Tag Archives: COVID

After back-and-forth week, Quebec signals willingness to play by new rules set by COVID variants

Just over one month ago, amid a lull in Quebec’s COVID-19 infection rates, the province’s leading public health official, Dr. Horacio Arruda, used a colourful metaphor to describe the threat posed by more contagious variants of the virus.

“We are right now in a period of calm seas,” he said. “But underneath there are sharks, and those sharks are the variants.”

Despite the warning, the government decided to authorize swimming in these shark-infested waters.

In the ensuing weeks, rules were relaxed across much of the province. The Quebec City area and the Outaouais were among the regions reclassified as orange zones. Restaurant dining rooms and gyms were reopened. There was hope in the air.

Even in Montreal — a perennial trouble spot — extracurricular school activities and large religious gatherings were permitted again. Older high-school students were told to go back to full-time, in-person classes.

But on Tuesday, Premier François Legault played the role of Chief Brody in the movie Jaws. Get out of the water, he told the province.


Quebec Director of Public Health Horacio Arruda responds to a question during Tuesday’s news conference in Montreal. (Paul Chiasson/The Canadian Press)

At a news conference in Montreal, he announced he was cancelling the small freedoms recently granted to residents of the greater Montreal area: gyms will close, extracurriculars will stop, religious services will be capped at 25 people max.

Last week, he announced a series of harsher measures for the Quebec City area and the Outaouais, where cases have grown at exponential rates.

Controlling the variants

Epidemiologists and other health experts had warned the government in March it was making a high-odds bet by lifting measures even though the variants were clearly gaining ground.

The normally staid public health research institute the INSPQ said bluntly on March 26 that the provincial measures in place “were insufficient to control the variants.”

But Arruda, Legault and Health Minister Christian Dubé — le trio, as the francophone press calls them — insisted the moves were justified because hospitalizations were continuing to decrease at the same time as elderly Quebecers were being vaccinated.

In an interview with La Presse last week, Arruda spelled out, with surprising candour, the province’s strategy to a younger journalist.

“If I have 2,000 [new] cases [a day] in Quebec, but we don’t have significant hospitalizations or deaths, we can live with that,” he said.

“Because older people are protected, we will, of course, have people your age who will find themselves in intensive care and die, which is horrible. But is it better if you close everything, and people break the rules in secret?”   

Avoiding Ontario’s fate

At the moment, Quebec is averaging 1,200 cases per day, and so far, hospitalizations haven’t returned to the critical levels seen around Christmas.

Legault said Tuesday he hoped by taking action now, before hospitalizations rise quickly, he can avoid the situation facing Ontario, where intensive care units are hitting capacity and many schools are set to close to in-person learning again.

“It’s a matter of days, or at most, weeks,” he said, before Quebec’s hospital numbers begin to tick upward.

The new measures announced Tuesday, along with those introduced last week, bring more coherence to the government’s message. The added restrictions reflect the danger of a virus that has been turbo-charged by variants.

“It was the right thing to do. We needed to be more proactive,” said Dr. Cécile Tremblay, an infectious disease specialist at the Université de Montréal health centre, following Legault’s announcement.

“The models showed we risked having an exponential growth in cases if we kept the measures as they were before.”

WATCH | Quebec being ‘proactive’ with new measures, says infectious diseases specialist:

Dr. Cécile Tremblay says by tightening measures and offering up AstraZeneca to people 55 and up, the province is trying to keep the third wave under control. 3:10

But the abrupt pivot — from downplaying the dangers of the third wave to re-imposing lockdown measures — has exposed the government to criticism that its public health approach is haphazard. And there are signs its credibility has been damaged.

On the one hand, the government faced protests last week in several Montreal-area schools where students and parents wanted more, not fewer, public health measures in place.

On the other hand, its flip-flop caused whiplash, bitterness and confusion in and around Quebec City. Over the weekend, police there received more than double their usual number of calls about illegal gatherings.

The new rules

Legault wouldn’t admit he had made a mistake by lifting measures last month. “We won’t stop ourselves from providing freedom when we’re able to do so, or closing things again when it’s necessary,” he said.

Throughout the pandemic, the premier has made clear the government’s priority is protecting the health-care network, as opposed to eliminating the virus outright (which was the stated goal of the Atlantic provinces, for example).

Arruda’s comments to La Presse last week only made it apparent what the trade-offs are.

It is a bargain the public has found reasonable to date. Freedom was maximized for the least vulnerable — school-aged children — and progressively reduced for the most vulnerable, especially the elderly.

WATCH | Youth who toil in grocery stores, cafés and restaurants feel the strain:

As the stress of the pandemic wears on, Quebec’s young adults do the essential work that is often overlooked. 3:54

Some in long-term care homes were effectively confined to their rooms for months on end as the virus circulated widely in the community. In turn, they were first up when vaccines became available.

But the more contagious variants of COVID-19 have upended the terms of the bargain. The old methods for containing transmission are no longer enough to prevent the virus from spreading like wildfire, and vaccines can’t be rolled out fast enough to prevent younger people from ending up in hospital.

With the measures announced over the last week, the Legault government signalled it is no longer just talking about these new realities of the pandemic — it has started to adjust to them as well.

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CBC | Health News

7 more Canucks added to NHL’s COVID protocol list, bringing total to 14

Seven Vancouver Canucks have been added to the NHL’s COVID-19 protocol list, bringing the team’s total to 14.

The NHL announced Saturday that goaltender Thatcher Demko, defenceman Tyler Myers and forwards Bo Horvat, Tyler Motte, Travis Boyd, Jayce Hawryluk and Brandon Sutter have been added to the list.

They join goaltender Braden Holtby, defencemen Alex Edler, Quinn Hughes and Travis Hamonic and forwards Adam Gaudette, Zack MacEwan and Antoine Roussel.

