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Europe considers new COVID-19 strategy: accepting the virus – The Globe and Mail

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A woman wearing a face mask reads a book on a subway in Madrid, Spain, on Jan. 20.Manu Fernandez/The Associated Press

When the coronavirus pandemic was first declared, Spaniards were ordered to stay home for more than three months. For weeks, they were not allowed outside even for exercise. Children were banned from playgrounds, and the economy virtually stopped.

But officials credited the draconian measures with preventing a full collapse of the health system. Lives were saved, they argued.

Now, almost two years later, Spain is preparing to adopt a different COVID-19 playbook. With one of Europe’s highest vaccination rates and its most pandemic-battered economies, the government is laying the groundwork to treat the next infection surge not as an emergency but an illness that is here to stay. Similar steps are under consideration in neighbouring Portugal and in Britain.

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The idea is to move from crisis mode to control mode, approaching the virus in much the same way countries deal with flu or measles. That means accepting that infections will occur and providing extra care for at-risk people and patients with complications.

Spain’s center-left prime minister, Pedro Sánchez, wants the Europe Union to consider similar changes now that the surge of the omicron variant has shown that the disease is becoming less lethal.

“What we are saying is that in the next few months and years, we are going to have to think, without hesitancy and according to what science tells us, how to manage the pandemic with different parameters,” he said Monday.

Sánchez said the changes should not happen before the omicron surge is over, but officials need to start shaping the post-pandemic world now: “We are doing our homework, anticipating scenarios.”

The World Health Organization has said that it’s too early to consider any immediate shift. The organization does not have clearly defined criteria for declaring COVID-19 an endemic disease, but its experts have previously said that it will happen when the virus is more predictable and there are no sustained outbreaks.

“It’s somewhat a subjective judgment because it’s not just about the number of cases. It’s about severity, and it’s about impact,” said Dr. Michael Ryan, the WHO’s emergencies chief.

Speaking at a World Economic Forum panel on Monday, Dr. Anthony Fauci, the top infectious diseases doctor in the U.S., said COVID-19 could not be considered endemic until it drops to “a level that it doesn’t disrupt society.”

The European Centre for Disease Prevention and Control has advised countries to transition to more routine handling of COVID-19 after the acute phase of the pandemic is over. The agency said in a statement that more EU states in addition to Spain will want to adopt “a more long-term, sustainable surveillance approach.”

Just over 80% of Spain’s population has received a double vaccine dose, and authorities are focused on boosting the immunity of adults with third doses.

Vaccine-acquired immunity, coupled with widespread infection, offers a chance to concentrate prevention efforts, testing and illness-tracking resources on moderate to high-risk groups, said Dr. Salvador Trenche, head of the Spanish Society of Family and Community Medicine, which has led the call for a new endemic response.

COVID-19 “must be treated like the rest of illnesses,” Trenche told The Associated Press, adding that “normalized attention” by health professionals would help reduce delays in treatment of problems not related to the coronavirus.

The public also needs to come to terms with the idea that some deaths from COVID-19 ”will be inevitable,” Tranche said.

“We can’t do on the sixth wave what we were doing on the first one: The model needs to change if we want to achieve different results,” he said.

The Spanish Health Ministry said it was too early to share any blueprints being drafted by its experts and advisers, but the agency confirmed that one proposal is to follow an existing model of “sentinel surveillance” currently used in the EU for monitoring influenza.

The strategy has been nicknamed “flu-ization” of COVID-19 by Spanish media, although officials say that the systems for influenza will need to be adapted significantly to the coronavirus.

For now, the discussion about moving to an endemic approach is limited to wealthy nations that can afford to speak about the worst of the pandemic in the past tense. Their access to vaccines and robust public health systems are the envy of the developing world.

It’s also not clear how an endemic strategy would co-exist with the “zero-Covid” approach adopted by China and other Asian countries, and how would that affect international travel.

Many countries overwhelmed by the record number of omicron cases are already giving up on massive testing and cutting quarantine times, especially for workers who show no more than cold-like symptoms. Since the beginning of the year, classes in Spanish schools stop only if major outbreaks occur, not with the first reported case as they used to.

