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Feds order supplies to give two doses of COVID-19 vaccine when ready – Weyburn Review

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OTTAWA — The federal government is ordering more than 75 million syringes, alcohol swabs and bandages so it can inoculate Canadians as soon as a COVID-19 vaccine is ready.

Procurement Minister Anita Anand says Ottawa intends to stockpile enough vaccine supplies to give at least two doses to every Canadian whenever a vaccine is available.

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There are almost two dozen vaccines in clinical trials around the world and at least 140 more in earlier stages of development, but most experts predict it will be well into 2021 before the first vaccines could be ready for wide use.

Quebec biopharmaceutical company Medicago began Canada’s first human COVID-19 vaccine trials July 13 and expects to have the initial results of its tests on 180 people by early fall.

Still, Anand says Canada wants to be ready and so has ordered 75.2 million each of syringes, alcohol swabs, bandages, and gauze pads, and 250,000 needle-disposal containers to be delivered no later than the end of October.

The contracts for the syringes are already in place but bids for the other supplies opened last week and will be accepted until the end of July.

Ottawa is also looking to transition its multibillion-dollar medical supplies purchase program from pandemic panic buying to longer-term planning. It is seeking a private company to take over the logistics of ordering, receiving, storing and distributing millions of face masks, respirators, surgical gowns and other personal protective equipment every month.

A request for bids for a logistics co-ordinator was posted July 16. The government wants a supplier that can procure or provide temperature-controlled warehouse space near Toronto and Hamilton airports, another near Montreal and a third in either British Columbia or Alberta. The winning bidder needs to be able to handle 27,000 pallets of supplies each month, as well as 220 shipping containers from cargo ships, and another 400 cases of other goods.

The frenzied global purchasing of COVID-19 medical supplies has dominated Public Services and Procurement Canada for months now.

Once described by Deputy Prime Minister Chrystia Freeland as the “wild west” of buying supplies, enormous demand for masks, gowns, gloves and hand sanitizer to respond to the pandemic turned into a season of Survivor in which governments needed to outwit, outplay and outlast others competing for the same goods.

The intensity of that process has relaxed slightly said Anand, but not enough that Canada is yet willing to disclose its international suppliers.

“We have to be careful not to put in jeopardy our supply chains,” she said.

“Where we believe the supply chain is still in jeopardy, in other words there is still intense global demand for a particular piece of PPE, it would not be prudent for us to reveal the names of suppliers as the competition is still very intense for that good.”

Canada has ordered millions of masks, gowns, gloves and other supplies to be delivered into 2021, and has accepted delivery of 99 planeloads of supplies to date.

In some cases, we did not need as much as we expected. More than 40,000 ventilators have been ordered, but not as many COVID-19 patients have needed ventilators as predicted. The 367 already delivered and the others on the way will be stored by Ottawa in case they are needed in future waves of the virus.

An agreement between Ottawa and the provinces means 80 per cent of what Ottawa buys it will turn around and ship to the provincial governments when they need it. The other 20 per cent is going into the “National Emergency Strategic Stockpile,” kept in a series of warehouses across Canada that store everything from medical supplies to temporary hospital cots and drugs to treat a variety of infectious diseases.

Ottawa is now asking for local warehouse owners in Ottawa to step up with space to expand the stockpile, which was found to be lacking last winter when Canada needed it most.

The country’s deputy chief public health officer Dr. Howard Njoo said Friday some “hard lessons” have been learned about the stockpile and Canada’s dependence on international sources to supply it.

He said it was always believed that the national stockpile and the supplies provinces had would be enough for an immediate emergency and whatever else the country needed could be ordered. That assumption proved very wrong when governments worldwide all needed the same things at the same time.

Before COVID-19, Canada had little ability to make much of what was needed here at home.

“We’ve also learned that we can’t in the future necessarily depend solely on global supply chains, we have to be more self sufficient,” he said.

“I certainly feel better, I think, about our situation, where we are now compared to let’s say back in January, February,” he said.

About 40 per cent of the supplies Canada needs are now being sourced in Canada, including, for the first time, testing swabs and N95 masks.

Anand said one of the key lessons is the need to make sure orders of supplies are distributed before they expire. Last year two million N95 masks kept in a warehouse in Regina were thrown out because they had expired. Those could have been used before the pandemic rather than wasted.

Anand said there is work ongoing to co-ordinate the federal procurement and provincial needs with the maintenance of a stockpile, and she said the same principle is being extended to other supplies, such as the vaccine equipment.

“Rest assured if those syringes are not used for vaccine, they are able to be used in other circumstances, for example, to administer the flu shot,” she said.

This report by The Canadian Press was first published July 18, 2020.

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The 1976 U.S. swine flu vaccinations may offer lessons for the COVID-19 pandemic – CBC.ca

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For Pascal Imperato, a communicable disease epidemiologist who in 1976 was in charge of immunizing New York City against a potential swine flu epidemic, the effort to vaccinate the population against COVID-19 feels like a familiar challenge.

