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Why Canadian health leaders are downplaying concerns about airborne COVID-19 microdroplets – CTV News

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TORONTO —
Some of Canada’s top provincial doctors are downplaying new concerns from hundreds of scientists that physical distancing and frequent handwashing are not enough to fully protect against airborne transmission of the novel coronavirus.

In an open letter to the World Health Organization (WHO), 239 scientists in 32 countries argued that particles smaller than what has previously been reported can carry SARS-CoV-2, the virus that causes COVID-19, posing more of a danger than public health officials have been warning against.

However, in a news conference on Monday, B.C. provincial health officer Dr. Bonnie Henry said the letter is controversial.

“When you’re in close contact with someone… particularly if you’re indoors where there’s poor ventilation and you’re coughing or sneezing or singing or hugging or dancing, those are the situations where you’re much more likely to transmit this virus, regardless of what size particle that you’re breathing in,” Henry said.

Henry said that microdroplets of airborne viruses such as measles and smallpox can float in the air for hours, move down hallways and even through ventilation systems, but the novel coronavirus appears to spread predominantly through larger droplets, according to Henry. She said that transmission of the virus requires more moisture and closer contact between people.

“We know that there is a gradation of how droplets come out when somebody coughs or sneezes or talks, and it is a smaller ones that can be breathed deep into the lungs, and it’s the larger ones that are often deposited up in the back of the throat or in the upper part of the lungs,” Henry explained.

“But we know that the amount of … moisture the virus needs to stay alive is a bit more for some of these viruses like influenza and COVID,” she added.

Since the start of the pandemic the WHO has maintained that the droplets that carry SARS-CoV-2 are spread through actions including coughing, sneezing and speaking, and recommends that people keep a one-metre distance from others. Many countries, including Canada, have gone farther, recommending a physical distance of two metres.

The WHO said Tuesday that it has been in constant discussions with many of the letter’s signatories since April and is looking into the possible role of airborne transmission of COVID-19.

The organization said it has looked at a number of different ways the virus could be contracted including through inanimate objects, fecal-oral transmission, droplet, aerosol, mother-to-child and animal-to-human to “try to consolidate the growing knowledge around transmission.” It will release a scientific brief in the coming days on its findings.

“This is a respiratory pathogen and so it is important that what we know fits into the guidance that we have, which is why a comprehensive package of interventions are required to be able to stop transmission,” Dr. Maria Van Kerkhove, head of the WHO’s emerging diseases and zoonosis unit, said in a press conference.

Henry said the novel coronavirus is “not transmitted long distances in the air column,” but a previous American study found signs that the smallest microdroplets can travel beyond the two-metre limit.

“Where there’s some challenges is how much of it is due to the small aerosols that are transmitted when I’m close to you, or the larger droplets that tend to followed more readily and how much of it do I breathe deep into my lungs and how much of it is deposited in the upper airways,” Henry said.

The debate over droplets has been playing out since the pandemic began. Toronto infectious disease expert Dr. Isaac Bogoch told CTV News Channel on Monday that “there’s a spectrum between droplet and airborne” viruses.

“It’s a bit of a false dichotomy to say something is one or the other, but [this] infection really falls closer towards the droplet end of the spectrum, and when we use personal protective equipment to protect us against droplets and contact, we’re safe,” Bogoch said.

Bogoch said the open letter regarding airborne transmission of COVID-19 does not provide any new information about the virus.

“We’re just rehashing the same arguments that we’ve heard throughout February, March, April, up until now. I’m not quite sure what the fuss is all about,” he said.

The WHO reinforced that regardless of how the virus is transmitted, physical distancing measures and the use of face coverings have shown to help slow the spread.

DOCTORS SAY CURRENT PRECAUTIONS ARE WORKING

Henry wasn’t the only public health official to downplay the risk of airborne transmission of the virus, even as evidence mounts that it is possible.

In one study cited as an example in the letter, droplets were found to be the most likely source of transmission among three dining parties at a restaurant in China, in a case where surveillance video footage showed neither direct nor indirect contact between the groups.

