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World needs to up game against emerging infectious diseases: Dr. Theresa Tam

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OTTAWA — Canada’s chief public health officer says the world must erect better defences against transmissible viruses as climate change and other factors raise the risk we will see more emerging infectious diseases in the years to come.

Dr. Theresa Tam’s comments come as Canada has now confirmed 77 cases of monkeypox, with 71 in Quebec, five in Ontario and one in Alberta.

Globally, there are at least 550 confirmed cases in 30 non-endemic countries where the virus has not usually been found. It is the largest outbreak ever outside West and Central Africa, where it is endemic now in at least 10 countries.

The World Health Organization has not pinpointed where this current outbreak began, but WHO director general Tedros Adhanom Ghebreyesus said Wednesday “the sudden appearance of monkeypox in many countries at the same time suggests there may have been undetected transmission for some time.”

Tam said the cases in Canada currently involve a specific group of individuals that have close, intimate sexual contact, but that could change.

“At the moment it hasn’t gone much beyond the initial risk groups, but it could happen and we need to be ready for that,” she said.

Public health officials have said while everyone is susceptible to the virus, clusters of cases have been reported among men who have sex with men.

Tam’s deputy, Dr. Howard Njoo, has said he’s mindful of the potential for stigma and discrimination and emphasized that the virus’s spread isn’t limited to any specific group.

Tam said from a broader perspective, Canada and the rest of the world need to be better equipped when outbreaks like this occur.

“Emerging infectious disease can always hit us,” she said. “And we should be as prepared as we can, which means reinforcing the global public health capacity.”

Tam said improving capacity in every country “is really important” because with climate change and other factors there is more human and animal interaction, which is often how animal-borne viruses turn into human pandemics.

“I think we’ll see an increase in numbers of these types of emerging infectious diseases, and with good capacity, not just in Canada, but globally we can help to manage them and reduce their impact as much as possible,” Tam said.

The first non-endemic cases of monkeypox were confirmed in the United Kingdom in early May. The first cases were confirmed in Canada May 19.

African scientists and doctors are weary about the sudden interest in monkeypox as it infects western countries, which largely have ignored the virus as it spread around parts of Africa.

Tam on Friday called it a “neglected tropical disease.”

“We need to have better international collaboration and support in order to collectively learn together globally,” she said.

Monkeypox got its name because it was first found in monkeys in a laboratory in Denmark in 1958, but in the wild it is found mainly in small rodents such as rats, squirrels and shrews.

A global population exhausted following two years of the COVID-19 pandemic view the arrival of monkeypox with alarm and fear, though the virus does not spread through the air like the one that causes COVID-19 does.

Instead, the monkeypox virus spreads mainly through close contact with the virus on other humans or objects such as bed linens. While it can be fatal, it is most often not, causing symptoms such as fever, headache and muscle aches, and pox-like lesions on the skin.

It can take one to two weeks for an infected person to show symptoms, and Tam warned that while we know a lot about how the monkeypox virus behaves in countries where it is endemic, we know little about how it may behave in populations that are both mostly unvaccinated against it and have no natural levels of immunity.

A vaccine created for smallpox is also approved for use against monkeypox and Canada has a supply of the vaccine. Some doses were already sent to Quebec to vaccine close contacts of known cases, and Tam said conversations with every province are ongoing to determine whether some should be “prepositioned” all over the country.

She said contact tracing is proving difficult and while there is no expectation of a wide-scale public vaccination campaign for monkeypox, the existing campaign may be expanded to try and bring the outbreak in Canada to a close.

This report by The Canadian Press was first published June 3, 2022.

 

Mia Rabson, The Canadian Press

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COVID-19 vaccines saved 20M lives in 1st year, scientists say – CTV News

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Nearly 20 million lives were saved by COVID-19 vaccines during their first year, but even more deaths could have been prevented if international targets for the shots had been reached, researchers reported Thursday.

On Dec. 8, 2020, a retired shop clerk in England received the first shot in what would become a global vaccination campaign. Over the next 12 months, more than 4.3 billion people around the world lined up for the vaccines.

The effort, though marred by persisting inequities, prevented deaths on an unimaginable scale, said Oliver Watson of Imperial College London, who led the new modelling study.

“Catastrophic would be the first word that comes to mind,” Watson said of the outcome if vaccines hadn’t been available to fight the coronavirus. The findings “quantify just how much worse the pandemic could have been if we did not have these vaccines.”