“We were going to vaccinate six million people in six weeks,” he said in a phone interview. “And we were absolutely certain we could pull it off. And we would have.”

Would have, because, ultimately, the largest national immunization program that had ever been undertaken in the U.S. was cut short as the epidemic never materialized, and public skepticism about the program began to mount.

Still, while the COVID-19 pandemic is very real, and the population is much larger, the vaccination program of 1976 may offer some lessons as governments around the world prepare to inoculate the public at large.

“If the program is well organized, mobilizing all of the resources that are capable of administering this vaccine, there [shouldn’t] be any problem whatsoever,” Imperato said. 

In March 1976, the administration of then president Gerald Ford launched a $137 million US nation-wide vaccination program to immunize every American citizen by the end of the year.

The diagnosis of swine flu on a New Jersey army base had led to panic among top U.S. scientists and officials who feared the disease could spread and potentially precipitate a health crisis similar to the deadly Spanish flu outbreak of 1918.

Even though it was cut short, by December 1976 more than 40 million Americans — about one-fifth of the population — had been vaccinated, and about 650,000 in New York City.

Utilizing volunteers, setting up sites

Imperato said that on any given day they had about 900 people who were involved in getting the vaccine out to the general public. That included 500 to 600 volunteers who were recruited each day through the city’s chapter of the American Red Cross.

University graduates, sanitary inspectors and public health nursing assistants were also hired and trained to use automatic jet injectors and to give cardiopulmonary resuscitation. 

Sixty vaccination sites were established in places that included schools and police precincts.

“Anywhere we could,” said Imperato, who is the founding dean and distinguished service professor at SUNY Downstate Medical Center School of Public Health.

Mary O’Brien, 77, resident of the St. Augustine Home, Chicago, winces as she is inoculated against the swine flu in 1976. (Bettmann Archive/Getty Images)

As well, 15 mobile teams were created to vaccinate over 40,000 people in more than 200 nursing homes and about 100,000 people in 150 senior citizen centres.

“This required military organization, if you will, and we were able to put together a team and put into place the people that we needed to bring this about,” he said.

A great deal of administrative and clerical support goes into a program of this kind, he said.

“We have to have people register. We had to have as much information about them as possible, because we needed to know who we were vaccinating and if any of them had any reaction. We had to have teams of people checking on adverse events.”

Local capacity can be the ‘weak link’

Nationwide, however, there  were some logistical problems, said Harvey Fineberg, a physician who was tasked with co-authoring a review into the 1976 Swine flu vaccine program.

The actual immunizations were quite erratic in their frequency in different communities, he said.

“So a lesson that’s still relevant today, whether in different provinces in Canada or different states and counties and the U.S., is the local capacity,” he said.

“That last mile, getting the immunization into the arms of the recipients, that’s the weak link in the chain.”

What made the difference  was the degree of organization and capacity of the public health departments in each community to plan and administer the vaccine, Fineberg said.

“So it wasn’t that it was only cities or only rural, rich or poor, it boiled down to ability to deliver.”

WATCH | Experts discuss strategies for Canada’s COVID-19 vaccine rollout 

As Canada prepares to distribute millions of doses of COVID-19 vaccines in January, Chair of the National Advisory Committee on Immunization Dr. Caroline Quach-Thanh and David Levine, who managed the H1N1 vaccine rollout for Montreal, say this vaccination campaign won’t be without challenges. 3:56

Dealing with ‘coincident events’

But one of the more significant problems of the program was the poor job officials did in communicating to the public when headlines emerged linking potential adverse effects to the vaccine, experts say.

“There are definitely — and this is going to be true this coming year — there will be coincident events,” Fineberg said.

“Preparing the public for expected coincidences simply because stuff happens every day, that’s really, really key,” he said.

During the 1967 vaccination program, three elderly people in Pittsburgh had heart attacks after receiving their vaccine. The publicity and headlines it generated led to a handful of states suspending their vaccination programs while they investigated a potential association, said George Dehner, an associate professor of history at Witchita State Univeristy and authour of Influenza: A Century of Science and Public Health.

While no link to the vaccination was found, polls at the time showed a significant decrease in the number of people who said they would get the vaccine because they feared some adverse effect, Dehner said.

A patient takes part in Pfizer’s COVID-19 vaccine clinical trial in May. On Sunday, a U.S. health official said the country’s first immunizations could begin on Dec. 12. (University of Maryland School of Medicine/File/The Associated Press)

There will be a certain expected death rate of people of a certain age on any given day, Pascal said. And what one has to look at is the death rate above the expected rate when running an immunization program.

“And so the CDC in this particular case did not do a good job of anticipating that and explaining that,” Dehner said.

But the vaccination rollout also saw dozens of people come down with the rare neurological disorder Guillain-Barre syndrome at a much higher rate than would be expected. Unlike the heart attacks, where no link was found, a scientific review has found there was an increased risk of Guillain-Barre syndrome after the swine flu vaccinations, according to the CDC. The exact reason for this link remains unknown.

