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Experts caution against the temptation to comparison shop COVID-19 vaccines – St. Albert Today

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TORONTO — While it’s tempting to compare various aspects of AstraZeneca-Oxford’s newly approved COVID-19 vaccine to others, several experts cautioned against focusing on data that is not comparable and the danger of underrating the product’s ability to curb hospitalizations and deaths.

Health Canada’s long-awaited announcement Friday that a third vaccine would soon be deployed came just as the provinces faced heightened scrutiny over regional immunization plans that vary by timeline, age eligibility and priority groups.

Prime Minister Justin Trudeau promised the boost to Canada’s pandemic arsenal would mean “more people vaccinated, and sooner,” and would be key to helping contain spread.

Nevertheless, Health Canada chief medical advisor Dr. Supriya Sharma acknowledged questions over how the public should evaluate trial results that show AstraZeneca has an efficacy of 62 per cent in preventing symptomatic cases. That’s compared to the 95 per cent efficacy of the country’s two other approved vaccines, from Pfizer-BioNTech and Moderna.

But Sharma stressed that all three have been shown to prevent 100 per cent of hospitalizations and deaths due to COVID-19.

“Each vaccine has unique characteristics and Health Canada’s review has confirmed that the benefits of the viral vector-based vaccine, as with the other authorized vaccines, outweigh their potential risks,” Sharma said.

Several medical experts including Dr. Stephen Hwang say Canadians do not have the luxury to pick-and-choose as long as COVID-19 cases continue to rage in several hot spots and strain health-care systems.

With multiple COVID-19 projections warning of a variant-fuelled third wave without tighter suppression measures, any tool that can slow the pandemic should be embraced, he argued.

“It would be important for people to be vaccinated with whichever vaccine is first available in their community to them, rather than trying to hold out for a specific vaccine,” advised Hwang, who treats COVID-19 patients at St. Michael’s Hospital in Toronto.

Still, Toronto resident Maria Brum couldn’t help but question whether AstraZeneca was safe for her 79-year-old mother.

The vaccine was not tested on people over the age of 65. Health Canada, however, says real-world data from countries already using the product suggest it is safe and effective among older age groups, promising an update on efficacy in the age group as more data comes in.

“I personally would take that one out as an option for my mom,” said Brum, who is her mother’s main caregiver.

“Maybe I am wrong but, I don’t know, I don’t see that it’s more useful. I’d like to see one that has a higher percentage of (efficacy).”

As for herself, Brum said she has allergies that she believes may put her at greater risk of adverse reactions and so she is unsure whether she can take any vaccine.

But she’d like the option of choosing, if possible, even while acknowledging that limited supply could make that unlikely.

“As a Canadian, I would like to see us all have choices, regardless of age, gender, or ability,” says Brum.

“I’m going to wait where I can have more choices.”

Such hesitancy could pose public health challenges to Canada reaching the vaccination coverage needed to build protective immunity against COVID-19, said Hwang.

He noted that Germany has seen a reported preference among some for the vaccine made by Germany’s BioNTech with Pfizer, as well as a misconception that the AstraZeneca vaccine is inferior because of a lower efficacy rate.

Hwang says efficacy between vaccines cannot be compared because each involved completely different trials at different time periods, in different countries, with different volunteers of different age groups and varying trial design.

“Until we have direct comparison studies where we give people one vaccine versus another and directly compare, it’s very difficult to know for sure how it’s going to pan out,” he says.

Then there’s the fact Canada’s initial AstraZeneca doses will be made at the Serum Institute of India, which dubs its version CoviShield, while later packages will be produced at the drug giant’s own manufacturing facilities.

Hwang acknowledges that could invite further scrutiny but says the Pune, India-based biotech firm has a “strong track record of producing vaccines.”

Sharma also stressed the similarities between the two shots Friday.

“For all intents and purposes they’re the same vaccine,” said Sharma.

“There are some slight differences in terms of manufacturing and the places that they are manufactured are different. The analogy is a bit like the recipe – so the recipe for the vaccine is the same, but they’re manufactured in different kitchens.”

This report by The Canadian Press was first published Feb. 28, 2021.

Cassandra Szklarski, The Canadian Press

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COVID-19 in Ottawa: Fast Facts for April 10, 2021 – CTV Edmonton

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OTTAWA —
Good morning. Here is the latest news on COVID-19 and its impact on Ottawa.

Fast Facts:

  • Ottawa’s top doctor warns schools could remain closed after the April break next week
  • Ottawa sets new record for COVID-19 cases and hospitalizations on Friday
  • The city of Ottawa admits it doesn’t have enough supply to vaccinate residents 50 and older in high-priority neighbourhoods
  • Kingston closes popular waterfront park to prevent COVID-19 spread

COVID-19 by the numbers in Ottawa (Ottawa Public Health data):

  • New COVID-19 cases: 242 new cases on Friday
  • Total COVID-19 cases: 19,030
  • COVID-19 cases per 100,000 (previous seven days): 146.0
  • Positivity rate in Ottawa: 9.2 per cent (April 2 to April 8)
  • Reproduction Number: 1.05 (seven day average)

Testing:

Who should get a test?

