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Canada quietly updates COVID-19 guidelines on risk of airborne spread –



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.

The WHO amended its guidelines days after the letter and acknowledged the possibility that aerosols can lead to outbreaks of COVID-19 in places like choir practices, restaurants and fitness classes.

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:

A signatory of the letter urging the WHO to change its recommendations around COVID-19 airborne transmission says it would be wise to do as much as we can to slow down the virus.   6:00

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.”

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 the air. (Evan Mitsui/CBC)

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.”

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COVID-19 in B.C.: Over 900 new cases, 28 schools with new exposures, mask enforcement, and more – The Georgia Straight



Today’s new case count not only hit a new record but reflected one of the largest jumps upward.

The number of deaths remains high and case numbers increased in all other categories.

There are also two new healthcare outbreaks, exposure events at a pub and one store, and seven flights and 28 schools with new exposures.

B.C. Minister of Public Safety and Solicitor General Mike Farnworth has once again extended the provincial state of emergency to December 8.

In addition, Farnworth issued a ministerial order in alignment with B.C. provincial health officer Dr. Bonnie Henry’s provincial health order announced on November 19 that masks must be worn in all public spaces.

All British Columbians who are 12 years or older must wear masks in settings including:

  • malls, shopping centres, coffee shops, and retail and grocery stores;
  • liquor and drug stores;
  • airports, city halls, libraries, community, and recreation centres;
  • restaurants, pubs, and bars;
  • places of public worship;
  • public transportation, in a taxi, or in ride-sharing vehicles;
  • common areas of office buildings, court houses, hospitals, and hotels;
  • common areas of sport and fitness centres, when not engaged in physical activity;
  • common areas of post-secondary institutions and non-profit organizations.

Emergency Management BC anticipates further orders to enforce masks being worn in common areas of apartment buildings, condos, and workplaces.

Face shields aren’t considered a substitute for a mask, as there remains open space below the mouth.

Those who cannot wear a mask or who cannot put on or remove a mask without the assistance of others are exempt.

Masks can be removed temporarily to identify an individual wearing a mask, while consuming food or beverages, while participating in a sport or fitness activity in a sport facility, or while receiving a personal or health service that requires the mask to be removed.

Anyone without a mask in an indoor public place or who refuses to comply with the direction of an enforcement officer, including directions to leave, or who responds with abusive or belligerent behaviour, may be subject to a $230 fine.

Between August 21 and November 20, 59 violation tickets were issued, including:

  • 25 $2,300 tickets to owners or organizers violating orders on gatherings and events;
  • nine $2,300 violation tickets for contravening the food and liquor serving order;
  • 25 $230 tickets to individuals who refused to comply with direction from law enforcement.

Since the pandemic began, B.C. police agencies have issued 64 violation tickets to individuals contravening the federal Quarantine Act, totalling $70,000.

B.C. Minister of Public Safety and Solicitor General Mike Farnworth
Province of British Columbia

Henry announced that there are 941 new cases in B.C. today, which sets a new record. (The last record was on 762 new cases on November 18.)

By region, that includes:

  • 678 new cases in Fraser Health;
  • 174 in Vancouver Coastal Health;
  • 49 in Interior Health;
  • 29 in Northern Health;
  • 11 in Island Health;
  • no new people from outside Canada.

Today, there are now 7,732 active cases, which is an increase of 372 cases since yesterday.

Currently, there are 284 individuals are in hospital (seven more people since yesterday), with 61 of those patients in intensive care units (two more than yesterday).

Public health is monitoring 10,283 people (83 more people than yesterday).

Tragically, the number of new deaths remain high once again—there have been 10 new COVID-19-related deaths. The cumulative total fatalities is now at  358 people who have died during the pandemic.

A total of 19,605 people (69 percent) who tested positive have recovered.

During the pandemic, B.C. has recorded a total of 28,348 cases in British Columbia. By region, that includes:

  • 17,724 new cases in Fraser Health;
  • 7,992 in Vancouver Coastal Health;
  • 1,356 in Interior Health;
  • 678 in Northern Health;
  • 505 in Island Health;
  • 93 people from outside Canada.
B.C. Health Minister Adrian Dix, with Dr. Bonnie Henry
Province of British Columbia

Fraser Health stated in a news release today that an outbreak in a medicine unit at Burnaby Hospital declared on November 10 has led to 55 patients testing positive and five people have died. In addition, 44 staff members who tested positive are under investigation to determine if they are connected to the outbreak.

