Elaine McCartney typically keeps a list on hand of her 30 or so health issues following a bout of COVID-19 a year ago— in part because she just can’t keep track of them all.
There’s the severe fatigue and memory issues. Brain fog, much like after a concussion. Constant headaches, low appetite, round-the-clock dizziness. And on and on.
The 65-year-old from Guelph, Ont., has been experiencing those symptoms for close to a year, after developing what felt like a severe case of influenza in April 2020 and which a physician identified as a probable case of the COVID-19 illness.
Then last month she got her first dose of the Pfizer-BioNTech vaccine. Her condition quickly seemed to improve.
“I was able to go to the store on my own, which I haven’t done for eight months,” McCartney said. “And my energy was up, and my pain was less. I had chronic debilitating pain in my shoulder, and it was gone.”
McCartney’s experience may offer a glimmer of hope for a growing number of people around the world living with prolonged health concerns after being infected with the virus causing the COVID-19 illness.
She’s not the only patient seeing unexpected improvements. Emerging research suggests vaccines may reduce symptoms for some of those suffering from what is now being called “long COVID”, where patients continue to suffer from a range of health concerns long after the infectious phase of the illness has passed.
‘Reassuring’ findings from U.K. study
More than a year into the pandemic, it’s not clear how many people are experiencing long-term health issues after having COVID-19, but their numbers are growing.
Researchers think around 10 per cent of people who get sick with COVID-19 continue to live with lasting symptoms — some suggest the number could be as high as 30 per cent — which could mean millions worldwide are coping with some lingering issues from the disease.
A new preprint study out of the U.K., which is still awaiting the peer review process, looked at a small group of such “long COVID” patients. It found those who had received at least one dose of the vaccine had “a small overall improvement” in long COVID symptoms and a “decrease in worsening symptoms” when compared to the unvaccinated patients.
The researchers followed 66 hospitalized patients whose symptoms persisted — issues like fatigue, breathlessness, and insomnia — including 44 who got vaccinated and 22 who didn’t.
A little over 23 per cent of the vaccinated patients saw some resolution of their symptoms, the researchers noted, compared to around 15 per cent of those who weren’t vaccinated — with no difference in response identified between the Pfizer-BioNTech or Oxford-AstraZeneca vaccines used among the participants.
The team also found another “reassuring result” — fewer vaccinated patients reported any worsening symptoms during the time period studied than the unvaccinated group, though they cautioned that there was a large potential for bias given patients self-reported their symptoms.
Dr. Fergus Hamilton, an infectious diseases researcher at the University of Bristol Medical School and part of the team behind the new study, said the findings offer a “slight hint” that vaccines might improve lingering symptoms.
“Although we’re a bit suspicious about that given the small numbers,” he added.
Science behind vaccine impact not clear
The study is limited by its small sample size, but other medical experts are observing a similar trend.
In the U.S., where roughly a quarter of the population is fully vaccinated, physicians now have a large pool of patients to follow.
Dr. Daniel Griffin, an infectious diseases physician at Columbia University in New York, said around 40 per cent of the patients he is treating for lingering health issues from COVID-19 are reporting either complete, or significant, improvement in their symptoms after being fully vaccinated.
He said the numbers in the U.K. study were “pretty on-target” with what he initially observed in his own patients, but that the impact seemed to bump up a couple weeks after people got their second dose.
“That’s the first bit of good news in a really a long time,” Griffin said.
But he acknowledged the mechanics behind why vaccination might clear up lingering COVID-19 symptoms isn’t yet clear.
WATCH | Long-COVID sufferers struggle with limited care options:
Kim Clark and Sonja Mally have jumped from specialist to specialist for the past year as they’ve sought relief for a series of crippling symptoms associated with post-acute COVID-19 syndrome. Some health experts say more dedicated funding and resources for COVID long-haulers would help sufferers like them and shed light on a little-understood aspect of the pandemic. 2:27
“I think the most persuasive theory for me is that the virus was never completely cleared, or whatever remnants might still be … are now able to be cleared because of the robust response that’s triggered by the vaccines,” Griffin said.
McCartney said her own post-vaccination experience felt nothing short of a miracle — even if the science behind what’s happening in her body remains hazy and more research needed to evaluate how much vaccines could actually help COVID long-haulers going forward.
“I was feeling so miserable, for so long,” she said.
“I’ve logged more than a thousand steps in the past four days and I haven’t done that for months and months and months — so I’ve definitely seen improvement.”
As more dangerous variants of the coronavirus spread, many Canadians are looking to upgrade their mask.
That has some people reaching for N95-style respirators that promise to filter at least 95 per cent of airborne particles.
When shopping online and in stores, consumers are most likely to find the international equivalents of the coveted N95, as these masks are still generally not available in stores.
The imported equivalents include the KN95 respirator, which meets the Chinese standard of 95 per cent filtration efficiency and the KF94, which meets the Korean standard of 94 per cent filtration efficiency.
However, as demand for these masks has grown, so has the presence of counterfeits and poor-quality respirators in Canadian stores.
To find out how much Canadians can trust what they’re buying, CBC’s Marketplace tested 14 KN95 and KF94 respirator brands purchased from Amazon and big box stores.
Three masks from each brand were tested at a lab at the University of Toronto’s Dalla Lana School of Public Health to see if they meet their filtration efficiency claims. Half failed.
“As a consumer in Canada right now, you can’t be confident of going to a reputable vendor, buying a pack of masks with a stamp that says KN95 or N95 or KF94, and have really any confidence that those masks meet that standard, and that’s a huge worry from me as an academic, but also as a consumer,” said James Scott, a professor of occupational and environmental health who oversaw the testing.
Marketplace shared the failing results with the stores and the manufacturers who made them. Some stores have since removed the products or say they are investigating further. Others maintain they are following regulatory guidelines.
What do the test results tell you?
While some masks tested well below the 95 per cent filtration standard threshold, others failed by just a percentage point or two. So how much do the results matter?
According to emergency room physician Dr. Jay Park of San Diego, Calif., it depends on who is using the mask and the level of protection they need or want.
