Tag Archives: ‘should

Canucks’, Habs’ COVID-19 setbacks should serve as wake-up call to all Canadians

Recent COVID-19 outbreaks on two Canadian NHL teams are concerning but should not come as a surprise, says a medical expert.

On Saturday the NHL announced seven additional members of the Vancouver Canucks were added to the league’s COVID-19 protocol list, bringing the total number to 14. The Canucks already had four of their games postponed. Vancouver also has an unnamed coach under COVID protocols.

In late March, two members of the Montreal Canadiens were placed on the COVID protocol list and the team had four games postponed.

“You have to look at the cities they’re in,” said Dr. Zain Chagla, an infectious disease physician for St. Joseph’s Healthcare in Hamilton, Ont. “Vancouver has a higher burden [of cases] than many other places in Canada. They just locked down the province because things are getting out of control.

“Montreal is not as bad as some of the other places, but still getting higher rates.”

Last week the B.C. government announced a three-week “circuit breaker” lockdown, resulting in sweeping restrictions on indoor dining in restaurants, group fitness and worship services.

Vancouver forward Adam Gaudette and defenceman Travis Hamonic tested positive for COVID-19 early last week. Since then defencemen Alex Edler, Tyler Myers and Quinn Hughes; forwards Zack MacEwen, Bo Horvat, Tyler Motte, Travis Body, Jayce Hawryluk, Brandon Sutter and Antoine Roussel; plus goaltenders Braden Holtby and Thatcher Demko have been added to the list.

A player under COVID-19 protocols has not necessarily tested positive for the virus.

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

Chagla said rising COVID cases in the general community increases the odds for a case sneaking through the NHL’s protective protocols. With some of the new variants, a player could be spreading the virus even before beginning to show symptoms.

“You really do have to get serious testing to really identify people right away,” said Chagla. “Even when you do identify them, it’s 24 or 48 hours later.”

The close proximity of a hockey environment allows for quick spreading.

“They’re in close contact, they’re sitting beside each other on the bench, they’re in contact in scrimmage, they’re training together,” said Chagla. “They’re so many different high risk encounters.”

At one point in February, of the 35 games the NHL had postponed due to COVID, none had involved Canadian teams.

U.S. seeing growth in herd immunity

Since March 20, of the 10 games postponed due to COVD, only two involved U.S.-based teams.

As of Friday, of the 13 players on the NHL’s COVID-19 protocol list, only four played on American teams.

Chagla attributes the drop in numbers to more people in the U.S. receiving vaccines and a growth in herd immunity.

“They are definitely seeing a rise in cases, but it’s not been as abrupt as Canada,” he said. “There’s still some vulnerabilities but that infection pressure is a whole lot less.”

David Legg, a professor of sports management at Mount Royal University in Calgary, said the COVID cases affecting NHL teams should serve as a wakeup call to all Canadians.

“Maybe it’s hubris on our part, because we were mocking the Americans for so long,” he said. “Now it’s our teams that are getting tested positive.

“We still perhaps need to be careful and the light is maybe not as close as we had thought to the end of the tunnels as we’re hoping for.”

The NHL has not said if more Canuck games will be postponed. Currently, Vancouver’s next game is scheduled for April 8 with no practices before April 6. Heading into Saturday night the Canucks sat six points out of the final playoff spot in the NHL’s North Division with 19 games remaining.

Make-up games extend regular season

Postponing games will mean revamping the NHL’s already shortened 56-game schedule, said Legg.

“They don’t really have to stress about arena availability because it’s really just the primary tenants that are using the facilities at the moment,” he said. “It’s not like they’re going to have to bump out a bunch of concerts or other events.”

Both the NFL and NBA were forced to reschedule games due to COVID. Major League Baseball’s opening day match Thursday between the New York Mets and Washington Nationals was also postponed.

The NHL season was originally scheduled to end May 8. The NHL built in a week window to reschedule games if necessary and already games are planned up to May 11.

“Maybe they’ll just have to push it back further then they would have originally wanted,” said Legg. “Or they just could cut back games in hand of other teams.

“I don’ know if that hurts the NHL because I don’t think they have necessarily figured out the playoff system yet.”

Legg doubts the challenges the NHL faced this season will leave an asterisk beside who ever wins the Stanley Cup.

“In some respects, you could probably argue the opposite and that it was a more arduous and difficult task because they had to deal with all these extraneous factors.”

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CBC | Sports News

Should I be worried about the AstraZeneca-Oxford vaccine? Your COVID-19 questions answered

As Canada announced it is recommending the use of the AstraZeneca-Oxford COVID-19 vaccine for those 65 and older, some countries overseas are suspending its use over safety concerns.

More than a dozen countries in the European Union — including its largest members Germany, France and Italy — have halted AstraZeneca inoculations pending the outcome of an investigation by the European Medicines Agency (EMA) into isolated cases of bleeding, blood clots and low platelet counts.

Non-EU countries, such as Indonesia and Congo, have also suspended use of the vaccine.

With such divergent guidance on the vaccine, many are asking if it’s safe.

Here’s what you need to know.

How many people have been affected?

Out of the approximately five million European residents who have received AstraZeneca’s shot, about 30 have experienced “thromboembolic events” — clots forming in blood vessels — and a very small number of deaths have been reported.

Denmark was the first country to halt its use of the AstraZeneca vaccine last week after reports of blood clots in some people, including one person who developed multiple clots and died 10 days after receiving at least one dose.

Danish health authorities said the suspension would last for at least two weeks while the cases were investigated, even as they noted that “it cannot be concluded whether there is a link between the vaccine and the blood clots.”

A medical worker prepares an AstraZeneca vaccine shot in Copenhagen, Denmark, on Feb. 11. Denmark was the first country to halt its use of the AstraZeneca vaccine last week after reports of blood clots in some people. (Liselotte Sabroe/Ritzau Scanpix/AFP via Getty Images)

Norway soon followed suit after authorities reported that four people under the age of 50 who had gotten the AstraZeneca vaccine had an unusually low number of blood platelets, which could lead to severe bleeding.

In Britain, where 11 million doses of the AstraZeneca vaccine have been administered — more than any other country — there have been reports of about 11 people who developed blood clots after getting a shot.

Is there proof the vaccine is responsible?


The EMA says there is “no indication that vaccination has caused these conditions.”

The EU regulator said its investigation was continuing and was conducting a “rigorous analysis” of all data, adding that while its review was ongoing, the benefits of the AstraZeneca vaccine outweighed the potential side-effects.

WATCH | EMA sees ‘no indication’ COVID-19 vaccine caused blood clots:

The European Medicines Agency is investigating whether there is a causal link between AstraZeneca’s COVID-19 vaccine and a small number of instances of blood clots. But at this point, it believes the vaccine is safe. 1:31

EMA executive director Emer Cooke said it was carrying out a case-by-case evaluation of incidents and was expected to complete a review on Thursday.

AstraZeneca Plc on Sunday said it had conducted a review of people vaccinated with its COVID-19 vaccine, and no evidence has been found of an increased risk of blood clots. The review covered more than 17 million people vaccinated in the European Union and United Kingdom.

The World Health Organization (WHO) and EMA have joined AstraZeneca in saying there is no proven link.

If not the vaccine, what else could be the cause?

Some doctors pointed out that since vaccination campaigns started by giving doses to the most vulnerable people, those now being immunized are more likely to already have health problems.