The news comes as British Columbia set a record for positive cases Saturday with 1,072 new infections, up 1,018 from the day before.

It remains to be seen whether the increased number of Canucks players under protocol will result in additional missed games for the team. Vancouver has already had four games postponed, and as of now the team cannot practice before April 6.

Gaudette was pulled from Tuesday’s practice following a positive test result and added to the list that afternoon.

The NHL postponed the Vancouver’s Wednesday matchup with the Calgary Flames after another player — later identified as Hamonic — and an unnamed member of the coaching staff entered the league’s protocols.

Holtby, Edler, Hughes, MacEwan and Roussel were added Friday.

WATCH | Rob Pizzo recaps week 11 in the NHL’s all-Canadian division:

In our weekly segment, Rob Pizzo catches you up on the week that was in the all-Canadian division in the NHL. 3:54

A player on the COVID-19 protocol list has not necessarily tested positive.

The league’s protocols require players and staff to be tested daily. Any time an individual’s initial test comes back positive, the lab does a second test on the initial sample.

If the second test is negative, a second sample is collected. But if that sample returns a positive result, it’s considered to be a “confirmed positive.”

The league requires individuals with positive tests to self isolate for 10 days, and for close contacts to self isolate for two weeks.

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CBC | Sports News

Canada’s COVID case count set to hit 1 million next week as variants spread

After two months of relative stability, Canada’s COVID-19 case count is expected to rise rapidly in the coming weeks as virus variants take hold.

Canada is projected to hit roughly 1 million total cases next week, according to data released today by the Public Health Agency of Canada (PHAC).

While the vaccination campaign has ramped up after a period of scarcity, the rollout can’t keep pace with the spread of the virus, said Dr. Theresa Tam, Canada’s chief public health officer. Tam today urged Canadians to reduce their contacts in the medium-term while provinces and territories deploy more shots in the months to come.

“COVID-19 still has a few tricks in store and we need to hold on together a bit stronger and longer until vaccines have us protected,” Tam said.

While the setback is “discouraging,” she said, better days are ahead. “We are closer now than ever, but it’s still too soon to relax measures.”

Asked today when things might return to a pre-pandemic “normal,” Tam said that day is not imminent. With the caseload curve trending up, variants accelerating and vaccine distribution still quite low, a post-COVID-19 Canada is still months away, she said.

“It’s not going to be, ‘Here’s a date and after that date all is going to be good.’ It’s data, not dates,” she said. “By the fall — that’s what I think we should be aiming for.”

WATCH: Tam is asked when life will return to a pre-pandemic normal

Dr. Theresa Tam, Canada’s chief public health officer, responds to a question about the pandemic’s likely end date. 3:37

COVID-19 variants like B117, which is thought to have originated in the U.K., now account for a high proportion of new cases and make up half of all new cases in some areas. There are roughly 3,000 new cases being reported each day nationwide, up from about 2,000 a month ago.

Case count could rise to 12,000 a day

With variants now circulating widely, PHAC said the case count could rise to 12,000 a day if Canadians maintain or increase the number of people they are in contact with daily. The public health measures in place in most jurisdictions will be “insufficient” to keep cases at bay, the agency said.

Alberta, B.C. and Ontario are projected to see the biggest spike in daily cases — early data suggest variants are particularly widespread in these provinces. PHAC predicts Ontario alone could record as many as 10,000 cases a day if public health measures are relaxed or maintained at their current level.

While an increase in the number of new cases is almost certain over the coming weeks in the six provinces west of Atlantic Canada, PHAC says that the country will be able to hold the line at 5,000 cases a day if Canadians reduce their contacts.

PHAC is projecting the death rate will be relatively lower than it was with past caseload spikes because some of the most vulnerable people — long term care home residents, seniors, Indigenous adults — have been vaccinated.

Tam warned, however, that the B117 variant may lead to more severe cases and could prove to be more deadly.

The public health agency said it expects many of the new cases to come from people aged 20 to 39. While death is less likely in this demographic, younger patients still face the prospect of severe health outcomes.

“The younger people, you’re going to get some people who are going to end up in hospital,” Tam said.

PHAC is predicting the cumulative case count — the number of cases reported since this pandemic began — will jump over the next week from 951,000 to between 973,000 and 1,005,000.

The spread of the variants — which are more transmissible than the strain first discovered in Wuhan — has also resulted in an increase in hospitalizations. There are now some 2,200 people in hospitals — 600 of them in intensive care units.

But the vaccination campaign is starting to bear fruit, with case counts among the 80-plus age cohort declining dramatically.

While there were 35 cases per 100,000 people aged 80 or older in January, the case rate has dropped to less than 5 per 100,000.

Most provinces and territories have been directing the early supply of mRNA vaccines like Pfizer and Moderna to seniors. About 60 per cent of all people over the age of 80 have received at least one shot, PHAC said.

The number of outbreaks in long-term care homes is also much lower than it was just three months ago. There were as many as 500 long-term care home outbreaks at any one time in December, while there have been fewer than 100 reported throughout March.

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‘People are talking about the same things they talked about back then’: COVID stirs up memories of polio

When Elizabeth Lounsbury was eight years old, she snuck out of the house to go swimming with her friends.

She had been taught to fear polio, a virus that paralyzed children every summer and paralyzed her southern Ontario hometown, where beaches and movie theatres were closed every August for “polio season.”

Lounsbury says she decided to just put her feet in the wading pool. 

“I was afraid to because I was afraid polio would get me. You kind of pictured it as a monster in your head,” she said.

Lounsbury tripped, fell into the pool and swallowed some water. The 77-year-old believes that’s how she contracted polio, which saw her wear braces most of her life and now has her getting around in a wheelchair.

“I never did tell my mother. She never knew,” she says.

Now living just outside of the small northern Ontario town of Hagar, Lounsbury has barely left her home in the past year of COVID-19. 