Since the beginning of the pandemic, Park has been working to verify the authenticity and quality of N95-style respirators destined for hospitals. He has since shared his expertise and compiled tips on what average consumers can look for when buying these masks.
“The respirators on the low end of the test results may provide a similar level of protection to many cloth masks,” said Park.
WATCH | We tested 14 types of KN95 and KF94 masks. Here’s what we found:
CBC Marketplace tested KN95 and KF94 masks sold online and at big box stores. Half of them didn’t offer the level of protection they’re supposed to. 6:27
As for the masks that came in just a percentage point or two below the standard, he said they can still be used.
“If you are a consumer and you’re just using this to go shopping or do low-risk activities, then yes, your testing results do show that it protects you better than cloth masks. You don’t have to throw them out. I think that you just need to be informed that these do not meet KN95, 95 per cent filtration standards.”
Scott said that the consequence of a failing mask could be greater for those at higher risk of exposure or more severe disease.
“They matter for [health-care] workers and to a similar extent they matter for members of the public who have very specific susceptibilities where they need to go that extra distance to [protect] themselves from people in the environment.”
Should I be wearing a KN95 or KF94 respirator?
Experts agree the best protection against COVID-19 is to limit contact with others by staying home and physical distancing. When it comes to masking, the level of protection is up to you.
“I don’t necessarily think that the general population necessarily needs the highest protection possible,” said Park. “Do you deserve the highest protection possible? Do you want the highest protection possible? Now those are different questions, right?”
He advises that those at higher risk choose the best protection available to them.
“If you’re telling me that you’re riding the subway or you need to ride public transportation, or you’re a teacher and you’re working in an indoor classroom full of children that typically don’t show signs and symptoms of COVID-19, then yes, I believe you should get the highest protection possible.”
What are some tips to avoid poor-quality or counterfeit respirator masks?
1. Cut out resellers
Park advises to avoid resellers. Instead, he said to buy directly from the source or companies with a history in selling personal protective equipment (PPE).
These companies, he said, are more likely to have a relationship with a reputable supplier. Some manufacturers also sell directly to consumers, including Canadian companies that have recently been ramping up production of N95-style respirators.
2: Avoid the FDA logo
Health Canada and the United States Food and Drug Administration had temporarily authorized the sale of some KN95 and KF94 respirators during the pandemic. However, even authorized respirators are not allowed to use the FDA logo.
“The FDA logo is for the official use of the U.S. Food and Drug Administration (FDA) and not for use on private sector materials,” the FDA website says.
3: Be wary of unmarked packaging or an unknown manufacturer
Some of the products Marketplace purchased arrived in unmarked packaging or in boxes that did not include the manufacturer’s name and address. That’s another red flag, said Park.
“You don’t want to buy something that is potentially a medical product and not know who the manufacturer is for you to be able to trace back and say OK, this is who made it and I can look up their registration or certification online,” he said.
4: Check Health Canada, the FDA and CDC websites
Health Canada has a list of authorized medical devices for uses related to COVID-19. You can check whether your mask is among them. However, only respirators authorized under the interim order introduced after COVID-19 struck are on this list.
Park has also created a PPE authentication site that aggregates the data on masks that are authorized for sale or recalled in Canada, the U.S and Europe.
What do the companies say about the results?
Marketplace reached out to the stores and retailers selling the KN95 and KF94 respirators that failed the filtration test. Here is how they responded:
Well.ca, whose masks tested among the lowest, did not respond directly to the test results. Instead, it directed Marketplace to contact the manufacturer. That information was not listed on the product packaging and Well.ca did not provide it when asked.
Amazon said that it verifies that all masks on their sites are legitimate. It said that there are “bad actors” that purposely evade their protections and that they removed the products that failed. The seller of the Seal Goods mask on Amazon said the ones purchased by Marketplace could be counterfeit.
Walmart also removed the mask that failed from its website. It said it does not permit the sale of KN95’s and that the product purchased should never have been for sale. They did not explain how this mask and other KN95s ended up on their site.
Home Depot and Home Hardware said they follow regulatory standards. Home Depot said that it is investigating further.
Marketplace also shared its results with Health Canada, which said it “monitors information about counterfeit, fraudulent and unauthorized COVID-19 devices, including personal protective equipment. Devices that are confirmed to be counterfeit or unauthorized are removed from the market and are not permitted to be sold in Canada.”
Watch full episodes of Marketplace on CBC Gem, the CBC’s streaming service.
Prime Minister Justin Trudeau said today the AstraZeneca-Oxford COVID-19 vaccine is safe and Canadians should have no concerns about receiving it, after nearly a dozen European countries suspended its use over concerns about blood clots.
“Health Canada and our experts have spent an awful lot of time making sure every vaccine approved in Canada is both safe and effective,” Trudeau said.
“The best vaccine for you to take is the very first one that is offered to you. That’s how we get through this as quickly as possible and as safely as possible.”
Trudeau said regulators are “following what has been happening with a specific batch used in Europe.” He said none of the AstraZeneca doses deployed in Canada have come from that batch.
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.”
Out of the approximately 5 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.
Quebec Premier François Legault, who joined Trudeau today for a funding announcement for an electric battery plant in Montreal, said health officials in the province have told him there’s nothing to worry about.
“There’s absolutely no risk associated with the AstraZeneca vaccine. It’s in fact safe,” he said in French. “They’re assuring us there’s no risk.”
Trudeau said he will not hesitate to get a COVID-19 vaccine when the time comes. “I will wait my turn,” he said.
Other world leaders — like U.S. President Joe Biden, who, at 78, is much older than the 49-year-old prime minister — have received their shots publicly to boost public confidence in the products’ safety and efficacy.
Trudeau’s mother Margaret, who lives in Quebec, recently received a dose.
WATCH: Trudeau says ‘I will wait my turn’ for COVID-19 vaccine
Prime Minister Justin Trudeau said he will wait for his turn to receive a COVID-19 vaccine. 0:59
France, Germany suspends AstraZeneca vaccine
On Monday, France and Germany joined Denmark, the Netherlands, Norway, Iceland and Ireland and several other countries in suspending the use of the vaccine.
