Canada has quietly revised its guidelines on how COVID-19 spreads to include the risk of aerosol transmission, weeks after other countries and international health organizations acknowledged the airborne threat of the coronavirus.
The Public Health Agency of Canada (PHAC) updated its guidance without notice this week, making mention of the risk of transmission from aerosols — or microscopic airborne particles — for the first time.
“SARS-CoV-2, the virus that causes COVID-19, spreads from an infected person to others through respiratory droplets and aerosols created when an infected person coughs, sneezes, sings, shouts, or talks,” the updated guidance said.
“The droplets vary in size from large droplets that fall to the ground rapidly (within seconds or minutes) near the infected person, to smaller droplets, sometimes called aerosols, which linger in the air under some circumstances.”
The federal agency’s guidelines previously said the virus spreads only through breathing in respiratory droplets, touching contaminated surfaces and common greetings like handshakes and hugs.
PHAC did not immediately respond to CBC’s request for comment on the changes to the guidelines.
Change to guidelines ‘pretty major,’ aerosol expert says
“This is pretty major,” said Linsey Marr, one of the top aerosol scientists in the world and an expert on the airborne transmission of viruses at Virginia Tech. “The big difference now is that ventilation is important — distancing alone is not enough.”
CBC News pressed the federal agency last month on why it still made no mention about the risk of aerosols despite other international agencies doing so.
The U.S. Centers for Disease Control and Prevention (CDC) updated its guidelines in early October to include that COVID-19 can sometimes be spread by airborne transmission, after mistakenly posting and later removing a draft version of guidelines in late September.
The World Health Organization also came under fire in July after 239 scientists from 32 countries wrote an open letter calling on the United Nations agency to update its messaging on the risk of airborne transmission of the coronavirus.
Update came after new mask advice
The update to PHAC’s guidelines came after Canada’s Chief Public Health Officer Dr. Theresa Tam recommended the use of three-layer non-medical masks Tuesday to prevent the spread of COVID-19 ahead of winter weather that could bring more people together indoors.
“This is an additional recommendation just to add another layer of protection. The science of masks has really accelerated during this particular pandemic. So we’re just learning again as we go,” she said Tuesday.
“I do think that because it’s winter, because we’re all going inside, we’re learning more about droplets and aerosols.”
Marr said that updated PHAC guidance on three-layer non-medical masks was in line with the threat of aerosol transmission.
“If we were only concerned about large droplets, then pretty much almost any piece of single layer of fabric would work,” she said.
“But because we are concerned about aerosols, then we do need to think about the quality and fit of our masks and we know that having multiple layers improves the filtering performance of masks.”
WATCH | Linsey Marr speaks in July about evidence the coronavirus could be airborne:
Tam said Tuesday public health officials also wanted to emphasize that the public should wear a mask indoors when not with people in their household, another significant update to its guidance.
“That will help prevent droplets or aerosols more so than if you were just relying on the two metre distance,” she said. “Again, adding another layer.”
PHAC previously told CBC News in a statement on Sept. 24 that it was not updating its guidance on airborne transmission — even though it said there “have been situations where aerosol transmission in closed settings has occurred.”
The agency said at the time its guidance would remain the same: limit time spent in closed spaces, crowded places and close contact situations, while maintaining physical distancing, hand-washing and mask-wearing.
Addressing aerosol transmission requires many measures
“Distancing helps, masks help, ventilation helps — no one of these things is perfect,” Marr said.
Aerosol transmission, she said, would not be addressed by focusing on just one of these measures alone. “But when we combine all these things, we haven’t seen any outbreaks.”
PHAC also said in September that it was reviewing evidence on the topic and acknowledged that aerosols could be suspended in the air and infect others nearby, but it wasn’t known at what rate that happens and under what conditions.
“It’s important for the public health agencies to acknowledge this so that the public can now take appropriate steps to reduce transmission,” Marr said. “And there’s a lot of organizations like schools and businesses that look to the public health agencies for guidance.”
