Health
U.K. first in world to start using Oxford-AstraZeneca vaccine – CTV News
LONDON —
The U.K. on Monday became the first nation in the world to start using the COVID-19 vaccine developed by Oxford University and drugmaker AstraZeneca, ramping up a nationwide inoculation program as rising infection rates are putting an unprecedented strain on British hospitals.
Brian Pinker, an 82-year-old dialysis patient, received the first shot at 7:30 a.m. at Oxford University Hospital.
“The nurses, doctors and staff today have all been brilliant, and I can now really look forward to celebrating my 48th wedding anniversary with my wife, Shirley, later this year,” Pinker said in a statement released by the National Health Service.
The rollout of the new vaccine comes at a crucial moment for U.K. authorities, who are battling a surge in infections blamed on a new virus variant that authorities have said is much more contagious. Scotland imposed a lockdown until the end of January amid increasing pressure on officials to tighten restrictions throughout the U.K.
Prime Minister Boris Johnson, who has said tougher measures are imminent, announced a nationwide address at 8 p.m. The UK Parliament will be recalled to sit on Wednesday.
“If you look at the numbers, there’s no question we will have to take tougher measures and we will be announcing those in due course,” Johnson said while visiting some of the people receiving the Oxford-AstraZeneca vaccine at Chase Farm Hospital in north London.
The U.K. is in the midst of an acute outbreak, recording more than 50,000 new coronavirus infections a day over the past six days. On Sunday, it notched up another 54,990 cases and 454 more virus-related deaths to take its confirmed pandemic death toll total to over 75,000, one of the worst in Europe. Some areas northeast of London have infection rates of over 1,000 cases per 100,000 people.
Scottish leader Nicola Sturgeon says that beginning Tuesday, people in Scotland will be legally required to stay at home except for essential reasons to help ease the pressure on hospitals and intensive care units.
Under the new lockdown rules in Scotland, people can go out for exercise but can only meet one other person from another household. School closures are extended until February except for children of key workers and children under social care.
“I am more concerned about the situation we face now than I have been at any time since March last year,” she said
Scotland, which has its own devolved government, has often imposed stricter coronavirus restrictions than those in England throughout the pandemic.
U.K. regulators last week authorized emergency use of the Oxford-AstraZeneca shot, giving public health officials a second vaccine in their medical arsenal. Britain’s mass vaccination program began Dec. 8 with the shot developed by New York-based Pfizer and its German partner BioNTech.
Britain has secured the rights to 100 million doses of the Oxford-AstraZeneca vaccine, which is cheaper and easier to use than some of its rivals. In particular, it doesn’t require the super-cold storage needed for the Pfizer vaccine.
The new vaccine will be administered at a small number of hospitals for the first few days so authorities can watch out for any adverse reactions. But the NHS said hundreds of new vaccination sites — including local doctors’ offices — will open later this week, joining the more than 700 vaccination sites already in operation.
A “massive ramp-up operation” is now underway in the vaccination program, Johnson said. But aspects of Britain’s vaccination plans have spurred controversy.
Both vaccines require two shots, and Pfizer had recommended that the second dose be given within 21 days of the first. But The U.K.’s Joint Committee on Vaccination and Immunization said authorities should give the first vaccine dose to as many people as possible, rather than setting aside shots to ensure others receive two doses. It has stretched out the time between the doses from 21 days to within 12 weeks.
While two doses are required to fully protect against COVID-19, both provide high levels of protection after the first dose, the committee said. Making the first dose the priority will “maximize benefits from the vaccination program in the short term,” it said.
Stephen Evans, a professor of pharmacoepidemiology at the London School of Hygiene & Tropical Medicine, said policymakers are being forced to balance the potential risks of this change against the benefits in the middle of a deadly pandemic.
“We have a crisis situation in the UK with a new variant spreading rapidly, and as has become clear to everyone during 2020, delays cost lives,” Evans said. “When resources of doses and people to vaccinate are limited, then vaccinating more people with potentially less efficacy is demonstrably better than a fuller efficacy in only half.”
