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Why rollout of COVID-19 vaccine could be ‘the most difficult part’ in Canada

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Despite promising COVID-19 vaccine candidates on the horizon worldwide, experts say Canada needs to overcome major hurdles before it can develop rollout strategies to get the right shot into Canadians’ arms.

News that Pfizer’s vaccine candidate has shown promising preliminary results in Phase 3 clinical trials made headlines this week, but specific data on which patients benefited from the trial, which could inform rollout plans, has yet to be released.

Last week, Prime Minister Justin Trudeau said the country needs “a very sophisticated” rollout plan that will require “high degrees of logistical support.”

But determining who should get a vaccine first is extremely challenging without specific data on who it would help most.

“The rollout is going to be the most difficult part of this vaccine and that’s the part I think everyone is starting to think of today,” Dr. Zain Chagla, an infectious diseases specialist at St Joseph’s Healthcare in Hamilton, told CBC’s The National.

“If the vaccine data shows that the highest risk populations also have the highest reasonable benefit here, I think that prioritization scheme works very well and hopefully that’s the target for the first 10 million doses.”

 

Pfizer says initial data suggests its COVID-19 vaccine is 90 per cent effective. Medical experts call it encouraging, but have a lot of questions. 2:05

But who is most at risk of severe illness and transmission of COVID-19 is still in question, meaning Canada might need to develop several contingency plans.

“If we decide to start with health-care workers, it’s going to be a completely different strategy than if we start by vaccinating the elderly in long-term care facilities,” Dr. Caroline Quach, a pediatric infectious disease specialist and chair of the National Advisory Committee on Immunization (NACI), said on The Current on Tuesday.

“So it’s difficult currently for provinces and territories to have a good idea and a good understanding of how they need to deploy.”

The federal government has reportedly secured enough syringes and needles for provinces and territories to vaccinate all Canadians who wish to receive a COVID-19 vaccine, but Quach says the specific plans are still unclear.

The Public Health Agency of Canada said in a statement to CBC News the federal government is working with provinces and territories to approve and distribute a vaccine as quickly as possible.

 

Dr. Caroline Quach says a lack of key data makes it difficult for provinces and territories to have a good understanding of how they need to deploy a potential vaccine. (CBC)

 

“It is anticipated that in the early stages of rollout, supply availability will be limited,” a spokesperson said.

“The quantity and schedule of availability of vaccines will be the subject of ongoing discussion with provinces and territories to manage expectations and plans for delivery.”

The NACI has released preliminary recommendations that prioritize the elderly and others at severe risk of illness: health-care workers, front-line staff and those with lower access to health care including Indigenous populations.

But to know who should be first in line, the NACI and government officials need to know who fell ill in the vaccinated group compared with the placebo group during clinical trials.

Without answers, governments across Canada will need to hedge their bets.

“They may have to work on two to three plans in parallel,” Quach said. “Just in case one of those will be picked as the first strategy.”

Logistical challenges

How to deploy a vaccine across the country, especially to remote communities such as First Nations, is also a key consideration.

Pfizer’s vaccine candidate needs to be stored at –70 C to –80 C, but commercial refrigerators typically go down to –15 C at the most.

Given that strict temperature requirement, Chaga suspects that Pfizer’s vaccine would be distributed much differently than a typical vaccine.

“We’re probably going to have centralized hubs and teams going out from those hubs to do mass immunization campaigns,” he said. “Rather than what we’re seeing with the flu vaccine with pharmacies and physician offices involved with distribution.”

But Quach says unlike influenza vaccines, there may not actually be enough doses of COVID-19 vaccines to make a significant impact — especially early on.

“We don’t have enough vaccines to vaccinate all Canadians,” she said, adding that COVID-19 vaccines could be distributed over the next 12 to 18 months. “The rollout will be slow.”

 

Alyson Kelvin says she’s discouraged by the fact that Canada has not released preliminary plans for the rollout of a potential vaccine. (Liam Richards/The Canadian Press)

 

Lack of plan concerning

Alyson Kelvin, an assistant professor at Dalhousie University in Halifax and virologist at the Canadian Center for Vaccinology, says she is eager to see a vaccine rollout plan for Canada.

