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WHO backtracks on claim that asymptomatic spread of COVID-19 is 'very rare' – CBC.ca

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A top official with the World Health Organization has walked back statements that the spread of COVID-19 from people who do not show symptoms is “very rare,” amid backlash from experts who have questioned the claim due to a lack of data. 

Maria van Kerkhove, an infectious disease epidemiologist and the COVID-19 technical lead for the WHO, said Monday that the available data from published research and member countries had shown asymptomatic cases were not a significant driver for the spread of the virus. 

“From the data we have, it still seems to be rare that an asymptomatic person actually transmits onward to a secondary individual,” she said at a media briefing in Geneva on Monday. “It’s very rare.”

On Tuesday, Van Kerkhove aimed to clear up “misunderstandings” about those statements in an updated briefing, stressing that she was referring to “very few studies” that tried to follow asymptomatic carriers of the virus over time to see how many additional people were infected. 

“I was responding to a question at the press conference, I wasn’t stating a policy of WHO,” she said. “I was just trying to articulate what we know.” 

Van Kerkhove said she didn’t intend to imply that asymptomatic transmission of the virus globally was “very rare,” but rather that the available data based on modelling studies and member countries had not been able to provide a clear enough picture on the amount of asymptomatic transmission.

“That’s a big, open question,” she said. “But we do know that some people who are asymptomatic, some people who don’t have symptoms, can transmit the virus on.”

WHO did ‘questionable job’ of communicating

Dr. Isaac Bogoch, an infectious disease physician at Toronto General Hospital, said there has been confusion over the evolving science on the amount of asymptomatic transmission since the start of the pandemic.

“At a fundamental level it’s extremely important to explain the science well and explain what our current knowledge is and also explain what the unknown questions are,” he said.

“I don’t think the WHO did a very good job of that yesterday and they did a questionable job of that today when they were trying to clarify their comments.” 

Bogoch said there is a key discrepancy between people who do not have symptoms, those who have not yet shown symptoms and those who only have mild symptoms, which can make studying the true amount of asymptomatic carriers of COVID-19 extremely challenging. 

“We still don’t understand the role of people who have no symptoms the entire time [they’re infected] versus people that have very, very mild symptoms that are misclassified as having no symptoms, versus people that have no symptoms for the first few days and then go on to develop them,” he said. 

“So, when we heard the WHO say that people without symptoms rarely transmit this infection, an eyebrow went up, because we certainly know that there are different types of people without symptoms and it’s a little more complicated than what they had reported.”

Some experts say it is not uncommon for infected people to show no symptoms, but data is sparse on how likely such people are to transmit the disease. (Evan Mitsui/CBC)

Timothy Caulfield, a Canada Research Chair in health law and policy at the University of Alberta who studies health misinformation, said it was notable how quickly van Kerkhove’s statement was criticized and shows how desperate people are for clear information on asymptomatic carriers of COVID-19. 

“It demonstrates how incredibly important it is to take great care in how you’re communicating science that is hyper-relevant to the public right now,” Caulfield said, adding we still don’t have a clear picture from the research community on how much asymptomatic spread is actually occurring. “The science is very uncertain and it’s evolving rapidly.”

He said van Kerkhove didn’t appear to have the intention of making a definitive statement on behalf of the WHO in her comments on Monday, and instead was speculating about her interpretation of the emerging research on the topic. 

“This is exactly the World Health Organization’s job, right? This is why they exist: to lead the world in these moments,” he said. “So when it’s less than ideal, it’s not surprising that people are critical. We need [WHO] to be a trusted voice.” 

Data on asymptomatic spread ‘flawed’

Some experts say it is not uncommon for infected people to show no symptoms.

A non-peer-reviewed study from Germany in May based on 919 people in the district of Heinsberg — which had among the highest death tolls from COVID-19 in Germany — found that about one in five of those infected were symptomless.

But data is sparse on how likely such people are to transmit the disease.

The co-head of Singapore’s coronavirus task force told Reuters on Monday there had been asymptomatic transmission cases there, between people living in close quarters.

China said last week that 300 symptomless COVID-19 carriers in the central city of Wuhan, the pandemic’s epicentre, had not been found to be infectious.

Dr. Lynora Saxinger, an infectious disease physician at the University of Alberta who has been reviewing the available literature on the topic, said studying asymptomatic transmission is extremely difficult. 

WATCH | How many asymptomatic people could there be?

Doctors answer your questions about the coronavirus, including if there’s any way of knowing how many asymptomatic people could be walking around when only symptomatic people are being tested.  4:20

Van Kerkhove was referencing modelling data that estimated anywhere between six per cent and 41 per cent of the population may be infected but not have symptoms.

Saxinger said that modelling data is “flawed” because it makes assumptions about how many people are asymptomatic and then runs a simulation on how many people could then transmit it.

“There’s a big question mark at the actual data in real-world observations with asymptomatic [carriers],” Saxinger said.

“Asymptomatic spread is a dumpster fire in terms of data.”

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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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