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Coronavirus variants are testing the limits of what we once thought was safe in Canada

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.

The rapid spread of more contagious coronavirus variants across Canada is driving a devastating third wave in much of the country and increasing the level of risk in situations previously thought to be relatively safe from COVID-19.

Experts say the risk of exposure is higher in everyday situations and the margin of error is lower for what we can and can’t do safely until more Canadians are vaccinated. 

“The things that you’ve gotten away with previously, and that you’ve put into your mindset that were safe … it wasn’t that they were safe, it’s that you got lucky,” said Erin Bromage, a biology professor and immunologist at the University of Massachusetts Dartmouth who studies infectious diseases. 

“That luck — it’s like rolling dice.” 

Bromage said activities such as visiting a loved one, sharing a meal or working out in a gym might seem safe because public health restrictions may allow them, but are even riskier now than they were before. 

The variants of concern not only appear to be more transmissible and potentially more deadly, but Bromage says they may also transmit for longer periods of time in infected individuals and bind to our cells more easily — providing more opportunities for infected people to spread the virus. 

WATCH | Canada facing perilous mix of coronavirus variants:

The mix of COVID-19 variants circulating in Canada has turned the country into a dangerous petri dish unlike anywhere else. 2:07

“If you’re only transmitting for a few days out of an infection cycle, you can only have so many contacts during those days,” he said. “But if that duration of shedding is now twice as long, you can have double the contacts and so therefore it moves more easily between people.”  

Linsey Marr, one of the top aerosol scientists in the world and an expert on the airborne transmission of viruses at Virginia Tech, says it’s possible variants may also be causing more virus particles in the exhaled air of infected individuals for longer.

“The virus is still transmitting the same way,” she said. “What’s different is likely that either the people who are infected are releasing more virus over a longer period of time or it’s possible that it takes fewer of those viruses to make you sick.” 

The number of confirmed variant cases in Canada has skyrocketed in recent weeks, rising from about 2,000 a month ago to close to 17,000 this week and counting, with more than 90 per cent of those being the B117 variant first identified in the United Kingdom.

The P1 variant first discovered in Brazil is also on the rise in Canada, with cases doubling in the past week to more than 1,000 — mostly in British Columbia, Ontario and Alberta. 

And the B1351 variant first found in South Africa is also picking up steam, with more than 150 cases identified in Quebec, more than 70 in Ontario and more than 50 in B.C. as of Thursday. 

“The race between the vaccine and the variants is at a critical point,” Dr. Theresa Tam, Canada’s chief public health officer, told reporters Friday. “It is clear that we need stronger control to combat variants of concern that are driving rapid epidemic growth in many areas of the country.”

Tam said in a statement Thursday that serious illness can occur at any age and evidence indicates that variants of concern can be associated with more severe illness and increased risk of death.

Younger Canadians are being impacted harder in the third wave as well, Tam said, with infection rates highest among those aged 20 to 39 and a rise in the number of hospitalizations and ICU admissions in those under 60. 

Experts say Canada’s third wave of COVID-19 is showing no signs of slowing down, meaning Canadians need to buckle down and take precautions until more of us get a dose of vaccine. (Evan Mitsui/CBC News)

Airborne transmission driving spread

New research is shedding light on the way in which infection was occurring around the world even before variants took hold, calling into question whether our previous public health guidelines go far enough. 

A recent study published by the U.S. Centers for Disease Control and Prevention showed that a singer at a church in Australia in July was able to infect several others from a distance of more than 15 metres indoors. 

While a second CDC study found an infection occurred in a New Zealand quarantine hotel in September after an exposure time of less than a minute in an open doorway. 

And a recent outbreak at a gym in Quebec City where physical distancing and mask use were not enforced has been linked to at least 440 cases of COVID-19 and one death in the community.

Quebec health officials say the rise of variants and a more relaxed approach to public health rules by residents have led to the spike in cases in the province, leading them to introduce a mandatory mask mandate for outdoor activities and indoor workplaces.

“The evidence just keeps piling up in favour of the importance of aerosol transmission,” said Marr. “We thought it was important before, I would say it’s probably predominant in terms of how the virus is transmitted.”