She said the updated PHAC guidelines would make it harder for these types of organizations to ignore the threat of aerosol transmission.
Studies of superspreading events, such as a choir practice in Washington state, a call centre in South Korea and a restaurant in China, have supported the conclusion that some degree of transmission is occurring through aerosols.
Virus particles were also found in the air at a nursing home outbreak in May in Montreal, where a faulty ventilation system may have been a source of transmission that infected 226 residents and 148 employees.
An outbreak at a spin studio in Hamilton, Ont., saw at least 85 people infected and prompted the city to announce new, enhanced guidelines for gyms and fitness centres including mandatory masking.
“The gym followed all the guidelines: they had distancing, they did hygiene, they had people wearing masks before and after,” Marr said, “but if it were just all large droplets, then the distancing and hygiene would be sufficient — but obviously, it wasn’t.”
“Because aerosols do play an important role in transmission and if you just distance and just do hygiene, that’s not enough.”
The latest on the coronavirus outbreak for Dec. 3 – CBC.ca
National vaccine deployment plan calls for up to 205 vaccine distribution locations across Canada
Canadians heard extensively for the first time on Thursday from Maj.-Gen. Dany Fortin, who has been tasked by the federal government with leading vaccination logistics and operations. While the country is facing unprecedented “logistical complexities,” the military and its partners will be ready to deploy COVID-19 vaccines as soon as they are approved in Canada, Fortin said.
The former NATO commander, along with the other public health officials who spoke at Thursday’s news conference, tried to provide assurances for the many questions still swirling in the air, including the cold storage capacities for feeding the supply chain given the temperature requirements of some of the vaccines.
Eventually, there will be 205 “points of issue” locations across the country where health-care professionals can administer the vaccine, Fortin said. It will be up to the provinces and territories to specify where and when individual Canadians will be inoculated.
The national operations centre has conducted one dry run scenario, with others planned. Fortin said exercises and planning have contemplated a number of possible complications, including treacherous winter delivery conditions, fires at distribution hubs and cyberattacks.
With respect to Pfizer’s vaccine, which needs to be kept at approximately -80 C to remain stable, Fortin said his team is in daily contact with the company and there have been no hiccups with Canada’s plans. The Pfizer product will be delivered by that company directly to provincial and territorial distribution points as early as the end of the month, he said, and the federal government has secured the cold storage required for this vaccine. In addition, the provinces have indicated where the Pfizer-specific fridges should be placed, according to Fortin.
The total supply of doses and prioritization of vaccine recipients will be key, ongoing questions. Government officials have previously said they hoped some three million people could get vaccinated through the first quarter of 2021, but Canada is not manufacturing COVID-19 vaccines and will rely on importing them through deals it’s struck with the pharmaceutical companies.
Health Canada has said its approval of at least one vaccine could come within the next two weeks, not long after U.S. regulators meet.
Dr. Howard Njoo, Canada’s deputy chief public health officer, said the federal government is now refining who is best suited to first get a dose of a vaccine. Early guidance from the National Advisory Committee on Immunization (NACI) suggests seniors in long-term care homes and front-line health-care workers will be among the first to get a shot.
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Alberta planning for COVID-19 field hospitals, according to internal document
An Alberta Health Services document obtained by CBC News shows the province has been planning for more than a week to set up indoor field hospitals that could treat up to 750 COVID-19 patients.
The document dated Nov. 28 outlines plans for 375 beds each in Calgary and Edmonton for patients with mild-to-moderate symptoms. Patients requiring intensive care would remain in city hospitals.
The field hospitals draft plan underscores the severity of the public-health crisis Alberta faces — and provides a sobering sign of where officials believe the trajectory of virus infections could be headed. There were 504 people in hospitals and 97 in ICUs in Alberta on Wednesday. A total of 561 people in the province have died from the disease since the start of the pandemic.
