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N.B. move to monthly COVID-19 updates ‘wrong thing to do,’ says epidemiologist

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An infection control epidemiologist says he disagrees with New Brunswick’s decision to cut back its COVID-19 updates to monthly instead of weekly, as of this week.

Colin Furness, an assistant professor at the University of Toronto, who has followed the progression of the pandemic in New Brunswick, says the move “reflects an attitude that COVID is a seasonal virus, a respiratory virus, and not a particularly serious health concern.”

“In my estimation COVID is not seasonal, it’s not a respiratory virus, and it’s extremely concerning,” he said.

“So I think … the decision is consistent with their logic. I just think that their logic is wrong.”

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Tuesday marked the final weekly COVIDWatch report before New Brunswick switches to monthly updates. The province recorded four more COVID deaths, 11 hospitalizations because of the virus, 78 new lab-confirmed cases and a positivity rate of 11 per cent.

The new Omicron subvariant that has caused a surge in India and has been detected in at least 33 countries, has now also spread to New Brunswick. Two cases of XBB.1.16 have been confirmed in the province to date, according to the Department of Health.

COVID-19 activity “continues to be an ongoing concern,” Dr. Jennifer Russell, New Brunswick’s chief medical officer of health, has said. But case numbers, hospitalizations and deaths have been “relatively stable” since January.

The switch to monthly COVID updates is “to ensure consistency in [the province’s] reporting on respiratory illnesses,” such as influenza, Russell has said.

Not necessarily seasonal and not ‘only’ respiratory

Furness contends treating COVID like the flu, with a “silent assumption” that it’s seasonal, is “dangerous.”

It may be logical to expect COVID numbers will be higher in the fall and winter, when people are gathered indoors more, with windows and doors closed, he said. That’s when all viruses tend to flourish, including common colds, which are not actually very contagious and require close indoor contact to spread.

However, COVID is “far more contagious” and doesn’t require ideal conditions to multiply.

So to assume COVID isn’t “worth paying attention to” during the summer months is “foolish,” said Furness.

Infection control epidemiologist Colin Furness said he understands the province’s logic in moving to monthly COVID-19 updates, but he ‘firmly disagrees with it.’ (CBC)

The change in reporting becomes “self-reinforcing” though, he said. “We’re going to conclude that we don’t need to measure it and we’ll justify that by not having any data to contradict.”

Similarly, Furness challenges the characterization of COVID as being “only” a respiratory virus.

He points to long COVID and the wide range of symptoms it can cause, such as brain fog.

“A data-driven view of COVID is that this is a virus that has efficiently evolved beyond being a respiratory virus to be a highly contagious, systemic virus causing neurological, vascular and organ damage, and immune dysregulation – along with an acute respiratory phase,” he said.

Maintaining the view COVID is only a respiratory virus, however, “enables social acceptance that it is not serious and that money does not need to be spent making people safer.”

Taking away ability to gauge risks

New Brunswick isn’t alone, Furness noted. Other provincial governments have also moved away from keeping the public informed about COVID. “It’s all in lockstep with the notion of ‘living with COVID,’ which is a euphemism for, ‘Let’s do nothing and see what happens.'”

It’s “wrong-minded,” according to Furness. He cites low vaccination rates as a consequence of the public not getting the clear message they should.

As of mid-April, only about 13 per cent of New Brunswickers aged five and older have received a COVID-19 vaccine booster dose in the past five months. That’s around 100,000 people.

A man with a mask and blue gloves holds a syringe in his hand.
COVID-19 vaccination rates have been stalled for weeks, the latest data from the province shows. Only 30.5 per cent of eligible New Brunswickers have received a second booster. (Ben Nelms/CBC)

Many people don’t think COVID is a significant problem anymore and don’t think getting boosted is worthwhile, said Furness.

“If we were doing public health well, we would be concerned about sickness, we would be concerned about disease and about equipping people to gauge risk.

“And we’re taking that away. I think that’s the wrong thing to do.”

‘Wastewater doesn’t lie’

Furness acknowledges some of that data in the province’s COVIDWatch reports has become less valuable over time in terms of helping to gauge risks.

COVID deaths, for example, are often a couple of months after the fact, due to a lag in reporting from date of death to the registration of death, according to the province. There are also fewer PCR (polymerase chain reaction) lab tests being conducted now because they’re available only to people with symptoms, where the results would directly influence their treatment, and a referral from a health-care provider is required.

That’s why he thinks more wastewater monitoring is needed.

A woman squatting deploys the sewer cage ball to gather a wastewater sample.
New Brunswick has COVID-19 wastewater monitoring in Moncton, Fredericton, Saint John, Bathurst, Campbellton and Miramichi. (Submitted by Graham Gagnon)

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 the Public Health Agency of Canada.

