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How many people died in BC during the first COVID-19 waves? – Powell River Peak

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British Columbia’s excess mortality rate dwarfed all other provinces in Canada during the first year of the COVID-19 pandemic, a new study says.

The peer-reviewed report, published in the Canadian Medical Association Journal Monday, used public data to look at how many excess deaths occurred in each of Canada’s provinces from March 2020, at the start of the pandemic, to October 2021, over a year and a half later. 

Excess mortality measures how many deaths actually occurred compared to what was expected under normal circumstances. It’s one way researchers have been able to figure out the true number of lives lost due to COVID-19. But what emerged from the research was a huge gap in the number of unexpected deaths each province recorded in period just before the Omicron variant hit.

“I think we all know that there have been deaths related to COVID. But to see the differences, at least in these estimates? …It was surprising,” said the study’s author, Kimberlyn McGrail, a professor at the University of British Columbia’s School of Population and Public Health.

In her analysis, McGrail used Statistics Canada data to track the observed number of deaths. She then compared those numbers with a model that estimated how many deaths would have occurred if the pandemic never happened. 

She found that during the first year of the COVID-19 pandemic, Canada saw a roughly five per cent increase in excess mortality. That’s higher than many countries but fewer than the United Kingdom, which recorded an 18 per cent increase in excess deaths, or the United States, which saw excess mortality climb to 22 per cent into early 2021. 

In Canada, McGrail calculated the mortality rates on a per 100,000 population basis. That way, she could directly compare provinces with different populations. The researcher avoided analyzing excess deaths in Canada’s three territories because of the small number of pre-Omicron COVID-19 cases reported there. 

In the end, McGrail found excess mortality was lowest in Canada’s eastern provinces — even dropping below what was expected in Prince Edward Island and Nova Scotia. 

Quebec had the highest reported COVID-19 mortality rate in Canada. But while there were moments during the pandemic where excess deaths outpaced reported deaths, at other times, there were “substantial periods during which mortality rates were lower than expected,” even dropping below zero.

Ontario appeared to have the smallest gap between reported COVID-19 deaths and excess mortality, something that suggested the province was the best at tracking pandemic deaths. 

With a 4.5-fold gap between reported COVID-19 deaths and excess mortality, B.C. outstripped all other provinces in the number of excess deaths that went unreported. Only Alberta and Saskatchewan came close to Canada’s westernmost province.

Determining how people have died throughout the pandemic has challenged health officials and vital statistics agencies globally. To date, nearly 6.3 million people have officially died from COVID-19 across the world. But some have estimated the real COVID-19 death toll could be three times higher

As the gap in B.C. makes clear, the virus wasn’t the only factor pushing up death rates to unexpected highs.

Heat dome drives highest weekly excess mortality rates in Canada

During the 2021 heat dome in late June, excess deaths per 100,000 people in B.C. literally spike off the chart, climbing to 90 deaths per 100,000 people. That’s higher than the weekly excess death rate anywhere in Canada at any time during the pandemic.

“Alberta, B.C. and Saskatchewan stand out for having had excess mortality rates nearly double (or more) those of other provinces,” wrote McGrail.

McGrail says the “remarkably diverse” mortality patterns across Canada likely have a number of explanations. She notes limited testing capacity, deaths occurring in the community rather than a hospital and different public health reporting practices all likely played a role in deciding whether or not to classify a cause of death as COVID-19-related.

“These provincial variations suggest to me that the very first thing to understand is how the different approaches to testing, contact tracing and encoding — identifying COVID-related deaths — might vary across the provinces,” she said.

Another wildcard factor that could have impacted how many people died in the first year of the pandemic: delayed or cancelled surgeries, diagnostic tests or doctor appointments.

To get a better understanding of which province actually had a “COVID-19 problem,” McGrail says differences in public health reporting practices need to be ruled out as a cause first. 

In places and times where mortality rates dipped below what was expected, McGrail points to a pandemic decline in car accidents due to fewer people on the road, and a reduction in influenza-related deaths. The Statistics Canada data, she said, currently doesn’t count avoided deaths as a result of COVID-19 measures. 

Other factors that need to be looked at include how pandemic policies and border shutdowns impacted an unsafe drug supply, leading to more people using and overdosing on opioids alone, said McGrail in her report.

A surge in unexpected deaths in B.C.

B.C. reported 9,496 excess deaths by October 2021, more than double that of Quebec and nearly as many as Ontario, a province with a much larger population.

Of those deaths, only 2,109 — or 22 per cent — were attributed to COVID-19. It’s not clear to what degree the opioid crisis and June 2021 heat wave drove the other nearly 7,400 unexpected deaths. But over that same period, the BC Coroners Service reported 3,416 people died overdosing on illicit drugs — more than suicides, murder and motor vehicle accidents combined. The heat wave is thought to have killed just shy of 600 people.

