The first person who had COVID-19 at a St. John’s funeral home— also known as the index case — did not spread the virus knowingly and did not violate any government orders by being there, says the province’s chief medical officer of health.
As of Monday, 111 people infected with coronavirus in Newfoundland and Labrador contracted it either directly or indirectly from Caul’s Funeral Home in St. John’s, between March 15 and 17. One man, 78, died Sunday as a result of the virus, linked to the funeral home.
Social media has been awash with vitriol, shaming and misinformation on the incident, with some calls for the individual to be charged, but Dr. Janice Fitzgerald called for calm.
“Nobody went out and intentionally spread this,” Fitzgerald said Sunday. “This happened at a time when we didn’t have the same measures in place that we do now.
“Taking our experience from now and trying to apply that to something that happened nearly two weeks ago is fraught with problems because where we are now is very different.”
Fitzgerald, who is Newfoundland and Labrador’s chief medical officer of health, said it does not appear anyone violated government rules at the time, and shaming individuals is not conducive in the fight against the ever-spreading virus.
Caul’s Funeral Home disclosed March 22 that people who had attended its LeMarchant Road business for visitation for two people between March 15 and March 17 were being contacted by public health, as a suspected infected person had visited the building.
The provincial government had only ordered public sector employees who returned from travel outside the country to self-isolate on March 16. Also on that date, the federal government advised all Canadians returning from outside the country to voluntarily self-isolate for 14 days.
It is unclear if the individual was showing symptoms at the time, and where they were prior to the funeral service.
“That is our balance we always have to achieve,” Fitzgerald said Sunday. “We want people to come forward, we want people to feel safe to come forward.”
The self-isolation period for anyone who did attend the funeral home and has not yet been sick ends Wednesday.
Possible link between more overdoses and pandemic isolation: Guelph health officials – CTV News
The number of suspect overdose deaths in Guelph since the outbreak of COVID-19 has already surpassed the number of deaths in all of 2019.
Health officials say isolation could be a contributing factor, as staff at the consumption treatment centre have seen about half of the regular users during the time of the pandemic.
“From mid March until just the end of May we’ve seen eight deaths,” said Raechelle Devereaux, executive director of the Guelph Community Health Centre.
In 2018, there were seven overdose deaths in Guelph.
Jade McAfee uses the CTS site and say she’s lost a lot of friends to overdoses.
“It is scary,” she said. “I myself have overdosed 13 times.”
While officials say a toxic supply is to blame for overdoses, the COVID-19 pandemic has added a hurdle when it comes to prevention.
“The same things that are keeping people safe during the pandemic like isolating and staying home are some things that work against us,” said Devereaux.
Registered nurse Danielle Castledine supervises injections and says they would normally see 30 people a day before the pandemic.
“Before we had an intermediate space where people could be before and after,” she said. “So even if they were waiting they were waiting with peer workers and nurses and social workers.”
To help with better spacing, they’ve opened a new booth to decrease wait times and encourage more people to use the services.
“[Before the crisis] you didn’t have to have a mask, get stopped, have your temperature taken when you could blow in and out easily,” said Eric Cunningham, a user of the CTS site.
Staff say the lack of foot traffic at the CTS is a bad sign and worry the alternative is using in isolation, which decreases the likelihood of potentially life-saving intervention.
“It’s better for anybody to not do it alone,” said McAfee.
The health centre says between March 17 and May 30 there were 63 overdoses.
In the same time period last year there were 74, but only one overdose death.
The Guelph Community Health Centre says the team is door knocking at vulnerable apartment and shelters to give more information on harm reduction to help those potential using alone.
Unmasking the stealth virus behind COVID-19 – CBC.ca
Scientists have discovered the pandemic-causing coronavirus is unique in short-circuiting the safest way our immune system kills off a virus, which could have implications for treating COVID-19 with interferon.
Interferon describes a family of proteins produced by the body’s immune system in response to an invading viral infection. As the name implies, interferon interferes with the virus’s ability to copy itself.
