A group of 239 scientists and physicians urging the World Health Organization to recognize the potential for airborne transmission of the novel coronavirus have sparked debate over how COVID-19 is spreading.
But some Canadian infectious disease experts say not to get hung up on the term “airborne,” and that the safety precautions we’re already taking to slow the spread of the virus are working.
“To the general public the word (airborne) can be pretty confusing because it suggests that COVID is gonna come through the keyhole and get you in your sleep. And well, it isn’t,” said Colin Furness, an epidemiologist with the University of Toronto.
“No one is suggesting COVID behaves anything like measles… That’s not the point (the scientists) are trying to make.”
In an open letter to the WHO published Monday, scientists across 32 countries called for the organization to revise its safety recommendations to mitigate possible spread of COVID-19 through aerosols — tiny, light particles expelled when people cough, sneeze or breathe that stay suspended in the air for longer periods of time.
The WHO currently classifies SARS-CoV-2 as a droplet virus, spreading through larger, heavier particles that can travel one to two metres before hitting the ground. While the organization acknowledged in a press briefing Tuesday that there is “some evidence emerging” for aerosol spread, they also say it is “not definitive.”
Furness says from what we’ve seen of COVID spread in clinical practice, it’s droplet based, but the scientists behind the letter have a point, too.
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He said people release particles of all sizes when they breathe, and SARS-CoV-2 can be found in smaller droplets. But that doesn’t mean they are effective in trasmitting the virus, he added.
The scientists’ letter mentions a COVID-19 outbreak at a Chinese restaurant where customers at tables further than two metres apart became infected. While the authors use that as an argument for COVID’s spread through aerosols, Furness said that’s not necessarily the case.
“It could be (evidence of aerosol spread) but it also could be that they touched the same thing. We don’t know,” he said. “Also one would need to explain why didn’t everyone in the restaurant get sick?”
“So WHO is right that there isn’t a clear case. And the scientists who signed that letter are right saying we do need to look at this … because it could have an impact on what we say is safe.”
Dr. Bonnie Henry, B.C.’s provincial health officer, praised WHO on Monday for “doing an amazing job trying to keep up with what’s going on,” and said she thought the scientists’ letter was “trying to foment a bit of controversy.”
Henry added that while COVID does seem to be released in small droplets as well as large droplets, we don’t know how potent those smaller particles are.
“Where there’s some challenges is how much is due to the small aerosols which are transmitted when I’m close to you, or the larger droplets that tend to fall out more readily,” Henry said. “So it’s really a bit of nuance, I think.”
Dr. Zain Chagla, an infectious disease physician and an associate professor at McMaster University in Hamilton, doesn’t believe the novel coronavirus is transmitting through aerosols, at least not to an extent we should be worried about.
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If it was “we’d be in trouble,” he said.
“We would have seen huge rates of transmission if this was a predominantly aerosol virus. We would have not been able to control it as well as we did.
“In reality, there is probably some degree of small aerosols that would carry COVID-19 in average day-to-day contact, but it’s probably very minimal.”
Chagla also believes the argument for aerosol versus droplet transmission is “more of a discrepancy on the exact scientific terminology” of what airborne actually means.
COVID-19 does have the potential to transmit through small particles when patients in hospital are undergoing “aerosol-generating procedures” like being intubated, Chagla said, and WHO also acknowledges that.
In those instances, health-care workers are given proper personal protective equipment (PPE), including N95 masks, which protect against small airborne particles.
But Chagla highlighted a specific case from early in the pandemic, before evidence of community spread, when health-care workers treated a COVID patient in California without proper PPE. Out of 121 health-care workers that treated the patient and performed “multiple aerosol-generating procedures,” only three got sick.
“So you had 118 individuals that … did not wear N95 masks which would be the only protection against aerosol viruses, and they did not get infected,” he said.
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Chagla compared the situation to measles, which has a reproduction number of about 18 –meaning one infected person will infect 18 others. Measles particles can stay suspended in the air of a room for hours after an infected person leaves it, Chagla said, and you can catch the virus from a much further distance away.
