It is possible, but rare, to be infected with flu and COVID-19 at the same time.
Getting a flu shot is always a good idea. But infectious diseases experts say it’s crucial this year as the northern hemisphere faces a “twindemic” — the perfect storm of the convergence of COVID-19 and the seasonal flu.
It’s a scenario that could endanger an already strained health care system.
“Having two circulating respiratory viruses is not a good thing. This is something we can do something about,” said Dr. Kumanan Wilson, a senior scientist in the clinical epidemiology program with The Ottawa Hospital Research Institute and a professor of medicine at the University of Ottawa.
If COVID-19 testing centres are already exhausted and people show up with respiratory symptoms, it will overwhelm testing capacity, he said.
“From a societal perspective, we have to reduce the pressure on our health-care system.”
The flu season also presents a potential drain on families and workplaces. People with any respiratory symptoms, whether they are flu or COVID-19, will have to remove themselves from school and work.
The flu presents its own dangers. According to the Public Health Agency of Canada, there are an average of about 12,200 hospitalizations and 3,500 deaths related to the flu every year. Based on laboratory testing, there were 42,541 cases of seasonal influenza in 2019-2020.
“Everyone should get the flu vaccine this year,” Wilson said. “It’s a no-brainer.”
Concern about a potential twindemic is not overblown, epidemiologist Dr. Jeff Kwong said.
“Most health care workers would say we’re barely managing in a normal flu season. We’re always on the verge of collapse. If you add COVID, we’re in big trouble,” said Kwong, a professor at the Dalla Lana School of Public Health at the University of Toronto.
“The biggest problem with how we view influenza is that there are other respiratory viruses circulating,” he said. “The flu is a whole bunch of viruses with a whole bunch of different presentations. They’re impossible to distinguish without lab tests.”
If people let down their guard on measures to prevent the transmission of COVID-19, such as wearing masks, physical distancing and hand hygiene, there will be a twindemic, Kwong said.
“If people keep having parties, we’ll have influenza. But, if you can control COVID, you can control influenza.”
It is also possible, but rare, to be infected with flu and COVID-19 at the same time. A study published in June in the Journal of Medical Virology found that, among 1,103 patients who had been diagnosed with COVID‐19 in three hospitals in Istanbul, Turkey, six were diagnosed as also being infected with influenza. Co-infected patients have been reported in China, Germany, Iran, Japan, Spain and the United States.
In Canada, provinces and territories have ordered nearly 13.8 million doses of flu vaccine, an increase of 2.6 million over estimated demand at this time in 2019, said Maryse Durette, a spokeswoman for the Public Health Agency of Canada. A small reserve has also been created and it will be available for provinces and territories if needed.
So far, so good. Last year at this time, there were concerns that the flu vaccine might not be available until early November for most people because of delays in recommendations and production.
This year, flu vaccine will be made available for delivery beginning in mid-September, with most deliveries completed by the end of October, Durette said. To meet the increased demand this year, a small portion of Canada’s requirement will also be supplied in November and December.
“At the present time, no supply issues are expected this year and the increased demand by provinces and territories that has occurred since orders were first placed with suppliers in February is expected to be met in full.”
But getting the flu vaccine rolled out this year may produce additional challenges.
Health Canada has flagged some concerns, including the availability of staff and access to PPE for those who will be administering flu shots.
There are also some unknowns, including the public’s fear of exposure to COVID-19 while being immunized for flu. At the same time, there is the potential of increased demand for flu shots early in the season, something that was seen in the southern hemisphere, where the flu season starts in March.
“We don’t want people congregating as they usually do in gymnasium-type programs,” Wilson said. “We need to do it differently. And well.”
Among the possibilities according to Health Canada: drive-through and parking lot clinics in locations ranging from car washes, arenas, insurance inspection centres and drive-thu tents.
Ottawa Public Health is still working out its flu shot strategy and is to present more detail Monday at a board of health meeting.
Pharmacists, who already administer between 40 and 50 per cent of flu shots in Canada, will also be enlisted to do more.
“We’re expecting increased demand. People are already making reservations,” said Shelita Dattani, director of professional affairs at the Canadian Pharmacists Association, which has already posted a fact sheet about what to expect from pharmacies this year.
Pharmacists may be delivering flu shots by appointment, through dedicated hours for walk-in clients, special hours for vulnerable patients, off-site services such as home visits and clinics at community halls or temporary structures.
“If there is one thing you can control this year, it’s the flu shot,” Dattani said. “It’s going to be a busy year.”
For those who monitor the spread of influenza, the Australian experience of the flu season, which just ended, is a sign for hope.
According to an Australian department of health report released Sept. 6, influenza and influenza-like illness activity was lower than average across all systems for this time of year.
