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The 3 main ways Coronavirus Spreads

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As the number of cases of coronavirus COVID-19 grows worldwide, the US CDC has detailed the primary ways in which the SARS-like illness could be spread, and which routes it is most concerned with. The first person-to-person infection in the US was confirmed at the end of January 2020, and since then the US Centers for Disease Control and Prevention have held several briefings to outline exactly what people should – and shouldn’t – be worried about.

One of the most pressing questions is the mechanisms of just how that person-to-person spread might take place. COVID-19 has a roughly fourteen day incubation period, and one of the challenges that healthcare providers face is that, if tested too early, the current tests for the infection can return a false-negative.

“Based on what we know now, we believe this virus spreads mainly from person to person, among close contact, which is defined as about six feet, through respiratory droplets produced when an infected person coughs or sneezes,” Nancy Messonnier, M.D., Director at the National Center for Immunization and Respiratory Diseases said today during a CDC briefing. “People are thought to be most contagious when they are most symptomatic: that is, when they are the sickest.”

There are, however, two other ways by which coronavirus could be transmitted. “Some spread may happen by touching contaminated surfaces and then touching the eyes, nose, and mouth,” Dr Messonnier added. “But remember, we believe that this virus does not last long on surfaces. Some spread may happen before people show symptoms. There have been a few reports of this with the new coronavirus, and it is compatible with what we know about other respiratory viruses, including seasonal flu.”

In reality, it’s coughing and sneezing that is the primary concern. “Right now, we do not believe these last two forms of transmission are the main driver of spread,” Dr Messonnier said.

Disease surveillance is ramping up in response

Five public health labs around the US have already been brought online to add COVID-19 surveillance to their existing work. “We are looking at existing surveillance systems both for influenza and for respiratory diseases,” Dr Messonnier explained. “Results from this surveillance would be an early-warning signal to trigger a change in our response strategy.”

The fear is that, while not currently an issue, coronavirus contagion could become more widespread. Although not guaranteed, that’s something the CDC and other agencies are getting ready for. “We must prepare for the possibility that at some point we may see sustained community spread in other countries, or in the US, and this will trigger a change in our response strategy,” Dr Messonnier said.

The current public health labs are in Los Angeles, San Francisco, Seattle, Chicago, and New York City. “This is just the starting point, and we plan to expand to more sites in the comping weeks until we have national surveillance,” the NCIRD director confirmed.

A testing delay

One of the biggest steps taken already was to expand testing of potentially-infected samples, using a fast-tracked coronavirus assessment. That hit a snag recently, when reports from external labs indicated non-conclusive results were being produced. Investigations by those labs and the CDCs identified problems in the reagents being used as part of the test.

The CDC is currently reformulating those reagents, Dr Messonnier confirmed, though there’s no timescale for when they might be ready for redeployment.

Meanwhile, however, the biggest risk for most people still isn’t COVID-19 at all. H1N1, aka Influenza A, has seen a sudden rise in numbers of infections in the US this season, in line with 2018’s “severe” rating. So far there have been 250,000 hospitalizations, and 14,000 deaths.

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

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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.

The Canadian Press. All rights reserved.

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

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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.

The Canadian Press. All rights reserved.

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

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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.

The Canadian Press. All rights reserved.

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