“We need a good strategy to get that out, we need a strategy to get it to our front-line health-care workers, the people who keep our daily lives running, the grocery store workers, as well as we also need to start thinking about the under-served communities.”

Kelvin says she was discouraged that Canada has not released preliminary rollout plans despite the U.S. Centers for Disease Control and Prevention and the World Health Organization doing so months ago.

“Just because we have a vaccine doesn’t mean we’re done. We need to think through how we’re going to get this into people’s arms and who should get it first,” she said. “This is going to be a huge undertaking … it concerns me that I haven’t seen a plan.”

Quach says, unlike the U.S.’s minimum requirement of 50 per cent efficacy for a COVID-19 vaccine, Health Canada has not set a bar for approving a vaccine.

“Being close to our neighbour, we are a little bit stuck with what they are going to decide,” Quach said.

Kelvin said the NACI recommendations were a good start, but were not released in a way that’s easy for average Canadians to understand. It’s also not yet clear whether the federal, provincial and territorial governments will follow those guidelines.

“Information will have to be easily accessible to the public, policy makers and stakeholders for the more effective use of a vaccine when it becomes available,” she said.

“Pharmacists and nurses or those approved to vaccinate the public will need accurate information about the vaccine being given and the rollout plan as it is put in place.”

 

The federal government has taken a very aggressive vaccine buying approach and has already bought millions of doses of Pfizer’s vaccine with the hope it works. And governments are already planning how to distribute vaccines when they’re available, including who will go first. 1:47

Source:- CBC.ca

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Canada adds 4,889 new coronavirus infections as global cases near 60 million – Global News

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Canada added 4,889 new novel coronavirus infections on Wednesday, bringing the country’s total case count to 342,132.
Health authorities also said another 97 have died after contracting COVID-19, pushing the total death toll to 11,618.

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A total of 2,218 people in Canada remain hospitalized after contracting the respiratory illness, while 273,391 have recovered after becoming sick.

Read more:
Two shots. A waiting period. Why the coronavirus vaccine won’t be a quick fix

Speaking at a press conference on Tuesday, Prime Minister Justin Trudeau said the government has secured a deal with Eli Lilly to secure up to 26,000 doses of the pharmaceutical company’s therapeutic drug to treat COVID-19 patients.

“To keep Canadians safe, we need access to as many potential vaccines and treatments as possible,” he said.

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Trudeau added that Canada will have the option to purchase thousands more doses.

The prime minister also said Canada has signed “strong contracts” with various vaccine companies, adding that the government is “working closely with allies on ensuring that there is a free flow of delivery of contracts.”

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Click to play video 'Coronavirus: Canada’s top doctor says implementation of rapid tests up to provinces, territories'



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Coronavirus: Canada’s top doctor says implementation of rapid tests up to provinces, territories


Coronavirus: Canada’s top doctor says implementation of rapid tests up to provinces, territories

Trudeau said the leaders of the G20 nations discussed equitable access to a potential COVID-19 vaccine during the virtual summit last weekend.

“It’s really important to ensure that everyone gets access to vaccines around the world because no one place gets through COVID-19 until all places are done with COVID-19,” he said.

New cases in the provinces

In Ontario, 1,009 new cases were detected on Wednesday. The province also saw 14 new fatalities, bringing the death toll to 3,519.

Meanwhile, Quebec saw 1,124 new infections and 45 new deaths, pushing the total case count and death toll to 134,330 and 6,887, respectively. 

Between Manitoba and Saskatchewan, 646 new infections were reported.

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Manitoba saw 471 new cases and 12 new deaths, while Saskatchewan added 175 new COVID-19 infections.

However, health officials said no one else had died.

In Atlantic Canada, 44 new coronavirus infections were reported.

Read more:
‘Behaviour changed’: Emergency hospital visits fell 50% in early days of pandemic

Nova Scotia added a record 37 new cases, while New Brunswick saw five new infections.