And to her it feels like a rerun of what happened in the 1950s with the emergence of an infectious disease followed by a mass vaccination campaign.

“People are talking about the same things they talked about back then,” she said. “Is it really safe? What are the side effects? Other people can’t wait to get it because they feel like they’ve been imprisoned in their own homes.”

To her it feels like “a repetition.

“And I suppose it will happen again. But I hope not in my lifetime.”


Elizabeth Lounsbury,77, of Hagar contracted polio when she was eight and sees a lot of parallels between COVID-19 and the lockdowns and vaccine rollout for polio in the 1950s. (Facebook)

In northern Ontario, the arrival of the polio vaccine in 1956 was trumpeted by newspapers in Sudbury and Sault Ste. Marie.

Concerns about polio vaccine

There were weeks of stories about the schedule for clinics and the vaccination rates, replacing the annual summer articles about the number of polio infections and the deaths in each district, with the names of victims published. 

But along with the polio vaccine, came concerns that public health officials would run out of vaccine, and questions about who was eligible to get it, which at the beginning was only children aged six months to six years.

There were also fears about side effects, especially after some bad batches in the United States sickened and even killed people, on top of worries about vaccine hesitancy, as only a fraction of the adult population in the north stepped forward to get the shot for what was widely seen as a children’s illness.


This Sudbury Star photo of liquid polio vaccinations in 1962 features a baby named Rita Brun, who is now a pharmacist preparing COVID-19 vaccines at a Toronto hospital. (The Sudbury Star)

The Sudbury Star photographed a baby named Rita Brun getting a spoonful of the pink liquid vaccine in 1962, which the health unit later moved away from out of fear it might be ineffective.

She is now a pharmacist packaging COVID-19 vaccines for a Toronto hospital, while her daughter treats coronavirus patients in an intensive care ward.

“It was interesting to reflect back on what it must have been like for my parents, as opposed to parents these days,” said Brun. 

“Maybe we know too much now.”

In some parts of the north, tuberculosis was seen as the larger threat and some old-timers remember local police posting signs on homes with people infected with scarlet fever and diphtheria in the early 20th century.

‘We’re so glad we weren’t involved in that’

Heather Mitchell grew up in Sudbury’s west end and remembers not being allowed to go to Bell Park in the summers out of fear of polio infection, but didn’t think much about the virus until she learned about it in theory during nursing school.

Then she and a classmate were cleaning out a storage room at the old general hospital and found a logbook where doctors and nurses discussed which polio patients should get treatment first. 


Similar to COVID-19, there were concerns in the 1950s about side effects from the polio vaccine, complaints about shortages and trouble convincing hesitant adults to get the shot. (Provincial Archives of New Brunswick P342-1143)

“To see these discussions, whether a housewife was more likely a candidate for it than a school teacher, that kind of rocks you. Having to make that decision. Having to live with that decision,” says Mitchell, who went on to be a public health nurse. 

“We both thought, ‘Oh my goodness, we’re so glad we weren’t involved in that.'”

Maurren Moustgaard was 12 when she went to that same Sudbury hospital to get her tonsils out and saw the unforgettable sight of a young polio patient in the iron lung, the early version of the ventilators being used today.

She joined the health unit in 1969 and worked in vaccinations most of her career. Including in 1978, when she was called back from holidays to meet a surge in demand for polio shots, after an outbreak in southern Ontario.


Polio patients seeing visitors outdoors at a polio clinic in New Brunswick in 1942. (Provincial Archives of New Brunswick P384-58)

Sudbury newspapers ran photos of long lineups and had stories about a public frustrated with a lack of vaccines. Moustgaard says most were parents who had not been keeping up with their polio shots, just 20 years after it was first discovered. 

“Something has to happen to jolt people’s memories,” she said of that time. 

After she was infected with polio, Elizabeth Lounsbury was still vaccinated against two other strains of the virus.

But given her complicated health challenges, she isn’t sure she wants to get the COVID-19 vaccine. 

“I am afraid of it. And I wonder if the vaccine is safe,” she said. 

“And I guess I won’t know until the time comes for me to go in.”

Morning North9:31COVID-19 has stirred up memories of the polio epidemic in the northeast

The rollout of the COVID vaccine is reminding some of the last time there was an urgent drive to stop a feared virus. Although largely forgotten, the polio vaccine had a similarly bumpy road getting into northern Ontario arms back in the 1950s. The CBC’s Erik White offered the details. 9:31

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CBC | Health News

Officials across Canada urge new vigilance as COVID variants spread

The latest:

Alberta’s top doctor is urging people to follow both the “detail and the spirit” of public health measures as the province deals with community spread of a variant of concern first reported in the U.K.

With 1,078 reported cases of the B117 variant reported on a federal tracking site as of Wednesday evening, Alberta trails only one other province — Ontario — in total reported cases of the more transmissible variant.

“The B117 variant is spreading in many different contexts and many different settings,” Dr. Deena Hinshaw said at a briefing on Wednesday. “And we’re seeing higher attack rates than we typically do in settings where people are exposed.”

Hinshaw said that so far, the cases the province has seen of the P1 variant (linked to Brazil) and the B1351 variant (first reported in South Africa) have been few in number and linked to travel.

The B117 variant, however, has been established in the community.

“While we are continuing to work hard to slow its spread, it is spreading in all zones of our province.”


Hinshaw said that while vaccination efforts are ramping up, the province is not yet at a point where the vaccination coverage is sufficient to “prevent severe outcomes.”

“For the next couple of months, including spring break, we need to just hold on and protect our communities with our choices.”

Hinshaw highlighted some progress around vaccinations, pointing to the province’s plan to offer first doses to all adults who want one by the end of June.

Alberta is not the only province concerned about the spread of variants of concern. As of Wednesday evening, the Public Health Agency of Canada had reported more than 4,200 cases of the variants, including:

  • 3,946 of the B117 variant.
  • 240 of the B1351 variant.
  • 71 of the P1 variant.