Ottawa Public Health says you can get a COVID-19 test at an assessment centre, care clinic, or community testing site if any of the following apply to you:

  • You are showing COVID-19 symptoms;
  • You have been exposed to a confirmed case of the virus, as informed by Ottawa Public Health or exposure notification through the COVID Alert app;
  • You are a resident or work in a setting that has a COVID-19 outbreak, as identified and informed by Ottawa Public Health;
  • You are a resident, a worker or a visitor to long-term care, retirement homes, homeless shelters or other congregate settings (for example: group homes, community supported living, disability-specific communities or congregate settings, short-term rehab, hospices and other shelters);
  • You are a person who identifies as First Nations, Inuit or Métis;
  • You are a person travelling to work in a remote First Nations, Inuit or Métis community;
  • You received a preliminary positive result through rapid testing;
  • You require testing 72 hours before a scheduled (non-urgent or emergent) surgery (as recommended by your health care provider);
  • You are a patient and/or their 1 accompanying escort tra­velling out of country for medical treatment;
  • You are an international student that has passed their 14-day quarantine period;
  • You are a farm worker;
  • You are an educator who cannot access pharmacy-testing; or
  • You are in a targeted testing group as outlined in guidance from the Chief Medical Officer of Health.

Where to get tested for COVID-19 in Ottawa:

There are several sites for COVID-19 testing in Ottawa. To book an appointment, visit https://www.ottawapublichealth.ca/en/shared-content/assessment-centres.aspx

  • The Brewer Ottawa Hospital/CHEO Assessment Centre: Open Monday to Sunday, 8:30 a.m. to 7:30 p.m.
  • The Moodie Care and Testing Centre: Open Monday to Friday from 8 a.m. to 3:30 p.m. Open Saturday and Sunday, 8 a.m. to 11:30 a.m. (testing only)
  • The Heron Care and Testing Centre: Open Monday to Friday from 8 a.m. to 4 p.m.
  • The Ray Friel Care and Testing Centre: Open Monday to Friday from 8 a.m. to 4 p.m.  Saturday and Sunday, 8 a.m. to 4 p.m. (testing only)
  • COVID-19 Assessment Centre at Howard Darwin Centennial Arena: Open daily 8:30 a.m. – 3:30 p.m.
  • Centretown Community Health Centre: Open Monday, Tuesday, Wednesday, Friday from 9 a.m. to 4 p.m.
  • Sandy Hill Community Health Centre: Open Monday to Friday from 9 a.m. to 3 pm.
  • Somerset West Community Health Centre: Open from 9 a.m. to 4 p.m. Monday to Wednesday.
  • COVID-19 Drive-Thru Assessment Centre at 300 Coventry Road: Open seven days a week from 10 a.m. to 6 p.m.

Vaccine eligibility screening tool:

To check and see if you are eligible to receive a COVID-19 vaccine in Ottawa, click here

COVID-19 screening tool:

The COVID-19 screening tool for students heading back to in-person classes can be found here.

Symptoms:

Classic Symptoms: fever, new or worsening cough, shortness of breath

Other symptoms: sore throat, difficulty swallowing, new loss of taste or smell, nausea, vomiting, diarrhea, abdominal pain, pneumonia, new or unexplained runny nose or nasal congestion

Less common symptoms: unexplained fatigue, muscle aches, headache, delirium, chills, red/inflamed eyes, croup

Ottawa’s top doctor warns it’s “more likely than not” that all elementary and secondary schools in Ottawa will be closed for in-person learning after the April break.

“I am now thinking the probability that schools will close to in-person learning after the spring break is higher than the probability the COVID-19 situation will improve in time to keep schools open,” said Dr. Vera Etches, Ottawa’s medical officer of health.

“My heart is heavy because I know how important schools are to the health of our community.”

Etches says Ottawa Public Health will make a decision by next Wednesday on whether schools will reopen or close after the April Break.

Ottawa Public Health reported 242 new cases of COVID-19 in Ottawa on Friday, the highest one-day case count in the capital during the COVID-19 pandemic.

The surging numbers prompted the city’s medical officer of health to issue a rallying cry to Ottawa residents, saying the city has reached a key point in the COVID-19 “marathon.”

“We are tired. We’re fatigued. We want this to be over. And this is the point in our COVID marathon where we’re hitting the wall,” Dr. Vera Etches told reporters Friday. “This is our defining moment. It’s a moment where we’ve got to break through that wall.”