In Portugal, with one of the world’s highest vaccination rates, President Marcelo Rebelo de Sousa declared in a New Year’s speech that the country had “moved into an endemic phase.” But the debate over specific measures petered out as the spread soon accelerated to record levels – almost 44,000 new cases in 24 hours reported Tuesday.

However, hospital admissions and deaths in the vaccinated world are proportionally much lower than in previous surges.

In the United Kingdom, mask-wearing in public places and COVID-19 passports will be dropped on Jan. 26, Prime Minister Boris Johnson announced Wednesday saying that the latest wave had “peaked nationally.”

The requirement for infected people to isolate for five full days remains in place, but Johnson said he will seek to scrap it in coming weeks if the virus data continues to improve. Official statistics put at 95% the share of the British population that has developed antibodies against COVID-19 either from infection or vaccination.

“As COVID becomes endemic, we will need to replace legal requirements with advice and guidance, urging people with the virus to be careful and considerate of others,” Johnson said.

For some other European governments, the idea of normalizing COVID-19 is at odds with their efforts to boost vaccination among reluctant groups.

In Germany, where less than 73% of the population has received two doses and infection rates are hitting new records almost daily, comparisons to Spain or any other country are being rejected.

“We still have too many unvaccinated people, particularly among our older citizens,” Health Ministry spokesman Andreas Deffner said Monday.

Italy is extending its vaccination mandate to all citizens age 50 or older and imposing fines of up to 1,500 euros for unvaccinated people who show up at work. Italians are also required to be fully vaccinated to access public transportation, planes, gyms, hotels and trade fairs.

Sign up for the Coronavirus Update newsletter to read the day’s essential coronavirus news, features and explainers written by Globe reporters and editors.

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Peel Region has major childhood vaccination backlog – CBC.ca

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Peel Region has a massive childhood vaccination backlog, with more than half of children missing at least one mandated vaccine dose.

That’s the warning from Peel’s acting medical officer of health, who says the lack of school immunizations is spelling trouble for communicable diseases.

“Without significant dedicated resources, we estimate it will take seven years to complete screening catch up and achieve pre-pandemic coverage rates,” said Dr. Katherine Bingham in a presentation to Peel council on April 11.

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She says low immunization coverage among students significantly increases the risk for the re-emergence of vaccine-preventable diseases such as measles.

Unless children have a valid exception, the following vaccines are mandatory for Ontario school children: diphtheria, tetanus, polio, measles, mumps, rubella, meningitis, whooping cough and chicken pox. Several other vaccines are strongly recommended by public health units and doctors. 

Advocates, doctors and Peel public health are advocating for more attention to the issue, more money from the province for public health and the formation of an action plan to quickly address the currently low vaccination rates.

Peel stacks lower than the provincial average on a number of vaccinations. For example, just over 37 per cent of seven-year-olds had been vaccinated against measles compared to more than 52 per cent province-wide as of August 31, 2022.

Peel Public Health says many children missed vaccinations they would have received at school or a doctor’s offices. Reporting of vaccines and enforcement also fell behind in the pandemic. To tackle the backlog more quickly, Peel Public Health opened public clinics for mandatory vaccines as of April 1 of this year.

‘We never thought it would be us’: mother

Jill Promoli, a Mississauga mother, lost her son, Jude, to a school flu outbreak eight years ago even though he was vaccinated. She’s now an illness prevention advocate championing immunizations and said the low vaccination rates in Peel children are “very concerning.”

“We never thought it would be us, but it is going to be someone,” said Promoli, who’s also a Peel District School Board Trustee, but did not speak to CBC Toronto in that capacity.

“The reason that we do vaccinate against these diseases is not because they’re inconvenient or uncomfortable, but it’s because people do die from them,” she said.

Jill Promoli, second from right, a Mississauga mother, says 50 per cent of Peel children missing a mandatory vaccine dose right now is “very concerning”. The Promoli family had this portrait taken before Jude, right, passed away eight years ago due to a school flu outbreak. (Submitted by Jill Promoli)

Promoli says she’s also concerned about children who are vaccinated being exposed, given vaccines do not provide complete immunity.

Pediatric and infectious disease specialist, Dr. Anna Banerji, called the proportion of Peel students missing a mandated dose “very high.”

“It needs to be addressed,” she said.

She says part of the problem in the region is access, including to family doctors, but the region also has a diverse population, which can mean additional challenges.

