It is possible, but rare, to be infected with flu and COVID-19 at the same time.
Manitoba unveiled a new colour-coded system Wednesday that will allow the government to roll out COVID-19 restrictions targeting specific regions, communities or industries in the province.
The new system has four risk levels, with each triggering possible measures that public health officials can take to limit spread of the virus.
“Our pandemic response system was established to ensure that all Manitobans have the most current information so they can plan, they can prepare, they can keep themselves safe,” Premier Brian Pallister said at a noon-hour news conference on Wednesday, along with Chief Provincial Public Health Officer Dr. Brent Roussin.
With this new system, the province hopes to focus restrictions on specific areas or sectors, rather than rolling them out across the province and impacting the broader economy.
“We need to find a way to live with this virus without requiring widespread shutdowns,” Roussin said.
Using the colours green, yellow, orange and red, the system lays out a range of responses broken down by sectors, such as schools, restaurants, child-care centres and community gatherings.
Manitoba at ‘yellow’ level
The four risk levels and their accompanying restrictions can be applied across the province, in a region or community, across a sector, or even at a specific site. Regional restrictions may not correspond to the boundaries of existing health regions, and restrictions can be scaled up or down.
As risk levels rise in a community or region, the province could impose additional restrictions, such as reducing the size of gatherings or restricting travel in and out of an area.
Information about current risk levels and restrictions will be available on the province’s website.
Manitoba as a whole is currently under the yellow “caution” risk level, meaning community transmission of COVID-19 is considered to be at low levels.
The yellow level includes many restrictions Manitobans are already familiar with, such as limits on gathering sizes, restrictions on people returning from out of province, and directions to practise good hygiene and physical distancing.
The orange, or “restricted,” level is intended to be used when health officials see evidence of community transmission, but new clusters can be contained with self-isolation, and the health-care system is able to handle the caseloads.
The highest risk level, red or “critical,” means there is extensive community transmission and clusters of COVID-19 that are not contained, and the cases are putting strain on the health system.
In order to reach the lowest level — green, or “limited risk” — spread of COVID-19 would have to be broadly contained and a vaccine or viable treatment for the disease would have to be available.
Risk levels higher than “yellow” are already either in effect, or being considered, in some areas within the province.
Health officials are closely watching the city of Brandon, where a cluster has grown to include dozens of COVID-19 cases, with some evidence of community spread. The risk level could be raised to orange, or “restricted,” in Manitoba’s second-largest city, Roussin said.
Also, the Bethesda Place personal care home in Steinbach, Man., is listed as red, or “critical,” after one person tested positive there earlier this week. The province has declared an outbreak there, and additional visitor restrictions are in place. Under normal circumstances, public health officials require more than one case to declare an outbreak, but the decision was made in this case due to the severity of the COVID-19.
Multiple factors considered
In creating Manitoba’s pandemic response system, health officials looked at similar tools in places like New Brunswick, Newfoundland and Labrador, and the United Kingdom. The Manitoban system was modelled after other risk communication systems, such as the one in place for wildfire conditions.
Generally speaking, no one indicator will be used to determine whether restrictions should be increased or eased, Pallister and Roussin said. There are multiple factors health officials will consider.
For example, a test-positivity rate — a rolling five-day average of how many COVID-19 tests come back positive — of two or three per cent would be considered higher risk.
Other factors that could indicate higher or lower risk include rapidly increasing case numbers, and whether contact tracing links new cases to known clusters or community transmission.
Cases of the disease caused by the new coronavirus have increased sharply in Manitoba over the last month, with rising numbers of infections in multiple communities across the province, including a cluster of more than 60 cases in Brandon.
The new system builds on efforts by the provincial government to make their response to the pandemic more focused and tailored to local conditions.
Last week, the province updated its online dashboard to show more details on where cases have been identified, broken into 68 districts across Manitoba: 13 in the Prairie Mountain Health region, 24 in the Southern Health region, 14 in the Interlake-Eastern region and 15 in the Northern region, plus the Winnipeg district.
