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'Immunity passport, please': Should antibody testing be the ticket out of lockdown? – National Post

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Some see them as get out of jail free cards to help economies stagger back to life. To others, the idea of “immunity passports” is COVID-19 madness.

As countries around the globe begin nervously emerging from pandemic lockdown, several are mulling the idea of immunity certificates — passes that would permit those who have tested positive for antibodies to COVID-19 to return to work, shop, board airplanes and otherwise circulate freely in public while the non-immune would remain mostly sheltered in place until vaccines become available.

This week, Chile said it was proceeding with plans to issue “immunity passports” that would liberate holders from quarantines and other restrictions. Germany, Italy and the U.K. have also floated the idea, while Anthony Fauci, a key member of the White House COVID-19 taskforce, told CNN last week the idea “might actually have some merit, under certain circumstances.” U.K. Health Secretary Matt Hancock has said that, should the science support it, the U.K. could introduce an immunity wristband “that says I’ve had it and I’m immune and I can’t pass it on and I’m highly unlikely to catch it.”

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The idea of a hall pass out of lockdown hinges on the mass availability of antibody tests — also known as serological tests — that can identify who has been infected and developed antibodies thought to give them some protection from future infection. About half of those infected never develop symptoms, meaning there could be tens of thousands of Canadians who never knew they had the illness.

A dozen companies are seeking Health Canada approval for serological tests, including Halifax-based MedMira Inc., whose rapid antibody test takes three minutes start to finish, using a drop of blood specimen. In the U.S., more than 70 developers have notified the Food and Drug Administration they have tests ready to launch. The agency has issued four emergency use applications for antibody tests and expects that number to grow in coming weeks. “Within a period of a week or so we’re going to have a rather large number of tests that are available,” Fauci said. New York Gov. Andrew Cuomo, meanwhile, has said people who can get antibody tests — people who can “show they have had the virus and resolved” — can go back to work when the state starts to reopen. U.K.-based software company Bizagi has already developed a “CoronaPass” app to “automate, track and validate” a person’s immunity status, based on his or her antibody test. A QR code could be scanned like a boarding pass and presented to “authorities” as needed. “Those with evidence of immunity can help care for the most vulnerable in the community, staff a restricted re-opening of a retail location, or be safely prioritized for front-line healthcare work to help those still in need,” the company says.


A man walks past a social distancing poster on Toronto’s Broadview Avenue during the Covid 19 pandemic, Tuesday April 21, 2020.

Peter J Thompson / National Post

The science, however, is still seriously murky: There are concerns about sensitivity — how good are the tests at identifying people who have had the disease — and specificity, meaning, are they cross-reacting with other coronaviruses that cause the common cold? A positive test may only indicate the person has been exposed, no more, no less. There’s no known understanding of how long immunity lasts — three months? three years? — or the level of antibodies necessary to presume a person is now “noncontagious.” Do the immune wear lanyards and badges? Would it trigger a black market of fake immunity passes? How would it be implemented and patrolled? Is a world of the immunes and the non-immunes a future we really want?

“For years, decades, we’ve been writing about stigma in infectious disease and how it’s problematic and now people are thinking of actually employing something that is by definition stigmatizing as a way out,” said University of Toronto bioethicist Dr. Ross Upshur, of the Dalla Lana School of Public Health.

“Play this out in your mind in several different scenarios,” said Upshur, an internationally recognized public health and bioethics expert. “You have to have an immunity pass. Do you get a jacket? Do you get a hat? How is it that people identify the fact they have an immunity pass or not? What happens if somebody who doesn’t have an immunity pass is found in a group of people who do? Do they get beaten up? We know humans can behave very savagely to each other under these types of circumstances.”

The proposal is tone deaf to how similar practices have worked in the past, Upshur added — “apartheid, colonial Africa, Nazi Germany” — and has a high likelihood of being used against already disadvantaged groups. Nobody wants to stay in lockdown longer than they absolutely have to. “But we do not have a valid serological test for determining immunity to SARS-Cov2,” Upshur said, and to base major decisions on who gets out and who doesn’t on antibody testing is not only premature, “it’s madness.”

We cannot all march forward out our doors

During the 1878 yellow fever epidemic in the Deep South, survivors became “acclimated,” Kathryn Olivarius, an assistant professor of history at Stanford University, wrote in New York Times. Unacclimated white people couldn’t get a job. “If you were white, immunity-status impacted where you lived, how much you earned, your ability to get credit and whom you were able to marry.”

Immunity passports could also present a perverse motivation to get deliberately infected, like misguided mothers who bundled their children off to chickenpox parties. “That may be unthinkable for those fortunate enough to be able to weather this economic storm from behind a monitor in their home office, but that option just isn’t available to millions,” Noah Rothman, author of Unjust: Social Justice and the Unmasking of America, wrote in Commentary magazine. With rolling lockdown-lift-lockdown cycles that could stretch a year or longer until vaccines become available, people with families to support and crushing debt “could begin to seek out the status that allows them to live fully once again — as dangerous as that may be,” Rothman said.

