TORONTO — Today, Christine Elliott, Deputy Premier and Minister of Health, and co-chair of the federal-provincial-territorial health table, released the following statement on Ontario’s preparedness for the Wuhan novel coronavirus following a joint call with her federal and provincial counterparts:
“While there remain no confirmed cases of the virus in Canada, the federal government is putting in place enhanced screening and detection measures at Toronto Pearson International Airport to further protect the health of the public from the Wuhan novel coronavirus.
Today, I joined Patty Hajdu, Minister of Health for Canada, and my ministerial colleagues from each of the provinces and territories to share important information and further coordinate our joint efforts to protect the health and well being of all Canadians, including Ontarians, from the emerging issues of the Wuhan novel coronavirus. The federal government outlined their enhanced measures, which now include:
- Screening questions at border kiosks will now include questions about previous travel to Wuhan, China in the past 14 days. A positive response would trigger an enhanced screening process, including sending the traveller to a Canadian border agent for further questioning about their health status. The border agent will determine whether the traveller needs to seek immediate medical assessment and treatment and, if so, EMS will transport the traveller from the airport directly to hospital. This screening will be done in Vancouver and Montreal as well.
- Fact sheets are also being developed in English, French and Chinese for people who have travelled to China and are not currently exhibiting signs of illness. These fact sheets will outline the symptoms that individuals should watch for and any next steps should they experience symptoms, including seeking an immediate medical assessment.
The federal government’s enhanced screening measures build on Ontario’s robust and comprehensive protocols in place to actively monitor for, detect and contain any suspected cases of Wuhan novel coronavirus. The federal government’s measures will further support my ministry, in collaboration with Public Health Ontario, local health units, hospitals and health care providers, to monitor the Wuhan novel coronavirus and contain any cases, should one present in Ontario.
While the risk to Ontarians remains low, we will continue to be in close contact with the Public Health Agency of Canada and other jurisdictions to monitor this developing situation and safeguard the health of all Ontarians.
I’d like to thank all our partners for their on-going efforts in responding to this emerging situation. I want to reiterate our top priority will always remain safeguarding the health of the public, patients and care providers.”
Ontario confirms new case of coronavirus in Toronto – Toronto Star
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Coronavirus Live Updates: New Unexplained Cases Reported in the U.S. – The New York Times
Here’s what you need to know:
- New cases in three U.S. states raise prospect of local, person-to-person spread.
- Markets slide as the virus spreads across the globe.
- South Korea reports 594 new cases, and North calls for an all-out containment effort.
- For companies, how bad can it get?
- The White House is controlling the message. Historians say that is a bad idea.
New cases in three U.S. states raise prospect of local, person-to-person spread.
Troubling new signs of how the coronavirus is spreading in the United States emerged on Friday, as cases not explained by overseas travel or contact with a person known to be infected were reported in California, Oregon and Washington State.
Officials from the three states announced that their testing had found new cases: a high school student from Washington State; an employee of a school in Oregon, near Portland; and a woman in Santa Clara County, Calif., in the heart of Silicon Valley.
Sixty-five cases of the virus have been reported in the United States, but until this week, all of them could be explained by overseas travel or contact with someone who had been ill. The three new cases on Friday, and a case earlier in the week, in California, were the first in the United States in which the cause was mysterious and unknown — a sign, experts warned, that the virus might now be spreading in this country.
“If we were worried yesterday, we are even more worried today,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center. “Now we have to ask: How widely, really widely, is this virus out there?”
As word emerged of the unexplained cases, local officials scrambled to trace everyone who had come in contact with those who were ill. California health officials said they were increasing testing. And in Washington State, officials suggested that people needed to prepare for the possibility of schools closing and businesses keeping workers home.
“We’re going to be increasingly recommending that people try and avoid crowds and close contact with other people,” Dr. Jeff Duchin, health officer for Public Health Seattle & King County, said. “We may get to a point where we want to recommend canceling large public gatherings — social events, sporting events, entertainment — until we get over a hump of what might be a large outbreak.”
Markets slide as the virus spreads across the globe.
Stocks tumbled for a seventh consecutive day on Friday, recording the market’s worst week since the 2008 financial crisis.
The S&P 500 index fell about 0.8 percent, and the Dow Jones industrial average fell more than 1 percent. The S&P index lost more than 11 percent in the week, and almost 13 percent since its peak on Feb. 19.
