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Mask advice in Canada as COVID-19, RSV, flu cases rise

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Over the course of 2022, provinces and territories dropped mask mandates as populations received multiple doses of vaccines targeting the illness, cases declined and Canada largely lifted health restrictions, as did many Western nations.

But now, nearly three years into the pandemic, infectious disease experts and those who work on the frontlines of the health-care system are urging Canadians to don masks again as hospitals grapple with a tidal wave of multiple illnesses, including COVID-19.

Cases of RSV have spiked abnormally this fall and are packing hospital emergency rooms with sick children, health-care workers report, as a shortage of children’s medication is worrying parents. Simultaneously, Canada is now officially in a flu epidemic, according to the federal public health agency, and there is increased concern from officials and public health experts about how new variants of COVID-19 could impact the population as the public heads indoors due to the cold weather.

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And while federal health officials are strongly recommending Canadians wear masks indoors, Dr. Theresa Tam, Canada’s chief public health officer, said last week that it’s up to provinces and territories to make decisions on whether to implement mandates.

“Although no individual layer of protection is perfect, when used consistently and together, vaccine plus layers can provide excellent protection against COVID-19 as well as other infectious diseases we may encounter,” said Tam at a press conference Nov. 10.

As well, only half of Canadians have received a booster dose of the COVID-19 vaccine, according to federal government data from Nov. 6.

But several jurisdictions have stopped short of issuing a mask mandate, instead opting to recommend masks are worn.

The absence of new mandates comes as a recent survey by NANOS research showed that seven in 10 Canadians would support the return of face masks to some extent. Fifty-two per cent said they’d support mandates.

Here’s what the provinces and territories are doing around masks.

BRITISH COLUMBIA

Health officials in B.C. say they are not bringing back a mask mandate at this time.

The Ministry of Health told CTV News Vancouver on Tuesday that through COVID-19 infection and vaccination, there is a high amount of population immunity.

The province’s health officer, Dr. Bonnie Henry, told reporters at a press conference Wednesday that the “heavy hand” of a mandate is not currently needed to send the message that masks are an “important tool” that can be used in every respiratory season.

“We should have one with us, we should use it in situations where it makes sense,” she said.

B.C. officials also said that the cases of RSV in Ontario are “more serious” than in B.C. and about a quarter of capacity was available in B.C. hospitals for pediatric ICU beds as of this week.

Getting children vaccinated is currently what’s needed the most, the ministry told CTV News Vancouver.

ALBERTA

In Alberta, premier Danielle Smith told reporters Monday that masking is a personal choice and those who want to wear one, can. Her message comes as the province, particularly schools, are battling influenza, RSV and COVID-19.

She said the government is focused on acquiring more children’s pain medication and ensuring hospitals can meet demand.

CTV News Edmonton reported that absenteeism in Edmonton’s public schools reached close to 14 per cent last Thursday. Catholic schools reported that about 15 per cent of students were absent due to illness as of Monday.

SASKATCHEWAN

On Monday, Saskatchewan Health Minister Paul Merriman told reporters that mask mandates have not been a discussion with the province’s chief medical officer of health, Dr. Saqib Shahab.

Merriman said it’s an individual’s choice whether they’d like to wear one. At the same press conference, Shahab said requiring masks in schools “probably is not a feasible thing at this point” and “may not be helpful.”

MANITOBA

Manitoba premier Heather Stefanson said at a press conference on Nov. 10 the province has no plans to reinstate a mask mandate.

However, she did encourage those “under the weather” to “protect others” and health-care workers. She did not specify what that protection would entail.

CTV News Winnipeg reports that the province is seeing increased hospital admissions, especially among children, for RSV and other illnesses.

ONTARIO

At a press conference Monday, Dr. Kieran Moore, Ontario’s chief medical health officer, said he is “strongly recommending” masking in all indoor public settings.

Hospitals in the province have reported they are dealing with an overwhelming number of sick children and pediatric ICU units are operating above capacity, according to The Canadian Press.

Influenza and RSV are driving the admissions and the wave of infections has arrived earlier in the fall season than in previous years prior to the pandemic.

Moore said the “difficult and complex” fall that was predicted has come to fruition and that COVID-19, influenza and RSV are circulating and Ontario must “use all layers of protection we have.”

However, Moore said he was not introducing a mask mandate as it hasn’t worked in social settings in the past and the announcement he’s made about recommendations is in an effort to get the public “back to basics” when it comes to infection prevention.

“This is protecting our children and those that are the youngest among us. Please parents, grandparents, siblings: If you have any respiratory symptoms, you must mask around those that are vulnerable,” he said.

But Moore said if the pressure on the health-care system continues to increase, a mask mandate would be the “furthest” the province goes when it comes to health restrictions.

