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Coronavirus FAQs: A Vaccinated Person's Guide To COVID Exposure And Elevator Etiquette – NPR

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Malaka Gharib/NPR

Each week, we answer frequently asked questions about life during the coronavirus crisis. If you have a question you’d like us to consider for a future post, email us at goatsandsoda@npr.org with the subject line: “Weekly Coronavirus Questions.” See an archive of our FAQs here.

We’ve been answering coronavirus questions from our audience for over a year, but this past week, I had some questions of my own. While on vacation with my family, I encountered four tricky COVID-19 situations. I really wanted an expert’s advice.

So I interviewed three COVID-19 specialists: Charlotte Baker, an assistant professor of epidemiology at Virginia Tech; Abraar Karan, an infectious disease doctor at Stanford University; and Jill Weatherhead, an assistant professor of adult and pediatric infectious diseases at Baylor College of Medicine. Here’s what they had to say about my concerns.

What if you’re exposed to someone who has COVID-19 — directly or one step removed?

While we were on vacation, an unvaccinated child who’d tested negative for the coronavirus a few days earlier came to an outdoor gathering. He wasn’t feeling so great. That night, he became ill and tested positive for the coronavirus.

My two adult children, who attended the gathering, were directly exposed, albeit briefly. My wife and I did not attend the event but hung out with our kids in a hotel room for a couple of hours immediately after the gathering. None of us were wearing masks.

We are all fully vaccinated. But we had so many questions! Should our kids quarantine and then get tested? And what about us? We figured we should avoid seeing our kids until their status is known … but were we at any risk of coming down with COVID-19?

All three experts said our children were at low risk of contracting COVID-19 because of their vaccine status and because the event was outdoors, where airflow does a good job dispersing pathogens. And they were only in close proximity with the little boy for a maximum of 10 minutes or so.

Yet the risk is not zero.

The experts’ recommendations: My kids should mask up when they are in public settings, indoors and outdoors, for three to five days in case they were infected and contagious. They should monitor for any potential COVID-19 symptoms such as fever, chills or sniffles. After that time period, they should get a coronavirus test. By that time, there’d be enough viral load for a test to pick up any possible infection.

The experts say it’s best to go to a health provider for a PCR test, which detects genetic material of the virus and thus provides more accurate results than the at-home antigen tests, which assess viral load.

One of my children was planning to fly home on Monday, two days after the exposure. The experts said that was OK given a) they were vaccinated and b) they’d wear a mask.

And what about my wife and me?

Karan, the doctor at Stanford, says that even if our children were infected at the gathering, the virus takes a couple of days to incubate before it can be transmitted. So we were basically in the clear. But out of an abundance of caution, we masked up in all public settings (which we do anyway because of our concern about breakthrough infections).

Our children waited three days and got tested. The results: negative! That gave my wife and me additional reassurance that we had no worries from the incident, so we could resume contact.

But what if our children were not vaccinated? Then it would have been a different story. The Centers for Disease Control and Prevention recommends an unvaccinated person — whose chances of getting infected and thus being contagious are greater than those who are vaccinated — should quarantine at home for 14 days after an exposure.

What should you say if you’re in an elevator and two maskless people enter at the next stop?

There were other moments of concern during our stay that had nothing to do with the little boy who had COVID-19. We were staying at a hotel. My wife and I got on an elevator, which had a sign on the door stating: “Guests should wear face coverings in the elevator.”

We had on masks. Two women without masks got on and eyed my mask.

“Should I put on a mask?” one asked.

“Well, if you want to, you can,” her friend replied.

Neither of them wanted to do so.

I didn’t say anything. And got off at the next elevator stop.

I wondered: Should I have spoken up?

Karan notes that in a fleeting elevator contact, an individual with a good mask (an N95 or KN95, for example, and not a thin cloth mask) would be unlikely to become either infected or spread the coronavirus.

You also have to ask yourself, he says: “Do I think saying something is going to get them to put a mask on?”

But there are other perspectives. Baker, the epidemiologist at Virginia Tech, has a medical condition that puts her at higher risk of getting infected and of severe disease. She says she would have either put in a polite request — “Please ma’am, could you put your mask on?” — or left the elevator at the next stop.

If you’re uncomfortable in an elevator for any reason – unmasked people, too crowded — “you could always get off and take the stairs,” adds Weatherhead, the assistant professor at Baylor College of Medicine.

