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Experts question, criticize new CDC guidance to shorten COVID-19 isolation – Global News

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U.S. health officials’ decision to shorten the recommended COVID-19 isolation and quarantine period from 10 days to five is drawing criticism from some medical experts and could create confusion among many Americans.

To the dismay of some authorities, the new guidelines allow people to leave isolation without getting tested to see if they are still infectious.

The guidance has raised questions about how it was crafted and why it was changed now, in the middle of another wintertime spike in cases, this one driven largely by the highly contagious omicron variant.

Read more:

CDC now recommends those with COVID-19 isolate for 5 days, down from 10

Monday’s action by the Centers for Disease Control and Prevention cut in half the recommended isolation time for Americans who are infected with the coronavirus but have no symptoms. The CDC similarly shortened the amount of time people who have come into close contact with an infected person need to quarantine.

The CDC has been under pressure from the public and the private sector, including the airline industry, to shorten the isolation time and reduce the risk of severe staffing shortages amid the omicron surge. Thousands of flights have been canceled over the past few days in a mess blamed on omicron.

“Not all of those cases are going to be severe. In fact, many are going to be asymptomatic,” CDC Director Dr. Rochelle Walensky said Monday. “We want to make sure there is a mechanism by which we can safely continue to keep society functioning while following the science.”

CDC officials said the guidance is in keeping with growing evidence that people with the virus are most infectious in the first few days.


Click to play video: 'COVID-19: Quebec to allow health-care, essential workers to work even if tested positive on case-by-case basis'



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COVID-19: Quebec to allow health-care, essential workers to work even if tested positive on case-by-case basis


COVID-19: Quebec to allow health-care, essential workers to work even if tested positive on case-by-case basis

Louis Mansky, director of the Institute for Molecular Virology at the University of Minnesota, agreed there is a scientific basis to the CDC’s recommendations.

“When somebody gets infected, when are they most likely to transmit the virus to another person?” he said. “It’s usually in the earlier course of the illness, which is typically a day or two before they actually develop symptoms and then a couple of days to three days after that.”

Research, including a study published in the journal JAMA Internal Medicine in August, backs that up, though medical experts cautioned that nearly all of the data predates omicron.

The CDC released a report Tuesday on a cluster of six omicron cases in a Nebraska household and found the median incubation period — the time between exposure and the appearance of symptoms — was about three days, versus the five days or more documented earlier in the pandemic. The six people also experienced relatively mild illness.

But other experts questioned why the guidelines let people leave isolation without testing.

“It’s frankly reckless to proceed like this,” said Dr. Eric Topol, founder and director of the Scripps Research Translational Institute. “Using a rapid test or some type of test to validate that the person isn’t infectious is vital.”

“There’s no evidence, no data to support this,” he added.

Read more:

Ontario health officials evaluating new CDC guidance on shortened COVID isolation

Mansky said CDC probably didn’t include exit testing in its guidelines for logistical reasons: There is a run on COVID-19 rapid tests amid the spike in cases and the busy holiday travel season. In many places, at-home tests are difficult or impossible to find.

The CDC is “driven by the science, but they also have to be cognizant of the fact of, you know, what are they going to tell the public that they’ll do,” Mansky said. “That would undermine CDC if they had guidance that everybody was ignoring.”

Qamara Edwards, director of business and events for Sojourn Philly, which owns four restaurants in Philadelphia, said about 15 per cent of its employees are out sick with COVID-19, and staffing is tight.

The CDC changes are “great for businesses, they do allow people to return to work sooner than they’ve expected,” Edwards said, though she understands why workers might be resistant and worried about their safety.

In Los Angeles, King Holder, who runs the StretchLab Beverly fitness business, likewise said omicron has caused “ample disruption” to his company, and he welcomed the more relaxed guidelines.

“The possibility of five days compared to 10-14 days is huge for our business and allows us to stay afloat,” he said.


Click to play video: 'Doug Ford comments on COVID-19 vaccine rollout, Ontario schools'



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Doug Ford comments on COVID-19 vaccine rollout, Ontario schools


Doug Ford comments on COVID-19 vaccine rollout, Ontario schools

But Dana Martin, a 38-year-old Philadelphia teacher and educational consultant, said: “The looser COVID guidelines make me nervous. I’m more hesitant to participate in holiday activities because of the omicron variant and the seemingly more lax protocols.”

Marshall Hatch, senior pastor of New Mount Pilgrim Church on Chicago’s West Side, said he is bracing for some confusion in his congregation. The church has been a strong advocate for testing, vaccinations and booster shots.

Hatch said the CDC’s latest guidance is confusing and “a little incongruous.”

“Either we’re in a surge that we need to take very seriously or are we winding down the pandemic and that’s why we’re shortening the isolation and quarantine times,” he said Tuesday. “They might want to give us a little more information to go with.”

Hatch said some members of the largely Black congregation, particularly senior citizens, are skeptical of information from government.

The CDC move follows global efforts to adjust isolation rules, with policies differing from country to country.