Others have argued that it would be entirely ethical for grocery stores, restaurants and other businesses to require immunity passports of customers — that, the price of coming out is to surrender some civil liberties. “If you don’t want to carry that document or don’t trust it, you’re not coming out,” said NYU Langone Medical Center bioethicist Arthur Caplan.

The tests measure the amount of antibodies, or proteins present in blood when the body responds to an infection caused by the virus. The tests don’t detect the virus itself, or an active infection, like the nasal and throat swab used to diagnose COVID-19, but whether the person’s immune system produced antibodies after having encountered the infection some time in the past.

However, it’s not clear which particular antibodies are actually providing immunity after the person recovers, or for how long.

It’s nice to think of an immunity passport if you’re the one “immune,” Upshur added. “Because that means there is at least the possibility that some of us would be able to freely move in the environment.”

But how to do the testing fairly and equitably? “You would need a regimen to give everybody the fair opportunity to have the test, and look at how well we’ve been rolling out testing in Ontario in the first place,” he said.

The plan would also be premised on the idea that the non-immune would remain largely sheltered until vaccines become available. But Upshur, who has been on multiple meetings with top scientific minds on World Health Organization teleconferences, says the probability that there will be a vaccine in the near future with over 90 per cent efficacy and available in seven billion doses “is almost non-existent.”


Road are closed on the way to the Nordic Centre and the parks in Spray Valley at Canmore. Mount Royal University professors say we need to carefully reopen parks and recreation area for mental and physical well-being.

Postmedia

It’s likely that people exposed to the pandemic virus in the past would have some reasonable degree of immunity. “One hundred percent immunity? Probably not. One hundred per cent of the time? Definitely not. But better than nothing,” said Amir Attaran, a professor of law and medicine at the University of Ottawa who has a PhD in immunology.

However, in our shelter-in-place isolation, we didn’t magically develop immunity, Attaran noted. “We’ve been sitting on the couch watching Netflix and drinking beer.

“We cannot all march forward out our doors. We are going to have to divide it up into batches, into cohorts of people who go back, more or less, to society and more or less the jobs they left behind, in stages,” based on disease susceptibility and occupation, he said.

Young people are just as likely as older ones to get infected, but they’re much less likely to die. “So, the first batch would favour young people over old, assuming they don’t have a pre-existing condition that makes them more vulnerable,” Attaran said. Later batches could include older people and the immune suppressed. “All the boomers get to take a little longer time out. This is the time of Gen X and Gen Y.”


People social distance as they stand in line to get in a grocery store in Fort Qu’Appelle, Saskatchewan on April 17, 2020.

Brandon Harder/Postmedia/File

Attaran said we ought to consider immune passporting, “giving those who are thought to be immune a bill of health that says they can circulate more extensively in society without risking the health of others.”

But what level of immunity makes someone passport worthy? How would it work? “The head waiter can go back to work but nobody else?” tweeted one Imperial College London scientist.

There are currently no validated serology tests in Canada “and thus there is no mechanism to implement such an initiative,” a spokeswoman for the Ontario health ministry said in an email. However, the province is working with the Public Health Agency of Canada “to understand the evolving technology and its applications,” she said.

While we wait for the testing to be sorted out, everyone wants to know the answer to, how soon can we come out? “Unfortunately, there is no clear answer,” Dr. Barbara Yaffe, Ontario’s associate chief medical officer of health said this week. It won’t be like a light switch, she said, “you know, on-off.” It will be gradual, and the impact of each change will have to be monitored carefully for signs of any fresh outbreaks. But once the genie is out of the bottle it will hard to put her back in. “Once we lift it, it will be very hard to go back,” Yaffe said.


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Kevin Neil Friesen Obituary 2024 – Crossings Funeral Care

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It is with heavy hearts that we announce the peaceful passing of Kevin Neil Friesen age 53 on Thursday, March 28, 2024 at the Bethesda Regional Health Centre.

A funeral service will be held at 2:00 pm on Thursday, April 4, 2024 at the Bothwell Christian Fellowship Church, with viewing one hour prior to the service.

A longer notice to follow.  

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Spring allergies: Where is it worse in Canada? – CTV News

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The spring allergy season has started early in many parts of Canada, with high levels of pollen in some cities such as Toronto, Ottawa and Montreal.

Daniel Coates, director of Aerobiology Research Laboratories in Ottawa, expects the elevated amounts to continue next week for places, such as most of Ontario, if the temperature continues to rise. Aerobiology creates allergen forecasts based on data it collects from the air on various pollens and mould spores.