In England alone, 23,557 people were hospitalized with COVID-19 on Saturday. While figures for Northern Ireland, Scotland and Wales haven’t been updated in recent days, that’s higher than the U.K.-wide peak during the first wave of the pandemic.
The government closed non-essential shops across London and parts of southeast England before Christmas to try to contain the new variant, but health officials say tougher measures are now needed.
Johnson said there were “tough, tough” weeks to come in the fight against COVID-19. More school closures, curfews and the total banning of household mixing could be on the agenda.
While schools in London are already closed due to high infection rates in the capital, students in many parts of the country were returning to in-person classes Monday after the Christmas holidays. Unions representing teachers, however, have called for schools throughout England to remain closed for at least two weeks, with classes shifted to remote learning.
Professor Andrew Pollard, one of the scientists who led development of the Oxford-AstraZeneca vaccine, received his shot on Monday.
“It was an incredibly proud moment for me, to have received the actual vaccine that the University of Oxford and the AstraZeneca teams have worked so hard to make available to the U.K. and the world,” he said.
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Associated Press Writer Sylvia Hui contributed
Health
There are now 34 confirmed cases of the B117 variant in Ontario and Toronto's top doctor says you should assume it is spreading – CP24 Toronto's Breaking News
There are 34 confirmed cases of the B117 COVID variant in Ontario and officials are now acknowledging that the strain may not just be more contagious but could also cause “more severe illness” in some people as well.
Chief Medical Officer of Health Dr. David Williams shared the latest data during a briefing on Monday afternoon. It is a big jump from last Thursday when officials were reporting just 15 cases of the so-called UK variant.
Of the 34 cases, 10 are in York Region, six are in Toronto, seven are in Simcoe, three are in Peel, three are in Durham and three are in Ottawa. Kingston and Midddlesex-London have also had single cases.
“The key issue is that with the aggressive nature of the UK variant in particular the reasons for being cautious and careful with masking and distancing are enhanced even further because it can be spread with breaches to those protocols in a very short period of time,” Williams warned. “We are going to have to be on our guard but the same measures that protect you from the other strain of COVID-18 will protect you from this one. But you have to do it consistently.”
Ontario has been screening positive samples from people who have returned from aboard for new variants as well as samples collected from large outbreaks.
Efforts, however, are now underway to conduct genomic sequencing on all of the positive samples from Jan. 20 to give officials a snapshot of how widely the variant might be circulating in Ontario but results are expected to take two to three weeks.
Speaking with reporters, Williams said that the variant was probably “moving around in Ontario” before it was discovered earlier this month and may now be “more prevalent than we think.”
For that reason, he said that a recent decline in case counts should be taken with somewhat of a “grain of salt” at this point as there remains a risk that transmission could ramp up again should the variant take hold.
“We don’t want to be casual and careless and open up too soon,” he said.
Just ‘assume’ variant is circulating de Villa
Officials have previously said that the B117 variant is at least 56 per cent more contagious but could be as high as 70 per cent more contagious.
At an earlier briefing on Monday afternoon, Toronto’s Medical Officer of Health Dr. Eileen de Villa said that residents should probably just “assume” that the variant is circulating widely at this point and act accordingly.
That, she said, means limiting your in-person contact with people outside of your household as much as possible.
“We can create barriers to variants spreading widely if we avoid situations where COVID-19 can spread,” she said. “You have heard before what I am going to say next. I hope you will take it to heart more than at any other time. This means keeping apart as much as possible and it means making as few exceptions for contact as we can.”
De Villa said that given the risk posed by the variant in congregate settings, Toronto Pubic Health has reached out to all long-term care homes, retirement homes and complex and continuing care facilities to get the to “review, audit and reinforce” their current infection prevention and control (IPAC) measures.
She said that there are also “heightened practices for case and contact management when there is reason to believe” a given case may involved the B117 variant.
