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More COVID-19 deaths at for-profit nursing homes in Ontario, study finds – Rimbey Review

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TORONTO — For-profit long-term care homes in Ontario saw significantly worse outbreaks of COVID-19 and more related deaths than their non-profit or municipally run counterparts, according to a new study released on Wednesday.

The paper in the peer-reviewed Canadian Medical Association Journal raises questions about the ownership status of nursing homes, a factor the association that speaks for the facilities said last year had no impact on quality of care.

The research looked at all 623 long-term care homes in Ontario, from March 29 — the date of the first reported case of coronavirus in a home — until May 20. Collectively, the facilities housed more than 75,000 seniors — most of them with multiple health conditions, both physical and cognitive.

In all, more than 5,200 residents contracted COVID-19 during the study period. More than one quarter of those infected — 1,450 — died.

In Ontario, 57 per cent of nursing homes are set up to be profit-making — the highest rate in the country. Another 26 per cent are non-profit and 16 per cent are municipally run. While profit status had no impact on whether a facility had a coronavirus outbreak, the study finds, it did play a significant role in what happened if one occurred.

“We did find evidence that for-profit LTC homes have larger COVID-19 outbreaks and more deaths of residents from COVID-19 than non-profit and municipal homes,” the study finds. “Those with older design standards appear to show worse outcomes.”

The study, co-authored by Dr. Nathan Stall with the Sinai Health System and University Health Network in Toronto, also suggests chain-operated for-profit homes — 85 per cent of the commercial facilities — run a significantly higher risk of worse COVID outcomes.

An accompanying commentary notes upgrading facilities — many beds are at or below 1972 standards — likely won’t fix the situation at for-profits if further research confirms chain ownership is a key factor on its own.

Dr. Samir Sinha, a Toronto-based geriatrician not involved in the study, said 30,000 long-term care beds in Ontario are in dire need of upgrades.

“Many of these older multi-bedded homes happen to be owned by for-profits,” Sinha said. “The study really speaks to the need to redevelop that.”

The government of Premier Doug Ford initially promised to build 15,000 beds in five years and redevelop another 15,000, Sinha said. However, only a relative handful have been built or redeveloped, and the government has now significantly tempered its ambitions.

Last week, the government announced it is changing the way it funds long-term care home expansions in a bid to spur construction, while conceding it would now pay for 8,000 new beds, and 12,000 renovated beds in the same five-year period.

In the interim, it has also limited room occupancy to two, further exacerbating bed shortages.

The Ontario Long Term Care association, which speaks for nursing homes and has complained about underfunding, did not respond to a request for comment on the study.

Separately Wednesday, the Ontario Health Coalition said 95 per cent of staff in the province’s nursing homes reported basic care needs of residents — such as bathing, oral care and emotional support — were going unmet due to staff shortages.

Others said they didn’t have enough time to properly feed residents, get them to the washroom on time, or make sure they didn’t develop pressure ulcers — a situation especially problematic at night and on weekends. Most respondents reported the situation had worsened since the pandemic hit in March.

In response, Ford said the survey findings show why his government passed ongoing emergency powers to be able to “flow staff from the hospitals into long-term care.”

Previous research has shown staffing levels play a key role in COVID-19 outcomes, with one California study finding under-staffing doubled the chances of residents’ becoming infected.

“If requirements to fund adequate levels of staffing affect the bottom lines of for-profit facilities, then it might be time for this care to be turned over to public and non-profit entities,” the journal commentary says.

This report by The Canadian Press was first published on July 22, 2020.

Colin Perkel, The Canadian Press

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EU regulator backs month-long storage of Pfizer COVID-19 vaccine in fridges

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Europe’s drug regulator on Monday recommended extending the storage time for the Pfizer-BioNTech COVID-19 vaccine at normal fridge temperatures to 31 days from five days, easing logistical challenges during rollouts in the region.