The greatest challenge to making the hospitals operational by December or January would be staffing, and the document references potentially calling in the military to assist. Other logistical challenges would be building adequate toilet, shower and handwashing facilities at the proposed sites as well as determining whether an oxygen supply infrastructure could be established.
Dr. Noel Gibney, a veteran Edmonton critical-care doctor who has publicly criticized the government’s pandemic response, says the field hospital planning is sensible due diligence planning, but he said the government has clearly not told the public the degree of risk they are now facing while continuing with policies that downplay the risk.
“On one hand, we are having provincial planning at a disaster level or for an upcoming disaster,” he said. “And on the other hand, we are being told everything is fine.”
In addition, CBC News has learned through a source close to the federal government that Alberta has inquired with the Trudeau government and the Red Cross about supplying field hospitals to help offset the strain COVID-19 is having on the province’s health-care system.
Quebec cancels plans to allow Christmas gatherings as COVID-19 cases surge
Quebec Premier François Legault on Thursday backtracked on his plan to allow gatherings over the Christmas holiday period after a rise in cases, hospitalizations and deaths that caused doctors at some hospitals to voice their concerns.
Legault said that gatherings in the province’s hard-hit “red zones,” which encompass most of the province, will be prohibited over the holidays.
“When we look at the situation, we are forced to realize that it is not realistic to think that we are going to succeed in reducing the progression of the virus in a satisfactory way by Christmas,” he said.
Legault announced last month that people would be allowed to gather in groups of 10 over a four-day period, from Dec. 24 through Dec. 27, if they isolated for a week before and after. He later said people should only gather twice during that period.
The province reported more than 1,500 daily cases for the first time ever on Wednesday, and more than 1,400 again Thursday.
“If we continue in this direction, hospitals will start to overflow. We have a limited number of nurses, and our nurses are very tired,” the premier said.
Legault did allow that Quebecers could individually visit a person living alone, particularly the elderly, over the holidays. But he stressed visitors in such circumstances need to be wearing masks, maintaining a two-metre distance and not staying very long. Visits to the province’s long-term care homes and seniors’ residences, however, will be prohibited — with the exception of caregivers.
Dozens of internationally educated nurses are on the sidelines in Manitoba
Manitoba Health Minister Cameron Friesen said recently a special designation will be granted to 39 internationally educated nurses waiting on English tests so they can practise in Manitoba and have the language requirement temporarily waived, but it’s not clear when that will happen.
Bhupinder Grewal, originally from India, is among the internationally educated nurses who’ve struggled and been inconvenienced by a recurring two-year English language test that is required for licensing. Both of the English tests that would be suitable to take are not being administered this year because of the pandemic.
Darlene Jackson, president of the Manitoba Nurses Union, said it’s a shame the internationally educated nurses are unable to work because of a language test when they have otherwise shown the necessary skills through bridging tests to meet Canadian standards. The union says the nursing vacancy rate in the Winnipeg Regional Health Authority and Shared Health combined is around 16 per cent.
“We are in a nursing shortage. We’re at a critical nursing shortage in many areas. We are desperate to have every possible nurse that can work in the system,” she said.
The Touchstone Institute, responsible for administering the Canadian English Language Benchmark Assessment for Nurses, says the two-year expiry date on the language requirement, is “based on the assumption that the measure of examinees’ capabilities at a given point in time may become less trustworthy indicators of those capabilities as time passes.”
When contacted by CBC for this story, Friesen’s office declined to comment, but said it will provide an update on the special designation soon.
Stay informed with the latest COVID-19 data.
Why children in Canada won’t immediately receive a COVID-19 vaccine
There is currently no human pediatric data for vaccine candidates to protect against COVID-19, although that could change in 2021.
Federal statistics show that at 8.1 million Canadians, children and teens make up one-fifth of the population. But younger immune systems are more active than those of adults, and children often show stronger immune reactions to vaccines in terms of side-effects.
