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U.S. issues advice to those fully vaccinated, but no shift in Canada yet – GuelphToday

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New U.S. guidelines say people fully inoculated against COVID-19 can drop some precautions when gathering with others, but at least two provincial health ministers say existing public health advice holds for now.

The Centres for Disease Control and Prevention said Monday that Americans who have waited two weeks since their second required shot can spend time with other immunized people indoors without masks or social distancing.

The same applies to gatherings by those at low-risk of severe disease, such as fully vaccinated grandparents visiting healthy grandchildren.

The U.S. guidelines recommend that fully vaccinated people continue to wear masks, avoid large gatherings and physically distance when in public.

British Columbia Health Minister Adrian Dix said Monday that physical distancing and other public health guidelines will be around for some time.

He said about 15 per cent of B.C.’s eligible residents are expected to be immunized by the end of the month, which is “nothing like herd immunity.”

“The future is bright, but we can’t live the future right now. We’ve got to live the now right now.”

Dix does expect visiting restrictions to be loosened in B.C.’s long-term care homes this month as about 90 per cent of residents and staff have been vaccinated.

University of Alberta infectious diseases specialist Dr. Lynora Saxinger said evidence on which the U.S. health agency based its advice is “very much in evolution” and such recommendations might not work everywhere.

Virus variants with the potential to break through vaccine protection are also a “wild card,” she said.

But Saxinger said the principles underlying the U.S. guidance make sense, especially since the initial vaccine rollout has targeted older individuals, many of whom have been kept away from their grandchildren for almost a year.

“They’re basically taking a balance-of-probabilities approach to say that if you’ve received vaccine, you should be highly protected against severe disease. Therefore this should be hopefully OK.”

Ontario Health Minister Christine Elliott said her province is still recommending people take precautions with gatherings and will take its cues from the National Advisory Committee on Immunization.

Ontario reported 1,631 new cases in its latest update, but said the higher-than-expected count was due to a system “data catch-up.” The seven-day average for new cases was at 1,155.

There were also 10 more deaths linked to the novel coronavirus.

Ontario lifted stay-at-home orders in Toronto, Peel Region and North Bay on Monday — the last three regions subject to the government’s strictest measures introduced two months ago.

Alberta also loosened some rules for banquet halls, community halls, conference centres, hotels, retail shops, performances and post-secondary sports, as hospitalizations stayed well below the provincial target of 450.

Health Minister Tyler Shandro said he believes it is safe enough to immediately ease more restrictions

The province reported 278 new cases of COVID-19 and six additional deaths. Six cases of the more contagious variant were also detected, bringing that total to 659. There were 254 people in hospital.

And residents in five regions of Quebec, including the capital, were again able to eat in restaurants and work out in gyms.

Restrictions remain in place in the Montreal area due to fear that variant cases will cause a spike in infections and hospitalizations.

Quebec reported 579 new cases in its update. New daily infections had been above 700 for the five previous days. The province also recorded nine more deaths.

All of New Brunswick shifted to a lower pandemic response level Monday. That means a circle of 15 regular contacts can socialize, up from 10. The Atlantic province had five new cases and 36 active ones.

Saxinger said a “judicious and slow” reopening is the safest approach.

She noted that many countries have seen their case counts come down, but the proportion of more contagious variants is higher, planting the seeds for a spike.

“We know that it’s possible that the variants can be responsible for another surge, that a variant surge is harder to contain and you need longer and more stringent restrictions to contain them.”

Also Monday, Prime Minister Justin Trudeau announced that Thursday will be a “national day of observance” to commemorate the 22,000 people in Canada who have died from COVID-19 and to acknowledge all the ways the virus has changed our lives in the last year.

This report by The Canadian Press was first published March 8, 2021

— With files from The Associated Press

Lauren Krugel, The Canadian Press

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Canada will not restrict AstraZeneca COVID-19 vaccine, says benefits outweigh risk

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OTTAWA (Reuters) – Canada‘s health ministry said on Wednesday it would not restrict use of AstraZeneca Plc’s COVID-19 vaccine after a review showed the benefits outweighed the very rare risk of blood clots.

A separate advisory council had earlier recommended Canada stop offering the vaccine to people under 55. The panel is now reviewing that advice, the health ministry said in a statement.

Denmark on Wednesday became the first country to stop using the vaccine altogether over a potential link to the rare blood clots. Other nations have imposed limits on its use.