The change is applicable to unopened vials, the European Medicines Agency (EMA) said, adding that the advice by its human medicines committee came after assessing additional stability study data submitted by Pfizer and BioNTech.

“EMA is in continuous dialogue with the marketing authorisation holders of COVID-19 vaccines as they seek to make manufacturing improvements to enhance vaccine distribution in the EU,” the watchdog said.

The EU has allowed for ramped-up production of the Pfizer-BioNTech vaccine in the region and is eyeing a new deal to secure more doses of the shot after the bloc was hit by cuts in the supply of AstraZeneca’s vaccine.

Vaccine deliveries were also slower initially under the EU’s centralised procurement strategy.

U.S. authorities in February had approved storage and transport of the Pfizer-BioNTech vaccine at standard freezer temperatures of -15 to -25 degrees Celsius for up to two weeks instead of the ultra-cold temperatures between -80 to -60 degrees Celsius it usually requires.

The EU storage change also comes as the U.S. and German drugmakers are seeking approval of the vaccine for inoculating adolescents aged 12 to 15 years. The United States and Canada have started vaccinating this group with the shot, which uses the brand name Comirnaty.

The two-dose vaccine, similar to the one developed by Moderna, uses new mRNA technology to deliver instructions to the human body to build immunity against COVID-19.

With 200 million vaccine doses delivered overall, the EU is on track to achieve its goal of inoculating 70% of its adult population by summer, European Commission President Ursula von der Leyen tweeted on May 9.

(Reporting by Pushkala Aripaka in Bengaluru; Editing by Ramakrishnan M. and Alex Richardson)

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Sanofi-GSK report positive interim results for their COVID-19 shot

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An experimental COVID-19 vaccine developed by Sanofi and GlaxoSmithKline showed a robust immune response in early-stage clinical trial results, enabling them to move to a late-stage study, the French drugmaker said on Monday.

Sanofi and Britain’s GSK said a global Phase III trial would start in the coming weeks and involve more than 35,000 adults, with the hope of seeing the vaccine approved by the fourth quarter after having initially targeted the first half of this year before a setback.

Sanofi and GSK last December were forced to restart their trial when the vaccine showed a low immune response in older adults as a result of a weak antigen formulation.

Sanofi and GSK shares were little changed in early trading.

“The Phase II interim results showed 95% to 100% seroconversion following a second injection in all age groups and across all doses, with acceptable tolerability and no safety concerns,” Sanofi said.

Seroconversion refers to the vaccine’s ability to prompt the body to produce antibodies against the coronavirus, as measured by blood readings. Later mass trials will be based on real infections.

“Interestingly, we also observed that our vaccine generated a higher antibody response in those with previous COVID-19 infection, we are analysing this further as it may suggest our vaccine could serve as a potential booster, regardless of what vaccine someone may have received (beforehand),” Su-Peing Ng, Sanofi’s global head of medical for vaccines, told reporters.

Ng said the vaccine had not been tested against so-called variants in the Phase II trial but that the Phase III study would be assessing it against various strains including a virus lineage known as B.1.351 first detected in South Africa.

But Sanofi, Ng said, has conducted parallel studies evaluating its vaccines against variants, with results expected to be published soon.

GSK and Sanofi’s vaccine candidate uses the same technology as one of Sanofi’s seasonal influenza vaccines. It will be coupled with an adjuvant, a substance that acts as a booster to the shot, made by GSK.

‘QUITE A POTENTIAL’

Some 162.75 million people have been reported to be infected by the coronavirus in more than 210 countries and territories since the first cases were identified in China in December 2019, while economies have taken a hit and restrictions have turned daily life upside down.

The United States and Europe have embarked on mass vaccinations programmes in the past months, raising hopes of a gradual reopening, although the virus is still in circulation in many regions, with variants causing concern.

Last month, the European Union executive’s President Ursula von der Leyen said protein-based COVID-19 vaccines such as the one developed by Sanofi and GSK offered “quite a potential”, a positive signal as the bloc develops its purchasing strategy for the next two years.