WATCH | Quebec City’s COVID-19 surge leads to more restrictions:

Quebec is imposing more COVID-19 restrictions as case numbers swell, especially in Quebec City where variants have gained control. Quebec City, Levis, Gatineau and Beauce are facing tougher controls while Montreal and Laval are returning to an 8 p.m. curfew. 2:02

Bromage says the reluctance of Canadian public health officials to acknowledge aerosol transmission in a meaningful way has been “frustrating” and adds to confusion among Canadians about how infections are occurring.

Aerosol transmission refers to spread via microscopic airborne particles that can remain suspended in the air longer than larger droplets, which tend to fall to the ground within a distance of two metres — a trait that informed the original physical distancing guidelines. 

“There has been a reluctance to accept that both in schools and in hospitals,” he said of aerosol transmission. “That poor messaging has led people indoors and infection starting up that really shouldn’t have.”

Canada revised its guidelines on how COVID-19 spreads to include the risk of aerosol transmission in November, weeks after other countries and international health organizations acknowledged the airborne threat.

“People tend to latch on to the first thing they hear, which was to wipe down your groceries a year ago,” said Marr. “But I think we need really a campaign to just clarify to people kind of how the virus is transmitting and then policies that match that.” 

The CDC also updated its guidelines to say the risk of COVID-19 infection from surfaces is now officially considered low — meaning disinfecting groceries, wiping down packages and cordoning off playgrounds are likely unnecessary.  

Outdoors not without risk 

Experts say now more than ever, Canadians need to mitigate the increased risk of transmission from variants by going above and beyond public health guidelines and moving activities outdoors — though not all outdoor environments are created equal. 

“Imagine, for example, the terrace of a cafe that would be enclosed by plastic sheeting on three of the four walls, in which you have a lot of people close to one another at tables,” said Dr. Raymond Tellier, an infectious diseases specialist and associate medical professor at McGill University. “This is logically outdoor, but physically has all the characteristics of an indoor environment.”

Now more than ever, experts say, Canadians need to mitigate the increased risk of transmission from variants by going above and beyond public health guidelines and moving activities outdoors — though not all outdoor environments have the same risk level.  (Ben Nelms/CBC)

Dr. Amesh Adalja, an infectious disease physician and a senior scholar at the Johns Hopkins Center for Health Security in Baltimore, Md., says it’s important to remember that while transmission can occur outdoors, it’s much less likely. 

“Even with the more contagious variants, the virus is still going to have difficulty transmitting in those settings,” he said. 

“But when you look at some of the issues that we had in the United States, for example the protests after George Floyd’s death, those were all outdoors and we saw very little transmission.” 

Even if you are moving activities outdoors, experts say to wear a mask with a high filtration level and stay as far apart from others as possible. 

The fact is Canada’s third wave of COVID-19 is showing no signs of slowing down as the vaccine rollout gradually ramps up — meaning Canadians need to buckle down until more of us get a shot, experts say.

Bromage says both Canada and the U.S. have a “rough” couple of months ahead, but that Canada’s slower vaccine rollout means our third wave could last into June. 

“The race is really on in the U.S.,” he said. “The variants are winning in Canada right now, whereas I think in the U.S. it’s sort of neck and neck.”

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CBC | Health News

Microsoft Now Testing Dual-Screen Gaming in Xbox Game Pass on Surface Duo

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Microsoft is continuing its quest to make Xbox Game Pass a first-class contender for gaming. The company has now introduced support for dual-screen gaming on devices like the Surface Duo.

Here’s how the feature works: Fire up Game Pass on a device such as the dual-screened Surface Duo, and your game controls will be mapped to the bottom screen, with the top reserved for displaying your actual game. Developers can tailor the way controls are displayed on the lower panel, allowing different games to offer different buttons or control layouts.

Games can also support the Surface Duo’s built-in gyro, Windows Central reports, allowing your view in-game to rotate when you move the device. For now, this feature is only available in beta, but it’ll hopefully roll out across the main service soon.

The Surface Duo hasn’t reviewed particularly well and likely hasn’t sold all that well, either. I doubt Microsoft’s goal is to specifically appeal to the dozens of potential customers who both own a Surface Duo and want to subscribe to a streaming service.