Ontario has seen the highest total number of cases of variants of concern of any province, with 1,134 cases of the B117 variant, 47 of the B1351 variant and 34 of the P1 variant.

In Saskatchewan, there’s growing worry about variants of concern in Regina, which has seen more than 80 per cent of the province’s variant cases.

Chief Public Health Officer Dr. Theresa Tam said on Twitter that with the increase of variant cases, “maintaining public health measures and individual precautions is crucial to reducing infection rates and avoiding a rapid reacceleration of the epidemic and its severe outcomes.”

-From CBC News and The Canadian Press, last updated at 7 a.m. ET


What’s happening across Canada

WATCH | Inside the race to get COVID-19 vaccines to Canadians:

CBC’s David Cochrane goes inside the processes of vaccine delivery and distribution as well as the challenges to deliver on the promise of at least one shot for every Canadian who wants it by July 1. 4:08

As of early Thursday morning, Canada had reported 919,244 cases of COVID-19, with 31,600 cases considered active. A CBC News tally of deaths stood at 22,554.

In Atlantic Canada, there were three cases of COVID-19 reported on Wednesday — two in Nova Scotia and one in New Brunswick. There were no new cases reported in Prince Edward Island or Newfoundland and Labrador.

In Quebec, health officials reported 703 new cases of COVID-19 on Wednesday and 13 more deaths attributed to the novel coronavirus. Health officials also reported a rise in the number intensive care patients, up 16 compared with the prior day, for a total of 107. Total hospitalizations dropped by one, to 532.

Health officials in Ontario reported 1,508 new cases of COVID-19 and 14 additional deaths on Wednesday. A provincial dashboard listed the number of COVID-19 hospitalizations as 741, with 300 of those patients in the province’s intensive care units.

The top doctors in Ontario’s two main COVID-19 hot spots are preparing for warmer weather. Dr. Eileen de Villa and Dr. Lawrence Loh said they’re seeking to ease some of the restrictions on outdoor activities in Toronto and Peel.

Both medical officers want to keep their communities in the strictest “grey-lockdown” category of Ontario’s colour-coded pandemic framework, but with adjustments that would allow for outdoor dining and fitness.

In the Prairie provinces, Manitoba reported 96 new cases of COVID-19 on Wednesday and no additional deaths.

The Manitoba government also moved to reduce the minimum age for COVID-19 vaccines by two years — to 53 and up for First Nations people, and 73 and up for others. Those numbers do not include younger age groups with underlying health conditions that are already eligible for vaccination.

In Saskatchewan, health officials reported 87 new cases and one additional death on Wednesday. The Saskatchewan Health Authority urged people to be vigilant in the face of variant of concern cases, particularly in the Regina area.

Across the North, Nunavut will now count 12 additional cases of COVID-19, including three deaths, in the territory’s total case count. The new numbers come from Nunavut residents who caught COVID-19 or died from the virus while in Manitoba.

Nunavut Chief Public Health Officer Dr. Michael Patterson said it’s been unclear since the start of the pandemic which jurisdiction these numbers would fall under. The cases and deaths occurred between December 2020 and January 2021. Patterson said attribution of cases of COVID-19 acquired outside the territory will continue to occur on a case-by-case basis.

There were no new cases reported in Yukon or the Northwest Territories on Wednesday.

In British Columbia, health officials reported 498 new cases of COVID-19 and four additional deaths. A joint statement from Provincial Health Officer Dr. Bonnie Henry and Health Minister Adrian Dix said no data about variant cases was available Wednesday due to a lab sequencing issue.

-From The Canadian Press and CBC News, last updated at 7:05 a.m. ET


What’s happening around the world

As of early Thursday morning, more than 121.2 million cases of COVID-19 had been reported worldwide, according to a tracking tool maintained by Johns Hopkins University. The global death toll stood at more than 2.6 million.

In Africa, the head of the Africa Centers for Disease Control and Prevention says the suspension of the AstraZeneca COVID-19 vaccine in some European Union nations hurts efforts to build public confidence and trust in vaccines on the continent of 1.3 billion people.

John Nkengasong said in a briefing Thursday that despite “unfortunate events” in Europe, African nations should continue rolling out the AstraZeneca vaccine, the only shot currently available in many countries that have accessed batches of it through the COVAX initiative.


A nurse prepares a dose of the AstraZeneca-Oxford COVID-19 vaccine at Mulago referral hospital in Kampala, on the first day of a vaccination campaign last week. (Badru Katumba/AFP/Getty Images)

Nkengasong said a recent meeting convened by his group concluded that vaccine-related decisions in Africa should not be “based on anything that is subjective.” He said instead there should be continuous monitoring and reporting of any adverse events following inoculations.

At least 22 of Africa’s 54 nations have received more than 14 million doses of the AstraZeneca vaccine as of March 13, according to the World Health Organization.

The European Medicines Agency, which is expected to update its findings later Thursday, has said there is “no indication” the AstraZeneca shot is responsible for dangerous blood clots in a few recipients. The World Health Organization has also said the benefits of the vaccine outweigh any risks and recommends its continued use. Other European nations are proceeding with vaccinations despite safety worries in countries such as Germany.

In Europe, Italy inaugurated a living monument to its COVID-19 dead Thursday as it marked the anniversary of one of the most haunting moments of the pandemic: when Bergamo’s death toll reached such heights that an army convoy had to transport coffins out because its cemeteries and crematoriums were full.

Premier Mario Draghi visited the northern city on Thursday to commemorate a national day of mourning for Italy’s coronavirus victims. Flags flew at half-mast around the country and public authorities observed a minute of silence.

Draghi laid a wreath at Bergamo’s cemetery and inaugurated a forest named in honour of the more than 100,000 victims in Italy, the first country in the West to be hit by the outbreak.

