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Ontario's 7th wave of COVID-19 is already hitting long-term care homes –



Jodie McConnell said as soon as she heard there was another COVID-19 outbreak at her mom’s long-term care home she panicked.

“I was scared this outbreak would be like the previous ones,” she told CBC News.

So far, the outbreak at St. Joseph’s Villa in Sudbury, Ont., where her mom, Jean, lives, is affecting 12 residents. Across the province there were 65 long-term care homes reporting outbreaks as of last weekend, according to Public Health Ontario data, as well as 51 retirement homes as of July 2.

This week, Ontario’s top doctor confirmed the province is now in its seventh wave of COVID-19, with those aged 80-plus seeing the sharpest increase in case rates. The wave, which is already hitting many staff and long-term care residents hard, has some doctors and experts calling for a greater push for fourth doses and a reinstatement of vaccine mandates for long-term care staff.

Professor Vivian Stamatopoulos, a long-term care advocate and researcher, says more needs to be done to prevent outbreaks in the sector, including a return to vaccine mandates for staff. (Submitted by: Vivian Stamatopoulos)

Dr. Samir Sinha, Director of Geriatrics at Mount Sinai and the University Health Network Hospitals in Toronto, says fourth doses of COVID-19 vaccine, which seniors are eligible for, are essential in preventing deaths. But, he said, “we need to do a much better job getting our residents, staff and their families access to these vaccines.”

In his view the return of a vaccine mandate for staff is critical in protecting the older populations they serve.

Professor Vivian Stamatopoulos, a long-term care advocate and researcher, says the removal of the vaccine mandate for workers in long-term care homes, which occurred in the spring, means “it’s still a very precarious situation, arguably, more so now than at any time before.”

She said the arrival of the seventh wave should trigger a vaccine mandate reinstatement.

More staffing shortages ‘devastating’

Terry Crystal’s mother, Marjorie, lives at Southlake Residential Care Village in Newmarket, Ont., a home with some of the highest case counts of this seventh wave so far. The facility is currently reporting 20 health care workers with COVID-19, a figure that was as high as 29 a few days ago.

There were also 15 residents reported as having the virus as of a report submitted Wednesday, but that’s down from 47 at the beginning of the week.

Her mother has Parkinson’s and dementia and the limited social interaction from lockdowns is making her depressed and causing stress and anxiety, Crystal said.

“I am afraid she will lose her will to live,” she said.

Terry Crystal worries for her mother’s mental health amid another outbreak at Southlake Residential Care Village where her mother, Marjorie, lives. (Submitted by Terry Crystal)

Ian Da Silva, national director of operations for the Ontario Personal Support Workers Association, which represents nearly 50,000 of these workers, says health-care workers being out with COVID-19 in this seventh wave is compounding the short-staffing challenges already present in the field.

“We’re talking about staffing that’s already stretched to the breaking point now and to add an infection on top of that, even one or two staff … it would be it would be devastating.”

The association is getting reports of PSWs being responsible for 30 to 40 people in their wings, he says.

“If one of those goes down with the COVID, then you can quickly do the math to see how that impacts the remaining residents. They’re simply not getting care. It’s just simply not possible.”

That’s a concern shared by Julie Perl, who is the primary caregiver for a dear friend living at Villa Colombo Homes for the Aged in Toronto, where at least six health-care workers have COVID-19.

Perl says even losing one health-care worker makes a difference to care her friend, who is bed-ridden, receives.

She says her friend, who is completely cognitive, tells her he uses the call button but it takes some time to get help.

“If he needs to be changed or repositioned, he could wait for over an hour,” she said. “For him being in a soiled diaper? He should be changed immediately.”

Family hires private personal support worker

Jean McConnell’s family made the decision to hire a private support worker during the seventh wave. (Submitted by: Jodie McConnell)

Worried about what the outbreak at St. Joseph’s Villa could mean for Jean’s well-being, the McConnell family made a more drastic move to ensure Jean has the support she needs during this wave.