Read more:

Ontario reports 8,825 new COVID cases on Tuesday

England last week trimmed its self-isolation period for vaccinated people who have tested positive for COVID-19 to seven days in many cases, provided two negative lateral flow tests are taken a day apart.

The French government said Monday that it will soon relax its isolation rules, although by exactly how much isn’t yet clear.

Health Minister Olivier Veran said the rule changes will be aimed at warding off “paralysis” of public and private services. By some estimates, France could be registering more than 250,000 new infections per day by January.

Italy, meanwhile, is considering doing away with a quarantine altogether for those who have had close contact with an infected person as long they have had a booster shot. Projections indicate as many as 2 million Italians could be put in quarantine over the next two weeks as the virus spreads.


Click to play video: 'COVID-19: Ontario issues temporary restrictions on long-term care homes amid Omicron surge'



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COVID-19: Ontario issues temporary restrictions on long-term care homes amid Omicron surge


COVID-19: Ontario issues temporary restrictions on long-term care homes amid Omicron surge

The U.S. airline industry applauded the CDC move.

“The decision is the right one based upon science,” said the lobbying group Airlines for America.

But the head of a flight attendants union criticized the change, saying it could lead businesses to pressure sick employees to come back before they are well.

If that happens, “we will make clear it is an unsafe work environment, which will cause a much greater disruption than any `staffing shortages,”’ warned Sara Nelson, president of the Association of Flight Attendants-CWA International.

© 2021 The Canadian Press

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Why has BC stopped doing contact tracing for coronavirus? – Dawson Creek Mirror

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Contact tracing is no longer an effective tool in the province’s fight against surging cases of the Omicron coronavirus variant, says B.C.’s top health officer. 

The province has adapted its strategy to prevent transmission of the highly-infectious COVID-19 strain, Provincial health officer Dr. Bonnie Henry told reporters in a press briefing Friday (Jan. 21) morning.

And while contact tracing has been an effective mechanism for public health intervention in the past, Henry noted that is an increasingly difficult process due to the infectious variant. 

“Disease characteristics that make contact tracing effective are things like having a longer incubation period because you have to have time to find people after somebody has been tested,” she explained, highlighting that the Omicron variant has a signifcantly shorter incubation period.

As COVID-19 strains “become more and more infectious,” it is more challenging to find people through contact tracing, added Henry. 

A disease such as measles, on the other hand, has a two- to three-week incubation period. The health officer said contact tracing for diseases with longer incubation periods like this allows time to identify and reach a high proportion of contacts and take measures to prevent the spread of the virus. 

Earlier in the pandemic, individuals infected with the Delta variant typically had a five- to seven-day incubation period, Henry noted. This period allowed public health teams to locate the individuals and prevent them from spreading the virus to others before they developed symptoms. 

Individuals infected with Omicron may also “have mild or asymptomatic infections and not even realize that they are affected,” she emphasized. Further, at this juncture in the pandemic, the majority of B.C. residents are vaccinated. Some adults with mild to moderate COVID-19 who are at high risk of progressing to serious disease will have access to Canada’s first oral antiviral COVID-19 treatment

“So with the emergence of these more transmissible variants are shorter incubation periods, COVID-19 is no longer an infection for which contact tracing is an effective intervention,” Henry underscored. 

“We now need to shift our management and think about the things that we can do across the board to prevent transmission and to prevent ourselves from being exposed.”

While vaccination is the most effective way to prevent transmission from COVID-19, individuals should also manage their symptoms and stay home if they feel ill. 

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Patients with COVID in Fraser Health may now share hospital rooms with uninfected – Chilliwack Progress – Chilliwack Progress

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A policy introduced to hospital staff last Friday by Fraser Health means some COVID-19 positive patients can share rooms with fully-vaccinated patients who are not infected with the virus.

Black Press received a copy of the memo issued Jan. 14 to staff at Chilliwack General Hospital (CGH) announcing the revised recommendations “for COVID-19 patient placement in acute care settings.”

The memo states that due to evolving epidemiology of the Omicron variant, and that “this virus generally causes mild disease,” areas for COVID patients will be reserved for only those with significant respiratory symptoms.

“A single occupancy room… is the preferred accommodation for any patients with respiratory symptoms. If a single occupancy room is not available, accommodate the patient in a multi-bed room ensuring at least two metres of space from other beds.

“Place COVID-19 positive patients only with fully vaccinated roommates.”

Hospital staff are directed to follow Infection Prevention and Control (IPC) droplet precaution guidelines, and the memo made it clear that COVID-positive patients should not share a room with immunocompromised patients, patients with chronic cardiac or respiratory disease, newborns, or others with respiratory illnesses.

At a briefing Friday morning with Health Minister Adrian Dix and Public Health Officer Dr. Bonnie Henry, Black Press asked about the rationale behind this revised policy, and she made it clear it was not unique to CGH.

Henry said the increased number of people being admitted to hospitals means that space is at a premium, and this policy helps maximize space with additional precautions in place.

She said the type of COVID-positive patients who might be placed with a non-COVID patient are those who come to hospitals for other reasons, they are tested, and the positive result is considered “incidental” to the reason they are in hospital.

