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Testing, contact tracing are keys to easing social restrictions. But is Canada ready? – CBC.ca

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There may be many different paths to the new COVID-19 “normal” as provinces announce various plans to gradually ease social restrictions across Canada.

But all of them share one critical requirement: the ability to test widely for infection and then trace contacts, in order to isolate people who were exposed and break the chains of infection.

Are we ready? Has Canada fixed the testing backlogs and shortages that made headlines just a few weeks ago?

Infectious disease experts on the front line of Canada’s COVID-19 outbreak say no, but it’s a question that doesn’t have an easy answer.

‘Easy to say, hard to do’

Each province is responsible for its own testing policy, and in many cases individual municipal or regional health units are responsible for contact tracing.

“I personally am concerned about testing and tracing capacity,” said Dr. David Naylor, who was appointed to the leadership committee of the newly established COVID-19 Immunity Task Force announced by Prime Minister Justin Trudeau last Thursday.

Dr. Isaac Bogoch, infectious disease specialist at Toronto General Hospital, agrees.

“We’re not in a position yet where we’re doing enough diagnostic tests to reopen,” said Bogoch. “The crucial elements of reopening will be no barriers to diagnostic testing, and then we need an army of people to do contact tracing so we can identify positive cases and their close contacts,” he said on CBC News Network on Sunday.

“Easy to say, hard to do.”

If Canadians lack confidence in the testing system, it’s understandable.

In the first days of Canada’s outbreak many were shocked to learn that they could not get tested even though they had both symptoms and a travel history.

Soon after, Ontario, B.C. and several other provinces reported backlogs that forced some people to wait more than a week for test results.

Among the criteria for lifting Ontario’s COVID-19 restrictions are a consistent two- to four-week drop in new infections, a drop in infections traceable to a source, and the ability to trace 90% of new case contacts within 24 hours. (Government of Ontario)

Even after the testing chaos prompted Ontario’s frustrated premier to warn he would accept “no more excuses,” Ontario still hasn’t reached the level of testing promised almost six weeks ago.

In March, Ontario officials said they would be testing 20,000 people by mid-April. But for the past seven days the province has only done 12,500 tests per day, with a target of 14,000 tests per day by the end of this week.

British Columbia is only testing about 2,000 people per day, according to Dr. Bonnie Henry, the province’s chief medical officer of health. 

“Partly that is because we are not seeing a lot of respiratory illness in the community right now,” said Henry. “We’re continuing to test anybody who goes to hospital with a respiratory illness or any other symptoms that we’re concerned about, and we have very broad symptoms that we’re talking about for the community.”

Canada’s Health Minister Patty Hajdu was asked about Canada’s COVID-19 testing capacity during a media briefing on Monday.

“I think, obviously, Canada can do better,” she said. “We’ve done a lot, and we’re very happy with the growth of testing that’s happening in the capacity of provinces and territories.”

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Hajdu added that the federal government has contracted a New Brunswick company to supply some of the desperately needed reagents — particular chemicals needed to conduct the tests.

“Now we have a local manufacturing source for that reagent, which is making it a lot easier to get that component of the testing done.”

LuminUltra is to supply the federal government with 500,000 RNA/DNA isolation kits per week. 

CEO Patrick Whalen said the company will have shipped one million test kits to provincial labs by Thursday.

“We are providing this RNA isolation kit that is optimized to function on a specific extraction device, a robotics device that processes 96 samples at a time,” said Whalen, adding it’s designed to work on equipment that is commonly used in provincial health labs across Canada.

But there are other chemicals needed at different stages of the test, and the supply of those chemicals is also strained.

“We are ramping up our ability to produce the assay kits, as well — the step that comes after the isolation process — but we have not been called upon or asked to produce those for the provincial health labs yet,” Whalen said.

What about the Spartan Cube?

Ottawa’s Spartan Biosciences has been applauded for its rapid DNA analyzer, the Spartan Cube, that has been adapted to do COVID-19 tests. Health Canada approved the test two weeks ago, but it’s still not clear whether the test has added any capacity to the system.