Others, such as Dr. Lynora Saxinger — an infectious disease expert at the University of Alberta in Edmonton — said cases of adverse effects are increasing because so many people are now getting vaccinated.

Saxinger also noted that blood clots are fairly common, so investigators will look at overall numbers of people who received the AstraZeneca vaccine compared with those who reported the condition.

“There’s so many people receiving vaccines daily that any health event that happens to anyone around the time they get their shot may or may not be related,” Saxinger told The Canadian Press.

Why did countries stop using the vaccine?

Any time vaccines are rolled out widely, scientists expect some serious health issues and deaths to be reported — simply because millions of people are receiving the shots, and problems would be expected to occur randomly in a group so large.

The vast majority of these end up not being connected to the vaccine, but because COVID-19 vaccines are still experimental and there is no long-term data, scientists must investigate every possibility that the shot could have unforeseen side-effects.

WATCH | No evidence AstraZeneca vaccine causes harm, epidemiologist says:

Despite millions of AstraZeneca-Oxford COVID-19 vaccinations in Europe, there is no evidence of harm from the doses there, says Dr. Christopher Labos, a cardiologist with a degree in epidemiology. 6:01

Governments say they acted out of an abundance of caution when suspending the use of the AstraZeneca vaccine, with German Health Minister Jens Spahn stating on Monday that the decision was not political but based on expert advice.

WHO’s chief scientist, Dr. Soumya Swaminathan, said officials at the United Nations health agency “don’t want people to panic” amid the reports. She noted that of the 300 million doses of coronavirus vaccines that have been given to people globally, “there is no documented death that has been linked to a COVID vaccine.”

Should Canadians be worried?

Prime Minister Justin Trudeau said the AstraZeneca-Oxford COVID-19 vaccine is safe, and Canadians should have no concerns about receiving it. Regulators are “following what has been happening with a specific batch used in Europe,” he said.

Some vaccinologists point to a possible contamination of a certain batch of the vaccine as a potential explanation for the blood clots, but Trudeau said that none of the AstraZeneca doses deployed in Canada have come from the batch that’s under scrutiny in Europe.

WATCH | Health Canada is monitoring Europe’s investigation of AstraZeneca vaccine:

Marc Berthiaume, director of the bureau of medical sciences at Health Canada, says the department is monitoring Europe’s investigation into adverse effects experienced by some people after receiving the AstraZeneca vaccine. 1:54

All of Canada’s current supply is manufactured by the Serum Institute of India, which secured separate regulatory approvals from Health Canada.

That version, which is biologically identical to the AstraZeneca shot but is manufactured under different conditions, has been branded “Covishield.”

Health Canada, which approved AstraZeneca for use on Feb. 23, said there is “no indication” the vaccine causes blood clots, and no adverse events from AstraZeneca doses have been reported in Canada so far.

Are there concerns with other vaccines?

The EMA is currently examining whether COVID-19 shots made by Pfizer-BioNTech, Moderna Inc. and AstraZeneca might be causing low levels of blood platelets in some patients, a condition that could lead to bruising and bleeding.

Data from Health Canada shows 0.085 per cent of doses administered in the country from mid-December to March 5 resulted in an adverse reaction, with 0.009 per cent considered serious. Pain, redness and swelling at the vaccination site were the most common effects.

Most of those doses would have been mRNA vaccines (such as Pfizer and Moderna), which are generally eliciting stronger reactions than the viral vector jabs (such as AstraZeneca).

A health worker administers a COVID-19 vaccine in Montreal on Monday. (Andrej Ivanov/Reuters)

Additionally, experts say that side-effects from vaccines may actually be a sign that they’re working.

“If you have a vaccine that doesn’t produce a reaction in people, the resulting immune response is weaker,” Earl Brown, a microbiologist at the University of Ottawa, said in an interview with The Canadian Press.

Brown said vaccines work by stimulating our immune cells to grow and communicate with each other, giving directions on where to set up for an impending attack by the virus. That results in inflammation, with some of those cells travelling to lymph nodes and causing swelling.

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CBC | Health News

Where should U.S. vaccine production go next? Canada and Mexico, says one lawmaker

This story is part of Watching Washington, a regular dispatch from CBC News correspondents reporting on U.S. politics and developments that affect Canadians. 

What’s new

News Tuesday that the United States is racing ahead to mass-vaccination against COVID-19 months faster than expected is a big deal not only for Americans but could also have implications for Canada, which has so far been prevented from importing U.S.-made vaccines.

U.S. President Joe Biden tweeted Tuesday that the U.S. should have enough vaccines for all Americans by the end of May, two months sooner than the previously announced target.

So, where will massive American production volumes shift next?

One U.S. lawmaker’s suggestion: Canada and Mexico. 

Vicente Gonzalez, a member of the House of Representatives, says the U.S. must make it a priority to ship vaccines across the border to its neighbours once Americans are inoculated.

The Texas Democrat says he’s looking forward to when the U.S. can ease up on an export ban that has prevented foreign shipments of doses produced in the country.

Biden’s administration, like the Trump administration before it, has blocked exports and rebuffed requests from Canada and Mexico for supplies.

“The borders are closed in my district,” the Democratic lawmaker, whose district sits along part of the U.S.-Mexico border, told CNN Monday.

“Mexican nationals with visas who normally travel here or own second homes [or] come and do business here are not allowed across the border right now.

“So, we definitely need to immunize our friends across the border at some point, once we’re finished doing it here in our country.”

Gonzalez said the U.S. will only truly recover from the pandemic when its neighbours are safe, too.

Vicente Gonzalez, seen here at an August 2020 press conference, serves a Texas-Mexico border community in the House of Representatives, and says the U.S. should lift its ban on the export of COVID-19 vaccines. (Joel Martinez/The Monitor via AP)

“I think we have five vaccines for every American, so we certainly have some extra vaccines that we could share with other countries — especially somebody like Mexico or Canada, who we do a lot of business with … where a lot of commerce and tourism flow on a regular basis,” Gonzalez said in the interview. 

“So we don’t live in this world, isolated. It’s a global community, and certainly, North America is a very tight-knit community. We have relatives on both sides of the border, we do business on both sides of the border, whether it’s Canada or Mexico.”

What’s next

Gonzalez’s comments point to a question that will only intensify over the coming months about what happens to the big production capacity within the United States once export bans are lifted on plants such as Pfizer’s in Michigan and Moderna’s in New England.

The United States has vaccinated residents at quadruple the rate of Canada. Biden has said in the past that there should be enough vaccines for all Americans by the end of July before revising that to late May on Tuesday.

That puts the U.S. schedule several months ahead of Canada’s.

Biden says vaccines arriving faster than expected:

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CBC | World News

Government agrees mentally ill should have access to assisted dying — in 2 years

The Trudeau government has agreed with the Senate that Canadians suffering solely from grievous and incurable mental illnesses should be entitled to medical assistance in dying — but not for another two years.

The two-year interlude is six months longer than what was proposed by senators.

The longer wait is one of a number of changes to Bill C-7 proposed by the government in response to amendments approved last week by the Senate.

The government has rejected another Senate amendment that would have allowed people who fear being diagnosed with dementia or other competence-eroding conditions to make advance requests for an assisted death.

It has also rejected one other amendment and modified two others in a motion that is to be debated today in the House of Commons.

