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In-depth contact tracing casts doubt on N.B. doctor as source of spring COVID-19 outbreak – CBC.ca

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Within an hour of finding out he had tested positive for coronavirus in May, Dr. Jean Robert Ngola was being blamed as the source of a COVID-19 outbreak in Campbellton, N.B., after his confidential health information was leaked on social media. 

But an investigation by CBC’s The Fifth Estate and Radio-Canada reveals new contact tracing information that casts doubt on the certainty with which Ngola was identified as “patient zero” in the outbreak that resulted in more than 40 cases of COVID-19 and two deaths and points to dozens of other people in the northern New Brunswick community who could have brought the virus into the area.

Ngola’s legal team also showed CBC documents that indicate some of the people with whom Ngola came in contact during a trip to Quebec did not have the virus. Ngola had travelled to the neighbouring province in early May to pick up his four-year-old daughter without informing the hospital where he worked and did not self-isolate upon his return.

“We’ll fight it on the facts. Because on the facts, Jean Robert was not wrong,” said Joel Etienne, Ngola’s lawyer.

Ngola has since left Campbellton after enduring weeks of threats that he says drove him from the town he called home for seven years, which lies across the Restigouche River from Pointe-à-la-Croix, Que. He had more than 2,000 patients at his family clinic and also worked shifts at the Campbellton Regional Hospital emergency room.

Campbellton Regional Hospital employs 90 health workers who live in Quebec. More than 20 per cent of its patients are also from Quebec. (Serge Bouchard/Radio-Canada)

At the time of the outbreak, Ngola was only seeing his clinic patients virtually but was treating patients in person in the ER.

You can go to Campbellton and ask what kind of physician is Dr. Ngola. I love this population but in one day, everything was destroyed,” said Ngola, 50, who has medical degrees from the Democratic Republic of Congo, Belgium and the University of Laval in Quebec.

No symptoms

In a two-hour interview, Ngola answered questions about his reasons for travelling to Quebec and described the extent of the racist attacks he endured and the betrayal he said he felt at the hands of his employer and the province.

The Congolese-Canadian doctor found out he had tested positive for COVID-19 in a phone call from public health authorities around 11 a.m. on May 27. He was shocked because he didn’t have any symptoms. One hour later, his clinic staff informed him that his positive virus result was leaked on Facebook and he was being called “patient zero.”

At the daily 2:30 p.m. provincial pandemic update that day, New Brunswick Premier Blaine Higgs confirmed three COVID-19 cases, including a child, a man in his 90s and an “irresponsible medical professional.” The premier didn’t name Ngola but publicly accused the unnamed “medical professional” of hiding his reasons for travel and breaking the rules by not self-isolating after his trip.

Two hours later, his employer, the Vitalité Health Network, suspended Ngola without pay over email. Another public health nurse called Ngola at 5 p.m. and informed him his daughter was also COVID-positive.

By the end of the week, spurred by a complaint by the province and Vitalité, the RCMP began investigating Ngola for criminal wrongdoing. 

The doctor blames a rush to judgment by the premier and his employer for tarnishing his reputation and putting him at risk. 

Lawyer Joel Etienne is representing Ngola and says the province rushed to judgment when it pinned an outbreak on him. (Jean-François Benoît/CBC)

“It’s more than racism — they put my life in danger,” said Ngola. 

His employer, however, says the physician violated the hospital’s COVID-19 protocols. Vitalité provided CBC with a copy of a self-assessment checklist emailed to all employees on April 6 that specified that anyone who travelled outside of New Brunswick — except those who commute from Quebec or Maine — had to self-isolate for 14 days upon their return.

Ngola said he received the email but that “there was a lot of confusion” and other doctors he worked with had not self-isolated after travelling out of province.

“I took precautions,” he said of his trip.

Disparaged on social media

Once his case was made public, Ngola was called a “disease” on Facebook and told to “go back to Africa.” One Campbellton resident posted a comment saying Ngola should be “lynched and dragged back across the bridge” referring to the span between Cambellton and Pointe-à-la-Croix, Que.

Meanwhile, photos of his home were splashed online. 

Residents called 911 with false reports that the doctor was seen shopping at Walmart. Ngola said police officers showed up at his door to ensure he wasn’t violating his quarantine. 

Unnerved by the invasion of his privacy, Ngola said he didn’t feel safe and “hid in the basement” with his child. 

“I have the fear in my belly. I don’t know what can happen,” he said. “You know some person — [if] mentally, they are not correct — they can come to do something. And I was alone with my daughter.”