“Children often will need either a slightly different formulation or a smaller dose of a vaccine, so it’s appropriate to ensure the vaccine is safe and effective in adults and then move on to that testing,” said Shannon MacDonald, an assistant professor in the faculty of nursing at the University of Alberta who conducts public health research, including on vaccines.
Earlier this week, Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, said on NBC’s Meet the Press that it could take months before those younger than 18 in the U.S. general public could get a coronavirus vaccine, if approved by regulators.
Pfizer announced in October it was expanding vaccine testing to those 12 and older, while Moderna said this week it expects to test the vaccine on children between the ages of 12 and 17 in the coming weeks and on younger children in 2021. The developments are likely welcomed by the American Academy of Pediatrics (AAP), which wrote an open letter to U.S. federal health officials to ensure children are not left out of vaccine efforts.
Although it’s far from guaranteed, it is possible adults will gain enough immunity from vaccinations that widespread vaccinations of children will not be necessary.
“Some vaccines contribute to herd immunity because the person who gets the vaccine doesn’t spread any infection,” says Dr. Joanne Langley of Dalhousie University, who is the co-leader of Canada’s COVID-19 vaccine task force. “We don’t know for sure yet whether that occurs with the COVID vaccines and how effective it is.”
From a tiny outport to a Vietnamese city, how one Newfoundlander is enduring the pandemic
Many Canadians who live abroad won’t be coming home for the holidays for safety reasons or because of the complications involved with travel quarantines, but Newfoundland and Labrador native Sabrina Pinksen is in one of the safest spots in the world, statistically speaking, with respect to the coronavirus.
Pinksen, who is originally from tiny Wild Cove, near the Baie Verte Peninsula, has been living in Hanoi since 2017. It’s a city nearly twice as populous as Canada’s biggest, but with one-third of the physical space.
But as of Wednesday, Vietnam has recorded 1,351 cases and 35 deaths since the pandemic began, according to the World Health Organization. Even if there was a moderate amount of underreporting, it would be a status that ranks favourably with any country in the world.
“I don’t even think about COVID, going out into my daily life,” Pinksen said. “It’s almost like it wasn’t real.”
Pinksen, who’s passionate about her art but earns her income teaching English through a school, said the disruptions that have occurred with daily life have actually led to more of a demand for her services, as some Vietnamese have more free time.
Unlike in North America, there is no cultural resistance to the most publicly visible mitigation measure. Pinksen said: “This is a mask-wearing country anyway. So even before COVID, a lot of people would wear masks.”
Pinksen is not able to travel to Canada for the holidays and admits to being homesick — it’s been 15 months since she’s been home and her father has a serious health issue.
But, she said, “I’m very grateful that everything in Newfoundland is OK right now.”
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Airbnb rolls out restrictions in Canada to prevent New Year's Eve parties – CBC.ca
Airbnb says it has a plan to curb New Year’s Eve parties this year while Canada works to slow the spread of the COVID-19 virus, with the announcement coming not long after a short-term rental was the site of a 60-person party in Mississauga, Ont.
In addition to its ongoing ban on parties, Airbnb now says guests will need a history of positive reviews on its app to reserve an entire home for New Year’s Eve in Canada.
Airbnb is making an exception for one-night bookings made up to Tuesday, based on data that suggests bookings made before early December rarely involve parties.
Most guests and hosts “are quite responsible, but there’s always a couple people who try to skirt those rules,” said Nathan Rotman, senior manager of public policy at Airbnb.
“We want to make sure that people are both adhering to public health guidelines and following the policies that we’ve put in place and our hosts have put in place.”
Still, Rotman says there are plenty of good reasons why hosts might get bookings over the holidays, including people who might need to use rental suites for isolation purposes after returning to Canada. This new restriction, he says, is to target people who are ignoring company policies.
The app is loosening its standards from a similar policy on Halloween by allowing users with previous positive reviews to book a home for one night.
But Airbnb says it will put more stringent policies in place as the new year nears, by using technology that blocks certain kinds of last-minute bookings.
