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Why doctors say we need to cast a wider net for COVID-19 in Canada – CBC.ca

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This is an excerpt from Second Opinion, a weekly roundup of eclectic and under-the-radar health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.


Canada’s first case of coronavirus not linked to travel suggests we need to expand our surveillance systems to prevent an explosion of new cases, infectious disease experts say.

The latest case of COVID-19 in British Columbia, a woman in her 50s who has no recent travel history to affected regions worldwide or contact with infected individuals, signals a shift in the spread of the virus in Canada. 

“There’s likely at least one other person out there who has this disease or had this disease, and we need to find them,” B.C. provincial health officer Dr. Bonnie Henry said Thursday.

Dr. Isaac Bogoch, an infectious disease physician at Toronto General Hospital, said this means there could be more cases in the province that are likely being missed by current screening measures. 

“There is some degree of transmission in B.C.,” he said. “We don’t know the size and scale of it, but it’s definitely there and the goal for surveillance systems would be to help shed light on what the degree of community transmission is.” 

B.C.’s provincial health officer, Dr. Bonnie Henry, said health officials are looking for at least one other person in the community who has or had the illness. (Ben Nelms/CBC)

Bogoch said Friday that while it’s been important to have systems in place to screen for patients travelling from affected regions, the concern now is how sensitive those systems are at picking up new cases in the community. 

“Clearly something is happening under the radar of the surveillance system,” he said. 

“It doesn’t mean the surveillance system is bad, it just means that there might be low levels of transmission or the surveillance system has not cast a wide enough net yet.” 

Currently, most health-care workers in Canada are screening only people who show up with flu-like symptoms such as fever and dry cough and say they’ve travelled to any of seven places  — China, Japan, Hong Kong, Italy, Iran, Singapore and South Korea.

An ambulance transports a patient from the Life Care Center of Kirkland, the long-term care facility linked to confirmed coronavirus cases in Washington state. (David Ryder/Reuters)

“We’ve been looking for people coming into the country with it; we have not been doing widespread community screening,” said Dr. Michael Gardam, an infectious disease specialist at Humber River Hospital in Toronto. 

“But, with the announcement from British Columbia, obviously that is going to continue to ramp up.” 

U.S. case a concern for Canada

Given B.C.’s proximity to Washington state, provincial health officials are working closely with their U.S. counterparts. 

Henry, the provincial medical officer of health, said one of the eight new cases in B.C. is a resident of Seattle who was visiting relatives in the Fraser Health region when she tested positive. 

“Clearly that is of concern with us,” she said. 

But part of what Henry calls the “disease detective work” to trace where the visitor may have contracted COVID-19 south of the border also depends on decoding the genetic sequence of the virus from Washington state’s “patient zero” — the initial patient. 

The traditional public-health approach relies on finding cases by interviewing someone who is infected and tracing those they’ve been in close contact with. Now, scientists also use genetic fingerprinting of the virus to complement efforts to find and isolate patients quickly. 

“If all community-based transmission can be traced back to a patient zero early on in an outbreak, that’s usually a good sign,” said Matthew Miller, who studies viruses and the immune responses to them at McMaster University in Hamilton, Ont.

The problem is that once the virus is spreading without a clear link to the source of the disease, tracking patient zero becomes less useful for containment purposes.

Canada isn’t there yet, Miller said, which is why community surveillance for COVID-19 takes on more importance right now. That’s why some hospitals across the country are moving toward testing all patients with flu-like symptoms.

Bogoch said expanding the list of countries to screen travellers from would be ineffective compared to community screening, because the list of places will become unmanageable. 

“It’s just going to be an extreme challenge to be able to detect all the imported cases,” he said. 

“At which point we’re just going to see more and more community-acquired cases in Canada.” 

WATCH | WHO chief worries ‘lean and mean’ hospitals lack ability to deal with emergencies

WHO director-general Tedros Adhanom Ghebreyesus says hospitals in wealthy nations try to operate efficiently, which could mean they don’t have enough capacity to deal with emergencies such as the COVID-19 outbreak. 1:48

Dr. Jerome Leis, medical director of infection prevention and control at Toronto’s Sunnybrook Hospital, led a study in the Canadian Medical Association Journal Friday on what the early Canadian experience screening for COVID-19 shows us about how to prepare for a pandemic.

Leis said curbing community spread limits the number of infections and reduces the proportion of patients who fall critically ill.

“Hospitals throughout Ontario have stepped up the surveillance … and so we’re testing individuals that have not travelled,” Leis said. “I think we should be stepping it up further.”