“This wood doesn’t only contain only the memory of the many victims,” Draghi said. “This place is a symbol of the pain of an entire nation.”

The anniversary came as much of Italy including Bergamo is under new lockdown, with schools and restaurants shuttered, amid a new surge of infections. And it comes as Italy’s halting vaccination campaign has slowed down further because of the suspension of AstraZeneca shots pending review.


A health-care worker prepares a dose of the Pfizer-BioNTech COVID-19 vaccine during home visits to carry out vaccinations in Rome on Wednesday. (Yara Nardi/Reuters)

France is set to announce new coronavirus restrictions on Thursday, including a potential lockdown in the Paris region and in the north of the country, as the number of COVID-19 patients in intensive care units spikes.

“We will make the decisions we need to make,” French President Emmanuel Macron said on Wednesday while visiting the hospital of Poissy and Saint-Germain-en-Laye, west of Paris. He said measures will be “pragmatic, proportionated and targeted.”

Prime Minister Jean Castex is scheduled to detail new restrictions on Thursday. The virus is rapidly spreading in the Paris region, where the rate of infection has reached over 420 per 100,000 inhabitants and ICUs are closed to saturation. France’s nationwide infection rate is about 250 per 100,000.

In the Asia-Pacific region, Pakistani authorities are warning that strict lockdown measures may need to be implemented if the public continues to violate physical-distancing measures to curb the spread of the coronavirus.

Health authorities say a potential lockdown could include closing businesses and restrictions on economic and social activities. The warning was issued Thursday by the National Command and Control Center, which oversees Pakistan’s response to COVID-19.

Amid a third wave of the coronavirus that is gripping Pakistan’s largest province, Punjab, and the northern part of the country, Pakistani health and administrative authorities have imposed a partial lockdown in affected areas since last week. Pakistan has reported 615,810 virus cases among 13,717 deaths.

Thailand will procure an additional 100,000 doses of China’s Sinovac vaccine to be used and paid for by businesses, in the first phase of a private sector vaccination scheme.

In the Americas, Paraguayan opposition lawmakers lost a bid to impeach President Mario Abdo over the government’s handling of the pandemic.

The United States is investing $ 12.25 billion on ramping up COVID-19 testing to help schools reopen safely and promote testing equity among high-risk and under-served populations.

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Prioritizing people with specific conditions for COVID vaccine slows race for herd immunity: N.S.’s top doctor

Amanda Robinson used to work part time five days a week for an organization that supports adults with disabilities. She went to bingo and bowling on the weekends and attended a Friday night social.

It all disappeared when COVID-19 struck.

Robinson, 36, has Down syndrome and is largely non-verbal. Her mother keeps her close to home these days because she worries about what will happen if her daughter contracts the coronavirus. 

“Amanda going out puts her life at risk every day and she doesn’t even know it,” said Carolin Robinson, outside her family’s home in Halifax. 

Robinson points to research in the U.K. that suggests people with Down syndrome who contract COVID-19 have a significantly increased risk of death. She is among the advocates across the country calling on governments to prioritize vaccinating people with disabilities. 


Amanda Robinson, left, with her mother, Carolin, and her brother, Aaron, in their Halifax home. (Eric Woolliscroft/CBC)

Some Canadian provinces are prioritizing people with various disabilities to varying degrees, but Nova Scotia, which currently has 29 active cases of COVID-19, is among those that are not, unless the individuals live in congregate settings such as group homes. 

Dr. Robert Strang, Nova Scotia’s chief medical officer of health, says the province is focusing on vaccinating by age, beginning with people 80 and older, and working down by brackets of five years at a time.  

“We certainly understand lots of different groups thinking about their own risk or the risk within their group, and I understand that perspective,” he said during a recent interview at Nova Scotia’s Department of Health. 

In fact, Strang understands better than most. 

His son, who turns 16 in September, lives with severe physical and intellectual disabilities, including autism, chronic pain and a mutation in the GRIN2A gene that causes a range of neurodevelopmental disorders.  

Speed is key 

But Strang insists age is “by far” the biggest risk factor. He also said it’s important to have a vaccine program that is fast and efficient, and trying to figure out how to prioritize a range of conditions would significantly delay the overall process.  

“It’ll be so much slower,” he said.

Because of his age, Strang’s son is going to be among the last to be vaccinated, he said. “But he’s going to be well protected because we’ve rapidly built herd immunity all around him.”

Nova Scotia has a higher percentage of people living with disabilities than any other province in Canada. 


Dr. Robert Strang, Nova Scotia’s chief medical officer of health, with his son, now 15. Despite the fact his son has severe physical and intellectual disabilities, Strang says he’s confident in the province’s age-based approach to determining the order for vaccinating the public. (Submitted by Dr. Robert Strang )

Krista Carr, the executive vice-president of Inclusion Canada, a national organization that works on behalf of people who have intellectual or developmental disabilities, wants all provinces and territories to create a separate vaccination category for people with disabilities and to clearly define who that will include. 

She acknowledges different disabilities might need to be prioritized in different ways. For example, some people may need to be moved up the list because they’ve been more isolated or unable to protect themselves by physically distancing because they rely on support workers, and others need to be prioritized because of their physical health. 

“People with disabilities often have co-occurring health conditions that go along with their disability, so that puts them at higher risk for the virus,” she said. 

She said by not creating a separate category to prioritize their vaccination, “we’re telling people with disabilities they don’t matter, and that’s just the wrong message to send.” 

Some provinces are prioritizing in various phases

British Columbia plans to vaccinate people who are “clinically extremely vulnerable” including “adults with very significant developmental disabilities that increase risk” in Phase 3. 

New Brunswick intends to vaccinate people who have “select complex medical conditions,” including people who live with Down syndrome, in Phase 2.