Ottawa’s positivity rate increased to 9.2 per cent for the period of April 2 to 8 from 8.8 per cent. Ottawa’s weekly incidence rate is now 146 cases per 100,000 people.

Residents aged 50 and over in three hot spot postal code areas in Ottawa can now book an appointment to receive a COVID-19 vaccine, but the city warns it doesn’t have enough vaccine supply to vaccinate everyone.

On Friday, Ontario opened vaccine appointments at community clinics to residents born in 1971 or earlier who live in certain “hot spots.” In Ottawa, the hot spots have been identified as postal codes K1T, K1V, K2V.

A memo from Dr. Vera Etches and Ottawa’s general manager of emergency and protective services Anthony Di Monte said residents 50 years of age and older living in the provincially identified “hot spots” of K1T, K1V and K2V are eligible for vaccine appointments at community clinics.

Residents living in the high-priority neighbourhoods of Emerald Woods – Sawmill Creek and Greenboro East and Ledbury – Heron Gate and Ridgemont will have the option to book at either a community clinic or at a pop-up clinic.

COVID-19 vaccine Ottawa immunization clinic

One day after a COVID-19 outbreak was declared in Kingston’s University District, the city is closing the popular Breakwater Park until the end of the university school year to prevent large gatherings.

Mayor Bryan Paterson has issued an emergency order to close Breakwater Park for the next 10 days.

“This timeline coincides with students move-out, but can be extended if needed. As one of our most popular community parks, closing it is a last resort,” said Paterson in a statement

“Yesterday, however, we saw troubling instances of overcrowding, which is especially concerning given the current outbreak in the nearby University District.”

Pictures on social media showed dozens of people in the popular park along the waterfront on Thursday.  During the provincewide shutdown, outdoor gatherings are limited to a maximum of five people.

Kingston's Breakwater Park

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Average age of Quebec COVID-19 patients has dropped by 10 to 15 years, doctors say – National Post

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MONTREAL — Over the past two to three weeks, Dr. Francois Marquis, head of intensive care at Montreal’s Maisonneuve-Rosemont hospital, says he started noticing the average age of COVID-19 patients dropping.

People arriving at the hospital are on average, about 10 to 15 years younger than earlier patients in need of medical care after contracting COVID-19, he said in an interview Wednesday.

“We are starting to see what was very unlikely during the first wave: 30 or 40-year-olds without any previous medical history, people in good health,” Marquis said.

“They’re not seeing a doctor, they’re not taking any kind of medication, they don’t have diabetes, they don’t have high blood pressure — they just get sick.”

Marquis’s observations echo a warning earlier this week from Dr. Theresa Tam, Canada’s chief public health officer, who said health officials across the country are reporting rising numbers of younger patients in hospitals who soon need intensive care.

“Many of them deteriorate quite quickly and have to be admitted to the ICU,” she said.

Dr. Gaston De Serres, an epidemiologist with Quebec’s public health institute, said the proportion of Quebecers over 80 in hospital with COVID-19 has been declining since mid-March — largely due to vaccination.

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He said it’s not just the proportion of hospital patients who are younger that’s increasing, the overall number of younger patients is rising as well. De Serres said there were 40 people between 50 and 59 years old who were hospitalized the week of March 7. During the week of March 28, there were 54.

But hospitalizations are still not rising significantly among people under 30. “It’s younger,” he said of the average age of patients. “It’s not young.”

Ten people between 20 and 29 years old were hospitalized with COVID-19 in Quebec the week of March 28, up from five two weeks earlier, De Serres said.

“If you have more cases, you will clearly have more hospitalizations, but the proportion of all hospitalized cases will remain small because these younger age groups are very low risk of being hospitalized.”

De Serres said he thinks more younger people are getting sick because the coronavirus variants of concern are more transmissible and they lead to more severe illness more frequently.

Mike Benigeri, director of the data bureau at the Institut national d’excellence en sante et services sociaux, a Quebec government health-care research institute, said that over the past two weeks, there has been a 40 per cent increase in the number of people aged 40 to 69 who have been infected with COVID-19. He said the percentage is even higher among people aged 18 to 30.

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Marquis said older people and those with other medical conditions may notice a COVID-19 infection sooner. People who are healthier may not seek medical attention until they’re very ill, he added.

“They will push the limits of endurance up to the point when they say, OK, it’s enough, I really need to go to the hospital,” he said.

Despite the odds of dying being low among younger people, that doesn’t mean the consequences among the small group who do get severely ill are any smaller, he said.

“If you’re that unlucky guy, well, you’re going to die — and you’re not going die 1.5 per cent, you’re going be fully dead.”

Quebec Premier Francois Legault has repeatedly said that with vaccination protecting older people, the province will be able to tolerate more COVID-19 cases.

Dr. Quoc Nguyen, a gerontologist at the Universite de Montreal hospital centre, said while that may be true when it comes to deaths, it may not be the case for ICU capacity.

