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Why a second wave of COVID-19 is more dangerous than it looks – CBC.ca

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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.


At first glance, Canada’s second wave of COVID-19 is looking a lot different than the first wave. 

Testing capacity has drastically improved, barriers to getting tested have been lowered, stocks of personal protective equipment have grown, and while we still don’t have a safe and effective vaccine — we know a lot more about COVID-19 and how to treat it

And despite a rapid rise in new cases across the country, hospitalizations and deaths are comparatively lower so far, which might lead you to believe the second wave will be less dangerous than the first.

“It may seem somewhat comforting to say, ‘Yes, there are a lot of cases, but we’re not seeing our hospitals overwhelmed, and we’re not seeing a huge number of deaths so far. So things are better, right?'” said Dr. Samir Sinha, director of geriatrics at Sinai Health and University Health Network in Toronto.

“The truth of the matter is, we’re just getting started.”

Sinha said COVID-19 outbreaks typically followed a predictable pattern: people increase their number of contacts amid relaxed restrictions, then weeks later cases rise, hospitalizations spike and more deaths occur. 

Dr. Samir Sinha says the rising case numbers across Canada are lagging indicators that will likely lead to increases in hospitalizations and deaths — suggesting older Canadians may be next to feel the brunt of the pandemic. (Evan Mitsui/CBC)

“We need to modify our behaviour and do everything we can to try and wrestle it down as soon as possible,” he said. 

“If we don’t, we’re going to be thinking back a month from now saying, ‘What were we doing, and why did we even allow it to get this bad?'”

Some provinces could face worse second wave

In Canada’s hardest-hit provinces, cracks are already beginning to show.

“The second wave isn’t just starting. It’s already underway,” Prime Minister Justin Trudeau said last week. “The numbers are clear.”

Ontario public health officials are projecting up to 1,000 new cases per day this month, and the number of patients in the province’s hospitals with confirmed cases of COVID-19 doubled in just one week.

Testing backlogs in Ontario also reached a record high of more than 90,000 this week, and the province’s associate chief medical officer of health, Dr. Barbara Yaffe, said the number of contacts per COVID-19 case is “much higher” than in the first wave. 

“We did lose focus over the summer, and we didn’t quite do enough to prevent a second wave,” said Dr. Irfan Dhalla, vice-president of physician quality at Unity Health, which includes St. Michael’s and St. Joseph’s hospitals in Toronto.  

“Everybody who works in health care is extremely worried, and now we need to think about what do we do to stop the second wave, and what do we do to prevent the third wave?” 

WATCH | Premier Ford introduces more restrictions in Ontario:

Though focused primarily on Ottawa, Toronto and Peel Region, Ontario Premier Doug Ford unveiled new public health measures for the province to stop the spread of the coronavirus. 3:57

Ontario introduced stricter public health measures on Friday, including pausing social circles and mandating mask-wearing provincewide where physical distancing isn’t possible, while targeting current hot spots like Toronto, Ottawa and Peel Region as the province reported a record-high 732 daily cases of coronavirus.

Quebec recorded more than 800 new daily cases three times this week, its highest daily increase since May, including 933 on Thursday and 1,052 on Friday. 

The seven-day rolling average of cases in the province also increased 68 per cent with 16 more deaths reported Thursday, and there are already more than 5,000 health-care workers in the Montreal hospital network on leave. 

Quebec also unveiled new legal tools for police to enforce stricter public health measures taking effect in the province’s designated red zones.

“Lives are at stake. We want to keep our children in schools,” Quebec Premier François Legault said Wednesday. “We also want to protect our health network.”

WATCH | Quebec’s red zones shut down for 28 days to slow COVID-19 spread:

Red zone restrictions are in effect in three Quebec areas, including Montreal and Quebec City, meaning bars are closed and restaurants no longer have indoor dining for the next 28 days as the province tries to manage a spike of COVID-19 cases. 2:01

British Columbia reported 14 outbreaks in long-term care or assisted-living facilities and three in acute-care facilities but has so far managed to avoid outbreaks in schools and has kept its daily average of cases trending downward for now.  

Alberta announced a total of 67 cases tied to outbreaks at Calgary’s Foothills hospital — the second largest outbreak at a health-care institution in the province since the pandemic began.