Germany’s health minister said the decision was taken on the advice of Germany’s national vaccine regulator, the Paul Ehrlich Institute, which called for further investigation into seven reported cases of clots in the brains of people who had been vaccinated.
“Today’s decision is a purely precautionary measure,” Jens Spahn said.
The European Union’s medicines agency and the vaccine maker itself have said that blood clots are not uncommon and there’s nothing to indicate that the vaccine is to blame for these events.
“A careful review of all available safety data of more than 17 million people vaccinated in the European Union and U.K. with Covid Vaccine AstraZeneca has shown no evidence of an increased risk of pulmonary embolism, deep vein thrombosis or thrombocytopenia, in any defined age group, gender, batch or in any particular country,” the company said in a statement.
The World Health Organization said in a media statement Monday its global advisory committee on vaccine safety is “carefully assessing the current reports related to the AstraZeneca vaccine.”
“As of today, there is no evidence that the incidents are caused by the vaccine and it is important that vaccination campaigns continue so that we can save lives and stem severe disease from the virus. The AstraZeneca vaccine has been administered to more than 10 million people in the United Kingdom with no evidence of related serious adverse events.”
The U.K. Medicines and Healthcare Products Regulatory Agency (MHRA) said Sunday there is no evidence the vaccine has caused any problems in that country — the AstraZeneca product has been in use there for months — and people should still get vaccinated when it’s their turn.
“Blood clots can occur naturally and are not uncommon. More than 11 million doses of the Covid-19 AstraZeneca vaccine have now been administered across the U.K.,” the MHRA told BBC News.
Microsoft’s purchase of Bethesda has finally born the fruit most of us were expecting. In a blog post supposedly welcoming its new set of studios to the Microsoft family, Phil Spencer, head of Xbox, laid out the real news:
With the addition of the Bethesda creative teams, gamers should know that Xbox consoles, PC, and Game Pass will be the best place to experience new Bethesda games, including some new titles in the future that will be exclusive to Xbox and PC players.
Back in November, Microsoft tried to argue there was more nuance to this point. Tim Stuart, CFO of the Xbox division, was trotted out to make mouth noises implying that while console exclusives could happen, Microsoft was much more focused on making games better on Xbox than cutting off Nintendo or Sony players. Here’s Tim Stuart:
What we’ll do in the long run is we don’t have intentions of just pulling all of Bethesda content out of Sony or Nintendo or otherwise. But what we want is we want that content, in the long run, to be either first or better or best or pick your differentiated experience, on our platforms. We will want Bethesda content to show up the best as — on our platforms. Yes. That’s not a point about being exclusive. That’s not a point about we’re being — adjusting timing or content or road map. But if you think about something like Game Pass, if it shows up best in Game Pass, that’s what we want to see.
While Stuart mentions being first, he puts more emphasis on quality, flexibility, and ensuring that games play well as Game Pass titles. The only type of exclusive he actually references is a timed exclusive. Games that only launch for Xbox and PC aren’t launching for those platforms first, they’re launching for those platforms exclusively.
With that said, we know a bit more about Bethesda’s plans than just these comments. The developer has already announced that Doom Eternal and The Elder Scrolls Online will be upgraded with enhanced effects for next-generation gaming on the Xbox Series S|X and the PlayStation 5. We also know that two PS5 exclusives — Deathloop and Ghostwire: Tokyo — will still ship for that console. Bethesda’s Todd Howard has publicly stated it was “hard to imagine” The Elder Scrolls 6 as a Microsoft-exclusive title. Nothing has been said about next-gen upgrades for games like Fallout 76 or the Wolfenstein games on either platform.
No word on whether Corvo gets a next-gen upgrade, either, though Dishonored 2 is old enough to make this unlikely.
A few things seem clear from this. First, Bethesda has been allowed to complete projects that were in the pipeline, even when those projects were for Microsoft’s chief competitor. Second, Bethesda employees have given the impression at least some future titles would still be developed for multi-platform releases.
Microsoft’s references to exclusivity may or may not come with timers attached. Historically, Sony has maintained its own stable of franchises like God of War, Horizon: Zero Dawn, and The Last of Us. Some of its exclusive games have later come to PC, but others have remained PlayStation-only for decades.
Spencer claims that “some” games will be PC/Xbox exclusive without clarifying how many games will or won’t be covered by the word, or how long it will apply for. If Microsoft’s goal is to build exclusive titles for the Xbox, it’s got precious little reason to share its IP with Sony. There were hopes that the Xbox Series S|X would hit differently than the Xbox One did back in 2012, but both Microsoft and Sony have been matching their previous launch figures, not beating them. Limited supply due to the ongoing semiconductor shortage has undoubtedly played a role here, but this probably isn’t the position Microsoft wanted to be in two console launches in a row.
If Microsoft wants to minimize fan reactions, it’ll keep existing multi-platform franchises on multiple platforms and only release new IP or spin-off concepts exclusively for Xbox. Moving most or all of Bethesda’s AAA franchises to Xbox exclusives might drive some console sales, but it would also create a lot of bad feelings.
Now that Microsoft owns Bethesda, it ought to give Obsidian permission to create another Fallout game. While I can’t speak for every Fallout fan, I’d be pretty happy to get either a spiritual sequel to Fallout New Vegas set elsewhere in the world or even a new turn-based isometric title somewhat more in the tradition of Fallout 2.
A battle between lawsuits related to the Humboldt Broncos bus crash is to be heard in a Regina courtroom this week.
Eleven lawsuits were filed after the crash on April 6, 2018. Sixteen people died and 13 were injured when the driver of a semi-truck blew a stop sign and drove into the path of the junior hockey team’s bus near Tisdale, Sask.
Lawyers for a proposed class action waiting for certification plan to ask a judge Friday to delay another lawsuit filed by five of the victims’ families until that’s done.
The possible delay has some of the families frustrated.
“We want to put certain pieces of this behind us. When they get dragged out longer and longer, it just makes it harder and harder. It causes more pain,” said Chris Joseph, a former NHL player from St. Albert, Alta. His 20-year-old son, Jaxon, died in the crash.