Dr. Howard Njoo, Canada’s deputy chief public health officer, said Wednesday that evidence so far has not shown COVID to be airborne “in that classic definition in a sense as measles.”
“And certainly based on what we’ve done so far in terms of public health measures, they’ve been proven effective,” he added.
Furness said COVID-19 has a reproduction number of two, while Njoo believes that number to be in the “3, 4 or 5” range, based on the most recent epidemiology.
Other coronaviruses have smaller reproduction numbers (0.5 for SARS and 1.5 for H1N1), so Furness says that could mean there’s more going on with COVID.
“COVID is doing something to be more infective than your average respiratory virus,” Furness said. “And I’m nowhere near saying it’s airborne, because I don’t think that’s an appropriate statement. But I think those aerosols, those smaller droplets that we’re disregarding, they might be important.”
Both Furness and Chagla say there’s no indication that the general public will need to do any more to protect from potential aerosol spread of the virus.
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Chagla says the points emphasized by the scientists in the letter mirror what we’re already doing, like having events outdoors rather than indoors to ensure proper air flow.
Face coverings become more important if we have to worry about aerosols, Furness says. And even though smaller particles can get through cloth masks, the fabric will slow them down.
“The more we can slow down the trajectory of what comes out of your mouth, the less it disperses,” he said.
— With files from Hina Alam
© 2020 The Canadian Press
COVID-19 case count increases in Manitoba; two more deaths reported – ThePeterboroughExaminer.com
WINNIPEG—Manitoba’s chief public health officer says he’s worried by an increase in COVID-19 cases in Winnipeg and that some people are going to many different locations while symptomatic.
“It’s concerning,” Dr. Brent Roussin said Monday.
The number of active cases in the capital city has almost tripled to more than 280 since the start of September. Sixteen of 22 new provincial cases reported Monday were in Winnipeg.
The province identified several Winnipeg restaurants, bars and gyms as sites of possible exposures over the last week. There have also been cases in schools and from gatherings in homes.
Roussin said the number of contacts for each person who tests positive has increased, which is putting pressure on staff tasked with tracking them. One person who tested positive in Winnipeg had 50 contacts, according to recently released data in the province’s public health report for the week of Sept. 6 to 12.
Roussin said mandating masks and bringing back other restrictions are on the table. But for now, the province is monitoring the situation.
Roussin is encouraging people to wear masks even if not officially required.
“If the vast majority of Manitobans want to wear a mask in indoor public places, we don’t really need a mask mandate.”
Roussin also announced that two more Manitobans have died after testing positive for COVID-19. That brings the total in the province to 18. The recent deaths were of a man in his 80s in the southern health region and a woman in her 80s in the Prairie Mountain region.
Those areas saw a resurgence in positive cases in July and August. As a result, specific regulations around masks and group sizes were put in place in Prairie Mountain, which includes Brandon. Infection numbers in those regions have since dropped, while cases in Winnipeg have surged.
The surge prompted the captain of the National Hockey League’s Winnipeg Jets to make a request on social media for mandatory masks.
“Time for universal mask mandate. Why not? Let’s take care of each other,” read a post on Blake Wheeler’s Twitter account, directed to Premier Brian Pallister.
When asked about the request, the premier said he would defer to health experts.
“I personally have a ton of affection for Blake Wheeler and the way he plays hockey,” Pallister said.
“To make sure that we get through this together, we have to demonstrate that we can respect those who we’ve put in a position of trusted leadership. And Brent Roussin’s been put in that position and it’s really important we respect that.
“It doesn’t mean we have to agree with everything Brent says or does — that’s not what I’m saying. But I am saying that I am going to respect … what our experienced public health officials decide.”
Also Monday, the government revealed details of how it will spend its $85.4-million share of recently announced federal funding to help schools during the pandemic.