At the time he tested positive, Ngola was only seeing patients virtually in his clinic but thinks he contracted the virus earlier from a patient while working in the Campbellton Regional Hospital ER.

“The pandemic is a war, and the physician is the first line,” he said. “We see patients who are asymptomatic.”

Currently on the campaign trail, Higgs brushed off criticism that singling out Ngola — even in a roundabout way — was reckless. 

“I had no knowledge of the individual until it appeared in social media,” he said. “The concern I had throughout this pandemic is that we have to be conscious, we rely heavily on our medical professionals. It was disappointing because it resulted in a situation where we had two fatalities.”

No criminal charges but could face fine

On May 30, the provincial government and Vitalité asked the RCMP to investigate possible criminal wrongdoing by Ngola. After a six-week investigation, police decided against laying criminal charges, but Ngola could still face a hefty provincial fine for violating the Emergency Services Act by not self-isolating for 14 days after travel. He is set to appear in provincial court in Campbellton on Oct. 26.

WATCH: Ngola describes the effect of the leak of his personal information:

Within an hour of finding out he was COVID-positive, he was attacked on social media. 1:27

The former lead investigator into the Walkerton tainted water scandal says he is in Ngola’s corner. Craig Hannaford, a former RCMP officer who is now a private investigator with the firm Haywood Hunt and Associates in Toronto and was hired by Ngola’s lawyer, spent one month retracing the physician’s overnight trip to Montreal looking for evidence that could prove Ngola didn’t get COVID-19 in Quebec.

Hannaford said he identified several health workers who were crossing into Quebec from Cambellton and not isolating upon their return around the same time as Ngola. 

“The long arm of the state seems to be pointing fingers [at Ngola], saying: ‘You did it.’ Yet there seems to be all sorts of explanations as to how this happened,” said Hannaford.

He said his investigation took one month compared to the few hours it took New Brunswick Public Health to zero in on Ngola.

“That’s not a fair and balanced investigation,” he said. 

Anatomy of a trip

When Ngola met the The Fifth Estate team in Quebec, along with his lawyer, they provided more information about his reasons for the trip to Quebec and the precautions he took.

In early May, Ngola said, he was in a conundrum. He was asked by his ex-partner, who lives in Montreal, to take care of their four-year-old daughter while she flew to Africa to attend her father’s funeral. Ngola had shifts at the Campbellton ER that he was concerned management couldn’t backfill. So he asked his younger brother, who is a student in Montreal, to look after the child for five days while he figured out how to pick her up. 

Unsure of the rules under the provincial Emergency Services Act, Ngola called the RCMP before his trip, who directed him to the New Brunswick COVID hotline. 

Ngola said the operator told him that as an essential worker, he did not have to self-isolate upon his return.

CBC found conflicting information on New Brunswick government websites about who needs to self-isolate when returning to the province. On one site outlining travel guidelines, a section labelled “People not required to self-isolate” lists healthy residents who must cross the border to access required goods services, patients accessing medical care and parents with a shared custody of children.

Ngola also called the Quebec COVID hotline for advice. He said the person who answered reminded him to bring a letter that showed he had permission to take his child across the border. He doesn’t have recordings of his conversations but said his cellphone logs prove he made those calls. 

The J.C. Van Horne Bridge spans the Restigouche River and connects Campbellton, N.B., to Pointe-à-la-Croix, Que. (Serge Bouchard/Radio-Canada)

On his 30-hour round trip, Ngola said he encountered a total of five people: his daughter, his brother, two doctors and a gas station clerk.

On May 12, Ngola left Campbellton after his ER shift ended at 4 p.m. He gassed up his car and drove nearly nine hours without stopping to Montreal. After a brief conversation with his brother, he went to sleep. The next morning, he left the city with his daughter around 9 a.m.

Ngola said he had a previously scheduled conference call with two doctors in Trois-Rivières on May 13 but decided to meet with them in person since he was passing through the town.

They met for 20 minutes, wearing masks and gloves, and sat two metres apart. They discussed a potential job for Ngola at their clinic. The only other stop Ngola said he made on this journey was at a gas station in La Pocatière, Que. 

After filling up, he went inside to pay for the fuel and some food before crossing into New Brunswick near Edmundston around 6 p.m. 

Ngola said he told peace officers at the border checkpoint that he was a doctor and that he had travelled overnight to pick up his daughter. He said he was given a pamphlet with general instructions about self-isolating. By 9 p.m., he was back home in Campbellton.  

