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Experts say Canada's three-layer face mask recommendations make sense – CP24 Toronto's Breaking News

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Melissa Couto-Zuber, The Canadian Press


Published Wednesday, November 4, 2020 4:05PM EST


Last Updated Wednesday, November 4, 2020 5:22PM EST

As the cold winter weather forces most of us indoors during the COVID-19 pandemic, Canada’s health leaders say it’s time to upgrade our cloth face masks.

Dr. Theresa Tam, the country’s chief public health officer, said in a news conference Tuesday that masks with three layers – two cloth plus a filter – are now recommended over the two-layer face coverings previously suggested.

While the new recommendations caused a stir in the House of Commons on Wednesday, with Conservative leader Erin O’Toole suggesting they’re not in line with current provincial advice and may breed confusion, medical experts across Canada agreed that a three-layer mask works better than one with two layers.

Dr. Jing Wang, a clinical instructor at the University of British Columbia who has studied different face mask materials, says the timing of the new recommendations makes sense.

“I think it’s prudent to have a more stringent indoor mask policy, because it’s very difficult to stay distant indoors,” she said. “And if we’re spending a lot of time indoors, there’s more aerosol buildup in the air, so we should especially be wearing an effective mask.”

Wang says a two-layer cotton mask is about 60 per cent effective in trapping coronavirus particles being spewed from the wearer’s mouth – provided the mask is being worn correctly and has a tight fit around the cheeks.

But adding a filter to the same two-layer cloth mask can increase its effectiveness.

“You can kick it up to about 80 or 90 (per cent), and a regular surgical mask is anywhere between 60 to 90 per cent effective,” she said. “So essentially, when you have a two-layer cloth mask with a filter, it could be just as good as a single-use surgical mask.”

Dr. Lisa Bryski, an emergency room physician in Winnipeg, wasn’t surprised by Canada’s new mask-wearing measures, saying they align with those of the World Health Organization (WHO).

Bryski also says our knowledge of face mask effectiveness has expanded since the pandemic began, which would explain why recommendations are evolving.

“We’ve come a long way since March, when you think of how we used to approach the virus,” Bryski said. “We have studies showing that wearing a mask is better than no masks, and that … two (layers) is better than one.

“And now we’re finding that two layers with a filter is better than just two.”

Tam said in Tuesday’s news conference that the new guidelines don’t necessarily mean we have to throw out all of our current cloth masks and replace them with new ones.

She recommended adding a filter to existing masks, and Health Canada’s website now includes instructions for making three-layered masks at home.

The website says filters “add an extra layer of protection against COVID-19 by trapping small infectious particles,” and suggests using either a folded paper towel or non-woven propylene materials like craft fabric, which is used to make some reusable shopping bags.

Wang warns that not all non-woven polypropylene products are created equal, however.

“And it’s not all equally effective,” she added. “Some of them are actually hazardous for the body because they contain preservatives.”

She suggests using a dried out baby wipe – one of the fabrics she tested in her research – because it’s biocompatible, breathable and contains little to no preservatives.

Wang doesn’t propose using coffee filters to line our masks, however, saying they can be thicker than other non-woven fabric and interfere with breathing.

Dr. Anna Banerji, an infectious disease expert with the University of Toronto, says most two-layer cotton masks can be easily transformed into a three-layer filtered mask by ripping out the seams and adding a filtered material.

“Just open it up and put in some filter paper,” she said. “You can still use them if you put a filter material in between to sort of trap the virus particles.”

Bryski agrees that old masks don’t need to be thrown out, and they can and should still be worn while in the process of replacing or modifying them.

She wouldn’t advise putting two, two-layer masks on top of each other though.

“Two layers is better than nothing right now, so whatever you have, keep wearing and upgrade as you can,” she said. “But there haven’t been studies showing whether four-layer masks, or wearing double masks, are better than two because most of them are made of the same material.”

Bryski said mask upgrades shouldn’t hamper their breathability, and to refrain from using obstructive material “like plastic wrap or other solids.”

Wang stressed that mask design can be more important than the number of layers on it.

And proper fit on the face will determine how effective a mask actually is.

“Just because you’re wearing a three-layer mask with a filter doesn’t mean it’s automatically more effective if have your nose exposed or if it’s not tightly fitted around your face,” she said. “If you’re not going to wear it tightly and properly, then I don’t see too much of an advantage of having a three-layer mask.”