The researchers used data from 185 countries to estimate that vaccines prevented 4.2 million COVID-19 deaths in India, 1.9 million in the United States, 1 million in Brazil, 631,000 in France and 507,000 in the United Kingdom.

An additional 600,000 deaths would have been prevented if the World Health Organization target of 40% vaccination coverage by the end of 2021 had been met, according to the study published Thursday in the journal Lancet Infectious Diseases.

The main finding — 19.8 million COVID-19 deaths were prevented — is based on estimates of how many more deaths than usual occurred during the time period. Using only reported COVID-19 deaths, the same model yielded 14.4 million deaths averted by vaccines.

The London scientists excluded China because of uncertainty around the pandemic’s effect on deaths there and its huge population.

The study has other limitations. The researchers did not include how the virus might have mutated differently in the absence of vaccines. And they did not factor in how lockdowns or mask wearing might have changed if vaccines weren’t available.

Another modelling group used a different approach to estimate that 16.3 million COVID-19 deaths were averted by vaccines. That work, by the Institute for Health Metrics and Evaluation in Seattle, has not been published.

In the real world, people wear masks more often when cases are surging, said the institute’s Ali Mokdad, and 2021’s Delta wave without vaccines would have prompted a major policy response.

“We may disagree on the number as scientists, but we all agree that COVID vaccines saved lots of lives,” Mokdad said.

The findings underscore both the achievements and the shortcomings of the vaccination campaign, said Adam Finn of Bristol Medical School in England, who like Mokdad was not involved in the study.

“Although we did pretty well this time — we saved millions and millions of lives — we could have done better and we should do better in the future,” Finn said.

Funding came from several groups including the WHO; the U.K. Medical Research Council; Gavi, the Vaccine Alliance; and the Bill and Melinda Gates Foundation.

——

AP health and science reporter Havovi Todd contributed

——

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content

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ACIP Backs Moderna's COVID Shot for Kids 6-17 Years – Medpage Today

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The CDC’s Advisory Committee on Immunization Practices (ACIP) voted unanimously on Thursday to recommend that children ages 6-17 years receive Moderna’s COVID-19 vaccine.

With a 15-0 vote, ACIP endorsed a two-dose primary series of the mRNA vaccine for kids ages 6-11 years (50 mcg per dose) and adolescents ages 12-17 (100 mcg per dose). The recommendation now awaits approval from CDC Director Rochelle Walensky, MD, MPH.

The recommendation was largely expected, and followed FDA’s emergency use authorization last week. Until then, only Pfizer/BioNTech’s mRNA vaccine had been authorized and recommended for these age groups.

At Thursday’s meeting, ACIP members considered safety and efficacy data on Moderna’s vaccine, which was primarily studied during periods where the ancestral SARS-CoV-2 and Delta strains were predominant, in teens and the younger kids, respectively. In both groups, the vaccine was effective against severe disease and hospitalization.

“We know that the benefits outweigh the risks for mRNA COVID-19 vaccine in all ages,” said Sara Oliver, MD, of the CDC’s National Center for Immunization and Respiratory Diseases, during the meeting. “Receipt of this primary series continues to be the safest way to prevent serious COVID-19.”

Oliver emphasized that serious outcomes with COVID-19 do not spare kids. The Omicron wave was accompanied by a surge in hospitalizations among children, and she pointed to 189 COVID-related deaths in kids 5-11 years and 443 in kids 12-17 throughout the course of the pandemic.

Several ACIP members raised questions about the intervals between the first and second dose of the Moderna vaccine, as such an approach may reduce the risk of myocarditis associated with the vaccine. Some evidence suggests the Moderna vaccine carries a higher risk of myocarditis or pericarditis than Pfizer’s vaccine, though CDC experts cautioned that these findings are not consistent in all U.S. monitoring systems.

Among close to 55 million doses of Pfizer’s vaccine administered to individuals ages 5-17 years, the rare adverse event has been observed in at least 635 children, according to the CDC. Risk is typically higher among children ages 12-17, in boys, and after the second dose. Among kids age 5-11, there were no signals detected.

