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COVID-19 patients may be most contagious one to two days before symptoms appear, study finds – USA TODAY

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COVID-19 patients may be most infectious in the days before they began showing symptoms, a new study from researchers in China found.

Researchers examined “viral shedding” in 94 patients with COVID-19 admitted to Guangzhou Eighth People’s Hospital, according to small study published Wednesday in the peer-reviewed journal “Nature.”

Scientists took throat swabs from the patients and found that viral loads were highest when symptoms began and gradually decreased towards the detection limit at about day 21. This finding is consistent with other small studies done at two hospitals in Hong Kong and with patients in Zhuhai, Guangdong, China.

The study also modeled COVID-19’s infectiousness from a separate sample of 77 pairs of people in which one had infected the other with coronavirus.

Using pairs obtained from publicly available sources within and outside mainland China, researchers estimated that 44% of the transmissions occurred during the index patient’s presymptomatic stage, “in settings with substantial household clustering, active case finding and quarantine outside the home.”

They were then able to infer that infectiousness started 2.3 days and peaked 0.7 days before symptoms appeared. Infectiousness was estimated to decline quickly within a week.

“Our analysis suggests that viral shedding may begin 2 to 3 days before the appearance of the first symptoms,” researchers wrote. “More inclusive criteria for contact tracing to capture potential transmission events 2 to 3 days before symptom onset should be urgently considered for effective control of the outbreak.”

These findings align with previous guidance from the World Health Organization which found infected people can be contagious and test positive 1 to 3 days before they develop symptoms. Presymptomatic transmission was seen in several cases in Singapore.

Tara Smith, a professor of epidemiology at Kent State University who was not involved in the study, said the research confirms both previous findings of presymptomatic transmission and that infected people seem to have a high viral load right around the time they began showing symptoms.

“That seems to be when they are maximally infectious,” Smith said.

Presymptomatic transmission is also seen in viruses like influenza and measles, Smith said, but is not seen with other coronaviruses like SARS and MERS.

Smith said more testing needs to be done to determine the role presymptomatic and asymptomatic transmission is playing in the current pandemic. She said these findings emphasize how important it is to keep social distancing measures in place to prevent those kinds of transmission.

“That’s why its important to avoid people as much as possible, to wash your hands, to wear masks,” she said. “To prevent you from spreading the virus.”

Follow N’dea Yancey-Bragg on Twitter: @NdeaYanceyBragg

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

The Canadian Press. All rights reserved.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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