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Why frequent use of hand sanitizer could make us sick down the road – The Globe and Mail

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An employee with tech startup company Fast uses hand sanitizer after playing a game of ping pong in the office in San Francisco, California, on March 24, 2021.

Justin Sullivan/Getty Images

For years, Brett Finlay has been encouraging people to get comfortable being surrounded by germs.

Dr. Finlay, a microbiologist at the University of British Columbia, has led studies and written papers and books about the importance of the human microbiome – the universe of microbes that live in and among us – and the need to expose ourselves to a diversity of microorganisms to keep us healthy.

But just as people began embracing probiotics and fermented foods, discarding antibacterial soaps and getting over our collective fear of germs, along came the COVID-19 pandemic. Almost overnight, hand sanitizer, disinfectants and stay-at-home rules have become the order of the day.

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While such measures are critical in the fight against COVID-19, Dr. Finlay and other experts worry they could have a harmful effect on our microbiomes, with lasting consequences for our health.

“Suddenly, hand sanitizer goes through the roof, we all wear masks and we don’t touch anyone or anything. And from what we know is that generally, that’s probably not good from just an ordinary microbial exposure point of view,” he said, saying that measures such as getting outside and eating a healthy diet can help counteract this.

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Over the past decade, researchers including Dr. Finlay have found dysbiosis, or an imbalance of the composition of microbes in the body, is associated with an array of chronic conditions and diseases, including obesity, diabetes, asthma and various auto-immune diseases.

And so while emphasizing that pandemic control measures are necessary in the near term, Dr. Finlay and his colleagues anticipate they’re also preventing people from acquiring a diversity of microbes, and accelerating the loss of microbes, potentially contributing to higher rates of these health issues in the long term. In response, they recommend spending time outdoors to increase one’s exposure to microbes, and eating balanced, high-fibre diets instead of highly processed foods.

Dr. Finlay and a team of scientists with the Humans and the Microbiome program at CIFAR, a Canadian-based global research organization, wrote a recent paper, published in the Proceedings of the National Academy of Sciences, to draw attention to this issue. They noted societal changes over the past century, such as urbanization, hygiene practices and increased consumption of processed foods, have led to a loss of microbial diversity. Moreover, when microbial species with which humans have evolved are wiped out, the loss may be permanent.

It’s yet unknown what the cost of the pandemic will be to the human microbiome, they said. However, they suggested sweeping changes over the past year likely contribute to microbial loss. These changes include intensive disinfection, physical inactivity and consumption of highly processed foods during lockdowns, a decline in social interaction and mobility and the use of antimicrobial treatments because of misdiagnosis or to treat secondary infections from COVID-19.

The consequences are also expected to be “very uneven,” as efforts to control transmission of the coronavirus and access to treatments differ, depending on where people live, their income levels and the size of their households, said co-author Tamara Giles-Vernick, a director of research at the Institut Pasteur in Paris.

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Faced with pandemic-related economic hardship and in some parts of the world, food shortages, for example, people now relying on food-assistance programs are experiencing changes to their diet, she said. This, at least in the short term, is expected to cause shifts in their microbiome, explained Dr. Giles-Vernick, head of the non-profit foundation’s anthropology and ecology of disease emergence unit.

Dr. Finlay said he expected any changes to the microbiome would have the most profound effects at “the bookends of life” – that is, among young children and older adults.

“We know that for a child to develop normally, you need microbial exposure,” he said, saying there’s a concern “kids just are not getting the normal microbes that they would have gotten pre-COVID.”

Microbes also influence healthy aging, he explained. After around the age of 65, one’s microbes become more inflammatory, while the gut becomes more permeable, and gut microbes can seep into the body, he said. This causes inflammation associated with tissue damage and aging.

This effect can be intensified when people are not exposed to normal microbes, he said.

Separately, at the University of California, San Diego, professor and infectious disease epidemiologist Steffanie Strathdee pointed to another potential unintended consequence of the pandemic: a worsening crisis of superbugs, or drug-resistant microbial pathogens.

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This is, in part, because the pandemic has shifted resources away from fighting superbugs, she said. For instance, many hospital antibiotic stewards, usually infectious disease pharmacists who advise doctors how to use certain antibiotics, have now been diverted to deal with COVID-19, she said.

Moreover, doctors around the world have been overprescribing antibiotics as a way to thwart secondary bacterial infections among COVID-19 patients, added Dr. Strathdee, co-author of The Perfect Predator, a book about her own husband’s near-fatal infection with a superbug.

To control superbugs, which by some estimates will cause 10 million deaths globally a year by 2050, Dr. Strathdee said there is a need to adopt a “one health” conceptual model to achieve health for people, animals and the environment.

“It isn’t enough to just tell doctors, ‘Limit your prescribing of antibiotics,’ ” she said. Rather, the fight against superbugs also requires limiting the use of antibiotics in farming and managing effluent from antibiotic manufacturing plants. It also requires international and multisectoral collaboration, she said.