Ontario has released a specific list of conditions that put people at an “increased risk of serious illness and death regardless of age” and will be included in Phase 2 vaccinations.  

Alberta says it will prioritize people “with underlying health conditions” in its Phase 2, but it has not yet determined the list of conditions that will qualify. 

Strang not ‘rigid’ in thinking

Strang says he is very comfortable with Nova Scotia’s approach but is not “rigid” in his thinking and will make changes if there is a shift in the science, epidemiology or vaccine supply.

Robinson says the idea of building herd immunity doesn’t give her peace of mind. She says the risks are just too high and the statistics too stark. 

“All my life, I’ve been fighting for her,” she said. “I’m her voice, and I wonder when I don’t need to be her voice, that it just happens because it should.”

Robinson said she’s not asking for her daughter to be first, just prioritized, so she can feel safer, sooner. 

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Asking ‘Where do you think you got COVID?’ helps contact tracers zero in on superspreader events

The painstaking detective work of contact tracing usually starts with an infected person and works forward, asking who has that person seen since they became potentially contagious with COVID-19.

But that mainstay of public health has a less high-profile cousin that’s become instrumental in spotting superspreader events quickly — working in reverse.

“Instead of asking who did that person potentially give the virus to, you’re asking where did that person get the virus?” said Dr. Trevor Arnason, associate medical officer of health with Ottawa Public Health.

“It makes you become better at finding people who have COVID-19 who you might not have known about.”

COVID-19 tends to spread explosively in situations where the virus can infect a bunch of people all at once, public health experts say, which is where what’s known as backward tracing comes in handy.

Ottawa Public Health cottoned on to the benefits of backward tracing when emerging evidence from Japan showed how focusing on where a person got COVID-19 and going back to that location helped to find many more who were infected.

“We started more systematically asking everybody, ‘Where do you think you got it? Or who do you think you got this from? And then we started working back from those places. You start to notice these patterns, which we’ve put together in infographics that we’ve shared with the public,” Arnason said.


Infographics tracing how many were affected from one indoor wedding allowed the public to see how seemingly disparate locations tied together, resulting in 22 people from eight households being affected in two weeks.

“Backward contact tracing is used to find the superspreading events. That’s the main goal.”

Ashleigh Tuite, an infectious diseases epidemiologist in Toronto, said most people who are infected don’t pass it to others. 

WATCH | Day in the life of COVID-19 contact tracers [May 2020]: 

The National’s Adrienne Arsenault spends a day with contact tracers in London, Ont., who help figure out where someone caught COVID-19 and determine who else may be at risk. 3:43

But the instances where an individual goes on to transmit to many others likely reflect how coronavirus transmission clusters at a particular location or environment.

An indoor gym where those working out are unmasked, breathing heavily in what may not be the best ventilated conditions is one example.

“It’s clear that telling people to wear masks when they move around a gym, but not when they’re exercising, which I think has been the protocol in a lot of places, wasn’t enough,” Tuite said. 

Suppressing variants

Backward contact tracing is a lot of work for public-health staff facing down outbreaks, said Tuite, but also potentially high yield.

It can be particularly helpful at the early stages an epidemic — which is long-gone for normal coronavirus, but the introduction of more-transmissible variants of concern is like a do-over, said Tuite, an assistant professor at the University of Toronto’s Dalla Lana School of Public Health.

“It’s an effective way of suppressing the growth of the variants of concern amongst this larger epidemic that’s happening,” she said.

“Overall, we have declining case counts and so if we can control sparks that are happening with the variants of concern, there is the potential to really keep it under control and at least keep case counts declining.”


This May 13, 2020, photo taken with a fisheye lens shows a list of the confirmed COVID-19 cases in Salt Lake County. The white board remains in the office as a reminder of how quickly the coronavirus spread. (Rick Bowmer/Associated Press)

Declining case counts mean hospital and health-care capacity can accommodate more surgeries and preventative care and allow the economy underpinning society to recover, too.

For now, Tuite said case counts will only decline if people restrict their interactions.

For Dr. Susy Hota, an infectious diseases specialist at Toronto’s University Health Network, keeping the variants of concern at bay is another goal of vaccinating as many people as quickly as possible.

“If we continue to allow transmission to occur, [the variants] will take over a larger and larger proportion of the market, so to speak,” said Hota, an associate professor of medicine at the University of Toronto.

Stopping spread fast

Regardless of variants, forward contact tracing to identify high-risk contacts and possible cases as aggressively as possible so they know to isolate quickly will always be a key public health tool.

For instance, a Manitoba spokesperson said they routinely collect information on where a COVID-positive case may have been exposed. But the focus is on forward contact tracing to stop spread as quickly as possible.

WATCH | Workplace physical distancing innovation:

A Calgary tech company’s device is in big demand as manufacturing companies look for ways to keep employees physically distanced while maintaining productivity. 3:09

Hota cautioned there are even more recall challenges with backward contact tracing than forward, using herself as an example.

“Do you think you were more than two metres away when you talked to that person? I think so. But I didn’t have a yardstick with me. And how long do you think you were talking? Oh, I’m terrible at that. I’ll tell you, like, five minutes. I have no idea.”

The recall problem gets amplified because to do backward contact tracing effectively means going back the full 14-day incubation period of the coronavirus. Hota does see a role for backward contact tracing in trying to pin down if there’s a single source of multiple cases, say at a meat-packing plant.

“The truth often doesn’t emerge until the epidemic is over,” Hota said.


(Tim Kindrachuk/CBC)

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Why people working snowy slopes may be at greater risk of catching COVID than skiers

Fresh air, blazing speed and spacious alpine terrain makes skiing and snowboarding low-risk activities for COVID-19 transmission, infectious disease doctors say.

But the threat is never zero during a global pandemic, they add. And people working on those snowy slopes may be at greater risk of catching the virus than those dashing down them.

