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Potential COVID-19 vaccine has re-energized anti-vaccination groups, health experts warn – CBC.ca

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As Canadians yearn for an end to the COVID-19 pandemic and a time they can once again hug their elderly loved ones or gather in large groups without fear of infection, many are pinning their hopes on unprecedented global efforts to develop a vaccine against the virus.

But even though most infectious disease experts say the earliest possible timeframe would be at least a year or two away, anti-vaccination groups are already well into online and social media campaigns stoking doubts about the safety — and even questioning the necessity — of a coronavirus vaccine. 

“I just am astonished at how early the anti-vaccine narrative has started,” Dr. Natasha Crowcroft, a vaccine expert at the University of Toronto’s Dalla Lana School of Public Health, said in an interview with CBC’s The Dose health podcast. 

“We are really facing a major, major challenge,” Crowcroft told podcast host Dr. Brian Goldman. 

“And unless our public health leaders can generate a lot of trust, it’s going to be very, very difficult.”

That’s because anti-vaccination groups have become extremely savvy communicators and “seem to be much better” than public health experts at reaching out to a variety of people with different ideologies — from those who distrust pharmaceutical companies to those protesting public health lockdowns aimed at curbing the spread of coronavirus, Crowcroft said. 

The global focus on developing a coronavirus vaccine is unlike anything ever seen before, says Dr. Natasha Crowcroft, a vaccine expert at the University of Toronto’s Dalla Lana School of Public Health and a senior technical adviser with the World Health Organization. (Claude Martel)

Anti-vaccination groups in both Canada and the U.S. are positioning themselves as advocates for what they call “personal freedoms” and “medical choice” in the midst of the coronavirus pandemic — posting content online and on social media that not only targets vaccination, but also protests the closure of businesses, physical distancing requirements and the wearing of masks.   

Vaccine Choice Canada — one of the most high-profile anti-vaccination organizations in this country, announced in a letter posted to its website on May 13 that it was “launching legal action against the Government of Canada and others for violating our rights and freedoms during the COVID-19 outbreak.” 

In a June 18 episode of Digi-Debates posted on YouTube, the president of Vaccine Choice Canada, Ted Kuntz, claimed that COVID-19 was no more deadly than influenza — and argued that a vaccine was unnecessary. 

But infectious disease and public health experts widely agree that COVID-19 is far more lethal than the flu. According to the Public Health Agency of Canada, more than 8,500 deaths in Canada have been related to COVID-19. Based on the agency’s most recent available data, deaths from influenza were far fewer. The 2018-19 flu season claimed the lives of 224 people, while just over 300 people died of influenza in the 2017-18 season. 

CBC reached out to Vaccine Choice Canada via its media relations email address and also sent a Facebook message to Kuntz inviting him to comment further but did not receive a response before deadline.  

LISTEN | How close are we to an effective vaccine for COVID-19?

As we continue to grapple with the COVID-19 pandemic, most of us are anxious to return to normal life, when we can hug our elderly parents or grandparents and once again gather in large groups. Many experts say that can’t happen safely until a coronavirus vaccine is developed. In this unprecedented time, researchers around the world are working toward that goal, but it has to be done safely and follow a careful scientific process. Dr. Natasha Crowcroft, a vaccine expert at the the Dalla Lana School of Public Health at the University of Toronto, joins host Dr. Brian Goldman to help explain how close we are to an effective vaccine against COVID-19, the barriers we must overcome to get there, and what we need to do in the meantime. 20:40

Part of the strategy used by anti-vaccination groups has been to take legitimate cautions by some well-recognized physicians in the U.S. that the quest to find a coronavirus vaccine must not be rushed and that it must go through all of the necessary steps to ensure it is safe and effective — and then misrepresent those comments as arguments against a vaccine, said Jonathan Jarry, a science communicator in the Office for Science and Society at McGill University in Montreal, which has a mandate to debunk misinformation for the public. 

“We have the beginnings of a perfect storm on our hands [to fuel vaccine misinformation],” Jarry said. 

In the midst of a worldwide pandemic and an unprecedented effort to develop a vaccine as quickly as possible, many people have questions and anxiety about the process, he said.

At the same time, Jarry said, the anti-vaccination movement is “seemingly re-energized and … pushing a lot of misinformation and disinformation and lies and fuelling that anxiety.”