Education Minister Kelvin Goertzen said the money is to help enhance remote learning for students who can’t attend classes, such as those with chronic health conditions who are advised by doctors to not attend.
Remote learning is also available for some high school students in more-crowded schools and for students whose classes have been temporarily cancelled due to a COVID-19 outbreak.
Goertzen said the province is not expanding remote learning to make it an option for any student who wants it.
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There are two schools in the province with outbreaks of five or more cases, including St. Wilfrid Elementary in Calgary and Vimy Ridge School. And the list of Calgary schools with outbreaks of two to four cases now includes Notre Dame High School, Lester B. Pearson High School, Henry Wise Wood High School, Auburn Bay School, Crescent Heights High School, Chris Akkerman School, Saddle Ridge School and Apostles of Jesus.
“Every single Albertan can make school reopening successful by working to limit and minimize community transmission. And again, that’s the message I want to make sure everyone understands,” said Hinshaw.
Meanwhile in British Columbia, the Ministry of Health has removed 10 symptoms from the student health checklist — including sore throat, runny nose, headache and fatigue — because they are common in children and there’s a low probability these symptoms by themselves are indications of COVID-19.
When asked if this is something being considered in Alberta, Hinshaw said it has been discussed at length because of the pressures the current checklist puts on families that have to adjust their daily schedules when they need to keep their child home from school because of a runny nose.
“In Alberta, we are not far enough along yet to know whether or not we could take some of those symptoms off of our list, without increasing the risk that COVID-19 could be introduced into the school,” she explained.
“We try to reach the right balance between keeping our kids in school, and making sure that their learning is as smooth as possible while at the same time, minimizing the risk of the COVID-19 introduction and spread. Right now, we are keeping our symptom list as is.”
Five more Manitoba healthcare workers test positive for COVID-19 – CTV News Winnipeg
Five Manitoba healthcare workers tested positive for COVID-19 in the span of a week.
The latest numbers from the Manitoba government’s surveillance data, from Sept. 6 to 12, shows that a total of 88 healthcare workers have contracted the disease since the beginning of the pandemic. This is an increase of five healthcare workers compared to the week before.
Of these 88 workers, 74 have recovered from COVID-19 and gone back to work.
According to the data, which monitors the intensity, characteristics, transmission and geographic spread of the disease, 29 of these workers are healthcare aids, 23 are nurses, nine are physicians or physicians in training, five are social/support workers, four are medical clerks and 18 fall into a combined category.
The majority of the 88 workers – 64 per cent – contracted the disease through close contact with a known case, about 13 per cent got it from travel, and for the rest of the cases, the source is unknown.
The province is reporting that a total of 20 pregnant Manitobans have gotten COVID-19, which is an increase of two pregnant cases from the week before.
During the week of Sept. 6 to 12, there were three more COVID-19 outbreaks in Manitoba, bringing the total number since the start of the pandemic to 20 outbreaks. Of these three new outbreaks, two were at long-term care facilities and one was at a school.
Over the span of this week, the province saw a decrease in terms of the number of confirmed cases and the volume of people going for tests. There were 108 lab-confirmed cases, which is down from 128 in the week before, and an average of 1,300 people were tested each day, down from 1,500 the previous week.
But, the province saw an increase in its test positivity rate, moving from 1.2 per cent last week to 1.4 per cent this week.
Of the 108 new cases during this week, 63 per cent were from Winnipeg Regional Health Authority, 14 per cent were from the Prairie Mountain Health Authority, and 13 per cent were in the Southern Health – Santé Sud Regional Health Authority. The Interlake-Eastern Regional Health Authority also accounted for about 10 per cent of cases.
The province is reporting that 57 per cent of the 108 cases were contracted through close contacts to known cases, and two per cent were from travel.
Of all of Manitoba’s cases, nearly 63 per cent contracted the disease from close contact with a known case. For more than 16 per cent, the cause is unknown, and approximately 15 per cent got it from travel.
For more than 5 per cent of cases, the source is still being investigated.
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