This report by The Canadian Press was first published Nov. 4, 2020.

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Why some say Canada needs to do more to protect essential workers until COVID-19 vaccine arrives – CBC.ca

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As Canadians await the rollout of the first round of COVID-19 vaccines, experts say Canada needs to double down on protecting essential workers most at risk of exposure to the coronavirus in the coming months. 

Canada will only have a limited supply of vaccines to start, with just 3 million expected to be vaccinated in the first few months of 2021, but the news of COVID-19 vaccines on the horizon could not come at a more critical time.

Over 400,000 Canadians have tested positive for the coronavirus since the pandemic began and the situation in our hardest-hit provinces shows no signs of slowing down. 

The percentage of COVID-19 tests across the country that have come back positive during the past week has skyrocketed to 7.4 per cent — up from 1.4 per cent in mid-September and 4.7 per cent in early November. A rising positivity rate can signal that cases are being missed and more people could unwittingly be spreading the virus.

“There’s a light at the end of the tunnel, but we still have to get through the tunnel to get there,” said Dr. Sumon Chakrabarti, an infectious disease specialist at Trillium Health Partners in Mississauga, Ont.  

“You also don’t want to be in a situation where you have a raging fire that’s going on and when you’re trying to roll out a vaccine, you’re doing it in a setting where the hospital is overwhelmed and health-care workers are getting sick.”

While much of the focus on public health messaging throughout the pandemic has been focused on individual actions, experts say Canada isn’t doing enough to protect those most in need of support in the coming months. (Ben Nelms/CBC)

Alberta positivity rate tops 10 per cent

Of all the COVID hotspots, Alberta has the biggest fire to put out at the moment, and this week asked the federal government and the Red Cross to supply field hospitals to help offset the strain COVID-19 is having on the health-care system.

There, the percentage of COVID-19 tests coming back positive hit an astonishing 10.5 per cent on Friday.

COVID-19 cases in Alberta are growing at such an explosive rate they’ve even outpaced Ontario, a province with 10 million more people, for the first time in the pandemic — with cases in Edmonton alone totalling more than those in Toronto and Peel Region combined

“If you think this is a hoax, talk to my friend in the ICU, fighting for his life,” Alberta Premier Jason Kenney said during a Facebook livestream Thursday.

“If you’re thinking of going to an anti-mask rally this weekend, how about instead send me an email, call me all the names you want, send me a letter, organize an online rally.” 

Yet while much of the focus on public health messaging throughout the pandemic has been focused on individual actions, experts say Canada isn’t doing enough to protect those most in need of support in the coming months. 

Ontario, Quebec see surge in workplace outbreaks

While elderly Canadians are most at risk for severe outcomes from COVID-19, totalling close to 90 per cent of all deaths, essential workers on the front lines are facing a worsening situation.

For the first time in the pandemic, active outbreaks in workplaces in Canada’s biggest provinces have outpaced those in long-term care facilities — accounting for 30 per cent of the outbreaks in Ontario and 40 per cent in Quebec, as first reported by The Globe and Mail

While limited information is available on exactly where the spread of COVID-19 is occurring, Ontario’s ministry of health said in a statement to CBC News the hardest-hit industries include construction, manufacturing, mining, warehousing and transportation.  

WATCH | Essential workers talk about being on the front lines of the COVID-19 pandemic

Essential workers — from grocery store employees to truck drivers — talk about their experiences on the front lines of the COVID-19 pandemic share how it has affected them and why they do it. 11:43

Because of the disproportionate risk of exposure they face, the union for workers in food retail, manufacturing, long-term care, home care and security said Friday that frontline workers should also be among the first recipients of COVID-19 vaccines.

“Workplaces are a big deal,” said Dr. Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare Hamilton and an associate professor at McMaster University. 

“There are people that need to go to work, unfortunately, for us to support society, and again we have to be willing and able to give them at least some measures of safety in their workplace.”

Paid sick leave key to stopping spread of COVID-19

Chakrabarti says one area that could help address rising transmission rates in workplaces is more paid sick leave for those who are unable to miss work due to COVID-19. 

Unlike policing people’s contacts in their own homes, it’s a problem policy could tackle, he said.

“Workplaces are things that are really important because you can only do so much to keep things safe.” 