Sinha said the rising case numbers across the country are lagging indicators that will likely lead to increases in hospitalizations and deaths — suggesting older Canadians may be next to feel the brunt of the pandemic.

“It’s only a matter of time before we start seeing older members of our society start catching this and then the consequences, unfortunately, become quite apparent,” he said. 

“Now if we’re looking at a second wave that’s going to be bigger than the last wave, we know that this is going to result in likely thousands of older people dying.” 

Lessons from the first wave

Let’s look at what we learned in the first wave of the pandemic in Canada. 

Older Canadians who are at higher risk of serious outcomes of COVID-19 paid a terrible cost, with those over 70 accounting for almost 90 per cent of all deaths in Canada. 

Coronavirus outbreaks hit the poorest and most diverse neighbourhoods of our major cities incredibly hard, while Black Canadians were more likely than others to be infected or hospitalized by the disease. 

We’ve also learned that physical distancing, wearing a mask and limiting your close contact with others — especially in confined settings with low ventilation — drastically reduce your risk of catching it. 

Asymptomatic transmission was also identified as a real and tangible threat, and superspreading events have also been recorded, most recently in the largest contact tracing study to date from India this week. 

But the virus also hasn’t significantly mutated to become any less infectious or less deadly. 

WATCH | Re-examining the role of COVID-19 superspreaders:

More research into how COVID-19 is spread shows that because not everyone sheds the same amount of virus, many infections are spread by a few people known as superspreaders. 2:01

“This is still a virus that hospitalizes people, and it still kills people, and it is still challenging to treat, and it is still disrupting the entire world,” said Dr. Amesh Adalja, an infectious disease physician and a senior scholar at the Johns Hopkins Center for Health Security. 

“The virus hasn’t changed. It’s still the same biologically. It’s just that now we have much more in our tool belt.”  

Adalja said despite the fact that health-care workers are getting more adept at treating it and there’s a better survival rate for those who are hospitalized, we still need to take the second wave seriously. 

Testing backlogs in Ontario reached a record high of more than 90,000 this week, and the province’s associate chief medical officer of health, Dr. Barbara Yaffe, said the number of contacts per COVID-19 case is ‘much higher’ than in the first wave. (Evan Mitsui/CBC)

“We still need more tools. We still don’t have a tool that can prevent somebody who’s infected from needing hospitalization,” he said. 

“Absent that, I think we still have to really be aggressive with controlling community spread.”

What can we do to slow the second wave? 

Steven Hoffman, director of the Global Strategy Lab and a global health law professor at York University in Toronto who studies pandemics, said it’s important to remember the second wave of COVID-19 is no less of a threat than the first. 

“It’s everyone’s hope that we’ll be better prepared to deal with the second wave because we’ve learned so much from the first wave,” he said. 

“But this virus remains as dangerous as it was before, and I’m actually even more worried for the second wave.” 

Hoffman said he became concerned early in the summer when hard-hit provinces began lifting restrictions because not enough was being done to prepare Canadians for the possibility that lockdowns could be reimposed. 

“No one was told from our political leaders that we’re now able to temporarily lift these measures until a time when they’ll likely be needed,” he said. “That’s just not the way to prepare people.”

Adalja said the threshold for re-entering lockdowns in the second wave needs to be “data-driven” and targeted toward activities that are proven to lead to spread in specific regions. 

Steven Hoffman says one of his biggest concerns is whether Canadians will be resistant to the idea of re-entering lockdown, if it’s deemed necessary. (Nathan Denette/The Canadian Press)

The ‘big worry’

“You should only use a lockdown when you have fouled up your response so bad that that’s all you have left to do,” he said. 

“You don’t want people to behave as if we’re not in a pandemic on the one hand, and on the other hand the alternative isn’t just to completely shut the whole country down again.”

Hoffman said one of his biggest concerns is whether Canadians will be resistant to the idea of re-entering lockdown, if it’s deemed necessary. 

“We know that people are exhausted from containment measures, and my big worry going into a second wave is that people won’t be willing to follow public health directives, which we all really need to do,” he said. 

“That’s when this pandemic would become much worse than it is and potentially worse than the first wave.” 


To read the entire Second Opinion newsletter every Saturday morning, subscribe by clicking here.

