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Ontario's 2nd wave of COVID-19 forecast to peak in October – CBC.ca

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Fresh projections suggest that Ontario’s second wave of COVID-19 will peak in mid- to late October and will likely send enough patients to intensive care that hospitals will need to scale back non-emergency surgeries.

The forecasts come from the COVID-19 Modelling Collaborative, a joint effort of scientists and physicians from the University of Toronto, University Health Network and Sunnybrook Hospital. 

Based on how quickly Ontario’s infection rate has been rising in recent weeks, the model projects the province is on track to exceed 1,000 new cases per day by the middle of October, unless stricter public health measures slow the accelerating spread.

The average number of new cases reported daily in Ontario is currently running four times higher than what it was at the end of August. Premier Doug Ford’s government has since shrunk limits on the size of private gatherings, reduced opening hours for bars and ordered strip clubs to close.

On Sunday, Ontario’s Ministry of Health reported 112 patients in hospital with a confirmed case of COVID-19, nearly triple the number of two weeks ago. The research team says the impact of the second wave on Ontario’s hospitals will depend on the demographics of who gets infected in the coming weeks. 

The dotted line shows the current prediction for the start of Ontario’s second wave of COVID-19, based on work by a team of researchers from the University of Toronto, the University Health Network and Sunnybrook Hospital. The solid lines model how the case numbers will evolve if the second wave follows the patterns seen in Ontario in the spring (orange), in Michigan this summer (light grey), in the Australian state of Victoria (dark grey), or Italy in the pandemic’s first wave (black). (COVID-19 ModCollab)

“We are at this critical moment right now where we see case numbers increase and we don’t quite know yet where it’s going,” said Beate Sander, a scientist at the University Health Network and Canada Research Chair in economics of infectious diseases. 

“Right now, we have predominantly younger, healthy people (contracting COVID-19 in Ontario),” Sander said in an interview with CBC News. “But what we’ve seen in other jurisdictions is that it really spills over into other population groups.” 

The team of researchers has run four scenarios for how Ontario’s second wave could play out from here.

The best-case scenario would mimic Ontario’s first wave in March and April, when case numbers increased rapidly but were then reined in by a lockdown. 

Two moderate scenarios would resemble how a second wave hit jurisdictions comparable to Ontario: the Australian state of Victoria (home to Melbourne, a city of 5 million), and the U.S. state of Michigan. 

Long lines at testing centres, like this one pictured in Toronto on Sept. 21, 2020, mirror a spike in cases of COVID-19 provincial health officials link to people under 40 not following public health guidelines at social gatherings. (Evan Mitsui/CBC)

None of those three scenarios shows COVID-19 patients filling Ontario’s hospital wards or ICUs beyond their capacity. That happens only in the modellers’ worst-case scenario: a second wave as severe as the first wave that hit Italy when the pandemic began.

However, in all but the best-case scenario, the researchers foresee ICU demand that exceeds the capacity required for patients undergoing scheduled surgeries. 

“The really high-risk cancer surgeries, for instance, won’t be able to go ahead if the ICUs are overwhelmed with people who are showing up in the emergency department dying of COVID-19 associated pneumonia and respiratory failure,” said Dr. Kali Barrett, a critical care physician at the University Health Network and part of the modelling research team. 

The researchers stress that their modelling scenarios are simply forecasts. They use data on the proportion of people who have have ended up in hospital and ICUs while positive for the coronavirus, and project those onto Ontario’s current trend in new cases.

The shifting demographics of who’s getting infected with COVID-19 as the second wave builds makes it challenging for the researchers to forecast just how many people will need hospital treatment.

“The second wave in Spain and France started in the younger populations, but it is spreading to the elderly and the people who are more at risk of ending up in the intensive care unit or in the hospitals,” said Barrett in an interview with CBC News.

“It is just a matter of time until this virus, if it’s affecting the young populations, spreads into the elderly population,” she said. “We’re already starting to see that happening in Ontario.”