But Health Canada, the federal health ministry, said in a statement that a review of data from Europe, Britain and AstraZeneca had not identified specific risk factors.

“Therefore, Health Canada is not restricting the use of the vaccine in any specific populations at this time … The potential risk of these events is very rare, and the benefits of the vaccine in protecting against COVID-19 outweigh its potential risks,” it said.

Canada on Tuesday said it had recorded its first case of blood clotting with low platelets after someone received the AstraZeneca shot. The patient in question, a woman from Quebec, is recovering. (Graphic on vaccines: https://tmsnrt.rs/3tUM8ta)

COVID-19 cases are surging in Canada with the country reporting a near-record number of new cases recently. (Graphic on cases: https://tmsnrt.rs/34pvUyi)

 

(Reporting by David Ljunggren in Ottawa and Allison Martell in Toronto; Editing by Lisa Shumaker)

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Factbox-Some countries limit AstraZeneca vaccine use, US pauses J&J shot

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(Reuters) -Some countries are restricting use of the AstraZeneca COVID-19 vaccine to certain age groups or suspending use after European and British regulators confirmed possible links to rare blood clots.

Denmark became the first country to stop using the vaccine altogether, as it said results of investigations showed “real and serious side-effects”.

Johnson & Johnson’s single-shot vaccine has also been hit by concerns over blood clots, with European regulators reviewing such cases and U.S. federal health agencies recommending pausing its use for a few days. J&J noted no clear causal relationship had been established between the clots and its vaccine.

The developments pose a risk to vaccination plans in Europe.

Regulators have said the benefits of the AstraZeneca shot outweigh risks.

Anglo-Swedish drugmaker AstraZeneca said it was working with regulators to list the possible brain blood clots as “an extremely rare potential side effect” on the vaccines labels.

As of April 4, the European Medicines Agency had received reports of 169 cases of a rare brain blood clot known as cerebral venous sinus thrombosis (CVST), after 34 million doses had been administered in the European Economic Area. Most cases were in women under 60 years of age.

ASTRAZENECA VACCINE BEING USED, WITH OR WITHOUT RESTRICTIONS

AUSTRALIA

Said on April 8 it recommends people under 50 should get Pfizer’s COVID-19 vaccine in preference to AstraZeneca’s shot.

AUSTRIA

Has resumed use.

BRAZIL

Authorities said they would not limit use of the AstraZeneca vaccine, saying benefits outweigh risks.

BRITAIN

The Joint Committee on Vaccination and Immunisation has said an alternative to the vaccine should be given for people under 30 where possible, but people should continue to have a second shot if they have received a first dose.

BULGARIA

Resumed inoculations from March 19.

CYPRUS

Resumed inoculations on March 19.

CANADA

Authorities said in early April they would pause offering the vaccine to people under 55 and require a new analysis of the shot’s benefits and risks based on age and gender. On April 13, the country said it had recorded its first case of blood clotting with low platelets.

ESTONIA

Suspended use of the vaccine for people under 60 on April 7.

FRANCE

Approved resumption of the vaccine on March 19 but said it should be given only to people aged 55 and over. On April 9, recommended that recipients of a first dose of the AstraZeneca shot who are under 55 should receive a second dose with a messenger RNA vaccine.

FINLAND

Resumed using the AstraZeneca vaccine from March 29, but only for people aged 65 and over.

GEORGIA

Has limited use of the vaccine following the death of a nurse from anaphylactic shock, and vaccinations will continue only in full-fledged medical centres, Russian news agency TASS reported on March 19.

GERMANY

Sticking to its guidance from March 31 to limit use of the vaccine to those aged over 60. On April 1, Germany’s vaccine commission recommended people under 60 who have had a first shot of the vaccine should receive a different product for their second dose.

HUNGARY

Continuing the vaccine’s rollout.

ICELAND

Resumed use on March 25 after suspending it on March 11.

INDONESIA

Resumed using the vaccine on March 22 but warned against its use in people with a low blood platelet count.

IRELAND

On April 12, the country said it was restricting use of the vaccine to those over 60.

ITALY

Has recommended the vaccine be used only for people over 60, the country’s top health adviser said.

LATVIA

Announced it was restarting administering the shots from March 19.

LITHUANIA

Restarted use on March 19.

