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How will COVID end? Experts look to past epidemics for clues – Burnaby Now

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NEW YORK (AP) — Two years into the COVID-19 pandemic, most of the world has seen a dramatic improvement in infections, hospitalizations and death rates in recent weeks, signaling the crisis appears to be winding down. But how will it end? Past epidemics may provide clues.

The ends of epidemics are not as thoroughly researched as their beginnings. But there are recurring themes that could offer lessons for the months ahead, said Erica Charters of the University of Oxford, who studies the issue.

“One thing we have learned is it’s a long, drawn-out process” that includes different types of endings that may not all occur at the same time, she said. That includes a “medical end,” when disease recedes, the “political end,” when government prevention measures cease, and the “social end,” when people move on.

The COVID-19 global pandemic has waxed and waned differently in different parts of the world. But in the United States, at least, there is reason to believe the end is near.

About 65% of Americans are fully vaccinated, and about 29% are both vaccinated and boosted. Cases have been falling for nearly two months, with the U.S. daily average dropping about 40% in the last week alone. Hospitalizations also have plummeted, down nearly 30%. Mask mandates are vanishing — even federal health officials have stopped wearing them — and President Joe Biden has said it’s time for people to return to offices and many aspects of pre-pandemic life.

But this pandemic has been full of surprises, lasting more than two years and causing nearly 1 million deaths in the U.S. and more than 6 million around the world. Its severity has been surprising, in part because many people drew the wrong lesson from a 2009-2010 flu pandemic that turned out to be nowhere as deadly as initially feared.

“We got all worried but then nothing happened (in 2009), and I think that was what the expectation was” when COVID-19 first emerged, said Kristin Heitman, a Maryland-based researcher who collaborated with Charters.

That said, some experts offered takeaways from past epidemics that may inform how the end of the COVID-19 pandemic may play out.

FLU

Before COVID-19, influenza was considered the most deadly pandemic agent. A 1918-1919 flu pandemic killed 50 million people around the world, including 675,000 in the U.S., historians estimate. Another flu pandemic in 1957-1958 killed an estimated 116,000 Americans, and another in 1968 killed 100,000 more.

A new flu in 2009 caused another pandemic, but one that turned out not to be particularly dangerous to the elderly — the group that tends to die the most from flu and its complications. Ultimately, fewer than 13,000 U.S. deaths were attributed to that pandemic.

The World Health Organization in August 2010 declared the flu had moved into a post-pandemic period, with cases and outbreaks moving into customary seasonal patterns.

In each case, the pandemics waned as time passed and the general population built immunity. They became the seasonal flu of subsequent years. That kind of pattern is probably what will happen with the coronavirus, too, experts say.

“It becomes normal,” said Matthew Ferrari, director of Penn State’s Center for Infectious Disease Dynamics. “There’s a regular, undulating pattern when there’s a time of year when there’s more cases, a time of year when there’s less cases. Something that’s going to look a lot like seasonal flu or the common cold.”

HIV

In 1981, U.S. health officials reported a cluster of cases of cancerous lesions and pneumonia in previously healthy gay men in California and New York. More and more cases began to appear, and by the next year officials were calling the disease AIDS, for acquired immune deficiency syndrome.

Researchers later determined it was caused by HIV — human immunodeficiency virus — which weakens a person’s immune system by destroying cells that fight disease and infection. For years, AIDS was considered a terrifying death sentence, and in 1994 it became the leading cause of death for Americans ages 25 to 44.

But treatments that became available in the 1990s turned it into a manageable chronic condition for most Americans. Attention shifted to Africa and other parts of the world, where it was not controlled and is still considered an ongoing emergency.

Pandemics don’t end with a disease ebbing uniformly across the globe, Charters said. “How a pandemic ends is generally by becoming multiple (regional) epidemics,” she said.

ZIKA

In 2015, Brazil suffered an outbreak of infections from Zika virus, spread by mosquitoes that tended to cause only mild illness in most adults and children. But it became a terror as it emerged that infection during pregnancy could cause a birth defect that affected brain development, causing babies to be born with unusually small heads.

By late that year, mosquitoes were spreading it in other Latin American countries, too. In 2016, the WHO declared it an international public health emergency, and a U.S. impact became clear. The Centers for Disease Control and Prevention received reports of 224 cases of Zika transmission by mosquitoes in the continental United States and more than 36,000 in U.S. territories — the vast majority in Puerto Rico.

But the counts fell dramatically in 2017 and virtually disappeared shortly after, at least in the U.S. Experts believe the epidemic died as people developed immunity. “It just sort of burned out” and the pressure for making a Zika vaccine available in the U.S. ebbed, said Dr. Denise Jamieson, a former CDC official who was a key leader in the agency’s responses to Zika.

It’s possible Zika will be a dormant problem for years but outbreaks could occur again if the virus mutates or if larger numbers of young people come along without immunity. With most epidemics, “there’s never a hard end,” said Jamieson, who is now chair of gynecology and obstetrics at Emory University’s medical school.

COVID-19

The Geneva-based WHO declared COVID-19 a pandemic on March 11, 2020, and it will decide when enough countries have seen a sufficient decline in cases — or, at least, in hospitalizations and deaths — to say the international health emergency is over.

The WHO has not yet announced target thresholds. But officials this week responded to questions about the possible end of the pandemic by noting how much more needs to be accomplished before the world can turn the page.

COVID-19 cases are waning in the U.S., and dropped globally in the last week by 5%. But cases are rising in some places, including the United Kingdom, New Zealand and Hong Kong.

People in many countries need vaccines and medications, said Dr. Carissa Etienne, director of the Pan American Health Organization, which is part of the WHO.

In Latin America and the Caribbean alone, more than 248 million people have not yet had their first dose of COVID-19 vaccine, Etienne said during a press briefing with reporters. Countries with low vaccination rates likely will see future increases in illnesses, hospitalizations and deaths, she said.

“We are not yet out of this pandemic,” said Dr. Ciro Ugarte, PAHO’s director of health emergencies. “We still need to approach this pandemic with a lot of caution.”

___

The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

Mike Stobbe, The Associated Press








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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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