CEO Paul Lem said he could not reveal precisely how many of the portable DNA analyzing machines Spartan has shipped to the federal government or the provinces, citing the need to protect proprietary information. 

“Unfortunately, I can’t tell you,” Lem said. “We want to keep that competitive intelligence away from our competitors.”

He would only say the company has shipped “close to 100 or more.”

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Each cube can perform one test per hour, which would be a maximum of 24 tests per day per machine. Lem said the company is shipping thousands of the tests that are designed to be used with the company’s tiny testing machine. But he couldn’t say whether they are being used yet.

“Good question, I don’t know,” said Lem.

Health Canada’s media office was unable to say how many Cubes have been purchased and received so far, or whether any of those Cubes is currently being used to do COVID-19 tests.

Who to test

One key question as social restrictions are eased will be determining who is tested.

As B.C.’s Henry noted, that province is testing anyone with symptoms.

“We need to have a broader understanding of where cases and clusters are coming up in our communities,” Henry said.

A bin full of disposable gloves at a drive-thru COVID-19 testing centres near Etobicoke General Hospital, in Toronto. (Evan Mitsui/CBC)

Henry said there is no point in testing people without symptoms unless they are within a specific outbreak, such as in prisons or long- term care settings.

Hospitals want to be able to test every patient who is admitted, not just people who have symptoms of COVID-19.

That’s one reason some front-line doctors are saying it’s too early to ease restrictions.

“It’s trying to find that balance between opening things up and not opening up too much because we’d have such a surge of cases, we’d go right back to the concern we had a month ago,” said Dr. Michael Gardam, chief of staff at Humber River Hospital in Toronto.

“It’s an unbelievably tricky balancing act to try to figure out the way forward,” he said. “To be blunt, it was so much easier to shut things down than it will be to open them up.”

Contact tracing

The other side of testing is the need for legions of contact tracers to track down everyone who was encountered by every person who tests positive. It’s a daunting undertaking.

“Contact tracing is really important,” said Henry. “It’s what helps us understand where people are that might have been exposed to the virus and maybe developing symptoms,” she said. “Because the incubation period is so long for COVID-19, that gives us the opportunity to find people and make sure they’re isolated before they can transmit to somebody else.”

B.C. has been building up its contact tracing capacity, Henry said.

“We’re looking at how we can use technology to facilitate that, but really there’s nothing out there that takes the place of having an individual connect with each of the contacts.”

The federal government put out a national call for COVID-19 volunteers that received almost 58,000 responses by the time it closed last Friday. The provincial and territorial governments can call upon those people as needed, said Andre Gagnon, a spokesperson for Health Canada.

 But he said most of them won’t be working in contact tracing.

“The lists of volunteers have been shared with a number of jurisdictions, mostly to support long-term care. Each jurisdiction will be determining when and how they will be deploying volunteers.”

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As sports betting addiction takes hold in Brazil, the government moves to crack down

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SAO PAULO (AP) — “King” doesn’t disclose his real name. Even clients of his Sao Paulo newsstand have to call him by his moniker. The Brazilian online sports gambling addict lowered his profile after a loan shark threatened to put bullets in his head if he didn’t pay up.

Broke and embarrassed, King sought treatment and support earlier this year.

“I was once addicted to slot machines, but then sports betting was so easy that I changed. I got carried away all the time,” he told The Associated Press.

King’s story is that of many vulnerable Brazilians in recent years. The country has become the third-biggest market in the world for sports betting, following the U.S. and the U.K., a report by data analysis company Comscore said last year. But unlike those countries, rampant advertising and sponsorship have been coupled with an unregulated market. The government is now — belatedly, some say — striving to get a handle on the epidemic.

On a recent evening, King’s Gamblers Anonymous meeting took place in an improvised classroom inside a church, with coffee and cookies to keep everyone awake, and supportive messages scrawled onto the blackboard. One that’s become ubiquitous in Brazil and beyond: “Only for today I will avoid the first bet.”