Pollens are fertilizing fine powder from certain plants such as trees, grass and weeds. They contain a protein that irritates allergy sufferers.

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Although pollen levels declined after a cold spell in some places, he said they are soaring again across parts of Canada.

“So the worst is definitely British Columbia right now, followed by Ontario and Quebec and then the Prairies and Atlantic Canada for the upcoming weeks,” said Coates in a video interview with CTVNews.ca. “We are seeing pollen pretty much everywhere, including the Maritimes.”

He said pollen has increased over the past 20 years largely due to longer periods of warm weather in Canada.

Meanwhile, the Maritimes is one of the best places to live in Canada if you have seasonal allergies, in part because of its rocky territory, Coates said.

With high levels of cedar and birch pollen, British Columbia is the worst place for allergy sufferers in Canada, he added.

“British Columbia is going strong,” Coates explained, noting the allergy season started “very early” in the province in late January. “It has been going strong since late January, early February and it’s progressing with high levels of pollen, mostly cedar, but birch as well, and birch is highly allergenic.”

Causes of high pollen levels

Coates expects a longer allergy season if the warm weather persists. He notes pollen is increasing in Canada and worldwide, adding that in some cases the allergy season is starting earlier and lasting longer than 15 years ago.

He says tree pollen produced last year is now being released into the air because of warmer weather.

“Mother nature acts like a business,” he said. “So you have cyclical periods where things go up and down. … So when it cooled down a little bit, we saw (pollen) reduce in its levels, but now it’s going to start spiking.”

Along with warmer weather, another factor in higher pollen levels is people planting more male trees in urban areas because they don’t produce flowers and fruits and are less messy as a result, he said. But male trees produce pollen while female ones mostly do not.

Moulds

Coates said moulds aren’t as much of a problem.

“They’ve been mainly at lower levels so far this season,” he explained. “Moulds aren’t as bad in many areas of Canada, but they’re really, really bad in British Columbia.”

In B.C., moulds are worse because of its wet climate and many forested areas, he said.

Coping with allergies

Dr. Blossom Bitting, a naturopathic doctor and herbal medicine expert who works for St. Francis Herb Farm, says a healthy immune system is important to deal with seasonal allergies.

“More from a holistic point of view, we want to keep our immune system strong,” she said in a video interview with CTVNews.ca from Shediac, N.B. “Some would argue allergies are an overactive immune system.”

Bitting said ways to balance and strengthen the immune system include managing stress levels and getting seven to nine hours of restful sleep. “There is some research that shows that higher amounts of emotional stress can also contribute to how much your allergies react to the pollen triggers,” Bitting said.

Eating well by eating more whole foods and less processed foods along with exercising are also important, she added. She recommends foods high in Omega-3 Fatty Acids such as flaxseeds, flaxseed oil, walnuts and fish. Fermented foods with probiotics such as yogurt, kimchi and miso, rather than pasteurized ones, can keep the gut healthy, she added. Plant medicines or herbs such as astragalus, reishi mushrooms, stinging nettle and schisandra can help bodies adapt to stressors, help balance immune systems or stabilize allergic reactions, she said.

To cope with allergies, she recommends doing the following to reduce exposure to pollen:

  • Wear sunglasses to get less pollen into the eyes;
  • Wash outdoor clothes frequently, use outer layers for outside and remove them when you go inside the house;
  • Use air purifiers such as with HEPA (high efficiency particulate air) filters;
  • Wash pets and children after they go outside;
  • Keep the window closed on days with high pollen counts.

Mariam Hanna, a pediatric allergist, clinical immunologist and associate professor with McMaster University in Hamilton, Ont., says immunotherapy can help patients retrain their bodies by working with an allergist so they become more tolerant to pollens and have fewer symptoms.

“Some patients will need medications like over-the-counter antihistamines or speaking with their doctor about the right types of medications to help with symptom control,” she said in a video interview with CTVNews.ca.

Coates recommends people check pollen forecasts and decrease their exposure to pollen since no cure exists for allergies. “The best is knowing what’s in the air so that you can adjust your schedules, or whatever you’re doing, around the pollen levels.”

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Do you need a spring COVID-19 vaccine? Research backs extra round for high-risk groups

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Recent studies suggest staying up-to-date on COVID shots helps protect high-risk groups from severe illness

New guidelines suggest certain high-risk groups could benefit from having another dose of a COVID-19 vaccine this spring — and more frequent shots in general — while the broader population could be entering once-a-year territory, much like an annual flu shot.

Medical experts told CBC News that falling behind on the latest shots can come with health risks, particularly for individuals who are older or immunocompromised.

Even when the risk of infection starts to increase, the vaccines still do a really good job at decreasing risk of severe disease, said McMaster University researcher and immunologist Matthew Miller.