The family has hired a private support worker for Jean, but the decision is coming at a cost. A couple of hours of care, delivered three times a week, will cost the family over $1,000 a month, McConnell said. 

Other families may be considering similar options, especially if the outbreaks continue or get larger.

At the Hellenic Centre for Seniors in Toronto and the Tilbury Nursing Home in Windsor-Essex, for example, more than a quarter of residents have COVID-19, while several staff members are out as well. 

CBC News provided the opportunity to the Minister of Long-Term Care to discuss the outbreaks, but was told he was unavailable.

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Canada hasn’t needed to declare monkeypox an emergency, top doctor says. Here’s why – Global News



Canada has not needed to declare an emergency over the monkeypox virus the same way the United States and the World Health Organization have as mechanisms are already in place to tackle the outbreak, the country’s top doctor said Friday.

Dr. Theresa Tam’s comments came a week after the U.S. declared a public health emergency in response to the monkeypox outbreak, which followed the WHO declaring monkeypox a global health emergency last month.

“There’s a very different approach in terms of accessing authorities and funding in the United States compared to Canada,” said Tam during a virtual news conference.

“We have different approaches … with the provinces being able to declare crises, emergencies at their level,” she added.

Read more:

The U.S. declared monkeypox a health emergency. Should Canada follow suit?

Tam noted that when the COVID-19 pandemic first hit Canada over two years ago, there was no actual declaration at the federal level for a public health emergency under the Emergencies Act.

“For monkeypox, we’ve been already doing all the things that the U.S. is also doing — being able to mobilize vaccines, being able to mobilize therapeutics,” she said, adding that the local and provincial authorities have the flexibility to do what they need to respond.

“Health Canada regulatory authorities are there for emergency purposes as far as needed as well,” Tam said.

Click to play video: 'About 50% of monkeypox vaccine supply used, Canada passes 1,000 cases: Tam'

About 50% of monkeypox vaccine supply used, Canada passes 1,000 cases: Tam

About 50% of monkeypox vaccine supply used, Canada passes 1,000 cases: Tam

In Canada, as of August 10, 1,059 monkeypox cases have been reported across the country, with Ontario leading the case count with 511 infections, followed by Quebec with 426.

To date, there have been 28 hospitalizations, including two ICU admissions, due to monkeypox, but no deaths in Canada.

Tam said there were some “early signs” that cases are slowing down in the country, but it’s “a little too soon to tell.”

The growing threat of monkeypox has raised alarm in countries, including Canada, not accustomed to seeing such a surge as much still remains unknown about the viral infectious disease.

Click to play video: '‘Too soon to tell’ if monkeypox plateauing in Canada, but some early signs of slow down'

‘Too soon to tell’ if monkeypox plateauing in Canada, but some early signs of slow down

‘Too soon to tell’ if monkeypox plateauing in Canada, but some early signs of slow down

Globally, more than 31,000 cases have been confirmed in 91 countries, according to the WHO. Tam said this represents a 19 per cent increase in global cases over one week.

On July 23, WHO’s chief declared monkeypox a public health emergency of international concern, citing the unprecedented rapid spread of the virus to many countries; the risk it poses to human health, and the potential for interference with international traffic.

Under the International Health Regulations (IHR), when a “public health emergency of international concern” is declared, international efforts are required to stop the spread of the virus. This could include sharing vaccines and treatments among countries and taking travel-related measures.

Read more:

Monkeypox cases in Canada surpass 1K, with most in Ontario

In Canada, the federal government has deployed to provinces and territories more than 99,000 doses of the Bavarian Nordic’s Imvamune or MVA-BN vaccine, normally used to treat smallpox.

More than 50,000 people have been vaccinated, as of August 11, said Tam.

U.S. health officials on Tuesday authorized a plan to stretch the nation’s limited supply of monkeypox vaccine by giving people just one-fifth the usual dose, citing research suggesting that the reduced amount is about as effective.

Tam said it was “an important approach to explore” and gather information to see if the same can be implemented in Canada.

