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Variants must be controlled to prevent third wave, say Ontario’s science advisors – The Sudbury Star

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It’s one of the reasons Sudbury has been placed into lockdown

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TORONTO — Ontario’s ability to control the spread of COVID-19 variants over the next few weeks will determine if there will be a third wave of infection, the province’s science advisors said Thursday.

Residents must continue masking and physical distancing even as vaccinations increase in order to prevent cases of the more contagious variants from overwhelming the health system, Ontario’s Science Advisory Table said as it released new pandemic projections.

Dr. Adalsteinn Brown, co-chair of the group, stressed that the province has arrived at a critical juncture of the pandemic as more people begin to get vaccinated, variants of concern increase, and public health restrictions ease.

The actions of individuals over the new few weeks will determine the quality of summer in Ontario, he said.

“We know exactly what to do,” Brown said. “Although it’s hard, and I know that everyone is at their limits, just a bit more discipline with masking and distancing will help bring cases down.”

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The group’s latest projections showed that the drive in recent months to vaccinate residents and workers in long-term care has paid off in declining illness, with no resident deaths from COVID-19 in the last five days.

But Brown warned that progress against the virus has stalled outside that sector. Declines in community cases and test positivity rates have levelled off as mobility rates jump in the aftermath of a provincial lockdown lifting, he said.

The projections estimate that in the next two to three weeks, COVID-19 rates could grow to up to 8,000 new cases a day under the worst case scenario, depending on the spread of variants.

If public health measures are followed and restrictions are put in place to contain any sudden spikes, that rate could be held to just under 2,000 cases a day, the projections indicated.

“There is a lot of uncertainty right now and with that, a lot of risk, and a lot of danger,” Brown said.

If case rates are again allowed to increase, there remains a danger that Ontario’s hospital system will be overwhelmed, Brown warned.

Even under an optimistic scenario, which sees a “small” capacity increase, the province could still see 400 patients occupying intensive care beds weekly, he said.

“It’s important to note that this is not (just) a small increase,” he said. “This is an increase on top of an already strained system which creates a challenge in access to care.”

Ontario’s chief medical officer of health warned that the province remains in a “minefield” and must proceed with caution.

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He pointed to the use of the province’s “emergency brake” measure on Thursday to move the Sudbury area into a lockdown because of a sudden increase of virus outbreaks linked to variants.

“This is a clear demonstration of why in Ontario we’re going to have to be very careful and move quickly as we try and curtail and limit especially these variants of concern,” he said.

Sudbury has been in the second-strictest “red” category of the province’s pandemic framework. The government said the region’s case rates increased by 54 per cent between March 3 and March 9, to 75.9 cases per 100,000 people.

The emergency brake measure was applied in the Thunder Bay and Simcoe Muskoka areas last month, moving those regions into lockdown from less restrictive levels of the framework after worrying pandemic trends emerged.

Williams said the province does not want to reimpose further restrictions anywhere in the province after just having lifted them in recent weeks, but did not rule it out.

“If there needs to be a state of emergency, again, that’s something that can be covered off,” he said. “It’s something we would rather not do.”

Ontario reported 1,092 new cases of COVID-19 on Thursday and 10 more deaths linked to the virus.

This report by The Canadian Press was first published March 11, 2021.

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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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In COVID-19 vaccination pivot, Canada targets frontline workers

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By Anna Mehler Paperny

TORONTO (Reuters) – Canada is shifting its vaccination campaign to target frontline workers, moving away from a largely age-based rollout as the country tries to get a handle on the raging third wave of the pandemic.

Canada‘s approach thus far has left unvaccinated many so-called “essential workers,” like daycare providers, bus drivers and meatpackers, all of whom are among those at higher risk of COVID-19 transmission. Provinces are now trying to adjust their strategy to tackle the surge driven by new variants.

Targeting frontline workers and addressing occupation risk is vital if Canada wants to get its third wave under control, says Simon Fraser University mathematician and epidemiologist Caroline Colijn, who has modelled Canadian immunization strategies and found “the sooner you put essential workers [in the vaccine rollout plan], the better.”