Craig Hannaford, a former RCMP officer who is now a private investigator, spent one month retracing Ngola’s overnight trip to Montreal to look for evidence that he didn’t get COVID-19 in Quebec. (Mia Sheldon/CBC)

Unlikely but not impossible

Hannaford said the Trois-Rivières doctors did not get COVID-19 nor did Ngola’s younger brother.

The Fifth Estate was unable to reach the doctors for comment but has seen the brother’s negative test result. The 36-year-old was tested at the Hôpital Maisonneuve-Rosemont in Montreal three days after Ngola’s own nasal swab. 

CBC also asked Dalhousie University epidemiologist Dr. Karina Top, who studies infectious disease and vaccine efficacy, to review the information. The physician said it’s unlikely, but not impossible, that Ngola contracted the virus on his brief trip.

“Overall, it’s a short time, and he was in contact with a small number of people,” Top said. “So it would seem like the risk would be reasonably low as to have been in contact with COVID-19. But it’s not impossible.”

Top said the public should be informed when they come in contact with someone who is infected, but she’s alarmed by the privacy breach in Ngola’s case. 

“It’s also counterproductive to public health efforts, because it means other people will see what he went through and may be less likely to get tested if they have mild symptoms,” she said. “And if they are found to have COVID, they may be less likely to be forthcoming and honest about where they’ve been and who they’ve been with out of fear that they will face the same stigma.” 

The investigation by Hannaford also points to a potential government worker in Campbellton as the source of the leak. 

Social media posts reviewed by The Fifth Estate suggest that Ngola was identified on Facebook by someone who said their spouse was on “the COVID-19 monitoring team.” The person did not respond to Facebook requests for an interview. 

Daycare contact

New Brunswick had just recorded two straight weeks without a coronavirus case when the outbreak publicly linked to Ngola forced the Restigouche region to remain in lockdown while the rest of the province opened restaurants and gyms and expanded social bubbles. 

The first sign of the outbreak came on May 21. Public health authorities announced a child in Campbellton tested positive for the virus. 

Two other cases quickly followed. On May 27, New Brunswick’s chief public health officer, Jennifer Russell, announced that a man in his 90s and a medical worker had also tested positive. 

At the time, she also said it was mandatory for health professionals to self-isolate after leaving the province and later lamented that the outbreak had been “preventable.”

Ngola was the medical worker, and the man in his 90s was one of his patients who had stopped by his clinic a few days earlier to ask for a prescription refill. Ngola said he filled the order while remaining physically distanced and wore a mask.

The boy who tested positive happened to also had spent one day at the same daycare that Ngola’s daughter attended, Garderie les Bouts et Choux, and his mother is a nurse who works at Campbellton Regional Hospital. 

Hours after Ngola’s name was leaked on the internet, residents started calling 911 with false reports that he was breaking his quarantine. RCMP were dispatched to his Campbellton home to ensure he was self-isolating. (Serge Bouchard/ Radio-Canada)

Daycare operator Cecile Castonguay said she doesn’t blame Ngola for the outbreak. 

“I don’t know if the boy gave the virus to [Ngola’s] daughter or if his daughter gave it to the boy. How can anyone know?” said Castonguay.

CBC News has learned and Vitalité confirmed that the nurse shares custody of the boy with a parent who lives on the Quebec side of the Restigouche River. 

Vitalité says 90 employees, or nearly 10 per cent of its hospital staff, live in Pointe-à-la-Croix and cross the bridge to Cambellton daily. More than 20 per cent of patients who visit the ER at Campbellton Regional Hospital are from Quebec.

Because of staff shortages, hospitals in northern New Brunswick rely heavily on doctors from outside the province. CBC had previously reported that 22 doctors who worked for the Vitalité Health Network, including nine in the Cambellton region, did not fully self-isolate after travelling out of province.

No apology owed, says employer

Despite initially warning that 150 people might have been at risk of infection, the head of the hospital network admits he doesn’t know if Ngola was the source of the spring outbreak.

“At Vitalité, we don’t know if he’s patient one, zero, four or five. We’re not privy to that information” said Gilles Lanteigne, Vitalité’s CEO. 

Lanteigne said he didn’t bow to political pressure but acted because the physician had violated the hospital’s COVID-19 protocols. 

Christian Michaud, a constitutional lawyer in Moncton, is a member of Ngola’s legal team. (Nicolas Steinbachs/Radio-Canada)

“I don’t think I owe Dr. Ngola an apology … that decision was done quickly based on the fact that Dr. Ngola had not informed us that he was leaving the province and that after he came back he didn’t self-isolate.” 

