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Yet-to-be-released analysis suggests 60% higher risk of death from COVID-19 variants: Sources – CBC.ca

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Variants of the virus behind COVID-19 double the risk of someone being admitted to intensive care — and increase the risk of death by roughly 60 per cent — according to a new analysis of recent Ontario data from the province’s science advisory table, multiple sources tell CBC News.

A briefing note prepared by table members for the province, which is expected to be made public early next week, is based on an analysis of Ontario hospitalization and death data between December and March.

The analysis is expected to show that variants substantially increase the risk of serious illness when compared to the initial strain of SARS-CoV-2, including:

  • 60 per cent increased risk of hospitalization.
  • 100 per cent increased risk of being admitted to an ICU.
  • 60 per cent increased risk of death.

The data didn’t differentiate between variants, though most instances in Ontario right now are thought to be the B117 variant first identified in southeast England.

The Ontario figures were also pooled with data from Denmark and the U.K., two countries hit hard by B117, several sources explained, with local data falling in line with those earlier international findings. 

“Clearly, these variants are … more transmissible — so you’re more likely to become infected if you’re exposed to the virus — and also, you’re more likely to be admitted to hospital and to potentially die from the infection,” said critical care physician Dr. Kali Barrett, a member of the COVID-19 Modelling Collaborative, a separate group that was not involved in the science table’s upcoming briefing note.

Those health impacts are regardless of your age or pre-existing medical issues, she said of the international research.

People need to ‘protect themselves’

CBC News has not obtained a copy of the upcoming briefing note but did speak to multiple sources familiar with the expected contents. They asked not to be named because they’re not authorized to speak about the findings publicly.

Several sources said the analysis accounts for the fact that the age distribution of cases has shifted over time, and now skews younger, thanks in part to ongoing vaccinations of older populations.

It not only aligns with the growing body of international research suggesting variants such as B117 can have dire health impacts, but also the growing concern among Ontario clinicians that patients with COVID-19 are presenting both younger and more seriously ill.

“This is not just a disease that sort of strikes the older among us, it really strikes those in the prime of our lives,” Barrett said. “And we all have to be careful until everyone’s vaccinated.”

The overall risk of death from COVID-19 does remain fairly small, though it’s hard to pin down a precise figure given the evolving nature of the pandemic. 

Ontario residents attend a COVID-19 vaccination clinic in March. (Evan Mitsui/CBC)

Canada’s case fatality rate is currently thought to be roughly 2.4 per cent, but it’s a number based on confirmed cases and deaths among all age groups, which doesn’t reflect people who never got tested for the virus, and has proven to be a moving target depending on who’s falling ill and who’s getting vaccinated.

With variants now making up more than half of all recent COVID-19 cases in Ontario, experts stress it’s a risky numbers game: more people getting infected with a more dangerous variant could cause more serious illnesses and deaths, even among a younger, healthier cohort.

“Unless we have more stringent public health measures enacted,” Barrett said, “individuals really need to be doing everything they can at an individual level to protect themselves.”

Evidence points to higher risk

Health experts around the world have been ringing alarms for weeks about the potential for variants to take hold and wreak havoc.

As early as January, preliminary findings from the British government’s chief scientific adviser suggested B117 carries a higher risk of death than the original SARS-CoV-2 strain.

Two Ontario COVID-19 science advisory table members who spoke on the record to CBC News — though not about the expected briefing note — said the growing body of research that has since emerged suggests those early concerns were valid.

“It’s confounded by a bunch of different factors, including different ages, and different social situations, and how people have acquired the disease,” said Dr. Andrew Morris, an infectious disease specialist with Toronto’s Sinai Health System.

“But I think the majority — or the overwhelming majority — of evidence that we have right now is that it is substantially more, not only contagious, but severe in the disease that it causes.”

Infectious disease specialist Dr. Gerald Evans, a professor at Queen’s University’s faculty of medicine in Kingston, Ont., said without restrictions in place over the past few months, Ontario may have fared far worse in terms of serious cases and deaths. 

Restrictions loosening in various regions

Now, as Ontario is relaxing rules around indoor shopping, dining and other forms of gatherings in various areas, Evans and Morris both said some regions — and younger populations — largely spared in the first two waves of the pandemic could be harder hit the third time around.

“It’s hard for people to continue to just be holed up in their homes,” said Morris. “Perhaps the right thing to do is to just encourage people to spend as much of their time outdoors as possible.”

Indeed, in the Toronto area, for example, public health officials recently got their wish for a loosening of lockdown restrictions that now allow for outdoor dining

WATCH | Ontario allowing outdoor dining in grey zones:

Ontario will allow outdoor dining in grey-lockdown zones after modifying some of its COVID-19 restrictions. Restaurants in the red and orange zones of the province’s colour-coded guidelines will have their indoor dining capacity increased to 50 per cent — up to a maximum of 50 or 100 people, respectively. 2:56

But Morris cautioned that reopenings and reduced restrictions don’t necessarily mean there’s any reduced risk, though that might be the public perception. 

“In no way, shape or form should people be minimizing this pandemic. It still has legs, unfortunately,” Morris said.

“And where you may have had some estimate of risk to yourself six months ago, even three months ago — that estimated risk has now increased a bit.”

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U.S. will accept mixed doses of vaccines from international travelers

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The U.S. Centers for Disease Control and Prevention (CDC) said late on Friday that it will accept mixed-dose coronavirus vaccines from international travelers, a boost to travelers from Canada and other places.

The CDC said last week that it would accept any vaccine authorized for use by U.S. regulators or the World Health Organization. “While CDC has not recommended mixing types of vaccine in a primary series, we recognize that this is increasingly common in other countries so should be accepted for the interpretation of vaccine records,” a CDC spokeswoman said.

