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Ventilator supply starts to increase as Tam warns of possible surge of COVID-19 – KitchenerToday.com

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Only a small fraction of the 40,000 new ventilators Canada ordered for hospitals last spring have already been delivered but several companies involved say their production lines will start delivering the products faster in the next few weeks.

The promise of new arrivals comes as Canada’s chief public health officer, Dr. Theresa Tam, warned Friday that a fall surge of COVID-19 cases could overwhelm the health-care system, including its supply of critical care beds and ventilators.

“What we know based on what we learned from other countries and cities that had a devastating impact in that initial wave, if you exceeded that capacity the mortality goes up really, really high,” she said.

Flu season and other respiratory infections common in the fall could put added pressure on the system if COVID-19 flares up in a big way.

Tam said there were many lessons learned from the spring, when the government was ill-prepared and without enough protective equipment for health-care workers, and feared a massive surge of COVID-19 would overwhelm the health-care system.

“We are much better prepared than we were before,” she said.

In March, Canadians watched in horror as northern Italy’s COVID-19 outbreak overran its health-care system, leaving doctors to choose which patients got a ventilator and which were left without one. That experience, coupled with warnings it could happen here too, compelled federal and provincial governments to order thousands of new ventilators.

But much like surgical face masks and N95 respirators, Canada didn’t already produce many ventilators domestically, and getting them from international sources is tough when global need for new ventilators is in the hundreds of thousands. So Canada asked firms here if they could step up, and out of that four new consortiums to build ventilators were formed.

A fifth contract was signed with Thornhill Medical, a Toronto firm that at that point was making about 50 of its portable breathing machines a month.

In all, Canada ordered 40,328 ventilators, for an estimated $1.1 billion, and as of Friday, it had just 606 in hand.

Paul-Emile Cloutier, the president of national health-care advocate HealthCareCAN, said there is concern about the status of the government’s orders for personal protective equipment and ventilators ahead of the possibility COVID-19 will surge again in Canada this fall.

“Details are crucial as we prepare for the expected next wave of COVID-19,” he said.

Procurement Minister Anita Anand said Friday the government is pushing on to get the entirety of the orders in place. A statement from her department said “Canada currently has sufficient ventilators to meet current demands” and that the ones on order are to bolster existing Public Health Agency of Canada stockpiles, as well as the units already in hospitals and provincial warehouses across the country. 

But Health Canada won’t say how many ventilators the country now has in total. It will also not disclose any modelling for how many could be needed in a worst-case scenario situation. In March there were about 5,000 ventilators nationally, and another 500 in the national emergency stockpile.

Canada’s ability to plank the COVID-19 curve in the spring meant warnings about running out of ventilators never came to fruition.

John Walmsley, the executive vice president at Starfish Medical in Victoria, said that took the pressure off his new coalition, Canadian Emergency Ventilators, Inc.

“We have a little bit more elbow room to do things in a bit of a controlled manner but I would say we’re looking to get it done this year,” he said.

“We’re all concerned about a second wave and being ready for that and so we’re on board to deliver for that.”

Canadian Emergency Ventilators is still waiting for Health Canada approval before it can start shipping its promised 7,500 machines. It submitted the documents in June and it is taking a bit longer than expected to get the green light.

Once that happens, the Public Health Agency of Canada would have to test the product, and then the units that have already been built could be shipped, said Walmsley. He is still hopeful to fill the order by the end of the year.

Thornhill Medical CEO Lesley Gouldie said her company’s partnership with Linamar, a manufacturer based in Guelph, Ont., has been a great success. Thornhill is to provide 1,020 machines to Canada, and has shipped 27 so far.

Gouldie said Linamar can make as many as 100 of the units a week, but getting the supplies for the 1,500 parts that make up their portable device proved to be difficult in a pandemic.

“The limiting factor is the supply chains,” Gouldie said.

She said the kinks are mostly worked out now, and she expects to ship enough machines each week to fulfil their contract by early December.

Rick Jamieson, the CEO of FTI Professional Grade, said they expect to fulfil their entire contract for 10,000 ventilators by Dec. 12. FTI is one of several companies in a consortium called Ventilators for Canadians, which has already delivered 132 ventilators. Another 120 are on track for delivery next week and 240 in the last week of August.

“We have activated a fourth shift to increase production knowing that a second wave is likely this fall and winter,” said Jamieson.

Montreal’s CAE received Health Canada approval for its new ventilator on June 17, and said that day it expected to begin shipping “hundreds each week.” It has a contract to deliver 10,000.

The final company, Vexos, was the last to sign a contract, and had to submit its product to Health Canada as well, and began shipping in late July.