The proposed class action so far includes the families of 24-year-old Dayna Brons, the team’s athletic therapist from Lake Lenore, Sask., who died in hospital after the crash, and injured goalie Jacob Wassermann, 21, from Humboldt, Sask. The suit names the Saskatchewan government, the inexperienced truck driver who caused the crash and the Calgary-based company that employed him.
Vancouver lawyer John Rice said the request for a stay, or delay, is about fairness.
“In situations where numerous claimants are harmed from the same event — and where the legal findings in one proceeding could impact all the others — the court needs to strike a balance between the competing interests of individual litigants to ensure that the most efficient and just process is adopted,” Rice said.
“In these awful circumstances, in this application, the court is being asked to exercise the ‘least-worst’ option, which is to press pause on the progress of one action until the application for certification is heard.”
Kevin Mellor of Regina, lawyer for the other lawsuit, said a delay would put his clients’ claim at risk. He represents the Joseph family as well as the families of Adam Herold, 16, of Monmartre, Sask.; Logan Hunter, 18, of St. Albert, Alta.; Jacob Leicht, 19, of Humboldt, Sask.; and assistant coach Mark Cross, 27, from Strasbourg, Sask. They all died from the crash.
That lawsuit, in addition to naming the Saskatchewan government, the driver and his employer, also lists the bus company as a defendant.
Mellor said Jaskirat Singh Sidhu was sentenced to eight years in prison for causing the crash, but could be deported to India before their lawsuit gets to trial.
“If the class action is going to delay … they’re going to miss out on material evidence because this guy will be deported,” Mellor said.
“We need to giddy-up and go.”
Co-counsel Sharon Fox said their clients shouldn’t be punished because they were first to file a lawsuit.
“We filed our claim in July 2018, three months after the crash happened,” Fox said.
“We have been at this for almost two years … They’re trying to hold us back, put us on the sidelines, so they can catch up. We’re saying that’s not fair and that’s going to impact our client’s ability to prove our case.”
Their clients also don’t want to put their healing on hold any longer, she said.
An affidavit from Herold’s father, Russ Herold, was filed in advance of Friday’s hearing.
“I feel I will suffer psychological harm if my lawsuit is delayed,” he says in the document.
“I want to advance my lawsuit to hold responsible those that should be held responsible for my son’s death.”
Lawyers for the Saskatchewan government recently argued in court that, because of the province’s no-fault insurance, it should be struck as a defendant from the class action. A judge has not yet ruled on that application.
Although difficult months remain ahead — especially for poorer countries lacking the resources to buy vaccines — the end of the coronavirus pandemic in the developed world is now in sight.
Virus variants remain an unpredictable element but trendlines suggest that the great majority of deaths anticipated in developed countries due to the COVID-19 pandemic have occurred already.
The range of impacts on different countries can be seen in the statistics as the first full year of the pandemic draws to a close.
These statistics compare how Canada has fared to the experiences of five other Western countries: the United States, the United Kingdom, Germany, France and Italy.
When historians look back on this pandemic, the first yardstick they’ll apply to measure its severity is, of course, the number of people it killed.
How bad did it get?
The United States is now coming down from its third wave of COVID infections. Canada has only had two so far. The peak came at different times in different places — but each of the six countries in this comparison experienced one week that was worse than any other.
In France and Italy, the pandemic peaked in November 2020, but in North America and the U.K. the first two weeks of 2021 were the worst.
On January 8, Canada reported a single-day record of 9,214 new cases. The following day, the U.S. reported a single-day record of 315,106 new cases.
The peak of intensity is measured here by the highest recorded daily caseload, per capita. At the pandemic’s height in the U.K., U.S. and France, COVID-19 was infecting almost one person in a thousand every day. In Canada, that number never reached one in 4,000.
Canada had the least intense pandemic of the six.
Immunizations vs infections
Vaccinations are the magic bullet that will end this pandemic. Some countries have done far better than others in administering them.
The U.K.’s vaccination effort started strong and stayed that way. Germany and the U.S. showed steady increases week over week. France was slow to start but soon caught up. Italy and Canada faltered and lost ground.
But vaccinations don’t tell the whole story. Vaccines entered the picture as much of the western world was racing to get ahead of a new wave of infections.
Canada placed last among this group of nations in terms of doses per capita. But it also has posted the lowest per capita caseloads through 2021.
The U.K. was the undisputed winner of the vaccine race but posted the worst per capita caseloads and death rates of the six. And the nation with the second-best record on vaccinations — the U.S. — had the second-worst caseloads.
Given this strange inversion, how should we measure each nation’s overall performance?
The next graph attempts to do that by dividing each nation’s total number of vaccines administered, week over week, by the number of new cases it recorded in the same week, to give an overall score — call it the “O Factor” — that may offer a clearer picture of how much progress each country has made so far in 2021.
The O Factor penalizes countries for failing to control infections in the present, but gives credit for the future caseload reductions they can expect to achieve by getting needles in arms now.
The damage to economies
Historians will one day study the pandemic’s social and economic effects. Some of those effects aren’t clear yet.
By killing a vast number of European peasants, the Black Death transformed the labour market, allowing workers to demand more for their work and ultimately helping to free them from feudalism. Perhaps this (far less apocalyptic) pandemic will free workers from the bondage of commuting and cubicles.
Whatever changes it leaves in its wake, it’s clear the economic blow of the pandemic has not fallen evenly on all nations.
The six countries we’re comparing here have taken different approaches to pandemic-related shutdowns and layoffs. Some (such as Canada) went big on public spending, while others held back. And some countries will struggle more than others with the debts they have accumulated.
All six of the nations measured here saw nearly unprecedented spikes in the number of unemployment claims as the pandemic took hold.
But some were hit harder than others and some bounced back faster than others.
The graphs shown here only offer snapshots of a pandemic that isn’t over yet. Although immunization appears to offer a path out of this global disaster, new mutations and new variants have the potential to delay that.
Unless Canada can improve its vaccination performance, other countries probably will be quicker to bend their rates of death and hospitalizations downward, closing a gap that currently favours Canada.
But the numbers suggest that one thing won’t change: when compared with its peers in Europe and North America, Canada’s pandemic experience has been less intense — and less deadly.
