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Is Canada dropping its COVID-19 guard too quickly? Experts weigh in – Global News

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As COVID-19-related public health restrictions continue to ease across Canada, experts are split on whether officials are letting their guard down too quickly.

The federal government is expected to announce Thursday that it is ending pre-arrival testing requirements for vaccinated travellers entering Canada by April 1, sources tell Global News.

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The decision comes as nearly all remaining provincial mask mandates are set to be lifted across the country by Monday, with plans to eliminate all remaining restrictions by the end of April.

Read more:

Canada poised to end pre-arrival COVID-19 testing for travellers: sources

While experts say they welcome the end of pre-arrival testing, they are wary about what lifting other public health measures could mean for the pandemic in Canada — and whether governments will bring them back if needed.

“For all we know, this is a temporary ceasefire in the pandemic,” said Kerry Bowman, a bioethicist and assistant professor at the University of Toronto.

“If it is, then we all need a break and we should have that break. But if there is a need for restrictions in the future, they need to make sense for that future moment, not for what worked six months ago.”

Bowman pointed to the decline in COVID-19 cases, deaths and hospitalizations nationally, which have indeed fallen from the record-breaking totals seen at the peak of the Omicron variant wave in late December and early January.

But those figures have continued to plateau for the past two weeks after stalling at levels higher than past “ceasefires” between waves.

There are still more than 3,700 people in hospital due to COVID-19, including over 400 patients in intensive care, while the country’s average daily death toll remains above 50.

Despite that, provinces are moving quickly to lift restrictions. Ontario and Nova Scotia will end their indoor mask mandates for most public settings on Monday, joining almost every other jurisdiction except for Quebec and Prince Edward Island, which are aiming for an April end to their mandates.

Capacity limits and moratoriums on large events have also been eased or eliminated entirely across most of the country, while vaccine passport systems are also ending.

Epidemiologists, meanwhile, are predicting a potential bump in cases, or “wavelet,” that could occur in the spring as people start to gather together more.

Yet they also acknowledge that the combination of Canada’s high vaccination rate — more than 80 per cent of the total population have received two doses, while nearly half have been boosted — and previous infection due to Omicron will limit another health-care system surge.


Click to play video: 'COVID-19: Ford encourages those concerned with lifting of mask mandate to continue wearing them'



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COVID-19: Ford encourages those concerned with lifting of mask mandate to continue wearing them


COVID-19: Ford encourages those concerned with lifting of mask mandate to continue wearing them

Dr. Sumon Chakrabarti, an infectious diseases physician with Trillium Health Partners, says having that “wavelet” hit in the next couple of months could be a best-case scenario.

“We should remember that in temperate climates, you occasionally see a small bump in respiratory infections near the end of the winter,” he told Global News in a previous interview.

“If you’re going to have a bit of a bump, you want that to happen as far away from the start of winter as possible. In the springtime … the impact on the health system is going to be much less.”

What could trigger a return to restrictions?

Federal health officials have said only the appearance of a more deadly variant of COVID-19 could trigger a return to restrictions.

But chief public health officer Dr. Theresa Tam said earlier this month that even if such a variant arrives, there are more treatment options for COVID-19, including the recently approved Paxlovid antiviral drug from Pfizer, as well as more access to rapid tests and a better understanding of how the virus works.

She told reporters at a March 4 COVID-19 update that with all of those measures, “we’ve got to be able to go into the fall and winter season, or indeed the next wave if it should come in between, with much more ability to respond without those really severe restrictions. That is the goal.”


Click to play video: 'Canada should focus on ‘easing societal disruptions’ as COVID-19 hospitalizations decline, Tam says'



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Canada should focus on ‘easing societal disruptions’ as COVID-19 hospitalizations decline, Tam says


Canada should focus on ‘easing societal disruptions’ as COVID-19 hospitalizations decline, Tam says – Mar 4, 2022

Yet other experts warn such a variant may already be here. The Omicron BA.2 subvariant, which is more transmissible than even the highly infectious original Omicron variant, has been rising in western Canada and is believed to be behind a recent surge in cases in the United States.

Dr. Gerald Evans, a professor at Queen’s University who specializes in infectious diseases, says masking and capacity limits should remain in place until the full impact of BA.2 is known.

“I think it’s just been rushed a little bit too quickly,” he told Global News. “If we’re not quick to reduce restrictions … we could probably keep that BA.2 wave down a little bit.

Provincial leaders and public health officials have warned that the easing of restrictions does not mean the pandemic is over, and say data will determine their response to future outbreaks.

“Public Health will continue to closely monitor data that informs our public health response, including COVID-19 cases, hospitalizations and the emergence of new variants of concern,” a statement from British Columbia’s health ministry said.

Similar responses were provided to Global News by the health ministries in Ontario and Alberta. Other requests for comment were not returned before publication.