“I think that language and cultural support and trying to get these kids vaccinated will be very important,” she said.

Banerji also pointed to vaccine hesitancy being higher for some coming out of the pandemic.

She says seven years is far too long to have school-aged children not protected against such concerning diseases.

Needs will only grow, says Caledon mayor

The public health unit says they have less money than several nearby health units to try and tackle the issue, receiving one of the lowest provincial per capita funding rates in the province. 

For cost-shared programs, in Peel, public health was funded by the province at approximately $34 per capita in 2022, while Toronto and Hamilton each received $49 per capita, according to the health authority’s report. 

Caledon Mayor Annette Groves says the funding needs to change now to address problems that will continue to climb for Peel Public Health.

“Peel is a growing region and there will be greater need for funding as our resident population increases,” she said in a statement.

Caledon Mayor Groves at Queen's Park.
Caledon Mayor Annette Groves says Peel needs to receive more money from the province to handle public health in a growing population. (Evan Mitsui/CBC)

Province says funding has been increasing

Asked why Peel Public Health gets fewer dollars per capita, Ministry of Health spokesperson Hannah Jensen didn’t dispute Toronto and Hamilton received more funding per capita.

“Since 2018, our government has increased our investment into Peel Public Health by nearly 20 per cent,” she said in a statement.

Jensen said that’s in addition to the $100 million the provincial government invested into public health units across the province to provide support throughout the COVID-19 pandemic.

The government has restored a funding model where the province pays 75 percent of cost sharing for public health units and municipalities including Peel pay 25 percent, she said, noting the province had been paying 70 per cent for some time, so this represented an increase.

The province also increased base funding by one per cent per year, over the next three years, starting this year for public health units and municipalities including Peel, she added. 

Asked why Peel would still receive a lower per capita rate that some of its neighbours, the province did not respond directly. 

She says the government is working closely with its partners to get children caught up on vaccines.

Teenage girl gets a vaccination from a Toronto Public Health nurse at a school immunization clinic.
A spokesperson for the Ministry of Health says since 2018, the provincial government has increased investment into Peel Public Health by nearly 20 per cent. Peel Public Health says it receives significantly less from the province per capita than nearby Toronto or Hamilton and is advocating for more money. (Evan Mitsui/CBC)

Promoli says the per capita discrepancy in funding between regions is “shocking” and diverse populations need more, not less.

“It’s always important to try to meet people where they are,” she said. “To hear those questions, to hear the reasons why people are hesitant or even refusing and to try to understand…and then find the best ways to help people make decisions that will best protect their families.”

Peel Public Health says it plans to return to council soon with more details about the challenges and its plans to address them.

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It's possible to rely on plant proteins without sacrificing training gains, new studies say – The Globe and Mail

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At the 1936 Olympics in Berlin, a scientist named Paul Schenk surveyed the eating habits of top athletes from around the world. The Canadians reported plowing through more than 800 grams of meat per day on average; the Americans were downing more than two litres of milk daily.

While there have been plenty of changes in sports nutrition since then, the belief that meat and dairy are the best fuel for building muscle persists. These days, though, a growing number of athletes are interested in reducing or eliminating their reliance on animal proteins, for environmental, ethical or health reasons. A pair of new studies bolsters the case that it’s possible to rely on plant proteins without sacrificing training gains, as long as you pick your proteins carefully.

The standard objection to plant proteins is that they don’t have the right mix of essential amino acids needed to assemble new muscle fibres. Unlike animal proteins, most plant proteins are missing or low in at least one essential amino acid.

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In particular, there’s one specific amino acid, leucine, that seems to play a special role in triggering the synthesis of new muscle. It’s particularly abundant in whey, one of the two proteins (along with casein) found in milk. That’s why whey protein is the powdered beverage of choice in gyms around the world, backed by decades of convincing research, which was often funded by the dairy industry.

But one of the reasons whey looks so good may be that we haven’t fully explored the alternatives. A 2018 study by Luc van Loon of the University of Maastricht in the Netherlands, for example, tested nine vegetable proteins including wheat, hemp, soy, brown rice, pea and corn. To their surprise, they found that corn protein contains 13.5 per cent leucine – even more than whey.

