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COVID-19: As Canada's child vaccination rates drop due to lockdown, experts fear other infectious outbreaks – National Post

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Vaccination rates among children have dropped as much as 20 per cent in parts of Canada, ramping up anxieties that the country could face a series of infectious outbreaks while still battling COVID-19.

As public health officials peel back coronavirus restrictions, allowing Canadians to return to a form of pre-pandemic normalcy, pediatricians worry children who are delayed in their vaccination schedules may be at higher risk of contracting vaccine-preventable diseases, such as measles and bacterial meningitis.

The National Post reached out to a number of pediatric infectious disease specialists in recent days, and nearly all said child and infant immunization rates are declining. They said the full extent of this decline is unknown, because most provinces and territories do not maintain up-to-date data.

One of the few provinces to provide the Post with data, Manitoba, saw a 25-per-cent decline in administered measles, mumps and rubella (MMR) vaccines for the months of March and April 2020, compared to the same period last year for children two and younger.

Manitoba also recorded a 21-per-cent decline in diphtheria, tetanus and pertussis (DTaP) vaccinations in the same age group for March and April of this year, compared to 2019.

The Post reached out to Dr. Jim Kellner, a pediatric infectious disease specialist based in Calgary who also sits on the federal government’s COVID-19 immunity taskforce. Kellner divulged a conversation he had with an unnamed public health physician. The physician estimated that Calgary had seen a 20-per-cent decline in overall vaccinations in March and April, meaning parents had been delaying their children’s routine vaccinations.

Every specialist pointed to COVID-19 restrictions implemented across the country as an inadvertent cause for diminishing immunity among child and infant populations.

Some spoke about the potential for an imported case of measles to wreak havoc on vulnerable populations in which, to be fully protected, a vaccination threshold of 95 per cent or more must be maintained. If that rate isn’t maintained, there is no herd immunity and outbreaks can emerge with even the slightest dip, said Dr. Caroline Quach-Thanh, a pediatric infectious disease specialist in Montreal. Like Kellner, she also sits on the federal government’s COVID-19 immunity task force.

Kellner added that a measles outbreak is highly worrisome because measles is far more contagious than COVID-19 due to its routes of transmission; the former is airborne while the latter is understood to infect largely via droplets that remain on surfaces. Measles primarily targets unvaccinated children, who can experience flu-like symptoms and rashes. In rare cases, it can lead to death. With children who contract COVID-19, experts have so far discovered they often experience mild illness, with a substantial portion remaining asymptomatic.


A vial of measles, mumps and rubella vaccine and an information sheet is seen at Boston Children’s Hospital in Boston, Massachusetts February 26, 2015.

Brian Snyder/Reuters

In 2018 alone, more than 142,000 people died — a large portion were children younger than five — due to measles and more than 9.7 million became infected worldwide., according to estimates from the World Health Organization.

Even if families largely adhered to social distancing and isolation guidelines laid out by public health officials during the pandemic, that is no guarantee a baby or toddler is safe from contracting a vaccine-preventable disease, warned Dr. Joan Robinson, a pediatric infectious disease specialist in Edmonton.

Which infectious disease should a parent particularly worry about? In Robinson’s mind, it’s bacterial meningitis.

“Most parents today have never come across a child who has had bacterial meningitis — that’s all because of vaccines,” she said.

Despite months of social distancing, isolating within the family unit and largely remaining at home, meningitis can infect younger children because older kids and adults can carry the disease for months without so much as a symptom.

A child who has missed his or her routine vaccination for meningitis, usually administered some time in middle school, can be more susceptible to catching bacterial meningitis. Most people who get it recover, but the disease can also cause lifelong problems such as learning difficulties, hearing loss and, in rare cases, death.

Follow the schedule

Children across Canada follow an immunization schedule in which, at two months old, the first set of vaccines is administered. From there, every two months, the child receives a set of vaccines until they are six months old. The next set of vaccines is typically administered at 12 months, then again at 18 months, at two years and then at four years of age. The vaccine a child receives depends on the province.

“Getting routine infant and toddler vaccinations are especially important because they are considered a ‘primary vaccination series’,” wrote Dr. Vinita Dubey, an immunizations and vaccine-preventable diseases expert with Toronto Public Health.

“Without those vaccines, the child may not have full protection against the diseases the vaccine can prevent. As well, vaccinations often require time to build up immunity, and many doses are required in infancy to get the best protection. Waiting to provide these vaccinations can leave a child vulnerable to disease infection.”