Most ski hills in Ontario were permitted to reopen Tuesday, joining other mountainous resorts across the country that have remained operational through the winter.

Many have implemented extra safety precautions and operate under local restrictions, including:

  • Asking patrons to wear face coverings on lifts.
  • Cancelling classes.
  • Limiting access to indoor spaces.

While the activity of skiing is relatively safe from a transmission standpoint, experts say spread can still happen, and COVID outbreaks have been reported at larger resorts over the last couple months, mostly affecting staff members.

One outbreak in Kelowna, B.C., in December began with workers living on site before it sprawled to include more than 130 cases. Popular Lake Louise and Nakiska resorts in Alberta also reported outbreaks among staff.

‘Tale of two pandemics’

Dr. Andrew Boozary, the executive director of population health and social medicine at the University Health Network, says it’s clusters of cases like those that make ski hills concerning.

“I have no anti-skiing bias — it’s an activity that makes a whole lot of sense in Canada — but there’s a lot of people who take on risk to ensure a ski hill is operational,” he said.

“A lot of the time we rely on people who are in temporary work or who’ve been underpaid, without living wages and without paid sick leave, to take on risk so some of us can have that pleasure and leisure activity.” 

Boozary likened the recent emphasis on ski hills to that of golf courses over the summer, or to policy around cottages and seasonal vacation homes that were tailored to higher-income populations.

Skiing, like golf, isn’t affordable to everyone, he says.

And while Boozary agrees that skiing and snowboarding can provide mental health benefits of exercise in a low-risk setting, he’d like to see more emphasis on ensuring lower-income populations have safe, outdoor spaces, too.

WATCH | Ont. ski resorts welcome people back to the slopes:

Jim Hemlin, chief operating officer of Calabogie Peaks Resort, says skiers and snowboarders are excited to be back on the hill after the extended shutdown. 0:45

“We’ve seen this dichotomy, this tale of two pandemics. And we’re seeing it now with skiing,” Boozary said. “There’s an income divide on who gets access to these spaces.”

Dr. Ilan Schwartz, an infectious disease expert with the University of Alberta, says staff members at ski resorts are more likely than visitors to become infected because of the close proximity workers tend to be in.

Sometimes they share indoor spaces like lunchrooms, which aren’t conducive to mask-wearing when people are eating, Schwartz says, and “transmission thrives” in those settings.

“The likelihood of infection is going to be a function of physical proximity, the amount of time they’re in that proximity, the activities they’re doing and whether there are precautions taken to minimize transmission.”

Precautions for skiers

While skiers will generally be safe, those who wish to hit the slopes still need to be mindful of safety precautions, Schwartz says.

He added that spread is more likely to happen before or after people glide down the mountains, like when they put on ski boots in a crowded indoor area. Those spots should be avoided when possible, Schwartz says, and masks should be worn when distance can’t be maintained.


Skiers and snowboarders hit the slopes as Mount Pakenham in Eastern Ontario reopens after being closed due to the COVID-19 pandemic in Pakenham, Ont., on Feb. 11. (Sean Kilpatrick/Canadian Press)

Other factors could make trips to snowy resorts more dangerous, he added, including guests travelling from COVID hot spots and potentially bringing the virus with them into small ski towns.

The rise of new variants of concern might require more stringent restrictions on skiers as well, says Parisa Ariya, a chemistry professor at McGill University who specializes in aerosol transmission.

Ariya says while outdoor settings are far safer than indoors, spread “actually does happen outside” in some instances, and she recommends wearing a mask while skiing or snowboarding.

Winters in Quebec and Ontario make air more dense, Ariya adds, which could have an impact on how long viral particles stay in the atmosphere.

WATCH | Ski resorts walk a fine line during pandemic: 

The ski industry in the Canadian Rockies is struggling during the pandemic, with operators trying to balance COVID-19 safety and industry survival. 2:00

Dr. Sumon Chakrabarti, an infectious disease expert in Mississauga, Ont., says that while cold air may cause physical changes to aerosols “it does not translate to increased risk of disease transmission.”

He says risk of outdoor spread remains “quite low,” except for situations with large crowds in close contact, like during concerts or sporting events.

“From a public health standpoint I would much rather see 50 people skiing outdoors than a group of 10 watching TV together indoors,” he said.

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B.C.’s provincial health officer seeks injunction against churches for defying COVID orders

B.C.’s provincial health officer is seeking an injunction prohibiting gatherings by three Christian churches that are challenging her orders suspending in-person religious services.

Lawyers for Dr. Bonnie Henry and B.C.’s attorney general will be in B.C. Supreme Court on Friday seeking orders against the leaders of Langley’s Riverside Calvary Chapel, Abbotsford’s Immanuel Covenant Reformed Church and the Free Reformed Church of Chilliwack.

The province filed an application for the injunction last week along with a response to a petition by the churches and a handful of others who want to overturn Henry’s orders.

According to the court documents, the province is seeking an order that would prevent elders and members from gathering to worship in their churches and from organizing celebrations, ceremonies, baptisms, funerals or any other “event” as defined by Henry’s orders.

The order would also authorize police to detain anyone they have grounds to believe is planning to attend a religious service organized by any of the three churches.

Freedoms ‘not absolute’

The application for the injunction comes just days after Henry announced an indefinite extension to the orders she issued last November suspending all events and social gatherings in an effort to reduce COVID-19 transmission.

In a petition filed in early January, pastors with the three Fraser Valley Christian churches claim that Henry is violating rights to expression and religious worship guaranteed by the Constitution by shutting churches while allowing restaurants and businesses to remain open.

Their petition seeks to overturn the order against in-person worship.

The province filed a response to the petition last week, claiming there is “no question that restrictions on gatherings to avoid transmission of (COVID-19) limit rights and freedoms guaranteed by the Charter of Rights and Freedoms.”

But the province says the limits are justified.

