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SARS lessons help Canada prep for COVID-19, but hospital capacity a worry – Nelson Star

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Canadian medical experts say the country’s already overstretched emergency rooms would find it difficult to cope if a true outbreak of the novel coronavirus, or COVID-19, were to take hold in Canada.

So far, the virus has been relatively contained to mainland China, thanks in part to one of the largest quarantines in modern history.

“We must not look back and regret that we failed to take advantage of the window of opportunity that we have now,” Dr. Tedros Adhanom Ghebreyesus, director general of the World Health Organization, said in a message to all the world’s countries Friday.

The risk of contracting the virus in Canada right now is extremely low, and public health officials have been lauded for their efforts to detect and isolate the nine cases confirmed in the country so far.

The hundreds of patients across the country who have tested negative for the virus are also a sign that containment efforts are working as they should.

But Canada’s most recent case in British Columbia has raised fears about where and how the disease is being transmitted abroad. Unlike others who’ve imported the virus from China or from people who have recently been to China, the woman in her 30s contracted the illness while in Iran.

“Any imported cases linked to Iran could be an indicator that there is more widespread transmission than we know about,” said Canada’s chief medical officer Dr. Theresa Tam Friday.

Canada has taken major steps to prevent the kind of shock that befell Ontario during the outbreak of the coronavirus known as SARS in 2003 that led to 44 deaths. Creating the Public Health Agency of Canada, which Tam heads, is one of them.

The country is now better co-ordinated, has increased its lab-testing capabilities and is prepared to trace people’s contacts to find people who might have caught a contagious illness without knowing it.

But once the number of incoming cases reaches a critical mass, the approach must change, according to infectious-diseases physician Dr. Isaac Bogoch of Toronto’s University Health Network.

He likens the response to trying to catch fly balls in the outfield: as the number of balls in the air increases, they become harder and harder to snag.

READ MORE: Woman in Fraser Health region confirmed as sixth COVID-19 case in B.C.

“Every health care system has limits,” Bogoch says. “The question is, if we start getting inundated with cases, how stretched can we get?”

Many emergency-room doctors argue Canada’s ERs are already as stretched as they can get and are worried about what would happen if they suddenly had to start treating COVID-19 cases en masse.

From the public-health perspective, the greatest challenge may be as simple communicating across all parts of the health system across the country, said Dr. Jasmine Pawa, president of the Public Health Physicians of Canada.

“We cover a very wide geographic area,” she said, though she added that Canada has made great strides over the course of the SARS experience and the H1N1 flu outbreak in 2009.

Dr. Alan Drummond of the Canadian Association of Emergency Physicians, who works at the hospital in Perth, Ont., says he doesn’t want to fearmonger, especially considering all the lessons Canada has learned from past outbreaks, but the reality of life in the ER gives him pause.

“Our day-to-day experience in crowded hospitals, unable to get the right patient in the right bed on a day-to-day basis … makes us really question what the integrity of our health-care system would be like in a major severe pandemic,” Drummond says.

He envisions that a disease like COVID-19, if it spread widely, would have a major impact, including the possibility of cancelled surgeries and moving stable patients out of hospitals who would otherwise stay.

“I think there would have to be hard decisions made about who lives and who dies, given our limited availability by both speciality and (intensive-care) beds and we would probably see some degree of health-care rationing,” he says.

The problem may be even more pronounced because of Canada’s aging population, he said. The virus tends to hit older people harder, according to observations made in China and abroad, and is also particularly dangerous for people with other health problems.

Older people also tend to stay admitted in hospital beds even when they are in relatively stable condition because of a lack of long-term-care beds across the country.

That keeps emergency rooms from being able to move acute patients out of the ER and into those beds, limiting hospitals’ capacity to handle new cases.

Tam agreed Friday that hospital capacity is a “critical aspect” of Canada’s preparedness for a potential coronavirus outbreak, but said even very bad flu seasons can have a similar effect on emergency rooms.

“If we can delay the impact of the coronavirus until a certain period, when there’s less influenza for example, that would also be very helpful,” she said.

She also suggested people who are concerned about the possibility that they’re developing COVID-19 symptoms should call ahead to a hospital so they can make proper arrangements for containment and isolation.

Canada is doing its best, along with every other country in the world, to seize this time of relative containment and plan ahead, Tam said.