“You know I am sympathetic to the sacrifices and to the strain of life in the COVID-19 pandemic but for now the time has passed for focussing on impositions, inconveniences or frustrations,” she said. “This current situation in the simplest terms is not good. For now we need to focus on things as they are and do everything we can to make sure that things don’t get worse.”
Health
Day 42 after first COVID-19 vaccines and still no second dose in sight as Quebec steps into 'wilderness': experts – CTV Montreal
MONTREAL —
It’s been 42 days since residents of Maimonides Geriatric Centre in Montreal received their first doses of the Pfizer COVID-19 vaccine, and with no appointments scheduled to administer the second dose, Quebec is now heading into the “wilderness,” says a leading Montreal geriatrician.
Dr. Jose Morais, Chief of Geriatric Medicine at McGill University, emphasized that he thinks “these are difficult decisions,” and “from the public health standpoint, maximizing the distribution of the vaccine is the right thing to do,” to protect a larger number of vulnerable seniors and front-line health-care workers.
From what is known about vaccines and immunity, he also said it’s unlikely the protective effects of one dose will just abruptly disappear. They usually diminish more slowly, and it is possible the effects could last for three months.
But Quebec’s decision to delay the second dose up to 90 days so that double the number of vulnerable Quebecers can be immunized with a first vaccine is not risk-free, Morais said.
“We are in unknown territory. We may be taking undue risks for these particular people because the science supports giving it up to six weeks, 42 days, and the WHO (World Health Organization) has looked into this data and this is what they suggest,” the geriatric specialist said.
Benoit Masse, a public health researcher at Universite de Montreal agreed with the assessment made by Morais.
“Yes, there are potential risks with delaying the second dose beyond six weeks. Unknown risks,” he said.
Canada’s National Advisory Committee on Immunization (NACI) also recommended a six-week delay in a report issued on Jan. 12, because that specific waiting period between doses has been proven to work in clinical trials for Pfizer and Moderna vaccines.
It advised the strategy only be deployed in response to a perfect storm: a rising number of cases, strain on hospitals and a limited supply of vaccines.
In a Jan. 21 update on the province’s decision to delay second shots as long as 90 days, the Quebec Public Health Institute (INSPQ) noted in French, that “no maximum interval between doses is specified,” by the NACI and that “the proposal to not exceed 42 days is therefore not based on data of decreased efficacy after this time period.”
That means the decision to not exceed 42 days was also made by the NACI, because there is currently no data to back it up, as Morais and Masse explained.
Quebec’s immunization committee does conclude administering a second dose is necessary to assure long-term protection, and that the timing of the second dose could be advanced if studies eventually show efficacy wanes after the first dose.
FAMILIES IN LIMBO
As they mark day 42 on the calendar, family members of the long-term care residents at Maimonides remain in the dark about the timeline.
Joyce Shanks, whose father lives at the facility, said the families did not get a response “to the original legal action that we took.”
The Maimonides Family Advocacy Committee is accusing the government of breach of contract.
Lawyer Julius Grey sent an open letter to the premier and health minister more than two weeks ago.
Nor have they heard anything from the West-Central Montreal health authorities (CIUSSS) about the second dose, said Shanks.
“They are toeing the government line. We have nothing specific to go on about the vaccine,” she said, adding “we are exploring every legal opportunity.”
When CTV asked the West-Central Montreal CIUSSS if it has set a date for the second shot to be administered, a spokesperson directed us to Quebec’s health ministry. A Quebec health ministry spokesperson, in turn, invited us to “reach out to the West-Central Montreal CIUSSS with that question.”
But the government is likely recalculating its timeline for the umpteenth time now that most of the province’s doses have been administered – and because Pfizer has delayed shipments of its vaccines to Canada, it is putting public health officials in an even more precarious position.
That was confirmed Monday when the health ministry told CTV that because of the “important” reduction in the number of Pfizer doses they had expected to receive over the next two weeks, they “must review the vaccination calendar, notably for the RPAs,” which are private seniors’ residences.