“Rights and freedoms under the charter are not absolute,” the response says.

Protection of the vulnerable from death or severe illness and protection of the health-care system from being swamped by an out-of-control pandemic is also clearly of constitutional importance.– Provincial response to petition

“Protection of the vulnerable from death or severe illness and protection of the health-care system from being swamped by an out-of-control pandemic is also clearly of constitutional importance.”

Offer ‘sadly rings hollow,’ pastor says

An affidavit from acting deputy provincial health officer Dr. Brian Emerson states that the science shows that COVID-19 spreads better in indoor settings where people from different households gather for longer than 15 minutes.

“Clusters of COVID cases stemming from religious gatherings and religious activities have been noted since the onset of the pandemic globally, nationally and in British Columbia,” the application for the injunction says.

The province’s response says Henry wrote to pastors at the Riverside Calvary Chapel and the Free Reformed Church in December after she became aware of their intention to defy her orders.

The pastor of the Free Reformed Church of Chilliwack allegedly wrote back to say Henry’s “offer to consider a request from our church to reconsider your order sadly rings hollow.”

The court documents say Henry consulted widely with faith leaders before issuing the order to suspend in-person religious services.


A lawsuit filed in January pits a number of Christian churches against B.C.’s provincial health officer. The churches claim Henry is violating their constitutional rights. Henry claims those freedoms are not absolute. (Gerald Herbert/Associated Press)

Churches also have the ability to ask for reconsideration under Section 43 of the Public Health Act.

The response says one such application led to an exemption for synagogues to hold services in open tents with no more than 25 people present.

The three churches at the heart of the lawsuit allegedly filed for reconsideration at the end of January — after suing the government.

The province says no decision should be made on the petition to overturn Henry’s orders until she has had a chance to consider their applications for an exemption from the rules.

Province cites threat of variants

The province’s application for an injunction says complying with Henry’s orders at this point is “critical” because of the threat posed by 18 cases of new variants of the coronavirus first detected in the U.K. and South Africa that have been found in B.C.

The province says the churches have provided no evidence from anybody with a scientific or medical background to say the orders are not reasonable.

“By contrast, the Attorney General and Provincial Health Officer have provided evidence that transmission occurs in social settings … that there is evidence from British Columbia, Canada and around the world of transmission in gatherings, and in particular, religious gatherings,” the application for the injunction says.


The province argues that restrictions on in-person religious services are necessary to prevent the transmission of COVID-19, which could overwhelm B.C.’s health-care system. (Ben Nelms/CBC)

The churches are being represented by the Calgary-based Justice Centre for Constitutional Freedoms.

In a statement, lawyer Marty Moore said the province’s data claims that 180 positive COVID cases have been associated with religious services but does not indicate whether health guidelines were being followed.

“Our clients continue to diligently implement health guidelines and protocols to minimize any risk of COVID transmission, and will be providing the court with evidence attesting to the safety of their services,” Moore wrote.

“The actions of the government to seek an injunction against these three churches who have brought a petition for judicial review of the public health orders does not appear to reflect a genuine effort to advance public health concerns.”  

‘Grassroots’ Christian group seeks intervenor status

On Wednesday, Chief Justice Christopher Hinkson is scheduled to hear an application to intervene in the case from the Association for Reformed Political Action (ARPA), a group that describes itself as a “grassroots Christian political advocacy organization.”

According to the application, the group speaks for reformed Christians who attend 165 congregations in Canada, including 28 in B.C.

“The impact of COVID-19 restrictions on the practice of in-person public worship (including celebrating communion) has been the top issue of concern for ARPA Canada’s constituency since March 2020,” the application reads.

“That constituency has been profoundly impacted by the orders under review in this proceeding — likely more so than certain other religious groups.”

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A 15-Minute Smartphone COVID Test Is Coming to the US

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The Biden administration has made tackling the coronavirus pandemic its top priority with plans to ramp up both testing and vaccine distribution. The Department of Defence and Department of Health and Human Services have awarded $ 230 million to Australian biotech firm Ellume to produce a 15-minute COVID test that sends results directly to your phone. 

Ellume has not gone through the full FDA approval process, but it received an Emergency Use Authorization (EUA) in December for the test, which is 95 percent accurate in diagnosing SARS-CoV-2 infection. When it got the EUA, Ellume was only manufacturing about 16,000 tests per day. With the influx of cash, Ellume plans to produce 19 million tests per month by the end of 2021. The company plans to ship 100,000 kits per month to the US between February and July. 

The Ellume test uses a nasal swab like many of the early COVID tests, but it’s not a “brain tickler” like the test you might have taken a few months ago. The swab only goes into the mid-sinus to collect its sample. The kit, which will be available over the counter, comes with a single-use swab, a vial of reagents, a dropper/mixer, and an analyzer. You’ll have to supply your own smartphone, though. 

The analyzer has a Bluetooth radio that links with the Ellume app, available for both iOS and Android. The app also has full animated instructions on how to perform the test. The Ellume test works by binding special fluorescent chemicals to the SARS-CoV-2 nucleocapsid — the external shall of the virus particle. When applied to the tester, the liquid absorbs into an embedded test strip where it encounters antibodies that recognize the SARS-CoV-2 shell. The analyzer reads the fluorescent illumination from different areas of the strip to determine if there is viral antigen in the sample. If the light signature rises to a certain level, that’s a positive test.

The result is beamed over Bluetooth to your connected phone in just 15 minutes. The company says its technique is very accurate, but it’s more likely to return false negatives for asymptomatic individuals. Meanwhile, anyone without symptoms who gets a positive test should consider that a presumptive positive, which should be confirmed via standard molecular testing. 

The current plan is to make the Ellume test available over-the-counter. So, you won’t need to visit a doctor to get one. You will, however, have to be lucky. As the first OTC COVID tests in the US, demand will probably be sky-high.

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