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Sorry to burst your COVID-19 ‘social bubble’ but even small gatherings are getting riskier

For months, Canadians have been bubbling up with other friends and family to socialize safely during the pandemic.But with COVID-19 case counts rising in many communities, kids back in schools and more people returning to work, many public health experts agree that what worked as a safe approach in the early days of the lockdown now comes with more risk.”I honestly think with the return to school right now, most people’s bubbles have burst,” says epidemiologist Ashleigh Tuite. “You’re talking about large numbers of connections.”In Ontario, “social circles” allow you to see up to 10 people without the usual pandemic precautions in place as long as all of those family members, friends or neighbours make a pact to socialize only with each other, while in Alberta, the cap for your “cohort” is your household plus up to 15 other people.In B.C., the guidelines for a “bubble” are now to try and limit it to six people. Officials initially said the members of your immediate household can be “carefully expanded” to include outsiders, with the goal of limiting the number as much as possible — since these are people you’re allowed to kiss, hug, chat with and dine with, all without masks or distancing.WATCH | B.C. moves toward limiting bubbles to 6 people:It’s a concept being adopted in several countries around the world. And while it works well in principle, experts warn it may be harder to maintain at this point in the pandemic.Bubble makes sense in ‘theory'”As a theory, the bubble makes a lot of sense,” said Dr. Dominik Mertz, an associate professor in the division of infectious diseases at Hamilton’s McMaster University. “But there’s a lot of confusion from people over what it is.”He also added it can be tough to do safely, particularly if the bubble involves multiple households “who all have different risks.”Say you have two four-person households socializing without the usual pandemic precautions. On paper, it follows the current Ontario guidelines.But what if one person is back at work, leaving them exposed to dozens of colleagues? Or either family’s children are in school, where physical distancing and mask wearing might be a challenge?A small sphere of contacts can quickly expand to include everyone that each family member comes in contact with, which means the bubbling approach really isn’t “useful” anymore, according to Tuite, an assistant professor at the University of Toronto’s Dalla Lana School of Public Health.’It’s not going to work for all people’Raywat Deonandan, an epidemiologist and associate professor at the University of Ottawa, agreed it’s not a “perfect model” at this point in the pandemic.”It would’ve worked better back when things were fully locked down,” he said, adding there’s still merit in bubbling with a few close friends or family if everyone is cautious.”I don’t want to remove any tools from the table,” he said. “If bubbling is working for some people, keep on doing it. But it’s not going to work for all people.”For instance, a supply teacher, with a social network of students and staff in various classrooms or even buildings, can’t realistically have a social bubble without any precautions, Deonandan said, while someone working from home might be able to do it more safely.WATCH | ‘Exponential’ growth in new cases in parts of Canada, says infectious disease specialist:For many people, losing their bubble could mean a long, lonely winter, made worse by mental health struggles or living alone.”We know there are benefits to having that human contact,” said Dr. Nitin Mohan, a physician epidemiologist and assistant professor at Western University in London, Ont. But when dropping temperatures push people indoors, where transmission risk is higher, and families start making plans to gather over the upcoming stretch of holidays, it could make adhering to the bubble principles even tougher. Bubble burst? Isolate for a while Mertz says Canadians should already be planning for upcoming gatherings like Thanksgiving.If outside-the-bubble family members want to celebrate together, find ways to do it safely, he says, by meeting outdoors and staying apart as much as possible. Otherwise, you’re blending several household bubbles together and upping the risk for everyone.And if you do throw caution to the wind for a turkey feast, there’s another approach: Isolate yourself as much as possible for two weeks after the gathering. “That would give us downtime, so in case someone got infected, you are not spreading it from that gathering into each individual bubble,” Mertz said.The various experts who spoke with CBC News acknowledged the challenges in sticking to even the safest bubbling plan, with peer pressure, slip-ups, and our innate desire for human connection all potential obstacles.For that reason, Dr. Andrew Morris, an infectious disease specialist with the Sinai Health System and University Health Network in Toronto, stresses the onus shouldn’t just be on individuals to reduce transmission.From a system-wide perspective, he says, provincial governments need to ensure every piece of the pandemic plan is adequately resourced: testing capacity, contact tracing, personal protective equipment and hospital staff.”If you can’t test people who are symptomatic, then you can’t contact trace … and you can’t identify people who are about to become symptomatic and are unknowingly and unwittingly spreading the disease,” he said.Ontario gathering sizes reducedOntario officials say they’re working to increase testing capacity amid hours-long lineups in multiple cities, including Ottawa and Toronto.The province is also lowering the maximum size limit for private gatherings — things like backyard barbecues or dinner parties, with precautions in place among people in different social circles — in some regions.The new limits will be 10 people indoors and 25 people outdoors, with hefty fines of $10,000 or more for organizers who flout the rules.Deonandan calls that the “single best policy intervention” for controlling the spread of COVID-19, given the growing body of research showing large gatherings can be hot spots for virus transmission.”Mask wearing, that’s important. Distancing, that’s important, too,” he said. “But time and time again we see explosions of cases in otherwise controlled areas … driven by these super-spreading events.”Even smaller gatherings can fuel the virus’s spread, like infections after a family outing documented in Toronto, and a 10-person cottage trip — which would still meet the province’s new rules — that led to 40 new cases in Ottawa.It’s not clear if anyone involved in those gatherings was bubbling together, and Mertz stresses in all situations, the same safety precautions apply.”Whether you continue with the bubble concept or not, it comes down to the less people gathering, the more time you can spend outside, the more you can spread out — the lower the risk.”

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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September 13, 2024

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 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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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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September 11, 2024

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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September 10, 2024

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

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