When it comes to mitigating the effects of the pandemic on the human microbiome, Jason Tetro, author of The Germ Code and The Germ Files, advised getting into nature, eating fresh fruits and vegetables and fermented foods, opening windows and practising “targeted hygiene” instead of indiscriminately disinfecting everything.

With COVID-19, “we have been shocked by a microbe,” he said, but it’s important to remember the vast majority of microbes out there “are harmless to us and many of them can actually provide us with benefits for our health.”

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Canada will not restrict AstraZeneca COVID-19 vaccine, says benefits outweigh risk

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OTTAWA (Reuters) – Canada‘s health ministry said on Wednesday it would not restrict use of AstraZeneca Plc’s COVID-19 vaccine after a review showed the benefits outweighed the very rare risk of blood clots.

A separate advisory council had earlier recommended Canada stop offering the vaccine to people under 55. The panel is now reviewing that advice, the health ministry said in a statement.

Denmark on Wednesday became the first country to stop using the vaccine altogether over a potential link to the rare blood clots. Other nations have imposed limits on its use.

But Health Canada, the federal health ministry, said in a statement that a review of data from Europe, Britain and AstraZeneca had not identified specific risk factors.

“Therefore, Health Canada is not restricting the use of the vaccine in any specific populations at this time … The potential risk of these events is very rare, and the benefits of the vaccine in protecting against COVID-19 outweigh its potential risks,” it said.

Canada on Tuesday said it had recorded its first case of blood clotting with low platelets after someone received the AstraZeneca shot. The patient in question, a woman from Quebec, is recovering. (Graphic on vaccines: https://tmsnrt.rs/3tUM8ta)

COVID-19 cases are surging in Canada with the country reporting a near-record number of new cases recently. (Graphic on cases: https://tmsnrt.rs/34pvUyi)

 

(Reporting by David Ljunggren in Ottawa and Allison Martell in Toronto; Editing by Lisa Shumaker)

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Factbox-Some countries limit AstraZeneca vaccine use, US pauses J&J shot

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(Reuters) -Some countries are restricting use of the AstraZeneca COVID-19 vaccine to certain age groups or suspending use after European and British regulators confirmed possible links to rare blood clots.

Denmark became the first country to stop using the vaccine altogether, as it said results of investigations showed “real and serious side-effects”.

Johnson & Johnson’s single-shot vaccine has also been hit by concerns over blood clots, with European regulators reviewing such cases and U.S. federal health agencies recommending pausing its use for a few days. J&J noted no clear causal relationship had been established between the clots and its vaccine.

The developments pose a risk to vaccination plans in Europe.

Regulators have said the benefits of the AstraZeneca shot outweigh risks.

Anglo-Swedish drugmaker AstraZeneca said it was working with regulators to list the possible brain blood clots as “an extremely rare potential side effect” on the vaccines labels.

As of April 4, the European Medicines Agency had received reports of 169 cases of a rare brain blood clot known as cerebral venous sinus thrombosis (CVST), after 34 million doses had been administered in the European Economic Area. Most cases were in women under 60 years of age.

ASTRAZENECA VACCINE BEING USED, WITH OR WITHOUT RESTRICTIONS

AUSTRALIA

Said on April 8 it recommends people under 50 should get Pfizer’s COVID-19 vaccine in preference to AstraZeneca’s shot.

AUSTRIA

Has resumed use.

BRAZIL

Authorities said they would not limit use of the AstraZeneca vaccine, saying benefits outweigh risks.

BRITAIN

The Joint Committee on Vaccination and Immunisation has said an alternative to the vaccine should be given for people under 30 where possible, but people should continue to have a second shot if they have received a first dose.

BULGARIA

Resumed inoculations from March 19.

CYPRUS

Resumed inoculations on March 19.

CANADA

Authorities said in early April they would pause offering the vaccine to people under 55 and require a new analysis of the shot’s benefits and risks based on age and gender. On April 13, the country said it had recorded its first case of blood clotting with low platelets.

ESTONIA

Suspended use of the vaccine for people under 60 on April 7.

FRANCE

Approved resumption of the vaccine on March 19 but said it should be given only to people aged 55 and over. On April 9, recommended that recipients of a first dose of the AstraZeneca shot who are under 55 should receive a second dose with a messenger RNA vaccine.

FINLAND

Resumed using the AstraZeneca vaccine from March 29, but only for people aged 65 and over.

GEORGIA

Has limited use of the vaccine following the death of a nurse from anaphylactic shock, and vaccinations will continue only in full-fledged medical centres, Russian news agency TASS reported on March 19.

GERMANY

Sticking to its guidance from March 31 to limit use of the vaccine to those aged over 60. On April 1, Germany’s vaccine commission recommended people under 60 who have had a first shot of the vaccine should receive a different product for their second dose.

HUNGARY

Continuing the vaccine’s rollout.

