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Flu Shot a Mismatch for Main Strain, Season Far From Over: CDC – Medscape

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Influenza is still going strong in the United States and isn’t expected to slow down for at least several more weeks, according to a report from the Centers for Disease Control and Prevention (CDC).

What’s more, this season’s vaccine is only a 58% match for B/Victoria, the strain that is hitting children especially hard.

“It’s not a very good match for B/Victoria,” Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, told CNN. “It’s not an awful match, but it’s not a very good match.”

Nationally, the predominant virus is B/Victoria, followed by A(H1N1)pdm09 viruses, with the predominant virus varying by region and age group. A(H3N2) and B/Yamagata viruses are circulating in low numbers.

“Key indicators that track flu activity remain high, but indicators that track severity are not high at this point in the season,” the CDC explains in the report.

Although levels of outpatient visits for influenza-like illness (ILI) remain elevated, hospitalization rates and the percentage of deaths resulting from pneumonia and influenza remain low.

“This is likely due to the predominance of influenza B/Victoria and influenza A(H1N1)pdm09 viruses which are more likely to affect children and younger adults than the elderly. Because the majority of hospitalizations and deaths occur among people age 65 and older, with fewer illnesses among that group, we expect, on a population level, to see less impact in flu-related hospitalizations and deaths,” the CDC explains.

Outpatient visits for ILI activity fell from 7% the previous week to 5.8%. “The decrease in the percentage of patient visits for ILI may be influenced in part by changes in healthcare seeking behavior and influenza virus transmission that can occur during the holidays,” the CDC notes in its report.

Regionally, the percentage of outpatient visits for influenza ranged from 3.6% to 8.6%, with all regions reporting a percentage of outpatient visits for influenza that were equal to or higher than their region-specific baselines.

The percentage of respiratory specimens that tested positive for influenza in clinical laboratories fell to 23.6% from 26.4% during the last week of 2019.

ILI activity was high in the District of Columbia, New York City, Puerto Rico, and 33 states; moderate in six states (Alaska, Indiana, Michigan, Minnesota, Rhode Island, and South Dakota); and low in eight states (Florida, Hawaii, Missouri, Montana, Nevada, Ohio, Vermont, and Wyoming).

Activity was minimal in New Hampshire and there were insufficient data to calculate ILI activity for Delaware, Idaho, and the US Virgin Islands.

Geographically, influenza activity was widespread in Puerto Rico and 46 states, regional in three states (Mississippi, North Dakota, and Vermont), local in the District of Columbia and Hawaii, and sporadic in the US Virgin Islands. Guam did not report.

Hospitalizations and Deaths

According to the CDC’s estimates, there have been at least 9.7 million illnesses, 87,000 hospitalizations, and 4800 deaths from influenza this season.

Between October 1, 2019, and January 4, 2020, 4228 laboratory-confirmed hospitalizations were reported. Of those, 2299 (54.4%) were linked to influenza A virus, 1906 (45.1%) to influenza B virus, 13 (0.3%) to influenza A virus and influenza B virus coinfection, and 10 (0.2%) to influenza virus, which had not been typed.

Among patients for whom influenza A subtype information was available, 461 (86.0%) were A(H1N1)pdm09 virus and 75 (14.0%) were A(H3N2) virus.

The overall cumulative hospitalization rate was 14.6 per 100,000 population. The rate was highest for those aged 65 years or older (33.3%), followed by children younger than 5 years (26.8) and those aged 50 to 64 years (17.0).

The percentage of deaths from pneumonia and influenza edged up to 5.8% (epidemic threshold 6.9%), from 5.5% during week 52 of 2019.

During week 1 of this year, the CDC received reports of five influenza-associated pediatric deaths that occurred during the weeks ending December 28, 2019, and January 4, 2020. Three of those were linked to influenza B viruses for which lineage was not determined, and two were related to influenza A(H1N1)pdm09 viruses.

So far, the CDC has received reports of 32 influenza-associated pediatric deaths that occurred this season, compared with 16 at this point last season. Of those, 21 deaths were related to influenza B viruses, five of which had lineage determined and were all B/Victoria viruses. Eleven deaths were linked to influenza A viruses, six of which underwent subtyping and were all A(H1N1)pdm09 viruses.

