Health

Rapid spread of COVID-19 should not be confused with severity, expert says – Montreal Gazette

Published

5 years ago

February 28, 2020

“The majority of people who are affected have no major problems or complications,” said Donald C. Vinh, an infectious disease specialist.

Quebec has reported its first case of the coronavirus epidemic that has been sweeping the globe.

During a press briefing on Thursday evening, Quebec’s health minister announced that a woman who returned from Iran on Monday went to a clinic later that day, experiencing mild symptoms of what the public health department presumes is COVID-19, the illness caused by a new strain of the ubiquitous coronavirus.

The news does not come as a surprise to scientists and physicians like Dr. Donald C. Vinh, an infectious disease specialist at the McGill University Health Centre. “I wouldn’t be surprised if it is already in Quebec,” he said in an interview on Wednesday. “We are a global village. If you look at the direction of travel across the Earth. It is not surprising that COVID-19 is coming to Quebec. This is what coronaviruses do.”

Coronaviruses are a large family of viruses that cause illnesses of the respiratory tract ranging from the common cold to such serious conditions as severe acute respiratory syndrome (SARS). They are named for the spikes that protrude from their membranes, which resemble the sun’s corona, and can infect both animals and people.

The new strain of coronavirus was first detected in the city of Wuhan, in central China, in December. As the number of confirmed cases in China has been dropping, caseloads in other countries have been rising, “almost like a wave.”

People are conflating the rate at which COVID-19 seems to be spreading with its severity, says McGill University Health Centre infectious disease specialist and McGill researcher Dr. Donald C. VInh. They shouldn’t.

Photo courtesy of the MUHC

“Now we are seeing it leak into other countries,” Vinh said. “It’s exactly what coronaviruses have done in the past, including more serious forms, such as SARS.”

Like SARS, which originated in China and ultimately affected people in 29 countries, COVID-19 has three phases: local, national and international.

And like the woman in the presumed Quebec case, who was not admitted to hospital and is now at home in voluntary isolation, about 95 per cent of people who develop the illness do not have a severe case of the respiratory illness, whose symptoms include fever, a cough and difficulty breathing.

“We know that the majority of people who are affected have no major problems or complications from the infection,” said Vinh, who is also a medical microbiologist and a clinician-scientist whose research focuses on genetic defects of the immune system that explain why certain people are prone to infections.

He said he believes that COVID-19 will become a pandemic, an epidemiological term used to describe the extent of the spread of a disease. “That is not unusual for coronaviruses,” he said.

What defines a pandemic is that it is international in scope, Vinh said. In our modern world, where people can — and do — travel anywhere, pandemics happen. Infections like influenza and tuberculosis are also pandemics, he said.

But the speed of the spread of COVID-19, he cautioned, should not be confused with severity.

“How quickly something spreads is not necessarily an indication of how dangerous it is,” VInh said. “I think people conflate the two.”

Another issue not being communicated clearly is that the increase in COVID-19 cases being reported is not taking place in real time, he said. Rather, it is based on the results of lab tests, which are done in batches and made reported several days after they are collected.

Like pandemic, the word quarantine is also frightening. But the term is often used in the medical profession, he said. “A quarantine is an infection control practice.” Through quarantine, “we try to prevent someone who has a contagious disease from spreading it to someone else.”

An actual quarantine requires a level of medical expertise, Vinh said. “You need expertise in the precaution measures to prevent spread, but also to protect personnel.”

The Diamond Princess cruise ship, which confined its passengers and crew in the Japanese port city of Yokohama for more than two weeks after a passenger who had disembarked nine days earlier was found to be positive for COVID-19, was not a proper quarantine, he said. Personnel were not adequately trained in infection control and resources were inadequate, he said.

As a result, “I suspect that a lot of people were infected.” Ultimately, it is believed that more than 600 people were affected, although, “we don’t know the actual numbers,” Vinh said. There were four deaths.

It is important to consider environmental, medical and social factors affecting an individual’s health, Vinh said. The majority of the more than 2,600 deaths from COVID-19, the overwhelming majority in China, have been elderly adults, mostly men, although “what is going on in Hubei province is not necessarily what will happen in Montreal or Texas.”

Pollution is far worse in China than in North America, for instance, and rates of smoking, which affects the lungs adversely, are much higher. “If you have bad lungs, you tend to be more sick,” VInh said.

As well, most Canadians live in less clustered environments than do residents of densely populated Chinese cities.

And seasonal factors should also be considered, he said. “We are still in the winter season. We are exposed to viruses every year and every year there are people to whom a respiratory virus is fatal.” The influenza virus, for instance, kills about 3,500 Canadians every winter.

Like COVID-19, influenza is spread in droplets when infected people cough, sneeze or breathe – and does not survive well in warm or humid weather. In summer, there are few cases of influenza in Canada.

What will probably happen in our neck of the woods as warm weather approaches, Vinh suggested, is that the likelihood of transmission of COVID-19 will decrease and probably burn out at same level as other respiratory viruses.

sschwartz@postmedia.com

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Health

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

Published

3 days ago

September 13, 2024

Anne Joseph

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.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

Published

5 days ago

September 11, 2024

Anne Joseph

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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Health

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

Published

6 days ago

September 10, 2024

Anne Joseph

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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