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How new treatments could quiet the ‘perfect storm’ of respiratory viruses



As a virus leaves some babies under the age of two wheezing — adding to the pressure on Canada’s hospitals — drug makers are working on new treatment and vaccine options for the illness.

Respiratory syncytial virus, or RSV, gets the “S” in its name for large cells known as syncytia that form when infected cells fuse. Syncytia are prone to die off and plug up airways, leading to respiratory distress, Dr. Clement Lee, a pediatrician at Newton-Wellesley Hospital in Newton, Mass., said in a recent Twitter thread.

For most healthy people, though, the highly contagious virus feels like an ordinary cold.

Dr. Rod Lim, medical director for the pediatric emergency department at Children’s Hospital in London, said while many infants weather RSV just fine, the virus tends to present in young children almost like asthma, with wheezing.


Before the COVID-19 pandemic, children were commonly exposed to RSV between November and March. By two years of age, it’s estimated 90 per cent of us have been infected.

But this year, RSV arrived early in parts of Canada and the U.S., based on swabs of those in the hospital — it even circulated in the summer.

“We’re seeing viruses circulate at different times than we have,” Lim said at a virtual briefing hosted by the Ontario Medical Association.

“It’s a little bit of a perfect storm right now.”

Dr. Rod Lim, who heads the pediatric emergency department at the Children’s Hospital at London Health Sciences Centre, says the higher number of patients, staffing challenges and supply chain issues have combined to make the hospital busier. (Submitted by Rod Lim)

Protecting babies

Lim’s emergency department was built for about 100 visits a day, and on Tuesday, there were 280 visits, forcing staff to look for alternate spaces to care for people, he said.

Staffing challenges and supply chain issues for medications to reduce pain and fever are adding to the burden, he added.

WATCH | Easing anxiety over kids’ pain reliever supplies:


Shortage of children’s painkillers causes anxiety for parents

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Duration 2:03

Parents across Canada are growing increasingly anxious as a shortage of children’s painkillers that began this summer shows no signs of easing.

“If I had an ideal world, [it] would definitely not allow babies to get RSV and to get any kind of infections for the first two to three months,” Lim said.

Eram Chhogala, a registered nurse working in emergency rooms in the Greater Toronto Area, said she’s seeing families show up with multiple children needing treatment.

“We’re talking whole families of four, maybe even six,” Chhogala recalled in an interview. “You have, say, for example, three kids all with cough and fever. Three patients that require treatment for a fever.”

When the parents are asked if they gave Tylenol or Advil, they say, “Sorry, we couldn’t, because there was nothing left and we tried going everywhere,” the nurse said.

What’s more, RSV is circulating at the same time as the flu, COVID-19 and common cold viruses like rhinovirus and enterovirus are giving people fever, cough and other symptoms.

The risk of RSV getting down into the lower respiratory tract is always greatest during your first infection, says Dr. Jesse Papenburg. (Submitted by Owen Egan)

Why infants are most vulnerable

Dr. Jesse Papenburg, a pediatric infectious diseases physician at the Montreal Children’s Hospital of the McGill University Health Centre, said infants are particularly vulnerable to respiratory infections. In part, that’s because airways and thoracic or chest muscles get stronger as they grow.

“The risk of the virus getting down into the lower respiratory tract is always greatest during your first infection” with RSV, Papenburg said in an interview. “The way your body can handle that lower respiratory tract infection is very different when … you’re two years old versus when you’re two weeks old.”

Papenburg said his hospital is also extraordinarily busy with a surge in respiratory viruses, which adds to wait times. As well, elective surgeries get cancelled to free up staffed beds in intensive care and elsewhere.

The positivity rate for RSV was above 25 per cent last month, which he called extremely unusual.

Treatment pipeline opens

Infants are born susceptible to RSV because they don’t have antibodies to fight off the infection, Papenburg said.

Drug maker GSK is developing a vaccine program for pregnant individuals as well as older adults, an age group Papenburg said is also now considered at risk for complications from RSV.

