gain mainstream global acceptance because of its limitations compared to case numbers. 

“It’s not perfect,” said Eric Arts, a professor of microbiology and immunology at Western University’s Schulich School of Medicine and Dentistry in London. “But it’s better than saying ‘13,000 cases today,’ when it’s probably three times more.” 

Dorner said Montreal’s wastewater provided a “very clear signal” that Omicron was heavily circulating in the population in December — before testing would have picked it up. 

Because the data is so readily available, with many public health labs across the country doing the testing, Dorner said she hopes Canadians will soon be able to use it to assess their personal risk level. 

But public health units across Canada have been slow to release wastewater data to the public to determine the level of virus being picked up in sewage, despite using the data to inform their own decision making. 

“We’re expected to kind of move on to managing all of our risks on a personal basis, because the health care system isn’t doing testing and tracing,” said Dorner, who had been helping run a wastewater pilot program in Quebec until funding ended last month

“So how does the individual access the information they need?”

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Hundreds of thousands of Canadians are travelling abroad despite Omicron – CBC News

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Despite growing concerns across the globe last fall over the new COVID-19 variant, Omicron, Sandy Long and her husband departed on Nov. 28 for a 10-day vacation in Mexico. 

Long said they felt comfortable travelling, because they planned to take strict safety precautions. Plus, the couple hadn’t gone abroad for two years due to the pandemic and were yearning to get away.

“Life is short,” said Long, 58, of Richmond, B.C. “We needed to feel some warmth [and] we really missed Mexico.”

It appears many Canadians have a similar attitude toward travel these days despite Omicron’s fast and furious spread, which prompted Canada to repost its advisory against non-essential international travel last month.

Statistics Canada tallied 742,417 Canadian air-passenger arrivals returning home from abroad in December. 

When adjusted to account for recent changes in tracking air travel, that total is almost six times the number of arrivals for the same month in 2020, and more than half the total for pre-pandemic December 2019.

The increase in international travel is likely to continue: there were 216,752 Canadian air-passenger arrivals to Canada during the week of Jan. 3 to Jan. 9, according to the latest data posted by the Canada Border Services Agency. 

Lesley Keyter, owner of The Travel Lady Agency in Calgary, said clients are booking trips despite the threat of Omicron because they want to return to travelling. (submitted by Lesley Keyter)

Travel agency owner Lesley Keyter said that, since October, the number of clients booking trips has jumped by between 30 and 40 per cent compared to the same time last year. 

She said popular destinations for her clients, most of whom are aged 50 or older, include Europe, Mexico and Costa Rica. When Omicron cases started to surge in December, Keyter said some clients cancelled their trip, but most kept their travel plans. 

“People are saying, “Listen, we only have a limited time on this planet.… We’ve put off travel for two years now, I don’t want to put it off anymore,” said Keyter, owner of The Travel Lady Agency in Calgary.

She said travellers also feel confident with the added protection of their COVID-19 vaccine and booster shot. Because Omicron is so transmissible and more able to evade vaccines, even vaccinated people may get infected, however, they’re less likely to wind up in the hospital.

Risk of testing positive abroad

But even if infected travellers only experience mild symptoms, they’ll still face hurdles returning home.

To enter Canada, air passengers must show proof of a negative COVID-19 test taken within 72 hours of departure. If a traveller tests positive, they must wait at least 11 days before boarding a flight home.

Brennan Watson of Milverton, Ont., tested positive for COVID-19 while on vacation in Ireland. (submitted by Brennan Watson)

Brennan Watson, 26, of Milverton, Ont., tested positive on Dec. 28 while travelling in Ireland. 

He was set to fly home the following day, but instead had to find a place to self-isolate in Belfast. Due to Canada’s rules at the time — which have now changed — Watson had to wait 15 days before he could fly home. 

“It was very stressful in the beginning,” he said. “It was a bit of a panic just to think that I’m stuck here.”

Brennan said the delay cost him: he missed 11 days of work as an electrician and spent $2,000 in added expenses, including another plane ticket home. 

“There’s nothing you can really do about it,” he said. “It’s just something I didn’t even think would happen.”

WATCH | Canada once again advises against travel abroad:

Canada warns against non-essential travel abroad as Omicron spreads

1 month ago

Duration 3:14

The federal government is urging Canadians to stay home or, if they must travel, to plan ahead for quarantine and ensure they have travel insurance coverage. 3:14

Travel insurance broker Martin Firestone said travellers can avoid such unexpected costs by purchasing trip-interruption insurance. He said most of his clients now opt for the coverage that will reimburse travellers for some or all of their costs if they test positive and must extend their trip. 

“Trip interruption — which used to be a very rarely [purchased product] — is now being added to all the emergency medical plans, because clients worry terribly about testing positive,” said Firestone with Travel Secure.

“That’s the new world we live in right now with the pandemic.”

Flight cancellations

Another hurdle travellers may face is unexpected flight cancellations. 

Since December, thousands of flights in Canada and the U.S. have been cancelled for pandemic-related reasons including crew members out sick due to the virus. 

This month, Air Canada Vacations announced it will suspend some flights to sun destinations between Jan. 24 and April 30. After cutting 15 per cent of its January flights, WestJet announced on Tuesday it will cancel 20 per cent of its February flights.

Long said she and her husband enjoyed their trip to Mexico so much, they had planned to return again in the upcoming weeks. However, the couple recently nixed their plans due to concerns over flight cancellations.

“It’s the uncertainty right now,” said Long. “I don’t want to get down there and then be stranded.”