Airbnb’s announcement comes after Deputy Chief Marc Andrews of the Peel Regional Police said a short-term rental unit was the site of a 60-person party this past weekend, resulting in thousands in fines to partiers who violated COVID-19 restrictions.
Canada will have vaccine infrastructure in place around ‘Christmas,’ 1st doses in January – Global News
The federal government laid out details for Canada’s coronavirus vaccine rollout Thursday, saying it plans to have logistics and infrastructure in place before Christmas, according to Dany Fortin, the lead on the nations’ COVID-19 distribution of a vaccine.
Speaking at a media conference, Fortin said although Health Canada is still reviewing approval for vaccines, the federal government and provinces are working on a rollout plan and will do a trial run next week.
“We’re not going to wait until the end of December … we are getting ready so that when it becomes possible we are poised to distribute,” he said.
Fortin said the vaccines that require colder storage, such as Pfizer and Moderna, are most likely to be first distributed in January.
But the initial shipments of vaccines to arrive in Canada, called “track one,” will be rolled out differently.
For example, Moderna’s vaccine will first be shipped to one location in Canada and then sent to communities across the country. But the Pfizer vaccine will be sent directly to the communities, according to the federal government.
This is because Pfizer’s vaccine requires specially designed temperature-controlled shipment and storage containers — the temperature has to be -70 C for up to 10 days unopened.
Alberta health minister expects shipments of COVID-19 vaccine to arrive in early January
Fortin said the military, federal government and provinces are implementing a “soft launch” of the distribution plan in order to ensure authorities are ready to handle the ultra-low temperatures required for Pfizer and Moderna.
Fourteen sites across Canada will be ready for Pfizer, he said.
Moderna expects the vaccine to be stable at normal fridge temperatures of two to eight degrees Celsius for 30 days and it can be stored for up to six months at -20 C.
Fortin said every province has already identified the “points of use” where the vaccines will be distributed. And by Dec. 14, he added that these locations are expected to be ready for the vaccines.
“So this gives you a sense that in December, we’re hard at it in the next couple of weeks to ensure you that we are ready,” he said. “I kind of like the idea of being ready before the Christmas timeframe so that we’re certain to be ready when it comes in January.”
First vaccines will cover 3M Canadians
Currently, Health Canada is reviewing approval for four coronavirus vaccines.
Deputy chief public health officer Dr. Howard Njoo said Thursday that he is “optimistic” that reviews of Pfizer, Moderna and several other vaccines will be complete soon, and expects the Pfizer one to be “a favorable one.”
The federal government plans to give three million Canadians the first round of coronavirus vaccines when they are approved and arrive in the country, Njoo said.
“We will immunize as many Canadians as possible, as quickly as possible and ensure that high-risk populations are prioritized,” Njoo said. “We expect certain Health Canada-approved vaccines to become available in early 2021. The initial supply of these vaccines will be limited, such that we will be able to vaccinate around three million Canadians. That means we need to be strategic on who gets vaccinated first.”
He said the National Advisory Committee on Immunization will release guidelines in the coming days that will help identify who receives the COVID-19 shots first, he said.
“Although the initial supply will be limited I want to be clear there will be enough vaccines for every Canadian,” Njoo added.
Coronavirus: O’Toole blames ‘secrecy and incompetence’ of Trudeau government for vaccine delay
On Wednesday, Canada’s chief public health officer, Dr. Theresa Tam, described the country’s vaccine effort as “one of the most consequential scientific endeavours in living memory” and “one of the most complex operations ever taken in public health.”
Speaking at a vaccine conference, she said the country is working to further refine the list of who gets the vaccine first, since the initial six million doses expected to come in early 2021 — enough for three million people — aren’t enough for everyone on the national vaccine advisory committee’s list of priority groups, which include the ill and elderly, health-care workers, essential workers and Indigenous communities.
© 2020 Global News, a division of Corus Entertainment Inc.
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