The World Health Organization (WHO) is opposing the use of “immunity passports” to allow people to leave self-isolation with a clean bill of health, noting it’s unclear how long immunity lasts after a patient recovers from COVID-19 — a view Canada’s chief public health officer shares.
As countries around the world cautiously emerge from pandemic lockdowns, some have considered the use of so-called immunity passports as a way to identify citizens who have tested positive for COVID-19 antibodies.
Those who test positive would be allowed to return to work, shop, travel and circulate freely in public, while the non-immune remain in isolation.
But the WHO cautions that most of the studies regarding COVID-19 antibodies have been inclusive and relying on antibodies as a way to reduce infections may have the opposite effect.
“At this point in the pandemic, there is not enough evidence about the effectiveness of antibody-mediated immunity to guarantee the accuracy of an ‘immunity passport’ or ‘risk-free certificate,’” read a scientific briefing posted to the WHO website Friday.
“People who assume that they are immune to a second infection because they have received a positive test result may ignore public health advice. The use of such certificates may therefore increase the risks of continued transmission.”
Most studies show that people who have recovered from the novel coronavirus have antibodies to the virus. But the WHO said it’s unclear how long the protection from those antibodies lasts, making the efficacy of immunity passports unclear.
Earlier in the day the WHO said there was “no evidence” that patients who have recovered from COVID-19 are protected from a second infection. However, the health organization clarified Saturday evening that most people who recover from COVID-19 have some level of protection, but scientists have yet to determine how long that protection lasts.
CANADA NOT EYEING IMMUNITY PASSPORTS
During his daily press briefing Saturday, Prime Minister Justin Trudeau said neither the federal nor provincial governments are basing plans to reduce lockdown restrictions on the possibility that people can develop an immunity to COVID-19.
“There is still an awful lot of science being done on the idea of immunity on protections, which is why we’ve invested significant amounts of money in a new Canada immunity taskforce that will be examining these issues,” he said.
“But it’s very clear that the science is not decided on whether or not having COVID once prevents you from getting it again… it is something that we need to get clearer answers to and until we have those clear answers, we have to err on the side of more caution.”
Chief Public Health Officer Dr. Theresa Tam said the immunity task force will play an important role in understanding how antibodies affect immunity, noting that there is still much to be learned about the novel coronavirus.
“We actually don’t understand the immunology of this virus very much,” Tam said Saturday during a press briefing.
“We don’t know when the peak of the antibody response might be reached, we definitely don’t know how long the antibody response might last for and what it means if someone gets infected.”
Germany, Italy and the U.K. have all floated the idea of using immunity passports in the next phase of their coronavirus response. Meanwhile, officials in New York state have already begun antibody testing, an effort Gov. Andrew Cuomo says could potentially help set policy on when to reopen parts of the state.
Despite questions surrounding immunity, Chilean government officials say they are moving with plans to offer the world’s first immunity passports to citizens. The country says 4,600 people have recovered from the virus and will now be eligible to receive a physical or digital card exempting them from quarantine rules.
While traditional COVID-19 testing strategies typically involve a nasal swab to detect a current infection, blood tests looking for antibodies are being developed rapidly all over the world, including in Canada.
Markham, Ont.-based biotechnology firm BTNX, for example, says it has developed a blood-based antibody test that looks similar to a pregnancy test and can deliver results in as little as 15 minutes.
The company previously told CTV News that Health Canada says the tests could not be sold in Canada until a “national strategy” on antibody testing is developed.
Health Canada did not respond to a request for comment from CTV News by the time of publication.
Tam noted Saturday that the reliability of these antibody tests has been varied because each test performs differently.
“Our national biology lab, having evaluated a range of tests, shows that a lot of them are not sensitive or specific enough,” she explained.
“Which means we could, in fact, get false positive where someone thinks they antibodies and they don’t.”
CTV News’ infectious disease specialist Dr. Abdu Sharkawy said the WHO is right to take a precautionary approach to the idea of immunity passports, highlighting previous evidence of the risk of re-infection.
“The concept that people could become re-infected after having recovered from COVID-19 is something we determined very early on in this pandemic,” he told CTV News Channel Saturday.
“We saw many case reports of this happening in Wuhan and Hubei province in China. The good thing is, that appears to be a relatively small number of people.”
Sharkawy notes that the medical community needs more time to confidently determine what level of antibodies need to be present in the blood stream to confer true protection before physical distancing measures can be relaxed.
“We can’t make recommendations that are going to be addressed to a whole society without knowing these tests are valid and without knowing what that true level of immune protection is needed,” he said.
“I think we will get there, but I think we need a little more patience and time.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
