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COVID cases on the rise in Hamilton – Hamilton Spectator



As COVID cases rise, Hamilton is missing a key tool used by the province as an early warning system.

Wastewater surveillance has been called the “canary in the coal mine” by Health Minister Christine Elliott and a closely monitored “key indicator” by chief medical officer of health Dr. Kieran Moore.

Wastewater data updated daily by the Ontario COVID-19 Science Advisory Table shows the virus is increasing across the province, including in Central West, which is Hamilton, Brant, Haldimand, Norfolk, Niagara, Waterloo and Wellington-Dufferin-Guelph.

But Hamilton public health doesn’t understand local wastewater surveillance data by it’s own admission. The department pulled its associate medical officer of health off of the project when resources became overwhelmed during the Omicron wave.

The reliability of wastewater surveillance has repeatedly been called into question by medical officer of health Dr. Elizabeth Richardson.

“Wastewater data continues to be under evaluation,” she said in a statement last week after making similar remarks to the board of health and at a city briefing.

She also blamed a lack of guidance from the province for the city’s reluctance to incorporate wastewater as a monitoring tool.

“There is no provincial guidance on its use for surveillance or disease control,” she said.

But Coun. John-Paul Danko questioned, “What guidance are we looking for from the province?”

He pointed to Ontario’s $22-million investment in surveillance at more than 170 locations covering all public health units.

“The reliance on wastewater signal for COVID seems to be fairly substantial across the province,” Danko said at a board of health meeting on March 21.

He raised the importance of wastewater as the general public has no access to PCR testing, making other metrics significantly underestimated.

“I think there would be a concern then that we’re not actually verifying the prevalence of COVID in the community,” said Danko. “The viral signal in the wastewater is one method of verifying.”

In addition, he asked about public health’s long insistence that wastewater surveillance hasn’t worked in Hamilton. Data made public for the first time on March 11 appears to show wastewater has been providing early warning of cases, hospitalizations, intensive care unit (ICU) admissions and deaths.

“I’m just looking at this as a layperson but it seems to me that for Omicron they are quite closely aligned to date,” said Danko.

The surveillance has been called “remarkable” by the lead researcher of the team at the University of Ottawa that has been analyzing the data from the Woodward Avenue and Dundas treatment plants since July 2020. Robert Delatolla claims wastewater has been an early predictor of Hamilton hospitalizations for over 18 months now.

Delatolla said in recent weeks there has been effort to come to an understanding between researchers and Hamilton public health since The Spectator started publishing stories on the divide March 5.

Richardson said public health is working with the university and the Ministry of the Environment, Conservation and Parks “to understand the data overall” and how it functions as an early indicator.

In addition, she says public health has kept in contact with Moore’s office, “and our approach that we are taking here in Hamilton has been supported … by the chief medical officer of health.”

A statement from the Ministry of Health neither confirms nor denies support for Hamilton’s stance on wastewater, but makes clear the province is using it as a key metric.

“At this time, the Ministry of Health is using the wastewater surveillance data in conjunction with other public health and health system indicators … to monitor the current epidemiology of the COVID-19 pandemic in Ontario,” it said.

Dr. Bart Harvey was looking at how wastewater could be similarly used to monitor COVID in Hamilton, but the associate medical officer of health was pulled away during the fifth wave that started in December.

“The unprecedented surge in infections and outbreaks in high-risk settings led Hamilton Public Health Services to prioritize resources to reduce the transmission of COVID-19 and its impact on the community,” Richardson said. “Dr. Harvey’s time, as with all staff, was prioritized to support the most urgent areas of the response.”

Richardson said there was still engagement with the project over the Omicron wave but at a “lower level.” Now, she’s waiting for provincial guidance that isn’t expected until the fall.

That time lag is significant considering COVID is on the rise. Hamilton’s average daily cases and weekly rate per 100,000 population have been increasing since March 19.

Hospital staff self-isolating was up to 394 Monday compared to 292 just under one week ago. During that same time, COVID patients hospitalized increased to 82 from 49.

Outbreaks in high-risk settings are up to 15 after holding steady between five and 10 for more than one month.

The city reported two deaths since Wednesday to bring the toll to 528 — one was a senior age 80 or older and the other was in their 70s.

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Monkeypox: Cases found and suspected in Portugal, Spain – CTV News




Portuguese authorities said on Wednesday they had identified five cases of rare monkeypox infection and Spain’s health services are testing eight potential cases after Britain put Europe on alert for the virus.

The five Portuguese patients, out of 20 suspected cases, are all stable. They are all men and they all live in the region of Lisbon and the Tagus Valley, the Portuguese health authorities said.

European Health authorities are monitoring any outbreak of the disease since Britain has reported its first case of monkeypox on May 7 and found six more in the country since then. 

None of the eight suspected cases in Spain has been confirmed yet, the Spanish Health Ministry said in a statement on Wednesday.

Monkeypox is a rare viral infection similar to human smallpox, though milder, first recorded in the Democratic Republic of Congo in the 1970s. The number of cases in West Africa has increased in the last decade.

Symptoms include fever, headaches and skin rashes starting on the face and spreading to the rest of the body.

It is not particularly infectious between people, Spanish health authorities said, and most people infected recover within a few weeks, though severe cases have been reported.