Story written by Mia Robson, Canadian Press.

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Five more Manitoba healthcare workers test positive for COVID-19 – CTV News Winnipeg

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WINNIPEG —
Five Manitoba healthcare workers tested positive for COVID-19 in the span of a week.

The latest numbers from the Manitoba government’s surveillance data, from Sept. 6 to 12, shows that a total of 88 healthcare workers have contracted the disease since the beginning of the pandemic. This is an increase of five healthcare workers compared to the week before.

Of these 88 workers, 74 have recovered from COVID-19 and gone back to work.

According to the data, which monitors the intensity, characteristics, transmission and geographic spread of the disease, 29 of these workers are healthcare aids, 23 are nurses, nine are physicians or physicians in training, five are social/support workers, four are medical clerks and 18 fall into a combined category.

The majority of the 88 workers – 64 per cent – contracted the disease through close contact with a known case, about 13 per cent got it from travel, and for the rest of the cases, the source is unknown.

The province is reporting that a total of 20 pregnant Manitobans have gotten COVID-19, which is an increase of two pregnant cases from the week before.

During the week of Sept. 6 to 12, there were three more COVID-19 outbreaks in Manitoba, bringing the total number since the start of the pandemic to 20 outbreaks. Of these three new outbreaks, two were at long-term care facilities and one was at a school.

Over the span of this week, the province saw a decrease in terms of the number of confirmed cases and the volume of people going for tests. There were 108 lab-confirmed cases, which is down from 128 in the week before, and an average of 1,300 people were tested each day, down from 1,500 the previous week.

But, the province saw an increase in its test positivity rate, moving from 1.2 per cent last week to 1.4 per cent this week.

Of the 108 new cases during this week, 63 per cent were from Winnipeg Regional Health Authority, 14 per cent were from the Prairie Mountain Health Authority, and 13 per cent were in the Southern Health – Santé Sud Regional Health Authority. The Interlake-Eastern Regional Health Authority also accounted for about 10 per cent of cases.

The province is reporting that 57 per cent of the 108 cases were contracted through close contacts to known cases, and two per cent were from travel.

Of all of Manitoba’s cases, nearly 63 per cent contracted the disease from close contact with a known case. For more than 16 per cent, the cause is unknown, and approximately 15 per cent got it from travel.

For more than 5 per cent of cases, the source is still being investigated.

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Ontario pediatricians warn 'crisis looming' unless more kids get flu vaccine this year – CP24 Toronto's Breaking News

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Ontario’s pediatricians are calling for a province-wide strategy for immunizing more young kids against the flu as the province prepares to deal with flu season and a rising tide of COVID-19 infections at once.

In an online petition by the pediatrics section of the Ontario Medical Association, the doctors say a number of steps are needed so that flu season does not compound the uptick in COVID-19 cases expected this fall and winter.

The petition points out that more than 1,000 children are hospitalized with influenza every flu season in Canada.

“COVID19 remains a growing and unpredictable threat.  Not only do we want to prevent our children from getting sick with the flu, we also must prevent them from making others around them sick,” the petition states.

The doctors say that several factors will make it more challenging to administer the vaccine to kids this season, including unprecedented interest among parents for the flu vaccine, COVID-19 and flu co-circulating in the community, and a decreased capacity to administer vaccinations due to health guidelines and limited resources in place because of the pandemic.

“Right now, Public Health seems to expect the status quo from years past, when individual doctor’s offices and scattered flu clinics gave flu vaccines,” the petition states. “But this year, there is a dramatically decreased capacity to administer flu vaccines in these settings.”

In order to significantly reduce the circulation of influenza among children this season, the doctors say the province needs to see uptake of the flu vaccine rise significantly above the usual 30 to 35% of the population.

To meet that goal, they are calling on the Ontario government to create a province-wide strategy for immunizing kids, especially those aged six months to four years of age who normally get their flu vaccine from their doctor.

The doctors point out that there is some urgency to the task as it usually takes the vaccine two weeks to build immunity in those who receive it.

In a statement in late August, the Ontario Medical Association urged parents to make sure their kids were up to date with their vaccinations. The OMA said then that doctors had seen “a dramatic decrease” in the number of parents bringing their children for routine vaccinations, in part because they didn’t realize they could during the pandemic.

The OMA told CP24 Monday that it is engaged in ongoing discussions with the provincial government about vaccinations and a host of other issues.

In an interview with CP24.com, OMA President Dr. Samantha Hill said she expects to see a plan around flu vaccination from the province shortly, but in the meantime the uncertainty is an added source of stress for doctors.