One of the major contributors to delayed vaccination and decreased immunity could be something as simple as a parent inadvertently forgetting to get their child immunized, said Dr. Scott Halperin, a pediatric infectious disease specialist in Nova Scotia.

When a parent has a newborn, it’s drilled into the parent’s mind that at two months old, the baby needs to get his or her first vaccines. If a baby reaches nearly six months old at the same time that COVID-19 restrictions are in place, it could be another few months before that child receives the required vaccines.

This isn’t because there are restrictions in place that prevent the child from receiving the vaccine, Kellner said. In fact, most public health clinics and many pediatricians have continued to administer vaccinations throughout the lockdowns.

Rather, the parent, because of the strong public health messaging to avoid doctor visits, may confuse the message and hold off from bringing the child in for routine immunization for fear of contracting COVID-19. In reality, the only public vaccination programs that were brought to a stop were in-school vaccination clinics, meaning children who would otherwise have received shots at school, may not have done so.

One Toronto pediatrician said his clinic had held off on allowing children to come in for routine vaccinations until the end of April, because he was unsure of the impact COVID-19 had on children. Understanding the danger in delaying early child vaccinations, however, Dr. Daniel Flanders initiated a drive-thru clinic so that parents could bring in their young ones for shots. Before installing the drive-thru, Flanders said he noticed children coming in for their immunizations had dropped by roughly half.

Most parents today have never come across a child who has had bacterial meningitis — that’s all because of vaccines

Every doctor contacted by the Post said that it’s important parents adhere to their child’s immunization schedules. These are designed to ensure a child has built enough immunity before he or she is at highest risk of contracting the infectious disease.

When there’s deviation from the schedule, communities lose their immunity and protection against vaccine-preventable diseases. Unlike measles, where 95 per cent or more of the population must be vaccinated for adequate coverage, most jurisdictions strive for vaccination rates of 90 per cent or higher when it comes to other infectious diseases for which there is a vaccine.

Before COVID-19 the latest available data, from 2017, showed vaccination uptake across the country as a whole did not meet public health goals, as published by the childhood National Immunization Coverage Survey.

In Canada, 90 per cent of two-year-olds had received at least one dose of the measles vaccine and 76 per cent of two-year-olds had received all four recommended DTaP vaccines.

The Post reached out to every province and territory, requesting data on child and infant vaccination rates for the months of January to April 2020 and for the same period in 2019.

Aside from Manitoba, the only other province to get back to the Post with data for January to April 2020 was Saskatchewan, which didn’t see any huge fluctuations in pertussis and measles vaccines among children who are registered in the province’s immunization database.

Toronto pediatrician Flanders shared concerns about the data coming from Saskatchewan.

“It would seem odd to me that the COVID situation would not impact vaccination rates at all,” in Saskatchewan, he said, whereas Manitoba — a province right next door — had a 20 per cent drop.

While vaccinations for kids aged two and younger dropped by about a fifth for measles and a quarter for pertussis in Manitoba during March and April this year, children between the ages of two and 17 saw a far greater drop during the same time period.

Administrations for the MMR vaccine dropped by more than 60 per cent and administrations for the DTaP vaccine dropped by 55 per cent.

A provincial spokesperson said the preliminary data is likely attributable to the COVID-19 outbreak.

British Columbia, Prince Edward Island, Nova Scotia, and the Yukon did not respond to the Post’s request for data. Ontario, the Northwest Territories, New Brunswick, Newfoundland, Nunavut and Quebec all said they did not have the requested data. Alberta did not provide a month-by-month breakdown, but rather the vaccination rates for January through April combined.

“We don’t have any great figures of how great of a problem delayed immunization is during the pandemic,” said Halperin, the specialist from Nova Scotia.

“We suspect from what we’re hearing that there are children delaying their immunizations, but we don’t know the extent of that. If anyone gets delayed, that’s a concern.”

Quach-Thanh surmised that in Quebec, those tasked with tracking vaccination rates in the province have largely been shifted to focus on the government’s coronavirus response.

A spokesperson with the Quebec’s health ministry confirmed that the province collects surveillance on immunizations every two years and that the province had begun working on the report for 2018 before halting it due to COVID-19 demands.

Quach-Thanh noted the lack of data available on population immunity is “absolutely” concerning. She echoed the stance put forward by the National Advisory Committee on Immunizations, which implored Canadians to adhere to vaccination schedules.

Both the committee and the doctor acknowledged governmental efforts to limit non-essential strains on the health-care system but firmly stated that immunizations, especially early vaccinations, are considered essential.

Quach-Thanh pointed to the United States, a country that is seeing a dangerous drop in vaccination rates, as the New York Times reported in April).