Influenza B viruses can cause severe illness in adults and children; however, adults often have built-up immunity from previous infections, whereas children may not have.

Both influenza A viruses and influenza B viruses can cause serious illness in adults and children; therefore, the CDC recommends vaccination for everyone aged 6 years or older and antiviral medications as soon as possible after illness onset.

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Possible COVID-19 exposure at 11 Prince Albert, Rosetown businesses: SHA – Global News

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Researchers whose projections for the spread of the novel coronavirus have proven grimly accurate for the United States say the number of deaths in Canada could surge dramatically late this year, unless measures change.

The latest model from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington says Canada could see 16,214 deaths by Jan. 1. That number drops down to 12,053 fatalities if masks are universally worn by people across the country.

At least one expert has expressed doubt on the projections, however, saying they don’t take increased protections for vulnerable populations into account.

Read more:
Canada ‘on the brink’ of coronavirus surge, second wave underway in some regions: Trudeau

Since the coronavirus was first detected in Canada in January, 9,244 Canadians to date have died of complications from COVID-19, the disease caused by the virus.

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Dr. Ali Mokdad, a member of the IHME’s senior management team and a professor of health metrics sciences, says the majority of the projected deaths will likely occur in December.






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Coronavirus: Trudeau says 2nd wave of COVID-19 infections ‘already underway’ in 4 biggest provinces


Coronavirus: Trudeau says 2nd wave of COVID-19 infections ‘already underway’ in 4 biggest provinces

“That’s when the weather will get much colder and align with what we see during a pneumonia season,” he said.

“We’re seeing the same pattern over and over between COVID-19 and pneumonia in every country in the southern hemisphere, and now that’s heading in our direction.”

While coronavirus cases have been surging across Canada over the past week, with over 1,000 new cases being reported daily, deaths have stayed relatively flat for months. The country hasn’t reported over 20 daily deaths since July 3, and has seen fewer than 10 nearly every day in September.

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But Mokdad says that could change if cases don’t start trending downward. He pointed to the U.S., where deaths began spiking over 1,000 a day roughly a month after cases surged this past summer.

“We saw this in other countries too: when you start opening schools and businesses, who’s more likely to go there? The younger generation,” he said.

“But they don’t live in a bubble. So they’ll start interacting with their parents and grandparents, and that’s when you’ll start to see a spike in mortality.”

Read more:
Canada is not in a second wave, but coronavirus cases increasing sharply: Tam

According to the IHME’s modelling, the majority of new deaths in Canada will be seen in Ontario and Quebec, which Mokdad says is based on population size. Ontario could rise from over 2,800 deaths now to 5,773 by Jan. 1 if measures stay the same. Quebec, which has seen more than 5,800 fatalities to date, is projected to jump to 9,825.

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The death tolls in British Columbia and Alberta, the other two provinces currently driving up the national case numbers, are projected to remain relatively flat through the winter, according to the modelling.


Click to play video 'Coronavirus: Canadians should ‘redouble their efforts’ at preventing COVID-19 spread as national case count rises, Tam says'



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Coronavirus: Canadians should ‘redouble their efforts’ at preventing COVID-19 spread as national case count rises, Tam says


Coronavirus: Canadians should ‘redouble their efforts’ at preventing COVID-19 spread as national case count rises, Tam says

Stephen Hoption Cann, an infectious disease expert at the University of British Columbia, thinks the IHME’s model doesn’t reflect protections now in place for vulnerable people like the elderly, which could help limit any new deaths.

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“We’re seeing more caution when it comes to long-term care residents, immune compromised people, where we’re limiting their interactions and keeping them protected,” he said.

That, coupled with the lower mortality rate among younger patients, makes Hoption Cann think the fall and winter could be less deadly than anticipated.

Read more:
Wearing a mask may reduce how sick you get from coronavirus

“So many people I talk to now who are in that older group, they simply don’t want to take the risk of opening themselves up to more interaction and the like,” he said. “So if that continues, we’ll be in a better place.”