Moderna said it plans a Phase 3 clinical trial of an mRNA vaccine for adults aged 60 and older.

Potential RSV vaccines from other companies are also in the works.

Vaccinating pregnant individuals could help protect infants, Papenburg said. That’s why pertussis (or whooping cough) vaccines are given in pregnancy, and the antibodies cross the placenta.

Earlier this month, Pfizer announced Phase 3 clinical trial results for its RSV vaccine candidate in a press release. The vaccine is given in pregnancy with the aim of protecting the infant.

Currently, those hospitalized for RSV receive supportive care for what brought them in, like dehydration or oxygen through a mask to ease their breathing.

Babies at high risk of RSV complications can be given monthly shots of a costly treatment called palivizumab during the regular RSV season. Some provinces and territories started rolling it out early this year.

Last week, drug makers Sanofi and AstraZeneca announced that the European Commission authorized a one-dose RSV drug called nirsevimab. It’s a laboratory-developed antibody designed to protect infants during their first exposure to RSV.

“You can give that one shot and the baby has protective levels of antibodies for the whole RSV season,” Papenburg said. “What the studies have shown is that it protects as well as palivizumab in terms of preventing hospitalizations” in both high-risk patients as well as otherwise healthy term infants.

The likely catch? Price.

“I think one of the big questions will be is, what will be the cost?” Papenburg said. “How much are we willing to pay to avert these hospitalizations due to RSV?”

Immunization advisory committees like NACI will likely be considering use of nirsevimab in all infants, said Papenburg, who reports potential conflicts of interest in the last 36 months from several drug makers, including AstraZeneca.

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Good morning! This is our daily news roundup with everything you need to know in one concise read. Sign up here to get this delivered to your inbox every morning.

The COVID emergency might end after 3 long years — but the virus is still a threat

It’s now been more than three years since SARS-CoV-2 began its march around the world, first as a virus totally foreign to humans, and later as an evolving pathogen capable of sneaking past our sharpened immune systems, infecting even those who’ve built up immunity from prior infections or vaccinations.

On Friday, a World Health Organization (WHO) committee is set to meet to consider whether the COVID-19 pandemic still represents a global public health emergency.


Multiple experts who spoke to CBC News said that regardless of what WHO decides in the days ahead, COVID-19 will remain a threat to our collective health for years to come — for a slate of different reasons — even as governments and the public move on.

“I know this is what happens at the end of pandemics,” Toronto-based microbiologist Dr. Allison McGeer said, “but watching it in real time is a bit depressing.”

WATCH | How WHO will decide if the COVID-19 emergency is over: 

How WHO will decide if the COVID-19 emergency is over

12 hours ago

Duration 5:04

There are reasons to be hopeful about the trajectory of the COVID-19 pandemic, even though this virus has claimed millions of lives.

By now, a majority of Canadians are vaccinated, which largely protects against serious illness. Drugs like Paxlovid are available for higher-risk groups, and critical care physicians have learned how to better treat those who do fall seriously ill.

As of mid-2022, vaccinated and boosted Canadians were three times less likely to be hospitalized — and five times less likely to die — than people who hadn’t gotten a single shot, federal figures show. 

Data from a B.C. research team also suggests SARS-CoV-2 has infected most of the population at least once, offering many people a blend of protective immunity through both viral exposure and vaccines. But most doesn’t mean everyone, McGeer stressed.

COVID-19 still killed hundreds of Canadians each week throughout much of the last year, and even now, the virus keeps finding new victims with grim regularity, she said, including isolated seniors and other high-risk individuals who managed to avoid the virus while taking precautions.

“We have too many older people who are as yet uninfected for it to plateau,” said McGeer. Read more on this story here.

Fashion flip

A model wears an upside-down blue dress at a fashion show in Paris.

(Stephane de Sakutin/AFP/Getty Images)

A model presents a creation for Viktor & Rolf during the haute couture spring-summer 2023 Fashion Week in Paris on Wednesday.