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Who needs another COVID shot?

Back in January, Canada’s national vaccine advisory body set the stage for another round of spring vaccinations. In a statement (new window), the National Advisory Committee on Immunization (NACI) stated that starting in spring 2024, individuals at an increased risk of severe COVID may get an extra dose of the latest XBB.1.5-based vaccines, which better protect against circulating virus variants.

That means:

  • Adults aged 65 and up.
  • Adult residents of long-term care homes and other congregate living settings for seniors.
  • Anyone six months of age or older who is moderately to severely immunocompromised.

The various spring recommendations don’t focus on pregnancy, despite research (new window) showing clear links between a COVID infection while pregnant, and increased health risks. However, federal guidance does note that getting vaccinated during pregnancy can protect against serious outcomes.

Vaccinated people can also pass antibodies to their baby through the placenta and through breastmilk, that guidance states (new window).

What do the provinces now recommend?

Multiple provinces have started rolling out their own regional guidance based on those early recommendations — with a focus on allowing similar high-risk groups to get another round of vaccinations.

B.C. is set to announce guidance on spring COVID vaccines in early April, officials told CBC News, and those recommendations are expected to align with NACI’s guidance.

In Manitoba (new window), high-risk individuals are already eligible for another dose, provided it’s been at least three months since their latest COVID vaccine.

Meanwhile Ontario’s latest guidance (new window), released on March 21, stresses that high-risk individuals may get an extra dose during a vaccine campaign set to run between April and June. Eligibility will involve waiting six months after someone’s last dose or COVID infection.

Having a spring dose is particularly important for individuals at increased risk of severe illness from COVID-19 who did not receive a dose during the Fall 2023 program, the guidance notes.

And in Nova Scotia (new window), the spring campaign will run from March 25 to May 31, also allowing high-risk individuals to get another dose.

Specific eligibility criteria vary slightly from province-to-province, so Canadians should check with their primary care provider, pharmacist or local public health team for exact guidelines in each area.

WATCH: Age still best determines when to get next COVID vaccine dose, research suggests:

 

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Age still best determines when to get COVID vaccines, new research suggests

It’s been four years since COVID-19 was declared a pandemic, and new research suggests your age may determine how often you should get a booster shot.

Why do the guidelines focus so much on age?

The rationale behind the latest spring guidelines, Miller said, is that someone’s age remains one of the greatest risk factors associated with severe COVID outcomes, including hospitalization, intensive care admission and death.

So that risk starts to shoot up at about 50, but really takes off in individuals over the age of 75, he noted.

Canadian data (new window) suggests the overwhelming majority of COVID deaths have been among older adults, with nearly 60 per cent of deaths among those aged 80 or older, and roughly 20 per cent among those aged 70 to 79.

People with compromised immune systems or serious medical conditions are also more vulnerable, Miller added.

Will people always need regular COVID shots?

While the general population may not require shots as frequently as higher-risk groups, Miller said it’s unlikely there will be recommendations any time soon to have a COVID shot less than once a year, given ongoing uncertainty about COVID’s trajectory.

Going forward, I suspect for pragmatic reasons, [COVID vaccinations] will dovetail with seasonal flu vaccine campaigns, just because it makes the implementation much more straightforward, Miller said.

And although we haven’t seen really strong seasonal trends with SARS-CoV-2 now, I suspect we’ll get to a place where it’s more seasonal than it has been.

In the meantime, the guidance around COVID shots remains simple at its core: Whenever you’re eligible to get another dose — whether that’s once or twice a year — you might as well do it.

What does research say?

One analysis, published in early March in the medical journal Lancet Infectious Diseases (new window), studied more than 27,000 U.S. patients who tested positive for SARS-CoV-2, the virus behind COVID, between September and December 2023.

The team found individuals who had an updated vaccine reduced their risk of severe illness by close to a third — and the difference was more noticeable in older and immunocompromised individuals.

Another American research team from Stanford University recently shared the results from a modelling simulation looking at the ideal frequency for COVID vaccines.

The study in Nature Communications (new window) suggests that for individuals aged 75 and up, having an annual COVID shot could reduce severe infections from an estimated 1,400 cases per 100,000 people to around 1,200 cases — while bumping to twice a year could cut those cases even further, down to 1,000.

For younger, healthier populations, however, the benefit of regular shots against severe illness was more modest.

The outcome wasn’t a surprise to Stanford researcher Dr. Nathan Lo, an infectious diseases specialist, since old age has consistently been a risk factor for severe COVID.

It’s almost the same pattern that’s been present the entire pandemic, he said. And I think that’s quite striking.

More frequent vaccination won’t prevent all serious infections, he added, or perhaps even a majority of those infections, which highlights the need for ongoing mitigation efforts.

Lauren Pelley (new window) · CBC News

 

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