This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.
Canadians considering gathering with loved ones over the holidays this year need to come to terms with some harsh realities.
But COVID-19 is insidious, an unwanted guest that can slip in unnoticed and wreak havoc despite our best efforts to control it.
“We have to ask ourselves honestly, must we socialize? And the answer is probably no,” said Raywat Deonandan, a global health epidemiologist and associate professor at the University of Ottawa.
“There is no way to eliminate risk except not to do it in the first place.”
But we’ve learned a lot more about how COVID-19 spreads since it first emerged at the beginning of this year, which can help inform us on where we’re most at risk.
Confusion over holiday guidelines
There’s understandably a lot of confusion about what sorts of holiday gathering might be reasonable to consider this year, especially since depending on where you live in this country the rules and recommendations differ.
The official advice from Canada’s chief public health officer is to avoid large gatherings, non-essential travel and to keep things as small as possible within your household.
Certain provinces, like Ontario, recommend skipping extended family gatherings altogether and taking precautions like self-isolating for 10 to 14 days for those travelling home from away, including colleges and universities.
While others, like Quebec, have put a lot of faith in their population by allowing gatherings of up to 10 people for four days over the holidays after a seven day period of self-imposed quarantine.
But Deonandan says we can’t necessarily rely on people to completely self-isolate on their own — that requires not leaving home for groceries, essential items or even to walk the dog.
WATCH | Dr. Theresa Tam advises no large gatherings or non-essential travel
“You’re also going to have outliers who have infectious periods longer than two weeks,” he said.
“If enough people do this, you’re going to get a sufficient number of people who do not fall under that umbrella who are indeed infectious and who start outbreaks.”
Silent spread a ‘key driver’ of outbreaks
While we weigh whether it’s even possible to gather safely with friends and family in a pandemic, it’s important to keep in mind the unseen dangers we could be inviting in — even in parts of the country that have low rates of COVID-19.
“The problem with this virus is that it’s like many other viruses,” said Dr. Allison McGeer, a medical microbiologist and infectious disease specialist at Toronto’s Mount Sinai hospital who worked on the front lines of the SARS epidemic in 2003. “You shed virus before you get sick and some people who get infected don’t develop symptoms.”
“That’s why what has worked is everybody wearing masks and everybody maintaining social distance, because you can’t tell who the next infected person is going to be.”
McGeer says viruses like influenza, chickenpox and measles typically present symptoms in the body before people are infectious — but the virus behind COVID-19 is different.
The U.S. Centers for Disease Control and Prevention released updated scientific guidance this week that acknowledged asymptomatic or presymptomatic individuals account for more than half of all COVID-19 transmissions.
“Silent transmission is one of the key drivers of outbreaks,” said Seyed Moghadas, a professor of applied mathematics and computational epidemiology at Toronto’s York University.
“There is an incorrect notion in the general population that if someone feels fine then they are not infected. A person can certainly be infected, infectious, and feel completely fine.”
Moghadas, the lead author of a study published in the journal PNAS on the silent spread of COVID-19 that was cited in the CDC guidelines, says this underscores how difficult the virus is to control, a challenge “magnified” in close quarters.
In Nova Scotia, which has successfully contained the spread of COVID-19 throughout the pandemic despite the bursting of the Atlantic bubble this week, catching those silent spreaders before they unknowingly infect others is key.
Dr. Lisa Barrett, an infectious disease specialist at Dalhousie University, has partnered with public health authorities in a pilot project to use rapid COVID-19 tests on people without symptoms in high-traffic areas of Halifax.
It’s only been a few days, but what they’ve found was surprising.
On the first day they tested 147 people and found one asymptomatic case, the second day they tested 604 more and found another one, and on the third day they did 804 tests and found five more.
“We recognized that there are a lot of people out there, even if they’re doing the right thing, that don’t know they’re infected, don’t know they’re infectious and could be spreading to other people,” said Barrett.
“When there’s community spread of a virus that has a long period of time when you can be infectious without symptoms, you have to test broadly in the community or you have no idea what’s going on.”
‘A negative test is not a license to socialize’
One novel approach to avoid meeting with loved ones while unknowingly infectious that has emerged is to get a COVID-19 test beforehand to pre-emptively detect it.
But the timing of that test is incredibly important and there’s a lot of room for error, so it may be a less effective strategy than it first appears.
A new study in the journal Science looked at 1,178 people infected with COVID-19 and more than 15,000 of their close contacts to determine when people were most infectious.
It found most of the transition — 87 per cent — happened in a fairly wide window of time, up to five days before or after symptoms appeared, while 53 per cent was in the pre-symptomatic phase.
“It’s possible to be early in the disease cycle such that you won’t detect any viral presence. But in two days suddenly you’re infectious and now we’re screwed,” said Deonandan, at the University of Ottawa.
“So a negative test is not a license to socialize.”
Still, Deonandan says there will be people who are going to socialize anyway, so it’s better they do so with precautions in place like testing and self-isolating than nothing — even if those precautions aren’t perfect.