Interferon drugs are made in the lab and were used for years to treat hepatitis, a liver infection, as well as other diseases that involve the immune system, such as multiple sclerosis and some cancers.
In May, researchers in Hong Kong published the results of their Phase 2 trial on fewer than 150 people who were admitted to hospital with mild or moderate COVID-19. Participants were randomly assigned to a combination of potential antivirals, including interferon, or placebo injections for two weeks.
The findings lent support to the idea of continuing research efforts, including in Canada, to investigate interferon in larger, blinded trials designed to find more definitive answers.
Dr. Jordan Feld, a liver specialist at Toronto General Hospital and senior scientist at U of T, previously used interferon to treat people infected with hepatitis. He’s now leading a Phase 2 clinical trial to test a targeted form of the drug, called peginterferon lambda, in injections compared with saline placebo injections.
“It’s kind of like a stealth virus,” Feld said of SARS-CoV-2, the virus that causes COVID-19.
Normally, when interferon in the body’s white blood cells responds to a viral invader, the interferon sends out a flare signal so nearby cells will work to stop the virus from copying itself or replicating if they, too, should be invaded.
In ferrets infected in the lab (a common animal model for studying respiratory viruses), healthy human lung cells, and in people with COVID-19, doctors and scientists say it seems like the natural interferon “flies under the radar” of the immune system and isn’t activated the way it should be.
Feld said the idea behind giving interferon medications is to provide the body with what it should be making to fend off the infection.
The potential therapeutic approach gained scientific backing last month when a study published in the journal Cell showed a “striking” feature of SARS-CoV-2 infection.
Ben tenOever is a Canadian-born professor of microbiology at the Icahn School of Medicine at Mount Sinai in New York who led the Cell study and has been flooded with e-mail requests from researchers the world over to test experimental drug compounds against the virus.
TenOever said every cell that gets infected has two major jobs:
- Fortify its defences and those around it with a “call to arms” mediated by interferon, like sending out an emergency flare for the immune system’s first responders.
- Send a “call for reinforcements” for a longer-term response by releasing proteins called chemokines.
Most viruses block both of those roles.
What makes SARS-Cov-2 unique is it blocks the call-to-arms function from interferon only.
Reinforce call to arms with drug?
“Treatment with interferon or drugs that induce interferon, the main character in the call to arms, is probably beneficial,” tenOever said.
“The secret is to do it early,” he said, when people have a mild cough and test positive for the virus and haven’t developed respiratory distress.
But there could also be mild side-effects.
When we’re fighting off a flu virus, blame interferon for feeling so crummy, feverish and achy as your immune system kicks into high gear.
Likewise, interferon drugs, could also lead to flu-like symptoms for a day or two.
Individuals enrolling in COVID-19 clinical trials of interferon based in Toronto, Hamilton, Ont., Harvard in Cambridge, Mass., Stanford in California, Johns Hopkins in Baltimore and elsewhere will need to weigh whether that (potential) shortfall is worth the (potential) payoff of protection from the deadly damage and delivers key answers that only their participation can offer.
TenOever said what the enormous scientific interest in the publication shows is an incredible demand for biosafety Level 3 labs like his during the pandemic. Without that lab capacity, the fear is that medical researchers won’t be able to run all the experiments they need to do to guide vaccine efforts.
Matthew Miller is an associate professor of infectious disease and immunology at McMaster University who isn’t involved in the clinical trials or studies.
Miller said interferon is what cells use to try to kill off the virus by themselves.
“Its sort of the preferred route,” Miller said, adding interferon is also the safest way for the body to get rid of a virus.
Miller called tenOever’s paper “an important first step in understanding how our body is responding to this particular new virus.”
Speed up recovery
Dr. Sarah Shalhoub, a transplant infectious disease physician at Western University’s medical school, studied the use of interferon to treat another coronavirus infection called Middle East Respiratory Syndrome or MERS.