The sell-off was fueled mostly by worry that measures to contain the coronavirus would hamper corporate profits and economic growth, and fears that the outbreak could get worse. The selling has in a matter of days dragged stock benchmarks around the world into a correction — a drop of 10 percent or more that is taken as a measure of extreme pessimism.
In Europe, the Britain’s FTSE 100 fell more than 3 percent and the Dax in Germany fell more than 4 percent. In Asia, the Nikkei 225 in Japan closed down 3.7 percent, the KOSPI in South Korea dropped 3.3 percent and the Shanghai Composite in China dropped 3.7 percent.
South Korea reports 594 new cases, and North calls for an all-out containment effort.
South Korea, which has the largest coronavirus outbreak outside China, reported 594 new cases on Saturday morning, bringing its total to 2,931. In North Korea, Kim Jong-un ordered all-out efforts to fight the virus at a high-level meeting, state media reported.
South Korean officials have warned that confirmed cases would rise sharply as they aggressively tested thousands of people, particularly in the southeastern city of Daegu. More than 86 percent of patients have been in Daegu and nearby towns; many have been associated with a church called Shincheonji, which has a strong presence in Daegu.
The United States military, which has more than 28,000 personnel in South Korea, said on Saturday that the spouse of an American soldier infected with the virus had also tested positive for it. She had been in self-quarantine since Wednesday, following her husband’s diagnosis, and was being transported to a military hospital, the military said.
Also on Saturday, Mr. Kim, North Korea’s leader, convened the Politburo of his ruling party to order an all-out campaign to prevent an outbreak, state media reported. The North has not reported any coronavirus cases, but there has been concern that the secretive, totalitarian country could be hiding an outbreak.
“In case the infectious disease spreading beyond control finds its way into our country, it will entail serious consequences,” the North’s official Korean Central News Agency quoted Mr. Kim as saying. It said that officials had discussed “measures to deter the influx and spread of the infectious disease in a scientific, preemptive and lockdown way.”
North Korea has already closed its 930-mile border with China, where the coronavirus emerged, and its border with Russia. But the Chinese border has long been porous for smugglers, who ferry goods across the shallow river that separates the countries. The North has also suspended all flights and trains to and from China and asked all foreign diplomats not to leave their compounds.
The state media report Saturday also said that Mr. Kim had fired one of his top aides, Ri Man-gon, and another official for corruption, but it was unclear whether the dismissals were connected to the antivirus campaign.
Coronavirus Map: Tracking the Spread of the Outbreak
The virus has infected more than 85,100 people in at least 56 countries.
For companies, how bad can it get?
As the coronavirus outbreak spreads, the world’s biggest companies have begun painting a bleak picture of broken supply chains, disrupted manufacturing, empty stores and flagging demand for their wares.
The announcements by businesses like Mastercard, Microsoft, Apple and United Airlines offer a look at how the virus is affecting consumer behavior and business sentiment. These corporate bulletins — and what executives do in response — could determine how much economic damage the outbreak inflicts.
Some companies have expressed optimism that governments will curb new infections and that consumer spending in Europe and North America will be largely unscathed. But if executives see a threat beyond the first three months of the year, they may pare planned investments and even lay off workers.
The stock-market plunge this week, the steepest since the financial crisis, suggests that investors are bracing for a bad news.
“Everything is slowing down even more — and that has not been fully appreciated,” said Michael O’Rourke, chief market strategist at JonesTrading.
The White House is controlling the message. Historians say that is a bad idea.
Many times in many countries, political leaders have tried to censor health officials and play down the risks of infection just as epidemics approached. This strategy has almost never worked, historians and former health officials said.
And if there are more deaths than leaders predict, stonewalling destroys the reputations of the leaders themselves.
This week’s efforts to reorganize the Trump administration’s chaotic response to the coronavirus outbreak risk falling into that pattern. The White House will coordinate all messaging, the public was told, and scientists in the government will not be popping up on television talk shows, saying what they think.
That may not be a winning strategy, experts warned. The stock market reacts to rumors, and the Federal Reserve Bank may succumb to political pressure. But pathogens, like hurricanes and tsunamis, are immune to spin.
“It’s crucially important that experts tell the public what they know and when they know it,” said Dr. Thomas R. Frieden, a former director of the Centers for Disease Control and Prevention. “That’s the only way to earn and maintain the public trust that is essential to work together as a society and fight an epidemic.”
As China awakened to the crisis, one community was left vulnerable.
When the coronavirus emerged in Wuhan, China, residents in a nearby suburb thought they were safe. Zuoling New Town, a bustling community of retired farmers, factory workers and white-collar professionals, was 22 miles from the market where the outbreak appeared to have started.