Alberta won't remove symptoms from COVID-19 student checklist – CBC.ca
Dr. Deena Hinshaw says Alberta won’t follow B.C’s lead and cut down the list of COVID-19 symptoms parents must screen their school children for each morning.
The B.C. list of symptoms shrunk by more than half on Monday when the province’s health ministry removed 10 of the 17 symptoms from the checklist including a sore throat and a runny nose.
Hinshaw, Alberta’s chief medical officer of health, says although mild symptoms are very common in children, it’s not a move the province is ready for.
“I think in Alberta, we’re not far enough along yet to know whether or not we could take some of those symptoms off of our lists without increasing the risk that COVID-19 could be introduced into the school,” Hinshaw said at her regular media briefing.
“So right now we are keeping our list as is.”
B.C.’s ministry said it removed some symptoms because of the low probability that the symptoms by themselves indicate the student had COVID-19.
There was also concern that because those symptoms, which also include headache and fatigue, are so common in children, some kids would be unnecessarily excluded, the ministry added.
“This has been something that has been discussed at length as we try to reach that right balance between keeping our kids in school and making sure that their learning is as smooth as possible, while at the same time minimizing the risk of a COVID-19 introduction and spread,” Hinshaw said.
She said Alberta Health officials would be watching the experiences of B.C. and other provinces and territories “and if we feel that we can make that change without putting our schools at risk, then we will consider it.”
The Alberta Teachers’ Association (ATA) is not in favour of following B.C.’s lead either, saying any decision must be made through science and research by Hinshaw.
“Daily symptom screenings is a cornerstone of the safety measures in place to protect students, teachers and educational staff in our schools,” wrote Jason Schilling, ATA president.
“We would not support any changes to the list of symptoms at this time.”
Will there be a twindemic? Fighting COVID-19 means fighting the flu – Nipawin Journal
Getting a flu shot is always a good idea. But infectious diseases experts say it’s crucial this year as the northern hemisphere faces a “twindemic” — the perfect storm of the convergence of COVID-19 and the seasonal flu.
It’s a scenario that could endanger an already strained health care system.
“Having two circulating respiratory viruses is not a good thing. This is something we can do something about,” said Dr. Kumanan Wilson, a senior scientist in the clinical epidemiology program with The Ottawa Hospital Research Institute and a professor of medicine at the University of Ottawa.
If COVID-19 testing centres are already exhausted and people show up with respiratory symptoms, it will overwhelm testing capacity, he said.
“From a societal perspective, we have to reduce the pressure on our health-care system.”
The flu season also presents a potential drain on families and workplaces. People with any respiratory symptoms, whether they are flu or COVID-19, will have to remove themselves from school and work.
The flu presents its own dangers. According to the Public Health Agency of Canada, there are an average of about 12,200 hospitalizations and 3,500 deaths related to the flu every year. Based on laboratory testing, there were 42,541 cases of seasonal influenza in 2019-2020.
“Everyone should get the flu vaccine this year,” Wilson said. “It’s a no-brainer.”
Concern about a potential twindemic is not overblown, epidemiologist Dr. Jeff Kwong said.
“Most health care workers would say we’re barely managing in a normal flu season. We’re always on the verge of collapse. If you add COVID, we’re in big trouble,” said Kwong, a professor at the Dalla Lana School of Public Health at the University of Toronto.
“The biggest problem with how we view influenza is that there are other respiratory viruses circulating,” he said. “The flu is a whole bunch of viruses with a whole bunch of different presentations. They’re impossible to distinguish without lab tests.”
If people let down their guard on measures to prevent the transmission of COVID-19, such as wearing masks, physical distancing and hand hygiene, there will be a twindemic, Kwong said.
“If people keep having parties, we’ll have influenza. But, if you can control COVID, you can control influenza.”