A fire had broken out at the hospital in November 15, and Fraser Health stated that the response to fire is considered a contributing factor to the outbreak.

Meanwhile, there are two new health-care facility outbreaks:

  • Valleyhaven Care Home (45450 Menholm Road) in Chilliwack, where Fraser Health stated two staff members tested positive;
  • Little Mountain Place (330 East 36th Avenue) in Vancouver, where Vancouver Coastal Health imposed restrictions on November 22.

Outbreaks at Fraserview Intermediate Care Lodge in Richmond and Agassiz Seniors Community in Agassiz have been declared over.

There aren’t any new community outbreaks.

Vancouver Coastal Health listed a public exposure event at a pub in Downtown Vancouver at the Morrissey at 1227 Granville Street from 6 to 11 p.m. on November 12 and 13. The pub has not posted any announcement about the exposure on its social media or website yet.

Loblaw announced that a staff member who last worked at the 7322 King George Boulevard location of Shoppers Drug Mart in Surrey on November 19 has since tested positive.

The B.C. Centre for Disease Control posted these seven flights confirmed with COVID-19 to its lists:

  • November 14: WestJet 133, Calgary to Vancouver;
  • November 16: Swoop 109, Hamilton to Abbotsford;
  • November 18: Air Canada/Jazz 8075, Vancouver to Victoria;
  • November 18: Air Canada/Jazz 8247, Terrace to Vancouver;
  • November 19: Air Canada 123, Toronto to Vancouver;
  • November 19: Air Canada/Jazz 8081, Vancouver to Victoria;
  • November 19: United Airlines 5312, San Francisco to Vancouver.

For affected row information, visit the BCCDC website. 

Richard Bulpitt Elementary

Four regional health authorities added new exposure dates for 28 schools.

Vancouver Coastal Health didn’t add any new dates for its schools.

Island Health added one school: Randerson Ridge Elementary (6021 Nelson Road), which had a cluster from November 4 to 6 and 9 to 10, has added November 12 as an exposure date.

Interior Health added one school: École Élémentaire Casorso Elementary School (3675 Casorso Road), which previously had exposures from November 5 to 6 and from November 9 to 10, had a new exposure on November 12.

Northern Health added one school: William Konkin Elementary School (9750 Carroll Street) in Burns Lake, with an exposure on November 16;

Fraser Health had 25 schools with new exposure dates.

In Abbotsford, two schools had new dates:

  • Rick Hansen Secondary (31150 Blueridge Drive)—which previously had exposures on October 6, 7, and 13; from October 14 to 16; on November 2; from November 3 and 4; from November 9 to 10—had a new exposure on November 17; 
  • St. John Brebeuf Regional Secondary (2747 Townline Road), which previously had exposures from October 27 to 29 and November 9 to 10, added November 16. 

In Burnaby, Moscrop Secondary (4433 Moscrop Street), which had previous exposures from November 3 to 4, had additional exposures from November 12 to 13.

In Coquitlam, Centennial Secondary (570 Poirier Street), which previously had exposures from October 15 to 16 and October 19 to 21, added November 13 and 17 as exposure dates.

In Chilliwack, G.W. Graham Secondary (45955 Thomas Road), which previously had exposures on October 23 and from October 26 to 29, had new exposures from November 16 to 18. 

Three schools in Langley had new dates:

  • Brookswood Secondary (20902 37a Avenue)—which previously had exposures on October 5, 13, 15, and 16—added November 10, 12, and 13; 
  • Peterson Road Elementary (23422 47th Avenue) had an exposure on November 16;
  • Richard Bulpitt Elementary (20965 77A Avenue) also added November 16.

Maple Ridge had one school: Thomas Haney Secondary (23000 116 Avenue), which had a previous exposure incident on October 26, had a new exposure on November 17. 