But as the virus spread, Zuoling emerged as a stubborn hot spot of infections, and a somber lesson in how the state’s effort to contain the virus left some communities vulnerable. The leadership’s top-down campaign relied on grass-roots mobilization, and the very newness and isolation of Zuoling proved to be a weakness, depriving residents of food supplies, medical care and labor.
Residents crammed into the only large supermarket to stock up. Those worried about fevers crowded the local clinic, and many were sent back to their high-rise homes, sometimes spreading the virus. The nearest public hospital assigned to take patients was 10 miles away, making it difficult to get treatment without a car.
“I never imagined that this would hit our home,” said Zhang Jin, a 47-year-old resident. His mother, Yan Yinzhen, who was living with him, contracted what doctors believed was the coronavirus, possibly from a neighbor. Mr. Zhang, his wife and father all fell ill.
“We’ve lost confidence,” said Mr. Zhang, a school bus driver. “Nobody in the neighborhood took charge.”
Reporting was contributed by Peter Eavis, Donald G. McNeil Jr., Choe Sang-Hun, Thomas Fuller, Sheri Fink, Nicholas Bogel-Burroughs, Amy Qin and Sui-Lee Wee.
New Study Suggests Milk Could Increase Breast Cancer Risk – Medscape
Hot on the heels of a review from top nutrition scientists that cautioned against drinking cow’s milk comes another study with another caution: drinking milk increases the risk of developing breast cancer, say the researchers. But this finding comes from an observational study, and there may be confounders that are not accounted for, says an expert not involved with the study.
The latest research was based on data from the long-running larger study called Adventist Health Study-2 (AHS-2), which is looking at diet and health among Seventh Day Adventists in North America. Past results from this study have suggested that Seventh Day Adventists have longer life spans and lower rates of some cancers, perhaps because of heathier lifestyles.
The latest analysis suggests that milk raises breast cancer risk, and the more you drink the higher your risk may be.
“Consuming as little as 1/4 to 1/3 cup of dairy milk per day was associated with an increased risk of breast cancer of 30%,” first author Gary E. Fraser, MBChB, PhD, said in a press statement. Fraser is affiliated with the School of Public Health at Loma Linda University, California.
“By drinking up to 1 cup per day, the associated risk went up to 50%, and for those drinking 2 to 3 cups per day, the risk increased further to 70% to 80%,” he added.
The findings were published February 25 in the International Journal of Epidemiology.
“The AHS study is provocative, but it’s not enough to warrant a change in guidelines. The caution being espoused by the authors is not warranted given the observational nature of this study,” commented Don Dizon, MD, director of Women’s Cancers, Lifespan Cancer Institute at Brown University in Providence, Rhode Island. He was not involved with the study and was approached by Medscape Medical News for comment.
Because of its observational design, the study cannot prove that cow’s milk causes breast cancer, Dizon emphasized.
“I’d want to see if the findings are replicated [by others]. Outside of a randomized trial of [cow’s] milk vs no milk or even soy, and incident breast cancers, there will never be undisputable data,” he said.
“Probably the biggest point [about this study] is not to overinflate the data,” Dizon added.
He noted that the results were significant only for postmenopausal women, and not for premenopausal women. Moreover, analyses showed significant associations only for hormone receptor-positive cancers.
“We know that breast cancer increases in incidence with age, so this tracks with that particular trend. It suggests there may be confounders not accounted for in this study,” he said.
Research so far has been inconclusive on a possible link between dairy and increased risk for breast cancer. Dairy has even been tied to decreased risk for breast cancer, according to the World Cancer Research Fund.
The current study included 52,795 Seventh Day Adventist women from North America who did not have cancer at the start of the study. Women had a mean age of 57.1 years, and 29.7% were black. At baseline, women reported their dietary patterns for the past year using food frequency questionnaires. For 1011 women, researchers double-checked food intake with 24-hour diet questionnaires, and verified soy intake by analyzing urine levels of soy isoflavones.
Data on invasive breast cancer diagnoses came from national registries in the US and Canada. Over the course of 7.9 years, 1057 women developed invasive breast cancer. Results were adjusted for a range of factors related to breast cancer risk, including diet, lifestyle, and family history of breast cancer.
Overall, women who consumed the most calories from dairy per day had 22% increased risk for breast cancer, compared with women with the fewest calories from dairy (hazard ratio [HR], 1.22; 95% confidence interval [CI], 1.05 – 1.40, P = .008). Women who drank the most cow’s milk per day had 50% increased risk for breast cancer compared with women who drank the least (HR, 1.50; 95% CI, 1.22 – 1.84, P < .001).