Seniors have been particularly hard hit by the coronavirus, with many deaths occurring in long-term care homes. Physical distancing measures, like this see-through barrier at a B.C. retirement home, is an effort to keep seniors safe during the pandemic. Some infectious disease experts say it may not be fully safe to hug elderly loved ones until an effective vaccine or treatment is developed. (Maggie MacPherson/CBC)

To combat that, both Crowcroft and Jarry agree, it’s essential that public health officials, physicians and community leaders talk openly and transparently with Canadians about the vaccine development process and directly answer their questions and concerns — and they need to start now. 

“There’s a small sliver of the population that is ferociously anti-vaccination. And it’s very difficult to reason with these people,” Jarry said. 

“But there’s a larger segment of the population that is vaccine-hesitant. And that is where our efforts need to be invested.”

‘The current situation is so different’

One of the key concerns that needs to be directly addressed is how a coronavirus vaccine can be developed more quickly than any vaccine before it and still be safe, Jarry said. 

The answer, Crowcroft said, is that “the current situation is so different that it is possible to get through the development steps faster without cutting any corners that might compromise safety.”

It normally takes “years and years and years” to develop a vaccine, she said. “I mean 10 years would not be unusual.”

A big part of the reason for that, Crowcroft said, is that scientists often come up with a vaccine candidate but have a difficult time getting funding to move it to the next phase of clinical trials, because every trial stage is expensive and pharmaceutical companies are hesitant to risk spending enormous amounts of money on a product that could fail at the next stage. Plus, there’s often no guarantee there will be a market for the vaccine even if it does work. 

But in the midst of a pandemic, the pharmaceutical industry is confident that the demand for a vaccine exists, she said. In addition, governments around the world are providing funding for vaccine development, which removes the potential for a huge financial loss if a company invests in a vaccine candidate that doesn’t succeed in the end. 

“Governments are helping to speed things up by funding the trials so they can go on in parallel and/or the gaps between each step are shorter, without the long delays for decision-making about whether the company wants to take the [financial] risk of moving forward,” said Crowcroft, who was recently appointed a senior technical adviser for the World Health Organization’s measles, mumps and rubella program. 

Because of that, there are more than 100 different vaccine candidates in various phases of research at the same time around the world, increasing the odds that at least one, possibly more, will prove to be safe and effective, she said. 

WATCH | States brace for impact of COVID-19 surge in U.S.:

Some parts of the U.S. are bracing for the impact on hospitals as cases of COVID-19 surge amid a lack of political will to respond. 2:01

Because of advances in genetic sequencing, scientists’ ability to learn about a new virus is also more advanced than it has ever been in the past, giving researchers a head start in figuring out what part of it to target with a vaccine. 

“Nothing in the history of humankind has ever been seen like this before,” Crowcroft said. 

Finally, she said, amid all the hype as companies put out news releases boasting about their progress in vaccine development,  it’s “important to remember that the press release does not determine whether a vaccine will eventually be used.”

It’s up to each country’s regulatory agency, such as Health Canada, to determine whether a vaccine can be used and be independent of any industry influence.

“Safety cannot be compromised,” Crowcroft said. “Health Canada will see to that. It is their statutory responsibility.”

In an emailed statement to CBC, Dr. Theresa Tam, Canada’s chief public health officer, said that before any vaccine is approved for use in this country, “Health Canada conducts rigorous scientific reviews and testing of the vaccine to assess the quality, safety and effectiveness.”

“Once a vaccine is in use, health authorities continue to monitor the vaccine to ensure ongoing highest standards of safety.”

‘Empathy’ and ‘building trust’

But if these kinds of questions about safety, as well as other concerns, aren’t dealt with directly by public health officials — or if the public doesn’t trust them —  anti-vaccination voices will fill that void with misinformation, Jarry warns. 

The most effective way to talk to people who are vaccine-hesitant, he said, “all boils down to empathy and to listening and to building trust.” 

It’s important not to criticize people for expressing concerns, even if they are based on misinformation that has long ago been debunked, he said. 

“If we ignore them because we don’t have time or if we ignore them because we think they’re silly, the anti-vaccination movement will end up polarizing the vaccine-hesitant segment of the population against vaccination,” Jarry said. “And then vaccine uptake is going to keep going down.”

We’ve already seen the toll that vaccine refusal can take with the re-emergence of measles, he said. 