Laura Osman, The Canadian Press

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Study suggests Pfizer COVID-19 vaccine only partially protects against Omicron – Toronto Sun

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The Omicron variant can partially evade protection from two doses of Pfizer and partner BioNTech’s COVID-19 vaccine, the research head of a laboratory at the Africa Health Research Institute in South Africa said on Tuesday.

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But the study showed that blood from people who had received two doses of the vaccine and had a prior infection was mostly able to neutralize the variant, suggesting that booster doses of the vaccine could help to fend off infection.

The Omicron variant, first detected in southern Africa last month, has triggered alarms globally of another surge in infections, with more than two dozen countries from Japan to the United States reporting cases.

The World Health Organization classified it on Nov. 26 as a “variant of concern,” but said there was no evidence to support the need for new vaccines specifically designed to tackle the Omicron variant with its many mutations.

Alex Sigal, a professor at the research institute, said on Twitter there was “a very large drop” in neutralization of the Omicron variant relative to an earlier strain of COVID-19.

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A separate lab test by virologist Sandra Ciesek of the University Hospital Frankfurt painted a somewhat bleaker picture.

Exposing the blood of vaccinated individuals to different virus variants, she found that the ability to mount an antibody response to Omicron in people who had three shots of BioNTech/Pfizer was up to 37 times lower than the response to Delta.

An antibody response to Omicron half a year after a two-shot regimen of Pfizer/BioNTech, Moderna or a mixed course of AstraZeneca/BioNTech was not even measurable, Ciesek added.

She posted only selected findings on Twitter, not including the number of samples, and the university said the paper had not yet been published.

“The set of data underscores that it makes sense to develop a vaccine that is adapted to Omicron,” Chiesek tweeted, adding that no conclusion could be drawn about protection against severe disease.

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WHO’s chief scientist, Soumya Swaminathan, said a large drop in the antibody response of vaccinated people to Omicron had been expected.

“This does not mean the vaccine will not work – T-cell immunity (is) likely to persist,” she said on Twitter, referring to a cellular immune response that is believed to prevent severe disease as a second line of immune defence.

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Researchers including Carsten Watzl of the German Society of Immunology and Penny Ward, visiting professor at King’s College London, said the findings underscored the need to get booster shots because a three-shot course would likely continue to protect against severe disease.

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Sigal’s lab tested blood from 12 people who had been vaccinated with two doses of the Pfizer/BioNTech vaccine, according to a manuscript posted on the website for his lab. The preliminary data in the manuscript has not yet been peer reviewed.

Blood from five out of six people who had been vaccinated as well as previously infected with COVID-19 still neutralized the Omicron variant, the manuscript said.

“These results are better than I expected. The more antibodies you got, the more chance you’ll be protected from Omicron,” Sigal said on Twitter.

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He said the lab had not tested the variant against blood from people who had received a booster dose, because they are not available in South Africa yet.

According to the manuscript, the lab observed a 41-fold decline in levels of neutralizing antibodies against the Omicron variant.

Sigal said on Twitter that figure is likely to be adjusted after his lab does more experiments.

While neutralizing antibodies are an indicator of the body’s immune response, scientists believe other kinds of cells such as B-cells and T-cells are also stimulated by the vaccines and help protect against the effects of the coronavirus.

The preliminary data does not indicate that the vaccine is less able to prevent severe illness or death. While lab tests are under way, BioNTech CEO Ugur Sahin said last week “we think it’s likely that people will have substantial protection against severe disease caused by Omicron.”

There is not significant data yet on how vaccines from Moderna, Johnson & Johnson and other drugmakers hold up against the new variant. All the manufacturers, including Pfizer and BioNTech, are expected to release their own data within weeks.

BioNTech’s Sahin told NBC News on Tuesday that the drugmaker has data coming on Wednesday or Thursday.

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Seven Omicron variant cases in Simcoe County linked to travellers from Nigeria – BayToday.ca

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The Simcoe Muskoka District Health Unit says it is investigating a household cluster in Simcoe County with seven confirmed COVID-19 cases that have a strong probability of being the Omicron variant of concern. All the cases are currently isolating at home.

“The cluster is linked to travellers who arrived in Simcoe County from Nigeria in late November,” says a news release.