“But for now, we are working together with the National Advisory Committee on Immunization for really pushing out the approach of one-dose first to reach as many people as possible in our most highly-affected populations,” she said.

Click to play video: 'Experts urge Canadian officials to take more action on monkeypox spread'

Experts urge Canadian officials to take more action on monkeypox spread

Experts urge Canadian officials to take more action on monkeypox spread – Aug 5, 2022

Monkeypox is primarily transmitted through prolonged close contact with an infected person and the majority of cases reported in the current outbreak involve men who had intimate sexual contact with other men.

The current outbreak in Canada is largely from person-to person spread, said Tam, but the virus can also spread through direct contact with contaminated objects such clothing, sheets or other personal items.

Symptoms of monkeypox include a painful rash that could last between 14 and 28 days, which can be accompanied by fever, chills, headache, swollen lymph nodes, muscle pain, joint pain, back pain or exhaustion.

Click to play video: 'Monkeypox: Canada exploring fractional vaccine doses, but focused on 1st dose push'

Monkeypox: Canada exploring fractional vaccine doses, but focused on 1st dose push

Monkeypox: Canada exploring fractional vaccine doses, but focused on 1st dose push

— with files from the Associated Press 

© 2022 Global News, a division of Corus Entertainment Inc.

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Coronavirus Update: Pregnant women who receive mRNA COVID-19 vaccines aren't more at risk of miscarriage, stillbirth, new study confirms – The Globe and Mail



Good evening. The coronavirus newsletter now publishes Mondays and Fridays.

Top headlines:

  1. Pregnant women who received mRNA COVID-19 vaccines were not more likely to experience miscarriage, stillbirth or other severe health events compared to unvaccinated pregnant women, a new study says
  2. ‘It’s hard to explain how much we’ve seen and how much we’ve been through’: A growing number of health professionals have been harassed and abused by individuals promoting COVID-19 conspiracies online and in person – despite a federal law that makes it illegal
  3. The Canadian economy was losing between $2.6-billion and $5.2-billion a week as a result of the countrywide trucker convoy blockades, newly disclosed cabinet documents show

An increasing number of health agencies have changed how they’re reporting data on the coronavirus. A look at the current numbers in Canada for reported cases, deaths from COVID-19 and for hospitalizations can be found here.

COVID-19 updates from Canada and the world

Looking for more top headlines? Subscribe to our Morning Update and Evening Update newsletters to get caught up on our latest stories.

Pandemic recovery

  • The pandemic has changed a lot about how we work, but it hasn’t changed when we are most productive, according to the results of a new survey. Daniel Pink, author of When: The Scientific Secrets of Perfect Timing, says that these patterns provide a strong argument for greater autonomy and flexibility in the workplace. While research has proven that workers are equally or more productive when they get to choose their work location, he believes there’s even more productivity to be gained by providing employees with greater control over when they work.
  • Outdoors activities were among the many things that got more expensive and difficult to enjoy when the pandemic hit. Here’s a list of a few relatively low- and medium-cost outdoor activities to pursue, as the pandemic heads further into recovery.
  • New Zealand welcomed the first cruise ship to the country since the coronavirus pandemic began, signalling a long-sought return to normalcy for the nation’s tourism industry.
  • Manulife missed analyst profit expectations after a $1.6-billion drop in earnings owing to market turmoil and extended COVID-19 restrictions in Asia.

Want in-depth analysis on what governments are doing with your tax dollars? Subscribe to our Tax & Spend newsletter.

Globe opinion

John Ibbitson: Pierre Poilievre’s goal to block COVID-19 vaccine mandates doesn’t reconcile with public harm it would cause

Campbell Clark: The convoy wasn’t leaving town – but that’s not the Emergencies Act question

David Parkinson: The Great Resignation has arrived in Canada

Want to hear more from our columnists? Subscribe to the Opinion newsletter, and get it in your inbox, Monday to Saturday.

More reading

Information centre

Thank you for subscribing to our Coronavirus Update Newsletter. As the pandemic eases, we plan to wind this down and eventually cease sending, but have many other newsletters to keep you informed, including Globe Climate, Carrick on Money and Breaking News.