There were 21,119 cases of laboratory-confirmed influenza and 36 laboratory-confirmed deaths related to flu in Australia. The numbers dropped and remained low as the flu season went on.
Many who monitor the situation, including Wilson and Kwong, believe COVID-prevention measures such as physical distancing helped to reduce the spread of flu in Australia.
Meanwhile, a study published last month in the Journal of Pediatrics of almost 3,000 families found that more parents planned to vaccinate their children for flu season.
The researchers asked parents who visited 17 emergency departments in Canada, Israel, Japan, Spain, Switzerland and the U.S. between mid-March and the end of June about their willingness to vaccinate their children. About 54 per cent said they did, an increase of nearly 16 per cent from last year. Among those who did not vaccinate their children last year, almost 29 per cent planned to vaccinate this year.
Dr. Ran Goldman, a researcher and professor of pediatrics at the University of British Columbia and the study’s lead researcher, is hoping that a minimum of 70 per cent of the population will get the flu vaccine.
It’s a tall order. Having 40 per cent of the population immunized for flu in an ordinary year is considered very good, Kwong said. Only among vulnerable groups such as people over 65 and those with chronic illnesses do the numbers reach 70 per cent.
As a pediatrician, Goldman says he sees parents are more open to flu shots for their children, especially after he explains to them that children may be vectors of the flu for older people, such as grandparents. If you protect children, you are protecting everyone around them, he said.
“I’m hoping for a milder flu season, but you can’t trust luck,” he said. “We need to tell parents to roll up their sleeves … and the sleeves of their children.”
The flu shot is not 100 per cent effective, as public health authorities have to make an educated guess about what strain will be in circulation. Given the low number of cases in 2020, it has been difficult to assess vaccine match and effectiveness, Australian authorities said.
For Canada, it’s still too early to say what might happen. Another strain of flu may appear in the early spring. The flu strain in circulation in November is not necessarily the same strain in circulation in March, Wilson said.
“But, if you could reduce your risk, why wouldn’t you do it? Even in a worst-case scenario, it’s still worth it.”
Meanwhile, Wilson sees the roll-out of this year’s flu vaccine as practice for rolling out a COVID-19 vaccine — when one becomes available — under physical distancing constraints.
“It will help us figure out the logistics.”
Quebec reports another quadruple-digit COVID-19 case count, 20 new deaths – Squamish Chief
A COVID-19 outbreak at a Quebec pork-processing plant grew Thursday as Manitoba expanded its restrictions and Alberta announced a testing pilot at two international border crossings that it hopes will eventually boost its ailing travel industry.
Olymel said 62 workers at its plant southeast of Quebec City had tested positive for the novel coronavirus.
The union representing plant workers is calling for a temporary closure, but the company says it is following guidance from public health officials who have not recommended a shutdown.
One worker died following a positive test result, but it wasn’t yet determined whether the death was due to the novel coronavirus.
Quebec, the province hardest-hit by COVID-19, reported 1,033 new cases Thursday and 20 additional deaths. Five hundred and fifty-three people were in hospital, including 101 in intensive care.
Premier Francois Legault said chances are slim restaurants in Quebec’s largest cities will be allowed to reopen this month as the province continue to report daily case increases in the quadruple digits.
Montreal and Quebec City have been under a 28-day partial lockdown since Oct. 1.
“At this time, we need to reduce even the risk of contact because we cannot afford to continue having about 1,000 new cases every day,” Legault said.
Manitoba reported four COVID-19 fatalities on Thursday in its deadliest day yet.
Dr. Brent Roussin, the chief provincial public health officer, announced 147 new cases — 87 in Winnipeg, where more restrictions on restaurants, pubs and gathering sizes came into effect this week.
He said the measures will also apply to the northern health region and Churchill starting next week. Extra measures are being put in place for schools in the Winnipeg area and the north starting Monday, including cancelling field trips, banning choirs and wind instruments and requiring substitute teachers to wear medical masks.
Manitoba’s daily test positivity rate is up to 5.6 per cent.
“We have to change things. We fell back on the fundamentals,” Roussin said. “We got back to all that normalcy that we want, but we just know this is what happens when we attempt that.”
Also Thursday, the European Union’s council reimposed a travel ban on Canada, reversing a decision in June that lifted entry restrictions on a number of non-EU countries. Europe is battling a second wave of the pandemic.
In Alberta, Premier Jason Kenney announced a joint federal-provincial pilot project that will enable international travellers re-entering Canada via the Calgary International Airport or the Coutts land border crossing from Montana to avoid a full 14-day quarantine. Instead, they would only have to isolate for a matter of days.
The pilot is to begin on Nov. 2 and is open to asymptomatic travellers returning to Canada who are Canadian citizens, permanent residents or foreign nationals permitted to enter Canada.