In a 2009 interview with the The Bulletin, the health journal of the World Health Organization, Fineberg said those cases wouldn’t have been “a blip on the screen had there been a pandemic but, in the absence of any swine flu disease, these rare events were sufficient to end the programme.” 

Focus on science, not politics

When Guillain-Barre syndrome increased, some members of the public “became very skeptical and saw the whole thing as politically based, and not science-based,” said Richard Wenzel, emeritus chairman and professor of the Department of Internal Medicine at Virginia Commonwealth University.

“There was a concern that maybe politics was driving some public health responses.”

“One of the things that I would say we’re still trying to learn is policy should be scientifically based. What I mean is that whoever gives the message has to say, ‘Here’s what we know, here’s what we don’t know. And here are the assumptions we’re making currently that guide our policy.

“That sounds simple, but it’s rarely done, even today.”

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Dozens infected after BC hockey team brings COVID-19 back from Alberta | Offside – Daily Hive

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A recent trip to Alberta had unintended consequences for an adult hockey team from British Columbia.

BC Provincial Health Officer Dr. Bonnie Henry highlighted what she called “another cautionary tale” during her media briefing today, as the province reported another 834 new COVID-19 cases. Alberta, by contrast, reported more than double that number today.

“We know that there are sports teams in BC that have travelled to other provinces despite the restrictions that we’ve put in place,” said Henry.

“There’s a hockey team in the interior that travelled to Alberta and has come back and now there are dozens of people who are infected, and it has spread in the community,” said Dr. Henry. “We need to stop right now to protect our communities and our families, and our health care workers. This is avoidable and these are the measures that we need to take.”

While adult hockey was allowed to continue, this team was in clear defiance of the provincial health order, which bans “travel for teams outside of their community.” Dr. Henry said the players who contracted the virus in Alberta have since spread it to their family members, workplaces, and community upon return to BC.

“Making an exception for yourself, or for your team, or for your recreational needs puts a crack in our wall and we see that this virus can exploit that very easily,” she said.

While adult hockey was allowed in the most recent health order, it appears that will be changing very soon.

“We are putting additional restrictions on adult team sports indoors as we are recognizing that these are indeed higher risk activities as well. What we will be focusing on is structured programs or sport for children and youth, recognizing how important those are for our young people.”

Dr. Henry said there have been “several incidents that are similar to this,” and as such, she didn’t want to give away which specific region they came from or where they travelled to.

“I’m asking in the strongest of terms, to stay put,” she said. “To stay in our communities and to protect our communities.”

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Origin of Revelstoke cluster unknown, but some visitors did test positive for COVID-19 – BC News – Castanet.net

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Interior Health has not been able to identify how a large cluster of COVID-19 cases were introduced to the community of Revelstoke, however, the region’s chief medical health officer admits some non-residents have tested positive for the virus.

During a Zoom press conference Wednesday afternoon, Dr. Albert de Villiers said a “patient zero” has not been identified, despite Premier John Horgan stating earlier in the day that the cluster was caused by people travelling for recreation.

“What we can say with the numbers that we have seen that, yes, there are some people that are not residents in Revelstoke that sadly are infected as well,” said Dr. de Villiers.

“But having said that, we have also seen there is no one specific incident that led to the bigger number of cases. There are some that have been household clusters, some people picked it up when they went to a worksite, some people may have gone to a private function. There are rumours out there we haven’t been able to substantiate that someone went to a hot spring somewhere.

“I think there are different pieces of this. It’s not just one person that travelled in and caused all of this, I don’t think it’s as simple as that.”

Dr. de Villiers says people travelling in from other communities has been a factor in cases in other communities, which is why, he says, part of the provincial recommendations are for people not to travel outside their community if they don’t absolutely have to.

“Sadly, skiing is not essential to most people,” he said. “For recreation purposes, try to stick to your own community and stick to your own ski hill.”

Dr. de Villiers also addressed an online post out of Revelstoke where an individual asked to be infected with the virus so he could become immune.

He says they’ve seen it before with chicken pox and the measles, but it’s a bad idea with COVID-19 because people don’t know how they’ll react.

“Most people will have a relatively mild form of the disease…but there are people, relatively healthy people, that can develop complications. We’ve had people throughout Canada of all ages that have passed away,” he said.

“I don’t think we want to put people at risk unnecessarily.”

The doctor also explained why it took two weeks for IH to publicly disclose the cluster in Revelstoke.

He says over a two-week period there were only 10 cases, one every day or second day, which isn’t abnormal within communities.

“But, all of a sudden in one day, there were 12 more cases,” he said. “That’s why when we did announce it, it was 22, because there was one day that had more than usual.”

He said they do expect cases to pop up in communities, but the large one-day jump was reason to believe there may have been an issue.

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