In brief

Canada is considering contributing four Leopard 2 tanks to Ukraine, senior sources told CBC News — but no decision has been made. The government could announce the donation of tanks as early as Thursday, the sources said. CBC News is not identifying the confidential sources because they were not authorized to speak publicly. One source said Canada is likely to send Ukraine the A4 variant of the tank — the oldest in the Canadian military’s inventory. Canada bought the A4s from the Netherlands during the Afghan war. The Globe and Mail first reported the number of tanks that Canada may send to Ukraine’s war effort. Read more here.

Alberta Premier Danielle Smith should call an independent investigation into contact between her office, the justice minister’s office and Crown prosecutors to put questions to rest, one political scientist says. Sources have told CBC News that Smith, over several months, asked for updates on cases or inquired whether it would be possible to abandon them. University of Calgary political science Prof. Lisa Young says questions about the actions of Smith and her staff may follow them until an impartial third party can look at the evidence. “There’s a lot of smoke around this, which suggests there is a fire,” Young said Wednesday. “And it’s very clear that there’s now a perception that something has gone on here. Which means, we need clarity.” Read the full story here.

As the union representing tens of thousands of federal public servants prepares to hold strike votes across the country, one expert in labour negotiations says we should be prepared for more contract disputes thanks to high inflation. Earlier this week, the Public Service Alliance of Canada (PSAC) announced it will hold strike votes for another 120,000 federal public servants, just two weeks after taking the same step for 35,000 taxation employees. The main issue during talks, which started in June 2021, appears to be wage increases, with PSAC asking for an annual increase of 4.5 per cent for 2021, 2022 and 2023. The government has countered by offering a 2.06 per cent raise on average over four years, an amount PSAC labelled as “insulting.” The negotiations have stalled, which doesn’t surprise Robert Hickey, an associate professor of industrial relations at Queen’s University. “The bargaining environment has been fundamentally changed by inflation,” said Hickey. “What PSAC is asking seems high, but in the context of relatively high inflation it’s not outside the ballpark for a starting offer.” Read more on this story here.

LISTEN | AI-generated essays are a growing concern, so this Canadian student created a free app to detect them: 

The extent of real estate fraud and its links to organized crime

3 days ago

Duration 3:26

Nearly a year after discovering something was wrong with their property, Stephanie and Derrick are sharing their story to sound the alarm on how they say current identification requirements in real-estate transactions are failing to protect homeowners from fraud. CBC Toronto is not using the couple’s real names because they are the victims of identity theft. “All the things you need to provide to buy a house, no one ever checks if those match up when you sell a house,” alleges Derrick. “You trust these institutions to protect you and it feels like they’re doing whatever they can to do things as fast and as cheap as possible.” The couple says the fraudsters who impersonated them to sell their house consistently spelled one of their last names wrong through the transaction, which was inconsistent with the fake ID they were using. Read the full story here.

WATCH | The extent of real estate fraud and its links to organized crime: 

Bank of Canada hikes interest rates again to 4.5%

13 hours ago

Duration 2:40

If you are one of those Canadians who remain confident that central bank governor Tiff Macklem has a good handle on the economy, the future looks pretty bright. “It’s working,” Macklem boasted at Wednesday’s monetary policy news conference. Yes, another quarter-point rate hike means Canadians paying off their mortgages will now be forking out 4.25 percentage points more than they expected just two years ago. And yes, interest costs on those lines of credit so many Canadians still carry will rise above seven per cent instead of the two per cent when the bank lent them the money. But according to Wednesday’s monetary policy report, not only does the Bank of Canada seem to think it may have inflation pretty well licked, Macklem said he expects the Canadian economy will pay a relatively mild price over the next six to nine months compared to some of the most worrying predictions. Not everyone shares his optimism, and even Macklem admits it won’t be painless. Read more here

WATCH | Bank of Canada hikes interest rates again to 4.5%: 

Day 69:03AI-generated essays are a growing concern, so this Canadian student created a free app to detect them