“When we look at one case in December versus one case in March, it seems that for a single case we have more intensive care than we used to before, but we don’t necessarily have more hospitalization,” he said.

It’s ICU capacity that worries Marquis. His ICU is supposed to have 24 beds, but because staff members have left the health-care system — particularly nurses — it now has a capacity of 14: seven beds dedicated to COVID-19 patients and seven for everyone else.

“I am really afraid that in two weeks we’re going to be in the same place as Ontario is right now and I don’t think that we can deal with that many patients,” he said.

Ontario Premier Doug Ford has imposed a four-week stay-at-home order after a third wave of COVID-19 started to overwhelm the health system.

“They’re going to saturate the ICU availability very, very quickly for a very long time,” Marquis said.

This report by The Canadian Press was first published April 8, 2021.

——

This story was produced with the financial assistance of the Facebook and Canadian Press News Fellowship.

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Canada’s hospitals deploy artificial lungs, scramble for staff as COVID-19 hits younger patients

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artificial lungs

By Anna Mehler Paperny and Allison Martell

TORONTO (Reuters) -Younger Canadians are bearing the brunt of the nation’s latest COVID-19 surge, creating growing demand for artificial lungs and a struggle to maintain staffing in critical care units as hospitals make last-ditch efforts to save patients.

Treatment with artificial lungs, known as extracorporeal membrane oxygenation, or ECMO, is much more likely to be deployed for patients under age 65, explained Marcelo Cypel, surgical director for the extracorporeal life support program at Toronto’s University Health Network (UHN).

Last week, there were a record 19 ECMO patients at UHN, 17 of them with severe COVID-19. When the sickest COVID-19 patients’ lungs fill with fluid and mechanical ventilators can no longer do the job, artificial lungs can save lives.

By Monday, doctors had weaned some off the machines and were down to 14 ECMO patients, 12 of them with COVID-19.

The need for these artificial lungs reflects a change in Canada‘s epidemic, which has taken a turn for the worse, with new cases surging and outbreaks hitting workplaces and schools.

With many seniors vaccinated and new, far more contagious coronavirus variants circulating widely, younger patients are increasingly arriving in intensive care.

“It’s very different now than the first wave, when we saw older people with comorbidities,” Cypel said. “We’re seeing more … young essential workers.”

The ECMO situation is under control for now, but things can change very quickly, Cypel cautioned.

When hospital systems in other countries were overwhelmed, they had to stop using ECMO because it requires a lot of staff – seven or more people to start the treatment.

About 55% of people who receive the therapy survive, Cypel said. However, they are often left with “severe physical limitations” from their extended hospital stay, he added.

Many of Canada‘s provinces are in the grip of a worsening third COVID-19 wave, as they struggle to hasten vaccine rollouts. The country reported more than 6,200 new cases on Monday, with the percentage of people testing positive for the virus up to 3.8%.

‘SEEING BURNOUT’

In British Columbia, where hospitals are bracing for a surge in demand for intensive care unit (ICU) beds caused by the highly concerning P.1 virus variant first discovered in, and now ravaging, Brazil, critical care doctor Del Dorscheid from Vancouver’s St. Paul’s Hospital is more worried about staffing than artificial lung use.

On a given shift, he said, a third of the staff are working overtime.

“They’re working so hard to find bodies to fill those empty spots,” he said. “I wouldn’t say we’re seeing more mistakes. Not yet, anyways. But we are certainly seeing burnout.”

For ICUs, there is no end in sight. As of Tuesday, there were 497 COVID-19 patients in Ontario’s ICUs, a new high. Last week, experts advising the provincial government said that could rise to 800 by the end of April even with a new stay-at-home order – or approach 1,000 without it. The province stopped short of a new stay-at-home order.

New restrictions implemented in Ontario last week change little for hardest-hit areas. In Toronto, patios for outdoor bars and restaurants closed, and a plan to reopen salons was shelved. On Monday, hard-hit Peel, west of Toronto, moved on its own to suspend in-person classes at schools for two weeks.

Canada‘s vaccination rate has picked up after a slow start, with 15% of the population getting at least one shot. But data from the Institute for Clinical Evaluative Sciences shows that the Ontario communities at highest risk of COVID-19 transmission also have the lowest rates of vaccination.

These communities tend to have a high proportion of residents unable to work from home, many of them non-white immigrants holding down jobs at high risk of virus exposure.

Some lack cars to drive to vaccination sites or paid time off to get the vaccine, said Brampton doctor Amanpreet Brar. Some of the hardest-hit neighborhoods lack pharmacies that dispense COVID-19 vaccines.

“It really reflects systemic inequities we see in our society,” said Brar. “They’re considered non-essential, while their work is considered essential.”

(Editing by Denny Thomas and Bill Berkrot)

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