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.
The prospect of locking society down again the way we did in the first wave of COVID-19 — and the collateral damage that comes with it — is daunting.
The financial devastation on businesses forced to close and lay off employees, the increase in mental health issues, the halting of elective medical procedures and the continuing risks to essential workers on the front lines all factor in.
Keeping society functioning and supporting devastated sectors of the economy while limiting the spread of the coronavirus is key to navigating the pandemic until a safe and effective vaccine is here.
But experts acknowledge there is growing resistance to some of the restrictions that highlights a need to manage the public mood as the pandemic rages on.
You arguably could not find a more politically charged term right now than “lockdown,” since everyone has a different, personal idea of what it is.
“This term has become equated with so many bad things that no one really understands what it means,” said Michael Osterholm, director of the Centre for Infectious Disease Research and Policy at the University of Minnesota.
“It’s everyone’s worst fear about what somebody else is doing to them regarding the pandemic.”
Osterholm, a veteran of SARS and MERS who warned the world for 15 years that a pandemic was coming, thinks the term lockdown should be abolished altogether.
Instead, Osterholm said we need to look at it as targeted public health measures necessary to reducing the spread of COVID-19 and getting back to normal as quickly as possible, while at the same time supporting those who have suffered financially.
The key to successfully riding out the pandemic lies in finding balance between working with the population to help keep the number of cases low without substantially changing life as we know it.
“The challenge is, the end isn’t coming soon,” he said. “But it’s coming, and what we need to do is try to have as few cases as possible between now and the time a vaccine arrives.”
‘Pandemic fatigue’ can turn to ‘pandemic anger’
Managing the public’s frustration presents a challenge for public health officials in the second wave.
During a journalism conference at Carleton University in Ottawa on Thursday, Canada’s Chief Public Health Officer Dr. Theresa Tam said that public health messaging can seem inconsistent because of the evolving science in the pandemic.
“We are living in a more challenging period right now,” she said, in which authorities have “to convince people who are fatigued to stick to sustainable habits or public health practices.”
Ontario and Quebec have already moved to close bars, restaurants and gyms in their hardest-hit regions amid rising cases, while Alberta and British Columbia weigh the need to tighten restrictions amid record-high rises in cases.
Osterholm said resistance to public health restrictions not only stems from the concept of “pandemic fatigue,” but also from something he calls “pandemic anger.”
“It’s people who don’t believe that the pandemic is real,” he said. “They think it’s a hoax.”
Raywat Deonandan, a global health epidemiologist and associate professor at the University of Ottawa, said the resistance also stems from “raw selfishness.”
“There’s an inability to think about community responsibility,” he said, explaining that people think they won’t personally be seriously affected by the virus because it has a comparatively higher survivability rate in younger age groups.
“But if you scale this up to a population, then that’s tens of thousands of deaths – and they don’t care.”
Perception of risk has a cost
The latest World Economic Outlook from the International Monetary Fund found that while lockdowns controlled the spread of the coronavirus, they also contributed to a global economic recession that disproportionately affected vulnerable populations.
But the IMF report also found the damage to the economy was largely driven by people “voluntarily refraining” from social interactions out of a fear of contracting the virus.
Osterholm said the perception of risk — and not strict public health restrictions — is what holds people back from doing things like travelling by plane or entering a retail store.
“Nobody is telling you you can’t go to the grocery store rather than ordering online — it’s just people don’t feel safe and secure,” he said.
“Well, how do you make that happen? You make it happen by making cases occur at a much, much lower rate than they’re occurring now. It’s not going to be just by telling the virus we’re done.”
Lockdowns should be last resort
Dr. Amesh Adalja, an infectious disease physician and a senior scholar at the Johns Hopkins Center for Health Security in Baltimore, Md., isn’t in favour of lockdowns as a first line of defence in the pandemic.
“If you’re going to take public health interventions, they have to be very targeted towards specific activities that are actually leading to spread,” he said. “You only use a lockdown when you have fouled up your response so bad that that’s all you have left to do.”
WATCH | Push to pursue COVID-19 herd immunity is ‘dangerous’:
But ignoring lockdowns isn’t an effective strategy, either.
The Great Barrington Declaration, a controversial proposal from a group of scientists (backed by a U.S. think-tank) to lift restrictions, made headlines last week for its calls to protect “the vulnerable” from COVID-19 with strict measures while allowing those “at minimal risk of death” to return to normal life and build up herd immunity to the virus.
But it failed to present a logical counterargument for controlling the virus or concrete ways to protect the vulnerable (including the elderly and the poor), not to mention those who care for them.
