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Testing wastewater could give early warning of second wave of COVID-19 – Alaska Highway News

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OTTAWA — As Canada continues to struggle to keep up with the level of COVID-19 tests needed to fend off a potential second wave of the viral disease, researchers say the best early warning system for a second wave could be right beneath our feet — in the sewers.

Several other countries have taken to testing wastewater for signs of the novel coronavirus as an indication of flare-ups in their communities.

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Now researchers are beginning to look at the option in Canada.

Given that some people can pass the virus on without even knowing they have it, health officials say testing large portions of the population will be key to detecting and quashing any new community spread of COVID-19.

Several provinces have struggled to keep up with the volume of tests needed to do that, particularly in Ontario and Quebec where rates of infection remain high.

But the virus isn’t only detected in the back of people’s throats. It’s also found in waste. And while not everyone will get tested for COVID-19, most everyone uses the toilet.

“This is a tool that can actually provide an early alert to our public health in regards to re-emergence of infectivity in communities,” said Mike McKay, the executive director of the Great Lakes Institute for Environmental Research at the University of Windsor.

His research group is one of several across the country looking at whether sampling sewage could be a viable way to alert public health officials to new outbreaks.

Initially, he said researchers were excited about the possibility that measuring the amount of virus found in the pipes could provide some sense of the number of cases in a community.

But not enough is known about how much of the virus is shed in people’s waste to be able to draw many conclusions yet.

Instead, researchers hope they’ll be able to detect whether the viral load has gone up or down, allowing researchers to flag sudden spikes to public health who will be able to focus their efforts accordingly.

“If it does that, that means it’s saving lives,” said Bernadette Conant, CEO of the Canadian Water Network.

The network is in the early stages of trying to co-ordinate a pilot project in Canadian cities, including Ottawa, Windsor, Montreal and Edmonton, to develop an effective method and determine whether wastewater tests could have the public health applications they hope for.

The ultimate goal, as the technique evolves, is to use the method to root out new outbreaks in certain neighbourhoods, or even specific buildings, like long-term care homes.

That would allow public health authorities to tailor testing, lockdowns or other containment measures to that area.

“This is not a silver bullet and it’s not about replacing the basic testing and contact tracing surveillance,” Conant said. “What it does is offer the potential to fill a gap.”

The idea was tried in the Netherlands and France in the early days of the epidemic, and according to non-peer reviewed studies, both were able to detect traces of the virus in wastewater before widespread outbreaks were confirmed in those countries.

Several states in the U.S., as well as Australia and Israel, have also looked to the sewers to for signs of the virus.

It’s not a totally foreign concept in Canada either. Last year, Statistics Canada released a report on its use of wastewater samples to detect signs of increased drug use.

Accurate information about societal use of drugs, particularly from illegal sources, is difficult to get, the authors explained. So they ran a pilot project to see if sewer systems could give them a better picture.

There were limitations to what the data could tell them, but they said the advantage was the low cost, timeliness and the ability to monitor change over time at the city level — which is what researchers hope to achieve with COVID-19 tests.

Edmonton’s water utility company, Epcor, said in a statement that workers already take regular wastewater samples, so the effort and risk in gathering extra samples for testing is minimal.

As for creating a national sewage surveillance system in Canada, Conant said public health officials are beginning to show an interest but logistics, including lab capability and capacity, would still need to be worked out.

This report by The Canadian Press was first published May 22, 2020.

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2,000 COVID-19 cases missing from Toronto's map of hot spots – CBC.ca

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More than 2,000 confirmed COVID-19 cases are missing from the map the City of Toronto released last week that shows infections by neighbourhood, CBC News has found.

The detailed geographic information about the spread of the novel coronavirus was released last week by Toronto Public Health, marking the first time such data has been made available in Ontario during the pandemic. It shows infections based on where patients live.

But in a review of published data, CBC News found the count on the map comes up short.   

On Thursday morning, the map showed 9,623 positive COVID-19 cases distributed over 140 neighbourhoods. That’s 2,029 cases short of the official 11,652 total count for that day.

That means roughly one out of every five cases is missing in the city’s own geographic analysis. Similar proportions of missing data were found in the map and case counts from previous days.

The data gap was not mentioned in any of the local health authority’s statistics or on its webpage until CBC pointed it out. 