King and other attendees, all Christian, started a prayer and the meeting began.

King said his financial problems arose from his addiction to online sports betting, chiefly on soccer.

“I miss the adrenaline rush when I don’t bet,” he said before the gathering. “I have managed to stop for a couple of months, but I know that if I do it once again, even a small bet, it will all come back.”

Driven by the pandemic

The COVID-19 pandemic was a key driver for Brazilians embracing sports betting. King said he transformed almost every sale during that time into a bet. His hook was the non-stop advertising on TV, radio, social media as well as sponsorship of local soccer teams’ jerseys. He asked for bank loans to pay his gambling debts and then, to cover those, went to the moneylender. His total debt now amounts to 85,000 reais ($15,000) — impossible to pay off with his monthly income of 8,000 reais.

Digging oneself out of debt in Brazil is especially daunting with its sky-high interest rates. Loans from Brazilian banks could add interest of almost 8% per month to the borrowed sum, and from loan sharks could be even more.

Four Gamblers Anonymous meetings attended by the AP in October featured discussions about difficulties paying down debts, forcing working-class members to postpone housing payments and cancel family vacations.

Some members of impoverished Brazilian families have used welfare money for betting instead of paying for groceries and housing, official data suggests. In August, beneficiaries of Brazil’s flagship program Bolsa Familia spent 3 billion reais ($530 million) on sports betting, according to a report from the central bank. That was more than 20% of the program’s total outlay in the month.

A host of gambling related problems

Sports betting was made legal in 2018 in a bill signed by former President Michel Temer. The subsequent turmoil has recently been setting off alarm bells, with addicts venting on social media and media reports of people losing huge sums.

On Oct. 1, the economy ministry prevented more than 2,000 betting companies from operating in Brazil for having failed to provide all the required documents. Soccer-loving President Luiz Inácio Lula da Silva said in an interview on Oct. 17 that he will shut down the entire market in Brazil if his administration’s new regulations — presented at the end of July— fail to work. And Brazil’s Senate on Oct. 25 opened an investigation into betting companies, focusing on crime and addiction.

“There’s tax evasion, money laundering of organized crime, the use of influencers to trick people into betting. These companies need to be audited,” Sen. Soraya Thronicke, who proposed the inquiry, told journalists in Brasilia.

Sérgio Peixoto, a ride-sharing app driver in Rio, is one of many lower-middle-income Brazilians who have reduced their spending due to sports betting debt. Peixoto’s debt currently amounts to 25,000 reais ($4,400). His monthly income is four times less than that.

“It stopped being a game, it wasn’t fun. I just wanted to get the money back, so I lost even more,” said Peixoto, 26. “I could have invested that money. It would surely have given me more benefits.

Pressure to bet

Pressure on people to gamble is everywhere. Current and former soccer players, including Vinicius Júnior, Ronaldo Nazário and Roberto Rivellino, are among the poster boys for local and foreign brands. All but one of the top-tier soccer clubs have betting companies among their main sponsors, with their name and logo emblazoned on their kits. There have been cases of kids and teenagers setting up accounts using their parents’ personal information and money, multiple local media outlets have reported.

Brazil’s economy ministry estimates that Brazil’s sports betting market had $21 billion in transactions last year, a 71% increase compared with the first year of the pandemic, 2020.

The ministry’s newly presented regulations include facial recognition systems for gamblers to bet, the identification of a single bank account for transactions involving sports betting, new protections against hackers and the government-authorized domain, bet.br, which will host all betting sites that are legal in Brazil. Once they are in place, come January, between 100 and 150 betting companies will continue to operate in the South American nation.

The changes in Brazil have prompted some companies to take preemptive action. A report by Yield Sec, a technical intelligence platform for online marketplaces, said several betting companies voluntarily restricted their operations in different places after the latest editions of the European Championships and Copa America in the hopes of presenting “the best possible license application face to the Brazilian authorities.”

