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Virus hunters: Inside the race to find and contain COVID-19 in Canada – The Globe and Mail

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Ling Orna tests samples at the Public Health Ontario Laboratory in Toronto on Friday, March 6, 2020. Local transmission of the coronavirus is certain to spur an increase in testing requests

Tijana Martin/The Globe and Mail

For more than a week, infectious-disease specialists and public-health leaders in Canada waited with bated breath for the day their stepped-up hunt for the coronavirus would hit pay dirt.

In hospitals and medical laboratories in British Columbia and Ontario, the strategy had shifted from testing for the new virus only in sick people who had recently travelled to China, Iran and other hot spots, to sentinel surveillance, a search for the new virus in hundreds of hospitalized patients who appeared to have influenza or other run-of-the-mill viruses.

“Sitting around waiting for local transmission is kind of agonizing,“ said Michael Gardam, chief of staff at Toronto’s Humber River Hospital and an infection-control expert, “because you assume you’re going to get it.”

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On Thursday night, the wait for community spread of the coronavirus in Canada ended when British Columbia announced it had discovered the respiratory illness in “Case 21,” a fiftysomething woman in the Fraser Health Region who had not travelled recently and had no known contacts with other patients diagnosed with COVID-19, the disease caused by the virus.

Diagnosed while she was being screened for influenza, Case 21 marks a turning point in Canada’s hunt for – and battle against – the novel coronavirus that has swept around the world, infecting more than 100,000 people and killing about 3,500.

B.C.’s Case 21 acquired the coronavirus somewhere and from someone, which means the new virus is circulating, undetected elsewhere, in British Columbia, and perhaps in other parts of the country, too.

This undated electron microscope image made available by the U.S. National Institutes of Health in February 2020 shows the Novel Coronavirus SARS-CoV-2, yellow, emerging from the surface of cells, pink, cultured in the lab.

The Associated Press

It was a case that B.C. Provincial Health Officer Bonnie Henry had anticipated.

“The fact that we picked it up, it reassures me that we are doing surveillance that allows us to pick up these events,” she said Friday. “It also assures me that these events aren’t that common – yet – here in B.C.”

Local transmission of the coronavirus is certain to spur an increase in testing requests, and there are questions about whether Canada’s medical laboratories can ramp up swiftly enough to meet the looming need.

“We’ve tested a lot of people,” said Vanessa Allen, who is leading Ontario’s hunt for the coronavirus as chief of medical microbiology at Public Health Ontario, “but once there is evidence of community transmission, the demand on testing is going to go up exponentially.”

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As of Wednesday, Canada’s National Microbiology Laboratory (NML) in Winnipeg had tested for COVID-19 infection in 533 patients. Ontario reported 1,763 completed tests as of Friday, while B.C. officials said the province has tested 2,008 people.

British Columbia now has four labs, in addition to the provincial lab, able to test for the virus. Dr. Henry said they are rapidly scaling up, and are able to run more than 1,000 tests a day.

The total number of patients tested in Canada is fewer than the sum of the Ontario, B.C. and NML figures because the national lab conducted confirmatory testing of presumptive positives found in B.C. and Ontario until Feb. 25.

The NML continues to play that role for every other province.

Medical program director Wendy Cheung, left, and Dr. Phil Shin, are photographed in an anteroom at the ICU of North York General Hospital during a tour on Monday, March 2, 2020.

Tijana Martin/The Globe and Mail

Along with the Ontario and B.C. coronavirus testing programs piggybacking on existing flu-season testing, British Columbia, Manitoba, Ontario and Nova Scotia now automatically test all patients with severe respiratory illness in intensive-care units for COVID-19, regardless of travel history.

Other provinces employ testing criteria that typically require the presence of flu-like symptoms such as a fever and cough, paired with recent travel to affected regions such as China’s Hubei province and Iran.

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Canada is hoping to avoid the testing snafus that had a part in some of the unchecked spread of the coronavirus in the United States, where 15 people had died as of Friday evening.

By the time California announced that country’s first case of “unknown origin“ – the equivalent of B.C.’s Case 21 – on Feb. 26, just 445 people had been tested in the United States, whose population is 10 times larger than Canada’s.

The U.S. Centers for Disease Control and Prevention had distributed testing kits with a faulty component, prompting the agency to reserve its limited testing capacity for patients with a travel history to China or exposure to a known case. The CDC initially declined to test the California patient.

In this illustration provided by the Centers for Disease Control and Prevention (CDC) in January 2020 shows the 2019 Novel Coronavirus (2019-nCoV).

The Canadian Press

Dr. Gardam said that, until a couple of weeks ago, the Ontario government was similarly “stringent” about who met the testing criteria.

“They were a bit slow, to be honest with you,“ he said. “They were still sticking with China when there were clearly issues in other parts of the world.”

In Ontario, Dr. Allen fully expected the new seek-and-find approach to turn up a case of COVID-19 soon after the agency’s main lab on the 19th floor of a tower in Toronto’s MaRS Discovery District began testing the sentinel samples on Feb. 27.

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The Ontario program began with hospitals in Toronto, and has since expanded to Hamilton, London, Ottawa, Kingston and Sudbury.

As of Friday morning, the Public Health Ontario lab had tested samples from 348 patients as part of the sentinel effort, and found no community-acquired cases of COVID-19.

Visitors pass a sign warning about the spread of germs, after another case of the COVID-19 disease caused by the newly-identified coronavirus was confirmed in the city, at the Prospectors and Developers Association of Canada annual conference in Toronto, Ontario, Canada March 1, 2020.

CHRIS HELGREN/Reuters

“I’m surprised we haven’t found one yet, to be honest,” Dr. Allen said in an interview from the lab. “I expect we will find some community transmission. If we could find it sooner rather than later, that would be helpful.”

Another 228 sentinel samples were in the queue Friday morning.

Testing for the coronavirus usually begins with a nasopharyngeal swab, a method of extracting cells from the back of a patient’s nose and throat with a probe inserted horizontally through the nose.

A sample of the cellular material is sent to Public Health Ontario’s lab, where technicians run two genetic tests known as rapid PCR tests on each sample to search for the coronavirus.

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Of the 28 cases of COVID-19 that Public Health Ontario has confirmed so far, all have been in recent travellers or close contacts of travellers. Dr. Allen has handled news of the positive cases herself, calling the Ministry of Health and the relevant public-health units and hospital infection prevention and control teams to discuss the cases.

As Public Health Ontario works toward a goal of conducting 1,000 tests a day, and of expanding sentinel coronavirus testing into primary care, Dr. Allen knows she won’t be able to handle every case personally. “It’s not sustainable,” she said. “But it’s been very helpful so far.”

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Health Canada approves updated Moderna COVID-19 vaccine

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TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 17, 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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These people say they got listeria after drinking recalled plant-based milks

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TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

The Canadian Press. All rights reserved.

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