This is an excerpt from Second Opinion, a weekly roundup of eclectic and under-the-radar health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.
As new outbreaks of coronavirus continue to appear in countries outside of China, experts are now recalculating the risk of the virus and our ability to contain it worldwide.
Until now, the focus of containing the coronavirus illness, known as COVID-19, has centred on China.
Millions remain under quarantine in China’s central Hubei province, where the outbreak began, and travel restrictions are still in place throughout the affected region.
But outbreaks have since emerged in South Korea, Italy and Iran. Infectious disease physicians say the rapid spread of coronavirus cases outside of China could signal a game changer in the response to the global outbreak.
“Globally, we will not be able to contain the spread of this virus. We can slow it down, but we can’t stop it,” said Dr. Allison McGeer, an infectious diseases specialist at Toronto’s Mount Sinai Hospital who worked on the front lines of the SARS epidemic in 2003.
“The number of countries with cases is going to continue to increase.”
The WHO is increasingly concerned about COVID-19 outside China, especially in South Korea and Iran. 2:51
Officials are also concerned about the number of cases with “no clear epidemiological link,” WHO Director-General Tedros Adhanom Ghebreyesus said Friday, such as travel history to China or contact with a known confirmed case.
He said while the number of cases outside of China remains small, they are “worrisome.”
“It’s in our hands now,” Tedros said. “If we do well within the narrowing window of opportunity, we can avert any serious crisis. If we squander the opportunity, then there will be a serious problem on our hands.”
1st case in Canada with no connection to China
Canada’s ninth presumptive case of coronavirus is a woman in her 30s who recently travelled to Iran and is now recovering at home in British Columbia.
Health officials were surprised to learn she had not travelled to China or any of its neighbouring countries, and have classified the case as a “sentinel event” — one that originated from a region that is completely unexpected.
Dr. Bonnie Henry, B.C.’s provincial health officer, said they are investigating where the woman may have contracted the virus, working alongside the Public Health Agency of Canada. The woman had a travelling companion, was visiting family and is now in isolation at home.
“Until very recently, we didn’t consider Iran as a place of transmission of COVID-19,” Henry said in an interview. “So that set off quite a number of warning bells for us.”
Henry said the investigation continues into where the woman travelled, but she hadn’t been to the city of Qom, where a handful of cases have been recorded. “She did report at the airport [in Tehran] that there were quite a lot of people who were sick and who were wearing masks,” she said.
The answers are important to public health measures aimed at containing the virus, such as whether Canada should expand its border-screening questionnaires for travellers from places beyond the epicentre in China’s Hubei province.
An Iranian man wearing a protective mask walks at Grand Bazaar in Tehran on Thursday. (Nazanin Tabatabaee/West Asia News Agency/Reuters)
Henry said the exportation of a case from a country like Iran, which hasn’t previously reported a lot of infections, also has parallels with the start of the epidemic in China.
“The first exported cases from China were similar,” she said, “and essentially an indication that there may be more cases than were recognized.”
If it is confirmed the traveller was infected in Iran, then it likely means there’s more than a handful of cases there, said Dr. Isaac Bogoch, an infectious disease physician at Toronto General Hospital who is researching the outbreak.
“The real question is how much disease burden is in Iran and do they have the capacity to really get this under control,” he said. “We might be inching toward this situation where this infection is not contained and we have to really be prepared for a possible scenario where there’s more widespread transmission throughout the world.”
‘Alarming numbers’ in South Korea
South Korea is also seeing a surge in new cases — reportedly linked to what authorities call a “super-spreading event” at a church congregation where the majority of infections originated.
“What we’re hearing out of South Korea is starting to sound like alarming numbers,” said Bogoch. “But South Korea has a pretty robust medical system and a fantastic public health infrastructure.”
Bogoch said South Korea’s health-care system was tested significantly with an epidemic of MERS in 2015, much like Toronto was with SARS in 2003.
“We learned incredible lessons from SARS that are really implemented to this day that are helping us cope with this COVID-19 epidemic,” he said.
“Hopefully Korea has really learned some lessons from their MERS epidemic a few years ago to really help them cope with this.”
People wearing masks wait for a signal at a crosswalk in central Daegu, South Korea on Friday. (Kim Hong-Ji/Reuters)
While managing ill patients and preventing hospital outbreaks are key to a country’s health-care infrastructure, McGeer said that infrastructure may have little to do with preventing the spread of the coronavirus.
“This is not about how strong your health-care system is,” she said. “They may well be able to identify chains of transmission and quarantine and isolate people. But the larger the number of cases, the more difficult it becomes.”
In northern Italy, officials shut down schools and public events after a cluster of 16 cases and one death were announced Friday. Five of those cases were identified as health workers.
WHO officials have pushed for countries to be transparent about its cases, so resources can be shifted to where the need is greatest.
For WHO, sub-Saharan Africa was a concern, given the degree of travel between China and Africa and limited ability to test for the virus in many African countries.