Nationwide, in the U.S., the administration of MMR vaccines dipped by 50 per cent from mid-February to the beginning of April.

“What is happening in the U.S. is happening here,” she said.

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German Chancellor Olaf Scholz coming to Canada to meet with Trudeau, business leaders

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OTTAWA — The Prime Minister’s Office says Justin Trudeau will accompany the chancellor of Germany, Olaf Scholz, on a brief Canadian visit later this month that will include stops in Montréal, Toronto and Stephenville in western Newfoundland.

In a statement released Saturday, the PMO confirmed the Aug. 21-23 visit starts in Montreal, where meetings will be held with German and Canadian business leaders, and a tour is scheduled at an artificial intelligence institute.

The two men will then head to Toronto, where Trudeau will take part in the virtual summit about Russia’s annexation of Crimea, followed by an appearance at the Canada-Germany Business Forum.

The trip will conclude with a stop in Stephenville, N.L., where Trudeau and Scholz will attend a hydrogen trade show.

The statement says the two men intend to talk about clean energy, critical minerals, the automotive sector, energy security, climate change, trade and Russia’s “illegal and unjustifiable invasion” of Ukraine.

The prime minister and chancellor last met in June at the G7 Summit in Germany.

This report by The Canadian Press was first published Aug. 13, 2022.

 

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Air passengers losing patience with enforcement agency as backlog of complaints balloons – CBC News

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Canadians whose travel plans have been derailed by flight delays or cancellations say they’re losing patience with the agency responsible for enforcing compensation rules.

The Canadian Transportation Agency (CTA) — a quasi-judicial tribunal and regulator tasked with settling disputes between airlines and customers — has been dealing with a backlog of air passenger complaints since new regulations came into place in 2019 that require an airline to compensate passengers when a flight is delayed or cancelled for a reason that is within the airline’s control.

But that backlog has spiked in the last few months as a hectic summer travel season has resulted in an increasing number of customers claiming airlines are skirting federal compensation rules.

  • Have you had filed an airline complaint with the CTA and haven’t heard back? Tell us about it in an email to ask@cbc.ca.

The CTA said the backlog of complaints has risen to 18,200 after a spike in new grievances filed in recent months. The agency said 7,500 new complaints were filed between April and July this year, more than half of the amount of complaints it received all of last year.

“The CTA continues to process air passenger complaints as quickly as possible, based on their merit, impartially and in a rigorous manner,” the agency said in a statement.

But those who have recently filed new complaints could be in for a long wait to get a response from the agency.

This graphic shows the compensation air travellers could be entitled to depending on the length of their flight delay. (CBC)

Michelle Jacobs waited nearly a year before hearing back from the CTA, and when she did it was only to confirm that she was filing on behalf of her two children. She filed a complaint in August 2021 after Air Canada cancelled the family’s flight from Deer Lake, N.L., to Toronto citing staffing issues.

“It’s frustrating,” she said of the CTA process, “I mean there are laws put in place for this type of stuff and it seems that they’re just really holding you off to see if you’ll just go away.” 

Jacobs said she had considered giving up her CTA complaint, but after she was contacted last week by the agency she now has a sliver of hope that an investigation of the case is proceeding.

Passenger considering going to court instead

Kevin Smith, who has been fighting Flair Airlines for compensation since an initial flight from Vancouver to Ottawa on New Year’s Eve was cancelled and rebooked the next day, says he’s running out of patience with the CTA.

Smith said he filed a complaint with the agency in early February but has not yet received a response.

While he’s frustrated with Flair continuing to deny him what he said would be fair compensation, he said the CTA not responding “makes everything worse.”

“You can’t rely on the enforcement, the laws are basically meaningless and it’s kind of like the wild, wild west,” he said.

The Canadian Transportation Agency has a case tracker to allow passengers to keep tabs on their complaints. Due to a current backlog, the site only indicates that the agency will process a complaint as quickly as possible. (Submitted by Kevin Smith)

Rather than waiting for the CTA to respond, Smith said he is now considering taking Flair to small claims court, something Gabor Lukacs, founder and president of Air Passengers Rights Canada, has started recommending to passengers who contact him.

“A judge may or may not agree with them but they are going to get a fair and impartial hearing which is way more than they can expect from the agency,” Lukacs said.

While the CTA said it has been able to process complaints faster in recent years, it is currently facing a staffing shortage and attempting to hire more facilitators who can help resolve complaints. The government has allocated funding to the CTA in recent years in an effort to address the backlog, including $11 million in April’s budget.