There’s another issue to consider besides a personal concern about the odds of catching COVID-19. “This is a community-based virus,” Weatherhead says. “Unless everybody has buy-in [regarding protective measures], really nobody’s going to be safe. Everybody has to do their part.”

Which brings me to my next situation. …

If all the staff in a hotel are masked, should I mask up, too?

As I walked down the hallways of the hotel, I was struck by a noticeable mask fact. The housekeepers and other employees walking the halls were all masked. The guests by and large were not.

Now it is true that these hotel employees are in contact with a greater number of individuals in the course of their day than guests walking to their rooms.

And maybe these unmasked guests are all vaccinated.

But maybe some of the employees are not yet vaccinated. “There’s a lot of privilege in being able to get vaccinated,” Karan notes. For one thing, “you have to be able to take time off.”

And this hotel is in a state where the virus is currently surging and the vaccination rate is below 50%.

So what’s the advice? “The idea of masks is they are providing some protection for the [people who are wearing them] and protection for the guests in that hotel or restaurant,” Weatherhead says. And if you’re in an area with high rates of COVID-19, “Having everybody masking is really important — and not just for service staff.”

What do I say to someone who asks me why I’m wearing my mask?

My wife and I were dining at a restaurant with outdoor seating. At a table about 12 feet away sat two gentlemen. One of them noted that my wife and I were both wearing green.

We smiled. True!

Then he asked, “Do you really think you need to wear that mask outdoors?”

I didn’t get to answer — a restaurant staffer escorted the two men to a different part of the outdoor dining area because they were smoking in a nonsmoking zone.

So what might I have said?

Karan says first of all, it would be fine for my wife and me to be unmasked at the outdoor restaurant with no nearby diners. We’d have to take off our masks anyway once our food and drinks arrived.

But there’s also an argument for masks. He suggests I could have answered: “When you have high rates of transmission of disease with high levels of spread, it makes sense to wear a mask. It can reduce the chance you’ll get exposed to the virus or transmit it to others like kids or unvaccinated people.”

Baker notes, “If you’re going to partake in public activities – [going to] shops, restaurants, bars – you have to do a good job of being a good steward, which is being vaccinated, putting on your mask. That shows you’re a willing participant in society to help other people.”

And make sure it’s a good quality mask, she says: “I see a people with bedazzled masks and I’m like, ‘You’re putting holes in it!’ “

Then again, perhaps a case of COVID-19 is in everyone’s future. “The reality is you will be exposed to the virus,” Karan says. “Nobody is going to avoid exposure forever.” That is problematic for those at high risk of severe disease – and he says he is seeing an increase in breakthrough cases among older people and the immunocompromised that require hospitalization. But if you’re vaccinated, “you’ll never know — or may have mild symptoms so you think you just had a cold.”

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Kevin Neil Friesen Obituary 2024 – Crossings Funeral Care

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It is with heavy hearts that we announce the peaceful passing of Kevin Neil Friesen age 53 on Thursday, March 28, 2024 at the Bethesda Regional Health Centre.

A funeral service will be held at 2:00 pm on Thursday, April 4, 2024 at the Bothwell Christian Fellowship Church, with viewing one hour prior to the service.

A longer notice to follow.  

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Spring allergies: Where is it worse in Canada? – CTV News

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The spring allergy season has started early in many parts of Canada, with high levels of pollen in some cities such as Toronto, Ottawa and Montreal.

Daniel Coates, director of Aerobiology Research Laboratories in Ottawa, expects the elevated amounts to continue next week for places, such as most of Ontario, if the temperature continues to rise. Aerobiology creates allergen forecasts based on data it collects from the air on various pollens and mould spores.

Pollens are fertilizing fine powder from certain plants such as trees, grass and weeds. They contain a protein that irritates allergy sufferers.

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Although pollen levels declined after a cold spell in some places, he said they are soaring again across parts of Canada.

“So the worst is definitely British Columbia right now, followed by Ontario and Quebec and then the Prairies and Atlantic Canada for the upcoming weeks,” said Coates in a video interview with CTVNews.ca. “We are seeing pollen pretty much everywhere, including the Maritimes.”

He said pollen has increased over the past 20 years largely due to longer periods of warm weather in Canada.

Meanwhile, the Maritimes is one of the best places to live in Canada if you have seasonal allergies, in part because of its rocky territory, Coates said.

With high levels of cedar and birch pollen, British Columbia is the worst place for allergy sufferers in Canada, he added.

