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COVID-19 in three Manitoba care homes

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A long-term health-care worker in Brandon tested positive for COVID-19 Saturday — the case involves an employee at the Hillcrest Place personal care home, which is the third long-term care home in the province to see cases of the novel coronavirus since mid-August.

Now, Jan Legeros, executive director of the Long Term & Continuing Care Association of Manitoba, says it was only a matter of time until COVID-19 spread to care homes, but cautioned it was to be expected amid the provincial reopening.

“I don’t think it was a matter of if — it was a matter of when we would see (COVID-19) walk into a personal care home,” Legeros said in an interview.

“We have cases rising exponentially throughout the province and so it is to be expected that we’ll see more and more — with the rise in cases we’re going to see more visitors and more staff test positive for COVID.”

Manitoba’s case numbers have risen dramatically in recent weeks — as of Sunday, there are 462 active cases of COVID-19 in the province, while 1,186 cases have been announced since March and 710 people have recovered.

Two of the long-term care homes are in the Prairie Mountain Health region, which has over half of the province’s active cases as of Sunday — 243.

 

Meanwhile, the province lifted visitation restrictions at long term care facilities in June.

“Personal care home staff are working around the clock to try to make sure that there isn’t an outbreak in a personal care home… it’s very difficult to do with the number of people coming in, coming and going now with visitor restrictions so much lifted,” Legeros said.

On Aug. 17, an outbreak was declared at Bethesda Place, a Steinbach long term care facility. Eight people have contracted the virus. Three were residents, while five were employees. Two residents died.

In Brandon on Aug. 27, an employee at the Rideau Park Personal Care Home tested positive for the virus — that worker wore personal protective while at the home, the province said earlier this week, as did the worker at Hillcrest Place.

 

“I don’t think it matters if it’s a visitor or a staff member, our numbers are climbing very rapidly and we are allowing many people to come and go from personal care homes,” Legeros said.

Hillcrest Place has restricted visitation since the positive test, the province said Saturday.

Legeros said the people in long term care are some of the most vulnerable to the virus.

“Many times, the seniors will have multiple physiological issues, such as liver disease, kidney disease, on top of having dementia — so they could have multi-system failures going on at the same time as this terrible virus,” she said.

“Seniors in care homes are at the very, very highest pinnacle of that risk.”

Personal care homes in the province have incurred hundreds of thousands of dollars of COVID-19 related expenses since the pandemic began in Manitoba in March, while the province has not yet committed to reimbursing the money spent, according to Legeros.

“It’s right now that we need those funds,” she said.

Legeros said long term care in Manitoba and Canada as a whole needs more investment.

“We have shone a light on long term care and the terrible deficits that are going on — it’s not just in Manitoba, it’s across Canada — we have allowed our seniors to be placed in a situation where not only are they there at the highest risk because of the physiological problems that they have, but they’re at high risk because of the terrible infrastructure that we have,” she said.

“We really need all of the public to step up and say enough already, let’s make some changes.”

 

Source: – Global News

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Half a million sharks could be killed for Covid-19 vaccine, say experts – Euronews

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Shark squalene is being considered for use in coronavirus vaccines, warn conservationists. Squalene is a natural organic compound, found in shark liver oil.

Between 2,500 – 3,000 sharks are needed to extract one tonne of squalene. Conservation group Shark Allies predicts that if the world’s population all received one dose of the vaccine, around 250,000 sharks would have to be slaughtered, depending on the amount of squalene used. Two doses for every person in the globe would amount to half a million sharks.

Currently, British pharmaceutical giant GlaxoSmithKine (GSK) uses squalene in flu vaccines. The oil is used as an adjuvant in medicine, an ingredient that increases the effectiveness of a vaccine by creating a stronger immune response. GSK has announced that it would manufacture a billion doses of the adjuvant for potential use in coronavirus vaccines.

Shark Allies is concerned that killing so many sharks will do irreversible damage to our oceans’ ecosystems.

It says we should be using plant-based and synthetic alternatives for squalene, which don’t derive from sharks.

“We are in no way trying to hinder or slow down the development of a COVID-19 vaccine or any other critical treatment that is needed to protect humanity from illness,” states Stefanie Brendl, founder of California-based Shark Allies.

However, she adds, “we are asking that sustainably sourced squalene is used in all non-critical applications and where the alternative is just as effective as shark squalene, and that all future testing of adjuvanted vaccines is giving plant-derived sources equal consideration.”