Hillcrest Elementary

In Surrey, 16 schools had new dates: 

  • Chimney Hill Elementary (14755 74 Avenue) had exposures on November 11, 13, 18, and 19;
  • City Central Learning Centre (13104 109 Avenue), which previously had an exposure incident on October 6, added November 18;
  • Ellendale Elementary (14525 110a Avenue) had an exposure on November 16;
  • Green Timbers Elementary (8824 144th Street)—which previously had exposure events on September 29 and from November 9 to 10—added November 16 to 18; 
  • Hillcrest Elementary (18599 65th Avenue) had an exposure from November 17 and 18;
  • Katzie Elementary (6887 194a Street), which previously had an exposure on November 9, added November 10, 12, and 13; 
  • Lord Tweedsmuir Secondary (6151 180 Street)—which previously had exposures from September 14 to 15, and on November 10 and 12—added November 16 to 17; 
  • Old Yale Road Elementary (10135 132nd Street) had exposures on November 10, 12, and 13;
  • École Panorama Ridge Secondary (13220 64 Avenue)—which previously had exposures on September 8 and 10; from September 30 to October 1; from October 6 to 9 and 13 to 15; from October 19 to 20; on November 3, 4, and 5—has added November 16; 
  • Princess Margaret Secondary (12870 72nd Avenue)—which previously had exposures on September 11; on October 12, 15, and 16; on October 26 and 29; from November 2 to 5; and on November 6—had an exposure on November 13; 
  • Semiahmoo Secondary (1785 148 Street), which previously had an exposure event from November 5 to 6, added November 10 and 12; 
  • Khalsa School Elementary Newton (6933 124th Street)—which previously had exposure events from September 22 to 25; from October 20 to 22; and from October 28 to 30—added  November 17 to 19;
  • Khalsa Secondary—Old Yale Road campus (10589 124th Street)—which had previous exposure events from September 9 and 10; September 30 to October 2; and from October 13 to 15—had new exposures from November 17 to 19; 
  • Pacific Academy (10238 168 Street), which had a previous exposure on November 9, added November 12, 13, 17, 18; and 19; 
  • Sikh Academy—Newton (12895 85 Avenue), which previously had an exposure on October 14, added November 16 and 17; 
  • St. Matthews Elementary (16065 88th Avenue) had exposures from November 16 to 18. 


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Barrie 'AAA' hockey team in isolation after positive COVID test –



A positive COVID test has taken a Barrie hockey team off the ice and into self-isolation.

On Tuesday’s call with local reporters, the region’s medical officer of health, Dr. Charles Gardner, confirmed the Simcoe Muskoka District Health Unit is investigating a COVID-19 community outbreak involving a youth hockey team in Barrie.

Details are limited right now, but Gardner said he and his staff hope to learn more soon about the dynamics of the outbreak. 

Gardner did confirm this is the first time the region has seen spread of this nature, though there have been COVID cases linked to spread among hockey teams in Toronto. 

He would not confirm how many cases are linked to the team outbreak in Barrie, but said the health unit would report the number of cases once they investigate further. 

Barrie ‘AAA’ hockey organization chairman Hugh Campbell confirmed to BarrieToday that it was his organization that had the positive test and added they are currently following the health unit’s guidelines.

“Last week, a player tested positive and the team have all been placed in isolation on the advice of the health unit,” said Campbell, although he would not comment on what age group the positive test involved. 

Campbell said this was the first positive test for the organization and he believes things are going “so far so good” for the youth hockey organization.

The ‘AAA’ organization does not allow spectators at the games.

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'Could be an Achilles heel': Why COVID-19 vaccines requiring two doses worry some experts – National Post



Article content continued

Their announcement followed on the heels of news from two rivals in the global coronavirus vaccine race — Pfizer and Moderna — that their products appeared to be 95 per cent effective in phase-three trials.

The promising results are better than expected. But all require two doses, with a gap of 21 days for Pfizer’s product and 28 days for the other two.

It has to be done

In fact, of the seven vaccines in late-stage trials that the federal government has pre-ordered, only one, developed by Johnson & Johnson, needs just a single injection. It has yet to report any phase 3 results.

Adherence to multi-dose vaccinations is relatively good for young children, who typically have regular medical appointments and are guided by their parents, noted Wilson.

The research around adult vaccination is more sparse but the findings have a consistent theme, the word “suboptimal” appearing in many of the papers.

A 2009 U.S. study, for instance, found that only 40-50 per cent of people completed two-dose hepatitis A and varicella (chicken pox) vaccinations, the numbers falling even lower for teenagers and young adults.

A U.K. study published last year found that a mere 11 per cent of adults got the required two doses of Hepatitis A vaccine within one year, the number rising to just 23 per cent by 36 months. A similar U.S. study in 2018 suggested only 32 per cent of adults had obtained their second Hepatitis A injection within 42 months.

People have told researchers they didn’t know an additional shot was needed, couldn’t fit it into their schedule or needed a reminder, said Houle, who helped conduct a similar study using Alberta data..

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