Crowcroft estimates that for a coronavirus vaccine to be effective at protecting the population, between 60 and 70 per cent of people need to be immunized. 

“I’m not sure we’re doing everything we can yet to prepare,” she said. “We really do need to start, you know, having those discussions with communities and building relationships so that they do trust in their [public health] leaders.”

An ad from the Ontario Medical Association aimed at combating overall vaccine hesitancy is pictured in a bus shelter. (Paul Smith/CBC)

In her statement to CBC, Tam said she recognized that “vaccine hesitancy is still very much an ongoing issue within Canada and worldwide.”

“In collaboration with my provincial and territorial colleagues and other stakeholders, foundational work has already begun to prepare for the possible release of a safe and effective COVID-19 vaccine in Canada, if and when it becomes available,” Tam said. 

That work, she said, would include “developing strategies and resources to inform and educate to build vaccine confidence as well as combat stigma, misinformation and fear around the release of a new vaccine.” 

The Public Health Agency of Canada, which Tam heads, said in a separate statement to CBC that “efforts to inform and educate to build vaccine confidence are part of the agency’s regular business” and that it would use similar information and social media campaigns “when a new COVID-19 vaccine is released to ensure that Canadians have the proper information to inform their choice to receive the vaccine when available.”

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HPE Public Health issues order to protect farm workers – Quinte News

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Hastings Prince Edward Public Health has issued an order to local farmers to help maintain the safety of workers through the COVID-19 Pandemic.
Requirements under the order include:
  • Ensuring that appropriate accommodations and adequate essentials such as food, water, laundry, and cleaning supplies are provided to any farm workers in isolation.
  • Ensuring workers have appropriate access to health care services and other supports.
  • Implementing consistent work teams/groups to minimize number of contacts throughout the work day.
  • Conducting active screening of workers on a daily basis.
  • Maintaining physical distancing requirements as best as possible.
  • Ensuring appropriate isolation of farm workers, when required, to reduce potential transmission of COVID-19, in alignment with current provincial guidelines.
  • Ensuring that workers from any area where there is community transmission of COVID-19 have tested negative within 48 hours prior to beginning work.
Acting Medical Officer of Health Dr. Alexa Caturay says maintaining appropriate public health measures in farm settings is crucial to preventing the spread of COVID-19.

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COVID-19 in Ottawa: From April spike to June plank – CTV News Ottawa

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OTTAWA —
Data suggest the COVID-19 pandemic curve has flattened in Ottawa and the gradual reopening of businesses has not yet had an impact.

Ottawa’s COVID-19 case count rose steadily in June, but at a much slower pace than previous months. By the latter half of the month, as the economic reopening began to take hold, daily reports of new cases were in the low single digits.

Here is a look at how the pandemic has progressed in Ottawa, 16 weeks since it began.

Cases spike in April

The first case of COVID-19 in Ottawa was confirmed on March 11. The total case count rose slowly during the latter half of March, but quickly ramped up in April. 1,178 new cases of COVID-19 were confirmed in Ottawa during the month of April and 73 people died.

Each day, the number of active cases rose, as new, laboratory-confirmed cases outpaced the number of recoveries. By the end of April, there were 673 known active cases of COVID-19 in Ottawa, according to data from Ottawa Public Health.

Since the end of April, the rise in the total number of cases has slowed and more people began to recover.

May saw the curve’s direction change, but it was also a tragic month for many families in the city.

Curve flattens in May at great cost

Between May 1 and May 31, Ottawa saw an increase in new cases of roughly half the rate seen in April, with 590 new confirmed infections. During that same month, the number of resolved cases jumped dramatically. At the start of May, 805 COVID-19 cases in Ottawa were considered resolved; by May 31, that number doubled to 1,610.

May, however, was also the deadliest month for the disease in Ottawa since the pandemic began, with 168 deaths, many of them in the city’s long-term care homes.

Many of the deadliest outbreaks in long-term care homes began in April, but lasted through the month of May. 

Curve plateaus in June

If April was the pandemic’s spike, then May was the hammer that would flatten the curve in June.

According to data from Ottawa Public Health, June has been a plank month. The number of COVID-19 cases and deaths has still been increasing, but at only a fraction of the pace seen in April and May.