Above all, the vaccine shortage and dosing strategy have now pushed Quebecers waiting for the booster shot well past the goal lines – three weeks past the vaccine manufacturer’s recommendations, and past the 42-day emergency interval laid out by the NACI.
CALCULATED RISKS
The decision to give the second dose any time past Pfizer’s 21-day schedule or Moderna’s 28-day recommendation has divided scientists and clinicians around the world, particularly in Canada and also in the U.K, where a 12-week dosing interval has also been approved.
“Even us, we are torn apart between these two scenarios,” revealed Morais, who works at two MUHC hospitals as well as the Jewish General Hospital.
“I have a colleague who decided to take no vaccination. He said if I didn’t receive the second dose within 42 days, why bother taking the first vaccination?” Morais said.
In an email exchange with CTV, public health expert Masse acknowledged that Quebec is walking a tightrope as he spelled out the province’s predicament.
“The benefit of delaying the second dose is (almost) immediate. We protect more people with a first dose, as we are in a large outbreak that we are barely able to control. We are talking about saving lives and hospitalizations in the short term,” he wrote.
Once immunity starts to kick in though and then builds – at 14 days after the first dose, according to a study in the New England Journal of Medicine – even some protection can mean the difference between a survivable illness and one that’s fatal.
However, if the risk turns out to be real – that the vaccine’s protective effects decline quickly or the effectiveness of the first dose turns out to be considerably weaker than expected – then Masse said we could “end up with no net gain overall or worse, an overall increase in death and hospitalizations.”
Masse argued, though, that it’s likely the intensity of the second wave will ease in the coming months and only if there is a rapid decline in the efficacy would we “undo all the benefits we can get right now by vaccinating the maximum number of people.”
Also, getting one dose of the vaccine, even two doses doesn’t mean anyone should stop following all recommended hygiene and distancing measures in the short-term. No one knows yet if the vaccines approved in Canada, will prevent transmission of the virus.
Finally, Masse offered the following assignment, suggesting people ask themselves what they’d do if they have two parents who are both 80 years old (as he does).
“If you give me two doses of a vaccine right now, what do I do? Vaccinate only my mother and keep the one dose in the freezer – or, vaccinate both my mother and father right now?”
In the current climate, when case numbers and community transmission are still high, “I choose the latter without hesitation. In the context of a huge outbreak, I want to protect both of them,” the public health researcher said.
Ontario adjusting vaccine rollout to address shipment delay
File photo courtesy of © Can Stock Photo Inc. / vetdoctor)
January 25, 2021 1:42pm
With a dwindling supply of COVID-19 vaccines in Ontario, the government has made changes in how the remaining doses will be distributed.
Premier Doug Ford provided an update on the vaccine rollout Monday afternoon at Queens Park, announcing that vaccine distribution will be adjusted with a goal of making sure all residents of long-term care facilities get a shot by February 5. The previous target date was February 15.
The adjustment ensures that the province’s most vulnerable population, such as long-term care residents, high-risk retirement community residents, and Indigenous elder care homes, have access to both required doses of the vaccines.
The change also means that, until more of the Pfizer vaccine arrives in Ontario, essential caregivers and health care employees may have to wait a little longer to get their shots.
“I know this will mean that some people may have to reschedule their vaccine appointments, but it is critical that our most vulnerable seniors receive the protection they need as soon as possible,” said Ford.
Doses of the Moderna vaccine will be redistributed to 14 of Ontario’s public health units to make sure long-term care homes are getting the vaccine as needed.
The government says once shipments of the vaccine are resumed, rollout will proceed at once. Up to 40,000 Ontarians a day can be vaccinated under the current system, with the ability to increase the capacity pending new shipments.
Also on Monday, Ontario extended its state-of-emergency declaration to Tuesday, February 9, unless extended or amended. Orders under the Reopening Ontario Act will continue to be enforced.
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