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Complex challenges mean mandatory COVID-19 vaccine unlikely: experts – ThoroldNews.com

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OTTAWA — While the government spends hundreds of millions of dollars to develop and test potential vaccines for COVID-19, experts say mandatory vaccination is unlikely given the difficult practical and ethical problems that would entail.

“A vaccine will be extremely important to getting back to normal,” Prime Minister Justin Trudeau said Tuesday, adding that effective treatment could help us get there too.

A recent poll conducted by Leger and the Association for Canadian Studies found 60 per cent of respondents believe people should be required to get the vaccine once it’s ready, although that is likely to be many months away.

It’s understandable people feel that way, said vaccine expert Dr. Noni MacDonald, but mandatory vaccines are a complicated proposition.

There are no truly mandatory vaccines in Canada. While provinces like Ontario and New Brunswick require children to be vaccinated in order to attend school, there are exemptions for medical and ideological reasons.

For adults, the only Canadian precedent for mandatory vaccines is for medical workers who must be immunized against certain diseases to protect themselves and their patients, MacDonald said.

“What’s your consequences for not doing it if you make it mandatory?” said MacDonald, a professor with the faculty of medicine at Dalhousie University. “What’s your penalty? Or what’s your incentive?”

Those questions are more complex than they appear, and can lead policy-makers down a rabbit hole.

Australia tried to convince parents to immunize their children by making certain tax benefits contingent on those vaccinations, MacDonald said.

“The group that it really harmed was the very low-income people who had to take time off work to get their child immunized,” she said. “And they got a double whammy. They not only didn’t get their child immunized, which meant they couldn’t go to daycare or go to school, but they also didn’t get the child tax credit.”

Ethically speaking, the government would have to make sure not to unduly penalize people who don’t get the vaccine.

Policy-makers also have to worry about a backlash, said Ubaka Ogbogu, an associate professor with the University of Alberta who specializes in law and bioethics.

“The reason why we should probably not raise the question of mandatory vaccination in relation to COVID-19 is because it’s deeply controversial,” Ogbogu said.

There is usually vehement opposition to mandatory vaccination, at least by small but vocal groups who worry about the safety of vaccines and government infringement on their liberties.

Those people are likely to be even more concerned about a rapidly developed vaccine, he said.

“The last thing you want is for (a vaccine) to become available, and then we spend a lot of time fighting over whether it should be mandatory or not, when I think people are going to want it,” he said. “I think what we’re going to have is the opposite issue.”

The question of whether to make the vaccine mandatory assumes there will be enough to go around, which both experts agree is doubtful.

It’s difficult to know what the uptake in an eventual vaccine will be, said chief public health officer Dr. Theresa Tam.

“Sometimes it’s quite an emotional reaction,” she said Saturday. 

“I recall in the last pandemic when you’d get an increase in deaths, for example, people will suddenly want to take up the vaccine very fast when you don’t have enough to go around.”

The more likely ethical quandary for policy-makers will involve figuring out how to distribute a limited supply of the vaccine in a way that is fair and effective.

That will depend on how knowledge of the vaccine and the disease develops.

Influenza, for example, spreads rampantly among kids who are in school so it’s important to boost their immunity. But it’s not clear if the same is true of COVID-19, MacDonald said. It may be that health-care workers should be the first to receive the vaccine, or people who work in long-term care homes.

To make matters more complicated, with several vaccines in development the successful candidates may be more effective in some populations than others.

Those are all factors that will have to be sorted out as the government works toward rolling out a vaccine in Canada.

The federal and provincial governments are going to have to make “extremely important decisions,” about how to achieve the optimal level of vaccination, Trudeau said Tuesday, and those decisions will be informed by research.

This report by The Canadian Press was first published April 28, 2020.

Laura Osman, The Canadian Press

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The Lancet retracts hydroxychloroquine study following data concerns – Global News

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One of the world’s most prestigious medical journals, The Lancet, has retracted an influential COVID-19 research paper after three of the paper’s authors said the patient data used for the study could not be independently verified.

The paper, published on May 22, sparked worldwide concern that using the anti-malarial drug hydroxychloroquine on COVID-19 patients may not be safe.


READ MORE:
Hydroxychloroquine doesn’t prevent COVID-19 in people exposed to the virus, study finds

“After publication of our Lancet article, several concerns were raised with respect to the veracity of the data and analysis conducted by Surgisphere Corporation and its founder and our co-author, Sapan Desai, in our publication,” authors Mandeep Mehra, Frank Ruschitzka and Amit Patel said in a statement published by The Lancet, Thursday.

“Our independent peer reviewers informed us that Surgisphere would not transfer the full dataset, client contracts, and the full ISO audit report to their servers for analysis as such transfer would violate client agreements and confidentiality requirements.

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“As such, our reviewers were not able to conduct an independent and private peer review and therefore notified us of their withdrawal from the peer-review process.

“We deeply apologise to you, the editors, and the journal readership for any embarrassment or inconvenience that this may have caused.”

The observational study had found that after reviewing 96,000 COVID-19 patients across six continents, those treated with hydroxychloroquine had a higher risk of heart arrhythmia and death.

