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Ontario's number of COVID-19 patients in ICUs climbs as Toronto reports a record 761 new cases – Toronto Star

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The increasing number of hospitalizations for COVID-19 amid the relentless spread of the virus are signs Ontario will have to keep tightening pandemic restrictions.

That was the message from the president of the Ontario Hospital Association as admissions of COVID-19 patients to intensive care units approached 200, a level above which non-emergency surgeries are hampered.

“My sense is stronger measures are inevitable at the rate we’re going,” Anthony Dale said Tuesday as Ontario marked more than 1,700 new infections for the fifth straight day, as well as seven more deaths.

They fuelled a major jump in the closely watched seven-day average of cases, which surged by an even 100 to 1,670, an all-time high. Toronto alone reported a record 761 new cases, which medical officer Dr. Eileen de Villa called a “blunt warning” of community spread.

With hospitalizations typically lagging new cases by several weeks, hospitals are expecting their number of COVID-19 patients to keep climbing — perhaps at a faster pace.

The Ministry of Health reported Tuesday that 27 more people were admitted to hospitals, bringing the total to 645, with at least 112 patients on ventilators, up from 91 a week ago.

A separate overnight survey found 26 more critically ill patients with COVID-19 were transferred to intensive care units, raising that total to 193.

That type of increase is “no surprise,” said Dr. Irfan Dhalla, an internist and vice-president at St. Michael’s Hospital, who noted this is “definitely not the time to be musing about relaxing restrictions.”

Health Minister Christine Elliott said Scarborough General Hospital is one of several hospitals that has had to postpone procedures because ICU beds are filling up.

“We know that there are some hospitals that are in the hot zones that are already having to shut down somewhat their non-emergency procedures,” she told reporters at a news conference Premier Doug Ford missed because of what his staff called an unexpected but “non-urgent” medical appointment.

“As tragic as it is to have lost a loved one to COVID, it would be equally tragic to lose someone because of a cancer surgery or a cardiac surgery that wasn’t performed in time,” Elliott said.

Elliott said more than 3,100 hospital beds have been added since March to help cope with the second wave of the pandemic as Ontarians await a vaccine next year.

The 28-day lockdown for Toronto and Peel Region is in place until Dec. 21 when it will be reviewed, with Ontario chief medical officer Dr. David Williams looking for indications that restrictions such as a ban on indoor dining and the closures of gyms, cinemas, hair salons and non-essential retailers are working.

Health experts have cautioned that lifting those restrictions in the week before Christmas could send the wrong signals about risks from the pandemic, lead to a mad dash of holiday shopping and a further spike in cases.

“Officials will look at the situation in areas that are locked down, see if we’re flattening or reducing the rate of community growth. They’ll look at areas that are not in lockdown but are at different levels in the provincial framework,” Dale said.

“If those trends are not in the right place or heading in the wrong direction, we’re hopeful they’ll take the aggressive action that, really, has been shown worldwide to be necessary if we’re to halt the spread of COVID-19.”

Epidemiologists and doctors have said any easing of restrictions should be tied to vigorous testing and the full ability of public health units to trace the contacts of people testing positive for the virus to keep it in check.

Provincial officials keeping an eye on computer modelling have warned that Ontario could hit 400 patients in intensive care units with weeks; when that number hits 350, non-emergency surgeries become almost impossible.

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Another risk factor for hospitals is the number of outbreaks that are occurring within their walls because there are so many cases in the community, said Dale.

In London, University Hospital was hit so hard recently it had to close admissions to medical wards and cancel elective surgeries, with the added complication of an outbreak in its acclaimed organ transplant unit.

“It’s very sobering,” said Dale.

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Worldwide coronavirus cases cross 161.42 million, death toll at 3,488,751

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More than 161.42 million people have been reported to be infected by the novel coronavirus globally and 3,488,751​ have died, according to a Reuters tally.

Infections have been reported in more than 210 countries and territories since the first cases were identified in China in December 2019.