Sanofi’s shot, however, even if approved, will come long after ones from Pfizer/BioNTech and Moderna, which have produced efficacy results of more than 90%.

So far, Sanofi has purchasing agreements with the United States, the EU, Britain and Canada, as well as with the World Health Organization-backed COVAX facility.

The company has pledged to help other drugmakers this year, striking “fill and finish” deals for vaccines made by Pfizer/BioNTech, Moderna and Johnson & Johnson.

In addition to its vaccine project in collaboration with GSK, Sanofi is working on a mRNA candidate with U.S. company Translate Bio for which it has started clinical trials.

 

(Reporting by Matthias Blamont; editing by Louise Heavens and Jason Neely)

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Worldwide coronavirus cases cross 161.42 million, death toll at 3,488,751

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More than 161.42 million people have been reported to be infected by the novel coronavirus globally and 3,488,751​ have died, according to a Reuters tally.

Infections have been reported in more than 210 countries and territories since the first cases were identified in China in December 2019.

Interactive graphic tracking global spread of coronavirus: open https://tmsnrt.rs/2FThSv7 in an external browser.

Eikon users can click  for a case tracker.

The following table lists the top 50 countries by the number of reported cases. A complete list is available with the above links.

COUNTRIES AND TOTAL DEATHS CONFIRMED DEATHS PER

TERRITORIES CASES 10,000

INHABITANTS

United States 584,768 32,926,288 17.9

India 262,317 24,046,809 1.94

Brazil 430,417 15,433,989 20.55

France 107,423 5,848,154 16.04

Turkey 44,301 5,095,390 5.38

Russia 254,590 4,922,901 17.62

United Kingdom 127,668 4,446,824 19.21

Italy 123,927 4,146,722 20.51

Spain 79,339 3,604,799 16.95

Germany 85,903 3,579,871 10.36

Argentina 69,254 3,242,103 15.56

Colombia 79,760 3,067,879 16.06

Poland 71,311 2,849,014 18.78

Iran 76,433 2,732,152 9.34

Mexico 219,901 2,375,115 17.43

Ukraine 47,620 2,143,448 10.67

Peru 65,316 1,873,316 20.02

Indonesia 47,823 1,734,285 1.79

Czech Republic 29,857 1,651,178 28.09

South Africa 55,012 1,605,252 9.52

Netherlands 17,423 1,589,282 10.11

Canada 24,825 1,312,408 6.7

Chile 27,520 1,266,601 14.69

Iraq 15,910 1,134,859 4.14

Philippines 18,958 1,131,467 1.78

Romania 29,413 1,070,605 15.11

Sweden 14,275 1,037,126 14.03

Belgium 24,645 1,026,473 21.56

Pakistan 19,384 873,220 0.91

Portugal 16,999 841,379 16.53

Israel 6,379 839,076 7.18

Hungary 29,041 796,390 29.71

Bangladesh 12,102 779,535 0.75

Jordan 9,203 722,754 9.24

Serbia 6,646 705,185 9.52

Switzerland 10,179 679,510 11.96

Japan 11,396 673,821 0.9

Austria 10,455 635,780 11.83

United Arab Emirates 1,626 543,610 1.69

Lebanon 7,569 534,968 11.05

Morocco 9,091 514,670 2.52

Malaysia 1,822 462,190 0.58

Nepal 4,669 439,658 1.66

Saudi Arabia 7,134 431,432 2.12

Bulgaria 17,194 413,320 24.48

Ecuador 19,442 405,783 11.38

Slovakia 12,168 387,162 22.34

Greece 11,322 373,881 10.55

Belarus 2,681 373,351 2.83

Panama 6,288 369,455 15.05

Source: Reuters tally based on statements from health ministries and government officials

Generated at 10:00 GMT.

 

(Editing by David Clarke)

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