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“It caused people to stop what they’re doing (and) delay the high quality science in order to sort out whether this initial paper was accurate or inaccurate” said Derek Exner, Associate Dean of Clinical Trials at the University of Calgary Cummings School of Medicine.


READ MORE:
Medical journal questioning findings of hydroxychloroquine coronavirus study

The World Health Organization immediately suspended the hydroxycholoroquine arm of its international Solidarity trial pending a safety review.

On Wednesday, WHO Director-General Dr. Tedros Adhanom Ghebreyesus announced that review was complete and that trial would be able to resume.

“The Data Safety and Monitoring Committee of the solidarity trial has been reviewing the data. On the basis of the available mortality data, the members of the committee recommended that there are no reasons to modify the trial protocol,” he said.

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“The executive group received this recommendation and endorsed the continuation of all arms of solidarity trial, including hydroxychloroquine.”

Enrollment for The Alberta HOPE COVID-19 trial at the University of Calgary was suspended following The Lancet study publication as well.


READ MORE:
Alberta’s hydroxychloroquine study cleared to resume, but remains on pause

“Our safety committee has reviewed everything and said that look, the trial looks totally safe and there’s no major adverse affects with hydroxychloroquine,” said Dr. Michael Hill, the trial’s co-lead.






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WHO halts hydroxychloroquine clinical trials


WHO halts hydroxychloroquine clinical trials

Still, the delay has been costly for the project.

In the nearly two weeks since the Alberta research was suspended, COVID-19 cases in that province have dropped.  A spokesperson for Alberta Health says the trial might not resume at all.

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“We understand the trial will remain on hold for the next 10 days while the researchers determine whether to suspend for the summer pending (a) fall recurrence of cases or close the trial formally with a plan for data pooling with international collaborators,” said Tom McMillan in an email to Global News.

The coronavirus pandemic has put pressure on scientists to work faster than ever before, but some researchers worry if the cost of speedy science may be too high.

“Of course this pandemic is unfolding at a very rapid pace and the rate of new knowledge is unprecedented and the rate of data sharing is also unprecedented,” said Dr. Isaac Bogoch, an infectious diseases physician at the University of Toronto.

“But it’s also important that you get it right and there’s clearly got to be a balance of speed with accuracy. You can’t compromise accuracy.

“(That would) erode public trust in science, in medicine and in public health and this is time more than ever before where we need public trust in science, medicine and in public health.”

© 2020 Global News, a division of Corus Entertainment Inc.

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2,000 COVID-19 cases missing from Toronto's map of hot spots – CBC.ca

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More than 2,000 confirmed COVID-19 cases are missing from the map the City of Toronto released last week that shows infections by neighbourhood, CBC News has found.

The detailed geographic information about the spread of the novel coronavirus was released last week by Toronto Public Health, marking the first time such data has been made available in Ontario during the pandemic. It shows infections based on where patients live.

But in a review of published data, CBC News found the count on the map comes up short.   

On Thursday morning, the map showed 9,623 positive COVID-19 cases distributed over 140 neighbourhoods. That’s 2,029 cases short of the official 11,652 total count for that day.

That means roughly one out of every five cases is missing in the city’s own geographic analysis. Similar proportions of missing data were found in the map and case counts from previous days.

The data gap was not mentioned in any of the local health authority’s statistics or on its webpage until CBC pointed it out. 

Muhammad Junayed, right, gets instructions for being tested for COVID-19 from a health-care worker at a pop-up testing centre at the Islamic Institute of Toronto. (Nathan Denette/The Canadian Press)

An extra row identified as “Missing addresses/postal code,” totalling 2,029 cases, has been added to the city’s downloadable spreadsheet showing the number of cases assigned to each neighbourhood.

Toronto Public Health blames the missing data on reports sent by testing labs. The public health authority says some forms only have a name and an address, while others don’t have a patient’s postal code or phone number, leaving health authorities scrambling to fill in gaps.

“Sometimes, they are not putting enough contact details, and in the legislation it doesn’t specify that you must include XYZ details of the individual,” said Dr. Vinita Dubey, Toronto’s associate medical officer of health, referring to the provincial law that requires medical labs to report positive results of certain tests to local health authorities. 

“It just requires that it be reported, so that’s where some of the missing information and gaps occur.”

Delays possible

Dubey said it’s “very unlikely” that the missing data had an impact on contact tracing, but that there could have been delays as her staff had to retrieve missing contact information before they could connect with a patient who tested positive. 

Toronto Public Health said that so far, it has been able to complete contact tracing for a patient within 24 hours in 88 per cent of cases. 

The issue of information transfer between laboratories and public health units was raised last Friday in a report to city council and the Toronto Board of Health by Toronto Medical Officer of Health Dr. Eileen de Villa. 

Dr. Eileen de Villa said that ‘case and contact management is a complex and time-consuming process,’ in a statement on Wednesday. (Rozenn Nicolle/Radio-Canada)

“Laboratories’ reports are received all together in one large fax, sometimes containing hundreds of individual lab results, which must be taken apart for further processing,” de Villa wrote. 

