News

Why COVID-19 testing varies so much across Canada – CBC.ca

Published

5 years ago

April 4, 2020

If you just came back from an overseas trip with a fever and a cough, you’ll be prioritized for a COVID-19 test in Manitoba and Nova Scotia, but not B.C., Alberta or Quebec.

Some provinces are expanding the groups of people who can get tests as others narrow them — and that may change from day to day. Why? And what does it mean for the accuracy of numbers of infections in different provinces and territories?

Here’s a closer look.

How variable is testing across Canada?

Each province or territory has a different rate of testing and different groups that are targeted, sometimes unique to that region. For example, the Northwest Territories lists people who have had lab exposure to biological material, while Manitoba and Ontario prioritize people in remote areas or work camps.

Many don’t test people outside those targeted groups, even if they have symptoms, and most even require people within those groups — such those who’ve been in contact with someone who has tested positive — to have symptoms before they can be tested.

To make things even more confusing, the priority groups change from day to day: Alberta, Manitoba and P.E.I. have all announced changes to their testing criteria in the past two weeks, and Quebec has announced multiple changes in that time.

Why are only certain groups prioritized for testing?

There is generally a shortage of tests, materials needed to run the tests and lab workers to run them. Exactly what is in short supply — and how short those supplies run — varies from province to province and possibly from week to week. That’s why some provinces, such as New Brunswick, are running relatively few tests, and some, such as Ontario, have long backlogs.

But to some extent, the shortage is Canada-wide — and worldwide.

“You’re just not going to be able to test everybody,” said Greta Bauer, a professor of epidemiology at Western University.

That means tests need to be rationed and each province or territory decides exactly which groups get priority, based on two main goals:

As a result, patients who need treatment in hospital are usually prioritized. Those who don’t need medical treatment, such as those with mild symptoms, often aren’t tested at all — they’re just told to self-isolate at home.

“We’re going to save the tests for the people who are really sick,” said Gaston De Serres, an epidemiologist practitioner at the Institut national de santé publique du Québec and a professor at Laval University, in an interview in French.

And to make sure those people can be properly treated, he said, health-care workers must also have good access to testing to ensure they can continue to safely work with patients.

Many people may think testing — and the daily infection numbers that come from the results — are an important way to measure the spread of COVID-19 in their communities. And more widespread testing would presumably better do that.

But while that is a way that governments might use testing, right now it “is not the primary use of tests,” said Bauer.

Why are priority groups changing so much?

Bauer acknowledged testing criteria are changing quickly — something that she called “appropriate” as the pandemic moves through different stages, particularly since a main goal of testing is to improve government response.

“That is, I think, what’s driving most of the changes we’ve seen,” she said.

Testing also needs to be responsive to what’s happening in different communities, she noted.

A medical staff member of a COVID-19 testing unit collects samples from people at a drive-thru location at the Santa Maria della Pieta hospital complex in Rome on April 3. (Alessandra Tarantino/Associated Press)

Why are some regions broadening their testing?

Initially, most cases across Canada were travel-related, so travellers and their close contacts were prioritized for testing in the hopes that COVID-19 could be contained in the way SARS was.

But now more than half of cases in Canada have been spread through community transmission and the numbers are getting higher, prompting many provinces to de-prioritize travellers.

Some provinces, such as P.E.I. and Nova Scotia, have broadened who they test in a bid to get a better handle on community spread.

Why are others making their testing more targeted?

Many provinces are now facing a shortage of tests and a strain on their health-care systems from COVID-19 infections, forcing them to narrow their criteria.

Alberta, for example, used to test more broadly, but on March 23 announced it would stop testing contacts of someone with COVID-19 and returning travellers to instead prioritize health-care workers, long-term care residents and clusters of cases.

And Quebec has changed its criteria twice in the past two weeks, as it struggles to balance testing shortages and a growing strain on its health-care system with a desire to get a better handle on community spread.

On March 19, the province announced that it would test more widely, and as recently as earlier this week, it said it would test asymptomatic contacts of people with symptoms. But on April 2, Quebec’s public health director, Dr. Horacio Arruda, said the province was no longer testing travellers, contacts of people who tested positive and people with mild symptoms.

The province’s priorities for testing are now hospitalized patients, people in long-term care, health-care workers, people in remote regions, and first responders, police and other essential services.

“There are lots of practical considerations that determine how the tests are going to be used,” said De Serres.

There has been a lot of debate about which groups should be considered priority in Quebec, he said, as the current list is beginning to represent a lot of people.

Members of the RCMP are seen at a COVID-19 testing area in Burnaby, B.C., on April 1. (Jonathan Hayward/The Canadian Press)

Who will be the big priorities for testing going forward?

Health-care workers and others who work in health-care settings are getting increasingly important, said Bauer. “And that’s because our response to the pandemic depends on those people.”

While other people are being told to self-isolate for two weeks if they have any respiratory symptoms, doing that for health-care workers could lead to a severe shortage. We need to know for sure whether they have COVID-19 or a different respiratory illness, she said, and then get them back to work as soon as possible after they recover.

But she said she thinks testing should be broadened to other groups that help to supply essentials to locked down communities, such as those connected to pharmacies, groceries and deliveries of things like food.

“Those are workers who are being asked to put themselves at risk and they are workers who we need on the job,” she said. “We need to not just think of essential services as people working in health-care settings.”

A nurse wears a protective mask and shield at a drive-thru clinic at Sainte-Justine children’s hospital in Montreal on April 1. Health-care workers are now prioritized for testing in many parts of Canada. (Paul Chiasson/The Canadian Press)

How do differences in testing change the apparent number of confirmed infections?

“They’re a function not just of what’s happening with the underlying pandemic, but with what’s happening with testing as well,” said Bauer.

An increase or decrease in testing, more targeted testing and changes to delays in getting test results can all impact the numbers of positive tests — even if the number of actual infections stays the same.

In a plot of the number of new cases to new tests before and after Alberta made its testing criteria more targeted, there were suddenly a lot more new cases, or positive tests, even while the same number of people were tested.

You can also see a pretty dramatic rise when Quebec removed a requirement to get lab results verified on March 23.

Small delays in getting results can have a big impact on the number of apparent cases, as the disease spreads exponentially; in Canada, it has been doubling about every three days.

For example, in Ontario, tests have been delayed at least four days — the same length of time it takes for the number of cases to double in that province. That means there are about half the number of cases reported than you would expect to see if test results were immediate.

An infected person detected through testing is not typically counted until two weeks after infection anyway, and obviously, only certain groups of infected people are even tested, so testing results are huge underestimates of actual cases.

“We’re looking at, you know, multiple cases that are undiagnosed for each one of those diagnosed at present,” Bauer said. “We have to remember that what we’re seeing is the tip of [the] iceberg. We’re seeing cases that have become symptomatic, where people have met testing criteria, [and] enough time has passed for them to have that positive test.”

Those are some reasons why epidemiologists like Bauer say hospitalizations and deaths provide a better understanding of the course of the pandemic than test-based reporting of cases.

Given that testing is so varied among the provinces, when it comes to the number of confirmed infections in each province, “we have to remember we’re almost never comparing apples to apples right now,” said Bauer.

Let’s block ads! (Why?)

Source link

News

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

Published

9 hours ago

November 14, 2024

Anne Joseph

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.

Source link

News

Vancouver Canucks winger Joshua set for season debut after cancer treatment

Published

9 hours ago

November 14, 2024

Anne Joseph

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.

Source link

News

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

Published

9 hours ago

November 14, 2024

Anne Joseph

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.

Source link