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Have we been treating depression the wrong way for decades? – CBC News



This is an excerpt from Second Opinion, a weekly analysis of health and medical science news. If you haven’t subscribed yet, you can do that by clicking here.

A new analysis of the cause of depression has seemingly upended what we know about this common condition and challenged the use of antidepressants. But it may also leave patients with more questions than answers as the science evolves.

A systematic umbrella review of 17 studies published in Molecular Psychology on July 20 looked at the decades-old theory that depression is caused by low serotonin, and found there was “no consistent evidence” of “an association between serotonin and depression.”

The theory that depression is caused by a chemical imbalance in the brain has been around since the 1960s. But for years, many experts have doubted this, feeling it oversimplified a complex condition.

“The serotonin theory is very old and has been very popular since the ’90s, when the pharmaceutical industry started promoting it,” said Dr. Joanna Moncrieff, a psychiatry professor at University College London and lead author of the study.

“But since about 2005, probably a bit before then, there’s been sort of rumours that actually the evidence isn’t very strong, or it’s inconsistent. Some studies are positive, some studies are negative, but no one’s really got that evidence together anywhere.”

Moncrieff and her team set out to challenge the serotonin theory in a systematic review of available research. They also went a step further in their conclusion by suggesting that antidepressants are ineffective at treating depression — and have largely worked as a placebo.

“Evidence from placebo-controlled trials show that antidepressants are a little bit better than a sugar tablet,” she said. “And if that little difference is not to do with rectifying a chemical imbalance, improving low serotonin levels, what is it to do with?”

The research paints a compelling picture that depression isn’t caused by low serotonin alone. Many experts say this is already widely accepted and that it’s also true that antidepressants can be extremely beneficial to some patients — even if we don’t know exactly why.

So where does this leave patients and physicians, and could the analysis impact the way we treat depression in the future?

Are antidepressants effective against depression?

Antidepressants are widely believed to affect the behaviour of neurotransmitters, chemical messengers in the brain like serotonin and dopamine, in a way that can alter emotions and mood to help improve the symptoms of depression in some patients.

WATCH | Living alone during pandemic can worsen anxiety, depression:

Living alone during pandemic can exacerbate anxiety, depression

2 years ago

Duration 2:02

The ongoing physical distancing precautions because of the COVID-19 pandemic can exacerbate anxiety and depression, especially for people living alone.

People with depression can face a wide range of symptoms, including persistent feelings of sadness and desperation, changes in appetite, sleep deprivation, fatigue, irritability and loss of interest in hobbies and social connections that can impact everyday life.

While it’s unclear exactly how antidepressants work at a biological level to alleviate those symptoms, it’s clear that they can still be hugely helpful to some patients.

“It’s a typical discovery in medicine — you find a drug that works, but you don’t quite know why,” said Dr. Phil Cowen, a professor of psychopharmacology at the University of Oxford.

“[The review] is a debunking exercise and in a way, they’re criticizing older studies that were hard to do,” he said. “These [older] studies, clearly, were very indirect and they’re messy, and I don’t think anyone thought that they were that great.”

Moncrieff’s team found that some depressed patients actually had higher serotonin levels in certain areas of the brain, and in some cases the long-term use of antidepressants could actually lower the amount of serotonin — though the findings were “inconsistent.”

“I think it makes a huge difference, because how [antidepressants] work actually influences whether they work,” she said. “It influences how helpful we think they are.”

The findings have caused a major stir in the media and scientific community, with hundreds of news outlets covering the study — quickly landing it in the top five per cent of all research scored by Altmetric, a company that analyzes where published research is shared.

Findings of this perceived magnitude can have a seismic impact on the way we understand and treat a widespread condition like depression, which affects an estimated one in eight Canadians at some point in their lives.

While the research questions the very nature of what we know about depression, many doctors are hesitant to change the way we treat it.