It is also possible, but rare, to be infected with flu and COVID-19 at the same time. A study published in June in the Journal of Medical Virology found that, among 1,103 patients who had been diagnosed with COVID‐19 in three hospitals in Istanbul, Turkey, six were diagnosed as also being infected with influenza. Co-infected patients have been reported in China, Germany, Iran, Japan, Spain and the United States.
In Canada, provinces and territories have ordered nearly 13.8 million doses of flu vaccine, an increase of 2.6 million over estimated demand at this time in 2019, said Maryse Durette, a spokeswoman for the Public Health Agency of Canada. A small reserve has also been created and it will be available for provinces and territories if needed.
So far, so good. Last year at this time, there were concerns that the flu vaccine might not be available until early November for most people because of delays in recommendations and production.
This year, flu vaccine will be made available for delivery beginning in mid-September, with most deliveries completed by the end of October, Durette said. To meet the increased demand this year, a small portion of Canada’s requirement will also be supplied in November and December.
“At the present time, no supply issues are expected this year and the increased demand by provinces and territories that has occurred since orders were first placed with suppliers in February is expected to be met in full.”
But getting the flu vaccine rolled out this year may produce additional challenges.
Health Canada has flagged some concerns, including the availability of staff and access to PPE for those who will be administering flu shots.
There are also some unknowns, including the public’s fear of exposure to COVID-19 while being immunized for flu. At the same time, there is the potential of increased demand for flu shots early in the season, something that was seen in the southern hemisphere, where the flu season starts in March.
“We don’t want people congregating as they usually do in gymnasium-type programs,” Wilson said. “We need to do it differently. And well.”
Among the possibilities according to Health Canada: drive-through and parking lot clinics in locations ranging from car washes, arenas, insurance inspection centres and drive-thu tents.
Ottawa Public Health is still working out its flu shot strategy and is to present more detail Monday at a board of health meeting.
Pharmacists, who already administer between 40 and 50 per cent of flu shots in Canada, will also be enlisted to do more.
“We’re expecting increased demand. People are already making reservations,” said Shelita Dattani, director of professional affairs at the Canadian Pharmacists Association, which has already posted a fact sheet about what to expect from pharmacies this year.
Pharmacists may be delivering flu shots by appointment, through dedicated hours for walk-in clients, special hours for vulnerable patients, off-site services such as home visits and clinics at community halls or temporary structures.
“If there is one thing you can control this year, it’s the flu shot,” Dattani said. “It’s going to be a busy year.”
For those who monitor the spread of influenza, the Australian experience of the flu season, which just ended, is a sign for hope.
According to an Australian department of health report released Sept. 6, influenza and influenza-like illness activity was lower than average across all systems for this time of year.
There were 21,119 cases of laboratory-confirmed influenza and 36 laboratory-confirmed deaths related to flu in Australia. The numbers dropped and remained low as the flu season went on.
Many who monitor the situation, including Wilson and Kwong, believe COVID-prevention measures such as physical distancing helped to reduce the spread of flu in Australia.
Meanwhile, a study published last month in the Journal of Pediatrics of almost 3,000 families found that more parents planned to vaccinate their children for flu season.
The researchers asked parents who visited 17 emergency departments in Canada, Israel, Japan, Spain, Switzerland and the U.S. between mid-March and the end of June about their willingness to vaccinate their children. About 54 per cent said they did, an increase of nearly 16 per cent from last year. Among those who did not vaccinate their children last year, almost 29 per cent planned to vaccinate this year.
Dr. Ran Goldman, a researcher and professor of pediatrics at the University of British Columbia and the study’s lead researcher, is hoping that a minimum of 70 per cent of the population will get the flu vaccine.
It’s a tall order. Having 40 per cent of the population immunized for flu in an ordinary year is considered very good, Kwong said. Only among vulnerable groups such as people over 65 and those with chronic illnesses do the numbers reach 70 per cent.