Four of the cases detected in Britain self-identified as gay, bi-sexual or other men who have sex with men, the U.K. Health Security Agency said, adding evidence suggested there may be a transmission in the community.

The agency in Britain urged men who are gay and bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay.

The Spanish Health Ministry and Portugal’s DGS health authority Spanish did not release any information on the sexual orientation of the monkeypox patients or suspected patients.

The two countries sent out alerts to health professionals in order to identify more possible cases.

(Reporting by Patricia Rua in Lisbon and Christina Thykjaer in Madrid; Editing by Inti Landauro and Alison Williams)

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Long Covid Patients' Symptoms Helped After Vaccination in Study – BNN



(Bloomberg) — Fewer Covid-19 patients reported lingering symptoms from the infection after getting vaccinated, according to a study that suggests the shots could help alleviate the burden of long Covid. 

A first vaccine dose after infection with the virus was associated with a 13% decline in the odds of having long Covid and a second shot with a 9% drop in the study published Thursday in the BMJ. Over the course of seven months in 2021, researchers regularly visited the households of more than 28,000 people to ask whether they were experiencing symptoms long after infection.

The findings, together with evidence that long Covid is reduced in those infected after vaccination, suggest that jabs may help decrease the prevalence of persisting symptoms.

“The large scale of this study means that we can be fairly confident about what has been observed, but it does not mean we can be sure what it means,” said Peter English, a former chair of the BMA Public Health Medicine Committee. 

“The most obvious — and perhaps the most likely inference — is that vaccination does prevent at least some cases of long Covid, and may reduce the severity of symptoms,” he said in emailed comments. But “we cannot yet say this with any confidence.” English wasn’t involved in the research. 

An estimated 1.8 million people in the UK had reported experiencing long Covid as of April 2022, with two in three people saying the symptoms had affected their day-to-day activities, according to the latest Office for National Statistics data.

The scientists who ran the study called for more research to “understand the biological mechanisms underpinning any improvements in symptoms after vaccination, which may contribute to the development of therapeutics for long Covid.” 

©2022 Bloomberg L.P.

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Europe, US on alert after new monkeypox cases emerge – Al Jazeera English



US, Spain and Portugal announce cases of rare viral infection, two weeks after UK identified its first case.

Health authorities are on alert for the spread of monkeypox, a rare viral disease first reported in the Democratic Republic of Congo in the 1970s, after new cases emerged in Europe, and the United States confirmed its first infection.

Portugal said on Wednesday it had identified five cases of monkeypox, Spain said it was testing 23 potential cases, and the US state of Massachusetts announced it had found a case in a man who recently travelled to Canada.

The United Kingdom was the first to confirm a case of monkeypox earlier this month. It has now detected seven cases and is working with the World Health Organization (WHO) to investigate the virus’s spread after being unable to make a link between the initial case, in a man who had travelled from Nigeria, and the more recent ones.

Health authorities suspect some of the infections may have occurred through sexual contact – in this instance among gay or bisexual men – with four of the UK cases identified among people who visited sexual health clinics after developing the rash associated with monkeypox.

“No source of infection has yet been confirmed for either the family or GBMSM clusters,” the WHO said in a statement in Wednesday. “Based on currently available information, infection seems to have been locally acquired in the United Kingdom. The extent of local transmission is unclear at this stage and there is the possibility of identification of further cases.”

Monkeypox, which is similar to human smallpox, typically begins with a flu-like illness and swelling of the lymph nodes, followed by a rash on the face and body. Most people recover from the illness, which is endemic in parts of central and western Africa and usually the result of close contact with infected animals, within a few weeks, but it can be fatal.

The five Portuguese patients, out of 20 suspected cases, are all in a stable condition, according to the country’s health authorities. They are all men who live in the region of Lisbon and the Tagus Valley, they added.

Health authorities in Madrid said the cases discovered in Spain appeared to be linked to sexual contact.

“In general, its transmission is via respiratory drops but the characteristics of the 23 suspected infections point to it being passed on through bodily fluids during sex relations,” they said in a statement, without giving further details.

“All of them are young adult males and most of them are men who have sexual relations with other men, but not all of them,” Elena Andradas, head of public health in the Madrid region, told Cadena Ser radio.

US health officials said the Massachusetts man who developed monkeypox went to Canada to see friends at the end of April and returned home in early May. He is currently being treated in hospital.

Jennifer McQuiston from the US Centers for Disease Control and Prevention (CDC) said while it was the only case the CDC was aware of, “I do think we are preparing for the possibility of more cases”.

The agency is in contact with its counterparts in the UK and Canada as part of the investigation, but McQuiston said no link had been established so far.

There are two types of monkeypox virus: the West African clade and Congo Basin (Central African) clade. The case-fatality ratio for the West African clade has been documented to be about 1 percent, and up to 10 percent for patients with the Congo Basin clade.

The WHO said that while smallpox vaccination has been effective against monkeypox, the end of mass vaccination programmes for smallpox meant people under the age of 40 or 50 no longer had that protection.

The UK has previously reported cases of monkeypox – all linked to travel to Nigeria – as has the US. An outbreak there in 2003 was traced to pet prairie dogs that had been housed with small animals imported from Ghana that were found to have the virus.

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