Quebec’s chief public health officer Dr. Horacio Arruda acknowledged Monday that there is some evidence the coronavirus may be airborne, but insisted that is not the principal transmission vector.

“Most of the transmission — if not more than 95 per cent — is going to be done by droplets because that’s what the epidemiology told us. It doesn’t mean that in certain situations there is no aerosols… So I would say that there is a debate on this,” Arruda said during a news conference. “[But] I think that the issue is around droplets, not aerosols.”

While there remain various unknowns about COVID-19, Ontario Minister of Health Christine Elliott said she is “satisfied” with current evidence that the virus is not spread when physical distancing is maintained.

“In terms of people respecting social distancing, being out on patios right now, the public health is satisfied that that’s not going to transmit COVID. But we have to be concerned about indoor establishments,” Elliott said on Monday.

Elliot said Ontario is focused on contract tracing as it continues to reopen its economy and said the province’s declining case numbers show that current public health measures are working.

However, she said the province will evaluate its protections as more medical information regarding COVID-19 is confirmed, adding that airborne transmission of the virus “definitely will be borne in mind.”

Henry said B.C.’s approach to COVID-19 involves several different measures of protection that prevent transmission of both small and large droplets. She said that this includes various types of personal protective equipment for health-care workers, physical distancing and non-medical face mask for the public.

“In a number of the food production places where we had outbreaks early on, once we put in place measures like plexi-glass barriers, like wearing medical masks or non-medical masks, even ensuring we have safe distances between people, we stopped the transmission of this virus,” Henry said.

However, Henry said the province will continue looking at its transmission data and may enforce additional measures if cases begin to spike.

“The best way to protect people is making sure that sick people stay away from others, making sure that we are keeping our safe physical distancing [and] putting in place the administrative things to reduce the number of people in that environment,” Henry said.

In Bogoch’s view, Canada has proven that the current precautions and restrictions have slowed the spread of the virus.

“We’re using personal protective equipment to protect us from droplets and contact transmission of this virus… and when we use droplet precautions — the right mask, the right gloves, right down the right eye protection — we were using it properly and we’re not getting this infection,” Bogoch explained.

While some provinces may take further safety precautions, Bogoch said there is currently no risk that the virus will be contracted through airborne transmission.

“If someone had COVID-19, they were in a room, then they left the room and if someone just went into that room an hour later and they just stood there, they’re not going to get COVID-19,” Bogoch said.

With files from CTVNews.ca’s Ryan Flanagan

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COVID-19 task force worries Trump’s rush to approve vaccine will spook Canadians

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Members of the federal government’s COVID-19 vaccine task force are casting worried eyes at the Trump administration’s political push to get a vaccine approved before the U.S. presidential election in November.

Dr. Joanne Langley, the task force co-chair, and member Alan Bernstein say they are concerned about “vaccine hesitancy” in Canada, the phenomenon where people have doubts about taking a readily available vaccine because of concerns about its safety.

Langley says that when a vaccine against COVID-19 is eventually found, governments and health-care professionals will have to mount a vigorous information campaign to counter opposition.

And it won’t help that President Donald Trump has said a pandemic-ending vaccine could be rolled out as soon as October, stoking concern that he is rushing the timeline to further his re-election chances on Nov. 3.

Countering concerns that an apparent hurry to approve a vaccine could spook people out of getting it is an ongoing concern among the approximately one dozen health experts on the government’s vaccine advisory panel.

It’s tasked with recommending which vaccine candidates the government should be spending money on.

This past week, Trump chided the director of the Centers for Disease Control and Prevention for being “confused” when he testified at a Senate committee that a safe and effective vaccine wouldn’t be ready by U.S. election day.

“As a scientist, and as a citizen, that’s concerning to me because the regulator is designed to be independent of any political influence,” Langley said in an interview. She is an expert in pediatric infectious disease at the Canadian Centre for Vaccinology at Dalhousie University.

“All the decisions are made based on the evidence of science, which includes the immune response, how well it protects, all of the adverse events,” she added. “And really, politicians have nothing to do with that.”

Bernstein said if politicians successfully pushed health regulators to approve a vaccine prematurely, that would violate public trust and discourage the widespread vaccine use needed to end the pandemic.

