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Should public health measures like masking continue beyond the pandemic? – Oakville News

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Public health measures, such as masking and physical distancing, that have been a high-profile part of the COVID-19 response for the past two years are now beginning to lift. However, surprisingly little attention has been paid to the remarkable effects of these measures on other respiratory illnesses that are caused or exacerbated by viral infections.

These effects are a valuable research discovery from the pandemic. It’s a discovery that suggests that selective, non-mandated use of public health measures like masking, physical distancing and hand-washing may have a continued role as we enter the endemic phase of COVID-19. Collectively, these measures are known as non-pharmacologic public health interventions (NPIs).

Decreases in acute care

Following the onset of the pandemic in March 2020, many regions around the world reported a dramatic decrease in demand for acute health-care services, including urgent care visits to emergency departments and inpatient hospital stays.

Early on, this was likely driven by stringent lockdown measures, patients avoiding health-care settings due to fears of contracting COVID-19 or the perception that hospitals were overwhelmed and unable to accommodate non-emergency cases.

However, as public health measures were relaxed over the following months, there was a rapid rebound in health-care services for conditions such as heart disease and appendicitis. Meanwhile, the decrease persisted for respiratory illnesses attributed to non-COVID-19 viruses.

In Canada, the usual annual surge in influenza infections has not occurred during the two winters since the beginning of the pandemic

Our research group — all front-line health-care workers — analyzed nationwide admissions data. Our analysis revealed that hospital admissions for major respiratory illnesses dropped sharply in the year following the start of the first lockdown. 

Specifically, flare-ups of chronic obstructive pulmonary disease (COPD), a severe lung disease related to long-term smoking, and community-acquired non-COVID-19 pneumonia decreased by nearly 40 per cent across Canada following the implementation of NPIs like masking and physical distancing

These findings were supported by another study of 15,677 patients from nine countries. That study reported a 50 per cent reduction in the hospital admissions for COPD following the onset of the pandemic. This is not entirely surprising as both COPD and non-COVID-19 pneumonia are often triggered by common cold viruses. If you are like most Canadians, you have not caught a cold in nearly two years. 

Impact on vulnerable patients

So, what’s the big fuss about a few runny noses and colds? While a viral infection such as the common cold or influenza is unlikely to significantly harm a healthy individual, it can be debilitating and sometimes deadly for someone who is elderly, immunocompromised or suffering from a lung disease. It can result in the need for acute care in the hospital, or even the ICU in severe cases, and some patients do not survive.

In Canada, acute and chronic respiratory diseases are the third greatest cause of death, trailing behind only cancer and heart disease. This also means virally linked respiratory illnesses place a substantial burden on limited health-care resources. 

There were several periods during the pandemic when our health-care systems were over capacity, and there was a fear that hospitals would need to triage resources and deny ICU care to some critically ill patients. 

Thankfully, this did not come to pass, and it seems that the likely reason was the significant additional capacity that became available due to hospitalizations avoided for other virally linked respiratory illnesses.

Ending COVID-19 prevention measures

As the pandemic drags on, people have become fatigued with ongoing public health restrictions. With vaccination rates in Canada among the highest in the world and expected to reach even higher with the approval of vaccinations for pediatric populations, many are looking forward to a time when NPIs may no longer be needed. 

However, before dispensing with the measures entirely, it is important to consider whether their demonstrated benefits warrant continued use. The fact that hospitalizations for non-COVID-19 respiratory illnesses have remained low, despite the relaxation of stringent lockdown measures, suggests that these benefits may be sustained with the use of masking and practices such as frequent hand-washing.

Even prior to the pandemic, public masking was a common practice in many Asian countries. With this now being the norm in Canada as well, continuing these practices may have significant merit and offer protection to the most vulnerable demographics of our society. 

This will certainly be challenging given opposition from a vocal minority and the lack of awareness among the general public about the benefits of continuing use of NPIs. Currently, most available evidence is largely observational, as no randomized trials have yet evaluated the efficacy of NPIs for reducing non-COVID-19 viral respiratory illnesses at a population level. 

Additionally, there is no consensus on which specific NPIs may be most effective in preventing disease spread. It’s also unknown whether reductions in acute care use have translated into a reduction in mortality rates for specific conditions. 

Future prevention

These limitations are currently being addressed in a large-scale Albertan study of over 500,000 patients. The preliminary results — which will be published in the proceedings of the 2022 American Thoracic Society International Conference — show that NPIs are an effective strategy for preventing both acute care visits and mortality related to respiratory illnesses. 

However, in the interim, public policy-makers should consider this compelling evidence and weigh in on whether the continued use of masking and other NPI measures is warranted, especially for individuals at high-risk for serious illness from viral respiratory infections and those close to them. 

Recommendations, policies or, if deemed necessary, mandates can be amended in the future as new evidence emerges. Until then, NPI use, even on an interim basis, may reduce the strain on our health-care system and help protect the most vulnerable members of our society.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Quebec health officials confirm 25 monkeypox cases now in province – Global News

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Quebec public health officials are reporting a total of 25 confirmed cases of monkeypox in the province as of Thursday.