“Though a lot of work lies ahead, we can see a return to normal travel,” said Kenney. “The results will help shape provincial and federal policy and ultimately they’ll help to find a new approach for international travel.”
Those who voluntarily participate will receive a COVID-19 test upon entry into Canada before going into quarantine. If the result is negative, they can leave, as long as they promise to get tested six or seven days later at a pharmacy.
Participants will be subject to daily symptom checks and will have to wear masks in public places and avoid visiting high-risk groups.
Anyone who chooses not to get a test will still have to quarantine for two weeks.
Kenney said the provincial tourism industry has suffered a 63 per cent drop in spending this year. He also noted that three per cent of the province’s active cases were acquired through travel.
“We must find ways to bring back safe travel if we’re ever going to get the economy firing again on all cylinders.”
Kenney made his remarks by phone as he was self-isolating at home. The premier tested negative for the novel coronavirus on Wednesday, but said he will remain in isolation for another week.
Kenney attended events with Municipal Affairs Minister Tracy Allard, who contracted COVID-19 last week.
Alberta reported 427 new infections in Thursday’s update, a new record and the second day in a row its daily case count breached the 400 mark. Its test positivity rate was at three per cent on Wednesday.
Ontario Premier Doug Ford said his government is keeping a “sharp eye” on the Alberta border pilot project.
“I’d be open to it, but I just first want to see what’s happening in Calgary,” said Ford, who noted that Pearson International Airport in Toronto gets far more volume and international traffic.
Ontario reported 841 new cases of COVID-19 on Thursday as two more Toronto hospitals declared outbreaks.
Canada’s most populous province also recorded nine more deaths and had a daily test positivity rate of 2.5 per cent.
Two hundred and seventy people were in hospital, including 74 in intensive care and 48 on ventilators.
The Scarborough Health Network said six patients were infected in one unit at its general hospital, and the University Health Network said it was dealing with an outbreak involving four patients at the Toronto Rehabilitation Institute.
St. Michael’s Hospital, St. Joseph’s Health Centre, Toronto Western Hospital and the Centre for Addiction and Mental Health have also declared outbreaks among staff or patients.
This report by The Canadian Press was first published Oct. 22, 2020.
COVID-19 Today: A look at the numbers for Newmarket, York Region, Ontario – NewmarketToday.ca
Newmarket (reported Wednesday, Oct. 21 at 5 p.m.)
- 348 cases of COVID-19
- 4 new cases since Oct. 20
- 303 (+5) cases resolved (87%)
- 23 (-1) active cases
- 22 deaths
- 1 (-2) hospitalized, 1 in ICU
- 2 institutional outbreaks: outbreak #2 at Mackenzie Place LTC (2 health-care workers);outbreak #2 at Vita Community Living (3 residents, 7 staff)
- 4 schools under surveillance: Newmarket High; Huron Heights Secondary, Terry Fox P.S., Sir William Mulock Secondary
- 18 (+1) new cases in last 7 days
- 390 (+5) cases per 100,000 population
- 1,084 tests Oct. 11 to 17: 14 positive (1%), 1,067 negative, 3 indeterminate
The Nitty Gritty
- 136 cases outbreak, or 39%
- 93 (+2) cases close contact, or 27%
- 65 (+1) cases community transmission, or 19%
- 13 cases under investigation, or 5%
- 24 cases travel, or 7%
- 11 cases workplace outbreak, or 3%
- 68 cases age 19 to 34, 20%
- 62 cases age 80+, or 18%
- 54 cases age 55 to 64, or 16%
- 54 (+1) cases age 35 to 44, or 16%
- 49 cases age 65 to 79, or 14%
- 43 (+3) cases age 45 to 54, or 12%
- 9 cases age 4 to 13, or 3%
- 8 cases age 14 to 18, or 2%
- 1 case age 0 to 3, or 0%
York Region (reported Wednesday, Oct. 21 at 5 p.m.)
- 5,816 confirmed cases of COVID-19
- 103 new cases since Oct. 20
- 4,846 (+76) cases resolved (83%)
- 703 (+23) active cases
- 2 more deaths, totalling 267
- An 86-year-old Markham woman passed away Oct. 20 at Mackenzie Health, Richmond Hill (institutional outbreak at Mackenzie Health)
- An 80-year-old Vaughan man passed away Oct. 17 at Etobicoke General Hospital (close contact)
- 41 (-3) cases are hospitalized; 6 (-1) patients in ICU
- 166 (+4) workplace outbreaks, 21 (+3) active, 871 (+9) cases
- 607 (-23) new cases reported in last 7 days
- 543 (+11) cases per 100,000 population
- 78 (+2) new community cases daily average in last 7 days
- 0.95 (-0.02) 7-day median reproductive number*
- 40% of new cases unknown source of infection
- 13,019 total tests Oct. 11 to 17: 550 (4%) positive, 12,448 negative, 21 indeterminate
*Rt is the average number of people who become infected by an infectious person. If above 1.0, the virus will spread quickly. When Rt is below 1.0, the virus stops spreading.