Read more:

COVID-19 cases jumped 8% globally last week, WHO says

Bowman says the end of the pre-arrival testing program has less to do with a decline in cases and hospitalizations than eliminating a measure that did little to stop the spread of COVID-19 in the country.

“Ninety per cent of the spread was already occurring inside the country, so the idea that we were going to stop the spread by testing before arrival never made much sense,” he said.

The planned continuation of rapid testing to detect new variants, on the other hand, will prove to be much more effective, he added.

Going forward, Bowman said it’s possible more provinces will allow people to make their own choices on what measures to follow in order to protect themselves, rather than mandating measures to protect all of society.

That, he added, would make more sense for the new reality of the pandemic and restore public trust.

“It’s just a different way of thinking,” he said. “We’re very divided right now. As long as people treat each other with respect, regardless of their choice to wear a mask or stay home, I think it could work.”

–With files from Global’s Aya Al-Hakim and the Canadian Press

© 2022 Global News, a division of Corus Entertainment Inc.

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Forecast: Coldest temperatures this winter coming to Eastern Canada – CTV News

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The beginning of February is expected to bring Arctic-like temperatures across much of Eastern Canada, thanks to frigid air from the polar vortex.

“I think it will be a real punch in the face for easterners,” Environment Canada senior climatologist David Phillips told CTVNews.ca. “It’s going to be pretty short-lived and it’s going to be right across the east.”

The cold snap will descend on Eastern Canada between Thursday night and Friday, with temperatures becoming seasonable again on Sunday. In between, much of Ontario, Quebec and Atlantic Canada can expect the coldest days yet this winter.

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“We’ll see temperatures that are really, brutally cold,” Phillips said from Toronto. “It’s really a one-and-a-half-day wonder.”

According to Environment Canada, as the cold air tracks east, daytime highs will only reach -13 C in Toronto, -20 in Ottawa, -21 in Montreal and -23 in Quebec City on Friday, and -18 in Fredericton, -15 in Halifax, and -18 in Charlottetown on Saturday.

“It’ll be sunny and bright, because it’s Arctic air,” Philips said. “It’s very dry, and it will be crisp”

Overnight temperatures on Friday night could dip as low as -20 in Toronto, -31 in Ottawa, -30 in Montreal, -34 in Quebec City, -28 in Fredericton, -21 in Halifax, and -23 in Charlottetown – all more or less double what’s normal for this time of year.

“The last time it was that cold in Ottawa was 27 years ago,” Phillips explained. “You can go year after year after year and not see a temperature of -20 in Halifax.”

These temperatures do not factor in wind chill, which could make things feel even icier.

“It’s going to be very punishing,” Phillips said. “It’s clearly an Arctic invasion of frigid air.”

The short-lived and bitter winter blast is being blamed on a weakened polar vortex, which causes icy Arctic air to push south, leading to rapid and sharp temperature drops.

There is a silver lining for those who have been missing out on winter activities.

“The second half of winter, according to our models, seems certainly a little colder, more winter-like, than what we saw at the beginning of the winter,” Phillips said. “But everywhere in Canada, we’re now well the beyond the halfway point. There’s more winter behind us than ahead of us!”

While much of Western Canada has been shivering through the winter, it’s been a different story in the unseasonably mild east. Phillips says December and January in Ottawa, for example, were the third warmest on record in 150 years; and both Ottawa and Montreal have experienced no days below -20 this winter, when normally they would each have about 10. Ottawa’s Rideau Canal Skateway is also still closed when it typically opens in January. Warmer winter temperatures, however, have also brought abundant snow.

“If you’re in the east, it’s looking like winter, but it doesn’t feel like winter,” Phillips said. “But it’s going to feel like winter when the cold arrives.”

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Canada province experiments with decriminalising hard drugs – BBC

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Needles of drugs being preparedGetty Images

Canada’s province of British Columbia is starting a first-in-the-nation trial decriminalising small amounts of hard drugs such as cocaine and heroin.

From Tuesday, adults can possess up to 2.5g of such drugs, as well as methamphetamine, fentanyl and morphine.

Canada’s federal government granted the request by the west coast province to try out the three-year experiment.

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It follows a similar policy in the nearby US state of Oregon, which decriminalised hard drugs in 2020.

Ahead of the pilot’s launch, British Columbia and federal officials outlined the rules under the federally approved exemption from the Controlled Drugs and Substances Act.

While those substances will remain illegal, adults found in possession of a combined total of less than 2.5g of the drugs will not be arrested, charged or have their substances seized. Instead, they will be offered information on available health and social services.

Federal minister of mental health and addictions Carolyn Bennett on Monday called the move “a monumental shift in drug policy that favours fostering trusting and supportive relationships in health and social services over further criminalisation”.

Some 10,000 residents have died from drug overdoses since British Columbia declared drugs to be a public health emergency in 2016, officials said.

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“Decriminalising people who use drugs breaks down the fear and shame associated with substance use and ensures they feel safer reaching out for life-saving supports,” said Jennifer Whiteside, the British Columbia minister for mental health and addictions.