The health ministry is currently discussing mask mandates in schools as a possible measure, he said.

Ontario Premier Doug Ford also urged the public to wear a mask the day before Moore’s announcement, but did not issue a mandate.

QUEBEC

In a move similar to Ontario, Quebec’s Health Minister Christian Dube said at a press conference Wednesday that he strongly recommended the public wear masks amid a “spicy cocktail” of viruses that are impacting hospitals, which include COVID-19, RSV and influenza.

He also recommended handwashing, and that the public stay home if they are sick.

Quebec’s Premier François Legault also said in a press scrum Tuesday that he recommends residents wear a mask in public settings, but added that it was up to an individual’s preferences.

“It’s really a citizen responsibility,” he said.

NEW BRUNSWICK

New Brunswick has not reissued a mask mandate. CTV News Atlantic interviewed several Maritime residents who had mixed opinions on whether a mandate would be welcomed or not.

But while many said they’d be sad to see masks worn again, they would wear one if they needed to in order to protect others.

CTV News Atlantic reached out to the Department of Health in New Brunswick regarding mandates on Monday and was told that if the “situation changes public health will determine a new approach.”

NOVA SCOTIA

Nova Scotia has not announced any mask mandates since public health requirements around wearing masks ended in July.

CTV News Atlantic contacted Chief Medical Officer of Health Dr. Robert Strang’s office on Monday regarding mandates and their request for an interview was declined.

In an emailed statement, the office said: “Public health continues to assess recommendations and will inform Nova Scotians if any changes are made”

PRINCE EDWARD ISLAND

Prince Edward Island has not reissued a mask mandate for the general public. However, the province still has a mask mandate for hospitals, long-term care homes and community care homes.

In an emailed statement to CTVNews.ca on Thursday, the province said PEI is experiencing an increase in respiratory illnesses, like other provinces.

“The mask mandate remains in place for hospitals, and long-term care and community care homes in PEI. At this time, there is no public mask mandate in place,” said Morgan Martin, a senior communications officer for the province’s department of health and wellness.

NEWFOUNDLAND AND LABRADOR

At a press conference Tuesday, Dr. Janice Fitzgerald, the province’s chief medical officer of health, said she can’t implement a mask mandate as the province isn’t currently experiencing a public health emergency.

Fitzgerald said she recommends masks be worn in places that are deemed higher risk for COVID-19 and other illness spread.

Recommendations “may become stronger as time goes on” and the government is continuing to monitor the situation and will make decisions based on the evidence, she said.

Newfoundland and Labrador are not seeing the same surges in illness as other provinces, she added.

YUKON

Yukon has made no moves toward re-issuing a mask mandate. The territory removed most health measures in March 2022 and removed mask mandates in schools on May 24.

NORTHWEST TERRITORIES

According to the territory’s website, masking remains a recommendation. The territory dropped its Public Health Orders on April 1, 2022.

However, masking is particularly recommended in several scenarios including if someone has tested positive for COVID-19, if they are caring for an individual who has tested positive and for those who are at higher risk of catching COVID-19.

NUNAVUT

Nunavut has not announced they are implementing a mask mandate and the territory lifted restrictions around masks in July.

However, masks are still required in community health centres, Elders’ facilities and in the Qikiqtani General Hospitaland Akausisarvik that requires patients and staff to wear masks.

With files from CTV News Edmonton, CTV News Atlantic, CTV News Winnipeg, CTV News Vancouver and The Canadian Press

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WHO decision on COVID-19 emergency won't effect Canada's response: Tam – CP24

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OTTAWA – On Monday, exactly three years from the day he declared COVID-19 to be a global public health emergency, World Health Organization director-general Tedros Adhanom Ghebreyesus will decide whether to call it off.

But declaring an end to the “public health emergency of international concern” would not mean COVID-19 is no longer a threat. It will also not do much to change Canada’s approach.

“In Canada, we’re already doing what we need to do,” chief public health officer Dr. Theresa Tam said in her most recent COVID-19 update.

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She said the WHO discussion is important but COVID-19 monitoring and public health responses are not going to end. That includes continued surveillance of cases, particularly severe illness and death, and vaccination campaigns.

The WHO’s emergency committee, which was struck in 2020 when COVID-19 first emerged as a global health threat, voted Friday on whether to maintain the formal designation of a public health emergency.

Tedros will make the final call Monday based on the advice the committee gives him.

He warned earlier this week that he remains concerned about the impact of the virus, noting there were 170,000 deaths from COVID-19 reported around the world in the last two months.

“While I will not pre-empt the advice of the emergency committee, I remain very concerned by the situation in many countries and the rising number of deaths,” he said Jan. 24.