Whether you’re a traveller getting a mandated COVID-19 test at the airport, or a worker on a job site like a film set or food processing plant that requires a negative test, odds are it’s being done by a private company.
Businesses offering polymerase chain reaction (PCR) tests are now a crucial part of Canada’s pandemic response, allowing thousands of people to continue to travel, visit loved ones in long-term care, and stay on the job.
But some doctors and health experts are concerned about what they say is a lack of regulation in what has become a rapidly growing part of the health-care industry.
“Who’s doing the tests? What are the standards? How do we know that they’re doing it at the same sensitivity and specificity as those done in provincial labs or hospital labs?” said Dr. AnnaBanerji, a physician and infectious disease specialist at the University of Toronto’s Dalla Lana School of Public Health.
Publicly administered PCR tests are free and are meant for people with symptoms of COVID-19. Private companies generally test people who are asymptomatic, and charge a fee for the service. Demand is soaring as many workplaces require on-site testing in order to stay operational.
The federal government and the Ontario government recently added to that demand when both declared international air travellers must have PCR tests when they arrive in Canada.
A quick and non-exhaustive search by CBC News found 15 companies offering PCR tests for COVID-19 in Canada. Some, such as LifeLabs, which says it has conducted more than one million COVID-19 tests to date, and Dynacare, are well-known names in the specimen collection and diagnostic testing industry.
Blackburn, who declined the CBC’s interview request, told The Pal’s Podcastrecently that he moved into COVID-19 testing because the pandemic had shut down his other enterprises.
“If the beast squashes your business, you might as well try to get into another business and try to fight the beast, right?” he said.
Blackburn’s partners include a registered nurse and a doctor.
HCP’s timing was good. The company incorporated in October, but its website actually went live a month earlier, the same week the Ontario government amended the Laboratory and Specimen Collection Centre Licensing Act in an effort to expand testing capacity.
The change allowed a wider range of people to get into the private testing business.
HCP is now providing on-site testing for film and TV production, construction sites, manufacturing and warehousing, as well as smaller businesses in Toronto’s downtown area.
In fact, HCP said it’s so busy, it had no time to talk with CBC News about its burgeoning business.
“Given the busy nature of our programs, I have been informed that our team will not be available,” HCP’s Emily Coles said in an email.
CBC News compared prices for PCR tests across the country and found they ranged from about $ 160 at Switch Health, which is also the company testing travellers at Pearson airport near Toronto, to as much as $ 400, the top price charged by GMF Sante Med Clinic in Toronto.
Lack of oversight, experts say
But as private testing’s role in the pandemic grows, so is concern among some that it’s largely unregulated.
“When you have people working privately in no man’s land, then you really don’t know, are the tests accurate? Are they doing the right infection control?” said Banerji.
“I think there needs to be a body that has some oversight.”
While public tests are generally done in health-care environments such as hospitals and clinics, private tests can be done anywhere from construction sites to homes. Companies must use equipment and tests approved by Health Canada, but there’s no regulatory body governing the cost private companies are charging for tests, and there’s no single external system beyond the companies themselves to deal with complaints.
There are different governing bodies in each province that regulatethe collection and processing of medical samples. In Alberta, for instance, the province does not license or approve companies for private COVID-19 testing.
In fact, no government agency in Canada is tracking how many companies are offering the service or even how many tests they’re doing across the country.
A spokesperson for Health Canada and the Public Health Agency of Canada said because medical tests fall under provincial and territorial jurisdiction, the CBC would have to contact each province and territory individually and compile the numbers ourselves.
So we did, and found the picture is still unclear.
Every province requires companies to report positive test results. But many provinces don’t know how many tests are being done overall.
WATCH | Calls to test truckers for COVID-19:
Commercial truckers who regularly cross the U.S. border as essential workers are increasingly worried about COVID-19 risks. Many are saying they want regular rapid testing and faster access to vaccines. 1:59
Of the nine provinces that responded, only Quebec and Nova Scotia provided a breakdown of the number of private versus public COVID-19 tests administered.
Saskatchewan and British Columbia say private tests are included along with public ones in a single number released to the public daily. But neither province could say what proportion of that daily number is private versus public tests.
Newfoundland, Ontario, Manitoba and Alberta don’t keep track of private testing data at all.
Apart from Quebec and Nova Scotia, none of the provinces that responded was able to provide a test positivity rate for private tests, a percentage that reflects how many of the total number of tests are coming back positive for COVID-19.
Experts say the lack of an accurate count and positivity rate of private tests means we may not have an accurate picture of the overall positivity rate in Canada.
“If the government is testing, say, 50,000 people and that gives us a positivity rate of four per cent, and the private sector is testing an additional 50,000 and they’re finding no cases at all, then in fact our test positivity rate is actually two per cent, not four per cent,” said Raywat Deonandan, an epidemiologist and associate professor at the University of Ottawa’s faculty of health sciences.
“That’s a big difference. The test positivity rate tells us two things: Are we testing enough? And how present the disease is in our population.”
CBC News also reached out to nearly a dozen companies to ask about the number of tests they conduct and the positivity rates they’ve observed.
Among those that responded was Quantum Genetix in Saskatchewan, which had been doing PCR testing on cattle prior to expanding to human COVID-19 testing late last year. Quantum Genetix said it has tested about 1,500 people and had a positivity rate of just under two per cent.
Another company, Dynacare, said it conducts between 5,000 and 10,000 PCR tests per day at its lab in Ontario. It said the positivity rate ebbs and flows, but over the past 30 days it has been near seven per cent.
Problems with private testing
With companies often dealing with customer complaints internally, it’s difficult to know how the quality of private testing compares with that of the public system.
The day before Christmas, Allan Asselin was visiting his 88-year-old mother, Mary, in her east end Toronto seniors’ residence when one of the nurses on staff walked into the room.
“She said, ‘Your mom has COVID. You have to leave,'” Asselin said.
“Needless to say, there were tears. She was shaking. She was just in a horrible state.”
Mary spent Christmas and several days afterward quarantined in her room, alone and scared.