What can bring the numbers down?

The IHME model has been considered a tentpole for data mappers during the pandemic and has been frequently cited by the White House Coronavirus Task Force. It has also largely aligned with projections from the country’s Centres for Disease Control and Prevention.

After projecting earlier this year that the U.S. would surpass 200,000 deaths in September — which proved to be accurate — the model now estimates there could be up to 371,509 lives lost by Jan. 1.

Modelling released by the Public Health Agency of Canada on Tuesday only goes as far as early October, when it predicts Canada’s death toll will reach up to 9,300. However, it does suggest cases could see a major upswing through October into early November if measures aren’t tightened, potentially reaching up to 5,000 new cases daily.

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COVID-19 modelling released by the Public Health Agency of Canada on Sept. 22, 2020, shows Canada could see a major upswing to as high as 5,000 new cases daily by November if measures don’t change.


COVID-19 modelling released by the Public Health Agency of Canada on Sept. 22, 2020, shows Canada could see a major upswing to as high as 5,000 new cases daily by November if measures don’t change.


Public Health Agency of Canada

While Hoption Cann says that upswing could lead to a surge in deaths a month later, he again said the majority of deaths projected by the IHME can be avoided.

“It all depends on what kind of further measures the provinces put in place to tamp down this rise in cases we’re seeing,” he said. “I don’t think we’ll see widespread business closures, but they’ll likely just ask people to kick what they’re already doing into a higher gear.”

Canada’s chief medical officer Dr. Theresa Tam said this week that the current surge can be countered if people “redouble their efforts with personal precautions.” In his address to the nation Wednesday, Prime Minister Justin Trudeau echoed that plea and said he’s confident Canadians can “bend the curve” together again.


Click to play video 'Coronavirus: Trudeau says Canada can ‘bend the curve’ together again'



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Coronavirus: Trudeau says Canada can ‘bend the curve’ together again


Coronavirus: Trudeau says Canada can ‘bend the curve’ together again

Mokdad agreed, saying widespread mask-wearing could help control the spread of COVID-19.

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“If 95 per cent of people in Canada wear a mask … you can avoid many of the cases and deaths that we are projecting,” he said.

“We can’t avoid new cases and deaths entirely, because we have schools and businesses open and the weather is getting colder. But masks can make a difference.”

Read more:
As coronavirus resurges, ‘now is the time’ to push COVID Alert app: experts

He pointed to countries like Singapore and American states like Alabama where universal mask mandates have brought down infection rates.

Mokdad, who is watching the Canadian response to the pandemic from the U.S., says he admires the steps Ottawa has taken to help flatten the curve — particularly compared to the conflicting messages coming from Washington, D.C.

“(Canada) went by the book,” he said. “The lockdown early on, the testing, all was by the book. But the most important part that was done right was the cohesive national message given to the public.

“And Canadians have done a better job than Americans at following those messages.”


Click to play video 'Coronavirus: CDC director says 90% of U.S. population still at risk for COVID-19'



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Coronavirus: CDC director says 90% of U.S. population still at risk for COVID-19


Coronavirus: CDC director says 90% of U.S. population still at risk for COVID-19

With 20 years of experience working at the CDC before joining the IHME, he says it’s “frustrating” to watch the institution struggle to deliver a clear message to Americans.

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“We have taught other countries how to handle situations like this one,” he said. “So when you’re watching people all over the world dealing with the pandemic, and you know that you taught them how to do it, and they have done what you taught them — why the people here are not doing the same thing here, and not being allowed to in some ways, it’s very frustrating.

“I’m a very optimistic guy. If we get our act together (in the United States), if we are united but not divided and let science dictate policies, then we can do what you guys have done.”

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

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2 students test positive for COVID-19 in North York in 1st Toronto school outbreak – CBC.ca

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Two students have tested positive for COVID-19 at a North York elementary school, marking the city’s first school-based outbreak. 

Two class cohorts at Glen Park Public School— one with 17 children and the other with 18 — were sent home to self-isolate for 14 days, said Dr. Eileen de Villa, the city’s medical officer of health, at a news conference Friday afternoon.