If people are going to decide between putting food on their table … or going into isolation … they’re going to show up to work sick.– Dr. Zain Chagla

Chakrabarti says mask wearing and physical distancing aren’t always possible in certain situations in workplaces, especially those that involve workers in close quarters indoors — as evidenced by outbreaks in meatpacking plants, warehouses, and mines.

“Many people are financially unstable and they’re scared because if they do have to go off work, they’ll end up losing income,” he said. Undocumented workers may also be hesitant to speak up about symptoms for fear of being deported

“So you have a lot of these kinds of factors that I think are barriers for people getting tested.”

Chagla says more targeted education, oversight and internal audits to control COVID-19 transmission are needed in high-risk workplaces, in order to ensure compliance and accountability. 

“There’s certainly tons of essential workplaces that will continue to have issues unless people actually intervene and do this type of stuff,” he said. 

Last month, the federal government created Canada Recovery Sickness Benefit to give up to $1,000 of support to workers with COVID-19 over two weeks, but Chagla said more could be done. 

“You have to incentivize people to get tested,” Chagla said. “If people are going to decide between putting food on their table and paying their rent, going to work or going into isolation … they’re going to show up to work sick.”

Isolating, outreach better than ‘finger wagging’

Chakrabarti says another way to protect essential workers is through the creation of more dedicated isolation facilities for those recovering from COVID-19. 

“One big place that amplification is happening is in large families,” he said. “So if you have a place for people to have their meals covered and they can isolate away from their family, that’s going to really help to reduce amplification of the cases that we’re seeing in workplaces.” 

Chakrabarti says the “condescension and finger wagging” in public health messaging across the country against individual actions isn’t always effective — especially nine months into the pandemic.

“Community outreach often helps,” said Chakrabati, who is also a member of a recently formed South Asian task force to connect with and inform people in Peel Region.

“I think that a lot of the focus right now is on people. ‘Hey, you stay home, stay home, stop partying,’ that kind of stuff. Whereas we don’t hear a lot of what’s happening in these workplaces.” 

“This is going to be a problem throughout the entire pandemic,” said Chagla. “Because they have to stay open.” 

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How the COVID-19 vaccines are being approved in Canada – CBC.ca

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The approval of a COVID-19 vaccine in Canada could potentially be days away with the initial supply to be limited to about three million Canadians, in the first three months of 2021. But what approval processes have the vaccines gone through? CBC explains:

Is the approval process for the COVID-19 vaccine different than for other vaccines?

Due to the immediate need for the COVID-19 vaccine, some flexibility has been introduced to the approval process. Typically, a vaccine manufacturer will do all their clinical trials, gather all their data, prepare a submission package and put that forward for approval, said John Greiss, a Toronto-based intellectual property lawyer with Norton Rose Fulbright, who advises companies in the life sciences sector that are regulated by Health Canada.

“Health Canada will comment on it or ask for additional information and it will go back and forth until they come to a decision, he said.

But with COVID-19, Health Canada has accepted what’s known as a “rolling submission.” 

“The new process allows for a company to start an application process, submit the information that they have available, as of that date and add new data and new information as it becomes available, Greiss said

Supriya Sharma, chief medical adviser to Health Canada, said this enables the organization to start reviewing the potential vaccine and will shorten the overall review process “while still maintaining those same standards for the safety and the efficacy.”

What’s included in the submission?

That really hasn’t changed, Greiss said. Vaccine manufacturers have to submit all of the scientific data that they have, which includes any kind of lab data that demonstrates how the vaccine works, any kind of clinical trial data that they have obtained, along with Phase 1 to Phase 3 clinical trial data.

WATCH | Vaccines are coming soon

Dr. Njoo tells reporters the federal government is expecting 6 million doses of first two vaccines to arrive in Canada after approvals within the first quarter of the new year. 1:35

They also have to submit information about the manufacturing process and standards and procedures that demonstrate they’re meeting good manufacturing processes in their facilities, Greiss said.

How is the vaccine reviewed?

One vaccine submission is hundreds of thousands of pages long and can take, on average around 2,000 person hours to review, Sharma said. For COVID-19, Health Canada is employing specialized teams of seven to 12 people who have experience in areas like toxicology, infectious diseases, clinical medicine, microbiology and epidemiology to review the vaccine.