Whether you celebrate Christmas, Hanukkah, Kwanzaa or the winter solstice, Canadians are being told to consider meeting virtually, avoid risky indoor gatherings without masks and instead find ways to connect while still physical distancing.
“I think the pitch to people is that yes, we’re used to having time off school and we’re used to seeing everybody,” said McGeer. “But this is the year to delay.”
WATCH | Tam on the holiday season and how the pandemic won’t go on forever
“The best advice this year is maybe not to go too far from home,” said Barrett. “Is it worth it to lose control of the virus?”
“We’re hanging on by a thread here. Please don’t let that thread break.”
To read the entire Second Opinion newsletter every Saturday morning, subscribe by clicking here.
Statement from the Chief Public Health Officer of Canada on January 23, 2021 – Canada NewsWire
OTTAWA, ON, Jan. 23, 2021 /CNW/ – As the resurgence of COVID-19 activity continues in Canada, we are tracking a range of epidemiological indicators to monitor where the disease is most active, where it is spreading and how it is impacting the health of Canadians and public health, laboratory and healthcare capacity. The following is the latest summary on national numbers and trends, and the actions we all need to be taking to maintain COVID-19 at manageable levels across the country.
Since the start of the pandemic, there have been 737,407 cases of COVID-19, including 18,828 deaths reported in Canada; these cumulative numbers tell us about the overall burden of COVID-19 illness to date. Though many areas continue to experience high infection rates, it is important to remember that the vast majority of Canadians remain susceptible to COVID-19. This is why it is important for everyone to continue with individual precautions to protect ourselves, our families and our communities.
At this time, there are 65,750 active cases across the country. The latest national-level data indicate a recent downward trend in daily case counts (past 10 days), with a 7-day average of 6,079 new cases daily (Jan 15-21). While this suggests that community-based measures may be starting to take effect, it is too soon to be sure that current measures are strong enough and broad enough to maintain a steady downward trend. With still elevated daily case counts and high rates of infection across all age groups, the risk remains that this trend could reverse. Likewise, outbreaks continue to occur in high-risk populations and communities, including hospitals and long term care homes, correctional facilities, congregate living settings, Indigenous communities, and more remote areas of the country. These factors underscore the importance of sustaining public health measures and individual practices and not easing restrictions too fast or too soon. This is particularly important in light of the emergence of new virus variants of concern that could rapidly accelerate transmission of COVID-19 in Canada.
As severe outcomes lag behind increased disease activity, we can expect to see ongoing heavy impacts on our healthcare system and health workforce for weeks to come. Provincial and territorial data indicate that an average of 4,651 people with COVID-19 were being treated in Canadian hospitals each day during the most recent 7-day period (Jan 15-21), including 870 of whom were being treated in intensive care units. During the same period (Jan 15-21), there were an average of 149 COVID-19-related deaths reported daily. This situation continues to burden local healthcare resources, particularly in areas where infection rates are highest. These impacts affect everyone, as the healthcare workforce and health system bear a heavy strain, important elective medical procedures are delayed or postponed, adding to pre-existing backlogs.
Stringent and consistent efforts are needed to sustain a downward trend in case counts and strongly suppress COVID-19 activity across Canada. This will not only prevent more tragic outcomes, but will help to ensure that new virus variants of concern do not have the opportunity to spread. Unless we continue the hard work to suppress COVID-19 activity across Canada, there is a risk that more transmissible virus variants could take hold or even replace less transmissible variants, which could result in a significant and difficult to control acceleration of spread. Staying the course will also buy critical time for vaccines to begin working, as we continue to prepare the way for widespread and lasting control of COVID-19 through safe and effective vaccines.
A range of public health measures and restrictions are in place across Canada as we continue our collective effort to interrupt the spread of the virus. Canadians are urged to continue following local public health advice and to consistently maintain individual practices that keep us and our families safer: stay home/self-isolate if you have any symptoms, reduce non-essential activities and outings to a minimum, avoid all non-essential travel, and maintain individual protective practices of physical distancing, hand, cough and surface hygiene and wearing a face mask as appropriate (including in shared indoor spaces with people from outside your immediate household).
Canadians can also go the extra mile by sharing credible information on COVID-19 risks and prevention practices and measures to reduce COVID-19 in communities and by downloading the COVID Alert app to break the cycle of infection and help limit the spread of COVID-19. Read my backgrounder to access more COVID-19 Information and Resources on ways to reduce the risks and protect yourself and others, including information on COVID-19 vaccination.
SOURCE Public Health Agency of Canada
For further information: Media Relations, Public Health Agency of Canada, 613-957-2983, [email protected]
Alberta confirms 643 new cases of COVID-19, 12 new deaths – 660 News
EDMONTON (660 NEWS) – Alberta has confirmed 643 new cases of COVID-19 and 12 additional deaths linked to the virus.
Of the 12 new deaths, five were from the Edmonton Zone, three were from the Calgary Zone, three were from the Central Zone, and one was from the North Zone.
All 12 of the deaths had additional health issues.