Newfoundland and Labrador saw two new cases, while Prince Edward Island did not report any new infections.

None of the Maritime provinces reported any new fatalities related to the respiratory illness.

Alberta Premier Jason Kenney declared a state of public health emergency on Wednesday, as 1,115 new cases and 16 additional deaths were reported.

The province is implementing more stringent measures for three weeks in order to stem the spread of the virus, including banning indoor social gatherings and expanding the holiday school break.

Meanwhile, British Columbia added 941 new COVID-19 infections, marking a new daily record.

Health officials in the province also said 10 more people have died.

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Cases rise in Nunavut

Ten new cases were detected in Nunavut on Wednesday, but health officials said no one else has died.

The new cases push the territory’s total case load to 144. So far, only two of those cases are considered to be recovered.

Read more:
For Canadians living abroad, a COVID-19 Christmas means difficult decisions

Neither the Yukon or Northwest Territories saw a new case or death related to the virus on Wednesday.

Global cases near 60 million

The total number of novel coronavirus infections around the world hovered below 60 million on Wednesday.

By 6 p.m. ET, there were a total of 59,597,658 confirmed cases of the virus globally, according to a tally from Johns Hopkins University.

So far, the virus has killed 259,372 Americans.

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© 2020 Global News, a division of Corus Entertainment Inc.

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Ford differentiates between Ontarians holding private gatherings and establishments defying COVID-19 rules – CBC.ca

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Premier Doug Ford drew a distinction between Ontarians flouting public health measures through private gatherings and establishments that openly defy the province’s COVID-19 rules Tuesday.

The remarks came in response to questions about at Toronto barbeque restaurant owner publicly vowing to keep his doors open amid the province’s lockdown for the city.

“They have to follow the rules. There can’t be rules for one group and not another,” he said at a news conference Tuesday, less forcefully than in other instances where the premier has come out swinging against people throwing large parties or weddings, for example.

“When it comes to private parties, that’s a different ball of wax,” Ford said. “I’m not going to get up here and start pounding the small business owner when the guy’s holding on by his finger nails. I differentiate between someone at home being reckless and having 100 people over and partying and renting a public storage place … that’s reckless.

“I don’t condone that he opened up but I feel terrible. My heart breaks for these guys … these business-owners, believe me. “But please, in saying all that, you’ve got to follow the protocols and guidelines.”

WATCH | Ford comments on Toronto BBQ restaurant vowing to stay open during COVID-19 lockdown:

Ontario Premier Doug Ford says the owner of a Toronto BBQ restaurant who opened for indoor dining in violation of provincial lockdown orders should follow the rules, and he says his ‘heart breaks’ for small business. 1:12

The restaurant was eventually ordered to shut down by the City of Toronto after bylaw officers, public health inspectors and police were called to the site, city officials said in a statement. 

Rapid testing begins, auditor general set to release report

The province also announced Tuesday that it has begun deploying rapid testing in long-term care homes, rural and remote areas — something the premier called a “gamechanger.”

The rapid tests, which can produce results in minutes rather than days, have been sent to 36 long-term care homes and 27 retirement homes, as well as some hospitals.

The testing kits are earmarked for a total of 22 hospitals, including two that are already using them, as well as remote
communities and some outbreak areas in hot-spot regions, the government said.

Some will also be sent to corporations such as Air Canada and Ontario Power Generation, while others will be used over several months in a pilot project involving private, public and non-profit sector employers to gauge the value of antigen testing on asymptomatic workers, the province said.

Ottawa began shipping the testing kits to the provinces late last month, but figuring out how to best put them to use has taken some time, and most jurisdictions are also verifying the results of rapid tests with a lab-based test.

The “gold-standard” COVID-19 tests need to be processed in a lab, which can take at least a day. Rapid tests can yield results right where the patient is tested but are generally considered less reliable than lab-based tests.