Muhammad Junayed, right, gets instructions for being tested for COVID-19 from a health-care worker at a pop-up testing centre at the Islamic Institute of Toronto. (Nathan Denette/The Canadian Press)

An extra row identified as “Missing addresses/postal code,” totalling 2,029 cases, has been added to the city’s downloadable spreadsheet showing the number of cases assigned to each neighbourhood.

Toronto Public Health blames the missing data on reports sent by testing labs. The public health authority says some forms only have a name and an address, while others don’t have a patient’s postal code or phone number, leaving health authorities scrambling to fill in gaps.

“Sometimes, they are not putting enough contact details, and in the legislation it doesn’t specify that you must include XYZ details of the individual,” said Dr. Vinita Dubey, Toronto’s associate medical officer of health, referring to the provincial law that requires medical labs to report positive results of certain tests to local health authorities. 

“It just requires that it be reported, so that’s where some of the missing information and gaps occur.”

Delays possible

Dubey said it’s “very unlikely” that the missing data had an impact on contact tracing, but that there could have been delays as her staff had to retrieve missing contact information before they could connect with a patient who tested positive. 

Toronto Public Health said that so far, it has been able to complete contact tracing for a patient within 24 hours in 88 per cent of cases. 

The issue of information transfer between laboratories and public health units was raised last Friday in a report to city council and the Toronto Board of Health by Toronto Medical Officer of Health Dr. Eileen de Villa. 

Dr. Eileen de Villa said that ‘case and contact management is a complex and time-consuming process,’ in a statement on Wednesday. (Rozenn Nicolle/Radio-Canada)

“Laboratories’ reports are received all together in one large fax, sometimes containing hundreds of individual lab results, which must be taken apart for further processing,” de Villa wrote. 

She called for changes in laboratory procedures and the provincial law.

Missing hot spots

Beyond potential delays in contact tracing, the missing geographic data might have another impact. 

Toronto’s current map distribution suggests that some of the city’s poorest and most diverse neighbourhoods — predominantly in the northwest and northeast areas — have had the highest number of cases so far and might be most vulnerable to the novel coronavirus. 

As Ontario is ramping up testing, resources like mobile testing clinics, staff and personal protection equipment will be focused on those hardest-hit areas of the city. 

But with 2,000 cases missing, one researcher familiar with Toronto’s map data said health authorities could be missing out on other vulnerable communities. 

Kate H. Choi, an associate professor in the department of sociology at Western University in London, Ont., said Toronto has been ahead of the curve in terms of COVID-19 data collection, so she was “really, really surprised” when she was told how many of the city’s confirmed cases were missing from its map.

Kate H. Choi is an associate professor of sociology at Western University. (Kate Choi)

She said part of the issue might also be that some populations are less likely to be able to provide a precise address or a postal code, including homeless people, migrant workers or nursing home residents. 

“We may be missing COVID-19 hot spots or certain vulnerable populations may be missing from the narrative about COVID-19 in Toronto.” 

Alternatively, some Torontonians might feel a false sense of security after assuming their neighbourhood is low-risk based on the map, said Choi. It’s also possible that resources and staff could fail to be deployed to hospitals in unknown hot spots, which could lead to more transmission of the virus.

“Those 2,029 individuals are someone’s loved one,” said Choi. “They are also 2,029 people who could be your neighbours. They could be residents in an area where there are a lot of asymptomatic carriers and unfortunately, that may mean they could bring COVID-19 to your doorsteps.”

WATCH | Toronto releases a map showing the city’s COVID-19 cases:

The City of Toronto has released the postal code data about where COVID-19 patients live in the city. Some fear it could stigmatize communities, but the information can help officials decide where to conduct more testing. 2:00

Choi stressed that more research on the age, gender and other characteristics of the missing 2,029 cases is needed to fully understand the impact and risks of this data gap.

Toronto Public Health has also repeatedly said that the map shows where patients infected with COVID-19 live and not where they acquired the infection. 

Gap won’t be fixed for weeks

Toronto Public Health said it does not have the resources to go looking for the 2,029 missing postal codes at the moment.

“Some of them were early on in our outbreak and so it would require going back to some of these cases in February and March. That work won’t be done until we either have less cases or have reached the end of the first wave,” said Dubey. 

This is the second data gap uncovered by CBC in less than a week. On Monday, it was revealed that Ontario hospitals had failed to flag 700 positive COVID-19 tests to public health officials because of a mixup. 

