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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.”

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.

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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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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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