Ngola’s lawyer, Etienne, said his client took all the necessary precautions and is being scapegoated and arbitrarily punished for what was a common practice among the public and medical staff. During the outbreak, at least 10 hospital employees, including at least one other doctor, contracted the virus, but only Ngola’s name leaked out.

“This is all about the arbitrariness of making rules when there were no rules, making them on the fly — and deciding that one person is guilty,” said Etienne.

WATCH: Lawyer sees lasting impact of leak of Ngola’s health information:

Joel Etienne says Ngola will face consequences for the rest of his life. 1:14

The most recent addition to Ngola’s defence team is Christian Michaud, a constitutional expert based in Moncton who says Ngola’s charter rights were violated by the premier when he de facto identified him as patient zero.

“This is a public interest case. It involves the premier who has prejudged the case,” he said. “I’m very concerned about what I’m observing in terms of breaches of basic fundamental principles of charter rights. For example, the presumption of innocence, the right to remain silent, the right not to suffer any abuses of power.” 

Ngola is focused on building a fresh start at a clinic in Louiseville, Que.

He said his suspension and the threats prevented him from helping his patients transition to a new doctor and drove him out of Campbellton before he could sell his house. But he has received more than 200 letters and emails of support from across Canada. Many are from strangers. 

Louiseville has a shortage of doctors and has embraced Ngola with open arms, he said, allowing him the opportunity to see his daughter more often without crossing provincial borders.

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Surge in health-care worker COVID-19 cases causing burnout, nurses union says – CBC.ca

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Nearly two-thirds of Manitoba health-care workers who contracted COVID-19 did so in the past two months, data from the province suggests, and unions representing front-line staff say that’s contributing to burnout.

In a seven-week period in August and September, 61 health-care workers tested positive, making up the bulk of the roughly 100 such cases over the past six months, according to COVID-19 surveillance data from the province.

The recent uptick is adding strain to several health-care sectors, where employees are being required to work more overtime due to staffing shortages, said the Manitoba Nurses’ Union and the Canadian Union of Public Employees.

“Nurses are incredibly stressed,” said nurses union president Darlene Jackson. “It’s increasing, and then when you add an outbreak at a facility or on a unit, and you have staff off self-isolating, it’s the perfect storm. It just makes things even worse.” 

Jackson said 27 nurses have tested positive since March. That represents a quarter of all health-care worker cases.

Between mid-March and early May, the province reported 36 cases of health-care workers testing positive. That trend flatlined for months amid mass closures and pandemic restrictions, before picking up again on the heels of loosened rules this summer.

Spikes in Prairie Mountain Health led to the reintroduction of restrictions at the end of last month. Similar rules were imposed in Winnipeg and surrounding communities this week amid what Manitoba’s chief provincial health officer recently called evidence of a second wave.

Sample results fast tracked

As of Tuesday, Winnipeg was home to more than 80 per cent of Manitoba’s 606 active cases. That has led to a rise in demand at COVID-19 test sites, resulting in hours-long wait times, particularly at drive-thru sites in Winnipeg.

The province opened a new mobile screening station Wednesday, but Jackson still worries about long wait times for nurses who can’t work until results are in.

“We’ve had staff shortages for a very long time,” she said. “Now, if you have an outbreak in your facility, we have nurses and health-care aides off self-isolating, waiting for test results. That has absolutely increased the shortage in nursing.” 

A provincial spokesperson said when it comes to getting tested, health-care workers have to stand in line like the rest of the public. But at the lab, their samples are flagged to reduce turnaround times.

A union that represents health-care aides, transporters, ward clerks, security guards and more said it’s seeing signs of a stressed-out workforce in its members.

Staff at personal care homes and home-care workers appear to be among those most affected by burnout, said the president of CUPE Local 204.

“Anxiety levels have come up big time with COVID just because they don’t know who they’re coming in contact with,” said Debbie Boissonneault.

At least 18 front-line workers represented by CUPE have tested positive in the past six months, she said.

‘It’s been a problem’

Workloads have also increased and staff are spread thin filling in holes when peers are off sick, she said.

“Someone calls in sick, the employer doesn’t replace that person, so now you have three people doing the work of four, and sometimes two [doing] the work of four,” said Boissonneault.

“It’s been a problem long before COVID, and with COVID it’s even become more.”

Darlene Jackson is president of the Manitoba Nurses’ Union. (Jeff Stapleton/CBC)

An outbreak at Winnipeg’s Health Sciences Centre early in the pandemic resulted in 16 staff members testing positive, along with five patients and four close contacts. Two people died as a result of that outbreak.