There have now been 1,512 deaths linked to the virus in Alberta.
– 643 new cases on 13,019 tests (4.9% +)
– 12 new deaths, now up to 1512
– 691 in hospital (-35), 115 in ICU (-4)
– 9987 active cases
– 97,785 vaccine doses administered#yeG #yyc #ableg pic.twitter.com/2PTYj15tkb
— Courtney Theriault (@cspotweet) January 22, 2021
Currently, there are 9,987 active cases in the province, 691 of which are in hospital and 115 in ICU.
A total of 97,785 doses of the COVID-19 vaccine have been administered.
The province’s positivity rate sits at 4.9 per cent.
Provinces doing 'extraordinary' job to avoid wasting doses of COVID-19 vaccine – CollingwoodToday
OTTAWA — Prime Minister Justin Trudeau tried to calm anxieties over COVID-19 vaccines Friday by reporting that the CEO of Pfizer is promising Canada’s deliveries will be fully restored in three weeks.
Trudeau spoke to Albert Bourla by phone Thursday evening, a week after the company informed Canada its deliveries of COVID-19 vaccines were going to be drastically cut over the next month while the company expands its production facility in Belgium.
“The next few weeks will be challenging when it comes to deliveries,” Trudeau said Friday.
“That said, Dr. Bourla assured me that hundreds of thousands of Pfizer doses will be delivered the week of Feb. 15 and in the weeks to follow.”
Canada is getting only one-third of its promised doses between Jan. 18 and Feb. 7, including none next week. Deliveries the week of Feb. 8 aren’t yet confirmed.
Trudeau said Canada will be caught up to its delivery schedule by the end of March, with all four million promised doses delivered by then.
He said there will be enough delivered from Moderna and Pfizer by September to vaccinate all Canadians who want it.
“We’re working around the clock to get as many vaccines as we can, as fast as we can,” he said. “It’s what I’m thinking about when I wake up, when I go to bed, and every hour in between.”
Gary Kobinger, a vaccine expert and director of the Research Centre on Infectious Diseases at Université Laval in Quebec City, said this week if we can get half the population immunized against COVID-19, it will start to have a real impact on the pandemic, but the magic number to see the spread start to plummet is 70 per cent.
With the two vaccines it has approved, and the delivery schedules promised from Pfizer and Moderna, Canada won’t get enough doses to get to 50 per cent until after Canada Day. Children have also not yet been approved to get any vaccine, with trials on kids as young 12 underway now, and those as young as five expected to start in the spring.
Ashleigh Tuite, an infectious disease epidemiologist at the University of Toronto, said the month-long delay in doses isn’t going to affect herd immunity because Canada wasn’t going to be anywhere near herd immunity by the middle of February even on the original vaccine delivery schedule.
But she said on an individual level, delaying the vaccination of highly vulnerable people can have an impact, particularly at a time when we have record numbers of cases and “raging epidemics” in long-term care homes.
“If you delay the time that it takes for the vaccines to get into those people’s arms, you’re delaying the ability to protect those people from getting infected and from having bad outcomes,” she said. “So it does have an impact.”
While COVID-19 can cause severe illness in anybody, the risks to people over the age of 60 are far greater overall. Health Canada reports that as of mid-January, people over the age of 60 account for about one-fifth of the total cases of COVID-19, but almost three-quarters of all hospitalizations, two-thirds of admissions to intensive care, and 96 per cent of deaths.
In Ontario alone since Jan. 1, 550 long-term care residents and two workers have died of COVID-19. There are 252 ongoing outbreaks in long-term care homes in Ontario, and 164 outbreaks in retirement residences.
Fears about future delivery delays grew Friday, when AstraZeneca warned European nations initial deliveries of its vaccine would be smaller than expected because of production issues.
Johnson & Johnson warned officials in the United States that it was about two months behind schedule producing doses of its vaccine.
Both companies have applied for approval of their vaccines in Canada but are still in the midst of final clinical trials and the reviews are not complete. It’s expected both could be approved for use here by early spring.
Health Canada did say this week that provincial vaccine workers were doing an “extraordinary” job preventing many doses of precious COVID-19 vaccine from going to waste.
Canada has received more than 1.1 million doses of COVID-19 vaccines from Pfizer-BioNTech and Moderna since mid-December, and has now given at least one dose to more than 767,000 people.
A spokeswoman says “wastage has been very minimal” and well below initial estimates.
Before the vaccination campaign began, there were concerns that as many as one-fifth of the doses delivered to Canada could end up being wasted due to intense cold-chain requirements and the complexity of distribution.
The federal department did not provide statistics but said provinces and territories are reporting their experiences and waste has not been a notable problem thus far.
Both vaccines have to be kept frozen, but the Pfizer-BioNTech vaccine is particularly delicate and must be stored at temperatures below -60 C until just before it is used.
This report by The Canadian Press was first published Jan. 22, 2021.
Mia Rabson, The Canadian Press
Statement from the Chief Public Health Officer of Canada on January 23, 2021 – Canada NewsWire
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