When asked by CBC, Transport Minister Omar Alghabra’s office didn’t say if the government is willing to do more to ensure the CTA can address the backlog and instead said airlines need to comply with regulations.

“Travellers also have rights regarding refunds and these must be respected,” Alghabra’s office said in an emailed statement.

But Conservative transport critic Melissa Lantsman said air passenger protections need to be strengthened because Canadians are currently bearing the brunt of a weak system.

“Whether it’s the CTA, whether it’s the government, whether it’s the airline, there is an abdication completely of responsibility,” Lantsman said.

NDP transport critic Taylor Bachrach agreed that regulations and enforcement need to be bolstered and argued that the fact there are so many complaints in the first place is indicative that airlines feel like they can get away with breaking the rules.

“The biggest problem is the airlines are making a mockery of these air passenger protection regulations,” he said.

Both Lantsman and Barchrach said the government needs to provide the agency with the resources needed to ensure passengers are compensated, but Lukacs said the CTA also needs to step up enforcement by issuing more fines when an airline breaks the rules.

Passenger rights advocate Gabor Lukacs questions the Canadian Transport Agency’s enforcement practices and says the agency should issue more fines when an airline violates air passenger protection regulations. (CBC)

Under the CTA’s regulations airlines could face up to $25,000 per incident every time they break air passenger protection regulations, something Lukacs said the agency doesn’t use often enough.

“If airlines knew that they are going to be facing hefty fines for each violation, they would not go that far,” he said.

The CTA recently announced new amendments to the regulations that would require airlines to provide a refund or a rebooking even if a delay or cancellations aren’t within their control. Lukacs said these new changes, which come into effect on Sept. 8, could make it harder for passengers to seek compensation from airlines.

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Toronto continues investigation into cause of massive power outage – CP24

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Hydro One says it will take “several days” to repair hydro lines that were damaged after an upright crane in the lake slammed into them and caused a massive power outage downtown on Thursday.

The outage occurred in the city’s financial district at around 12:30 p.m., leaving approximately 10,000 customers without power at its peak.

A portion of the Eaton Centre was left in the dark, forcing hundreds of stores to temporarily close. The outage also knocked out power in parts of the Hospital for Sick Children’s campus.

Traffic lights were down in some intersections causing heavy traffic and significant streetcar delays. However, the outage did not affect subways.

Toronto Fire said crews responded to a number of elevator rescues, but no injuries connected to the outage were reported yesterday.

Hydro One says the outage was caused when a barge moving an upright crane in the Port Lands area hit overhead high voltage transmission lines.

“Now, what happened when that crane hit the line resulted in a downstream effect where a surge of power affected a nearby station on the Esplanade that we were actually using to reroute power to Toronto Hydro,” Hydro One Spokesperson Tiziana Baccega Rosa told CP24 Friday morning.

The City of Toronto says the barge was being operated by a subcontractor to Southland-Astaldi Joint Venture (SAJV), which is a contractor for the Ashbridges Bay Treatment Plant outfall project.

Crews were reportedly preparing to move equipment into the lake for the project when the incident occurred.

“We’re going to use stone that needs to be placed out in the lake and the subcontractors were going to do that work for us but they were moving equipment. The event occurred off-site while they were doing their preparatory work,” Lou Di Gironimo, Toronto Water’s general manager told CP24 Friday.

Outage

Baccega Rosa said Hydro One crews were able to reroute about 50 per cent of the power shortly after the incident, which resulted in power being restored in some areas quicker than others.

Crews then had to stop their efforts and wait for the fire department to clear the site for workers to safely enter and reroute the rest of the power.

Outage

Once crews gained access, they were able to reroute all power to Toronto Hydro and power was fully restored downtown by 8 p.m.

Baccega Rosa said there are established safety protocols to stay a minimum of 10 metres away from power lines, which were not followed yesterday.

“And that’s (for) anyone whether, you know, you’re a barge passing under them (power lines) or if you’re doing work around your house and you need to trim the tree branches around the line connecting your home. You know, everyone was very lucky yesterday that there was not a safety incident and no one was hurt as a result of this,” she said.

The city has launched an investigation into the incident and has requested a full report from SAJV to understand what happened.

“So the big thing that we’re going to look at is what happened? Who was in charge of the subcontractor work? What were the safety procedures in place at the time? And then what exactly happened when the crane hit the wires?,” Di Gironimo said.

Di Gironimo could not confirm if the subcontractors will face any consequences for the incident.

“That will be part of the investigation to find out what happened. What were those precautions that were supposed to be in place. What was followed? What wasn’t?”

He said the city is meeting with SAJV next week and plans to complete the investigation within a matter of weeks.

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