Dr. Luc Boileau, interim public health director in the province, described it as a “serious outbreak” of the virus. Officials are investigating several more suspected cases.

“We had about 20 to 30 suspected cases under investigation so far,” Boileau said.

The province will also begin administering the Imvamune vaccine to close contacts of confirmed or suspected cases of monkeypox as soon as Friday. A single dose will be provided within four days of exposure to the virus.

Quebec’s Health Ministry said in a statement that a second dose of the vaccine could be administered, but only if the risk of exposure is “still present 28 days later” and “only following a decision by public health authorities.”

READ MORE: Mass vaccinations for monkeypox not needed, WHO official says

Boileau said the majority of confirmed cases in the province are tied mostly to men who have had sexual relations with other men. There has been one case in a person under 18.

Last week, Quebec recorded the first cases of the virus in the country. The first suspected cases were reported on May 12 in Montreal.

Monkeypox is a rare disease that comes from the same family of viruses that causes smallpox, which the World Health Organization declared eradicated around the globe in 1980.

The virus spreads through prolonged closed contact. It can cause fever, headache, muscle aches, exhaustion, swollen lymph nodes and lesions.

— with files from Global News’ Dan Spector and the Canadian Press

© 2022 Global News, a division of Corus Entertainment Inc.

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Quebec to start monkeypox vaccination of contacts as officials confirm 25 cases

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MONTREAL — Quebec’s interim public health director says the province could start vaccinating people against monkeypox as soon as Friday.

Dr. Luc Boileau says there are now 25 confirmed cases of the disease in the province and about 30 suspected cases are under investigation.

He says the province has received supplies of smallpox vaccine from the federal government, and it will be administered to people who have been in close contact with confirmed cases of the disease.

Dr. Caroline Quach, the chair of Quebec’s immunization committee, says the vaccine has been shown to prevent monkeypox in animal studies if it is administered within four days of an exposure and can reduce severity if it is administered up to 14 days after an exposure.

She says the disease is transmitted only through prolonged close contact.

Boileau says the majority of cases are in adult men who have been in sexual contact with people who have the disease, and there has been one case in a person under 18.

This report by The Canadian Press was first published May 26, 2022.

 

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Monkeypox Warnings Ignored; Dominant COVID Strain Emerges; Better Paxlovid Access – Medpage Today

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Warning signs of the current monkeypox outbreak may have been ignored. (STAT)

The CDC issued a monkeypox travel alert encouraging “enhanced precautions” after cases were reported in North America, Europe, and Australia.

Roche announced it has developed three PCR test kits to detect the monkeypox virus.

The U.S. has a new dominant COVID-19 strain — BA.2.12.1 — a highly contagious sublineage of the BA.2 omicron subvariant that now accounts for 57.9% of all cases, according to CDC estimates.

Washington Gov. Jay Inslee, as well as Lt. Gov.Denny Heck, both tested positive for COVID-19, as did U.S. Rep. Liz Cheney (R-Wyo.). (Seattle Times, The Hill)

As of Thursday at 8:00 a.m. EDT, the unofficial U.S. COVID toll was 83,697,199 cases and 1,004,558 deaths, increases of 218,146 and 913, respectively, compared with this time Wednesday morning.

The Biden Administration, projecting COVID infections will continue to spread during the summer travel season announced additional steps to make nirmatrelvir/ritonavir (Paxlovid) more accessible. (ABC News)

The White House also reported the launch of the first federally-supported test-to-treat COVID site.

U.K. Prime Minister Boris Johnson and other senior leaders of the government are to blame for booze-filled parties that violated the country’s COVID-19 lockdown rules, according to an investigative report. (NPR)

A mouse study suggested that maraviroc (Selzentry), a FDA-approved drug used to treat HIV, may be able to reverse middle-aged memory loss. (Nature)

The University of California system will be paying nearly $700 million to women who said they were sexually abused by a UCLA gynecologist over the course of several decades. (AP)

The parents of a 4-year-old girl spoke out about her mysterious case of pediatric hepatitis that required a liver transplant, one of 180 similar cases under investigation in the U.S. (Today)

Teva Pharmaceuticals has issued a voluntary nationwide recall of one lot of anagrelide capsules, which are used to treat thrombocythemia secondary to myeloproliferative neoplasms, due to dissolution test failure during routine stability testing.

Servier announced the FDA approved ivosidenib (Tibsovo) in combination with azacitidine for certain patients with newly diagnosed IDH1-mutated acute myeloid leukemia.

A report from the American Medical Association shows that payers are not following the prior authorization reforms agreed to in 2018. (Fierce Healthcare)

The mass shooting in Buffalo earlier this month is a reminder that millions of Americans don’t have easy access to grocery stores. (NPR)

COVID-era misinformation is leading a wave of parents to reject ordinary childhood immunizations. (New York Times)

The FDA issued guidance spelling out rules for states that want to import certain prescription drugs from Canada.

  • Mike Bassett is a staff writer focusing on oncology and hematology. He is based in Massachusetts.

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