If the Commons approves the government’s response, the bill will go back to the Senate, where senators will have to decide whether to accept the verdict of the elected chamber or dig in their heels.

Government proposes expert review

Bill C-7 would expand access to assisted dying to intolerably suffering individuals who are not approaching the natural end of their lives, bringing the law into compliance with a 2019 Quebec Superior Court ruling.

As originally drafted, the bill would have imposed a blanket ban on assisted dying for people suffering solely from mental illnesses.

A strong majority of senators argued that the exclusion was unconstitutional. They said it violated the right to equal treatment under the law, regardless of physical or mental disability, as guaranteed in Canada’s Charter of Rights and Freedoms.

They voted to impose an 18-month time limit on the mental illness exclusion, which the government now wants to extend to two years.

WATCH | Changes to medical assistance in dying bill for dementia, mental illness up for debate

Senate amendments to the medical assistance in dying bill would make it easier for Canadians with mental illness or the prospect of dementia to get help ending their lives. But as those changes are debated there are concerns a sensitive subject will become a political football. 2:19

During that interlude, the government is also proposing to have experts conduct an independent review of the issue and, within one year, recommend the “protocols, guidance and safeguards” that should apply to requests for assisted dying from people with a mental illness.

In the meantime, senators had wanted to clarify that the exclusion of mental illness does not apply to people with neurocognitive disorders like Alzheimer’s disease. However, the government has rejected that amendment.

In rejecting advance requests, the government motion argues that the Senate amendment on that issue “goes beyond the scope of the bill” and requires “significant consultation and study,” including a “careful examination of safeguards.”

It suggests that the issue should be examined during the legally required five-year parliamentary review of the assisted dying law, which was supposed to begin last June but has yet to materialize.

The government has agreed, however, to a modified version of a Senate amendment to finally get that review underway within 30 days of Bill C-7 receiving royal assent.

The government is proposing the creation of a joint Commons-Senate committee to review the assisted dying regime, including issues related to mature minors, advance requests, mental illness, the state of palliative care in Canada and the protection of Canadians with disabilities. The committee would be required to report back, with any recommended changes within one year.

Court-imposed deadline looms

The government has also agreed to a modified version of another Senate amendment to require the collection of race-based data on who is requesting and receiving medical assistance in dying.

It is proposing to expand that to include data on people with disabilities and to specify that the information be used to determine if there is “the presence of any inequality — including systemic inequality — or disadvantage based on race, Indigenous identity, disability or other characteristics.”

That is in response to the strenuous opposition to Bill C-7 from disability rights advocates who maintain the bill sends the message that life with a disability is a fate worse than death. They’ve also argued that Black, racialized and Indigenous people with disabilities — already marginalized and facing systemic discrimination in the health system — could be induced to end their lives prematurely due to poverty and a lack of support services.

Some critics have also raised concerns about unequal access to assisted dying for marginalized people, rural Canadians and Indigenous people in remote communities.

Since the Liberals hold only a minority of seats in the Commons, the government will need the support of at least one of the main opposition parties to pass its response to the Senate amendments.

The Conservatives, who largely opposed expanding access to assisted dying in the original bill, and New Democrats, who are reluctant to accept any changes proposed by unelected senators, have indicated they’re not likely to support the motion.

That leaves the Bloc Québécois as the government’s most likely dance partner. Despite his own contempt for the Senate, which he maintains has no legitimacy, Bloc Leader Yves-François Blanchet, has said senators’ amendments to C-7 are “not without interest and indeed deserve to be looked at.”

The government is hoping to have the bill passed by both parliamentary chambers by Friday to meet the thrice-extended court-imposed deadline for bringing the law into compliance with the 2019 ruling.

But with the Conservatives signalling that they may drag out debate on the Senate amendments, the government will ask the court on Thursday to give it one more month — until March 26.

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CBC | Health News

Most at risk, first in line: Public health experts say racialized Canadians should be prioritized for vaccines

Two public health experts in Toronto say governments must prioritize vaccinating Black Canadians and other people of colour against COVID-19 because the data shows they are most at risk of contracting the virus.

Akwatu Khenti and Ananya Tina Banerjee told CBC Radio’s The House that failing to vaccinate those communities will not only put them at greater risk of getting COVID-19, but also increases the chance that the virus will spread more widely.

“The reason that Black people have a higher rate of positivity, or higher hospitalization rates, is actually because of social inequities, systemic racism and neighborhood vulnerabilities,” said Khenti, who teaches at the University of Toronto’s Dalla Lana School of Public Health and chairs the city’s Black Scientists Task Force on Vaccine Equity.

“If we use some type of vulnerability index we would arrive at the same conclusion, the most vulnerable should be first in line. Right now, the most vulnerable are racialized health professionals, racialized communities.”

Banerjee founded the South Asian Health Research Hub, and like Khenti, is on the faculty at the Dalla Lana School of Public Health. She said the data shows racialized communities are not only hardest hit by the virus, but many people in those communities work in manufacturing, distribution, the service industry and travel to their jobs using public transportation.

“And so given this information, it has to be prioritized that … the hardest hit neighbourhoods have to get vaccinated first or community transmission is just going to escalate,” she told The House.

CBC News: The House10:31Building an equitable vaccine rollout

Akwatu Khenti, chair of Toronto’s Black Scientists’ Task Force on Vaccine Equity, and Ananya Tina Banerjee, founder of the South Asian Health Research Hub, share what’s needed to create an inoculation campaign that provides equal access to shots. 10:31

Advisory committee looking at next priority groups

CBC News put those concerns to Canada’s chief public health officer, Dr. Theresa Tam, on Friday.

Tam noted that the goal of prioritizing specific groups or locations, such as congregate settings, is to reduce serious illness. But, she added, different provinces would use their own evidence to inform their rollout plans.

She said the National Advisory Committee on Immunization (NACI) created last year is examining the next set of priority populations for vaccines as deliveries begin to ramp up in the weeks ahead.

“For example, if you are in Toronto or if you’re in Ontario, they’ve already got data in relationship to where those higher risk populations are and that they be considered as part of the rollout for the prioritization of vaccines.”

Chief Public Health Officer Theresa Tam said Friday that the National Advisory Committee on Immunization (NACI) is looking at who should be next in line for a vaccine. (Adrian Wyld/The Canadian Press)

Ontario’s Ministry of Health told CBC News that the province is already collecting some demographic information, including age and sex, from people receiving vaccinations on a voluntary basis; it is also exploring how additional data might be used “to support the efficient, equitable and effective vaccine rollout for communities that are at-risk and disproportionately impacted by COVID-19.”

The statement goes on to say that the ministry recognizes Black and racialized communities have been disproportionately affected by COVID-19 and is working with local health authorities to establish guidelines for delivering the shots.

“The ministry works with its health system partners to ensure the guidance and information provided is clearly understood by all partners regarding the prioritization of populations for COVID-19 vaccines.

Racialized populations at risk elsewhere

The federal government already identified the need to prioritize Indigenous communities for vaccination. But this country isn’t alone in grappling with how to protect the most vulnerable sectors of the population from COVID-19 amid shortages of vaccine doses.

In the United States, Black and Hispanic Americans are bearing the brunt of infections, hospitalizations and death linked to the coronavirus. Experts there, and in Canada, are warning that the lack of race-based data on vaccinations runs the risk of leaving those same communities behind.

Khenti said part of the effort needed now is to overcome the reluctance of some people in racialized communities to get the vaccine by working with community partners and other local agencies.

