As the first pandemic-response guidelines of the year were released in Canada, public health officials warned its “too early” to relax COVID-19 measures, noting the spread of the subvariant known as XBB.1.5, or Kraken.
At a news conference in Ottawa Friday, Chief Public Health Officer Dr. Theresa Tam the country’s health-care sector is still recovering, and while levels of influenza and RSV have returned to the seasonal norms, COVID-19 cases still fluctuate across Canada.
“For this reason, it is still important to do everything we can to prevent severe illness,” Tam said.
She and Health Minister Jean-Yves Duclos used the news conference, during which they also discussed wastewater testing at major Canadian airports, as an opportunity to echo just-released advice from the National Advisory Committee on Immunization (NACI) urging the continuation of booster doses of vaccines against the disease.
The latest guidance from NACI, Tam said, includes that boosters “remain one of our best defences” against the most severe outcomes of COVID-19.
Vaccines are not 100 per cent effective, federal guidelines say, but they can impact the severity of illness, including whether hospitalization is necessary.
While not everyone experiences severe symptoms from COVID-19, they can include trouble breathing, persistent pain and pressure in the chest, confusion, inability to wake up or stay awake, and pale grey- or blue-coloured skin, lips and nails, according to a Health Canada. Anyone experiencing these should call 911.
More common symptoms of COVID-19, including of the Kraken subvariant, include sore throat, runny nose, sneezing, cough, shortness of breath, fever, chills, fatigue, body aches, loss of smell or taste, headache, diarrhea and vomiting.
NACI’S FIRST REPORT OF 2023
Ahead of the news conference, NACI released updated guidelines – its first of the new year – on how it proposes to manage the spread of COVID-19 through 2023.
Its “initial considerations” revolve around booster shots and are, as written in the report, “based on current evidence, vaccine principles and NACI expert opinion.”
The report suggests that top of mind for those on the committee is the uncertainty of the future of the pandemic, including how many more booster shots could be advised, and when.
NACI advised its guidance is likely to change as it monitors COVID-19 activity.
For now, its advice is the same as given in the fall, and that those who didn’t get a booster shot in the fall, despite recommendations at the time, should do so now. As in the fall months, a bivalent Omicron-containing vaccine is preferred for everyone aged five and older in Canada, NACI’s guidelines say.
Booster doses should be at least six months from an infection or previous dose, the committee said, and children between the ages of five and 11 should still only get one shot after their primary series.
In determining its guidelines, NACI noted that age is still the greatest risk factor for severe outcomes from infections.
NACI also monitors national and international data, including what Tam called “contextual information, like the level of immunity in the population,” as well as the impact of different variants as they spread.
“We are seeing an increase in the proportion of sequence detections associated with the XBB.1.5 variant,” she said.
Nicknamed Kraken because of its ability to spread quickly, this variant is an indication not only that COVID-19 continues to evolve, but that there is a need for vaccine equity globally to prevent further evolutions.
“Through whole genome sequencing of clinical specimens, XBB.1.5 is known to have been circulating in Canada at 2.5 per cent during the week of Dec. 25 to Jan. 2,” Tam said.
“This proportion is projected to rise at approximately 7 per cent by mid-January. While XBB variants are expected to increase in Canada, it is not known whether they will become the dominant lineage.”
Tam said in Canada, the subvariant has not been tied with increased severity, but those studying Kraken, including infectious disease specialists at Yale Medicine, say it appears to be the most transmissible, as well as more efficient and contagious.
“Like winter weather, it can be difficult to predict exactly what we’re going to see next, but we do know it’s too early to put away our winter coats and boots. Similarly, it’s still too early to start taking (away) the personal protective measures that have helped us weather the COVID-19 storm,” she said.
WASTEWATER TESTING AT AIRPORTS
Duclos mentioned further measures related to travel to Canada from China, in addition to restrictions announced earlier this month that denies entry to all passengers arriving from China, Hong Kong and Macau who do not have a negative COVID-19 test.
Those who are permitted to enter the country, including travellers who’ve passed through those destinations within 10 days, are given additional information from Canadian public health officials.
Citing a “limited amount of epidemiological and genomic sequence data testing” regarding a recent surge in cases, Duclos said Friday further action will be taken to get a sense of the spread of COVID-19.
Pilot projects at two major airports – in Vancouver and Toronto – will see the testing of wastewater from flights originating from China and Hong Kong.
“This will further enhance our ability to track the emergence of variants coming into Canada,” he said.
“Wastewater monitoring is a key tool for public health surveillance. It can alert public health officials to where diseases like COVID-19 and new variants of concern may be spreading.”
Wastewater monitoring is currently being used across Canada to monitor the spread here as well.
With files from CTVNews.ca’s senior digital parliamentary reporter Rachel Aiello
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