“British Columbia is going strong,” Coates explained, noting the allergy season started “very early” in the province in late January. “It has been going strong since late January, early February and it’s progressing with high levels of pollen, mostly cedar, but birch as well, and birch is highly allergenic.”

Causes of high pollen levels

Coates expects a longer allergy season if the warm weather persists. He notes pollen is increasing in Canada and worldwide, adding that in some cases the allergy season is starting earlier and lasting longer than 15 years ago.

He says tree pollen produced last year is now being released into the air because of warmer weather.

“Mother nature acts like a business,” he said. “So you have cyclical periods where things go up and down. … So when it cooled down a little bit, we saw (pollen) reduce in its levels, but now it’s going to start spiking.”

Along with warmer weather, another factor in higher pollen levels is people planting more male trees in urban areas because they don’t produce flowers and fruits and are less messy as a result, he said. But male trees produce pollen while female ones mostly do not.

Moulds

Coates said moulds aren’t as much of a problem.

“They’ve been mainly at lower levels so far this season,” he explained. “Moulds aren’t as bad in many areas of Canada, but they’re really, really bad in British Columbia.”

In B.C., moulds are worse because of its wet climate and many forested areas, he said.

Coping with allergies

Dr. Blossom Bitting, a naturopathic doctor and herbal medicine expert who works for St. Francis Herb Farm, says a healthy immune system is important to deal with seasonal allergies.

“More from a holistic point of view, we want to keep our immune system strong,” she said in a video interview with CTVNews.ca from Shediac, N.B. “Some would argue allergies are an overactive immune system.”

Bitting said ways to balance and strengthen the immune system include managing stress levels and getting seven to nine hours of restful sleep. “There is some research that shows that higher amounts of emotional stress can also contribute to how much your allergies react to the pollen triggers,” Bitting said.

Eating well by eating more whole foods and less processed foods along with exercising are also important, she added. She recommends foods high in Omega-3 Fatty Acids such as flaxseeds, flaxseed oil, walnuts and fish. Fermented foods with probiotics such as yogurt, kimchi and miso, rather than pasteurized ones, can keep the gut healthy, she added. Plant medicines or herbs such as astragalus, reishi mushrooms, stinging nettle and schisandra can help bodies adapt to stressors, help balance immune systems or stabilize allergic reactions, she said.

To cope with allergies, she recommends doing the following to reduce exposure to pollen:

  • Wear sunglasses to get less pollen into the eyes;
  • Wash outdoor clothes frequently, use outer layers for outside and remove them when you go inside the house;
  • Use air purifiers such as with HEPA (high efficiency particulate air) filters;
  • Wash pets and children after they go outside;
  • Keep the window closed on days with high pollen counts.

Mariam Hanna, a pediatric allergist, clinical immunologist and associate professor with McMaster University in Hamilton, Ont., says immunotherapy can help patients retrain their bodies by working with an allergist so they become more tolerant to pollens and have fewer symptoms.

“Some patients will need medications like over-the-counter antihistamines or speaking with their doctor about the right types of medications to help with symptom control,” she said in a video interview with CTVNews.ca.

Coates recommends people check pollen forecasts and decrease their exposure to pollen since no cure exists for allergies. “The best is knowing what’s in the air so that you can adjust your schedules, or whatever you’re doing, around the pollen levels.”

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Do you need a spring COVID-19 vaccine? Research backs extra round for high-risk groups

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Recent studies suggest staying up-to-date on COVID shots helps protect high-risk groups from severe illness

New guidelines suggest certain high-risk groups could benefit from having another dose of a COVID-19 vaccine this spring — and more frequent shots in general — while the broader population could be entering once-a-year territory, much like an annual flu shot.

Medical experts told CBC News that falling behind on the latest shots can come with health risks, particularly for individuals who are older or immunocompromised.

Even when the risk of infection starts to increase, the vaccines still do a really good job at decreasing risk of severe disease, said McMaster University researcher and immunologist Matthew Miller.

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Who needs another COVID shot?

Back in January, Canada’s national vaccine advisory body set the stage for another round of spring vaccinations. In a statement (new window), the National Advisory Committee on Immunization (NACI) stated that starting in spring 2024, individuals at an increased risk of severe COVID may get an extra dose of the latest XBB.1.5-based vaccines, which better protect against circulating virus variants.