“You have to work through trusted partners because the issue isn’t just one of information, it’s one of trust. And to date, many institutions haven’t made the effort to earn that trust,” he said. “Systemic racism has been ignored. It hasn’t been given the priority that it deserves, especially with respect to anti-Black racism, which is the issue facing my task force.”

Community outreach critical

That kind of community outreach is being credited with reducing coronavirus infections in South Asian communities in BC’s lower mainland

The province, like most others, doesn’t systematically track race-based COVID-19 data. But Banerjee told The House it’s possible to replicate anywhere.

“I mean, think about it. We need to bring the vaccine to the people and meet them where they’re at right now … We need to be thinking about that. We can’t just rely on these large health care systems, malls and chain pharmacies to have these vaccination programs,” she said.

Ananya Tina Banerjee, a faculty member at the Dalla Lana School of Public Health, said vaccination programs must work at the community level and meet populations where they are. (Yanjun Li/CBC News)

” And so we need to be, I think, at these access points of trust, as we call it. Just this past weekend in the U.K., there were hundreds of people actually vaccinated at a pop up clinic set up by the East London mosque to encourage Muslims to be inoculated and given their widespread concerns about the vaccination. And I think that is an incredible model that is community driven, that can be rolled out to temples, churches, gurdwaras, mosques in Ontario, especially if you want to target those racialized communities.”

But both Khenti and Banerjee warned that time is short. New, more contagious variants of the virus are beginning to spread, increasing the need to act now to give priority to Black Canadians and others who are already at higher risk of contracting COVID-19.

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CBC | Health News

What are the coronavirus variants and how should we respond to them? Your COVID-19 questions answered

We’re answering your questions about the pandemic. Send yours to COVID@cbc.ca, and we’ll answer as many as we can. We publish a selection of answers online and also put some questions to the experts during The National and on CBC News Network. So far, we’ve received almost 67,000 emails from all corners of the country.

Canada’s chief public health officer, Dr. Theresa Tam, warned Wednesday that variant strains of the coronavirus had been found in eight provinces, and that they could quickly reverse the gains the country has made in recent weeks in the battle against COVID-19.

At least two of three variants of concern are spreading in Canada, in some cases with no known link to travel, and have already led to devastating outbreaks in long-term care homes.

Here’s a look at some of the most common questions Canadians have about the variants.

Have a question or something to say? CBC News is live in the comments now.

What is it about the new coronavirus variants that makes them more transmissible?

As a virus infects people, it can mutate as it makes copies of itself. Some mutations can be harmful to a virus, causing it to die out. Others can offer an advantage and help it spread.

“Not every mutation is created equal,” Mary Petrone, who studies infectious diseases at Yale University, told The Associated Press. “The virus is going to get lucky now and again.”

There are many variants circulating around the world, but health experts are primarily concerned with the emergence of three

  • B117, first discovered in the U.K., which has “a large number” of mutations, according to the U.S. Centers for Disease Control and Prevention (CDC).
  • B1351, first discovered in South Africa, which shares some of the same mutations as B117.
  • P1, which was first discovered in Japan, in four travellers who had been in Brazil. 

Dr. Eric Topol, a U.S. physician, scientist and clinical trials expert who heads the Scripps Research Translational Institute in California, told CBC News in January that the variant first found in the U.K. exhibits changes in the spike protein — a key component of how the coronavirus binds to human cells.

He said those changes are likely behind its higher transmission, with the altered spike protein potentially allowing the coronavirus to infect cells more easily. The other two variants of concern also have changes to the spike protein.

WATCH | Dr. Bonnie Henry ‘confident’ variant transmission isn’t widespread:

B.C.’s provincial health officer says the province is aiming to control the spread of more infectious coronavirus variants over the next few weeks as it ramps up vaccinations. 1:14

If the variants are more contagious, do we need to distance more?

Ashleigh Tuite, an infectious diseases epidemiologist and assistant professor at the University of Toronto’s Dalla Lana School of Public Health, noted to CBC’s Adam Miller earlier this month that the 15-minute exposure time and two-metre distance guidelines from the federal government are “arbitrary.” 

“The new variants, I think, provide us with a reason to re-evaluate those rules and I think that’s something that hasn’t necessarily been well-communicated to the public,” she said. “There’s nothing magical about that distance that was based on science, that’s based on sort of what we know about how airborne pathogens are spread. But I think the science has evolved, or at least our thinking has evolved.” 

Erring on the side of caution makes sense, she said.

Dr. Lucas Castellani, an infectious diseases specialist at Sault Area Hospital, told CBC News Network on Feb. 2 that there’s no set distance the virus can travel, regardless of variants.

“We know it potentially can go farther and there are a lot of factors involved,” he said in regards to a question about smoking or vaping during the pandemic. “How heavy the person has been breathing, how good the ventilation is in the room or the space you’re in.”

At the same time, Castellani said he suspected based on the mutations that it’s not a case of the virus hanging in the air longer or travelling farther.

“Based on the type of mutations they have, it is unlikely that those are the types of characteristics that are leading to the change that we’re seeing,” he said.

WATCH | With COVID-19 variants, questions of whether guidelines go far enough:

The spread of the highly transmissible COVID-19 variant first found in the U.K. has some Canadian doctors wondering if our current distancing recommendations are enough. 2:02

Should we be wearing better masks?

Yes. Experts say we should consider finding better quality masks, wearing two at a time and/or wearing them more often.

In fact, the CDC released new guidance on Wednesday that said a lab experiment had found two masks meant double the protection.

The CDC said a cloth mask worn over a surgical mask can tighten the gaps around the mask’s edges that can let virus particles in.

The researchers found that wearing one mask — surgical or cloth — blocked around 40 per cent of the particles coming in during an experiment. When a cloth mask was worn on top of a surgical mask, about 80 per cent were blocked.

WATCH | COVID variants can cause cases to increase exponentially, Ontario health official says:

There is obvious community transmission of COVID-19 variants, according to York Region Medical Officer of Health Dr. Karim Kurji, who says the virus needs to be contained as it has the capacity to increase case numbers exponentially. 7:51

Canada recommends the use of three-layer non-medical masks with a filter layer to prevent the spread of the virus, but has not updated its recommendations since November, before the emergence of the new variants. 

Dr. Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare Hamilton, told CBC News that while three-layer non-medical masks are a good “minimum standard,” Canadians should opt for masks that offer better protection whenever possible.

Those include surgical masks, which are a step below N95s and KN95s and come in three different filtration levels determined by the American Society for Testing and Materials (ASTM).

“When I go to the grocery store now, I wear my very best mask,” said Linsey Marr, one of the top aerosol scientists in the world and an expert on the airborne transmission of viruses at Virginia Tech. “Before I was wearing an OK mask that was comfortable and easy.”

She said a cloth mask can “easily filter out half of particles, maybe more, but we’re at the point where we need better performance.” 

WATCH | Must detect variant COVID-19 cases quickly to stop spread, immunologist says:

In order to limit the spread of COVID-19 variants, cases must be detected quickly to ensure isolation occurs, says microbiologist and immunologist Craig Jenne. 3:21

Erin Bromage, a biology professor and immunologist at the University of Massachusetts, Dartmouth, who studies infectious diseases, said a tight-fitting mask is more important than ever due to the emergence of variants.