Even if those two causes of death were taken away, that still leaves roughly 3,000 deaths unaccounted for under normal conditions. 

Pointing to the collision of the SARS-CoV-2 virus, public policy and climate change, McGrail noted a potential cascading effect leading to the most vulnerable facing a double or even triple crisis. 

McGrail cited a Human Rights Watch report released in October 2021 that concluded an inadequate response from B.C. authorities made heat-related deaths worse in the province. But because those deaths were “highly associated with social and material deprivation,” COVID-19 and the poverty that came with it may well have set the stage for the most vulnerable to suffer the worst effects from extreme heat.

“If you think about the implications of COVID, they would have had some impact on the heat dome deaths because it would have affected the policy response,” McGrail said, pointing to public health measures that pushed people, in particular older British Columbians, to isolate. 

McGrail called for all provinces and territories to come together and conduct a forensic analysis of how mortality has played out over the pandemic. To that end, she has shared her work with federal and B.C. government health authorities and plans to reach out to more now that her work is public. 

Reforming the system tracking deaths could not come too soon. One international analysis from The Economist found that Canada is three to four months behind its peers in reporting deaths. 

“Even the basic recording of mortality, we’re very slow in Canada. That surely could and should be fixed,” said McGrail.

But it’s not just the government she is trying to convince.

On a second front, McGrail says more work needs to be done to involve the public in responding to public health crises.

“When we have another one of these events… part of our response is going to be being able to rally community organizations, community groups and the public at large very quickly,” she said. 

“And that requires information. That requires trust.”

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First reported case of a person getting COVID from a cat – Nature.com

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Cats can catch and transmit SARS-CoV-2.Credit: Vachira Vachira/NurPhoto/Getty

First there were sneezing hamsters, now sneezing cats. A team in Thailand reports the first solid evidence of a pet cat infecting a person with SARS-CoV-2 — adding felines to the list of animals that can transmit the virus to people.

Researchers say the results are convincing. They are surprised that it has taken this long to establish that transmission can occur, given the scale of the pandemic, the virus’s ability to jump between animal species, and the close contact between cats and people. “We’ve known this was a possibility for two years,” says Angela Bosco-Lauth, an infectious-disease researcher at Colorado State University in Fort Collins.

Studies early in the pandemic found that cats shed infectious virus particles and can infect other cats. And over the course of the pandemic, countries have reported SARS-CoV-2 infections in dozens of pet cats. But establishing the direction of viral spread — from cat to person or from person to cat — is tricky. The Thai study “is an interesting case report, and a great example of what good contact tracing can do”, says Marion Koopmans, a virologist at the Erasmus University Medical Center in Rotterdam, the Netherlands.

The feline finding, published in Emerging Infectious Diseases1 on 6 June, came about by accident, says co-author Sarunyou Chusri, an infectious-disease researcher and physician at Prince of Songkla University in Hat Yai, southern Thailand. In August, a father and son who had tested positive for SARS-CoV-2 were transferred to an isolation ward at the university’s hospital. Their ten-year-old cat was also swabbed and tested positive. While being swabbed, the cat sneezed in the face of a veterinary surgeon, who was wearing a mask and gloves but no eye protection.

Three days later, the vet developed a fever, sniffles and a cough, and later tested positive for SARS-CoV-2, but none of her close contacts developed COVID-19, suggesting that she had been infected by the cat. Genetic analysis also confirmed that the vet was infected with the same variant as the cat and its owners, and the viral genomic sequences were identical.

Low risk

Researchers say that such cases of cat-to-human transmission are probably rare. Experimental studies have shown that infected cats don’t shed much virus, and shed for only a few days, says Leo Poon, a virologist at the University of Hong Kong.

Still, Chusri says it is worth taking extra precautions when handling cats suspected of being infected. People “should not abandon their cats, but take more care of them”, he says.

Other animals suspected of infecting people include farmed mink in Europe and North America, pet hamsters in Hong Kong and wild white-tailed deer in Canada. Adding cats to the list “expands our understanding of the zoonotic potential of this virus”, says Poon.

But researchers say these are all rare events and animals don’t yet play a significant part in spreading the virus. “Humans are clearly still the major source of the virus,” says Bosco-Lauth.

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WHO warns of monkeypox risk to kids, pregnant people if spread continues – CBC News

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The World Health Organization said “sustained transmission” of monkeypox worldwide could see the virus begin to move into high-risk groups, such as pregnant people, immunocompromised people and children.

WHO said on Wednesday it is investigating reports of infected children, including two cases in the United Kingdom, as well as following up reports in Spain and France. None of the cases in children have been severe.

The virus has now been identified in more than 50 new countries outside the countries in Africa where it is endemic. Cases are also rising in those countries, said WHO, calling for testing to be ramped up.