In the event of a pandemic with widespread community spread, it’s “simply not feasible, nor is it safe,” to test everyone, he said. 

“It will lead to overcrowding of hospitals and emergency departments,” he added. “That could just further increase the risk of exposure as people are diverted to hallways and have long wait times to be seen.”

Instead, Leis recommends building capacity both in hospitals for those who are critically ill with COVID-19 as well as in the community for the majority who have mild illness. 

“Hospitals are not the best place to be assessed and tested for COVID-19,” said Leis. 

“We really need to be changing the conversation from a hospital-driven model for people that are concerned about COVID-19, to one that is better supported in the community for the people who don’t need hospitalizations.” 


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

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UK’s Kendal Nutricare to deliver 2 million cans of baby formula to the US by June

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London, United Kingdom (UK)- Will McMahon, the commercial director of Kendal Nutricare, has said the company will deliver 2 million cans of baby formula to the United States (US) by June this year.

Baby formula shortages began to take hold in the US last year amid supply chain issues caused by the COVID-19 pandemic. However, the situation deteriorated in February when Abbott Laboratories, one of the country’s main manufacturers, with a 40 percent market share, recalled some of its products and shut down a manufacturing plant after four babies who had been fed formula made at the facility contracted a rare bacterial infection (Cronobacter sakazakii) with two of them later dying.

“The bigger opportunity here is as a company we have been in touch with the FDA (Food and Drug Administration) and working with them for over five years with the aim of bringing a product into the US. There is enormous curiosity and demand for Kendamil in the States, so we are hopeful that we will have everything in place with the FDA to be able to continue to supply legitimately well beyond November,” said McMahon.

More so, the US normally produces 98 percent of the infant formula it consumes, with imports mainly coming from Mexico, Ireland and the Netherlands but last week, the White House eased import requirements and announced an effort to transport baby formula from abroad dubbed Operation Fly Formula.

Nevertheless, the FDA said it is doing everything in its power to make sure there is enough baby formula for parents and caregivers who need it adding that it is in discussions with other manufacturers and suppliers about bringing other baby formulas to the US.

“Our recent steps will help further bolster the supply of infant formula, including through the import of safe and nutritious products from overseas based on our increased flexibilities announced last week.

Importantly, we anticipate additional infant formula products may be safely and quickly imported into the US in the near-term based on ongoing discussions with manufacturers and suppliers worldwide,” said FDA Commissioner, Dr. Robert Califf.

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Trudeau cancels appearance at Surrey fundraiser over protest-related safety concerns – CBC.ca

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Prime Minister Justin Trudeau cancelled plans to attend a Liberal party fundraising dinner in Surrey on Tuesday evening as a result of safety concerns over a large gathering of protesters outside the event.

Protesters allegedly harassed and hurled racial slurs at attendees and volunteers, many of whom were South Asian, according to Surrey Centre MP Randeep Sarai. 

The fundraiser was being held at Aria banquet hall.

Sarai says that a group of protesters were stationed outside the front gates of the event, eventually growing to around 100 people.

“They just started swearing, yelling, screaming at anyone that was going through,” said Sarai.

“We had a lot of South Asian volunteers… that were harassed, sworn at, called towel head, rag head, you’re all immigrants.”

He says it’s unclear what the group was actually protesting.

Surrey RCMP confirmed in a statement that there were several vehicles and larger trucks towing trailers that were travelling “in a convoy style loop around the roadway.”

“Due to the size and composition of the protest group and for the safety of everyone in attendance, a decision was made that it was not safe for the prime minister to attend the location,” said Cpl. Vanessa Munn.

Trudeau did not enter the building and spoke to a crowd for about three minutes by Zoom instead of making a speech in person. Trudeau said he would return to see his supporters in Surrey in the future.

WATCH | Justin Trudeau talk about the unruly crowd and its impact on free speech:

Trudeau says nobody should be intimidated for supporting a political party

7 hours ago

Duration 1:27

The prime minister comments on protesters yelling racial slurs at an event he was forced to cancel.

Wednesday, at an event in Saskatoon, Trudeau addressed what happened at the fundraiser in Surrey, adding that nobody should be intimidated for supporting a political party.

“The safety of Canadians choosing to make their voices heard in politics should never be in question as it was last night,” he said.

“The fundamental freedoms we have as a country, and we enjoy as Canadians, need to be defended, need to be protected.”

Protesters swore at Prime Minister

Protesters used expletives as they chanted against Trudeau and honked horns outside the convention centre. About half a dozen RCMP officers stood by watching the crowd.