While interferon hasn’t yet panned out to fight MERS, Shalhoub is optimistic for COVID-19.
“Patients that received interferon beta clear their viruses faster and the duration for hospital admission was also significantly lower,” Shalhoub said of the Hong Kong findings last month.
“It was encouraging in that sense that there might be an effective therapy that’s available on the market that can be repurposed.”
Shalhoub was quick to add a caution. Since no one in either the drug or placebo group died, the mild infections and response to them are difficult to interpret without more research.
The Lancet retracts hydroxychloroquine study following data concerns – Global News
One of the world’s most prestigious medical journals, The Lancet, has retracted an influential COVID-19 research paper after three of the paper’s authors said the patient data used for the study could not be independently verified.
The paper, published on May 22, sparked worldwide concern that using the anti-malarial drug hydroxychloroquine on COVID-19 patients may not be safe.
“After publication of our Lancet article, several concerns were raised with respect to the veracity of the data and analysis conducted by Surgisphere Corporation and its founder and our co-author, Sapan Desai, in our publication,” authors Mandeep Mehra, Frank Ruschitzka and Amit Patel said in a statement published by The Lancet, Thursday.
“Our independent peer reviewers informed us that Surgisphere would not transfer the full dataset, client contracts, and the full ISO audit report to their servers for analysis as such transfer would violate client agreements and confidentiality requirements.
“As such, our reviewers were not able to conduct an independent and private peer review and therefore notified us of their withdrawal from the peer-review process.
“We deeply apologise to you, the editors, and the journal readership for any embarrassment or inconvenience that this may have caused.”
The observational study had found that after reviewing 96,000 COVID-19 patients across six continents, those treated with hydroxychloroquine had a higher risk of heart arrhythmia and death.
“It caused people to stop what they’re doing (and) delay the high quality science in order to sort out whether this initial paper was accurate or inaccurate” said Derek Exner, Associate Dean of Clinical Trials at the University of Calgary Cummings School of Medicine.
The World Health Organization immediately suspended the hydroxycholoroquine arm of its international Solidarity trial pending a safety review.
On Wednesday, WHO Director-General Dr. Tedros Adhanom Ghebreyesus announced that review was complete and that trial would be able to resume.
“The Data Safety and Monitoring Committee of the solidarity trial has been reviewing the data. On the basis of the available mortality data, the members of the committee recommended that there are no reasons to modify the trial protocol,” he said.
“The executive group received this recommendation and endorsed the continuation of all arms of solidarity trial, including hydroxychloroquine.”
Enrollment for The Alberta HOPE COVID-19 trial at the University of Calgary was suspended following The Lancet study publication as well.
“Our safety committee has reviewed everything and said that look, the trial looks totally safe and there’s no major adverse affects with hydroxychloroquine,” said Dr. Michael Hill, the trial’s co-lead.
WHO halts hydroxychloroquine clinical trials
Still, the delay has been costly for the project.
In the nearly two weeks since the Alberta research was suspended, COVID-19 cases in that province have dropped. A spokesperson for Alberta Health says the trial might not resume at all.
“We understand the trial will remain on hold for the next 10 days while the researchers determine whether to suspend for the summer pending (a) fall recurrence of cases or close the trial formally with a plan for data pooling with international collaborators,” said Tom McMillan in an email to Global News.
The coronavirus pandemic has put pressure on scientists to work faster than ever before, but some researchers worry if the cost of speedy science may be too high.
“Of course this pandemic is unfolding at a very rapid pace and the rate of new knowledge is unprecedented and the rate of data sharing is also unprecedented,” said Dr. Isaac Bogoch, an infectious diseases physician at the University of Toronto.
“But it’s also important that you get it right and there’s clearly got to be a balance of speed with accuracy. You can’t compromise accuracy.
“(That would) erode public trust in science, in medicine and in public health and this is time more than ever before where we need public trust in science, medicine and in public health.”
© 2020 Global News, a division of Corus Entertainment Inc.
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