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Virginia Democrats advance efforts to protect abortion, voting rights, marriage equality

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RICHMOND, Va. (AP) — Democrats who control both chambers of the Virginia legislature are hoping to make good on promises made on the campaign trail, including becoming the first Southern state to expand constitutional protections for abortion access.

The House Privileges and Elections Committee advanced three proposed constitutional amendments Wednesday, including a measure to protect reproductive rights. Its members also discussed measures to repeal a now-defunct state constitutional ban on same-sex marriage and ways to revise Virginia’s process to restore voting rights for people who served time for felony crimes.

“This meeting was an important next step considering the moment in history we find ourselves in,” Democratic Del. Cia Price, the committee chair, said during a news conference. “We have urgent threats to our freedoms that could impact constituents in all of the districts we serve.”

The at-times raucous meeting will pave the way for the House and Senate to take up the resolutions early next year after lawmakers tabled the measures last January. Democrats previously said the move was standard practice, given that amendments are typically introduced in odd-numbered years. But Republican Minority Leader Todd Gilbert said Wednesday the committee should not have delved into the amendments before next year’s legislative session. He said the resolutions, particularly the abortion amendment, need further vetting.

“No one who is still serving remembers it being done in this way ever,” Gilbert said after the meeting. “Certainly not for something this important. This is as big and weighty an issue as it gets.”

The Democrats’ legislative lineup comes after Republican Governor Glenn Youngkin, to the dismay of voting-rights advocates, rolled back a process to restore people’s civil rights after they completed sentences for felonies. Virginia is the only state that permanently bans anyone convicted of a felony from voting unless a governor restores their rights.

“This amendment creates a process that is bounded by transparent rules and criteria that will apply to everybody — it’s not left to the discretion of a single individual,” Del. Elizabeth Bennett-Parker, the patron of the voting rights resolution, which passed along party lines, said at the news conference.

Though Democrats have sparred with the governor over their legislative agenda, constitutional amendments put forth by lawmakers do not require his signature, allowing the Democrat-led House and Senate to bypass Youngkin’s blessing.

Instead, the General Assembly must pass proposed amendments twice in at least two years, with a legislative election sandwiched between each statehouse session. After that, the public can vote by referendum on the issues. The cumbersome process will likely hinge upon the success of all three amendments on Democrats’ ability to preserve their edge in the House and Senate, where they hold razor-thin majorities.

It’s not the first time lawmakers have attempted to champion the three amendments. Republicans in a House subcommittee killed a constitutional amendment to restore voting rights in 2022, a year after the measure passed in a Democrat-led House. The same subcommittee also struck down legislation supporting a constitutional amendment to repeal an amendment from 2006 banning marriage equality.

On Wednesday, a bipartisan group of lawmakers voted 16-5 in favor of legislation protecting same-sex marriage, with four Republicans supporting the resolution.

“To say the least, voters enacted this (amendment) in 2006, and we have had 100,000 voters a year become of voting age since then,” said Del. Mark Sickles, who sponsored the amendment as one of the first openly gay men serving in the General Assembly. “Many people have changed their opinions of this as the years have passed.”

A constitutional amendment protecting abortion previously passed the Senate in 2023 but died in a Republican-led House. On Wednesday, the amendment passed on party lines.

If successful, the resolution proposed by House Majority Leader Charniele Herring would be part of a growing trend of reproductive rights-related ballot questions given to voters. Since 2022, 18 questions have gone before voters across the U.S., and they have sided with abortion rights advocates 14 times.

The voters have approved constitutional amendments ensuring the right to abortion until fetal viability in nine states: Arizona, California, Colorado, Maryland, Michigan, Missouri, Montana, Ohio and Vermont. Voters also passed a right-to-abortion measure in Nevada in 2024, but it must be passed again in 2026 to be added to the state constitution.

As lawmakers debated the measure, roughly 18 members spoke. Mercedes Perkins, at 38 weeks pregnant, described the importance of women making decisions about their own bodies. Rhea Simon, another Virginia resident, anecdotally described how reproductive health care shaped her life.

Then all at once, more than 50 people lined up to speak against the abortion amendment.

“Let’s do the compassionate thing and care for mothers and all unborn children,” resident Sheila Furey said.