Magnho José Santos de Sousa, the president of the Legal Gambling Institute, a betting think tank, said Brazil is currently “invaded by illegal websites that have licenses in Malta, Curação, Gibraltar and the United Kingdom.”

De Sousa expressed hope that the new regulations for advertising, responsible gambling and qualification of sports betting companies will transform the country’s deregulated arena into a more serious one that doesn’t exploit the vulnerable.

“The whole operation could turn from water into wine,” he said.

Gamblers Anonymous in high demand

Meantime, the demand for Gamblers Anonymous meetings in Sao Paulo has grown so much in recent years that the weekly gathering, in place since the 1990s, was no longer enough. Many groups have added a second day in the week to help new people recover, mostly sports bettors.

Earlier in October, a group on Sao Paulo’s northern edge admitted a man who was struggling with sports betting and card games. The 13 other people in the room stressed that he wasn’t alone.

“Welcome,” one long-time attendee said, in a greeting that has become a regular for the group. “Today, you are the most important person here.”

___

Dumphreys reported from Rio de Janeiro.



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Saskatchewan’s Jason Ackerman improves to 6-0 at mixed curling nationals

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SAINT CATHARINES, Ont. – Saskatchewan’s Jason Ackerman remained undefeated on Wednesday with a 7-4 win over Newfoundland and Labrador’s Trent Skanes at the Canadian mixed curling championship.

After going down 3-1 through four ends, Ackerman (6-0) outscored Skanes (3-3) 6-1 the rest of the way, including three points in the seventh end.

Alberta’s Kurt Alan Balderston also earned a win, defeating New Brunswick’s Charlie Sullivan 9-2 in another matchup in the final draw.

The win improved Balderston’s record to 4-2 and sits in third in Pool B.

The top four teams from each pool will play four more games against the survivors from the other pool. The remaining three teams from the pool will play three more seeding games to help set the rankings for next year’s event.

The championship final is scheduled for Saturday.

This report by The Canadian Press was first published Nov. 6, 2024.

The Canadian Press. All rights reserved.



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Oilers fall 4-2 to Golden Knights in McDavid’s return from injury

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EDMONTON – Noah Hanifin had a pair of goals as the Vegas Golden Knights won their first road game of the season, coming from behind to shock the Edmonton Oilers 4-2 on Wednesday.

Jack Eichel had a goal and two assists and Mark Stone also scored for the Golden Knights (9-3-1), who have won two in a row and six of their last seven. The Knights entered the game 0-3-1 on the road this year.

Brett Kulak and Zach Hyman replied for the Oilers (6-7-1), who have lost two straight despite getting captain Connor McDavid back from injury earlier than expected for the game.

Adin Hill made 27 saves for Vegas, while Stuart Skinner managed 31 stops for Edmonton.

Takeaways

Golden Knights: With an assist on the Knights’ second goal, William Karlsson has recorded at least a point in all five games he has played this season (two goals, four assists).

Oilers: McDavid was a surprise starter for the Oilers, coming back just nine days after suffering an ankle injury in Columbus and initially being expected to miss two to three weeks. The star forward came into the contest with 11 points (three goals, eight assists) during a six-game point streak versus the Golden Knights, but was held pointless on the night.

Key moment

With just 48.4 seconds left to play, the Golden Knights won a race to the corner and Ivan Barbashev was able to send it out to a hard-charging Hanifin, who sent a shot glove-side that beat Skinner for his second goal of the third period and third of the season.

Key stat

It was Hyman’s third goal in the last four games after the veteran forward went scoreless in his first 10 games this season following a 54-goal campaign last year. Hyman now has five goals in his last six games against Vegas.

Up next

Golden Knights: Head to Seattle to face the Kraken on Friday.

Oilers: Travel to Vancouver on a quick one-game trip to clash with the Canucks on Saturday.

This report by The Canadian Press was first published Nov. 6, 2024.

The Canadian Press. All rights reserved.



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