Maintaining ocean health is critical

Sharks are critical to ocean health and function. They are a key element in life systems that affect ocean health, food security, and livelihoods for generations to come. We need the ocean and the ocean needs sharks. But populations have been severely depleted in recent decades.

Using squalene in universally deployed Covid vaccines could be detrimental for many shark species.

“It would be unconscionable if more harm was done by something that was avoidable,” says Brendl.

“Moving society away from harmful practices requires awareness and a willingness to tackle a transition period. Profit margins may not look as favorable if taking wild animals is seen as cheaper and easier than other processes. Sourcing an ingredient from a wild animal is not a long-term solution.”

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Canada at risk of another lockdown as coronavirus cases surge – Hindustan Times

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Canada’s two largest provinces have warned they may have to lock down parts of the economy again after a spike in Covid-19 cases.

Quebec, which has had more virus deaths than 40 US states, is an epicenter of the problem. The province has about 5,000 active cases, a 71% jump from the beginning of August, and is on the verge of closing bars and restaurants again in its two biggest cities, Montreal and Quebec City. Hospitalizations went up 26% in six days.

Ontario, the largest province with 14.7 million people, reported 700 new cases Monday, the most ever in a day, though it’s also testing far more people than it was in spring. A group of hospitals called on Premier Doug Ford’s government to revert to stricter “stage two” measures in Toronto and Ottawa, which would mean restricting or closing indoor businesses such as gyms, movie theaters and restaurants.

“It’s up to each of us. Together our collective actions will decide if we face a wave or a tsunami,” Ford said Monday at a news conference during which he pleaded for residents to follow rules and get the flu vaccine — but did not move the province back to stage two.

It’s a reversal of fortune for a country that avoided the summertime spike that hit the US As the pandemic got worse in Sun Belt states, a largely compliant Canadian population hunkered down and wore masks.

Provincial governments, which set the rules for most companies, allowed the vast majority of businesses to open up again, sometimes with capacity limits and new sanitation rules. In Toronto, the financial capital, many restrictions were lifted on July 31.

As Labor Day neared, virus cases started to rise again. They flared in British Columbia, praised for its early handling of the crisis. Nationally, active cases have more than doubled since Sept. 1, to 12,759. Almost 95% are in the four largest provinces, with the greatest problems in big cities.

Six months of restrictions left some Canadians just as restless as their counterparts in the rest of the world. Across the country, the spike in new cases is being driven by social gatherings among people in their 20s and 30s, fed up with social distancing and hoping to take advantage of the last weeks of warm weather.

“What we’ll tell people is: Stay home. We’re going to ask for a considerable social sacrifice,” Quebec Health Minister Christian Dube said in an interview on Radio Canada late Sunday. “There’s going to be difficult decisions for bars and restaurants” he added, as Quebec City and Montreal are about to be declared a “red zone,” the highest level in the province’s alert system.

The greater concern is that Covid-19’s toehold is becoming a foothold just as the country begins its rapid slide through autumn to winter, said Colin Furness, an infection control epidemiologist at the University of Toronto. This coronavirus survives and stays in the air longer in cold, dry weather, he said — people’s mucous membranes are less effective at filtering it out and infection rates are much higher indoors. Despite a run on fire pits and patio heaters, most policy makers are not expecting Canadians to dine outside in sub-zero temperatures.

Lower Mortality

One bright spot in the situation is the relatively low mortality rate in Canada. With the tragic exception of elder care facilities in Ontario and Quebec, where death rates soared early on, Canada’s fatality rate, per capita, is less than half that of the U.S. since the pandemic began — roughly 25 people per 100,000 population versus 63 in the U.S.

As treatments have improved, along with better protection for the elderly and, crucially, greater testing — and therefore identification — of cases in younger people, so have the mortality numbers.

But while a lower fatality rate is good news, it doesn’t protect hospitals from being overwhelmed by a surge in cases, especially during flu season. And there are significant health consequences with the virus, Furness said.

“If we focus just on the death rate, eventually everyone is going to say this is no big deal,” Furness said. “We should reframe our understanding of Covid as vascular disease that causes widespread brain damage in the population.”

For policy makers and politicians, protecting the hospitals, which already have enormous backlogs of delayed surgeries, and keeping the schools open are key. But the rising numbers threaten disruption on all fronts.