Her COVID-19 test was processed in a private lab.
Three negative tests later, she was cleared. When Allen checked the Ontario government’s COVID-19 test results site, he found two entries for that first test back on Dec. 22, one positive and one negative.
“So did she have it or did she not have it?” he said.
In another case, a 34-year-old Montreal woman who pays $ 300 every two weeks to get tested to see her elderly father says she got a positive result in the mail with her name on it but the wrong date and location of the test, wrong home address, no health insurance card number, and the notification came a month after her test was performed.
“What good does it me, or the public, to get this information a month later, after walking around and hanging out with my family, [possibly] being unknowingly positive for a month?” said the woman, whom CBC News agreed not to identify for privacy reasons.
Private testing necessary
The fact is, however, the economy would likely not be reopening nearly as quickly as it is without private testing, which epidemiologists say plays a vital role in Canada’s pandemic response.
“I approve of private testing, if done strategically, because it alleviates strain on the public health system that should be used for things like proper surveillance, that should be used for actual symptomatic people arriving at hospitals and things like that,” said Deonandan.
Private companies, he said, should be tasked with what he calls “reassurance testing.”
“That’s when you need a test to go back to work or to keep going to work or maybe to engage in some other activity,” he said.
“But even then, that requires some serious ethical oversight.”
As enthusiastic crowds of tens of thousands marched through the streets of Myanmar’s biggest city on Sunday to protest last week’s coup ousting Aung San Suu Kyi’s elected government, their spirits were lifted by the return of internet service that had been blocked a day earlier.
Separate protests that began in various parts of Yangon converged at Sule Pagoda, situated in the centre of a roundabout in the city’s downtown area. Protesters chanted “Long live Mother Suu” and “Down with military dictatorship.” Protesters in other parts of the country echoed their calls.
Authorities had cut access to the internet as the protests grew Saturday, fanning fears of a complete information blackout. On Sunday afternoon, however, internet users in Yangon reported that data access on their mobile phones had suddenly been restored.
The demonstrators are seeking to roll back last Monday’s seizure of power by the military and demanding the release from detention of Suu Kyi, the country’s ousted leader, and other top figures from her National League for Democracy party.
The military has accused Suu Kyi’s government of failing to act on its complaints that last November’s election was marred by fraud, although the election commission said it had found no evidence to support the claims.
The growing protests are a sharp reminder of the long and bloody struggle for democracy in a country that the military ruled directly for more than five decades before loosening its grip in 2012. Suu Kyi’s government, which won a landslide election in 2015, was the first led by civilians in decades, but it faced a number of curbs to its power under a military-drafted constitution.
During Myanmar’s years of isolation under military rule, the golden-domed Sule Pagoda served as a rallying point for political protests calling for democracy, most notably during a massive 1988 uprising and again during a 2007 revolt led by Buddhist monks.
The military used deadly force to end both of those uprisings, with estimates of hundreds if not thousands killed in 1988. While riot police have been sent to watch the protests this past week, soldiers have been absent and there have been no reports of clashes.
Several videos posted online Sunday that were said to be from the town of Myawaddy, on Myanmar’s eastern border with Thailand, showed police shooting into the air in an evident effort to disperse a crowd. There were no signs of panic and no reports of injuries.
Showing little fear, protest crowds have grown bigger and bolder in recent days, while remaining non-violent in support of a call by Suu Kyi’s party and its allies for civil disobedience.
In one of Sunday’s gatherings, at least 2,000 labour union and student activists and members of the public gathered at a major intersection near Yangon University. They marched along a main road, snarling traffic. Drivers honked their horns in support.
Police in riot gear blocked the main entrance to the university. Two water cannon trucks were parked nearby.
The mostly young protesters held placards calling for freedom for Suu Kyi and President Win Myint, who were put under house arrest and charged with minor offences, seen by many as providing a legal veneer for their detention.
“We just want to show this current generation how the older generation fights this crisis, by heeding the guideline of Mother Suu, which is to be honest, transparent and peaceful,” said 46-year-old protester Htain Linn Aung. “We don’t want a military dictator. Let the dictator fail.”
Reports on social media and by some Myanmar news services said demonstrations were taking place in other parts of the country as well, with a particularly large crowd in the central city of Mandalay, where there was also a motorbike procession in which hundreds took part, constantly beeping their horns.
Saturday had seen the size of street protests grow from the hundreds to the thousands, but it also saw the authorities cut most access to the internet. Holes in the military’s firewall allowed some news to trickle out, but it also fanned fears of a complete information blackout.
WATCH | Myanmar coup sparks international condemnation, concern for Rohingya:
The military has seized power in Myanmar and detained Aung San Suu Kyi as well as other elected officials, sparking international concern for the Rohingya minority, many of whom fled past military crackdowns. 1:58
Social media platforms such as Facebook and Twitter were earlier ordered blocked but had remained partially accessible. Social media platforms have been major sources of independent news as well as organizing tools for protests.
Social media still affected, monitoring service says
NetBlocks, a London-based service that tracks internet disruptions and shutdowns, confirmed that there had been a partial restoration of internet connectivity on Sunday, but it noted that it might be temporary and social media remained blocked.
The communication blockade was a stark reminder of the progress Myanmar is in danger of losing. During Myanmar’s decades of military rule, the country was internationally isolated and communication with the outside world strictly controlled.
The elected legislators of Suu Kyi’s party met in an online meeting on Friday to declare themselves as the sole legitimate representatives of the people and asked for international recognition as the country’s government.
Pope Francis joined the international chorus of concern over the situation.
In remarks to the public in St. Peter’s Square on Sunday, the Pope said he has been following “with strong worry the situation that has developed in Myanmar,” noting his affection for the country since his visit there in 2017.
He said he hoped that Myanmar’s leaders worked sincerely “to promote social justice and national stability for a harmonious democratic co-existence.”
As countries such as Canada and the United States continue vaccinating millions of citizens, global health experts warn the pandemic could keep raging if lower-income nations don’t get their share of much-needed doses.