As a pediatrician, Goldman says he sees parents are more open to flu shots for their children, especially after he explains to them that children may be vectors of the flu for older people, such as grandparents. If you protect children, you are protecting everyone around them, he said.
“I’m hoping for a milder flu season, but you can’t trust luck,” he said. “We need to tell parents to roll up their sleeves … and the sleeves of their children.”
The flu shot is not 100 per cent effective, as public health authorities have to make an educated guess about what strain will be in circulation. Given the low number of cases in 2020, it has been difficult to assess vaccine match and effectiveness, Australian authorities said.
For Canada, it’s still too early to say what might happen. Another strain of flu may appear in the early spring. The flu strain in circulation in November is not necessarily the same strain in circulation in March, Wilson said.
“But, if you could reduce your risk, why wouldn’t you do it? Even in a worst-case scenario, it’s still worth it.”
Meanwhile, Wilson sees the roll-out of this year’s flu vaccine as practice for rolling out a COVID-19 vaccine — when one becomes available — under physical distancing constraints.
“It will help us figure out the logistics.”
COVID-19 case count increases in Manitoba; two more deaths reported – ThePeterboroughExaminer.com
WINNIPEG—Manitoba’s chief public health officer says he’s worried by an increase in COVID-19 cases in Winnipeg and that some people are going to many different locations while symptomatic.
“It’s concerning,” Dr. Brent Roussin said Monday.
The number of active cases in the capital city has almost tripled to more than 280 since the start of September. Sixteen of 22 new provincial cases reported Monday were in Winnipeg.
The province identified several Winnipeg restaurants, bars and gyms as sites of possible exposures over the last week. There have also been cases in schools and from gatherings in homes.
Roussin said the number of contacts for each person who tests positive has increased, which is putting pressure on staff tasked with tracking them. One person who tested positive in Winnipeg had 50 contacts, according to recently released data in the province’s public health report for the week of Sept. 6 to 12.
Roussin said mandating masks and bringing back other restrictions are on the table. But for now, the province is monitoring the situation.
Roussin is encouraging people to wear masks even if not officially required.
“If the vast majority of Manitobans want to wear a mask in indoor public places, we don’t really need a mask mandate.”
Roussin also announced that two more Manitobans have died after testing positive for COVID-19. That brings the total in the province to 18. The recent deaths were of a man in his 80s in the southern health region and a woman in her 80s in the Prairie Mountain region.
Those areas saw a resurgence in positive cases in July and August. As a result, specific regulations around masks and group sizes were put in place in Prairie Mountain, which includes Brandon. Infection numbers in those regions have since dropped, while cases in Winnipeg have surged.
The surge prompted the captain of the National Hockey League’s Winnipeg Jets to make a request on social media for mandatory masks.
“Time for universal mask mandate. Why not? Let’s take care of each other,” read a post on Blake Wheeler’s Twitter account, directed to Premier Brian Pallister.
When asked about the request, the premier said he would defer to health experts.
“I personally have a ton of affection for Blake Wheeler and the way he plays hockey,” Pallister said.
“To make sure that we get through this together, we have to demonstrate that we can respect those who we’ve put in a position of trusted leadership. And Brent Roussin’s been put in that position and it’s really important we respect that.
“It doesn’t mean we have to agree with everything Brent says or does — that’s not what I’m saying. But I am saying that I am going to respect … what our experienced public health officials decide.”
Also Monday, the government revealed details of how it will spend its $85.4-million share of recently announced federal funding to help schools during the pandemic.
Education Minister Kelvin Goertzen said the money is to help enhance remote learning for students who can’t attend classes, such as those with chronic health conditions who are advised by doctors to not attend.
Remote learning is also available for some high school students in more-crowded schools and for students whose classes have been temporarily cancelled due to a COVID-19 outbreak.
Goertzen said the province is not expanding remote learning to make it an option for any student who wants it.
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