“If politicians do not have the political fortitude to reintroduce some restrictions, then our risk of sliding into something much worse — like the U.K. or Spain — that’s still on the table,” said Furness. Canada needs to implement rapid testing across the country, tighten definitions on “non-essential” travel and hold the line on 14-day quarantine periods for those who have been out of the country, he said.

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COVID-19 cases will climb in Canada before effects of latest restrictions kick in, experts say – CBC.ca

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Cases of COVID-19 will likely continue to climb in Canada’s most populous provinces for a while even if people start to hunker down, experts say, because of the nature of the infection.

Epidemiologists look at the effective reproductive number of COVID-19, which describes how many other people an infected person will pass the coronavirus onto on average.

Public health experts like to see the value significantly below one so cases don’t snowball and spread out of control.

The effective reproductive number of COVID-19 in Canada continues to hover at 1.4, the Public Health Agency of Canada reported on Friday. That means for every 10 people who test positive for COVID-19, they’ll likely infect 14 others who then pass it on to 20 others and so on.

Christopher Labos, a physician in Montreal with an epidemiology degree, said the effective reproductive number also varies depending on the population in which a virus is spreading.

“If nothing changes, certainly it’ll keep rising and may even surpass a number of cases we had before,” Labos said. 

The doubling time depends on how contagious someone is, the likelihood they’ll contact and infect another susceptible person and the frequency of contact.

But Labos said there’s another important factor: individual changes in behaviour.

A woman wears a face mask as she walks by a sign instructing people to wear masks at a market in Montreal on Sept. 13. The city’s restaurants will face new restrictions this week. (Graham Hughes/The Canadian Press)

“We probably will see rising case numbers in the next few days, maybe in the next few weeks. But if we take action now and control stuff, we might see this virus plateau before the end of the year. And that’s really what we’re trying to hope for.”

To that end, Quebec’s premier announced on Monday partial shutdowns in areas with high case counts, namely Montreal, Quebec City and Chaudière-Appalaches, south of the provincial capital.

“We see that our hospitals are in a fragile situation,” Premier François Legault said.

As of Thursday for 28 days, visiting those in other households won’t be allowed (with exceptions), restaurants will be serving delivery and takeout only and other gathering places such as bars, concert halls, cinemas, museums and libraries in the affected regions will close, he said

To explain why, Legault said protecting people in school communities, hospitals and long-term care homes are a priority.

Sacrifices required to change course

“None of this is a given. We can change the outcome,” Labos said. “It simply requires us to sacrifice a little bit.”

Nicola Lacetera, a behavioural economist at the University of Toronto, first studied compliance with physical distancing during the start of the pandemic in Italy. He found that the more frequently governments extended lockdown dates, the more disappointed the public tended to get, which could lessen co-operation.

“People say, ‘Well, I don’t know anybody who has COVID,'” Lacetera said. “From a statistical point of view, it makes no sense. But people tend to over-weigh what’s closer to them, like having known someone who got COVID.”

When the public can’t see the health consequences of COVID-19 directly in their daily lives then Lacetera said making hygiene, distancing and wearing masks more of a habit, alongside consistent messaging from different levels of government and communicating the science, could help.

Dr. Eileen de Villa, Toronto’s medical officer of health, announced new restrictions for restaurants to help curb COVID-19 spread. (Michael Wilson/CBC)

‘Targeted’ measures

Ontario’s Chief Medical Officer of Health, Dr. David Williams, suggested “targeted” measures are under consideration. His Toronto counterpart, Dr. Eileen de Villa, called for new limits in restaurants on Monday, such as reducing the number of patrons from 100 to 75 and requiring establishments to collect contact information from those attending.

De Villa also said the extent of spread of the infection in the city means the concept of the bubble or a social circle “no longer reflects the circumstances in which we live.” 

Jacob Wharton-Shukster said his Toronto restaurant would stay open until 2 a.m. before the pandemic. He voluntarily chose to close at 11 p.m. after watching what can happen elsewhere in the world late at night when people have been drinking alcohol.

“The numbers are doubling from last week, and this is all reasonably foreseeable,” he said. ” We would have had to have taken a mitigation strategy a month ago to see any result now.”

Epidemiologists agree, saying the effects of measures only become apparent two weeks down the road because of the lag when someone is newly infected, develops symptoms, gets tested and receives the result.

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