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Ontario's COVID signs point to the start of a summer wave – Toronto.com

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Signs are emerging that point to the beginnings of a summer wave of COVID-19 in Ontario, the head of the province’s science advisory table is warning.

Dr. Fahad Razak, scientific director of the science table, points to a rising COVID wastewater signal, increasing test positivity and a surge of public health units experiencing exponential growth in cases.

There has been a gradual increase in the provincewide wastewater signal since the beginning of June along with test positivity that has been going up for the past three to four weeks. Then there’s the fact, he says, that about 40 per cent of public health units now have a reproduction number greater than one — all amounting to evidence the province has entered another wave.

“Putting all of this together, I think we’re seeing the beginning of a wave,” Razak said. “But it does not look like it has the intensity in terms of amplitude or pace of what we saw with the start of the Omicron wave. How fast it will rise and what the peak will be are unclear.

“Based on everything that we’re seeing, both in Ontario and globally, this is likely to be a less severe wave than what we’ve experienced in the past with less direct pressure on the health-care system.”

Razak’s red flag comes as the National Advisory Committee on Immunization recommended this week that additional boosters be given to a larger portion of the population in the fall. Other regions are also seeing a rise in hospitalizations driven by Omicron subvariants, including Quebec, which recently experienced a surge in community transmission and cases in health-care workers.

Meanwhile, the World Health Organization reports that infections are growing in 110 countries driven by the BA.4 and BA.5 subvariants, resulting in an overall 20 per cent increase in global cases.

Several infectious disease experts say fourth doses should be offered to all residents now ahead of a possible fall wave, while others say only those who are deemed at higher risk should be getting a second booster.

“If you’re someone who is higher-risk or is in a situation where you’re being exposed to a lot because you’re on TTC twice a day, in and out of work or something like that, it would be very reasonable to go and get that fourth shot now,” Razak said. “On the other hand, if you are otherwise low-risk and you have very little day-to-day exposure, it is reasonable to wait to get that booster dose until you’re closer to the fall or there’s more concretely a rise happening.”

At a press conference Thursday, Dr. Theresa Tam, Canada’s chief public health officer, said up-to-date vaccinations are the “foundation of our protection” and that those who had two doses and a booster shot had hospitalization rates that were five times lower than unvaccinated people during the Omicron wave in April and May.

She also reiterated NACI’s recommendations that those at risk of severe illness receive a fourth shot now, as boosters “increase protection by activating your immune response to restore protection that may have decreased over time.”

Dr. Gerald Evans, the chair of the division of infectious diseases at Queen’s University, said it’s uncertain whether fourth doses will be effective enough against BA.4 and BA.5 for the larger population. Those subvariants have an alteration within its genomes, making it more difficult for antibodies to bind to the spike proteins, which in turn makes these variants more likely to have immune-evading properties, he explained.

Pfizer and Moderna are developing vaccines that will specifically target Omicron, known as bivalent vaccines, which will likely be available in the fall. Both companies say they’ve tested their vaccines and they appear to be highly effective against Omicron, and plan to submit their data to governments in the next few months.

“I do totally agree that we should be rolling out boosters in the fall,” said Evans. He predicts a wave will occur in the late fall or early winter, and another will follow in the late winter or early spring because that’s how the COVID-19 virus has behaved previously, similar to other illnesses in the coronavirus category, he said.

NACI also announced in a release Wednesday that everyone aged 12 to 65 may be offered another dose in the fall, regardless of the number of previous doses, but that recommendation is “discretionary” and not categorized as a strong recommendation.

Those groups include all residents over 65; people 12 and older who have underlying medical conditions; Indigenous adults; racialized and marginalized communities that have been harder hit by the virus throughout the pandemic; migrant workers; residents of shelters, correctional facilities and group homes.

Recommendations will be provided on the type of COVID-19 booster dose that should be offered as evidence emerges on bivalent vaccines.

NACI said in its press release that “cases of COVID-19, including associated hospitalizations and deaths, are currently declining in Canada. However, the likelihood, timing, and severity of a future wave of COVID-19 is uncertain.”

Colin Furness, an infection control epidemiologist at the University of Toronto, said he is afraid the increasing signals Ontario is experiencing could mean we are approaching endemicity.

“My belief is that when we took masks off on the TTC, we started to harmonize different wastewater signals across the GTA. In other words, mixing people together on the TTC is not going to cause the signal at one wastewater treatment plant to go down, it’s going to cause the other ones to come up to match,” he said.

“If you think about that logically, that kind of synchronization, that’s a path to endemicity. Not a wave that comes and then subsides, but a new normal where the line is flat but it is at a very elevated level.”

He added that the elevations in wastewater signals, as well as cases in public health units, reflect the dropping of mask mandates earlier this month.

“But it’s not just that. It’s the mindset that goes with it. We see more and more people who ought to know better engaging in crazy, risky behaviour,” Furness said. “If I can be on the TTC and I don’t need to have a mask, then I can go out to dinner because that’s obviously less dangerous and if that’s the case, I can definitely go see a movie.

“It’s causing self-destructive logic to take hold.”

Olivia Bowden is a Toronto-based staff reporter for the Star. Reach her via email: obowden@thestar.ca

Kenyon Wallace is a Toronto-based investigative reporter for the Star. Follow him on Twitter: @KenyonWallace or reach him via email: kwallace@thestar.ca

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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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