Cases in schools, child care centres
- Full daily reporthere
- 4 (+1) school outbreaks
- Outbreak declared Oct. 21 at Sir Walter Scott Public School, Richmond Hill (2 staff)
- 2 schools closed
- 99 (+5) school cases to date
- 69 (+4) schools under surveillance, 41 (+4) active
- 5 (+3) active child care centre outbreaks
- 12 (+4) child care cases to date
- 108 (+1) institutional outbreaks; 23 (-1) active
- Outbreak #3 declared Oct. 20 at Participation House – Farintosh, Markham (1 health-care worker)
- 12-day outbreak #3 resolved Oct. 20 at Villa Leonardo Gambin LTC, Vaughan (2 health-care workers)
- 25-day outbreak resolved Oct. 20 at Mackenzie Health LTC, Richmond Hill (2 health-care workers)
The Nitty Gritty
- 2,528 (+46) cases, or 43%, close contact
- 1,415 (+29) cases, or 24%, community transmission
- 1,076 (+2) cases, or 19%, institutional outbreak
- 229 cases under investigation, or 4%
- 250 cases, or 5%, travel
- 238 (+4) cases, or 4%, workplace outbreak
- 1,547 (+25) cases age 19 to 34, or 27%
- 972 (+20) cases age 45 to 54, or 17%
- 908 (+11) cases age 55 to 64, or 16%
- 710 (+18) cases ages 35 to 44, or 12%
- 622 (+10) cases age 65 to 79, or 11%
- 599 (+2) cases age 80+, or 11%
- 211 (+8) cases age 14 to 18, or 4%
- 188 (+6) cases age 4 to 13, or 3%
- 59 (+1) cases age 0 to 3, or 1%
Around the region:
- Vaughan 2,512 (+39) cases, 341 (+11) active
- Markham 1,356 (+41) cases, 167 (+16) active
- Richmond Hill 731 (+13) cases, 60 (+1) active
- King 143 (+1) cases, 37 (-1) active
- Aurora 232 cases, 24 (-2) active
- Newmarket 348 (+4) cases, 23 (-1) active
- Whitchurch-Stouffville 166 (+2) cases, 23 active
- East Gwillimbury 130 (+2) cases, 22 active
- Georgina 182 (+1) cases, 2 active
Ontario (reported today at 10:30 a.m.):
- 67,527 confirmed cases of COVID-19
- 841 new cases since Oct. 20
- 9 more deaths, totalling 3,071
- 58,066 resolved 86% of cases
- 270 (+10) cases are hospitalized; 74 (+3) in ICU; 48 (-1) on ventilators
- 38,860 more tests completed, with 34,784 awaiting results
- 2.5% (-1.1%) positivity Oct. 20
Cases in schools, child care centres and homes
- Full daily reporthere
- 531 (+2) outbreaks at long-term care homes, 79 (-1) active
- 249 outbreaks at retirement homes, 45 (-2) active
- 118 outbreaks at hospitals, 15 (-1) active
- 1,984 (+3) long-term care resident deaths
- 6,487 (+25) cases are long-term care residents
- 7,532 (+29) cases are health-care workers (11.3%)
70 new COVID-19 cases, 1 more death in Ottawa – CBC.ca
Ottawa Public Health (OPH) is reporting 70 cases of COVID-19 and one additional death Thursday.
That’s precisely on par with the rolling seven-day average of new cases in the city. Slightly more than half of the new cases reported Thursday are people under 40, OPH said.
A total of 6,296 Ottawa residents have now tested positive for COVID-19, including 675 known active cases, 5,312 resolved cases and 309 deaths.
Ottawa’s medical officer of health Dr. Vera Etches, who announced on Sept.18 that a second wave of the illness had struck Ottawa, said Wednesday there are signs the rate spread in the capital may be plateauing.
There was still plenty of availability at Ottawa’s COVID-19 testing sites Thursday, though the backlog of swabs sitting at local labs for more than 24 hours had grown to more than 2,300 on Wednesday.
OPH is now hearing about positive tests within 48 hours 73 per cent per cent of the time, continuing its slow improvement.
There are now 49 patients being treated for COVID-19 in Ottawa hospitals, five of them currently in intensive care — the fewest in an ICU since early October.
There are new outbreaks at All Saints High School and École élémentaire catholique Montfort, while OPH has declared an outbreak at École élémentaire catholique Saint-Joseph d’Orléans over. There are active outbreaks at 10 Ottawa schools.
Elsewhere, the Hastings Prince Edward Health Unit is reporting three new cases of COVID-19, while 32 more people have tested positive in western Quebec.
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