There were 132 new lab-confirmed cases of COVID-19 between June 1 and June 30, with 19 new deaths.

Active cases continued to fall to a low of 40, though data from June 30 showed a slight increase in the number of active cases, from 40 to 46.

Recoveries continued to increase, but the rate of recovery was also much slower. OPH reported 175 new resolved cases in June, as opposed to 805 in May.

Many of the deadliest outbreaks at long-term care homes officially came to an end in June. Ottawa’s deadliest outbreak, at Carlingview Manor, was officially declared over on June 18. The outbreak claimed 60 lives in the home. The outbreak at Madonna Care Community, where 47 residents and two workers died, ended June 8.

By the end of June, only two outbreaks remained active.

The data suggest fewer people are contracting the virus, accounting for the slower rate of not only new cases, but recoveries as well. The testing figures provided by Ottawa Public Health show that testing remains strong and fewer positive cases are being returned.

At the start of June, as many as three per cent of all tests came back positive. By the end of the month, that number had dropped to 0.3 per cent.

Laboratories returned more than 19,000 test results between June 1 and June 28, for an average of 680 tests per day.

COVID-19 testing in Ottawa in June

However, OPH notes that those who did contract the virus in June were still getting it from the community, and not from a close contact or institutional outbreak.

According to the data, two-fifths of all new confirmed COVID-19 cases in Ottawa in June are believed to be the result of community spread.

COVID-19 Community Spread in Ottawa in June

The rate of hospitalizations also fell in June. At the start of the month, 39 people were in hospital with COVID-19 complications. By the end of the month, there were two, with one in intensive care.

Full details can be seen at Ottawa Public Health’s COVID-19 Dashboard page, which is updated daily.

COVID-19 Hospitalizations in Ottawa in June

Holding the line in July

Ottawa’s medical officer of health, Dr. Vera Etches, says Ottawa has done well to flatten the curve of COVID-19, but the risk of a second wave is real.

“We are seeing second waves emerge in other parts of the world and, while we are fortunately in a much better position here in Ottawa at this point, we are also at risk of a second wave,” Dr. Etches said in a statement on June 29. “We can watch other countries and communities to learn about what works to control COVID19 and adapt approaches to what is appropriate for our city.”

A recent outbreak at a Kingston, Ont. nail salon has led to 30 cases in that city. None of the affected individuals have been hospitalized, but it shows how easily one case can turn into dozens. Recently lifted lockdowns in some parts of the U.S. have been reinstated as cases continue to surge south of the border.

With 40 per cent of all new cases in Ottawa linked to community transmission, Dr. Etches said all of these figures are based only on what has been confirmed by laboratories.

“Currently case numbers are steady, outbreaks are decreasing and we are maximizing testing and contact tracing capacity. This is good news, but the positive case numbers you see updated on our website every day are still just a fraction of the infections truly present in the community,” Dr. Etches said.

“The risk of an increase in COVID19 cases and outbreaks is real. Modelling data shows that a decline of just twenty per cent in public control measures could lead to a second wave. Our actions influence whether a second wave occurs and its severity. Ottawa residents have already shown that they are capable of doing what needs to be done to keep the virus at a manageable level.”

The next step for Ottawa could be a mandatory mask order. Those rules are already in place in Kingston and set to go into effect in the Eastern Ontario Health Unit’s jurisdiction. The City of Toronto also recently passed a by-law making masks mandatory in indoor public spaces starting July 7.

Dr. Etches said she is “seriously considering” a similar mask order, and Ottawa Mayor Jim Watson said he would not be opposed.

The Ontario government is currently discussing how to move regions into the third stage of its reopening framework. Health Minister Christine Elliott said she is waiting for another week’s worth of data before going ahead.

Stage 3 would allow the size of public gatherings to increase and all workplaces to open, according to provincial guidelines.

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Why some people don't want to take a COVID-19 test – The Conversation AU

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Last week, outgoing chief medical officer Brendan Murphy announced all returned travellers would be tested for COVID-19 before and after quarantine.

Some were surprised testing was not already required. Others were outraged some 30% of returned travellers in hotel quarantine in Victoria had declined to be tested.

This week, Victorian premier Daniel Andrews said more than 900 people in two Melbourne “hotspots” had declined door-to-door testing.

Again, there was outrage. People refusing COVID-19 tests were labelled selfish and rude.