It’s a concern that’s growing even as Dr. Anthony Fauci, chief medical advisor to newly inaugurated U.S. President Joe Biden, announced on Thursday the country will rejoin the World Health Organization (WHO) — and with it, the COVAX Facility, a global initiative to ensure COVID-19 vaccines reach those in greatest need.
It’s long overdue, some say. Others worry it’s just the latest example of lip service after what’s so far been a deeply inequitable vaccine roll-out around the world.
“I would characterize the approach to global vaccine distribution as a massive failure,” said Jenna Patterson, the South Africa-based director of health economics at the Health Finance Institute, a U.S. non-governmental organization.
‘No doses in the pipeline’ for some countries
While Canada is among the nations signed on with COVAX, it’s also one of the wealthy countries buying up massive shipments from a slate of vaccine producers — with millions of doses already administered between them.
Meanwhile, other countries have no doses in the pipeline, with some lower-income nations waiting for international aid that could take months.
That could amount to “catastrophic moral failure” on a global scale, WHO director general Tedros Adhanom Ghebreyesus warned on Monday.
And from both an ethical and economic standpoint, the disparities could prove a lose-lose.
“Everyone wants to go back to some sense of normal,” said Dr. Ranu Dhillon, a global health physician who teaches at Harvard Medical School.
“But that won’t be possible unless we solve this globally.”
WATCH | WHO chief describes vaccine inequity between countries:
The wealthier countries of the world are buying up too much of the COVID-19 vaccine supply and leaving too little for poorer countries, says WHO Director-General Tedros Adhanom Ghebreyesus. 0:57
Ignoring vaccine equity could ‘prolong’ pandemic
On one hand, countries without COVID-19 vaccination programs could experience more infections and deaths for far longer; on the other, the possibility of vaccine-resistant variants emerging from ongoing hot zones could backfire on already-vaccinated countries as well.
“Not only does this me-first approach leave the world’s poorest and most vulnerable at risk; it is also self-defeating,” Tedros said at the opening of the annual meeting of the WHO’s executive board.
“Ultimately, these actions will only prolong the pandemic.”
Allowing the virus to continue its spread in certain regions could impact travel and tourism, supply chains and the world economy, warned several experts who spoke to CBC News.
The coronavirus doesn’t respect international borders, said Dhillon, evidenced by the ongoing global spread of variants first found in countries such as Brazil and the U.K., meaning there’s no way to end the pandemic by focusing solely on national response.
If transmission continues largely unchecked in lower-income countries, there’s a possibility that variants emerge that don’t respond to current vaccines being rolled out in wealthy nations, he said.
A situation like that could derail widespread vaccination efforts, travel routes and economic recoveries.
“We can’t control COVID unless we control it in the rest of the world,” echoed Dr. Anna Banerji, an associate professor at the University of Toronto’s faculty of medicine and the Dalla Lana School of Public Health.
“And so that’s an additional incentive to get the whole world working together to try to get all places, rich and poor, vaccinated as soon as possible.”
WATCH | U.S. health economics expert: one nation’s health affects another
Jenna Patterson, the South Africa-based director of health economics at U.S. non-governmental organization the Health Finance Institute, says an equitable global vaccination effort is crucial to fighting COVID-19 for both public health and economic reasons. 0:44
Canada has administered 700,000 shots
While Canada’s vaccination program got off to a slow start, including an imminent pause on shipments from Pfizer-BioNTech, it remains among the countries poised to vaccinate tens of millions in the months ahead.
Canada has administered close to 700,000 shots so far, providing at least one dose to roughly 1.7 per cent of the population.
Israel, the world leader in doses per capita, has vaccinated more than three million people; the United Kingdom more than five million; and the U.S. and China have both inoculated more than 15 million and counting.
That’s a stark contrast to some of the world’s poorest nations.
Many African countries, in particular, are in danger of being left behind as countries in other regions strike bilateral deals, driving up prices, according to the WHO.
The delay is, in part, because of the stringent cold-storage requirements for certain vaccines, which can be challenging to accommodate in remote areas. But WHO officials said they’re working to ensure countries’ readiness to receive shipments, and suggested clear inequities are also at play.
“It is deeply unjust that the most vulnerable Africans are forced to wait for vaccines while lower-risk groups in rich countries are made safe,” said Dr. Matshidiso Moeti, the WHO’s regional director for Africa, in a statement the organization released on Thursday.
Guinea is currently the only low-income country in Africa to provide its residents with COVID-19 vaccines, and to date, according to the WHO, those have only been administered to 25 people.
No doses yet in many countries
Patterson, who’s based in South Africa and was speaking for the Health Finance Institute, said it’s in the world’s best interest to ensure all countries are vaccinated against this virus, on both economic and moral fronts — since the death toll in unvaccinated regions could continue skyrocketing while infection rates drop elsewhere.
“And COVID has displayed this better than any other disease, how the health of one nation affects another,” she said.
South Africa is the hardest-hit country in Africa with more than 1.3 million cases to date. It’s also now known for first discovering one of several concerning new variants of the SARS-CoV-2 virus — one which appears to be more transmissible, and potentially capable of evading some level of immune response.
Yet the country hasn’t vaccinated any of its residents and is set to pay more than twice as much per dose for its batch of the AstraZeneca coronavirus vaccine from the Serum Institute of India compared to purchases made by countries in the European Union, according to a Reuters report.
Malawi, a low-income country in southeastern Africa, also has no vaccination campaign underway, even though the situation on the ground is a “disaster” according to Dr. Titus Divala, a physician and lecturer with the University of Malawi College of Medicine.
“I think we’re going to be in a situation where we do need the vaccine, but we don’t have access to it for some time,” Divala said.
COVAX aims to bring 600 million doses to Africa
Through the COVAX initiative — organized by the WHO, the Coalition for Epidemic Preparedness Innovations and Gavi, the Vaccine Alliance — international aid is meant to arrive, albeit slowly, in the shadow of vaccination programs elsewhere that are months ahead.
The coalition has secured at least two billion doses of vaccines from multiple companies, with sources telling Reuters on Thursday that Pfizer-BioNTech, one of two companies with vaccines currently approved for use in Canada, will be signing on as well.