ICELAND

Resumed use on March 25 after suspending it on March 11.

INDONESIA

Resumed using the vaccine on March 22 but warned against its use in people with a low blood platelet count.

IRELAND

On April 12, the country said it was restricting use of the vaccine to those over 60.

ITALY

Has recommended the vaccine be used only for people over 60, the country’s top health adviser said.

LATVIA

Announced it was restarting administering the shots from March 19.

LITHUANIA

Restarted use on March 19.

MEXICO

Drug regulator Cofepris said on April 7 it did not “at this time” plan to limit the vaccine’s use but was investigating the information raised by Britain.

NETHERLANDS

Limited use of the vaccine to people over 60, the Dutch government said on April 8.

NORTH MACEDONIA

Health minister said on March 31 the vaccine would be limited to people aged over 60 as a precautionary measure.

PHILIPPINES

Suspended use of the vaccine for people under 60 on April 8.

ROMANIA

Has resumed use of the vaccine after temporarily stopping vaccinating people with one batch of the vaccine on March 11.

SOUTH KOREA

Resumed use of the shot for people aged 30 or older on April 12. On April 7, it had suspended providing the AstraZeneca shot to people under 60.

SPAIN

From April 8, it was giving the vaccine only to people over 60.

SWEDEN

Resumed use of the vaccine on March 25 for people aged 65 and older.

THAILAND

Began use on March 15 after delaying rollout the week before.

COUNTRIES WHERE ASTRAZENECA VACCINE USE SUSPENDED

CAMEROON

Suspended administration of the vaccine it was scheduled to receive on March 20 as part of the global vaccines sharing scheme COVAX, the health ministry said.

DENMARK

In a world first, Denmark decided to stop using the AstraZeneca vaccine altogether after initially suspending use of the shot.

NORWAY

Authorities said on March 26 Norway would delay a decision on use of the vaccine, with a decision expected by April 15.

J&J VACCINE DELAYS AND RESTRICTIONS

UNITED STATES

On April 13, U.S. federal health agencies recommended pausing use of J&J’s COVID-19 vaccine for at least a few days after six women under the age of 50 developed rare blood clots after receiving the shot.

EUROPEAN UNION

The company said it would delay the rollout of the vaccine to Europe, after regulators said they were reviewing rare blood clots.

Widespread use in the EU had not yet started after the company began delivering the doses in the week beginning April 12. The European drug regulator recommended storing doses already received until its safety committee issues an expedited recommendation

SOUTH AFRICA

Suspended use of J&J’s vaccine on April 13.

(Reporting by Pushkala Aripaka, Yadarisa Shabong, Manas Mishra, Vishwadha Chander, Amruta Khandekar and Mrinalika Roy in Bengaluru; editing by Josephine Mason, Alison Williams, Timothy Heritage, Larry King, Barbara Lewis)

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Ontario hospitals may have to withhold care as COVID-19 fills ICUs

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By Allison Martell and Anna Mehler Paperny

TORONTO (Reuters) – Doctors in the Canadian province of Ontario may soon have to decide who can and cannot receive treatment in intensive care as the number of coronavirus infections sets records and patients are packed into hospitals still stretched from a December wave.

Canada‘s most populous province is canceling elective surgeries, admitting adults to a major children’s hospital and preparing field hospitals after the number of COVID-19 patients in ICUs jumped 31% to 612 in the week leading up to Sunday, according to data from the Ontario Hospital Association.

The sharp increase in Ontario hospital admissions is also straining supplies of tocilizumab, a drug often given to people seriously ill with COVID-19.

Hospital care is publicly funded in Canada, generally free at the point of care for residents. But new hospital beds have not kept pace with population growth, and shortages of staff and space often emerge during bad flu seasons.

Ontario’s hospitals fared relatively well during the first wave of the pandemic last year, in part because the province quickly canceled elective surgeries.

The College of Physicians and Surgeons of Ontario told doctors last Thursday that the province was considering “enacting the critical care triage protocol,” something that was not done during earlier waves of the virus. Triage protocols help doctors decide who to treat in a crisis.

“Everybody’s under extreme stress,” said Eddy Fan, an ICU doctor at Toronto’s University Health Network. He said no doctor wants to contemplate a triage protocol but there are only so many staff.

“There’s going to be a breaking point, a point at which we can’t fill those gaps any longer.”

In a statement, the health ministry said Ontario has not activated the protocol. A September draft suggested doctors could withhold life-sustaining care from patients with a less than 20% chance of surviving 12 months. A final version has not been made public.

Ontario’s Science Advisory Table had been forecasting the surge for months, said member and critical care physician Laveena Munshi. During a recent shift she wanted to call the son of a patient only to discover he was in an ICU across the street.

“The horror stories that we’re seeing in the hospital are like ones out of apocalyptic movies,” she said. “They’re not supposed to be the reality we’re seeing one year into a pandemic.”

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