Referring to the declaration, Deonandan said, “If there wasn’t a vaccine coming, if nothing changes and this has to be how we live in perpetuity, then OK, maybe we have to discuss some other options. But none of that is true.”
Canada has had more than 200,000 cases and is approaching 10,000 deaths, but modelling predicts the situation would be much worse if public health guidelines like physical distancing, mask-wearing and proper hand hygiene weren’t followed.
Osterholm said those pushing the the Barrington Declaration completely misunderstood the concept behind public health restrictions and the reasons behind enacting them in the first place.
“If you’re going to keep thinking about this as a lockdown, then we’re going to find a lot of resistance to this,” he said. “But on the other hand, if you don’t suppress transmission, we’re also going to see a lot of deaths.”
A question of public tolerance
Lockdowns are one of many tools a country can use in the face of an infectious disease outbreak, but their effectiveness is dependent on the public’s willingness to tolerate them.
China imposed some of the most severe public health restrictions in modern history upon the discovery of the coronavirus at the beginning of this year, something democratic nations would be unlikely to imitate.
But China is already seeing the rewards of its draconian efforts to control the spread. It’s the only major economy expected to grow this year, with retail spending surpassing pre-pandemic levels for the first time and factory output rising on the backs of demand for exports of masks and other medical supplies to countries like Canada.
Other regions like New Zealand, Singapore, Taiwan and Hong Kong acted swiftly by closing borders, imposing strict public health measures and opting for shorter, more strategic lockdowns, which have allowed them to carefully reopen society.
South Korea, meanwhile, didn’t lock down at all and instead focused on testing, tracing and isolating cases to control the spread of the virus successfully.
“The lesson here is you choose one path and you stick with it,” Deonandan said. “What is not acceptable is vacillating between different strategies.”
Australia imposed targeted lockdown measures in the face of outbreaks, which University of Western Australia epidemiologist Dr. Zoë Hyde said has been “enormously successful” in eliminating the virus in much of the country.
“While lockdowns absolutely have harms associated with them, the harms are much less than those of an unmitigated epidemic,” she said. “Governments can also minimize the harms of lockdowns by making them short and sharp, and by financially supporting workers and businesses.”
Lockdowns ‘a sign of failure’
Hyde said the eastern Australian state of Victoria was a precautionary tale for the debate over lockdowns, because of mistakes made in a hotel quarantine system that allowed the virus to spread again.
“If governments have not tried hard enough to suppress the virus, then a lockdown is inevitable, whether people want one or not,” Hyde said.
“Lockdowns are a sign of failure. They’re a sign that governments have not been doing enough.”
Victoria was recording around 700 new cases per day in July, but a second lockdown coupled with a mask mandate have brought case numbers down to only a handful a day at most.
“Measures to combat the virus have to be tailored. They can’t be more than the economy can bear,” Hyde said, “but equally we must remember that the best way to protect the economy is to suppress the virus.”
“Ultimately it’s the virus doing the damage to the economy, not the measures designed to suppress it. No matter what we wish, the economy won’t go back to normal if a dangerous virus is circulating.”
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34 new cases of COVID-19 in Ottawa; more than 1700 in Ontario – CTV Edmonton
Ottawa Public Health is reporting 34 additional people in Ottawa have tested positive for COVID-19 and one more person has died.
The figure marks a slight increase from Monday’s report, when 29 new positive tests were reported.
Across Ontario, another 1,707 people have tested positive for COVID-19 and seven more people have died. Figures are highest in Toronto, where more than 700 new positive cases were reported.
According to Ottawa Public Health’s COVID-19 dashboard, there have been 8,521 total laboratory-confirmed cases of COVID-19 in Ottawa since the pandemic began.
Ottawa’s death toll from the pandemic is now 375.
In the past seven days, Nov. 25 to Dec. 1 inclusive, OPH has reported an average of 41.4 new cases of COVID-19 per day. In the seven days previous, Nov. 18 to Nov. 24 inclusive, OPH reported an average of 37.6 new cases per day.
OPH says the rate per 100,000 popluation in the city over the past seven days is 26.8, down from 27.2 on Monday. The R(t) number — that is, the number of additional people an indivudual who has tested positive spreads the virus to — is estimated at 1.18 as of Nov. 30. A week prior, on Nov. 23, the estimated R(t) number was 0.87.
“R(t) values greater than 1 indicate the virus is spreading faster and each case infects more than one contact, and less than 1 indicates the spread is slowing and the epidemic is coming under control,” OPH says.
Ontario health officials say 34,640 COVID-19 tests were performed across Ontario on Monday and 34,046 people are still waiting for test results provincewide.