That means:

  • Adults aged 65 and up.
  • Adult residents of long-term care homes and other congregate living settings for seniors.
  • Anyone six months of age or older who is moderately to severely immunocompromised.

The various spring recommendations don’t focus on pregnancy, despite research (new window) showing clear links between a COVID infection while pregnant, and increased health risks. However, federal guidance does note that getting vaccinated during pregnancy can protect against serious outcomes.

Vaccinated people can also pass antibodies to their baby through the placenta and through breastmilk, that guidance states (new window).

What do the provinces now recommend?

Multiple provinces have started rolling out their own regional guidance based on those early recommendations — with a focus on allowing similar high-risk groups to get another round of vaccinations.

B.C. is set to announce guidance on spring COVID vaccines in early April, officials told CBC News, and those recommendations are expected to align with NACI’s guidance.

In Manitoba (new window), high-risk individuals are already eligible for another dose, provided it’s been at least three months since their latest COVID vaccine.

Meanwhile Ontario’s latest guidance (new window), released on March 21, stresses that high-risk individuals may get an extra dose during a vaccine campaign set to run between April and June. Eligibility will involve waiting six months after someone’s last dose or COVID infection.

Having a spring dose is particularly important for individuals at increased risk of severe illness from COVID-19 who did not receive a dose during the Fall 2023 program, the guidance notes.

And in Nova Scotia (new window), the spring campaign will run from March 25 to May 31, also allowing high-risk individuals to get another dose.

Specific eligibility criteria vary slightly from province-to-province, so Canadians should check with their primary care provider, pharmacist or local public health team for exact guidelines in each area.

WATCH: Age still best determines when to get next COVID vaccine dose, research suggests:

 

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Age still best determines when to get COVID vaccines, new research suggests

It’s been four years since COVID-19 was declared a pandemic, and new research suggests your age may determine how often you should get a booster shot.

Why do the guidelines focus so much on age?

The rationale behind the latest spring guidelines, Miller said, is that someone’s age remains one of the greatest risk factors associated with severe COVID outcomes, including hospitalization, intensive care admission and death.

So that risk starts to shoot up at about 50, but really takes off in individuals over the age of 75, he noted.

Canadian data (new window) suggests the overwhelming majority of COVID deaths have been among older adults, with nearly 60 per cent of deaths among those aged 80 or older, and roughly 20 per cent among those aged 70 to 79.

People with compromised immune systems or serious medical conditions are also more vulnerable, Miller added.

Will people always need regular COVID shots?

While the general population may not require shots as frequently as higher-risk groups, Miller said it’s unlikely there will be recommendations any time soon to have a COVID shot less than once a year, given ongoing uncertainty about COVID’s trajectory.

Going forward, I suspect for pragmatic reasons, [COVID vaccinations] will dovetail with seasonal flu vaccine campaigns, just because it makes the implementation much more straightforward, Miller said.

And although we haven’t seen really strong seasonal trends with SARS-CoV-2 now, I suspect we’ll get to a place where it’s more seasonal than it has been.

In the meantime, the guidance around COVID shots remains simple at its core: Whenever you’re eligible to get another dose — whether that’s once or twice a year — you might as well do it.

What does research say?

One analysis, published in early March in the medical journal Lancet Infectious Diseases (new window), studied more than 27,000 U.S. patients who tested positive for SARS-CoV-2, the virus behind COVID, between September and December 2023.

The team found individuals who had an updated vaccine reduced their risk of severe illness by close to a third — and the difference was more noticeable in older and immunocompromised individuals.

Another American research team from Stanford University recently shared the results from a modelling simulation looking at the ideal frequency for COVID vaccines.

The study in Nature Communications (new window) suggests that for individuals aged 75 and up, having an annual COVID shot could reduce severe infections from an estimated 1,400 cases per 100,000 people to around 1,200 cases — while bumping to twice a year could cut those cases even further, down to 1,000.

For younger, healthier populations, however, the benefit of regular shots against severe illness was more modest.

The outcome wasn’t a surprise to Stanford researcher Dr. Nathan Lo, an infectious diseases specialist, since old age has consistently been a risk factor for severe COVID.

It’s almost the same pattern that’s been present the entire pandemic, he said. And I think that’s quite striking.

More frequent vaccination won’t prevent all serious infections, he added, or perhaps even a majority of those infections, which highlights the need for ongoing mitigation efforts.

Lauren Pelley (new window) · CBC News

 

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