What Microsoft wants to do is make Xbox Game Pass the accessible way to turn any mobile device into a gaming platform, even niche products. With Xbox Game Pass, the Surface Duo becomes a portable Xbox. Moving controls to the second display doesn’t fix all of the problems with touchscreen gaming and the lack of feedback is still a likely deal-breaker for some, but a second-screen device is easier to imagine using for Xbox Game Pass than a conventional smartphone.

Offering this feature on a Surface device is also an example of hardware/software synergy that companies like Apple often lean on in their marketing. I don’t think Microsoft is going to try and position Surface as a gaming brand, but if this capability works as advertised, the Surface Duo just picked up a neat feature. Future devices from other manufacturers should also be able to take advantage of this capability, which gives Microsoft a certain claim to ubiquity and flexibility that other services don’t offer yet.

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ExtremeTechGaming – ExtremeTech

Moderna begins testing on its new COVID-19 vaccine candidate

Moderna Inc. said on Monday it had dosed the first participant in an early-stage study of a new COVID-19 vaccine candidate that could potentially be stored and shipped in refrigerators instead of freezers.

The company said its new candidate could make it easier for distribution, especially in developing countries where supply chain issues could hamper vaccination drives.

The early-stage study will assess the safety and immunogenicity of the next-generation vaccine, designated as mRNA-1283, at three dose levels, and will be given to healthy adults either as a single dose, or in two doses 28 days apart, the company said.

Moderna also plans to evaluate the new vaccine, mRNA-1283, as a potential booster shot in future studies.

Last week, Moderna began dosing the first participants in a study testing COVID-19 booster vaccine candidates targeting the variant, known as B.1.351, that was first detected in South Africa.

The booster vaccine candidates, designated mRNA-1273.351, will be tested in a trial of both a variant-specific shot and a multivalent shot, according to the company’s announcement.

Moderna’s first vaccine (mRNA-1273) was approved for use by Health Canada on Dec. 23.

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Pilot programs reveal benefits and limitations of COVID-19 rapid testing

On a recent weekday afternoon, a fishing vessel called the Arctic Endurance prepared to depart from Mulgrave, N.S., for a month-long clam harvesting trip. Blustery winds blew snow across the ship as it left the dock, but at least on the pandemic front, the coast was clear.

All 35 crew members had undergone testing for COVID-19 within the previous 24 hours, and all their results were negative.

Their employer, Clearwater Seafoods, organized the tests. The company bought its highly accurate polymerase chain reaction (PCR) testing kits from Precision Biomonitoring last fall, putting it among the early corporate adopters of mobile COVID-19 testing technology in Canada. The tests are like those used in health care settings, but results come back in just a couple of hours.

Tony Jabbour, vice-president of Fleet Operations, admits it was a gamble.

“We’re harvesters, we’re not lab technicians or medical professionals. And so getting a fairly complicated system purchase set up was a fairly big undertaking for us,” he said.

Onboard challenges related to physical distancing had compelled the company to put in place added COVID-19 precautions for its crews. Clearwater hasn’t seen any outbreaks to date, but Jabbour said asymptomatic transmission onboard a vessel would be “catastrophic,” both on the business side and for employees.

“Throughout this, I think we’ve been really cognizant of the fact that people are leaving home to go to sea,” he said. “And making sure we take that extra level of precaution was certainly comforting.”

All the crew members aboard Clearwater Seafoods’ fishing vessel Arctic Endurance were screened for COVID-19 using PCR testing before the ship recently put out to sea for a month-long voyage. (Steve Lawrence/CBC)

It’s a notion that has enticed numerous Canadian businesses and institutions to begin pilot programs of their own for onsite COVID-19 testing. As Canadians await full access to vaccines and essential workplaces continue to guard against outbreaks, the appeal of screening asymptomatic front-line staff is growing, driven partly by wider availability of the technology in Canada.

At a busy Shoppers Drug Mart pharmacy in Mississauga, employees without COVID-19 symptoms can get tested twice a week for the virus. Though many pharmacies are already equipped to offer PCR testing to members of the public who meet certain criteria, this new employee-focused pilot uses rapid antigen tests. These are not currently as accurate as PCR, but require a less invasive nasal swab and deliver results much faster.

“Results are being given to me within 15 minutes, so you can’t really beat that,” said Sabina Kapoor, a pharmacist at the store who is participating in the trial program.