“That is an infection prevention control team decision made at a hospital by hospital, and actually room by room and ward by ward basis, depending on the needs in that facility.”

Dix added that yesterday there were 891 people hospitalized in the province with COVID-19, and the pre-Omicron record was 500.

“When you have a lot of people in the hospital, you have to manage within the space you have and ensure infection control stays high and that’s what our teams are doing across B.C.”


Do you have something to add to this story, or something else we should report on? Email:
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COVID-19 in Nova Scotia, Jan. 21: weekly recap, 94 hospitalized, 601 new cases – Halifax Examiner

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Jump to sections in this article:
Overview
Vaccination
Testing

There are now now 94 people in hospital who were admitted because of COVID symptoms, 13 of whom are in ICU. Those 57 range in age from 0 to 100 years old, and the average age is 68.

Additionally, there are:
• 73 people admitted to hospital for other reasons but who tested positive for COVID during the admissions screening or who were admitted for COVID but no longer require specialized care
• 113 people in hospital who contracted COVID in the hospital outbreaks

The 94 people now hospitalized because of COVID have the following vaccination status:
The vaccination status of those 94 is:
• 11 (11.7%) have had 3 doses
• 60 (63.8%) have had 2 doses but not 3
• 4 (4.3%) have had 1 dose
• 19 (20.2%) are unvaccinated
Note that only 9.3% of the population is unvaccinated

My very rough calculation of the rate by vaccination status of those hospitalized (based on numbers of the population in each category two weeks ago) is as follows:
• (11) a rate of 6.1 per 100K with 3 doses
• (60) a rate of 9.8 per 100K with 2 doses (but not 3)
• (4) a rate of 5.7 per 100K with 1 dose only
• (19) a rate of 18.0 per 100k unvaccinated

Additionally, the province announced 601 new cases of COVID-19 today. The new cases are people who received a positive PCR test result from a Nova Scotia Health lab; it does not include people who tested positive using a take-home rapid (antigen) test.

By Nova Scotia Health zone, the new cases break down as:
• 269 Central
• 120 Eastern
• 49 Northern
• 163 Western

Public Health estimates that there are 5,241 active cases in the province; the actual number is undoubtedly much higher.

The graph above shows the weekly (Sat-Fri) number of new cases for the duration of the pandemic.

The graph above shows the number of weekly cases (green, left axis) and weekly deaths (red, right axis). If deaths lag three weeks behind cases, we may (nothing is certain) see 10-20 more deaths in the next couple of weeks.

The graph above shows the number of weekly cases (green, left axis) and the number hospitalized on Fridays (orange, right axis) for the duration of the pandemic.

Jail outbreak

“Active COVID-19 cases at the provincial jail in Burnside are down to 11,” reports Zane Woodford:

The Central Nova Scotia Correctional Facility has had an outbreak since late-December, and Justice Department spokesperson Heather Fairbairn told the Halifax Examiner there have now been a total of 140 cases at the jail.

“As of Jan. 21, there are 11 active cases among those currently in custody at the Central Nova Scotia Correctional Facility,” Fairbairn wrote in an email.

As has been the case throughout, according to Fairbairn, none of the prisoners is in hospital and there are no cases in the jail’s women’s unit.

Fairbairn said since January 1, five people have been approved for temporary absences or early release. The population at the jail, as of January 20, was 223. That means about 63% of prisoners at the facility have had COVID-19.

Hospital outbreaks

There are two new cases at ongoing hospital outbreaks, one each at:
• Cape Breton Regional Hospital for a total of fewer than 10 in that ward
• Victoria General for a total of fewer than 10


Vaccination

Vaccination data were not reported today “due to a technical issue.”

The graph above shows the vaccination progress as captured on Fridays through the pandemic, except Thursday for this week. The yellow line is people with at least one dose of vaccine The blue line is people with only one dose. The green line is people with two doses but not three. The grey line is people with three doses. The red line is 80% of the population.

Appointments for boosters are now open to people 30 and over for whom 168 days have passed since their second shot.

Vaccination appointments for people 5 years of age and older can be booked here.

People in rural areas who need transportation to a vaccination appointment should contact Rural Rides, which will get you there and back home for just $5. You need to book the ride 24 hours ahead of time.

There are many drop-in Pfizer vaccine clinics scheduled, starting next week, several for kids five years old and older.


Testing

Nova Scotia Health labs completed 3,975 PCR tests yesterday, with a positivity rate of 15.1%.

If you test positive with a rapid (antigen) test, you are assumed to definitely have COVID, and you and your household are to self-isolate as required.

But take-home rapid testing kits are no longer widely available.

Pop-up testing has been scheduled for the following sites:

Saturday
Halifax Central Library, 11am-6pm
Alderney Gate, 10am-2pm
Glace Bay Legion, 11am-3pm

Sunday
Halifax Central Library, 11am-6pm
Knights of Columbus (KOC) Hall (New Waterford), 11am-3pm

Monday
Halifax Central Library, noon-7pm
Hubbards Lions Club, 11am-3pm

You can volunteer to work at the pop-up testing sites here or here. No medical experience is necessary.


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