“It’s not that double-masking provides extra protection if the mask was fitting well,” he said. “Double-masking helps the mask that is closest to your skin fit more snugly, meaning more air goes through that mask.”

If you’re already wearing a high-quality mask that fits well, with air going through the material rather than out the sides, Bromage said there’s no extra benefit in throwing an extra mask on top.  

He recommends looking at yourself in the mirror before you go out to make sure your mask isn’t too loose fitting.

“I really want people to look at them and think, is all the air going through the material? And if it’s not, work out a way to do that,” he said. “And that may be putting a second mask on or finding a different mask that fits their face.” 

WATCH | Simple hacks to make your face mask more effective:

Canadian respirologist Dr. Samir Gupta explains the latest COVID-19 mask recommendations and demonstrates simple hacks to make yours more effective. 2:38

Are the variants more deadly?

It’s possible. There is some evidence the variant first found in the U.K. carries a higher risk of death than the original strain, the British government’s chief scientific adviser said in January.

“The verdict is still slightly out but theoretically, yes, it’s possible,” Castellani, the infectious diseases specialist at Sault Area Hospital, told CBC News. “And unfortunately that’s the way viruses work and the way mutations potentially catch up with us.”

WATCH | The race between COVID-19 vaccines and variants continues despite concern about efficacy:

South Africa has halted its rollout of the AstraZeneca COVID-19 vaccine after a study showed it offered minimal protection against mild infection from a variant spreading there. While experts say it’s cause for concern, they say vaccines can be reconfigured to protect against mutations. 2:01

Is it possible to be re-infected from any of the variants?

“Yes, it is possible to be re-infected,” Castellani said on Tuesday. “We’re seeing that in some parts of the world, in particular South Africa, that some individuals are in fact being re-infected with the virus. It’s felt that once you get the immunity from the virus it may last for some time, but not everyone’s will last the same as the next person.”

Dr. James Hamblin, a Yale University public health policy lecturer and a writer with the Atlantic, told CBC’s Front  Burner that a raging outbreak in the Brazilian city of Manaus also pointed toward re-infection.

“It’s been very tragic there: places running out of oxygen, people being buried in mass graves,” he said. 

The city was hit so hard by the coronavirus in the spring that researchers estimated that 76 per cent of the population had been infected, which makes the severity of this recent outbreak unexpected and concerning.

Hamblin said the leading theory is that it’s a combination of fading immunity given that the first surge in Manaus was about nine months ago, along with the dangers of the P1 variant. 

The variant “shares a mutation that the South Africa variant also has, which gives it a propensity to evade immune responses.”

Front Burner21:02A mutating virus and the need for global herd immunity

Does giving one dose of the vaccine and waiting beyond recommended days for the second dose help the virus adapt?

“It can,” said Dr. Isaac Bogoch, a Toronto-based infectious diseases specialist and member of Ontario’s vaccine task force, in an interview with CBC News Network on Monday. 

He said the concern is if you only give one dose of a two-dose vaccine regimen you can create an environment that allows the virus to “selectively evade that protection, and that’s certainly a theoretical concern.”

However, he said, in Canada most people will get the second dose on the optimum day (21 or 28, depending on the vaccine), and if not, within the recommended 42 days. 

Is there concern that 14 days is not long enough to quarantine and protect others from virus variants?

Bogoch said that while the variants of concern may have greater transmissibility or the ability to evade vaccination more readily, the incubation time or duration of the illness hasn’t changed.  

“Obviously we have to be open-minded, we have to be humble, there might be new data that results in a change in policy, but I think the 14-day [quarantine] should be fine for now.”

However, Alberta did strengthen its quarantine rules, because the variants are more easily spread through households.

“If cases choose to stay home during their isolation periods [rather than other isolation options], their household contacts will need to stay at home as well in quarantine, until 14 days have passed from the end of the case’s isolation period, for a total of 24 days,” said Dr. Deena Hinshaw, Alberta’s chief medical officer of health, during a news conference last week.

“Given how easily this variant is spreading in homes, this enhancement is necessary to prevent spread in the community.”

WATCH | AstraZeneca vaccine can be used against coronavirus variant first found in South Africa, says WHO:

WHO’s expert advisory group says there is a ‘plausible expectation’ that the AstraZeneca vaccine will be effective against severe disease from the coronavirus variant found in South Africa, despite a small study that prompted concerns. 2:09

We’re answering your questions every night on The National. Last night, we asked our experts about the impact of stress — nearly one year into the pandemic.

A physician and psychiatrist talk about the impact that stress is having on mental and physical health a year into the COVID-19 pandemic and what the longer-term effects might be. 6:10

Have questions about this story? We’re answering as many as we can in the comments.

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People with developmental disabilities should be prioritized for COVID-19 vaccine, say advocates

Kelton Broome sweats during interval training with Special Olympics NWT in a large Yellowknife gym. For most of the pandemic, group activities like this were stressful for him, but since getting a COVID-19 vaccine, he feels safer.

“I feel really safe, even though I only had just one shot so far,” said Broome, 25. “If I got sick, my immune system isn’t as good as others.”

He has autism and gross and fine motor skill delays, which means things like walking up and down the stairs can be difficult, as is unlocking a door. He also has a tendency to get sicker for longer than others, said his mother. 

“It can be pretty scary,” Broome said via Skype about COVID-19.

Broome lives with his mother in Yellowknife and functions with skills that range between a five and 25-year-old.

While he did get the vaccine, there is concern among advocates that others with developmental and intellectual disabilities — who don’t fall into existing priority groups, such as seniors or those living in long-term care facilities — can be at higher risk for contracting COVID-19 and are unsure when they’ll get access. 

Broome, back right, feels safer when working out for the Special Olympics NWT now that he has the COVID-19 vaccine. (Kate Kyle/CBC)

Much of that risk comes from necessary supports that can’t be accessed remotely.

Like many people with developmental and intellectual disabilities, Broome needs help from people outside his household: support workers drive him to work and help him handle money when shopping, and he has a job coach at work. This makes physical distancing difficult.

“He can’t function without support,” said his mother, Barb Kardash, who is grateful Broome has his first dose.

“What a relief. You know, just that extra layer of protection.”

May not realize the risk

Late last month, 23 clients and dozens of staff with Inclusion NWT, a group that supports people with intellectual and other disabilities, got the Moderna vaccine, according to the organization.

However, people who aren’t linked to advocacy groups could still be been left out.

“If we’re looking at people with developmental and intellectual disabilities living at home, they might not even realize that they’re at risk and neither do their families,” said Denise McKee, NWT Disabilities Council’s executive director.

“These are the groups that we have to be reaching out to.”

Both Inclusion NWT and the NWT Disabilities Council wrote letters lobbying to make people with disabilities a priority. The territorial government included them in its vaccination plans, in the category of “congregate settings,” which was for facilities where people live or stay overnight and used shared spaces. People in remote communities have also been offered the vaccine.

We’ve done everything we can to put them as a priority. ​​​​– Dr. Kami Kandola, N.W.T. chief public health officer

Dr. Kami Kandola, the N.W.T.’s chief public health officer said adhering to public health measures like wearing masks can also be challenging for some people.

“They don’t always have a choice of who enters into the home or have a choice about limiting their personal space,” said Kandola.

She said anyone in the N.W.T. who has a developmental and intellectual disability and doesn’t fit into a priority group can reach out to her office to make a request for the vaccine.