“Wastewater doesn’t lie,” said Furness.

It also doesn’t rely on people getting tested, and it focuses on “what’s coming” instead of what has already happened, he said.

Should track changes in life expectancy, like U.S.

In addition, Furness would like to see New Brunswick and other jurisdictions track changes in population life expectancy. They should look, for example, at rates of heart attacks, strokes and other diseases associated with long COVID.

The United States does keep track of these, he said, and they’re going up.

Although Canada looked at the U.S. earlier in the pandemic “with a sense of horror” for “letting [COVID] run wild,” the two countries are “more or less the same now” in terms of their attitudes and policies, according to Furness.

“So I think we can look at the U.S. data and say, ‘Well, that’s almost certainly to some extent what’s going on here too.'”

It’s difficult to predict what changes new variants like XBB.1.16 might bring, said Furness.

The virus seems to be settling on an evolution track where it’s improving its ability to infect and reinfect without becoming more severe, which he suspects will continue.

It could, however, change at any time, he stressed.

Precautions urged

For now, Furness cautions against being “fooled” into thinking COVID isn’t a problem by those who want the pandemic to be over and are taking risks.

People should continue to take steps to protect themselves to avoid infection or reinfection, he said. “There’s no question the cumulative harm is there. Not for everybody, it’s a bit of a Russian roulette game. But you don’t want to find out the wrong way or the hard way that that reinfection really, really hurt.”

He recommends people stay outside as much as possible this summer, use ventilation indoors, and avoid large crowds. “There’s lots of ways to have fun while also minimizing that risk.”

The next COVIDWatch report is scheduled to be released on May 30.

 

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Measles case reported locally turns out to be negative: health unit

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NEWS RELEASE
SIMCOE MUSKOKA DISTRICT HEALTH UNIT
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On March 26, the Simcoe Muskoka District Health Unit (SMDHU) was notified by Public Health Ontario’s (PHO) laboratory that due to laboratory error, the case of measles that had been lab-confirmed positive on March 12, based on symptoms and a positive urine measles laboratory result by PHO’s laboratory, is in fact negative for the measles virus.

“With this new information of the negative lab result, we believe that that individual was not infected with measles and that there has not been any public exposure to measles resulting from this individual’s illness,” said Dr. Charles Gardner, medical officer of health. “We recognize that notifying the public of what we believed to be a positive measles case in our area created worry, anxiety and disruption for some, and we regret this.

“We do know that, despite best efforts, on rare occasions laboratory errors can occur. We are working closely with the PHO’s laboratory to do all that we can to ensure that such an incident does not occur again.”

Measles is a highly contagious viral infection that spreads very easily through airborne transmission. The measles virus can live in the air or on surfaces for up to two hours.

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Symptoms of measles begin seven to 21 days after exposure and include fever, runny nose, cough, drowsiness, and red eyes. Small white spots appear on the inside of the mouth and throat but are not always present. Three to seven days after symptoms begin, a red, blotchy rash appears on the face and then progresses down the body.

The risk of transmission to those vaccinated with two doses is low, and when it does occur tends to show a reduction in the severity of these symptoms.

“Although we are relieved for the individual involved, and for all Simcoe-Muskoka residents, that this case has now been confirmed as negative, we know that measles is still active in Ontario at this time and the potential remains for new cases to arise, especially given the increase in Ontarians travelling to areas in the world that have higher numbers of measles cases,” said Dr. Gardner. “This is why we continue to advise individuals to keep up to date with their routine immunizations, including measles, mumps and rubella (MMR) vaccination.”

The risk of measles is low for people who have been fully immunized with two doses of measles vaccine or those born before 1970; however, many children have been delayed in receiving their routine childhood immunizations and people who have not had two doses of measles vaccine are at higher risk of contracting the disease.

People who do get sick usually recover without treatment, but measles can be more severe for infants, pregnant women, and those with compromised immune systems. Possible complications include middle-ear infections, pneumonia, diarrhea, or encephalitis (swelling of the brain) and occasionally death in the very young. Even individuals who are up to date with the measles vaccine should watch for symptoms of measles for 21 days after exposure.

For more information about measles, please visit smdhu.org or call Health Connection at 705-721-7520 or 1-877-721-7520, Monday to Friday between 8:30 a.m. and 4:30 p.m. to speak with a public health professional.

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Kate Middleton Not Alone. Cancer On Rise For People Under 50, Say Experts

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Kate Middleton revealed on Friday that her cancer was discovered after she received abdominal surgery

London:

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When Catherine, Princess of Wales, revealed she was being treated for cancer last week, part of the shock was that an otherwise healthy 42-year-old has a disease that mostly plagues older people.