Antidepressants can be ‘lifesaver’ for some

Dr. David Juurlink, head of clinical pharmacology at Sunnybrook Health Sciences Centre in Toronto, said he’s not surprised by the findings, because the chemical imbalance theory for depression is now widely seen as an “obvious oversimplification” for a complex condition.

“Although I think doctors prescribe serotonin-enhancing antidepressants far too often, in part because of this oversimplification, it’s important to acknowledge that they really do improve the well-being of some patients,” he said in an email.

“How exactly they do that isn’t as clear-cut as we’ve been led to believe.”

A bottle of antidepressants is shown in Miami, Fla. A new analysis suggests depression isn’t caused by low serotonin, and that antidepressants are ineffective at treating it. (Joe Raedle/Getty Images)

Dr. David Gratzer, a psychiatrist and attending physician at the Centre for Addiction and Mental Health (CAMH) in Toronto, said he wasn’t surprised by the findings — just that they got as much attention as they did.

“This suggestion that depression is all about serotonin all the time hasn’t been accepted by psychiatrists for many years, probably many decades,” he said, adding that the researchers are “terribly biased” in their assessment of antidepressants.

“Their paper shows things are much more complicated than serotonin — no surprise — and then they turn around and say, ‘You see, that’s another example of the fact that antidepressants don’t really work.’ One doesn’t necessarily give rise to the other.”

Gratzer said he still prescribes antidepressants regularly as a treatment option for depression, and has no plans to stop doing so based on the research.

“That’s not going to change. These medications work,” he said.

“An antidepressant is not necessarily [recommended] in everyone who has depression — some people might in fact do better with talking therapy — but it is certainly a tool in our tool kit and, to be blunt, it’s a lifesaver for some of our patients.”

Research calls antidepressants into question

Moncrieff said the research found that another way in which antidepressants may function is by desensitizing the brain to negative emotions associated with depression. In theory, that could also impact other feelings.

She said one of the effects previous studies have reported in patients is “emotional numbing,” where they not only don’t have unwanted emotions like depression and anxiety, but positive emotions like joy and happiness.

“There may be some people that feel that that’s an effect they want. But I think generally, people aren’t going to want to be emotionally numbed, not for long periods, anyway, and so I think it totally changes the sorts of decisions people might make about antidepressants,” said Moncrieff.

Chris Davey, the head of the department of psychiatry at the University of Melbourne, said in an email that undermining the confidence that people with depression have in their treatments can be “very damaging.”

“People will stop their medications suddenly, without supervision,” he said, “which can cause dramatic deteriorations in their mental health.”

Davey said he is concerned that the paper diminished a treatment option that can be incredibly beneficial to some patients, especially when alternatives may not always be available to those at risk of severe depression.

WATCH | Research shows exercise can help alleviate pandemic depression:

Research shows how exercise helped fight pandemic depression

7 months ago

Duration 2:04

A study conducted by B.C. researchers during the COVID-19 pandemic showed how exercise, especially a combination of yoga and high-intensity exercise, helped fight depression – backing up decades of research on how exercise improves mental health.

“This [research] shouldn’t make any difference to the treatment of depression. I hope it makes people realize that depression is a very complex condition, and that there are no simple explanations for it,” Davey said.

“Everyone should know that improving their diet, exercising more and paying attention to their sleep can be helpful. Everyone should have access to psychotherapy. And for those people for whom those things don’t help, that’s when we think about medications.”

Gratzer said there are many new areas of research into treatment options for depression that can be beneficial, including novel ways of delivering psychotherapy, emerging medications and discoveries like the use of ketamine

Ketamine is a general anesthetic first approved in Canada in the 1960s for medical or veterinary surgery, as well as a psychedelic party drug sold on the illicit market. It’s also increasingly being used as a fast-acting and effective treatment for depression in low doses, by working to restore synapses in the brain that are destroyed by stress.

There’s “an understanding that certain life experiences might be more connected, and so research is very active. Maybe at the end of the day, we’ll understand depression isn’t one illness,” Gratzer said.

“As is often the case with mental health care, these are early days.”

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