“We’ve done everything we can to put them as a priority,” said Kandola. 

While that was possible in N.W.T., where one in four people have had their first dose, it might not be so easy in more populated parts of Canada which have much lower per-capita access to vaccines.

Still, national advocates want people with developmental disabilities made a priority in early vaccination efforts elsewhere.

‘These are the groups that we have to be reaching out to,’ said Denise McKee, NWT Disabilities Council’s executive director, about people with disabilities living at home who may not realize they’re at risk. (Submitted by Denise McKee)

People with Down syndrome at much higher risk

Inclusion Canada, a national federation that works on behalf of people with developmental and intellectual disabilities and their families, says to its knowledge, currently no region in Canada has made the clients it represents, who live alone or with family, their own high-risk priority group.

Krista Carr, Inclusion Canada’s executive vice president, says people with Down syndrome are four times more likely to contract COVID-19 and over 10 times more likely to die from it, based on research published last fall. (Submitted by Krista Carr)

The focus has mostly been prioritizing long-term care residents and staff, and other congregate living facilities and designated supported living facilities, said Krista Carr, Inclusion Canada’s executive-vice president.

“People with Down syndrome are four times more likely to contract COVID-19 and over 10 times more likely to die from COVID-19,” Carr said, citing research published last fall. While that study is specific to those with Down Syndrome, Inclusion Canada says more generally that people with disabilities tend to be more vulnerable to disease at younger ages than the general population.

It’s not always clear in the rollout plans who is included in vulnerable population vaccine priority groups, said Carr.

“If you look at all the jurisdictions and the vaccine prioritization, the information they do have available, you rarely actually see disability mentioned at all …That causes a lot of fear and anxiety for families,” she said.

“This is obviously a life-and-death issue.”

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Should I wear a mask outdoors? Your COVID-19 questions answered

We’re answering your questions about the pandemic. Send yours to COVID@cbc.ca, and we’ll answer as many as we can. We publish a selection of answers online and also put some questions to the experts during The National and on CBC News Network. So far, we’ve received more than 65,000 emails from all corners of the country.

Should I be wearing a mask outdoors? 

It depends on the circumstances. Federal public health officials recommend wearing a non-medical mask or face covering when:

  • You’re in public and you might come into close contact with others.
  • You’re in shared indoor spaces with people from outside your immediate household.
  • Advised by your local public health authority.

So if your circumstances meet any of these conditions — whether indoors or out — you should probably be wearing a mask.

However, if you’re doing something like walking in a quiet neighbourhood then the risk of transmission is very low, said Dr. Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare Hamilton and an associate professor at McMaster University.

If you are going in and out of stores, or getting on and off transit while doing errands, it is best to just keep your mask on the whole time, to minimize touching it and potential contamination, Chagla advised in December.

And If you’re interacting with others outside you should wear your mask, while also staying two-metres apart, Chagla said.

More recently, Chagla called three-layer, non-medical masks a good “minimum standard.” He suggested Canadians should opt for masks that offer better protection whenever possible.

The rapid spread of more contagious coronavirus variants across the country has led people in some hard-hit regions to question whether national public health guidelines go far enough to protect Canadians.

The concern is that people could be at risk of getting the virus from very little exposure to it. 

Public Health Ontario (PHO), an arm’s-length, provincial government agency, recently told health units across the province they should reduce their thresholds for classifying all COVID-19 exposures given the emergence of variants.

If a person infected with COVID-19 and a contact are both wearing masks, but the contact isn’t wearing eye protection, PHO said they should be considered “high-risk” if they were within two metres for at least 15 minutes.

If neither of them is wearing a mask or eye protection — PHO said any amount of exposure time is risky, aside from briefly passing by each other. 

In York Region, just north of Toronto, public health officials made headlines after releasing startling new information on individuals infected with the variant first identified in the United Kingdom. 

Dr. Karim Kurji, the region’s medical officer of health, said the new variant spread despite people taking precautions.  

“Some of these people who caught it were just doing essential visits and not for very much time, just a minute or two,” he said in a statement to CBC News. 

Have a question or something to say? CBC News is live in the comments now.

It’s recommended that you wear a face mask if you’re in shared indoor spaces with people from outside your household. In Calgary, people taking public transit have to wear them. (Helen Pike/CBC)

As for mask-wearing tips, if you’re wearing a high-quality mask that fits well, then air will go through the material, rather than escaping out the sides. A properly fitted mask will expand and collapse with each breath.

B.C. Provincial Health Officer Dr. Bonnie Henry told CBC News there have been several cases of outdoor transmission between spectators “clustering and talking with each other” during soccer games and wedding receptions where people gathered under tents, but not from brief outdoor encounters.

However, Dr. Vera Etches, Ottawa’s medical officer of health, suggested that with infection rates climbing, residents in the capital should wear masks outdoors at all times.

“People should wear masks when they’re outside of their house as much as possible,” Etches said in a recent CBC Radio interview. “It’s an added barrier. You don’t know if you’re going to come into close contact with someone or not.” 

Doctors recommend people stay two metres apart, even while wearing masks outside. (Martha Dillman/CBC)

“Outdoors is much safer than indoors, but if you are right beside someone, you could breathe in their respiratory secretions,” she said. “We’re in a situation now where we need to have stronger protections.”

Places such as San Francisco and New Brunswick have mandated outdoor mask use, and Toronto recently made wearing face masks for outdoor activities such as skating mandatory.

I’ve had Bell’s palsy. Should I get the COVID-19 vaccine?

We’ve been hearing from a number of Canadians who have experienced Bell’s palsy, which causes a temporary weakness or paralysis in muscles in the face, and they’re wondering if it’s OK to get vaccinated.

First, it’s important to note that it is always best to talk to your doctor when making important decisions about your health, including weighing the benefits and potential risks of receiving any vaccine.

Generally, it should be fine for people who have had Bell’s palsy to get vaccinated, said Dr. Michael Hill, a neurologist and professor in the department of clinical neuroscience at the University of Calgary’s medical school. 

Health Canada collects information on adverse events following immunization. There were about 90 reports of issues after more than 600,000 vaccine doses were administered, according to recent statistics. (Kristopher Radder/The Brattleboro Reformer/The Associated Press)

However, some people might get Bell’s palsy after having a viral infection such as COVID-19, he said. 

Health Canada collects information on adverse events after immunization, from a variety of sources. Of the more than 600,000 doses administered as of Jan. 15, there were 90 adverse reports — only 0.015 per cent of all doses administered. Of those, 27, or 0.004 per cent of the total, were considered serious. It didn’t have any Bell’s palsy specific data.

“The benefits of vaccines authorized in Canada continue to outweigh the risks,” according to Health Canada’s website. 

Internationally, Bell’s palsy was reported after vaccination in a very small number of participants in the Pfizer-BioNTech and Moderna trials. 

Pfizer reported six cases of Bell’s palsy, including four in the vaccine group, which it said was a rate typical of the general population

“From what I understand, [experts] say that that incidence is on par with the normal population and therefore isn’t considered to be statistically significant,” Pfizer Canada’s president Cole Pinnow told CBC News.

The benefits of vaccination outweigh the risks, according to Health Canada. (Lee Smith/Reuters)

Pfizer continues to collect safety information and submit regular updates to Health Canada, it said in a February statement.

Moderna reported four cases in its trials, including three among people who had the vaccine and one in the placebo group. The company said that three of the cases had resolved themselves.