Drinking full or reduced fat cow’s milk did not change the findings (P for trend = .002 and P for trend < .0001, respectively).
No significant association was found between breast cancer risk and cheese or yogurt consumption (P = .35 and P = .80, respectively).
Need for Change?
US dietary guidelines are under review. A new version, which will cover pregnant women and children under age 2 for the first time, is expected later this year.
Current guidelines recommend that adults and children aged 9 and over drink three 8 oz glasses of milk per day, or equivalent portions of yogurt, cheese, and other dairy products.
“Evidence from this study suggests that people should view that recommendation with caution,” Fraser said.
Milk Is Complex Topic
A top nutrition scientist agrees. Walter Willett, MD, DrPH, professor of epidemiology and nutrition at Harvard T.H. Chan School of Public Health in Boston, Massachusetts, told Medscape Medical News: “There is little scientific justification for the recommendation of 3 cups of milk per day. This new study adds a further reason for caution.”
“This was a high-quality study conducted by experienced investigators,” Willett said. Strengths of the study include the high soy intake and low consumption of foods from animal sources, factors that are hard to study in other populations.
Willett was a coauthor, along with David Ludwig, MD, PhD, also from Harvard, of the recent review published in the New England Journal of Medicine that questioned the science behind milk-drinking recommendations. An article about this review on Medscape Medical News has attracted a huge number of comments from our readers.
Milk is a complex topic, Willett explained. As a good source of essential nutrients, especially calcium and vitamin D, cow’s milk has been touted to have several health benefits, especially decreased fracture risk. But Willett said calcium recommendations have probably been overstated, and current evidence does not support high milk intake for fracture prevention.
Other benefits include improved nutrition in low-income settings, taller stature, and decreased colorectal cancer risk. But cow’s milk has also been linked to increased risk for some cancers, including prostate and endometrial cancer. Many of the benefits derived from nutrients found in milk may be obtained from other sources without these risks, according to Willett.
“Given the risks and benefits, we suggest a possible range from zero to two servings per day of dairy foods, including milk, cheese, and yogurt. If intake is zero or one serving, taking a calcium/vitamin D supplement would be good to consider,” he said.
However, Fraser and Willett also suggested another option: replacing cow’s milk with soy milk. Analyses from the current study showed no significant association between consumption of soy and breast cancer, independent of dairy (P for trend = .22).
In addition, substituting average amounts of soy milk for cow’s milk was linked to a 32% drop in risk for breast cancer among postmenopausal women (HR, 0.68; 95% CI, 0.55 – 0.85, P = .002). However, these results were not significant among premenopausal women (HR, 0.70; 95% CI, 0.36 – 1.38, P = .31).
“The suggestion that replacing some or all of [cow’s] milk with soy milk may reduce risk of breast cancer is consistent with other studies supporting a benefit of soy milk for risk of breast cancer,” Willett said.
“If someone does choose soy milk, picking one with minimal amounts of added sugar is desirable,” he added.
Drinking Milk, or Some Related Factor?
Fraser, the lead author of the current study, said in a statement that the results provide “fairly strong evidence that either dairy milk or some other factor closely related to drinking dairy milk is a cause of breast cancer in women.”
That ‘other’ factor is probably complicated, but may be related to what humans have done to cows. To increase milk production, humans have bred cows to have higher levels of insulin-like growth factor, which in turn has been linked to some cancers, including breast cancer.
Sex hormones in cow’s milk may also be involved. About 75% of a dairy herd is pregnant and the cows are by definition lactating. So the milk they produce may have higher levels of progestins and estrogens, which may play a role in hormone-responsive breast cancer.
Other factors that researchers did not measure in this study, such as poverty and the income of participants, may be at play.
But to know what’s really going on, all agree that more research is needed.
“The overall evidence so far has not shown a clear increase or decrease in risk of breast cancer with higher [cow’s] milk intake. Thus, this topic needs further examination,” Willett said.
The study was funded by the National Cancer Institute at the National Institutes of Health, and the World Cancer Research Fund in the UK. Three of the authors report following largely vegetarian diets. All authors report regular and free use of dairy products without religious or other restrictions. No authors report associations with the soy product or dairy industries. Willett reports being a consultant during the design and early years of the Adventist study, but has not been involved with it for at least 8 years. Dizon has disclosed no relevant financial relationships.
Int J Epidemiol. Published online February 25, 2020. Abstract
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