“All steps have been followed as expected in a situation of this nature,” she said.

Parents in the school community were notified in writing, she said, adding that protocols at the school continue to be strictly followed, including masking requirements and enhanced cleaning measures. 

“One of the realities of living in a world with COVID-19 is that there will be cases in schools,” de Villa said. 

“Today’s news is expected. I expect there will be similar announcements in future and you can be confident the steps developed to manage the situation and reduce the risk of spread will be followed,” she added. 

This occurrence qualifies as an outbreak, de Villa said, because it fits the definition of at least two cases within a 14-day period with one at least linked to the school. 

And she said declaring it as an outbreak means a swift response.

“That’s really what the point of declaring the outbreak is,” she said. “[It’s] to make sure that you’re marshalling all the resources necessary, that the appropriate attention is paid to the circumstances so that we can manage the risk and reduce transmission.” 

The Toronto District School Board posted on Twitter that it had updated its mask guidelines as a result of rising cases in the city, as well as due to confirmed cases in their community. 

4 Toronto businesses caught breaking COVID-19 rules

Toronto’s top public health official also ordered four hospitality businesses to close on Friday after it was discovered they weren’t following the rules. 

The businesses were flouting public health protocols and evading investigators, de Villa said. She added that some were pressuring staff to work even when sick.

The businesses, whose names she did not share because the operation to shut them down was not yet complete, will be allowed to reopen once the city is satisfied they’ll follow the rules. 

“In these circumstances, the action taken is the right action to protect your health. The names of the affected businesses and their locations will be released to media once the process of serving the orders is completed,” she said. 

While the reasons for the closures were “distinct” to each business, de Villa said Toronto Public Health found that “many people” were connected to more than one of the four businesses.

De Villa said some people who were infected with COVID-19 worked at more than one of the four locations.

In one instance, a business was also found to serve food buffet-style, which is prohibited by provincial regulations. 

She added that the operators of the locations were so uncooperative that the city’s investigation efforts were “significantly impeded.” 

Businesses who have complied with the city’s investigations, she said, are commended for stepping up. 

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Number of COVID-19 cases in schools on the rise in Quebec – Global News

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Two Lower Canada College (LCC) teachers have tested positive for COVID-19, according to the school.

The college located in the Notre-Dame-de-Grâce borough sent a letter to parents with the news Thursday.

“In order to limit the possibility of further transmission in the school and after consulting with Public Health, teachers and staff who were in close contact with these teachers have been asked to be tested for COVID-19 and will remain at home for a period of 14 days following their exposure,” the letter read in part.

Read more:
Coronavirus: Quebec school bus drivers want to be informed of positive cases they’ve transported

According to the school’s headmaster Christopher Shannon, no student was exposed. Shannon says teachers are in full personal protective equipment when they are with students and maintain a two-metre distance at all times.

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Lower Canada College is just one of 489 schools that have reported cases of the virus in Quebec so far, according to numbers released by the province on Friday.

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It brings the total of cases in schools to 1,163 of which 722 are currently active.

Read more:
Quebec reports 377 coronavirus cases at 223 schools

Olivier Drouin, a Montreal-based parent who decided to track COVID-19 cases in schools on a website he created, says he’s alarmed about the increase in cases lately.

Drouin believes it’s time for the government to take more measures in schools.

“I am worried and I would like at least — if the schools are going to stay open — that we introduce maybe mandatory masks in schools, or a little bit more of social distancing, or online learning,” Drouin said. “But [that] doesn’t seem the way the government is going right now.”






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Coronavirus: Parents worried over differing protocols in Quebec schools


Coronavirus: Parents worried over differing protocols in Quebec schools

Health officials insist schools are not a problem.

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READ MORE: Quebec raises coronavirus alert level for Montreal, other regions as situation becomes ‘critical’

“There are a lot of cases because there are a lot of schools and schools are a reflection of what’s going on in the community,” said Dr. Horacio Arruda, Quebec’s public health director.

“There’s going to be small outbreaks under control. If they are not in control then we can go to other steps.”

Arruda added that the virus is being brought into schools rather than it being a matter of schools driving the spread.

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

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