“I think it would be a big mistake. So I don’t see it happening before Nov. 3, no,” Bernstein said in an interview. Bernstein is the head of CIFAR, a Canadian-based global research organization.

“What a disaster it would be if we actually got a great vaccine, but in the U.S., the population didn’t trust it, because they felt that the decision was being compromised.”

In Canada, the federal government has made advance purchase deals with a handful of international biotech companies for tens of millions of vaccine doses if they are found to be safe and effective.

Canadian politicians and public health officials have said that widespread use of a vaccine is key to stamping out the novel coronavirus.

Bernstein said the government’s purchasing decisions have been based on recommendations born out of the painstaking research that his advisory group has undertaken. The task force reports to Health Minister Patty Hajdu and Innovation Minister Navdeep Bains.

“They’ve been very conscientious in terms of listening to us, visiting with us, talking with us. Both ministers,” said Bernstein, who was the first president of the Canadian Institutes of Health Research. He serves on medical advisory boards in the U.S., Britain and Australia, and with the Bill and Melinda Gates Foundation.

“Science is driving the decisions.”

Langley said there is an onus on governments and health professionals to communicate to Canadians the merits of taking a safe vaccine when a viable candidate is found and approved for use.

“We want to make sure that the Canadian public has a chance to learn about the very high standards that will have to be met for these vaccines,” she said, “and that they feel confident that people have chosen these vaccines with a view to their best interest.”

Bernstein said Canadians have a high level of trust in the institutions and political leaders.

“I’m not a Liberal or Conservative. I’m not commenting on Prime Minister Trudeau, but just in general, Canadians are pretty trusting, and that trust has been earned.”

Langley and her co-chair Mark Lievonen spent half a day briefing the Liberal cabinet during its two-day retreat in Ottawa this past week.

“It was all about the health consequences for Canadians of COVID and what we know so far, and what we might further be able to do and what the future is going to look like,” said Langley.

The vaccine task force was formally announced by the government in early August but it has been working since June. Over the summer it met in six-hour Zoom sessions at least twice a week, “interviewing various companies, various scientists, comparing notes with other national task forces to hear what they’re up to,” said Bernstein.

He and Langley are hopeful at least one viable vaccine candidate will emerge before the end of December from the several ongoing human trials.

They both say it could take several months after that before Health Canada gives the necessary final approval.

“We have to educate the public,” said Langley.

“It will be absolutely our responsibility to make sure that the public is informed so that they’re confident and can get those vaccines for themselves and their families knowing that the regular high standards that we have in Canada for vaccines are all met.”

Source:- PrinceGeorgeMatters.com

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COVID-19 case identified at Winnipeg daycare – CBC.ca

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Public health officials are warning that a confirmed case of COVID-19 is connected to the Munroe Early Childhood Education Centre in Winnipeg’s Elmwood neighbourhood.

A person who tested positive for the novel coronavirus was in the Chalmers Avenue daycare on Monday in the morning and afternoon, according to a letter sent to parents from the Winnipeg Regional Health Authority on Saturday.

“Be assured that public health investigations begin within 24 hours of a confirmed laboratory test to identify individuals who may have been exposed,” the letter said.

The centre immediately closed off areas that may have been used by the infected person after it was informed of the positive test result. Those areas won’t be used until they have been thoroughly cleaned.

All close contacts in the same room as the person who tested positive are being told to self-isolate for 14 days, but public health officials will contact those people directly.

Officials aren’t providing the name or any identifying information about the person who tested positive.

Parents are asked to monitor their kids for COVID-19 symptoms and isolate them at any sign of illness; those who show symptoms should be tested for the coronavirus.

The centre will remain open to all other children and staff.

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Health unit prepares for possible ‘twindemic’

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Symptoms of influenza and COVID-19 share a number of similarities

North Bay Parry Sound District Health Unit
Nugget File Photo


When it comes to a possible “twindemic” – the arrival of flu season in the midst of the COVID-19 pandemic – “all you can do is expect the worst, plan for the worst, and hope for the best.”