Updated local figures from the Ottawa COVID-19 Testing Taskforce are due this afternoon.
HOSPITALIZATIONS IN OTTAWA
The number of people in Ottawa hospitals with COVID-19 remained steady on Tuesday.
OPH says there are 24 people in hospitals in the city with COVID-19 and one person is in intensive care.
Of the people in hospital, one is in their 20s, one is in their 30s, one is in their 40s, three are in their 60s, seven are in their 70s, eight are in their 80s (one in the ICU) and three are 90 or older.
ACTIVE CASES OF COVID-19 IN OTTAWA
The number of people with known active infections of COVID-19 has risen to 351 from 344 on Monday.
OPH reported 26 additional recoveries on Tuesday, bringing the number of resolved cases in Ottawa to 7,794.
The number of active cases of COVID-19 is the number of total laboratory-confirmed cases minus the numbers of resolved cases and deaths. A case is considered resolved 14 days after known symptom onset or positive test result.
CASES OF COVID-19 IN OTTAWA BY AGE CATEGORY
Here is a breakdown of all known COVID-19 cases in Ottawa by age category:
- 0-9 years old: Two new cases (581 cases total)
- 10-19 years-old: Four new cases (986 cases total)
- 20-29 years-old: 11 new cases (1,746 cases total)
- 30-39 years-old: Six new cases (1,145 cases total)
- 40-49 years-old: Four new cases (1,072 cases total)
- 50-59 years-old: One new case (992 cases total)
- 60-69-years-old: Two new cases (664 cases total)
- 70-79 years-old: Two new cases (438 cases total)
- 80-89 years-old: Two new cases (531 cases total)
- 90+ years old: Zero new cases (366 cases total)
CASES OF COVID-19 AROUND THE REGION
According to provincial figures, the Eastern Ontario Health Unit reported seven new COVID-19 cases on Tuesday.
Six more people in the Hasting Prince Edward Public Health region have tested positive.
Kingston, Frontenac, Lennox & Addington Public Health have added one new case.
The Leeds, Grenville & Lanark District Health Unit has two additional cases of COVID-19 in its region.
There are no new COVID-19 cases in the Renfrew County and District Health Unit’s area on Tuesday.
The Quebec government reports that 15 more people in the Outaouais region have tested positive for COVID-19 and one additional person has died.
Ottawa Public Health is reporting COVID-19 outbreaks at 25 institutions in Ottawa, including long-term care homes, retirement homes, daycares, hospitals and schools.
One new outbreak was declared on Tuesday at the Carleton Lodge long-term care home.
There are five active community outbreaks: one linked to an unidentified community organization, one from an unspecified social event and three at unidentified workplaces in the city.
The schools and childcare spaces currently experiencing outbreaks are:
- École élémentaire publique Gabrielle Roy
- Manordale Public School
- Ottawa Technical Secondary School
The long-term care homes, retirement homes, hospitals, and other spaces currently experiencing outbreaks are:
- Alta Vista Manor
- Amica Westboro Park
- Association Intégration Sociale d’Ottawa – 21034
- Bearbrook Retirement Residence
- Bridlewood Trails Retirement Home
- Carleton Lodge long-term care home (NEW)
- Courtyards on Eagleson
- Couvent Mont-Saint-Joseph retirement home
- Extendicare Medex
- Extendicare New Orchard Lodge
- Extendicare Starwood
- Forest Hill long-term care home
- Garden Terrace long-term care home
- Montfort Hospital – 3C
- Park Place
- Peter D. Clark long-term care home
- Shelter – 20868
- St. Patrick’s Home
- The Glebe Centre
- The Ravines retirement home
- The Ottawa Hospital General Campus – 5E
- Waterford Retirement
A single laboratory-confirmed case of COVID-19 in a resident or staff member of a long-term care home, retirement home or shelter triggers an outbreak response, according to Ottawa Public Health. In childcare settings, a single confirmed, symptomatic case in a staff member, home daycare provider, or child triggers an outbreak.
Under provincial guidelines, a COVID-19 outbreak in a school is defined as two or more lab-confirmed COVID-19 cases in students and/or staff in a school with an epidemiological link, within a 14-day period, where at least one case could have reasonably acquired their infection in the school (including transportation and before or after school care).
Ontario reports 1,707 new coronavirus cases, 7 more deaths – Global News
Ontario reported 1,707 new cases of coronavirus on Tuesday, bringing the provincial total to 118,199.
Tuesday’s case count is slight decrease from Monday’s which saw 1,746 new infections. On Sunday, 1,708 cases were recorded, 1,822 on Saturday and 1,855 on Friday.