With a front-line job and two children at home, Kapoor said she didn’t hesitate when the store offered her regular screening for COVID-19 using rapid tests.

“It brings some sort of security and comfort, I think, when we go home to our families after a shift or working the full week. So, I think everyone was pretty much on board for it,” she said.

Pharmacist Sabina Kapoor is participating in a COVID-19 rapid-testing pilot program at her Shopper’s Drug Mart store in Mississauga. (Jared Thomas/CBC)

Parent company Loblaw is currently offering rapid tests to employees at 20 of its pharmacy and retail locations in Ontario and Alberta. As part of the pilot, staff at the company’s Medisystem service, which provides pharmaceutical services to seniors residences and care homes, can also stop by participating stores to get tested.

If the program is deemed successful, Loblaw said it plans to offer the rapid-testing service to other small and medium-sized businesses and their employees — in a sense, outsourcing workplace COVID-19 testing.

According to Ashesh Desai, the executive vice-president of Pharmacy and Healthcare at Shoppers Drug Mart, employees of participating workplaces could get tested at their local Loblaw pharmacy in the near future.

“So, if I’m grocery shopping [on] Sunday afternoon, maybe there’s an opportunity for me to book a screen at that time,” he said.

Desai added that the test results would go to the employer, and as is currently done for those participating in the pilot, anyone with a positive antigen test result would have to seek out a regular PCR test at a hospital or test centre for confirmation.

Rapid antigen testing cannot be used ‘to rule out infection’

A negative test “does not mean you can let down your guard,” said Desai. He added that Loblaw is working on messaging to convey that masks and social distancing are still “extremely important,” even when a workplace is regularly using rapid tests.

University of Alberta infectious disease specialist Dr. Lynora Saxinger cautions that rapid antigen testing cannot be used “to rule out infection.”

While research on the reliability of rapid tests is growing, the current understanding is that people can rely on a positive test result, but not on a negative one, she added, “which kind of goes against human nature a little bit.”

“It’s just an extra step,” said Antonella Picillo, director of student services at Le Pensionnat du Saint-Nom-de-Marie in Montreal, which is trying out the use of daily rapid testing on the school’s asymptomatic students and teachers.

The private school has a now-familiar myriad of COVID-19 precautions in place, from mandatory masks, to class bubbles, to ventilation upgrades. Rapid test screening is, “just one more way to make sure we have a handle on the situation,” Picillo said.

Le Pensionnat du Saint-Nom-de-Marie in Montreal is pilot-testing daily rapid tests for the school’s students and teachers. (CBC)

The idea was proposed by Dr. Caroline Quach, a pediatric infectious diseases consultant at Montreal’s Sainte-Justine Hospital, as well as a parent at the school.

“I think that in a classroom, when you have a [coronavirus] case and you screen the students around them, you might be able to find secondary transmission right away,” Dr. Quach said.

The goal of the pilot program is to research how well random, daily rapid testing can do that in a school setting. But the limitations of widespread rapid testing are also becoming clearer.

“I’m not convinced that using these rapid tests on a larger scale to screen everybody walking into the school without symptoms is actually a good use of resources,” Dr. Quach said.

One of the main reasons, she explains, is that administering and processing those tests is labour intensive.

It’s one of the reasons there has been less widespread adoption of testing so far across the country. According to the Public Health Agency of Canada, the federal government has delivered nearly 17 million rapid tests to the provinces, but only a fraction of them are in use.

With resources across public health systems already strained, Dr. Saxinger said, “there’s limited bandwidth to expand things” when it comes to rapid testing.

“A lot of places have been doing relatively limited pilot testing of these, but haven’t yet had the capacity to roll them out more broadly,” she said.

It’s an issue the Province of Manitoba has been trying to tackle as it offers rapid testing for educators in the province. Teachers are getting access to rapid testing if they display COVID-19 symptoms, with the idea being they’ll get a potential positive result back faster.

Curtis Aab, acting chair of the life sciences department at Red River College, said proper handling and processing of testing samples is crucial. (Jaison Empson/CBC)

The province has partnered with Red River College to design a micro-credential program to train more people in the skills required to properly process rapid tests, such as transferring liquids using a pipet tube.