Dr. Jim Chirico, medical officer of health with the North Bay Parry Sound District Health Unit, says there are “so many unknowns” about what this year’s flu season will look like.

The flu season in the southern hemisphere, which can provide indications of what will happen in the northern hemisphere, was very mild this year, but Canadians can’t take that as a true indicator of what will happen here.

“Was it mild because of the COVID-19 measures that were in place?” Chirico asks. “We don’t know. We don’t know how severe it might be.”

The flu normally starts to be felt in this region in the late fall, running until January. Canada has been weathering the COVID-19 pandemic since March, and there are no signs it will let up anytime soon. In fact, the number of cases across the country have been climbing over the past week.

Testing impact

Having two pandemics at the same time, Chirico says, can put more pressure on the health system as symptoms of influenza and COVID-19 share a number of similarities. That means the number of people seeking testing for COVID-19 could increase as the seasonal flu takes hold.

The flu, he says, affects children more, it appears, than COVID-19 does, but elderly residents are particularly susceptible to both.

Chirico advocates everyone possible get the flu vaccine when it arrives in the region. It helps reduce the possibility of contracting the flu and may reduce the severity of influenza, although it does not offer 100 per cent protection from contracting it.

“It protects not only you but those around you,” Chirico says. If we can reduce the number of flu cases, it will reduce the pressure on the health-care system.”

The health unit, he says, is working with primary health-care providers and pharmacies to make sure as many people who want the flu vaccine can get it. The health unit will be providing vaccination clinics, while the vaccine will also be available at doctors offices and at pharmacies.

‘Experience’

Chirico notes that when the H1N1 flu was prevalent some years ago, the health unit was able to conduct “mass immunization clinics.

“So we have that experience” to fall back on and to prepare for the eventuality that it might be necessary again, he says.

“We do have plans in place to do that.”


Dr. Jim Chirico

He also believes that the measures put in place to protect against COVID-19 can help prevent a serious flu season.

“I really do believe those efforts will pay off. The same recommendations for COVID-19 will prevent the flu, as well.”

Those measures include wearing face masks, social distancing, regular washing or sanitizing of hands with soap and water or an alcohol-based rub, sneezing or coughing into your arm, not touching your eyes, nose or mouth, staying home if you feel unwell and, if you develop a fever, cough and difficulty breathing to seek medical attention.

‘Done very well’

“People have been very mindful” of following those measures, he says, and the North Bay-Parry Sound area has “done very, very well.

“I do believe all the efforts to reduce the impact of COVID will do as well with the flu because they are transmitted in the same way,” he says.

The region has reported a total of 39 positive COVID-19 cases since the middle of March. Thirty-seven of those cases have been resolved and one person is in self-isolation. One person has died of COVID-19 in the region.

Chirico also notes that there was “a very reduced number of cases” of influenza last year, compared to the previous four or five years.

The area has reported between 126 and 298 cases annually with “very little mortality” over those years, he says, although the number of total cases “is obviously likely more” because most people who get the flu don’t go for treatment.

According to JAMA, the Journal of the American Medical Association, both influenza and COVID-19 can present with fever, chills, headache, cough, fatigue and myalgias – muscle aches and pain, which can involve ligaments, tendons and fascia, the soft tissues that connect muscles, bones and organs.

Influenza differs in that it also generally features nasal congestion and sore throat, while COVID-19 can include shortness of breath and loss of the senses of taste and smell.

Assessment centres

There are five COVID-19 assessment centres in the region. Appointments must be booked in advance.

The centres are located at:

• Hopital de Mattawa Hospital. Book an appointment by calling 705-744-5511 ext. 0

• North Bay Regional Health Centre. Book an appointment by calling 705-474-8600 ext 4110

• West Nipissing COVID-19 Assessment Centre, 219 O’Hara St., Sturgeon Falls. Book an appointment by calling 705-580-2186

• 75 Ann Street, Bracebridge. Book an appointment by calling 1-888-383-7009

• West Parry Sound COVID-19 Assessment Centre at 70 Joseph St., Parry Sound, Unit 105-106. Book an appointment by calling 705-746-4540 ext 5030

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