The U.S. Food and Drug Administration has not concluded that these cases were caused by vaccination, and the U.S. Centers for Disease Control and Prevention (CDC) is advising people who previously had Bell’s palsy that they “may receive an mRNA COVID-19 vaccine.”

It is possible that vaccines can cause side-effects like Bell’s palsy “in very rare instances,” Matthew Miller, an associate professor of infectious diseases and immunology at McMaster University in Hamilton, Ont. said in a CBC News interview in January. 

But, there’s likely a greater chance of getting those side-effects from COVID-19 than from the vaccine, Miller said.

You can read more about that here.

Have questions about this story? We’re answering as many as we can in the comments.

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Should Canada divert vaccines from regions with low COVID-19 levels to hot spots?

This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.

In a week bookended with significant COVID-19 vaccine delays while confirmed cases of coronavirus variants continue to climb in Canada, experts are divided on whether vaccines should be diverted from parts of the country with fewer cases to those with hot spots.

On one hand, Canada’s three hardest-hit provinces have collectively received more than 10 times the Atlantic provinces, which have had much lower COVID-19 levels.

But at a per-capita level, the situation looks much different. 

Ontario, Alberta and Quebec have each received between 2,200 and 2,800 doses per 100,000 people, while Prince Edward Island has over 4,700, Nunavut close to 13,300, Yukon more than 14,000 and the Northwest Territories in excess of 21,000 doses. 

“I know cities in Canada that have more patients hospitalized than there are patients in the Atlantic with COVID-19 total,” said Dr. Zain Chagla, an infectious disease specialist and associate professor at McMaster University in Hamilton, Ont.

“They have functional health care, they’re separate from the rest of Canada. That’s fine, it’s working for you, but let us take the doses — give it to the rest of Canada that’s suffering.”

But others say the vaccine should be distributed equitably across the country because outbreaks can flare up quickly.

Alyson Kelvin, an assistant professor at Dalhousie University in Halifax and a virologist at the Canadian Center for Vaccinology who is evaluating vaccines with the VIDO-InterVac lab in Saskatoon, said Atlantic provinces that have faced serious lockdowns shouldn’t be forced to wait.

“It’s almost like you’re continuing to punish certain groups that have been following the rules,” she said.  

The federal government, meanwhile, isn’t ruling out shifting who receives how much of future shipments, but it’s a thorny issue both logistically and ethically in a country with vast disparities and limited vaccine supply. 

‘Redistribution’ required

Chagla said while an equitable approach to vaccine distribution in Canada is admirable, it doesn’t make sense on the ground in places with disproportionate spikes in cases like Toronto and nearby Peel and York Regions.

He’s among the health experts suggesting that regions with larger populations and more widespread COVID-19 levels be prioritized in Canada’s vaccine roll-out, due to the higher rates of hospitalizations and death they face.

“Especially if you’re having issues with vaccine shortages, we should probably do a bit of redistribution to these higher geographical spots as well,” said Dr. Sumon Chakrabarti, an infectious disease physician with Trillium Health Partners in Mississauga, Ont.

Chakrabarti says that in areas of the country where community transmission is high, long-term care facilities will bear the brunt of harm because residents are most at risk of severe outcomes and death from COVID-19 as the virus spreads.

“That’s where we should be focusing our vaccinations. And right now in Atlantic Canada, with due credit to them, they don’t have very much community transmission,” he said. 

“So I think that the best thing to do right now would be to shift that over to hot spots.” 

‘I know cities in Canada that have more patients hospitalized than there are patients in the Atlantic with COVID-19 total,’ said Dr. Zain Chagla, an infectious disease specialist and associate professor at McMaster University in Hamilton, Ont. (Craig Chivers/CBC)

Vaccines ‘not the tool’ to contain outbreaks

Dr. Lisa Barrett, an infectious diseases physician and immunologist at Dalhousie University in Halifax, said that from a scientific perspective, vaccines are meant to work on a wider population level and shouldn’t be used to try to contain flare ups.  

“This is not the tool that was ever meant to be a primary firefighting mechanism for hot spots,” said Barrett, “It was meant to be the long-term forest management that keeps things in good shape, when they’re in reasonable shape already.” 

“But having said that, is it a wrong thing to get long-term care vaccinated in hot spots where there is currently no vaccine? No, that’s a good idea; those people are likely to die.”

Kelvin says vaccines should be equally distributed throughout Canada, because even if an area has low levels of COVID-19 transmission for the time being, it doesn’t make a population any less vulnerable.

Canadian virologist Alyson Kelvin maintains that Atlantic provinces shouldn’t be forced to wait on vaccines. (Liam Richards/The Canadian Press)

“Northern communities had nothing for a really long time, but they were absolutely vulnerable to drastic and damaging consequences if the virus got in,” she said. 

“So to use that as a reason to not vaccinate those populations could lead to some serious consequences.” 

Dr. Anna Banerji, an infectious diseases specialist and Indigenous health expert at the University of Toronto, said remote Indigenous communities in particular need to remain prioritized for vaccines, due to the poor quality of healthcare they already receive. 

“The average person in Canada, if they get sick, if they’ve been exposed, they can go to see a doctor or go to a hospital,” she said.

“But when you’re in these remote communities, you need to fly down into hospitals that are usually further south or far away. So that means that if you’re sick, then you have to wait.”

Feds not diverting doses

For its part, the federal government is staying the course on its vaccine distribution plan, with no plans to redirect doses from provinces and territories with low levels of community transmission — but that could change. 

“We have not considered shifting doses from one province or one jurisdiction to another at this time. I think it would be counterproductive to do that in the midst of our immunization plan,” said Maj.-Gen. Dany Fortin, the military commander leading Canada’s COVID-19 vaccine logistics, during a press conference Thursday.

“What we could anticipate being prepared to do is adjust based on per-capita distribution at the locations that require the most future shipments long enough out for provinces to plan accordingly.” 

It would be ‘counterproductive’ to shift doses between regions in the midst of Canada’s immunization plan, said Maj.-Gen. Dany Fortin, the military commander leading Canada’s COVID-19 vaccine logistics. (Justin Tang/The Canadian Press)

Canada’s Deputy Chief Public Health Officer Dr. Howard Njoo said the emergence of more contagious variants has led to active discussions with health officials across the country, but he ultimately feels the provinces are better positioned to redistribute vaccines within their jurisdictions.

“They’re the people who have the data and know what’s going on in terms of the situation on the ground with respect to specific outbreaks and what variants might be emerging,” he said. “They can make the adjustments I think much more easily.” 

WATCH | Prime Minister Justin Trudeau shares update on COVID-19 vaccine delays:

Prime Minister Justin Trudeau spoke with reporters outside Rideau Cottage in Ottawa on Friday. 1:38

Concerns over rural, urban divide

Other physicians agree the focus shouldn’t be on redistribution across the country, but rather where supplies are most needed within each region.

“It does feel like it’s a bit of a distraction to argue about which province should have more,” said Dr. Nili Kaplan-Myrth, a family physician in Ottawa. “That’s not the point.”

Within Ontario, for instance, there’s a stark divide between which regions were sent vaccines, she said, with healthcare workers in rural areas still waiting to be vaccinated while hospital staff in larger cities are often receiving shots sooner.

“If you work in a hospital that already has the vaccine, and your name comes up, or they had extra doses, it was like this kind of quick free-for-all — ‘come down and get the vaccine’ — because we don’t want to throw out any doses,” she said.