She called for changes in laboratory procedures and the provincial law.

Missing hot spots

Beyond potential delays in contact tracing, the missing geographic data might have another impact. 

Toronto’s current map distribution suggests that some of the city’s poorest and most diverse neighbourhoods — predominantly in the northwest and northeast areas — have had the highest number of cases so far and might be most vulnerable to the novel coronavirus. 

As Ontario is ramping up testing, resources like mobile testing clinics, staff and personal protection equipment will be focused on those hardest-hit areas of the city. 

But with 2,000 cases missing, one researcher familiar with Toronto’s map data said health authorities could be missing out on other vulnerable communities. 

Kate H. Choi, an associate professor in the department of sociology at Western University in London, Ont., said Toronto has been ahead of the curve in terms of COVID-19 data collection, so she was “really, really surprised” when she was told how many of the city’s confirmed cases were missing from its map.

Kate H. Choi is an associate professor of sociology at Western University. (Kate Choi)

She said part of the issue might also be that some populations are less likely to be able to provide a precise address or a postal code, including homeless people, migrant workers or nursing home residents. 

“We may be missing COVID-19 hot spots or certain vulnerable populations may be missing from the narrative about COVID-19 in Toronto.” 

Alternatively, some Torontonians might feel a false sense of security after assuming their neighbourhood is low-risk based on the map, said Choi. It’s also possible that resources and staff could fail to be deployed to hospitals in unknown hot spots, which could lead to more transmission of the virus.

“Those 2,029 individuals are someone’s loved one,” said Choi. “They are also 2,029 people who could be your neighbours. They could be residents in an area where there are a lot of asymptomatic carriers and unfortunately, that may mean they could bring COVID-19 to your doorsteps.”

WATCH | Toronto releases a map showing the city’s COVID-19 cases:

The City of Toronto has released the postal code data about where COVID-19 patients live in the city. Some fear it could stigmatize communities, but the information can help officials decide where to conduct more testing. 2:00

Choi stressed that more research on the age, gender and other characteristics of the missing 2,029 cases is needed to fully understand the impact and risks of this data gap.

Toronto Public Health has also repeatedly said that the map shows where patients infected with COVID-19 live and not where they acquired the infection. 

Gap won’t be fixed for weeks

Toronto Public Health said it does not have the resources to go looking for the 2,029 missing postal codes at the moment.

“Some of them were early on in our outbreak and so it would require going back to some of these cases in February and March. That work won’t be done until we either have less cases or have reached the end of the first wave,” said Dubey. 

This is the second data gap uncovered by CBC in less than a week. On Monday, it was revealed that Ontario hospitals had failed to flag 700 positive COVID-19 tests to public health officials because of a mixup. 

In a statement to CBC, Ontario Health has said the impact of the error “may not be fully understood for some time.”

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Safety officers heading to Manitoba beaches amid COVID-19, no new cases reported Thursday – Globalnews.ca

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Health officials say safety officers are being deployed to three popular Manitoba beaches to make sure beach-goers are staying safe while enjoying the sun amid the coronavirus outbreak.

The safety officers will be patrolling the beaches in Birds Hill, Winnipeg Beach, and Grand Beach Provincial Parks starting Thursday, the province said in a release.


READ MORE:
Coronavirus: 1 more case in Manitoba, active cases fall below 10

The news comes as health officials reported no new cases of COVID-19 in Manitoba Thursday, leaving the province’s total number of lab-confirmed positive and probable cases at 298.

While provincial parks and beaches are open to the public, health officials are warning those heading into the great outdoors physical distancing rules remain in place, and beach-goers should keep at least four metres of separation between each group’s towels and blanket on the beach.

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They also recommend bringing your own life jackets and personal flotation devices as the province’s life-jacket loaner program has been suspended to help stop the spread of COVID-19.

The province says there are currently seven active cases of COVID-19 in Manitoba and no one is in hospital or intensive care because of the virus.


READ MORE:
Winnipeg groups unclear how many of their workers will qualify for coronavirus ‘risk pay’

To date 284 people have recovered from COVID-19, the province says.

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There have been 46,701 tests for the virus completed across the province since early February, health officials say, with 899 done on Wednesday.

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0:58
Coronavirus outbreak: Manitoba seeing ‘historically low’ wait times, health officials say


Coronavirus outbreak: Manitoba seeing ‘historically low’ wait times, health officials say

Questions about COVID-19? Here are some things you need to know:

Symptoms can include fever, cough and difficulty breathing — very similar to a cold or flu. Some people can develop a more severe illness. People most at risk of this include older adults and people with severe chronic medical conditions like heart, lung or kidney disease. If you develop symptoms, contact public health authorities.

To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. They also recommend minimizing contact with others, staying home as much as possible and maintaining a distance of two metres from other people if you go out. In situations where you can’t keep a safe distance from others, public health officials recommend the use of a non-medical face mask or covering to prevent spreading the respiratory droplets that can carry the virus.

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For full COVID-19 coverage from Global News, click here.

© 2020 Global News, a division of Corus Entertainment Inc.

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