MEXICO

Drug regulator Cofepris said on April 7 it did not “at this time” plan to limit the vaccine’s use but was investigating the information raised by Britain.

NETHERLANDS

Limited use of the vaccine to people over 60, the Dutch government said on April 8.

NORTH MACEDONIA

Health minister said on March 31 the vaccine would be limited to people aged over 60 as a precautionary measure.

PHILIPPINES

Suspended use of the vaccine for people under 60 on April 8.

ROMANIA

Has resumed use of the vaccine after temporarily stopping vaccinating people with one batch of the vaccine on March 11.

SOUTH KOREA

Resumed use of the shot for people aged 30 or older on April 12. On April 7, it had suspended providing the AstraZeneca shot to people under 60.

SPAIN

From April 8, it was giving the vaccine only to people over 60.

SWEDEN

Resumed use of the vaccine on March 25 for people aged 65 and older.

THAILAND

Began use on March 15 after delaying rollout the week before.

COUNTRIES WHERE ASTRAZENECA VACCINE USE SUSPENDED

CAMEROON

Suspended administration of the vaccine it was scheduled to receive on March 20 as part of the global vaccines sharing scheme COVAX, the health ministry said.

DENMARK

In a world first, Denmark decided to stop using the AstraZeneca vaccine altogether after initially suspending use of the shot.

NORWAY

Authorities said on March 26 Norway would delay a decision on use of the vaccine, with a decision expected by April 15.

J&J VACCINE DELAYS AND RESTRICTIONS

UNITED STATES

On April 13, U.S. federal health agencies recommended pausing use of J&J’s COVID-19 vaccine for at least a few days after six women under the age of 50 developed rare blood clots after receiving the shot.

EUROPEAN UNION

The company said it would delay the rollout of the vaccine to Europe, after regulators said they were reviewing rare blood clots.

Widespread use in the EU had not yet started after the company began delivering the doses in the week beginning April 12. The European drug regulator recommended storing doses already received until its safety committee issues an expedited recommendation

SOUTH AFRICA

Suspended use of J&J’s vaccine on April 13.

(Reporting by Pushkala Aripaka, Yadarisa Shabong, Manas Mishra, Vishwadha Chander, Amruta Khandekar and Mrinalika Roy in Bengaluru; editing by Josephine Mason, Alison Williams, Timothy Heritage, Larry King, Barbara Lewis)

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Ontario hospitals may have to withhold care as COVID-19 fills ICUs

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By Allison Martell and Anna Mehler Paperny

TORONTO (Reuters) – Doctors in the Canadian province of Ontario may soon have to decide who can and cannot receive treatment in intensive care as the number of coronavirus infections sets records and patients are packed into hospitals still stretched from a December wave.

Canada‘s most populous province is canceling elective surgeries, admitting adults to a major children’s hospital and preparing field hospitals after the number of COVID-19 patients in ICUs jumped 31% to 612 in the week leading up to Sunday, according to data from the Ontario Hospital Association.

The sharp increase in Ontario hospital admissions is also straining supplies of tocilizumab, a drug often given to people seriously ill with COVID-19.

Hospital care is publicly funded in Canada, generally free at the point of care for residents. But new hospital beds have not kept pace with population growth, and shortages of staff and space often emerge during bad flu seasons.

Ontario’s hospitals fared relatively well during the first wave of the pandemic last year, in part because the province quickly canceled elective surgeries.

The College of Physicians and Surgeons of Ontario told doctors last Thursday that the province was considering “enacting the critical care triage protocol,” something that was not done during earlier waves of the virus. Triage protocols help doctors decide who to treat in a crisis.

“Everybody’s under extreme stress,” said Eddy Fan, an ICU doctor at Toronto’s University Health Network. He said no doctor wants to contemplate a triage protocol but there are only so many staff.

“There’s going to be a breaking point, a point at which we can’t fill those gaps any longer.”

In a statement, the health ministry said Ontario has not activated the protocol. A September draft suggested doctors could withhold life-sustaining care from patients with a less than 20% chance of surviving 12 months. A final version has not been made public.

Ontario’s Science Advisory Table had been forecasting the surge for months, said member and critical care physician Laveena Munshi. During a recent shift she wanted to call the son of a patient only to discover he was in an ICU across the street.

“The horror stories that we’re seeing in the hospital are like ones out of apocalyptic movies,” she said. “They’re not supposed to be the reality we’re seeing one year into a pandemic.”

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