“That only works for people who are already there, and so it doesn’t work when you’re hundreds of kilometres away.”

A Canadian North flight lands on the tarmac in Iqaluit at the end of December, carrying Nunavut’s first doses of the Moderna COVID-19 vaccine. (Jackie McKay/CBC)

That’s also a concern for the Society of Rural Physicians of Canada (SRPC), which issued a statement in late January calling on all Canadian vaccine task forces to consider the potential disparity that could arise if the needs of rural communities aren’t met.

Both long-term care and retirement homes in many rural and remote areas haven’t been vaccinated at the same rate as settings in urban areas, despite experiencing outbreaks at various facilities, the organization stressed. 

In Ontario, for instance, COVID-19 immunization clinics had been held at all 87 long-term care homes in Toronto by mid-January, while vaccinations for all of Lambton County near the Ontario-Michigan border only started on January 26 — even as that rural region continues to face deadly outbreaks at multiple long-term care homes. 

“If one or two people get sick, or need to be isolated or quarantined, that can have major detrimental effects on the entire health system in a rural area,” said SPRC president Dr. Gabe Woollam, a physician working in Happy Valley-Goose Bay, N.L.

“That’s one of the reasons why we see it as very important to ensure equitable access to vaccines.” 

Determining best approach ethically ‘tricky’

Given the competing priorities and perspectives on how to vaccinate Canadians effectively — all while the country faces a vaccine supply crunch — there’s no perfect approach for policymakers trying to wade through the debate.

“I look at the communities that could be devastated if they had the virus spread through them,” said Kelvin. 

“If we went to a model of only vaccinating places where the virus was, then I think we would be in some serious trouble in some places.”

University of Toronto associate professor Alison Thompson, a researcher on the ethical issues arising from public health policies, stressed there’s no easy road here: staying the course won’t please everyone, while redistributing doses between regions would be logistically challenging.

“What we’re ultimately saying is that some people are more vulnerable than others,” she said.

“It’s tricky ethically.”

To read the entire Second Opinion newsletter every Saturday morning, subscribe by clicking here.

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China, WHO should have acted quicker to stop pandemic: expert panel

A panel of experts commissioned by the World Health Organization has criticized China and other countries for not moving to stem the initial outbreak of the coronavirus earlier and questioned whether the UN health agency should have labelled it a pandemic sooner.

In a report issued to the media Monday, the panel led by former Liberian President Ellen Johnson Sirleaf and former New Zealand Prime Minister Helen Clark said there were “lost opportunities” to set up basic public health measures as early as possible.

“What is clear to the panel is that public health measures could have been applied more forcefully by local and national health authorities in China in January,” it said.

China’s Foreign Ministry spokesperson Hua Chunying disputed whether China had reacted too slowly.

“As the first country to sound the global alarm against the epidemic, China made immediate and decisive decisions,” she said, pointing out that Wuhan — where the first human cases were identified — was locked down within three weeks of the outbreak starting.

“All countries, not only China, but also the U.S., the U.K., Japan or any other countries, should all try to do better,” Hua said.

WHO has ‘no powers to enforce anything’

At a press briefing on Tuesday, Johnson Sirleaf said it was up to countries whether they wanted to overhaul WHO to accord it more authority to stamp out outbreaks, saying the organization was also constrained by its lack of funding.

“The bottom line is WHO has no powers to enforce anything,” she said. “All it can do is ask to be invited in.”

Last week, an international team of WHO-led scientists arrived in Wuhan to research the animal origins of the pandemic after months of political wrangling to secure China’s approval for the probe.

The panel also cited evidence of cases in other countries in late January, saying public health containment measures should have been put in place immediately in any country with a likely case, adding: “They were not.”

The experts also wondered why WHO did not declare a global public health emergency — its highest warning for outbreaks — sooner. The UN health agency convened its emergency committee on Jan. 22, but did not characterize the emerging pandemic as an international emergency until a week later.

“One more question is whether it would have helped if WHO used the word pandemic earlier than it did,” the panel said.

WHO did not describe the COVID-19 outbreak as a pandemic until March 11, weeks after the virus had begun causing explosive outbreaks in numerous continents, meeting WHO’s own definition for a flu pandemic.

WATCH | PM Justin Trudeau reacts to WHO interim report: 

Prime Minister Justin Trudeau spoke with the CBC’s Tom Parry on Tuesday outside Rideau Cottage. 1:19

As the coronavirus began spreading across the globe, WHO’s top experts disputed how infectious the virus was, saying it was not as contagious as flu and that people without symptoms only rarely spread the virus. Scientists have since concluded that COVID-19 transmits even quicker than the flu and that a significant proportion of spread is from people who don’t appear to be sick.

The WHO is underpowered and underfunded, and must be reformed to give it the resourcing to be more effective, according to an independent panel reviewing the WHO and the global response to the COVID-19 pandemic.

“We are not here to assign blame, but to make concrete recommendations to help the world respond faster and better in future,”Johnson Sirleaf, told reporters on a briefing on Tuesday, a day after the panel’s interim report was issued.

“I do believe that WHO is reformable.”

WHO response has faced criticism 

Over the past year, WHO has come under heavy criticism for its handling of the response to COVID-19. U.S. President Donald Trump slammed the UN health agency for “colluding” with China to cover up the extent of the initial outbreak before halting U.S. funding for WHO and pulling the country out of the organization.

The UN health agency bowed to the international pressure at the annual assembly of its member states last spring by creating the Independent Panel for Pandemic Preparedness and Response. The WHO chief appointed Johnson Sirleaf and Clark — who both have previous ties to the UN agency — to lead the team.

Canada’s official response

Prime Minister Justin Trudeau said his government will review the report for how to apply its lesson to Canada’s pandemic response both now and in the future. 

“Obviously there are things looking back that we could have, should have done differently,” he said on Tuesday. “I think one of the most important things, as we move forward is making sure that we learn from this experience for future governments and future administrations.”

Steven Hoffman, director of the Global Strategy Lab at York University in Toronto, said the report’s authors give a scathing assessment of current pandemic response. 

“Every political leader in the world was just hoping that the next pandemic wouldn’t happen on their watch. The results? Deadly consequences,” said Hoffman, a professor of global health, law, and political science. 

Hoffman said he hopes COVID-19 catastrophe will be a rallying cry to ensure governments invest in public health not only to prevent emergencies but also to promote health. Health promotion includes increasing rates of physical activity and cutting down on smoking, which also saves money, he said. 

A COVID-19 field hospital gets ready for patients last spring during the height of the crisis in Wuhan, in China’s central Hubei province. (Noel Celis/AFP/Getty Images)

An Associated Press investigation in June found WHO repeatedly lauded China in public while officials privately complained that Chinese officials stalled on sharing critical epidemic information with them.

Although the panel concluded that “many countries took minimal action to prevent the spread (of COVID-19) internally and internationally,” it did not name specific countries. It also declined to call out WHO for its failure to more sharply criticize countries for their missteps instead of lauding countries for their response efforts.

Last month, the author of a withdrawn WHO report into Italy’s pandemic response said he warned his bosses in May that people could die and the agency could suffer “catastrophic” reputational damage if it allowed political concerns to suppress the document, according to emails obtained by the AP.

To date, the pandemic has killed more than two million people worldwide.

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CBC | Health News