However, researchers have been increasingly sounding the alarm that more and more people under 50 are getting cancer — and no one knows why.

Across the world, the rate of under-50s diagnosed with 29 common cancers surged by nearly 80 percent between 1990 and 2019, a large study in BMJ Oncology found last year.

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The researchers predicted the number of new cancer cases among younger adults will rise another 30 percent by the end of this decade, with wealthy countries particularly affected.

The increase in cases — and soaring global population — means that the number of deaths among under 50s from cancer has risen by nearly 28 percent over the last 30 years.

This occurred even as the odds of people of all ages surviving cancer have roughly doubled over the last half century.

Shivan Sivakumar, a cancer researcher at the UK’s University of Birmingham, called it an “epidemic” of young adult cancer.

Since Kate Middleton revealed on Friday that her cancer was discovered after she received abdominal surgery earlier this year, Sivakumar and other doctors have spoken out about the uptick in younger cancer patients they have been seeing at their clinics.

While breast cancer remains the most common for people under 50, the researchers expressed particular concern about the rise of gastrointestinal cancers — such as of the colon, pancreas, liver and oesophagus — in younger adults.

Colon cancer is now the leading cause of cancer deaths in men under 50 in the United States, according to the American Cancer Society. For women, it is number two — behind only breast cancer.

One high profile case of colorectal cancer was “Black Panther” actor Chadwick Boseman, who died at the age of 43 in 2020.

Why is this happening?

“We just don’t have the evidence yet” to say exactly what is causing this rise, Sivakumar told AFP, adding it was likely a combination of factors.

Helen Coleman, a cancer epidemiology professor at Queen’s University Belfast who has studied early onset cancer in Northern Ireland, told AFP there were two potential explanations.

One is that people in their 40s were exposed to factors known to cause cancer — such tobacco smoke, alcohol or being obese — at an earlier age than previous generations.

She pointed out that the “obesity epidemic” did not start until the 1980s.

Sivakumar felt that at least part of the puzzle could be explained by obesity.

However, there is “another wave” of under-50 patients who are neither obese nor genetically predisposed still getting cancer, he emphasised, adding that this could not be put down to “statistical chance”.

The other theory, Coleman said, is that “something different” has been going on with her generation.

Fingers have been pointed out a range of possible culprits — including chemicals, new drugs and microplastics — but none have been proven.

Some have suggested that so-called ultra-processed foods could be to blame. “But there’s very little data to back any of that up,” Coleman said.

Another theory is that the food we eat could be changing our gut microbiome.

While there is nothing conclusive yet, Coleman said her own research suggested that cancer causes changes to the microbiome, not the other way around.

Anti-vaxx conspiracy theorists have even tried to blame Covid-19 vaccines.

This is easily disproven, because the rise in young adult cancer has taken place over decades, but the vaccines have only been around for a few years.

What can be done?

To address the rise in younger colorectal cancer, in 2021 the US lowered the recommended age for screening to 45. Other countries have yet to follow suit.

But the researchers hoped that Catherine’s experience would remind people at home that they should consult their doctor if they sense anything is wrong.

“People know their bodies really well,” Sivakumar said.

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“If you really feel that something isn’t right, don’t delay — just get yourself checked out.”

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Almost 3,000 students suspended in Waterloo Region over immunization issues

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Close to 3,000 children attending elementary school across Waterloo Region were suspended from school on Wednesday morning for not having up-to-date immunization records.

The region says Waterloo Public Health suspended 2,969 students under the Immunization of School Pupils Act (ISPA).

For several months, the region has been campaigning for people to get their children’s vaccinations up to date, including sending letters home to parents on a couple of occasions, warning that students’ records needed to be up to date or they would be suspended.

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It announced in January that 32,000 students did not have up-to-date records: 22,000 elementary students and 10,000 high school students.


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“We have made remarkable progress from the original 27,567 immunization notices we sent to parents in November and December 2023,” Dr. Hsiu-Li Wang, medical officer of health, stated.

“Since that time, we have resolved more than 24,500 outdated vaccination records, providing students with valuable protection against these serious and preventable diseases.”

The high school students still have a few weeks to get their records up to date or else face suspension.

The ISPA requires students to have proof-of-vaccination records for diphtheria, polio, tetanus, pertussis, measles, mumps, rubella, varicella (chickenpox) and meningitis, which must be on file with public health.

Public health says caregivers whose children are suspended will need to book an appointment at regionofwaterloo.ca/vaccines for clinics, which will be held in Cambridge and Waterloo on weekdays.

“Given the high number of suspensions, it may take several days before you can be seen at an appointment and return your child to school,” a release from the region warns.

“Record submission and questions must be done in person to ensure immediate resolution.”

The last time suspensions over immunizations were issued was in 2019, when 1,032 students were suspended.

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