COVAX has committed to vaccinating at least 20 per cent of the population in Africa by the end of 2021 by providing a maximum of 600 million doses, with a first round of 30 million doses expected to start arriving in countries by March.
The WHO, however, warned shipments and timelines could change if vaccine candidates fail to meet regulatory approval — or if production or funding challenges arise.
Alison Thompson, an associate professor at the University of Toronto and researcher on ethics and public health, said countries like Canada and the U.S. who participate in COVAX need to either support other countries’ vaccination efforts financially or, at some point, take a backseat so other nations can enter the crowded queue.
“That’s a hard sell politically,” she added, “but it really does raise the question about, what are Canada’s global obligations to public health?”
Need to ‘mass-manufacture’ globally
Dhillon, the physician from Havard, said this pandemic has shown the level of innovation and technology available, and now it’s just a matter of scaling up to meet international need.
“How do we mass-manufacture these vaccines in the quantities needed globally?” he questioned. “There is manufacturing capacity in other areas of the world. We need to remove issues with patents, we need to remove issues with intellectual property.”
It’s all easier said than done in a charged climate where citizens are clamouring to access shots in short supply within their own borders, and Canada is no exception.
But Dhillon compared the current vaccine landscape to the therapies that emerged to prevent AIDS, the often-devastating illness caused by HIV, or human immunodeficiency virus.
Wealthier nations accessed those first, he explained, while poorer countries were left waiting, with many of those infected in the developing world still starting therapy late.
“Instead of waiting to look back in retrospect and question why we didn’t do more — I think we’re in that moment now,” Dhillon said.
As Quebec becomes the first province to implement a curfew to help curb the spread of COVID-19, there isn’t clear consensus whether similar efforts around the world have had much of an effect.
Quebec’s 8 p.m. to 5 a.m. curfew went into effect this weekend and is scheduled to last until Feb. 8, meaning many of the province’s residents will be prohibited from going outside at night. Those caught outside without a valid reason could face a fine of between $ 1,000 and $ 6,000.
The province is following in the footsteps of other jurisdictions that have implemented similar curfews. Spain, Italy, Switzerland and France have all put in nation-wide curfews, and this weekend, 15 zones of France will have even earlier restrictions, beginning at 6 p.m. and lasting until 6 a.m.
Despite the widespread use of curfews, some health experts have challenged what they actually do to fight COVID-19
“I don’t think there is any strong evidence that that kind of approach works,” said Amesh Adalja, an infectious disease physician and a senior scholar at the Johns Hopkins Center for Health Security.
However, researchers in France have found data suggesting it has worked to slow spread there — at least for some age groups.
Curfews associated with slowing spread
A team of French researchers looked into three waves of the French government’s health policy measures to combat COVID-19.
Starting Oct. 17, 16 of France’s zones known as départements were put under curfew from 9 p.m. to 6 a.m. The following week, 38 were added, so more than half the country was under mandatory curfew from October 23 onwards.
Finally, starting on October 30, a nation-wide lockdown was implemented.
The researchers found that the curfew was able to reduce the acceleration of the pandemic, but the strongest effect was only for people who were 60 and older.
For people younger than 60, it was the subsequent lockdown that did more to curb the spread.
“This suggests that if health policies aim at protecting the elderly population generally more at risk to suffer severe consequences from COVID-19, curfew measures may be most effective,” according to the study, which was released in November on SSRN, a pre-print server.
Patrick Pintus, an economics professor at Aix-Marseille University inMarseille, France, who was one of the researchers, acknowledged this was not a controlled experiment, that the results can only show correllation, not cause-and-effect.
“But what we found was that, especially the first week of the curfew, did seem to have an effect in terms of curbing the pandemic in the sense [of] reducing the acceleration,” he said.
“Our interpretation is that it’s probably due to the fact that because of the curfew, there were much less interactions between that age group in bars, in the restaurants.”
Pintus said they couldn’t say why the curfew didn’t have the same impact on virus spread among the younger age groups.
However, the older demographic is key — not just because they are more vulnerable but because, pre-curfew, the virus was circulating at twice the rate in those over 60 as under, said Pintus.
He did say that from his own experience, he believes people are following the curfew.
“And I think the reason is that our own people prefer the curfew to the lockdown. Of course, they complain about it. And so it’s a huge constraint. But, you know, compared to lockdown, it’s much better.”
Meanwhile, in other jurisdictions, including U.S. states with curfews, there have been mixed results from the public health measure — and the specifics of timing may be key.
On Nov. 19, Ohio implemented a curfew from 10 p.m to 5 a.m., requiring people to stay inside a place of residence between those hours. That order has since been extended three times, with the most recent curfew set to last until at least Jan. 23.
In announcing the extension, Ohio Governor Mike DeWine said they had seen a “somewhat flattening of cases” and that the rate of increase was slowing down.
He attributed the change to both mandatory mask-wearing in retail locations and the curfew — but not everyone is convinced.
“I have not seen any data suggesting they [curfews] have been effective in curbing viral spread in Ohio,” Tara Smith, a professor of epidemiology at Kent State University said in an email.
In California, some areas are under a “limited stay-home order” which includes a restriction of some activities after 10 p.m.
“I can tell you just looking at what’s going on in California, that this particular curfew hasn’t made much of an impact,” said Dr. Lee Riley, professor and chair of the division of infectious disease and vaccinology at the School of Public Health, University of California, Berkeley.
“I’m not really sure curfews do much.”
Karin Michels, professor and chair of the UCLA department of epidemiology, said she believes the 10 p.m. starting time still invites too much social contact, and that an 8 p.m. curfew, like in Quebec, could make a difference.
“If I have to be home at 8:00 I have to start early. If I want to go to somebody else’s house, and maybe I don’t have much time because I work until 5:00 or 6:00 or something.
“I think [8 p.m.] is more effective. And really, I think given the situation of the pandemic right now, I think we just have to bite the bullet and be more more restrictive.“
WATCH | Why Quebec has decided to implement a curfew:
Quebec has imposed a nightly curfew from 8 p.m. to 5 a.m. as part of a four-week provincial lockdown aimed at reducing the spread of COVID-19 after record cases have put a strain on the health-care system. 2:00