However, she’s still optimistic about a trip the couple has booked in May to Spain. 

Despite testing positive while travelling, Brennan hopes to return to Ireland this summer — even if the pandemic hasn’t waned by then.

“I spent a year and a half of my life not seeing family, not seeing friends,” he said. “I’m not going to stop living my life.”

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Immigration: Canada border tragedy a sign of what's ahead – CTV News

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PEMBINA, N.D. —
The discovery of four people who perished in the cold trying to cross the Canada-U.S. border could put a new twist on the immigration debate in the United States.

The group, which included an infant and a teen, were found Wednesday near Emerson, Man., just metres from the Canadian side.

U.S. officials allege they were part of a larger group of Indian migrants trying to cross into the U.S. from Canada.

Border expert Kathryn Bryk Friedman, a University at Buffalo law professor, calls it a troubling sign that the country’s immigration challenges are getting worse.

Friedman says the discovery is likely a “warning shot” that more people are willing to put their lives on the line to enter the U.S., even on foot in the dead of winter.

Florida resident Steve Shand is to appear in court Monday in Minneapolis to face human smuggling charges.

“I do think it’s a warning shot,” said Friedman, who remarked about the enduring appeal life in the U.S. seems to hold for people all around the world.

Indeed, the crush of South American migrants at the U.S.-Mexico border has become a defining characteristic of American politics in recent years, most notably during the tenure of former president Donald Trump.

Nor is Canada a stranger to the problem: thousands of asylum seekers crossed the border in Quebec each year while Trump was in office, though the numbers have dropped precipitously since then.

But an organized effort to sneak groups of people into the U.S. from Canada is a new one on Friedman.

“It just demonstrates the allure still — maybe the enduring allure — of trying to get to the United States. It’s really kind of fascinating,” she said.

But a single incident isn’t likely to prompt either country to seriously rethink the way they manage and defend their shared frontier, she added.

“This sounds terrible, but I think it’s going to take more than four people dying at the border to really galvanize action on the part of Canada and the United States.”

This report by The Canadian Press was first published Jan. 22, 2022.

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Omicron's potential peak has experts cautiously optimistic – CTV News

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Canada’s top doctor has said the latest wave of COVID-19 driven by the Omicron variant may have reached its peak.

But while the modelling appears encouraging, experts say the news should be interpreted with cautious optimism.

Chief Medical Officer of Health Dr. Theresa Tam told reporters on Friday that there are “early indications that infections may have peaked at the national level” based on daily case counts, test positivity, the reproduction number and wastewater data.

“I hope we’re at or nearing the peak, but the problem that I have is where we’ve got some uncertainty in the counting now since we don’t do as much PCR testing as we once did,” Dr. Ronald St. John, former director-general of the Public Health Agency of Canada’s Centre for Emergency Preparedness and Response, told CTV News Channel on Saturday.

Due to the shortages in PCR testing capacity, many people who develop COVID-19, particularly if they’re not in a high-risk group and have mild or no symptoms, have been unable to get PCR tests.

“We can’t count people who are asymptomatic, so we have to look at other datasets (like) wastewater concentration, things like that, to try to get an understanding of where we are.” St. John said.

Dr. Jason Kindrachuk, an infectious disease expert at the University of Manitoba, says the news shows “some optimism that things will slowly get back to normal, what they were like prior to Omicron.”

However, Tam said that hospitalizations and ICU admissions are still climbing across Canada and health systems remain under “intense strain.” Kindrachuk says it’s unclear how quickly we might start seeing hospitalizations and ICU admissions start to decrease.

“I think we’ve learned over and over again from the pandemic is that you know, cases rise and then hospitalizations lag behind … and that trend also stays in place when cases start to recede,” he told CTVNews.ca over the phone on Saturday.

“You may be able to slow down that hospitalization rate over time, but you are still going to have pressure on a health-care system that that has been pushed to its limits.”

Dr. Christine Palmay, a Toronto-based family physician, says the hospitalization and ICU data also leave out a lot of patients dealing with debilitating symptoms. She and her colleagues have seen numerous patients who have tested positive for COVID-19 and are struggling with the virus at home.

“They’re not captured by ICU stats. They’re not necessarily accessing ER, but they’re not functioning,” she said.

PROVINCES BEGIN EASING RESTRICTIONS

Several provinces have also reported that Omicron may be peaking or close to peaking. In Ontario, Health Minister Christine Elliott said cases are expected to peak this month, followed by a peak in hospitalizations and ICU admissions. Quebec also reported that hospitalizations declined for the third straight day on Saturday.

Wastewater data in B.C. and Alberta have also shown signs that the virus may have peaked. However, health officials in Manitoba and Saskatchewan say it’s too early to tell.

When COVID-19 cases began to reach unprecedented highs throughout Canada last month, provinces and territories imposed numerous health measures affecting restaurants, movie theatres, gyms, in-person schooling and more. Now, some provincial and territorial governments have plans to life some of these restrictions.

Kindrachuk says these restrictions, on top of the rollout of booster shots, appear to have helped plateau cases. However, as these restrictions start to ease, he notes that cases have the potential to rise again.

“When you start to remove those safety breaks, you have the potential that things could start to build back in the opposite direction. So, we have to do it very methodically and certainly with a lot of oversight,” he said.

St. John says he’s also worried about health measures being lifted too quickly.

“We have to wait and stick to our public health measures as long as possible until we can be absolutely sure that we’re coming out of the woods, and I’m not sure that we are yet,” he said.

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