Sarai says the protesters turned the event into a hostile environment.

“This is not reflective of Surrey at all,” he said.

“Surrey is a very diverse city, a very friendly city, a very welcoming city.”

And while he respects the public’s right to protest, he says “you should never spew hate and use the vulgarity that was being used there.”

Protests against party leaders

Earlier this month, police began investigating after a video circulated on social media showed people hurling verbal abuse at NDP Leader Jagmeet Singh during a protest in Peterborough, Ont.

The federal NDP leader had dropped by the campaign office of an Ontario NDP candidate running in the provincial election.

A video shows Singh encountering protesters as he left the campaign office, and they can be heard shouting expletives at him and calling him a “traitor”‘ as he gets inside a vehicle.

Singh later told reporters he found the experience “intense, threatening [and] insulting”‘ but that he is more worried about what it means for politics in general.

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The latest on the French-language Conservative leadership debate in Laval

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LAVAL, Que. — Conservative leadership hopefuls are squaring off — in French — in the second official debate of the race, which is being held in Laval, Que.

Here are the latest developments. All times eastern:

8:55 p.m.

Conservative leadership candidates Patrick Brown and Leslyn Lewis took turns attacking rival Pierre Poilievre for his embrace of the cryptocurrency Bitcoin as a solution to inflation.

Lewis, who is often reading from her notes during the French-language debate in Laval, Que., said Poilievre’s position was wrong.

At one point, Brown said Poilievre’s position on Bitcoin was similar to that of the leadership in El Salvador, which adopted Bitcoin as legal tender.

The International Monetary Fund urged the Central American country to drop Bitcoin as its official currency earlier this year, citing its volatility.

___

8:20 p.m.

Former Quebec premier Jean Charest says Canada must renegotiate the Safe Third Country Agreement with the United States.

He says that is how he would deal with “illegal immigration,” such as migrants entering the country through the unofficial border crossing at Roxham Road south of Montreal.

Candidates were asked about immigration as the first question in the debate.

Brampton Mayor Patrick Brown used the question to say he was trying to build an inclusive party and attacked Ottawa-area MP Pierre Poilievre for not publicly condemning the “white replacement” conspiracy theory espoused by Pat King, a leader of the Ottawa convoy protest.

Poilievre responded by saying he has in fact condemned King’s remarks and that people couldn’t believe anything Brown says.

While answering a question about public safety, Poilievre said the country needs to better deal with guns illegally brought into Canada.

Charest said Poilievre has no businesses talking about law and order when he supported the Ottawa convoy, which he called an illegal blockade.

The room then erupted into a mix of cheers and boos.

___

8:10 p.m.

Candidates took to the stage and began by outlining one by one what legacy they wanted to leave behind as leaders.

Pierre Poilievre says he wants his legacy to be making Canada the freest country in the world, including by making sure people don’t feel forced to get vaccinated and that young people are able to afford a home.

Patrick Brown says he can win in urban areas, which the party needs, and has what it takes to build a party that can succeed in a general election.

Roman Baber, an Independent member of the Ontario legislature, introduced himself to the crowd.

He says he knows Canada is bilingual and has taken lessons, but still asked those watching to forgive his French.

___

8:05 p.m.

The Conservative party’s leadership organizing committee announced before the debate began that it will announce the results of the leadership race at a downtown Ottawa convention centre on Sept. 10.

The party’s president, Robert Batherson, says it will be the first time since 2018 that members will gather together at a national event.

The party held a convention in Halifax in 2018.

___

7:50 p.m.

House music issued from amplifiers as Conservatives of all ages began to take their seats ahead of tonight’s leadership debate.

Several hundred attendees, who were not wearing masks, crowded the ballroom of the Chateau Royal venue north of Montreal, seated between television cameras and the stage.

The six contenders are slated to appear at their podiums at 8 p.m.

___

7:30 p.m.

Conservative leadership candidates filed in for the race’s only French-language debate, being held at a reception hall north of Montreal.

The suburban venue in Laval, Que., saw scores of federal Tories and onlookers mingling in the foyer before the six contenders take the stage.

Former Quebec premier Jean Charest greeted a handful of supporters with kisses, while Ontario MP Scott Aitchison chatted with party members amid sign-up booths for each candidate.

Bookending the stage beneath ballroom chandeliers were a bank of speakers and 14 flags — six with the Fleur-de-lis, eight with the Maple Leaf.

This report by The Canadian Press was first published May 25, 2022

 

The Canadian Press

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