One type of rapid test looks for the genetic material of the novel coronavirus, as does the traditional lab version. The other looks for the specific markers the virus leaves on the outside of a cell, known as antigens.

Ford said the province will continue to deploy the 98,000 ID Now tests and 1.2 million Panbio tests it has received from the federal government in the coming weeks. Health Minister Christine Elliott says another 1.5 million Panbio tests are expected to arrive in Ontario next month.

The announcement comes as a data error resulted in an artificially low daily total of 1,009 new COVID-19 cases on Tuesday.

It also comes just one day before the province’s auditor general is set to issue a three-part report on the province’s pandemic emergency preparedness and its response to COVID-19, including lab testing, case management and contact tracing. 

A spokesperson for Health Minister Christine Elliott said that yesterday’s figure of 1,589 cases (which appeared to be a record high) inadvertently included eight-and-a-half extra hours worth of data from Nov. 22, meaning the total count was inflated. Today’s number adjusts for the mistake.

The new cases include 497 in Toronto, 175 in Peel Region and 118 in York Region. The seven-day average now sits at 1,395.

Other public health units that saw double-digit increases were:

  • Waterloo Region: 40
  • Windsor: 31
  • Simcoe Muskoka: 25
  • Ottawa: 19
  • Niagara Region: 19
  • Durham Region: 16
  • Wellington-Dufferin-Guelph: 16
  • Hamilton: 10
  • Thunder Bay: 14

[Note: All of the figures used in this story are found on the Ministry of Health’s COVID-19 dashboard or in its Daily Epidemiologic Summary. The number of cases for any region may differ from what is reported by the local public health unit, because local units report figures at different times.]

Testing falls to about half of capacity

Today’s additional cases include 270 that are school-related: 223 students and 47 staff. The Ministry of Education said in a statement that the figure is not a one-day increase. Rather it reflects cases identified in schools from 2 p.m. last Friday to 2 p.m. yesterday, and also some others that were not reported Friday because of professional learning days in some boards, including the Toronto public and Catholic boards.

There are currently 703 publicly-funded schools in Ontario, or about 14.6 per cent, with at least one reported instance of COVID-19. Four schools are closed due to the illness, including one in Windsor with 39 cases, the largest school-related outbreak in the province.

There are now 12,917 confirmed, active cases of the illness provincewide, a slight drop from yesterday as 1,082 cases were marked resolved today. 

The further infections in today’s update come as Ontario’s network of labs processed just 27,053 test samples for the novel coronavirus, and added 29,316 to the queue to be completed. There is currently capacity in the system for up to 50,000 tests daily. Meanwhile, the province reported a test positivity rate of 5.8 per cent.

The official COVID-19 death toll grew by 14, up to 3,519. So far this month, 374 people with COVID-19 have died in Ontario. 

Hospitalizations of people with COVID-19 also jumped, up 27 to 534. Of those, 159 are being treated in intensive care and 91 with ventilators. Public health officials have identified 150 patients in ICUs as the threshold for when unrelated surgeries and procedures are likely to be postponed because of burdens on the hospital system.

Meanwhile, a group of engineers, physicians and other professionals issued an open letter to the province Tuesday, calling for updated COVID-19 guidelines that emphasize the importance of ventilation when it comes to curbing the risk of spreading the virus

‘With winter approaching, our activities are moving indoors and it is therefore imperative that public institutions, workplaces and individuals understand the risk of aerosol transmission as well as the actions that can be taken to combat it,” the letter says.

Backed by 36 professionals, it also calls on the province to mandate and fund ventilation assessments and upgrades of settings like schools and long-term care homes, establishing ventilation standards for reopening, among other measures.

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The latest news on COVID-19 developments in Canada on Nov. 23, 2020 – Kamloops This Week

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The latest news on COVID-19 developments in Canada (all times Eastern):

6:15 p.m.

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There have been 17 deaths in British Columbia over three days due to COVID-19 and provincial health officer Dr. Bonnie Henry says most of the victims were seniors in long-term or assisted care.

There have been 1,933 new cases since Friday, with 1,304 of them diagnosed in the Fraser Health region.