Initially, Canada prioritized long-term care residents and staff for the vaccines, as well as the very elderly, health workers, residents of remote communities and Indigenous people.

Targeting vaccinations by age made sense early on in a pandemic that ravaged Canada‘s long-term care homes, Colijn said. But now, immunizing those at highest risk of transmission brings the greatest benefit.

“If you protect these individuals you also protect someone in their 60s whose only risk is when they go to the store. … The variants are here now. So if we pivot now, but it takes us two months to do it, then we will lose that race.”

Data released on Tuesday from the Institute of Clinical and Evaluative Sciences showed that Toronto’s neighbourhoods with the highest rates of COVID-19 infections had the lowest vaccination rates, underscoring the disparities in vaccination.

‘IT’S A JUGGERNAUT’

On Wednesday, Ontario Premier Doug Ford announced a plan to have mobile vaccine clinics target COVID-19 “hotspots” and high-risk worksites, although he stopped short of giving people paid time off to get the shot.

Karim Kurji, medical officer of health in York Region north of Toronto, characterizes the shift in vaccination priority from age to transmission risk as moving from defence to offence.

“It’s a juggernaut in terms of the immunization machinery, and turning it around takes a lot of effort,” Kurji said.

Meanwhile, officials in the western province of Alberta say they are offering vaccines to more than 2,000 workers at Cargill’s meatpacking plant in High River, site of one of Canada‘s largest workplace COVID-19 outbreaks. Provincial officials said in a statement they are looking to expand the pilot to other plants.

Quebec will start vaccinating essential workers such as those in education, childcare and public safety in Montreal, where neighbourhoods with the highest vaccination rates have been among those with the lowest recorded infection rates.

The people doing the highest-risk jobs, from an infectious disease perspective, are more likely to be poor, non-white and new Canadians, health experts say. They are less likely to have paid leave to get tested or vaccinated or stay home when sick and are more likely to live in crowded or multi-unit housing. They need to be prioritized for vaccination and their vaccination barriers addressed, experts say.

Naheed Dosani, a Toronto palliative care physician and health justice activist, said making vaccines available to high-risk communities is not enough without addressing barriers to access.

“The face of COVID-19 and who was being impacted changed dramatically. The variants seemed to take hold in communities where essential workers live. … This [pivot] is a step in the right direction and will hopefully save lives.”

 

(Reporting by Anna Mehler Paperny; Editing by Denny Thomas and Aurora Ellis)

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Canada finance minister: Pandemic an opportunity to bring in national childcare

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OTTAWA (Reuters) – The COVID-19 pandemic and its damaging impact on women has underlined the need for a national childcare plan, which would also help the economic recovery, Finance Minister Chrystia Freeland said on Thursday.

Since taking up her job in August, Freeland has repeatedly spoken about a “feminist agenda,” and has said childcare will be part of a stimulus package worth up to C$100 billion ($79.6 billion) over three years. She will unveil details in her April 19 budget.

“I really believe COVID-19 has created a window of political opportunity and maybe an epiphany … on the importance of early learning and childcare,” Freeland told a online convention of Canada‘s ruling Liberal Party.

The budget is set to be a springboard for an election that Liberal insiders say is likely in the second half of the year.

Canadian governments of various stripes have mused about a national childcare program for decades but never acted, thanks in part to the cost and also the need to negotiate with the 10 provinces, which deliver many social programs.

Freeland said a childcare program would help counter “an incredibly dangerous drop” in female employment since the start of the pandemic.

“It is a surefire way to drive jobs and economic growth … you have higher participation of women in the labor force,” Freeland said. “My hope … is that being able to make that economic argument as well is going be to one of the ways that we get this done.”

Freeland, who is taking part this week in meetings of the Group of Seven leading industrialized nations and the International Monetary Fund, said U.S. Vice President Kamala Harris and Treasury Secretary Janet Yellen had told her they saw early learning and child care as a driver for economic recovery.

($1=1.2560 Canadian dollars)

 

(Reporting by David Ljunggren; Editing by Leslie Adler)

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