Edward Tian, 22, of Toronto created GPTZero in response to the wildly successful artificial intelligence content-generating app ChatGPT, to give people a way to ascertain whether writing samples were produced by humans or bots. ChatGPT came out in November, and was released by San Francisco-based OpenAl. Users can ask it questions and assign it to produce things such as essays, poetry or computer code. It then scrapes text from across the internet to formulate a response. When it surfaced, educational institutions were concerned about it being used for cheating. Tian’s program, GPTZero, which was released in early January, is free and was designed to red flag AI-generated writing. “I think writing can be so beautiful,” said the computer science and journalism student. “There are parts and qualities of human writing that the machines can never do.” Read Tian’s conversation with Day 6 host Brent Bambury

Now for some good news to start your Thursday: It took 50 years, and it was worth every minute for Vic Mercredi to see his face on an NHL rookie card. Mercredi is one of eight Indigenous NHLers to be featured in the First Peoples Rookie Card series, from trading card company Upper Deck. He still plays hockey casually with his kids and grandkids, but it’s been five full decades since he was drafted by the Atlanta Flames. The picture on his card features a young Mercredi — a photo taken back during his first day of training camp for the purpose of cards and programs. “Fifty years later? Better late than never,” Mercredi said with a chuckle. “It is quite an honour to have something like that at this point in my life.” Read more on this story here.

Nothing is Foreign: ‘No future here,’ says man who fled Russia after getting draft notice

As Russia’s invasion of Ukraine drags on, experts say Vladimir Putin is preparing to do what was once unthinkable: launch another wave of mobilization. 

Russian military analysts say Putin is preparing the country for a long war and needs the extra recruits. In addition, Ukrainian intelligence officials have also claimed that a second round of mobilization is imminent.

But what do ordinary Russians think? This week, Nothing is Foreign speaks to a Russian man who fled when he first received his draft notice. He says that if the war effort persists, he does not see a future for himself and his family in Russia.

Nothing is Foreign28:54‘No future here,’ says man who fled Russia after getting draft notice

Today in history: January 26

1891: Famed Montreal brain surgeon Dr. Wilder Penfield is born in Spokane, Wash. He accurately mapped the cortical areas related to speech for the first time. He also discovered that stimulation of the temporal lobes provoked startlingly vivid recollections — proof of the physical basis of memory.

1905: The world’s largest uncut diamond is found in South Africa. The 3,100-carat Cullinan diamond weighed more than 600 grams.

1950: India becomes a sovereign democratic republic — the first within the Commonwealth.

2006: Hudson’s Bay, Canada’s oldest company, accepts a friendly $1.5-billion takeover offer from U.S.-based Maple Leaf Heritage Investments, headed by Jerry Zucker.

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Northumberland Hills Hospital declares COVID-19 outbreak – 93.3 myFM



Northumberland Hills Hospital has declared an outbreak in COVID-19 cases.

The hospital is experiencing its first surge in COVID-19 cases since October 2022.

They’ve temporarily paused visiting to NHH’s Inpatient Rehabilitation Unit due to four active COVID-19 cases among admitted inpatients.


Visiting continues as usual outside the unit unless patients are in isolation for COVID-19 infection or exposure.

Written by Lee McConnell

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Top doctor says Ontario 'must remain vigilant' past flu peak, COVID variant advances – TimminsToday



TORONTO — Ontario’s top doctor says even though COVID-19 and flu activity is declining, the province “must remain vigilant” as a more transmissible variant gains ground. 

In a statement, Dr. Kieran Moore says parts of Ontario are reporting a rise in the number of cases of the more easily spreadable XBB 1.5 variant of COVID-19. 

He says while the new strain has not been associated with more severe illness, infections could climb as it becomes the “main variant in Ontario.”


Moore says Ontario is seeing a decline in COVID, respiratory syncytial virus and flu activity throughout the province, offering some relief to hard-hit hospitals.

In recent weeks, Ontario pediatric hospitals have ramped up surgeries after a three-month surge of flu and RSV cases pushed them to redeploy staff to intensive care units and emergency departments. 

Moore says flu cases peaked at the end of November and continue to decline.

This report by The Canadian Press was first published Jan. 26, 2023. 

The Canadian Press

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