“I’m concerned about sustained transmission because it would suggest that the virus establishing itself and it could move into high risk groups including children, the immunocompromised and pregnant women,” said WHO chief Tedros Adhanom Ghebreyesus.

Sustained transmission is characterized by the World Health Organization as an illness that can transmit easily from one person to others in the population.

Monkeypox is usually mild, and is endemic in parts of western and central Africa. It is spread by close contact, so it is relatively easy to contain through measures such as self-isolation and hygiene. 

A monkeypox virus particle is seen in this coloured transmission electron micrograph. The World Health Organization is warning that the virus could pose a risk to vulnerable people if it continues to spread. (UK Health Security Agency/Science Photo Library)

There have been more than 3,400 cases of monkeypox and one death since the outbreak began in May, largely in Europe among men who have sex with men, according to a WHO tally. There have also been more than 1,500 cases and 66 deaths in countries this year where the disease more commonly spreads.

At least 275 cases of monkeypox have been confirmed in Canada. Those include 202 cases in Quebec, 67 cases in Ontario, four in Alberta and two in British Columbia.

The Public Health Agency of Canada (PHAC) declined to comment on WHO’s warning on Wednesday.

Health officials will likely face questions about Canada’s monkeypox response at a media conference scheduled for 11 a.m. ET on Thursday.

Not a global health emergency ‘at this stage’

WHO’s warning comes days after it said the global outbreak of the virus should be closely monitored, but does not warrant being declared a global health emergency.

In a statement Saturday, a WHO emergency committee said many aspects of the outbreak were “unusual” and acknowledged that monkeypox — which is endemic in some African countries — has been neglected for years.

“While a few members expressed differing views, the committee resolved by consensus to advise the WHO director general that at this stage the outbreak should be determined to not constitute” a global health emergency, WHO said in a statement.

WHO nevertheless pointed to the “emergency nature” of the outbreak and said controlling its spread requires an “intense” response.

The committee said the outbreak should be “closely monitored and reviewed after a few weeks.” But it said it would recommend a re-assessment before then if certain new developments emerge, such as cases among sex workers, spread to other countries or within countries that have already had cases, increased severity of cases or an increasing rate of spread.

The UN agency said it was also working on a mechanism to distribute vaccines more equitably, after countries including Britain and the United States suggested they were willing to share their stockpiled smallpox vaccines, which also protect against monkeypox.

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Heart Attack Drug Proves Effective at Treating Stroke – Technology Networks

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In the largest stroke clinical trial ever run in Canada, researchers have shown Tenecteplase (TNK), a safe, well tolerated drug, commonly used as a clot buster for heart attacks, is an effective treatment for acute ischemic stroke. Led by researchers with the University of Calgary at the Foothills Medical Centre and Sunnybrook Health Sciences Centre, fully affiliated with the University of Toronto, the study included 1600 patients at hospitals throughout Canada.

“It is truly an important finding that I share with my colleagues from coast to coast. Through this collaboration these findings could revolutionize stroke treatment throughout the world,” says Dr. Bijoy Menon, MD, professor at the University of Calgary, neurologist at the Foothills Medical Centre and co-principal investigator on the study. “Tenecteplase is known to be an effective clot dissolving drug. It is very easy to administer which makes it a game changer when seconds count to save brain cells,”

Based on current guidelines, Alteplase (tPA) is the recommended drug for acute ischemic stroke patients. The challenge is that the drug is more complex to administer. It takes up to an hour and requires an infusion pump that needs to be monitored. The pump can be cumbersome when transporting a patient within a hospital, or to a major stroke center for treatment.

“One of the reasons Tenecteplase is so effective is that in can be administered as a single immediate dose,” says Dr. Rick Swartz, MD, PhD, clinician-researcher at the University of Toronto, co-principal investigator, and stroke neurologist at Sunnybrook Health Sciences Centre. “That’s a big advantage, saving critical time and complication. TNK could potentially be administered wherever the patient is seen first, at a medical centre or small hospital,”

The AcT Trial compared TNK to tPA in a randomized trial. The results published in The Lancet show that TNK worked as well as, if not better than, the current recommended drug, tPA. TNK attaches itself to the clot for a longer period of time than tPA which means that blood flow is restored faster and for a longer period of time. Along with discovering a better way to treat acute ischemic stroke, the team also established a more cost effective, and efficient way to conduct clinical trials. 

Reference: Menon BK, Buck BH, Singh N, et al. Intravenous tenecteplase compared with alteplase for acute ischaemic stroke in Canada (AcT): a pragmatic, multicentre, open-label, registry-linked, randomised, controlled, non-inferiority trial. The Lancet. 2022;0(0). doi: 10.1016/S0140-6736(22)01054-6

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

 

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