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Lessons from Pauingassi: How a variant scare at a remote First Nation can better prepare Manitoba – CBC.ca

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In the space of one week, Manitoba bounced around an epidemiological version of a roller-coaster ride, thanks to the real and supposed presence of the COVID-19 variant first found in the U.K.

On Feb. 9, public health officials confirmed the province’s first case of the more contagious B117 COVID-19 variant, contracted by a traveller who visited Africa and Europe.

Four days later, First Nations health officials disclosed they found seven potential cases of the same variant in Pauingassi, an Anishinaabe community nestled into the coniferous forest of eastern Manitoba, accessible only by plane, winter road or an arduous ascent of the Berens River by canoe.

The unsettling prospect of a more contagious variant reaching one of the province’s most remote communities didn’t last long. Only three days later, the National Microbiology Laboratory in Winnipeg determined the Pauingassi cases in question were nothing out of the ordinary.

Manitobans can be forgiven for feeling as if someone just yanked their chains.

It would be fair to describe the collective mindset as somewhat fragile, given that the province only recently managed to reduce its COVID infection and hospitalization rates — after a miserable and deadly fall — to the point where most businesses are allowed to reopen to some degree.

Nonetheless, nobody at Manitoba public health or the First Nations pandemic response team was engaged in any funny business over the weekend. Red flags were attached to the Pauingassi cases in completely good faith.

“This is a fantastic learning opportunity,” said Dr. Marcia Anderson Manitoba, the head of the First Nations pandemic response team, on Tuesday, explaining this initial B117 scare will prepare remote communities for the real deal. 

“There are some enhanced measures that we will be taking whenever there’s a potential variant of concern. That includes longer isolation periods for contact [and] potential retesting of contacts.”

Two steps to finding a variant

Determining whether a COVID-19 sample is one of three new more contagious variants is more complicated than testing for COVID itself.

For starters, it involves two steps.

The first step is a relatively straightforward screening test for a genetic mutation known as N501Y.

The mutation is found in all three of the more contagious COVID variants of concern to epidemiologists: the B117 strain first found in the U.K., the B1351 strain first discovered in South Africa and the P1 variant first found in Brazil.

The presence of this mutation does not mean a sample is one of these more contagious variants. There are other, more banal variants with same mutation.

That’s why most positive COVID-19 samples that turn out to have the N501Y mutation are sent to Winnipeg’s National Microbiology Laboratory for a complicated form testing known as genomic sequencing, which maps out the entire genetic fingerprint of the virus.

It takes more than one technician or scientist to analyze the results of sequencing, which not only determines whether a sample is in fact a variant of concern but also adds another entry into a library of COVID genetics.

“Many different variants are discovered and tracked this way, including those that might be unique to Manitoba,” Manitoba public health said in a statement.

Act now, confirm later

Dr. Brent Roussin, Manitoba’s chief provincial public health officer, said his office doesn’t wait until genomic sequencing is complete before it acts on how to handle someone suspected of carrying one of the three problematic variants.

“Whenever we see an indication of variants of concern are so important to us that public health, we’re going to act on it immediately as if it is,” Roussin said on Tuesday. “If we get sequencing that changes that, then we can adjust our measures.”

Those measures include more rigorous contact tracing and potentially more lengthy isolation. The province is in the process of figuring out new tracing-and-isolation standards for COVID-19 variants of concern.

Roussin acknowledges Manitoba public health would not announce a positive result to the initial screening phase, as the First Nations pandemic response team did on Saturday. But he did not criticize the team for doing so, given the abundance of caution that must be exercised when you’re dealing with a remote and vulnerable community.

For now, it seems, Manitoba has been spared the worst of the variant transmission seen in some other provinces. But it’s only a matter of time before more contagious variants supplant the COVID-19 strains circulating in Manitoba right now.

“We should be expecting further variants of concern to develop over time,” Roussin said.

The question is how many Manitobans can get vaccinated before this happens — and how many continue to adhere to pandemic precautions after more contagious variants arrive.

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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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.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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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.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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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.

The Canadian Press. All rights reserved.

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