In a statement to CBC, Ontario Health has said the impact of the error “may not be fully understood for some time.”

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Safety officers heading to Manitoba beaches amid COVID-19, no new cases reported Thursday – Globalnews.ca

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Health officials say safety officers are being deployed to three popular Manitoba beaches to make sure beach-goers are staying safe while enjoying the sun amid the coronavirus outbreak.

The safety officers will be patrolling the beaches in Birds Hill, Winnipeg Beach, and Grand Beach Provincial Parks starting Thursday, the province said in a release.


READ MORE:
Coronavirus: 1 more case in Manitoba, active cases fall below 10

The news comes as health officials reported no new cases of COVID-19 in Manitoba Thursday, leaving the province’s total number of lab-confirmed positive and probable cases at 298.

While provincial parks and beaches are open to the public, health officials are warning those heading into the great outdoors physical distancing rules remain in place, and beach-goers should keep at least four metres of separation between each group’s towels and blanket on the beach.

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They also recommend bringing your own life jackets and personal flotation devices as the province’s life-jacket loaner program has been suspended to help stop the spread of COVID-19.

The province says there are currently seven active cases of COVID-19 in Manitoba and no one is in hospital or intensive care because of the virus.


READ MORE:
Winnipeg groups unclear how many of their workers will qualify for coronavirus ‘risk pay’

To date 284 people have recovered from COVID-19, the province says.

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There have been 46,701 tests for the virus completed across the province since early February, health officials say, with 899 done on Wednesday.

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0:58
Coronavirus outbreak: Manitoba seeing ‘historically low’ wait times, health officials say


Coronavirus outbreak: Manitoba seeing ‘historically low’ wait times, health officials say

Questions about COVID-19? Here are some things you need to know:

Symptoms can include fever, cough and difficulty breathing — very similar to a cold or flu. Some people can develop a more severe illness. People most at risk of this include older adults and people with severe chronic medical conditions like heart, lung or kidney disease. If you develop symptoms, contact public health authorities.

To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. They also recommend minimizing contact with others, staying home as much as possible and maintaining a distance of two metres from other people if you go out. In situations where you can’t keep a safe distance from others, public health officials recommend the use of a non-medical face mask or covering to prevent spreading the respiratory droplets that can carry the virus.

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For full COVID-19 coverage from Global News, click here.

© 2020 Global News, a division of Corus Entertainment Inc.

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COVID-19 study linking hydroxychloroquine, death risk retracted from medical journal – Global News

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Three of the authors of an influential article that found hydroxychloroquine increased the risk of death in COVID-19 patients retracted the study on Thursday, citing concerns about the quality of the data behind it.

The anti-malarial drug has been controversial in part due to support from U.S. President Donald Trump, as well as implications of the study published in British medical journal the Lancet last month.

READ MORE: Medical journal questioning findings of hydroxychloroquine coronavirus study

The three authors said Surgisphere, the company that provided the data, would not transfer the full dataset for an independent review and that they “can no longer vouch for the veracity of the primary data sources.”

The fourth author of the study, Dr. Sapan Desai, the CEO of Surgisphere, declined to comment on the retraction.

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The observational study published in the Lancet on May 22 looked at 96,000 hospitalized COVID-19 patients, some treated with the decades-old malaria drug. It claimed that those treated with hydroxychloroquine or the related chloroquine had higher risk of death and heart rhythm problems than patients who were not given the medicines.






1:47
WHO halts hydroxychloroquine clinical trials


WHO halts hydroxychloroquine clinical trials

Several clinical trials were put on hold after the study was published. The World Health Organization, which paused hydroxychloroquine trials after The Lancet study was released, said on Wednesday it was ready to resume trials.

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Many scientists voiced concern about the study. Nearly 150 doctors signed an open letter to the Lancet last week calling the article’s conclusions into question and asking to make public the peer review comments that preceded publication.


READ MORE:
Hydroxychloroquine doesn’t prevent COVID-19 in people exposed to the virus, study finds

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“I did not do enough to ensure that the data source was appropriate for this use,” the study’s lead author, Harvard Medical School Professor Mandeep Mehra, said in a statement. “For that, and for all the disruptions – both directly and indirectly – I am truly sorry.”

Surgisphere was not immediately available for comment.

The Lancet in a statement said, “there are many outstanding questions about Surgisphere and the data that were allegedly included in this study.”

© 2020 Reuters

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