There are 60 active outbreaks in health-care facilities, including 54 long-term care or assisted-living sites and six hospitals or acute-care facilities.

Henry says it’s now the most challenging time of COVID-19 and everyone is feeling the strain.

4:10 p.m.

Saskatchewan Premier Scott Moe is self-isolating due to a possible exposure to COVID-19.

A spokesman for Moe’s office says the potential exposure happened on Nov. 15 in the Prince Albert area.

Jim Billington says the premier is not experiencing symptoms but was tested today out of an abundance of caution.

He says Moe is to work remotely from his home in Shellbrook until Sunday.

The province announced 235 new cases today and four new deaths.

2:55 p.m.

Nova Scotia is reporting 11 new cases of COVID-19 today.

The province says the new cases were identified on Sunday in the Central Zone, bringing its total active case count up to 51.

Eight of the infections are connected to previously reported cases, while three are still under investigation.

Officials say the recent rise in cases has led to stricter rules for metro Halifax Regional Municipality and parts of Hants County which go into effect today.

2:10 p.m.

New Brunswick is reporting one new death and 15 new cases of COVID-19.

The new death brings the provincial fatality total to seven.

The province currently has 89 active cases of novel coronavirus and has registered 445 total cases and 349 recoveries.

Premier Blaine Higgs says there are no changes planned at this point around the Atlantic bubble despite the temporary withdrawal of Newfoundland and Labrador and Prince Edward Island.

1:40 p.m.

COVID-19 cases in Yukon have jumped to 38, 14 more infections than just a week ago.

Territorial health officer Dr. Brendan Hanley says two of the new cases involve children under nine years old and at least one of those infected is over 60.

Yukon increased restrictions last week as infection rates jumped in jurisdictions around it, requiring all but critical services workers to self-isolate for two weeks when they enter the territory.

Hanley says community transmission has not yet been ruled out in some of the latest cases.

1:40 p.m.

Manitoba health officials are reporting a record-high 543 new COVID-19 cases.

Chief public health officer Dr. Brent Roussin says there are some positive signs, however.

He says the average number of contacts per case is dropping, which could slow the spread of the novel coronavirus.

Manitoba brought in strict measures last week that limit store openings and public gatherings.

11:40 a.m.

Newfoundland and Labrador is reporting two new cases of COVID-19 and its first case confirmed in a school.

In a press conference today, officials announced one of the new cases is a student at the elementary school in Deer Lake, in western Newfoundland.

The student’s infection is connected to a cluster of cases in the area.

Officials say the other case is also in western Newfoundland, but is related to travel and is not connected to the ongoing cluster.

11:20 a.m.

Prince Edward Island Premier Dennis King has announced his province will be temporarily withdrawing from the Atlantic bubble for a two-week period starting tomorrow.

He says it’s a necessary step because of a spike in COVID-19 cases in the other three Atlantic provinces.

King says all non-essential travel to and from the Island will be suspended until December 7th, at which time the situation will be re-evaluated.

The Island reported one new case of COVID 19 today.

11:10 a.m.

Quebec is reporting 1,164 new cases of COVID-19 and 13 more deaths attributed to the novel coronavirus, including three that occurred in the past 24 hours.

Health officials say today that hospitalizations decreased by eight, to 634, and 98 patients were in intensive care, a drop of five.

The province says 1,282 more people recovered from COVID-19, for a total of 115,367 recoveries.

Quebec has reported 133,206 COVID-19 infections and 6,842 deaths linked to the virus since the start of the pandemic.

10:45 a.m.

Ontario is reporting 1,589 new cases of COVID-19 today, and 19 new deaths due to the virus.

Health Minister Christine Elliott says 535 in Peel Region, 336 cases are in Toronto, and 205 cases in York Region.

The province says it has conducted 37,471 tests since the last daily report.

In total, 507 people are hospitalized in Ontario due to COVID-19, including 156 in intensive care.

This report by The Canadian Press was first published Nov. 23, 2020.

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