The audience gave a collective “Amen,” followed by a round of applause.

___

Associated Press writer Geoff Mulvihill in Cherry Hill, New Jersey, contributed to this report.

___

Olivia Diaz is a corps member for The Associated Press/Report for America Statehouse News Initiative.

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Vancouver Canucks winger Joshua set for season debut after cancer treatment

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Vancouver Canucks winger Dakota Joshua is set to make his season debut Thursday after missing time for cancer treatment.

Head coach Rick Tocchet says Joshua will slot into the lineup Thursday when Vancouver (8-3-3) hosts the New York Islanders.

The 28-year-old from Dearborn, Mich., was diagnosed with testicular cancer this summer and underwent surgery in early September.

He spoke earlier this month about his recovery, saying it had been “very hard to go through” and that he was thankful for support from his friends, family, teammates and fans.

“That was a scary time but I am very thankful and just happy to be in this position still and be able to go out there and play,,” Joshua said following Thursday’s morning skate.

The cancer diagnosis followed a career season where Joshua contributed 18 goals and 14 assists across 63 regular-season games, then added four goals and four assists in the playoffs.

Now, he’s ready to focus on contributing again.

“I expect to be good, I don’t expect a grace period. I’ve been putting the work in so I expect to come out there and make an impact as soon as possible,” he said.

“I don’t know if it’s going to be perfect right from the get-go, but it’s about putting your best foot forward and working your way to a point of perfection.”

The six-foot-three, 206-pound Joshua signed a four-year, US$13-million contract extension at the end of June.

This report by The Canadian Press was first published Nov. 14, 2024.

The Canadian Press. All rights reserved.

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Trump chooses anti-vaccine activist Robert F. Kennedy Jr. as health secretary

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NEW YORK (AP) — President-elect Donald Trump says he will nominate anti-vaccine activist Robert F. Kennedy Jr. to lead the Department of Health and Human Services, putting him in charge of a massive agency that oversees everything from drug, vaccine and food safety to medical research and the social safety net programs Medicare and Medicaid.

“For too long, Americans have been crushed by the industrial food complex and drug companies who have engaged in deception, misinformation, and disinformation when it comes to Public Health,” Trump said in a post on his Truth Social site announcing the appointment. Kennedy, he said, would “Make America Great and Healthy Again!”

Kennedy, a former Democrat who ran as an independent in this year’s presidential race, abandoned his bid after striking a deal to give Trump his endorsement with a promise to have a role in health policy in the administration.

He and Trump have since become good friends, with Kennedy frequently receiving loud applause at Trump’s rallies.

The expected appointment was first reported by Politico Thursday.

A longtime vaccine skeptic, Kennedy is an attorney who has built a loyal following over several decades of people who admire his lawsuits against major pesticide and pharmaceutical companies. He has pushed for tighter regulations around the ingredients in foods.

With the Trump campaign, he worked to shore up support among young mothers in particular, with his message of making food healthier in the U.S., promising to model regulations imposed in Europe. In a nod to Trump’s original campaign slogan, he named the effort “Make America Healthy Again.”

It remains unclear how that will square with Trump’s history of deregulation of big industries, including food. Trump pushed for fewer inspections of the meat industry, for example.

Kennedy’s stance on vaccines has also made him a controversial figure among Democrats and some Republicans, raising question about his ability to get confirmed, even in a GOP-controlled Senate. Kennedy has espoused misinformation around the safety of vaccines, including pushing a totally discredited theory that childhood vaccines cause autism.

He also has said he would recommend removing fluoride from drinking water. The addition of the material has been cited as leading to improved dental health.

HHS has more than 80,000 employees across the country. It houses the Food and Drug Administration, the Centers for Disease Control and Prevention, the Medicare and Medicaid programs and the National Institutes of Health.

Kennedy’s anti-vaccine nonprofit group, Children’s Health Defense, currently has a lawsuit pending against a number of news organizations, among them The Associated Press, accusing them of violating antitrust laws by taking action to identify misinformation, including about COVID-19 and COVID-19 vaccines. Kennedy took leave from the group when he announced his run for president but is listed as one of its attorneys in the lawsuit.

__ Seitz reported from Washington.

The Canadian Press. All rights reserved.

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