Thousands of police officers in the province have been offered training on the rule change, including those in Vancouver, the largest city in the province.

The programme will run from 31 January 2023 until 31 January 2026, unless it is revoked by the federal government.

Some experts have questioned the 2.5g limit, saying that it is not enough to account for the habits of many addicts.

There are some exemptions to the scheme.

The sale of drugs remains illegal. It is also illegal to possess drugs on the grounds of schools, childcare facilities and airports.

Canada legalised the use of recreational cannabis for adults nationwide in 2018.

But the four drugs now allowed in small quantities remain prohibited, meaning there are no plans to sell them in stores, unlike marijuana. Trafficking them across borders also remains illegal.

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Health Canada reviewing safety of controversial breastfeeding drug – CBC.ca

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Health Canada has launched a safety review of the psychological withdrawal symptoms associated with stopping or reducing use of a drug commonly prescribed to help women breastfeed.

The agency confirmed the review in an email to CBC News.

“A safety review is currently under way for domperidone and drug withdrawal symptoms after stopping or reducing the dose of domperidone used to stimulate lactation,” the statement said. 

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Domperidone is approved in Canada to treat gastrointestinal disorders. Health Canada has never authorized its use as a lactation aid, but it is widely prescribed off-label for this purpose. 

The Health Canada review follows a CBC News investigation into severe psychological effects that can occur when some women stop taking the drug. Women who spoke to CBC described anxiety, lack of sleep and thoughts of self-harm severe enough that in some cases they became incapable of caring for their children or returning to work. One woman described multiple attempts to take her own life. 

CBC’s investigation also found domperidone is prescribed by some doctors to stimulate lactation at doses three to five times higher than what is recommended by both Health Canada and the drug manufacturer. Because this is not an approved use or dosage anywhere in the world, there are no large-scale clinical trials that shed any light on how often these side effects occur. 

This makes it challenging for regulators like Health Canada to evaluate the safety of a drug for an off-label purpose, said Mina Tadrous, an assistant professor at the Leslie Dan Faculty of Pharmacy at the University of Toronto who specializes in drug safety.

Toronto pharmacist Mina Tadrous says it is challenging for regulators to evaluate the safety of a drug used for off-label purpose. (CBC)

“The company may not have intended it for that, so the original clinical trials were not designed for that. And so it means that they have to look at different mechanisms to be able to evaluate the safety of these drugs,” he said.

That can include looking at data from other countries with larger populations, according to Tadrous.

Case studies document concerns

There are, however, case studies documenting the withdrawal effects, including three published in November 2022 in the peer-reviewed journal Breastfeeding Medicine. Domperidone blocks dopamine receptors in the brain, which stimulates the release of prolactin. This causes lactation, the authors note, but can also cause domperidone to act as an antipsychotic. The authors also noted withdrawal symptoms are typically less severe when women taper off the drug slowly.

The most recent case studies are from the United States, where domperidone is not approved by the Food and Drug Administration for any purpose. CBC’s investigation found some American women get the drug from doctors in Canada.

Health Canada will review “all relevant domestic and foreign case reports,” the statement said.

Reviews can result in Health Canada requesting more information, studies or monitoring by the manufacturer. They can also result in warnings to patients and health care providers, changes to how a drug is labelled or, if necessary, the withdrawal of a drug from the market “if the benefits no longer outweigh the risks of the product,” according to the statement released by the department.

“The decision to take action, including issuing a warning, is not based solely on the number of case reports, but on a comprehensive assessment of the information contained in these case reports,” Health Canada’s statement said. 

“Should new safety risks be confirmed, Health Canada will take appropriate action and continue to keep Canadians informed.”

WATCH | Women report alarming withrawal effects after taking domperidone as a lactation aid:

Women report alarming withdrawal effects from drug prescribed for breastfeeding

2 months ago

Duration 7:08

WARNING: This story contains distressing details about suicidal thoughts and attempts. Correction: A previous version of this video included inaccurate Health Canada data about the number of domperidone prescriptions that were filled in 2020. That publicly available data has since been updated to show that 1.7 million prescriptions were filled that year.

The distinction between quantity and quality of reports is important, Tadrous said, because large numbers of reports, especially from non-clinicians, may only indicate people believe there’s a connection between a drug and a reaction. 

“That’s the lesson we’ve learned with vaccines, for example, where these adverse event systems are flooded,” he said.

“And so if you base something just on the number of reports without doing a thorough investigation and a different type of study design that reduces bias … you might reach a false conclusion.”

Health Canada has conducted multiple safety reviews of domperidone, most recently in 2021. Previous reviews confirmed the risk of serious abnormal heart rhythms and sudden cardiac death related to domperidone use. These reviews resulted in Health Canada introducing a maximum daily dose recommendation of 30 mg and restricting its use in patients with certain cardiac conditions or taking other drugs.

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