The Simcoe Muskoka Health Unit borders the North Bay Parry Sound District Health Unit to the immediate south.

“Although the health unit is awaiting whole genomic sequencing of the samples which should be available in the next 7 to 14 days, given the travel history and the preliminary laboratory screening results, the likelihood of an Omicron cluster is very high.”

The Unit’s case and contact management team is currently following up with each case to identify close contacts regarding isolation and testing.

“Scientific data about the Omicron variant is still emerging,” said Dr. Charles Gardner, Medical Officer of Health. “Early evidence suggests that the variant might be more transmissible. While we continue to closely monitor this local situation, I urge all residents to remain vigilant about following public health measures, to monitor themselves for symptoms of COVID-19 and seek testing immediately if any should develop, and get vaccinated if they have not already done so.”

The rate of COVID-19 infection among the unvaccinated vaccine-eligible Simcoe Muskoka population is seven times higher than it is for the fully vaccinated population and the rate of COVID-19 hospitalizations is 15 times higher says Gardner. Getting the vaccine can lower the risk of serious illness, hospitalization, and death.

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Eating disorder symptoms and self-harm linked to higher levels of depression and anxiety during COVID-19 pandemic – Medical Xpress

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Timeline of ALSPAC assessments. NEET Not in education, employment or training. Gray text indicates the name of the ALSPAC questionnaire. Credit: DOI: 10.1186/s40337-021-00510-9

Young adults with previous self-harm or eating disorders reported higher levels of depression and anxiety during the pandemic, even when restrictions had eased, according to new research.

The study, led by the University of Bristol and funded by Elizabeth Blackwell Institute, Medical Research Council and Medical Research Foundation, has been published in the Journal of Eating Disorders. It looked at questionnaire information for 2,657 individuals from world-renowned health study Children of the 90s (also known as the Avon Longitudinal Study of Parents and Children) before and during the COVID-19 pandemic.

Researchers analyzed the relationship between previous reports of eating disorder symptoms and before the pandemic, and (symptoms of depression and anxiety) and mental wellbeing during the COVID-19 pandemic. The study also assessed whether , such as more sleep, relaxation techniques, or visiting green space, could be linked to and wellbeing in young adults with and without previous eating disorder symptoms or self-harm.

Researchers studied questionnaire data from 2017, when the participants were then aged 25 years, as well as data taken during the pandemic in 2020.

At age 25, 32 percent of the 2,657 young adults reported at least one eating disorder , 9 percent reported self-harm, and 5.5 percent reported both an eating disorder symptom and self-harm in the last year.

During the pandemic, those with previously reported eating disorder symptoms and/or self-harm had more symptoms of depression and anxiety, and worse mental wellbeing, compared to individuals without previous symptoms. This remained the case after adjusting for their pre-pandemic levels of depression, anxiety and mental wellbeing.

Lifestyle changes appeared to have little effect on the increased risk for mental health problems in those with prior eating disorder symptoms or self-harm.

Lead author Dr. Naomi Warne, Senior Research Associate at the University’s Centre for Academic Mental Health, said: “Eating and self-harm are common and troubling mental health problems among . In the UK, approximately 1.25 million people are living with an eating disorder and almost 1 in 15 adults report self-harm.

“Our research has highlighted individuals with prior self-harm and eating disorder symptoms are key risk groups and further longitudinal research is needed to understand their ongoing mental health as well as risk and protective factors.

“Individuals with previous eating disorder symptoms and self-harm should be considered vulnerable to depression and anxiety throughout the pandemic and beyond. Funding for rapid and responsive service provision is essential to reduce the impact of the on those with mental health problems.”


Explore further

One in four adults with depression or anxiety lacked mental health support during pandemic


More information:
Naomi Warne et al, Disordered eating and self-harm as risk factors for poorer mental health during the COVID-19 pandemic: a UK-based birth cohort study, Journal of Eating Disorders (2021). DOI: 10.1186/s40337-021-00510-9

Citation:
Eating disorder symptoms and self-harm linked to higher levels of depression and anxiety during COVID-19 pandemic (2021, December 8)
retrieved 8 December 2021
from https://medicalxpress.com/news/2021-12-disorder-symptoms-self-harm-linked-higher.html

This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no
part may be reproduced without the written permission. The content is provided for information purposes only.

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