According to Tuesday’s provincial report, 727 cases were recorded in Toronto — the highest single day increase, 373 in Peel Region, 168 in York Region and 72 in Durham Region.
All other public health units in Ontario reported under 70 new cases.
The death toll in the province has risen to 3,663 as seven more deaths were reported.
Ontario has 645 people hospitalized due to COVID-19 (up by 27 from the previous day), with 185 patients in an intensive care unit (up by 17) and 112 patients in ICUs on a ventilator (up by four).
More than 34,600 tests were processed in the last 24 hours — which is the lowest number of tests completed in the last week.
There is currently a backlog of 34,046 tests that need results. A total of 6,309,556 tests have been completed since the pandemic began.
Meanwhile, 100,012 Ontarians have recovered from COVID-19, the disease caused by the virus, which is 85 per cent of known cases. Resolved cases increased by 1,373 from the previous day.
Active cases in Ontario now stand at 14,524, up from the previous day at 14,197, and up from last Tuesday at 12,917.
Here is a breakdown of the total cases in Ontario by gender and age:
- 57,519 people are male — an increase of 882 cases.
- 59,973 people are female — an increase of 813 cases.
- 14,204 people are 19 and under — an increase of 255 cases.
- 43,126 people are 20 to 39 — an increase of 666 cases.
- 33,814 people are 40 to 59 — an increase of 511 cases.
- 17,157 people are 60 to 79 — an increase of 219 cases.
- 9,885 people are 80 and over — an increase of 55 cases.
The province notes that not all cases have a reported age or gender.
The newly reported numbers for Tuesday’s report are valid as of Monday afternoon.
Ontario long-term care homes
According to the Ministry of Long-Term Care, there have been 2,228 deaths reported among residents and patients in long-term care homes across Ontario which is an increase of five deaths.
Eight health-care workers and staff in long-term care homes have died which has remained unchanged for months.
There are 109 current outbreaks in homes, unchanged from the previous day.
The ministry also indicated there are currently 743 active cases among long-term care residents and 509 active cases among staff — up by 33 cases and up by 26 cases respectively in the last day.
Ontario child care centres and schools
Meanwhile, government figures show there have been a total of 4,872 school-related COVID-19 cases in Ontario — 3,107 among students and 677 among staff (1,088 individuals were not identified). This is an increase of 299 more cases over a three-day period.
In the last 14 days, the province indicates there are 1,119 cases reported among students and 233 cases among staff (one individual was not identified) — totaling 1,353 cases.
The COVID-19 cases are currently from 737 out of 4,828 schools in the province.
Six schools in Ontario are currently closed as a result of positive cases, the government indicated.
There have been a total of 806 confirmed cases within child care centres and homes — an increase of 40 (21 child cases and 19 staff cases.) Out of 5,249 child care centres in Ontario, 154 currently have cases and 18 centres are closed.
Numbers for cases in schools and child care centres are updated weekdays only, at 10:30 a.m. On Tuesday’s, numbers are included from Friday afternoon to Monday afternoon.
© 2020 Global News, a division of Corus Entertainment Inc.
COVID-19: Ontario reports 1,707 new cases; disease spread at 'critical point,' says Elliott – Ottawa Citizen
Article content continued
In the public health unit regions surrounding Ottawa, the total number of people who’ve had a case of COVID-19 confirmed rose by seven in Eastern Ontario, by six in Hastings Prince Edward, by two in Leeds, Grenville & Lanark and by one in Kingston, Frontenac and Lennox & Addington.
In other news, the province announced $550,000 in support for two companies with plans to add to the supply of made-in-Ontario surgical masks — Viva Healthcare Packaging in Toronto and Ckdpack Packaging in Straffordville.
The funding is being made available through the Ontario Together Fund, a pandemic initiative that’s allowed businesses to apply for money to pivot to PPE production.
Ottawa Public Health reported a new outbreak of COVID-19 Tuesday involving one staff member at the city-run Carleton Lodge long-term care home.
There are 22 ongoing outbreaks of the virus in local health care or congregate living institutions, as well as three in Ottawa schools, and five in community settings (three workplaces, one community organization and one social event).
OPH reported one new COVID-19 death Tuesday, bringing the number of local lives lost to the disease to 376.
With 34 new cases reported Tuesday, the number of active cases now sits at 351.
There are 24 Ottawans hospitalized with COVID-19, (unchanged from the previous day), with one person in ICU.
Quebec reported 1,177 new cases of COVID-19 on Tuesday.
Twenty-eight new deaths were reported, including three over the past 24 hours. Another 22 deaths occurred between Nov. 24 and 29, one happened before Nov. 24 and two more on unknown dates.
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