Stephen Hoption Cann, an epidemiologist at the school of population and public health at the University of British Columbia, said if COVID-19 continues to spread worldwide, there is the possibility of the virus becoming endemic — or something that re-emerges on a seasonal basis.
“Are we going to be able to contain this virus and prevent it from spreading into the next season?” he said. “It’s really hard to say now; it’s looking like there’s a possibility that we will be seeing it back again next winter.”
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VANCOUVER – Contract negotiations resume today in Vancouver in a labour dispute that has paralyzed container cargo shipping at British Columbia’s ports since Monday.
The BC Maritime Employers Association and International Longshore and Warehouse Union Local 514 are scheduled to meet for the next three days in mediated talks to try to break a deadlock in negotiations.
The union, which represents more than 700 longshore supervisors at ports, including Vancouver, Prince Rupert and Nanaimo, has been without a contract since March last year.
The latest talks come after employers locked out workers in response to what it said was “strike activity” by union members.
The start of the lockout was then followed by several days of no engagement between the two parties, prompting federal Labour Minister Steven MacKinnon to speak with leaders on both sides, asking them to restart talks.
MacKinnon had said that the talks were “progressing at an insufficient pace, indicating a concerning absence of urgency from the parties involved” — a sentiment echoed by several business groups across Canada.
In a joint letter, more than 100 organizations, including the Canadian Chamber of Commerce, Business Council of Canada and associations representing industries from automotive and fertilizer to retail and mining, urged the government to do whatever it takes to end the work stoppage.
“While we acknowledge efforts to continue with mediation, parties have not been able to come to a negotiated agreement,” the letter says. “So, the federal government must take decisive action, using every tool at its disposal to resolve this dispute and limit the damage caused by this disruption.
“We simply cannot afford to once again put Canadian businesses at risk, which in turn puts Canadian livelihoods at risk.”
In the meantime, the union says it has filed a complaint to the Canada Industrial Relations Board against the employers, alleging the association threatened to pull existing conditions out of the last contract in direct contact with its members.
“The BCMEA is trying to undermine the union by attempting to turn members against its democratically elected leadership and bargaining committee — despite the fact that the BCMEA knows full well we received a 96 per cent mandate to take job action if needed,” union president Frank Morena said in a statement.
The employers have responded by calling the complaint “another meritless claim,” adding the final offer to the union that includes a 19.2 per cent wage increase over a four-year term remains on the table.
“The final offer has been on the table for over a week and represents a fair and balanced proposal for employees, and if accepted would end this dispute,” the employers’ statement says. “The offer does not require any concessions from the union.”
The union says the offer does not address the key issue of staffing requirement at the terminals as the port introduces more automation to cargo loading and unloading, which could potentially require fewer workers to operate than older systems.
The Port of Vancouver is the largest in Canada and has seen a number of labour disruptions, including two instances involving the rail and grain storage sectors earlier this year.
A 13-day strike by another group of workers at the port last year resulted in the disruption of a significant amount of shipping and trade.
This report by The Canadian Press was first published Nov. 9, 2024.
The Royal Canadian Legion says a new partnership with e-commerce giant Amazon is helping boost its veterans’ fund, and will hopefully expand its donor base in the digital world.
Since the Oct. 25 launch of its Amazon.ca storefront, the legion says it has received nearly 10,000 orders for poppies.
Online shoppers can order lapel poppies on Amazon in exchange for donations or buy items such as “We Remember” lawn signs, Remembrance Day pins and other accessories, with all proceeds going to the legion’s Poppy Trust Fund for Canadian veterans and their families.
Nujma Bond, the legion’s national spokesperson, said the organization sees this move as keeping up with modern purchasing habits.
“As the world around us evolves we have been looking at different ways to distribute poppies and to make it easier for people to access them,” she said in an interview.
“This is definitely a way to reach a wider number of Canadians of all ages. And certainly younger Canadians are much more active on the web, on social media in general, so we’re also engaging in that way.”
Al Plume, a member of a legion branch in Trenton, Ont., said the online store can also help with outreach to veterans who are far from home.
“For veterans that are overseas and are away, (or) can’t get to a store they can order them online, it’s Amazon.” Plume said.
Plume spent 35 years in the military with the Royal Engineers, and retired eight years ago. He said making sure veterans are looked after is his passion.
“I’ve seen the struggles that our veterans have had with Veterans Affairs … and that’s why I got involved, with making sure that the people get to them and help the veterans with their paperwork.”
But the message about the Amazon storefront didn’t appear to reach all of the legion’s locations, with volunteers at Branch 179 on Vancouver’s Commercial Drive saying they hadn’t heard about the online push.
Holly Paddon, the branch’s poppy campaign co-ordinator and bartender, said the Amazon partnership never came up in meetings with other legion volunteers and officials.
“I work at the legion, I work with the Vancouver poppy office and I go to the meetings for the Vancouver poppy campaign — which includes all the legions in Vancouver — and not once has this been mentioned,” she said.
Paddon said the initiative is a great idea, but she would like to have known more about it.
The legion also sells a larger collection of items at poppystore.ca.
This report by The Canadian Press was first published Nov. 9, 2024.
