New Brunswick has expanded its COVID-19 wastewater monitoring to four more cities.
Saint John, Bathurst, Campbellton and Miramichi were added to the national COVID-19 wastewater surveillance dashboard on Tuesday, with their most recent test results dating from between March 20 and March 27.
Wastewater results can serve as an early warning of increased community infection levels and risks.
People who are infected shed the virus in their feces in the form of a genetic material called ribonucleic acid, or RNA, before they show symptoms of COVID-19. This can be found in raw sewage and can detect the virus in a community up to 10 days prior to clinical testing, according to Health Canada.
Data for the four newly added cities shows a recent spike in viral load for Miramichi, a slight increase for Campbellton, a levelling off following a jump for Saint John, and slight decrease for Bathurst.
Moncton and Fredericton, meanwhile, both saw recent drops in viral loads, according to the dashboard.
In the works for months
The Department of Health told CBC in January that testing in Saint John and Bathurst was coming “in the near future.”
“It takes time for sites to get set up, as there is new equipment, processes and procedures for project participants to navigate,” department spokesperson Sean Hatchard said Wednesday in an emailed statement.
About three to four weeks of COVID-19 wastewater data are needed for “meaningful trend results,” said Health Canada spokesperson Anna Maddison,
Saint John and Bathurst have now met the data requirement for “trending results” and are included,” she said.
Hatchard did not respond to questions about how or why Campbellton and Miramichi were selected, or what, if any other sites are planned.
Delayed results
The Department of Health did not respond when asked how useful it is to post test results as much as 15 days after the fact, such as the case in Miramichi, if they do show increased levels, and whether that’s too late for people to try to protect themselves from potentially being exposed to people who were infectious all that time.
The Health Canada spokesperson did not answer directly.
“We are constantly working to improve this process to ensure results are available as soon as possible,” said Maddison.
Public Health Agency of Canada’s National Microbiology Laboratory in Winnipeg is “consistently optimizing its workflows to make data more readily available,” she said.
“We are also routinely communicating with our partners to address any delays in sample transport to help ensure samples arrive in our laboratory as soon as possible.”
Wastewater monitoring for COVID-19 can give officials an early indication of viral trends. (Submitted by Graham Gagnon)
Asked why some other sampling sites, such as Vancouver and Toronto, have more timely results than most of those in New Brunswick, Maddison said the differences in reporting times can be due to the time it takes to ship and transport samples to the national lab.
“On average, the shipping time for these [New Brunswick] sites is a day or two longer than other sites, which can contribute to the delays in reporting,” she said in an emailed statement.
In addition, if samples arrive on a Friday or during the weekend, it can further delay processing and testing by the national lab, Maddison said.
The lab maintains a consistent three-day turnaround time between sample receipt and results, she said.
“However, due to the complex nature of wastewater samples, sometimes retesting of samples is required to ensure the utmost confidence in the results, which adds more time to the process.”
The Department of Health has previously said New Brunswick wastewater samples are tested at the Dr. Georges-L.-Dumont University Hospital Centre laboratory in Moncton and are also being sent to the national lab in Winnipeg for “validation” and sequencing.
Maddison did not immediately respond to questions about why New Brunswick samples need to be tested by the national lab as well before the results can be posted on the dashboard.
Future of public health surveillance
Public Health Agency of Canada continues to collaborate with other federal departments, provincial, territorial and municipal governments and academics across the country to expand the COVID-19 wastewater surveillance dashboard to provide additional data to citizens, including additional cities, she said.
“With limitations to clinical testing in many provinces and territories, wastewater results have been a key tool for public health officials to monitor the levels of COVID-19 in a community. Wastewater results can also be used by people in Canada to help them make decisions about personal health measures when going out into their community.”
Wastewater monitoring is “one of the key tools for the future of public health surveillance,” according to Maddison.
“Knowing the daily or weekly changes in the amount of infectious disease detected in wastewater can help manage outbreaks (through public health action such as vaccination and testing) as well as health care resource allocation (such as hospital beds and staffing needs),” she said.
The selection of sites for wastewater sampling and the decision to release results on the national dashboard is always at the discretion of provinces, territories, and municipalities, she added.
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.