“I think everyone, including the government is pretty aligned on the fact that this year is a special year when it comes to the flu. We’re all on the same wavelength, that it’s going to be essential to get as many people vaccinated as possible, and especially to make sure the most vulnerable are vaccinated appropriately,” Hill said. “The challenges with that, of course this year, are numerous compared to the normal, numerous challenges.”

Hill said that while the medical system is being stretched to its limits, all stakeholders should be able to agree on and work together to make sure that more people get vaccinated this year than in previous years.

“This is the year you know, if you’ve never had a flu vaccine before, this is the year you’re going to want to have it,” she said. “We don’t know what it looks like if you get the flu and COVID back-to-back. We don’t we don’t know what it looks like if you get them both at the same. But I’m pretty sure it doesn’t look pretty.”

She said that while health care professionals want to be there for their patients and communities, the system “quite frankly, is stretched to the max.”

“Physicians are working all out, nurses are working all out. Everyone has stepped up and done what they can. But you can’t you can’t give 110 per cent for three years. It doesn’t work.

“While everyone’s committed and everyone is here for their patients and here for their communities, we need to know the plan and we need to know that there is support to enact the plan.”

Hill said the flu vaccine normally becomes available in mid-October and doctors would like to know in advance how the province will ensure greater uptake of vaccination this year.

She said a number of ideas have been floated this year to expand vaccinations, including mobile clinics, parking lot vaccination centres, greater use of pharmacies, as well as private clinics.

“The concern is about making sure that this is done in a way that best utilizes the resources available, and covers as much of the population as possible,” Hill said. “Like I said, if there was ever a year this is the year where you want to have your best uptake.”

She stressed that in addition to vaccinations, other infection-prevention measures such as distancing, hand-washing and mask-wearing will also reduce the spread of infection if practiced widely.

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CDC changes, then retracts, web posting on how virus spreads – Airdrie Today

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NEW YORK — The top U.S. public health agency stirred confusion by posting — and then taking down — an apparent change in its position on how easily the coronavirus can spread from person to person through the air.

But officials at the Centers for Disease Control and Prevention say their position has not really changed and that the post last week on the agency’s website was an error that has been taken down.

It was “an honest mistake” that happened when a draft update was posted before going through a full editing and approval process, said Dr. Jay Butler, the CDC’s deputy director for infectious diseases.

The post suggested that the agency believes the virus can hang in the air and spread over an extended distance. But the agency continues to believe larger and heavier droplets that come from coughing or sneezing are the primary means of transmission, Butler said.

Most CDC guidance about social distancing is built around that idea, saying that about 6 feet is a safe buffer between people who are not wearing masks.

In interviews, CDC officials have acknowledged growing evidence that the virus can sometimes be transmitted on even smaller, aerosolized particles or droplets that spread over a wider area. Certain case clusters have been tied to events in which the virus appeared to have spread through the air in, for example, a choir practice. But such incidents did not appear to be common.

Public health experts urge people to wear masks, which can stop or reduce contact with both larger droplets and aerosolized particles.

But for months, agency officials said little about aerosolized particles. So when the CDC quietly posted an update Friday that discussed the particles in more detail, the agency’s position appeared to have changed. The post said the virus can remain suspended in the air and drift more than 6 feet. It also emphasized the importance of indoor ventilation and seemed to describe the coronavirus as the kind of germ that can spread widely through the air.

The post caused widespread discussion in public health circles because of its implications. It could mean, for example, that hospitals might have to place infected people in rooms that are specially designed to prevent air from flowing to other parts of the hospital.

But the CDC is not advising any changes in how far people stay away from each other, how they are housed at hospitals or other measures, Butler said.

The CDC has come under attack for past revisions of guidance during the pandemic, some of which were driven by political pressure by the Trump administration.

Butler said there was no external political pressure behind the change in this instance. “This was an internal issue,. And we’re working hard to address it and make sure it doesn’t happen again,” he said.

In a statement released Monday, the CDC said the revisions to the “How COVID-19 Spreads” page happened “without appropriate in-house technical review.”

“We are reviewing our process and tightening criteria for review of all guidance and updates before they are posted to the CDC website,” the statement said.

At least one expert said the episode could further chip away at public confidence in the CDC.

“The consistent inconsistency in this administration’s guidance on COVID-19 has severely compromised the nation’s trust in our public health agencies,” said Dr. Howard Koh, a Harvard University public health professor who was a high-ranking official in the Department of Health and Human Services during the Obama administration.

“To rectify the latest challenge, the CDC must acknowledge that growing scientific evidence indicates the importance of airborne transmission through aerosols, making mask wearing even more critical as we head into the difficult fall and winter season,” Koh said in a statement.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

Mike Stobbe, The Associated Press

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