“While we are clearly in better shape than three years ago when this pandemic first hit, the global collective response is once again under strain.”

He is worried not enough health-care workers or seniors are up to date on vaccinations, that access to antivirals is limited and that health systems around the world remain fragile following three years of pandemic strain.

In Canada, there was a noticeable rise in cases, hospitalizations and deaths over Christmas and early in January but all are trending down again. Tam said there were no surges of the virus anywhere in Canada, though the latest variant of Omicron was being watched closely.

Federal surveillance data shows more than 30 people are still dying of COVID-19 every day, and hundreds of people are still hospitalized.

The formal designation of the global public health emergency was made on Jan. 30, 2020, when 99 per cent of confirmed COVID-19 cases were still restricted to China.

The decision was made to declare an emergency because human-to-human transmission was starting to occur outside China, and the hope was that by designating an emergency it could prompt a public health response that could still limit the impact of COVID-19.

That did not happen. On March 11, 2020, Tedros declared a global pandemic, practically begging countries to do more to slow it down.

The declaration of a pandemic meant that there was exponential growth in the spread of the virus.

By WHO terminology, a “public health emergency of international concern” is the highest formal declaration and the one which triggers a legally binding response among WHO member countries, including Canada.

It is what is done when a health threat is “serious, sudden, unusual or unexpected,” when it carries global public health implications and may require “immediately international action.”

A designation prompts the WHO director-general to issue recommendations for member countries including increased surveillance to identify new cases, isolating or quarantining infected people and their close contacts, travel measures such as border testing or closures, public health communications, investments in research and collaboration on treatments and vaccinations.

Dr. Sameer Elsayed, an infectious diseases physician and the director adult infectious diseases residency training at Western University in London, Ont., said to his mind the WHO should end the global emergency designation even though the pandemic itself is not over.

“I don’t know that we should continue to call it an emergency,” he said. “I hope they say that we’re going to bring it down a notch.”

Elsayed said for vulnerable populations, including the elderly and those with compromised immune systems, COVID-19 continues to pose a serious threat, but for most people there are far bigger threats, including suicide. He said with limited health resources, COVID-19 needs to be put in its proper place alongside other health issues.

Children, in particular, said Elsayed, are much more at risk from influenza and RSV than COVID-19 in wealthy countries, and from food insecurity and the lack of access to clean water in many developing nations.

Tam said regardless of what WHO decides, Canada won’t stop monitoring the evolution of the virus that causes COVID-19, including for new variants that may require adjustments to vaccines or other treatments.

She also said we must continue to monitor the ongoing developments in long COVID.

“We mustn’t, I think, let go of the gains that we’ve had in the last several years,” she said.

“I think whatever the decision is made by the director-general of WHO, I think we just need to keep going with what we’re doing now.”

This report by The Canadian Press was first published Jan. 27, 2023.

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COVID still a concern despite drop in flu, RSV cases: expert – CTV News

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As RSV and flu cases steadily decline in Canada, the World Health Organization (WHO) is set to announce on Monday whether it still considers COVID-19 a global health emergency.

Ahead of that announcement, one of Canada’s top infectious disease specialists warns that the WHO’s consensus won’t necessarily mean the virus is behind us.

“I think it’s important to point out that this is not about … whether COVID is gone or not,” said Dr. Lisa Barrett, an assistant professor in the Department of Microbiology and Immunology as well as the Department of Medicine in the Faculty of Medicine at Dalhousie University.

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“This is a real committee-based decision at the WHO level to decide in whether this is still a public health emergency of international concern,” she told CTV News Channel Sunday.

Barrett explained that this a matter of prioritizing access to resources and research, and not to determine an end point for COVID-19.

“So what this all means is that COVID is not done,” she said. “And the way it looks in different countries is different in many situations. That’s what they’re trying to decide at this point, not whether a pandemic is done or whether COVID is going away.”

WHO director-general Tedros Adhanom Ghebreyesus will make the official call on the status of COVID-19, based on the advice of his committee. Earlier this week, he warned that he remains concerned about the impact of the virus and mentioned that there were 170,000 COVID-related deaths reported around the world in the last two months.

The WHO update comes at a time when concerns over a combination of respiratory illnesses are easing. Canadian data shows that influenza hospitalizations are now dropping.

“We’re starting to see influenza, perhaps RSV, starting to come down somewhat,” Barrett said.

“There’s still a lot of debate about whether we’re catching many cases that are not important. But really, I think the big [question] from the last year as we start to see influenza and RSV maybe go down is, what’s the best way forward?”

Barrett noted that the FDA recommended a change to booster shot roll outs.