A positive test result, together with contact tracing, gives public health authorities important information about the spread of SARS-CoV-2, the coronavirus that causes COVID-19, in a community.

So why might people at higher risk of a positive result be reluctant testers? And what can we do to improve testing rates?

The many reasons why

Reluctance to be tested for COVID-19 is not unique to returned travellers in hotel quarantine or people living in “hotspot” suburbs.

In the week ending June 28, FluTracking, a voluntary online surveillance system, reported only 46% of people with a fever and cough had gone for a COVID-19 test.

That can be for a variety of reasons.

A medical test result is not a neutral piece of information. People may refuse medical testing (if they have symptoms) or screening (if no symptoms) of any type because they want to avoid the consequences of a positive result.

Alternatively, they might want to avoid the perceived burden of the test procedure itself.

Reasons may relate to potentially losing money or work

Many reasons for avoiding testing are likely to be structural: a casualised workforce means fewer workers with sick leave and a higher burden associated with having to isolate while waiting for test results. After a COVID-19 test in NSW, for instance, this can take 24-72 hours.

Then there’s the issue of precarious work. If people can’t attend work, either waiting at home for test results or recovering from sickness, they may lose their job altogether.




Read more:
If we want workers to stay home when sick, we need paid leave for casuals


In the case of hotel quarantine, a positive result on day ten will mean a longer stay in isolation. Hotel quarantine is not an easy experience for many, particularly if quarantining alone.

An extension of time at a point where the end is in sight may be a very difficult proposition to stomach, such that avoiding testing is a preferable option.

Another structural issue is whether governments have done enough to reach linguistically diverse communities with public health advice, which Victoria’s chief health officer Brett Sutton recently admitted may be an issue.

Through no fault of their own, may people who don’t speak English as a first language, in Victoria or elsewhere, may not be getting COVID-19 health advice about symptoms, isolation or testing many of us take for granted.




Read more:
Multilingual Australia is missing out on vital COVID-19 information. No wonder local councils and businesses are stepping in


People might fear the procedure or live with past traumas

Reasons may be personal and include fear of the test procedure itself (or fear it will hurt their children), distrust in government or public health systems, and worry about the extent of public health department scrutiny a positive result will bring.

Not everyone is comfortable with door-to-door testing.
James Ross/AAP Image

People may also feel unprepared and cautious in the case of door-knocking testing campaigns.

We can’t dismiss these concerns as paranoid. Fears of invasive procedures are associated with past trauma, such as sexual abuse.

People who have experienced discrimination and marginalisation may also be less likely to trust governments and health systems.

COVID-19 can also lead to social stigma, including blame and ostracism, even after recovery.

As with any health-related decision, people usually consider, consciously or not, whether benefits outweigh harms. If the benefit of a test is assumed to be low, particularly if symptoms are light or absent, the balance may tip to harms related to discomfort, lost income or diminished freedoms.

Should we force people to get tested?

Although federal and state laws can compel certain people to undergo testing under limited circumstances, acting chief medical officer Paul Kelly said it was “a last resort”.

Forcing a person to undergo a test contravenes that person’s right to bodily integrity. This is the right to make decisions about what happens to your own body, without outside coercion.

It also involves medical personnel having to override their professional responsibility to obtain voluntary and informed consent.

Some states have indicated they will introduce punishments for refusing testing. They include an extension of hotel quarantine and the potential for fines for people not willing to participate in community testing.




Read more:
Lockdown returns: how far can coronavirus measures go before they infringe on human rights?


Forced testing will backfire

We don’t think forced testing is the way to go. A heavy-handed approach can create an antagonistic and mistrustful relationship with public health institutions.

The current situation is not the only infectious disease emergency we will face. Removing barriers to participating in public health activities, in the immediate and long term, will enable people to comply with and help build trusted institutions. This is likely to create an enduring public good.

Victoria is trying to make testing easier. It is offering a test that takes a saliva sample rather than a nasal swab, which is widely perceived to be unpleasant.




Read more:
Explainer: what’s the new coronavirus saliva test, and how does it work?


This may encourage parents to have their children tested. The test is less sensitive, however, so the gains in increased uptake may be lost in a larger number of false negatives (people who have the virus but test negative).

Ultimately, we need to understand why people refuse testing, and to refine public health approaches to testing that support individuals to make decisions in the public interest.

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