The latest figures from the province’s Ministry of Health show 227 people aged 70 or older with an active confirmed case of COVID-19. That number has increased 34 per cent in the space of a week.

Changes in the eligibility criteria for testing can also muddy the forecast. When testing is widespread and captures larger number of mild cases, the percentage who end up in hospital will be smaller than when testing is restricted to priority groups most likely to have the virus, as it was in Ontario in the spring. 

Ontario altered its “anyone can get a test” policy on Friday, so far fewer people without symptoms are now eligible for testing. 

ICU demand could lengthen surgical backlog 

Ontario has around 2,000 intensive care beds, and the province plans to add 139 in October. The province’s ICU beds are typically two-thirds occupied by patients whose cases have nothing to do with COVID-19, whether it’s a heart attack, car accident, or another critical illness. 

Since ICUs can’t actually function at 100 per cent occupancy full time, the researchers calculate that Ontario has around 475 beds available for non-emergency surgery patients and COVID patients. When scheduled surgeries are running at full pace, those patients take up all but 100 of those beds.

This graph forecasts what will happen in Ontario if the second wave resembles what happened in the Australian state of Victoria, home to the city of Melbourne. It would see some 1,200 patients in Ontario’s general hospital wards and 350 to 400 patients in intensive care (ICU) beds at the peak in late October. (COVID-19 ModCollab)

   

Their conclusion: if more than 100 people with COVID-19 need ICU care, they’d be competing for space with scheduled surgery cases. 

“Then we would have to make decisions in terms of who to treat,” said Sander. “Do we admit COVID patients or do we do (non-emergency) surgery?”

The projections suggest if Ontario’s second wave follows what happened in the Australian state of Victoria — a sharp spike in new infections that drops off quickly after a strict lockdown — some 350 to 400 people will need an ICU bed at peak demand in late October.

If the second wave in this province plays out as Michigan’s did — a rise in new infections that levels off but doesn’t slow down for a long time — the forecast is for more than 200 patients with COVID-19 in the ICUs from late October onwards. 

Figures published Sunday by the Ministry of Health show 28 ICU patients with a confirmed case of COVID-19.   

In Ontario’s first wave, the number of COVID-19 patients in ICU peaked at 264, while the number of people in hospital at one time peaked at 1,043. Non-emergency surgeries were postponed across the province.  

If the majority of Ontario’s second wave infections come among younger healthier people — as has been happening through September — hospitalization rates are expected be lower than in the spring. 

The modellers say ICU occupancy numbers will be of more critical concern than total hospitalization numbers because Ontario’s hospital system can far more easily free up general ward beds than it can make space in intensive care.   

That’s less about the available beds and ventilators, and more about the having enough doctors and nurses capable of the specialized care that ICU patients need.    

“You can’t just train people overnight to do this type of thing,” said Sander. “You can buy a lot of beds and you can buy a lot of ventilators, but you can’t get these highly qualified staff on the ground within a very short period of time.” 

Barrett agrees that human resources are the key limiting factor, and is concerned about how the second wave could hit hospital staff and their families. 

“The majority of people working in hospitals are in their 30s, 40s and 50s, so many of them have children who go to school,” she said. “If there is a massive outbreak amongst the younger population and school children, that’s a whole sector of our health workforce that won’t be able to come to work.”


Still have questions about COVID-19? These CBC News stories will help.

Is another lockdown coming in Ontario? What do we know about the Ford government’s fall plan?

CBC Queen’s Park reporter Mike Crawley obtained a draft copy of the plan

What’s the latest on where I should get tested?

It’s confusing, but here’s an explainer complete with a flow chart

What’s the most recent guidance on mask use?

Reporter Lauren Pelley took a look at what the experts are advising

What should I do about my COVID bubble?

With cases going up, even small gatherings are getting riskier

Who is getting COVID-19?

CBC News crunched the data from across Canada to get the clearest picture possible

Let’s block ads! (Why?)



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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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