“They’re suggesting a once-a-year, similar to a flu shot. I think that’s the right approach at this point,” she said.

“I think the first thing we should remind Canadians is that if they are due for an additional dose in the vulnerable populations — older folks, people who have bad immune systems — please don’t think it’s too early to go out and get that last dose from the fall if you haven’t.”

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Where did B.C.’s beloved Nanaimo Bar come from?

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The Nanaimo bar. It’s a sweet treat made from chocolate, custard, coconut and walnuts. Love it or hate it, it’s uniquely British Columbian.

But where did this chocolatey delicacy come from?

To celebrate the launch of CBC’s new permanent Nanaimo bureauNorth by Northwest host Margaret Gallagher spoke to food historian Lenore Newman about the origins of the treat that shares the city’s name.

Newman says it can be traced back to three women in Nanaimo after the Second World War.

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Originally — and uncreatively — called chocolate slices, Newman says the “dainties” popped up around 1952, in, no surprise here, Nanaimo. The base layer, made of graham wafer crumbs, shows up earlier, but the square as we know it with the thick custard middle and chocolate on top appeared in a local hospital auxiliary cookbook in the early ’50s, Newman said.

 

A B.C. baker’s “ultimate” Nanaimo bars

 

CBC’s Midday talks to a woman who extended her recipe into a business selling aprons and tea towels in 1987.

It was first deemed the Nanaimo bar by Vancouver Sun columnist Edith Adams in 1953 when she wrote that the dessert came from Nanaimo.

This is important to note, Newman says, because other places such as Mississauga and England have tried to claim it as their own.

The bar was later featured in the Expo ’86 cookbook, giving it a little more notoriety.

“I think if it had been called the chocolate slice, it would have faded into the past, but the fact that it was called the Nanaimo bar kept it rolling forward,” Newman said.

 

A modern interpretation of Nanaimo Bar loved around the world

 

Samuel Hartono of Northern Bars shows the unique shippable design

The Nanaimo bar’s fame has been far-reaching; when Harry and Megan visited B.C. in 2020, their interest in the treats caused a media frenzy in the U.K. and the U.S., prompting questions of what the square was and where it came from.

The Daily Mail even printed a headline titled: Were Harry and Meghan Markle lured to Canada by chocolate treats?

And in 2021, British Columbians were nonplussed when the New York Times published a recipe and photo of a Nanaimo bar that was, quite frankly, all wrong.

That wasn’t the first time people were offended over Nanaimo bars. In 2019, a Canada Post stamp featuring the dessert showed far too much of the middle layer, prompting outrage from Nanaimo bar enthusiasts.

Famous, infamous

Any self-respecting British Columbian can confirm that these layers are just plain wrong. (Canada Post)

“I like to say it’s like the Kardashian of Canadian desserts in that it’s famous for being famous and sometimes infamous, and it’s amazing how much play it gets,” Newman said.

So, how do you make the perfect Nanaimo bar? Here’s a recipe from The Great Canadian Baking Show.

Ingredients

For the crust:

  • 1 cup graham wafer crumbs.
  • 3/4 cup unsweetened flaked coconut.
  • 1/2 cup finely chopped walnuts.
  • 1/3 cup cocoa.
  • 1/4 cup sugar.
  • 1/4 tsp salt.
  • 1/3 cup unsalted butter, melted.
  • 1 egg, beaten.
  • 1/2 tsp vanilla.

For the middle layer:

  • 1/3 cup unsalted butter, softened.
  • 2 tbsp custard powder.
  • 2 tbsp milk.
  • 1/2 tsp vanilla.
  • 1/8 tsp salt.
  • 2 cups icing sugar.

For the glaze:

  • 110 g semi-sweet chocolate, roughly chopped (about 3/4 cup).
  • 2 tbsp unsalted butter.

Instructions

Heat oven to 350°F. Line an eight-inch pan with parchment paper, with ends extending over the sides of the pan. Set aside.

Stir together graham crumbs, coconut, walnuts, cocoa, sugar and salt. Add butter, egg and vanilla, stirring to combine.  Press firmly into the prepared pan.

Bake until firm, about 10-12 minutes. Set aside to cool.

Meanwhile, prepare the middle layer. Mix butter and custard powder in a large bowl with a hand mixer. Add milk, vanilla and salt and mix to incorporate. Add icing sugar in two additions. Mix until light and fluffy. Spread over the bottom layer. Refrigerate for one hour.

While the crust and middle layer are in the refrigerator, stir chocolate and butter together in a medium heatproof bowl over a pot of simmering water until melted.

Spread chocolate glaze over the middle layer. Chill for 30 minutes. Remove from the pan with parchment edges and cut into 25 squares.

Store in an airtight container in the fridge.

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