After emerging from the first wave with no serious care home outbreaks, Manitoba has faced several in recent weeks, including one at Bethesda Place personal care home in Steinbach that has resulted in four deaths.

Jackson said cuts and closures stemming from the Pallister government’s health-care overhaul led to an increase in vacant nursing positions before the pandemic hit. That void contributed to a nurse workload that is “much heavier than it’s ever been,” said Jackson.

Jackson said appropriate personal protective equipment isn’t always available in some facilities, and that absence is also weighing on an already tired workforce.

“These nurses are incredibly stressed because not only do you have the workload and the staff shortage, now you have concerns about, ‘Am I protected? Are my residents or patients protected? And what am I taking home to my family?”

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COVID-19: Delta Hospital outbreak claims a life as 105 new cases reported – Vancouver Sun

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There have been 105 new cases of COVID-19 reported in B.C. over the past day and one death.

The provincial health officer, Dr. Bonnie Henry, said there are now 1,268 cases of the disease, of which 69 are being treated in hospital including 20 in intensive care. The number of active cases has been falling.

There have been 9,013 cases of COVID-19 reported in B.C. since the first case appeared in late January in a man who returned to Vancouver from Wuhan, China, on a business trip.

Henry said 3,337 people are under active public health monitoring as a result of identified exposure to known cases and 7,485 people who had tested positive have recovered.

“There has been one new COVID-19 related death in Fraser Health, for a total of 234 deaths in British Columbia,” she said.

The death was connected to the Delta Hospital outbreak, where 17 people have contracted the disease.

Four of the 105 new cases are in long-term care facilities, including one at St. Paul’s Hospital.

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Moderna’s Covid Vaccine Generated Strong Antibodies in the Elderly – Barron's

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Protection of vulnerable groups will be a major factor when government regulators consider an emergency authorization of Moderna’s vaccine.


Maddie Meyer/Getty Images


Moderna

announced that elderly people in the first trial of its Covid-19 vaccine generated high levels of antibodies against the coronavirus, on a par with younger test subjects and patients who have recovered from the illness.

In recent trading, Moderna stock (ticker: MRNA) was up 3.1%, at $72.73, while the

Nasdaq Composite

was up 1%.

Protection of vulnerable groups like the elderly will be a major factor when government regulators consider an emergency authorization of Moderna’s mRNA-1273 vaccine, upon completion of its Phase 3 study in the next month or two.

“Given the increased morbidity and mortality of Covid-19 in older and elderly adults, these data give us optimism in demonstrating mRNA-1273’s protection in this population,” said Moderna medical chief Tal Zaks in the Tuesday night announcement,

Moderna and a team of

Pfizer

(PFE) and

BioNTech

(BNTX) are both racing down the home stretch of enormous pivotal trials of their Covid vaccines. Pfizer has said it might have results by late October, but most observers are betting the two trials will reach their conclusions in November or December.

Johnson & Johnson

(JNJ) will be only a month or so behind with its Phase 3 trial results.

BioNTech and Pfizer use a similar technology to Moderna’s. BioNTech stock was up Wednesday morning, by 1.6%, at $67.95, while Pfizer was up 0.7%, at $36.42.

The U.S. Food and Drug Administration has told all vaccine developers that their studies must include participants from the populations hit hardest by Covid. Those groups are the elderly, disadvantaged minorities, and people with pre-existing medical conditions.

So Moderna was happy to announce a study that will appear in Wednesday’s New England Journal of Medicine, which analyzed the elderly participants in its vaccine’s Phase 1 trial.

The data show that the vaccine was well-tolerated in two age cohorts: those between ages 56 and 70, and those aged 71 and older. At the dose level that is being tested in Phase 3, the vaccine elicited levels of antibodies on a par with patients who have recovered from Covid. In the lab, the antibodies from Moderna’s elderly test subjects stopped the virus from infecting cells at an even higher rate than the antibodies of recovered patients.

Phase 3 studies will show whether vaccines from Moderna and its rivals actually prevent Covid infection—but the latest data from Moderna bodes well. The company notes that it already has a deal to sell 100 million doses to the U.S. government for $1.525 billion, with an option for another 400 million doses. It’s also getting $955 million in federal funding and can recoup its development costs.

So there is surely good revenue ahead for Moderna, if its vaccine works. Whether there will be enough to justify the company’s $26 billion market cap is something that investors must decide.

Write to Bill Alpert at william.alpert@barrons.com

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