Interactive graphic tracking global spread of coronavirus: open https://tmsnrt.rs/2FThSv7 in an external browser.

Eikon users can click  for a case tracker.

The following table lists the top 50 countries by the number of reported cases. A complete list is available with the above links.

COUNTRIES AND TOTAL DEATHS CONFIRMED DEATHS PER

TERRITORIES CASES 10,000

INHABITANTS

United States 584,768 32,926,288 17.9

India 262,317 24,046,809 1.94

Brazil 430,417 15,433,989 20.55

France 107,423 5,848,154 16.04

Turkey 44,301 5,095,390 5.38

Russia 254,590 4,922,901 17.62

United Kingdom 127,668 4,446,824 19.21

Italy 123,927 4,146,722 20.51

Spain 79,339 3,604,799 16.95

Germany 85,903 3,579,871 10.36

Argentina 69,254 3,242,103 15.56

Colombia 79,760 3,067,879 16.06

Poland 71,311 2,849,014 18.78

Iran 76,433 2,732,152 9.34

Mexico 219,901 2,375,115 17.43

Ukraine 47,620 2,143,448 10.67

Peru 65,316 1,873,316 20.02

Indonesia 47,823 1,734,285 1.79

Czech Republic 29,857 1,651,178 28.09

South Africa 55,012 1,605,252 9.52

Netherlands 17,423 1,589,282 10.11

Canada 24,825 1,312,408 6.7

Chile 27,520 1,266,601 14.69

Iraq 15,910 1,134,859 4.14

Philippines 18,958 1,131,467 1.78

Romania 29,413 1,070,605 15.11

Sweden 14,275 1,037,126 14.03

Belgium 24,645 1,026,473 21.56

Pakistan 19,384 873,220 0.91

Portugal 16,999 841,379 16.53

Israel 6,379 839,076 7.18

Hungary 29,041 796,390 29.71

Bangladesh 12,102 779,535 0.75

Jordan 9,203 722,754 9.24

Serbia 6,646 705,185 9.52

Switzerland 10,179 679,510 11.96

Japan 11,396 673,821 0.9

Austria 10,455 635,780 11.83

United Arab Emirates 1,626 543,610 1.69

Lebanon 7,569 534,968 11.05

Morocco 9,091 514,670 2.52

Malaysia 1,822 462,190 0.58

Nepal 4,669 439,658 1.66

Saudi Arabia 7,134 431,432 2.12

Bulgaria 17,194 413,320 24.48

Ecuador 19,442 405,783 11.38

Slovakia 12,168 387,162 22.34

Greece 11,322 373,881 10.55

Belarus 2,681 373,351 2.83

Panama 6,288 369,455 15.05

Source: Reuters tally based on statements from health ministries and government officials

Generated at 10:00 GMT.

 

(Editing by David Clarke)

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Canada plots course to fully vaccinated return to gatherings in fall

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Canada on Friday said there would be a gradual return to a world with indoor sports and family gatherings as more people get vaccinated, but it did not go as far as the United States in telling people they could eventually ditch their masks.

Canada has administered one dose of a COVID-19 vaccine to just over half its adult population, and the country may be over the worst of its current third wave of infections, Chief Public Health Officer Theresa Tam said.

On Thursday, the U.S. Centers for Disease Control and Prevention (CDC) advised that fully vaccinated people do not need to wear masks outdoors and can avoid wearing them indoors in most places, guidance the agency said will allow life to begin to return to normal.

On Friday, Canada‘s public health agency offered guidelines to the 10 provinces, which are responsible for public health restrictions.

The agency says once 75% of Canadians have had a single dose and 20% are fully vaccinated, some restrictions can be relaxed to allow small, outdoor gatherings with family and friends, camping, and picnics.

Once 75% of those eligible are fully vaccinated in the fall, indoor sports and family gatherings can be allowed again.

“I think masks might be the last layer of that multi-layer protection that we’ll advise people to remove,” Tam told reporters, noting that in Canada colder temperatures meant people would start spending more time indoors in the fall.