“Each vaccine submission has its own team that’s dedicated to it. And they will go through all of that information,” she said.

Reviewers must confirm there are no significant safety concerns, determine that the vaccine is able to prompt an adequate immune response in vaccinated people and show that it can protect against disease, she said.

“We go through all of that to see if it actually meets our standards for safety, efficacy, quality,” Sharma said. 

“We need to make sure that the benefits of the vaccine outweigh the potential risks and that we know that it’s being made in at a licensed place that’s up to standards and up to code.”

Greiss said that during the review process, Health Canada officials might, for example, ask for further clarification about the clinical trial procedure, or how patients were recruited.

The approval process has been modified to accommodate the pressing need for the COVID-19 vaccine. (Dado Ruvic/Illustration/Reuters)

“Or if they see anomalies in the data, they’ll ask the company to justify or clarify that information,” he said. “So there is still that back and forth in terms of Health Canada sort of digesting and analyzing the data and the company having to provide answers for that before they get an approval.”

Are the vaccine manufacturing facilities inspected?

For manufacturing facilities around the world, not just for vaccines, but for medications as well, Health Canada has entered into mutual recognition agreements with other regulators, Sharma said.

“We actually have sent our inspectors over to their country,” she said. “They’ve sent inspectors over to our country. We make sure that our standards are the same, our processes are the same.”

Every facility that manufactures vaccines needs to have an inspection before it’s licensed. And there are ongoing inspections to make sure standards are maintained, she said.

What are they looking for in these facilities?

They’re looking at key factors, known as the four Ps, Sharma said. 

  • Product: What’s being made there.
  • Premises: There are very detailed specifications on the facilities themselves. For example, special flooring and ventilation systems have to be in place.
  • Process: All the processes that go into manufacturing the product.
  • People: The qualifications and training of the people that work there.

All of those things are really important in terms of making sure that standards are met, she said.

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It’s ‘unknown’ when Canada will reach herd immunity from coronavirus vaccine: Tam – Global News

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The percentage of the Canadian population that needs to be vaccinated in order to reach widespread immunity against the coronavirus is unknown, according to Canada’s chief public health officer Dr. Theresa Tam.

Speaking at a media conference Friday, Tam was asked what entails a “successful vaccine campaign,” in order to determine when the population reaches herd immunity.

READ MORE: Canada is nowhere near herd immunity to the novel coronavirus as second wave surges, Tam says

“Nobody actually knows the level of vaccine coverage to achieve community immunity or herd immunity,” Tam explained. “We have an assumption that you will probably need 60 to 70 per cent of people to be vaccinated. But we don’t know that for sure … that’s modelling. Lots of these calculations are being done but bottom line is that we actually don’t know.”

The end goal, Tam added, is to vaccinate as many Canadian as quickly as possible.

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According to the World Health Organization (WHO), herd immunity is when a population can be protected from a certain virus, like COVID-19, if a threshold of vaccination is reached. It’s achieved by protecting people from a virus, not by exposing them to it, the WHO added.

[ Sign up for our Health IQ newsletter for the latest coronavirus updates ]

However, the percentage of people needed to be vaccinated in order to create herd immunity depends on the disease.

For example, herd immunity against measles requires about 95 per cent of a population to be vaccinated and for polio, the threshold is about 80 per cent, the WHO stated.


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Canada is nowhere near herd immunity to the coronavirus as second wave surges: Tam


Canada is nowhere near herd immunity to the coronavirus as second wave surges: Tam – Nov 1, 2020

Tam previously told Global News in November that Canada is still nowhere near herd immunity with the coronavirus.

“We’re only at a few percentage points in terms of the immunity in our population. That leaves over 90 per cent of the population, or 95 per cent of the population still vulnerable,” Tam said.

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Read more:
Two shots. A waiting period. Why the coronavirus vaccine won’t be a quick fix

Canada is currently battling a severe second wave of COVID-19 cases. Officials are urging people to remain vigilant in stopping the spread of the virus, despite the promising vaccine news.

Canada expects the first doses of the COVID-19 vaccine to be administered in January, which will go to the country’s most vulnerable populations.

Last week Prime Minister Justin Trudeau said he hopes to see the “majority” of Canadians vaccinated by September, though he did not specify exactly what that means as far as a percentage of the population.

© 2020 Global News, a division of Corus Entertainment Inc.

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