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?”
MIAMI GARDENS, Fla. (AP) — Nick Saban has a message for Tua Tagovailoa: Listen to experts, then decide what happens next.
Antonio Pierce had another message: It’s time to retire.
Saban, Pierce and countless others within the game were speaking out Friday about Tagovailoa, the Miami Dolphins quarterback who is now dealing with the third confirmed concussion of his NFL career — all coming within the last 24 months. He was hurt in the third quarter of the Dolphins’ 31-10 loss to the Buffalo Bills on Thursday night, leaving the game after a scary and all-too-familiar on-field scene.
“This has to be a medical decision,” Saban said on ESPN, where the now-retired coach works as an analyst. “I mean, you have to let medical people who understand the circumstances around these injuries, these concussions — and when you have multiple concussions, that’s not a good sign.
“I think Tua and his family and everyone else should listen to all the medical evidence to make sure you’re not compromising your future health-wise by continuing to play football.”
That process — gathering the medical facts — was getting underway in earnest on Friday, when Tagovailoa was set to be further evaluated at the team’s facility. He was diagnosed with a concussion within minutes of sustaining the injury on Thursday and there is no timetable for his return.
“I’ll be honest: I’d just tell him to retire,” Pierce, the coach of the Las Vegas Raiders, said Friday. “It’s not worth it. It’s not worth it to play the game. I haven’t witnessed anything like I’ve seen that’s happened to him three times. Scary. You could see right away, the players’ faces on the field, you could see the sense of urgency from everybody to get Tua help. He’s going to live longer than he’s going to play football. Take care of your family.”
Concern — and opinions — have poured in from all across the football world ever since Tagovailoa got hurt. It is not a surprising topic — the questions of “should he? or shouldn’t he?” continue to play — nor is this the first time they have been asked. Tagovailoa himself said in April 2023 that he and his family weighed their options after he was diagnosed twice with concussions in the 2022 season.
But Dolphins coach Mike McDaniel said it’s not his place, nor is it the time, to have discussions about whether Tagovailoa should play again.
“Those types of conversations, when you’re talking about somebody’s career, it probably is only fair that their career should be decided by them,” McDaniel said.
The Dolphins said Friday that they will bring in another quarterback, and for now are entrusting the starting job to Skylar Thompson. McDaniel said the team will not rush to any other judgments, that the only opinions that truly matter right now come from two sides — Tagovailoa and his family, and the medical experts who will monitor his recovery.
“The thing about it is everybody wants to play, and they love this game so much, and they give so much to it that when things like this happen, reality kind of hits a little bit,” Jacksonville coach Doug Pedersen said Friday. “It just shows the human nature, or the human side of our sport.”
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AP Sports Writer Mark Long in Jacksonville, Florida, contributed to this report.
BRUSSELS – Canadian shot putter Sarah Mitton rebounded from a disappointing performance at the Paris Olympics by capturing Diamond League gold on Friday.
Mitton, of Brooklyn, N.S., won the competition, the final Diamond League event of the season, with a heave of 20.25 metres on her third throw.
Chase Jackson of the U.S. placed second with a throw of 19.90, while German’s Yemisi Ogunleye, the Olympic gold medallist, claimed bronze with a toss of 19.72.
Mitton, the runner-up of last year’s world championship, failed to qualify for the top eight in Paris.
Edmonton runner Marco Arop, who won silver for Canada in the men’s 800 metres at the Paris Games, was scheduled to race in the 800 on Saturday.
Olympic bronze-medallist Alysha Newman, of London, Ont., also competes Saturday in the women’s pole vault.
This report by The Canadian Press was first published Sept. 13, 2024.
ANN ARBOR, Mich. (AP) — Greg Harden, who counseled countless people at the University of Michigan from Tom Brady to Michael Phelps, and Desmond Howard to J.J. McCarthy, has died. He was 75.
Michigan athletics spokesman Dave Ablauf said the family informed the athletic department that Harden died Thursday due to complications from surgery.
The late Bo Schembechler, a College Football Hall of Fame coach, hired Harden in 1986 as a staff consultant and student-athlete personal development program counselor.
“He meant the world to me and I could never have had the success I had without the time, energy, love and support he had given me,” said Brady, a former Michigan quarterback who went on to win seven Super Bowls in a 22-year career.
Howard, who won the Hesiman Trophy in 1991, was part of the first wave of Wolverines to count Harden as a confidant, mentor and friend.
“Greg brought wisdom, joy and his calming nature to every encounter,” Howard said. “His presence will be missed by all of us.
“Although my family and I are heartbroken, we hold on to the lessons, guidance and memories that will forever be Greg’s legacy. We are blessed beyond measure to have had him in our lives.”
Harden, who was from Detroit, earned undergraduate and master’s degrees at Michigan.
Phelps lived and trained in Ann Arbor, Michigan, after emerging as swimming star at the 2004 Athens Olympics, and worked on his mental health with Harden.
Harden retired from his role as director of counseling for Michigan’s athletic department in 2020. He still continued to work, advising student-athletes at Michigan along with the Toronto Maple Leafs as the NHL team’s peak performance coach.
He published his first book, “Stay Sane in an Insane World: How to Control the Controllables and Thrive,” last year.
Michigan athletics announced Harden’s death, and shared statements from some of the many people who knew him.
McCarthy, a Minnesota Vikings rookie quarterback, sent the school his thoughts in the form of a letter to Harden.
“You gave me the courage and belief as we fought hand and hand against the demons that I’ve spent my entire life fighting,” McCarthy wrote. “You have inspired me by your ability to unconditionally love everyone and everything.”
While many famous football players worked with Harden, he also was a trusted adviser for women and men in all sports and walks of life, including broadcaster Michelle McMahon, who played volleyball at Michigan.
“He poured his heart into thousands of students, athletes, and celebrities alike without any expectation of gaining anything in return,” McMahon said. “He dedicated his entire life to making a difference and investing in the growth of the young impressionable minds that were lucky enough to meet him.
“His captivating presence and charisma captured the rooms he walked in. Greg’s gift to the world was his unwavering ability to help people see themselves fully, in full acceptance of their flaws and their gifts. His relentless approach made it impossible for his mentees to give up on themselves.”