The White House said Friday the new vaccine requirements for foreign nationals traveling to the United States will begin Nov. 8 for visitors crossing at land borders as well as international air travelers.

Representative Brian Higgins, a New York Democrat representing a district along the Canadian border, had on Friday asked the CDC if it would accept the mixed vaccine doses noting “nearly four million Canadians, equivalent to 10% of their fully vaccinated population, have received mixed doses of the available mRNA COVID-19 vaccines – this includes the AstraZeneca vaccine.”

The CDC said the vaccines approved by the Food and Drug Administration (FDA) for use, as well as those authorized by the WHO, will be accepted for entry into the United States, including the AstraZeneca vaccine.

The CDC said “individuals who have any combination of two doses of an FDA approved/authorized or WHO emergency use listed COVID-19 two-dose series are considered fully vaccinated.”

The CDC plans to answer other questions and release a contact tracing order for international air visitors by Oct. 25.

 

(Reporting by David Shepardson; Editing by Leslie Adler and Aurora Ellis)

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Transplant programs reviewing policy on recipients being vaccinated against COVID-19 – Squamish Chief

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Transplant centres in Western Canada have stopped short of requiring organ recipients to be fully vaccinated against COVID-19, but they say conversations about such a policy are ongoing.

Some centres in other parts of the country, including Ontario, are requiring proof of vaccination before a patient is approved for the life-saving surgery.

BC Transplant, located in Vancouver, said COVID-19 vaccination is not required to be eligible for a transplant, but programs in the province are actively reviewing it.

“The transplant programs are strongly encouraging all pre-transplant patients to be vaccinated against COVID-19, as they do with many other vaccine-preventable infections,” the agency said in a statement.

Similarly, Alberta Health Services told The Canadian Press it has long been a requirement that patients preparing for transplant have all vaccines to help maximize their chances of success post-transplant. It notes, however, it’s only a practice guideline at this point.

Saskatchewan has also not made any changes.

“Saskatchewan’s organ transplant teams are strongly supportive of all recipients and donors having COVID vaccinations, and the issue of requiring these vaccinations in recipients is actively being discussed,” Lisa Thomson, a spokeswoman for the Saskatchewan Health Authority, said in a statement. 

The Ajmera Transplant Centre at Toronto’s University Health Network recently announced its decision to implement a policy that requires patients who may benefit from receiving a transplant be fully vaccinated against COVID-19 before they are listed for solid organ transplant.

However, there may be exemptions for medical reasons or in cases of urgent need of a transplant.

“We all recognize that (COVID-19) is a massive, massive risk factor. The prudent and ethical thing to do to protect patients and to protect each other, and show fidelity and respect to those organ donors, is to require this (policy) to be a price of pass and go,” UHN president and chief executive officer Kevin Smith said in an interview. 

The decision to enact the policy is based on a few factors, according to the organization. 

It said transplant patients are severely immunocompromised because of lifelong treatment to prevent rejection of a new organ. If someone who is immunocompromised gets COVID-19, they are at a very high risk of being hospitalized or placed on ventilation.

Unvaccinated recipients could also pose a risk to other patients post-surgery. Transplant recipients have high health needs after their transplants and require frequent visits to a hospital. These individuals may pose a greater risk of spreading illness, should they get infected, to other immunocompromised patients in an inpatient or outpatient setting.

“Thinking about an outbreak in an environment like that would be just a massacre,” Smith said. 

Infectious disease experts noted this type of policy isn’t new.

“There’s just requirements pre-transplant in order to be eligible for listing. Some of it is complying with some of the medical measures to see if patients would be eligible,” said Dr. Dima Kabbani, an assistant professor in the division of infectious diseases at the University of Alberta. 

Kabbani added pre-transplant vaccine recommendations are already in place for hepatitis B, pneumococcal disease and influenza. 

Manitoba’s Shared Health said there is no requirement for Manitobans awaiting a transplant to be vaccinated for COVID-19, but noted patients may be required to show proof of vaccinationif there are requirements elsewhere.Kidney transplants are performed in the province while all other organ transplants take place in other provinces. 

Jessica Bailey, 35, is living with stage five kidney disease and awaiting a transplant in Saskatoon. 

The government has postponed surgeries as the province deals with a devastating fourth wave of COVID-19.

Bailey said she is not in favour of requiring recipients to be vaccinated against COVID-19. She said she is double vaccinated but believes recipients should still have the choice on whether they want the vaccine. 

She does encourage patients who may be on the fence to look at the bigger picture.

“If you can get a transplant just by getting the vaccine, go and do it. Pick and choose your battles,” Bailey said. 

This report by The Canadian Press was first published on Oct. 15, 2021.

— 

This story was produced with the financial assistance of the Facebook and Canadian Press News Fellowship. 

Brittany Hobson, The Canadian Press

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Health Unit Gearing Up For Flu Shot Program – ckdr.net

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With the colder months not far away, the Northwestern Health Unit is preparing for their annual flu shot program.

“The Northwestern Health Unit will begin to offer the flu vaccine in November and we will inform the public when they can start booking appointments,” says Medical Officer of Health Dr. Kit Young Hoon. “As always the influenza vaccine will also be available at many pharmacies and from other health care providers.”

The Public Health Agency of Canada only reported 79 lab confirmed cases of influenza in 2020 compared to 54-thousand cases just the year before.

The drop is largely attributed to strong public health measures and lockdowns due to COVID-19, but officials say there could be more documented cases this year.

“Influenza vaccination were relatively high last year so we’re working off a similar assumption for this year that they will be high,” says Dr. Young Hoon. “I believe we will have enough vaccine to provide to whoever wants to be vaccinated and we’re prepping to have a relatively high rate this year.”

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