“We are taking a bit of a different approach to the United States,” she added. While in most of Canada masks are not required outdoors, they are mandatory indoors.

Less than 4% of Canada‘s adult population has been fully vaccinated compared to more than 36% of Americans.

Prime Minister Justin Trudeau, who has promised that everyone who wants to can be fully vaccinated by September, this week spoke of a “one-dose summer” and a “two-dose fall” without explaining what that might look like.

 

(Reporting by Steve Scherer and David Ljunggren; Editing by Hugh Lawson)

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Delayed 2nd Pfizer/BioNTech shot boosts antibodies in elderly; COVID-19 obesity risk higher for men

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The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Delaying second Pfizer/BioNTech dose boosts antibodies in elderly

Delaying the second dose of the Pfizer/BioNTech COVID-19 vaccine beyond the originally recommended three-week gap used by the companies in clinical trials appears to induce a stronger antibody response in the elderly, UK researchers found. Shortly after the vaccine became available, UK health officials advised that the second dose should be given 12 weeks after the first to allow more people to get protected by a first dose early on. In a new paper seen by Reuters and expected to appear on medRxiv on Friday ahead of peer review, researchers found that among 175 people ages 80 to 99, those who got their second dose at 12 weeks had antibody responses that were 3.5 times higher than those who got it after three weeks. Antibodies are only one part of the immune system, and vaccines also generate T cells that fight infections. The peak T cell responses were higher in the group with a three-week interval between doses, and the authors cautioned against drawing conclusions on how protected individuals were based on which dosing schedule they received. (https://reut.rs/3wjPK9B)

Impact of obesity on COVID-19 risks may be greater in men

The known increased risk of severe COVID-19 and death linked to obesity may be even more pronounced for men than women, new data suggest. Researchers studied 3,530 hospitalized COVID-19 patients with an average age of 65, including 1,469 who were obese. In men, moderate obesity was associated with a significantly higher risk of developing severe disease, needing mechanical breathing assistance and dying from COVID-19. (The threshold for moderate obesity is a body mass index (BMI) of 35. In an 5-foot, five-inch tall (1.65 m) adult, that would correspond to a weight of 210 pounds (95 kg). In women, however, only a BMI of 40 or higher, indicating severe obesity, was linked with the increased risks. In a report published in European Journal of Clinical Microbiology & Infectious Diseases, the researchers note that while obesity is known to be linked with body-wide inflammation, patients’ levels of inflammatory proteins did not appear to explain the association between obesity and severe illness. For now, they conclude, “particular attention should be paid” to protecting patients with obesity from the coronavirus, “with priority to vaccination access, remote work, telemedicine, and other measures given the higher risk of adverse outcomes once they are diagnosed with COVID-19.” (https://bit.ly/3eO6GiA)

COVID-19 testing rates low among symptomatic Americans

Sick Americans appear to be passing up opportunities to get tested for coronavirus and thus are likely unknowingly spreading the infection throughout their communities, new research shows. Among 37,000 adults across the United States who participated in a smartphone app survey between March and October 2020, nearly 2,700 reported at least one episode of fever and chills. But according to a report published in JAMA Network Open, only a small fraction reported receiving a COVID-19 test result within seven days of the onset of illness. At first, as tests became more accessible, the numbers improved. In early April 2020, less than 10% of survey participants reporting illness with fever received test results within a week. By late July, that proportion had increased to 24.1%. Throughout the summer and fall, as tests became easier to find, the number of sick participants who reported getting tested remained flat. By late October, only 26% reported receiving a test result within a week of febrile illness. “It’s shocking to me that when people have a fever they’re still not getting tested,” said coauthor Dr. Mark Pletcher of the University of California, San Francisco. “Tests are easy to come by. People might have coronavirus, might be spreading it to their friends and neighbors, and they’re not getting tested.” (https://bit.ly/2QUyMzf)

Open  in an external browser for a Reuters graphic on vaccines in development.

 

(Reporting by Nancy Lapid, Alistair Smout and Ronnie Cohen; Editing by Bill Berkrot

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