Based on that insight, van Loon decided to pit corn against milk in a direct test of muscle protein synthesis. Volunteers consumed 30 grams of one of the proteins; a series of blood tests and muscle biopsies were collected over the next five hours to determine how much of the ingested protein was being turned into new muscle fibres. The results, which appeared in the journal Amino Acids, were straightforward: Despite all the hype about whey, there was no discernible difference between them.

A second study, this one published in Medicine & Science in Sports & Exercise by a team led by Benjamin Wall of the University of Exeter in Britain, had similar findings. Instead of corn, it used a mix of 40 per cent pea, 40 per cent brown rice and 20 per cent canola proteins. Since different plants have different amino acids profiles, mixing complementary proteins has long been suggested as a way overcoming the deficiencies of any single plant protein. Sure enough, the protein blend triggered just as much new muscle synthesis as whey.

On the surface, the message from these studies is straightforward: Plant proteins are – or at least can be – as effective as even the best animal proteins for supporting muscle growth. There are a few caveats to consider, though. One is that the studies used isolated protein powders rather than whole foods. You would need nearly nine cobs of corn to get the 30 grams of protein used in van Loon’s study, compared to just three-and-a-half cups of milk.

Another is that plants are generally harder to digest, meaning that not all the amino acids will be usable. That may not be a problem for healthy young adults consuming 30 grams of protein at once, which is enough to trigger a near-maximal muscle response. But for older people, who tend to have blunted muscle-building responses to protein, or in situations where you’re getting a smaller dose of protein, the details of protein quality may become more important.

Of course, the effectiveness of plant proteins won’t be news to notable plant-based athletes such as ultrarunner Scott Jurek or basketball star Chris Paul – but it’s encouraging to see the science finally begin to catch up.

Alex Hutchinson is the author of Endure: Mind, Body, and the Curiously Elastic Limits of Human Performance. Follow him on Threads @sweat_science.

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See how chicken farmers are trying to stop the spread of bird flu – Fox 46 Charlotte

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CLOVER, S.C. (QUEEN CITY NEWS) — Poultry farmers across the Carolinas aren’t taking any chances.  Many are turning to strict protocols as another wave of bird flu continues to threaten the chicken population across the country. 

Since 2022, it is estimated more than 90 million birds have either died from the virus or were killed to prevent further spread in the U.S. 

“We try to make them the happiest as possible. We always say a happy chicken is a tasty chicken,” owner of Eden Farms Adam Shumate said. 

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With their happiness in mid, Shumate also wants to keep his chickens alive and healthy. On his farm in Clover, he has implemented protocols to minimize a potential bird flu outbreak.  

“We want to be prepared,” he said. “We feel like the things that we can do to prevent it first is the best case because we don’t want to start from scratch with a whole new flock.”  

Because bird flu is commonly spread through bird droppings, Shumate is limiting the number of people coming into contact with his flocks. He says this would minimize the chances of someone walking onto the property with bird droppings on the bottoms of their shoes. 

On top of monitoring the chickens closely, Shumate and his staff are constantly cleaning their equipment, including what they wear on their feet.   

“We have specific shoes that are just for working with the flock and for when we are taking care of them,” Shumate said. 

Other farmers, like Holly Burrell, haven’t let a visitor step foot near her hens in Gastonia for more than two years. 

No visitors or outside cars are welcomed, and her chickens are separated in what she calls “tent cities.” 

“We don’t want to do that because we want them to live their best life,” Burrell said in a 2022 interview with Queen City News. 

Recently, health officials have detected bird flu in other animals like seals, squirrels and dolphins. 

Earlier this month, bird flu was detected in one of the state’s dairy cow herds. While concerning, state health officials say the overall risk to the general public remains low. 

“I’ve not heard of any cases, zero cases of people being affected by this virus associated with food consumption, milk consumption with egg consumption… any of these products we’re getting from farm animals is not really been associated with any human risk at this point,” said Dr. Michael Martin, director of the Veterinary Division at the N.C. Department of Agriculture and Consumer Services. 

As of March 28, at least 80 birds in North Carolina were detected with the virus. Back in York County, Shumate says it all starts with the individual farms. 

“When it comes to wildlife and things that that, there is only so much that you can do is be observant,” Shumate said. “Keep a healthy flock that way they can find off the infections that may come about.” 

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