In a presentation on clinical considerations, Elisha Hall, PhD, of the CDC’s National Center for Immunization and Respiratory Diseases, said that although the current recommendation is for a 4-week gap between the first and second doses, the CDC will likely be recommending an 8-week interval for adolescent males. (The CDC also recommends shorter dose intervals for children who are immunocompromised.)

Some of the ACIP members expressed confusion about the product labels on Moderna’s vaccines in each age group. The product authorized for kids 6-11 will have the same color cap as the vaccine for children ages 6 months to 5 years, but a different color border to distinguish the higher concentration. For the product authorized for kids ages 12-17, it will have the same label as the adult vaccine, as it is the same dose.

“I am … concerned about vaccine administration errors,” said Matthew Daley, MD, chair of ACIP’s working group. Others echoed concerns about administration blunders, encouraging more resources for providers and further clarification on labeling from the manufacturer.

Safety and efficacy data for Moderna’s vaccine in this younger population came from two ongoing phase II/III clinical trials (study mRNA-1273-P203 for adolescents ages 12-17 and study mRNA-1273-P204 for kids ages 6-11 years). The studies included nearly 8,000 kids in total.

Among participants ages 12-17, vaccine efficacy was 93.3% (95% CI 47.9-99.9) during a time when the ancestral and Alpha strains were predominant. Among the younger group, vaccine efficacy was 76.8% (95% CI -37.3 to 96.6) during a period when Delta was most prevalent.

The committee agreed on the data that COVID-19 vaccines protect children against severe disease. Many children in this age group, however, remain unvaccinated. Approximately 30% of teens and 65% of younger kids have yet to receive a vaccine, according to Oliver.

“We can predict with future COVID-19 surges, the unvaccinated will continue to bear the burden of disease,” she said.

  • Amanda D’Ambrosio is a reporter on MedPage Today’s enterprise & investigative team. She covers obstetrics-gynecology and other clinical news, and writes features about the U.S. healthcare system. Follow

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COVID Rates Dropping; Vaccination Campaign Continues – ckdr.net

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Health officials in Canada are warning of a seventh wave of COVID-19 this fall, with a possible new variant.

Dr. Kit Young Hoon is the Medical Officer of Health for the Northwestern Health Unit and stresses they will be ready.

“Although the timing of an increase in COVID-19 specifically is difficult to predict, the Northwestern Health Unit will be prepared to offer large-scale COVID-19 vaccinations in the fall to protect our communities most vulnerable.”

She notes the vaccine remains the best way to stay protected and vaccines continue to be offered for those eligible.

The Health Unit is reporting 132 COVID cases confirmed through PCR testing.

One hundred of them are in communities under the jurisdiction of the Sioux Lookout First Nations Health Authority.

Medical Officer of Health Dr. Kit Young Hoon says numbers are lower elsewhere.

“Overall, there’s been a steady decrease in hospitalizations due to COVID-19 locally. Case numbers in most health hubs are low, as are our institutional outbreak numbers”.

The positivity rate is sitting at 11.2%.

Case count (Health Hubs):

-Sioux Lookout (on reserve): 100
-Kenora: 15
-Sioux Lookout: (off reserve): 5
-Dryden: 4
-Red Lake: 3
-Fort Frances: 3
-Atikokan: 2

There are 3 institutional COVID outbreaks in the region.

That includes one at the Pinecrest home for the aged in Kenora.

Recent testing showed 25 residents testing positive for the virus.

Day and overnight absences have been placed on hold for the time being, but one essential caregiver is allowed for each resident.

Meantime, the Northwestern Health Health Unit says it’s important to continue to get booster doses for COVID-19 vaccinations.

Dr. Kit Young Hoon says there is evidence that the first or second dose starts to drop.

“The vaccine protection does wane somewhere around the six month mark, maybe a little bit earlier or a little bit later, depending on the individual,” says Dr. Young Hoon.

“So its important to have some sense what’s going on, with respect to vaccination policy, and know when you might be eligible in the future for your next dose.”

She adds vaccination criteria hasn’t changed that much over the past few months.

“If its been more than three month since you had COVID then you should be looking to book an appointment for your booster dose. There is added benefit from and protection from a booster dose so you have significantly reduced risk of severe illness and decreased risk from being infected.”

Dr. Young Hoon expects fourth dose eligibility will decrease from 60 years of age and older over the next few months, and the vaccine for kids under the age of five should be available later this summer.

For information on vaccinations, visit Northwestern Health Unit

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