“When you’re doing the COVID-19 testing, it’s really important that that pipetting is done accurately and precisely to produce reliable, trusted results,” said Curtis Aab, acting chair of the life sciences department at Red River College.

However, despite the issues around accuracy and administering rapid tests, Dr. Saxinger said targeted use in controlled settings, such as schools and places where people work face-to-face, makes sense.

“I think there’s a possibility that these can add a layer of safety when they’re applied in a structured way to the right places,” she said.

Watch full episodes of The National on CBC Gem, the CBC’s streaming service.

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Canada’s private COVID-19 testing industry is booming, but some experts say oversight is lacking

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. Anna Banerji, 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.

New entrants

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.

Others, such as Calgary’s Ichor Blood Services, pivoted to COVID-19 testing mid-pandemic.

Pure Lifestyle in Winnipeg offered fitness and medical services prior to launching its COVID-19 testing business just after Christmas.

Private companies across Canada are jumping in to meet the growing demand for COVID-19 testing. (Evan Mitsui/CBC)

In Toronto, HCP Diagnostics garnered attention last fall when it started offering in-home COVID-19 testing for $ 400 per test. One of the directors of HCP is James Blackburn, who also co-owns an event company that organizes large parties, and a nightclub in Toronto’s Entertainment District.

Blackburn, who declined the CBC’s interview request, told The Pal’s Podcast recently 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.

Dr. Anna Banerji is a pediatric infectious disease specialist and associate professor of pediatrics at the University of Toronto’s Dalla Lana School of Public Health. She says she has concerns about the lack of oversight of the private testing industry. (Submitted by Mike Cooper)

There are different governing bodies in each province that regulate the 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. 

Possible ramifications

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.”

University of Ottawa epidemiologist Dr. Raywat Deonandan, pictured here in Toronto, says reporting complete private testing data could have an impact on COVID-19 positivity rates. (Evan Mitsui/CBC)

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 Asselin, 88, had two entries for results for a single COVID test from December, one positive and one negative. (Submitted by Allan Asselin)

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.”

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Patients receiving treatment abroad exempt from testing, quarantine rules

Patients who need medical treatment in another country will not have to follow new COVID-19 testing and quarantine rules required for those entering Canada.

Official regulations posted on the federal government website confirm that people receiving “essential medical services” in a foreign country will not have to undergo tests and mandatory quarantines if they have a written statement from a licensed health care practitioner in Canada — and from a practitioner in the country where they are receiving the treatment — affirming that the treatment is essential.

Proof of a negative polymerase chain reaction test — also known as a PCR test — is now required for non-essential travellers crossing into Canada via the land border. 

The test result must be obtained within 72 hours of arriving at the border but essential workers — such as truckers, emergency service providers and those in cross-border communities — are exempt.

After passing through the land border, travellers have to take another test upon arrival and a third test near the end of their 14-day quarantine periods.

That additional layer of testing comes into effect on Feb. 22 — the same day air passengers landing in Canada will be subjected to a new rule requiring them to quarantine in a hotel at their own expense for up to 72 hours while they wait for PCR test results.

The cost of those hotel stays is estimated at about $ 2,000, but it depends on where the traveller is isolating. Passengers will need to book a hotel in the city in which they first arrive: Vancouver, Calgary, Toronto or Montreal. 

Quarantine presents financial burden

Vancouver resident Kimberly Muise, who travels to Los Angeles every month to take part in an immunotherapy clinical trial to treat Stage 4 cervical cancer, told CBC Chief Political Correspondent Rosemary Barton on Sunday that a mandatory quarantine at the traveller’s expense would be a financial burden.

Reacting to confirmation of the exemptions in a government order-in-council (OIC), Muise said Tuesday she’s glad the government listened to Canadians’ concerns.

“This will make a huge difference in my life and the life of my family as I continue my battle with cancer,” she said in an email to CBC.

“I know that the inclusion of essential medical services and treatment in this OIC will also improve the lives of so many Canadians who require medical treatment outside of Canada and were similarly facing almost unbearable stress in dealing with their essential travel during the pandemic.” 

In an interview Sunday, Public Safety Minister Bill Blair had told Barton that there will be some leeway in determining what constitutes essential travel and that the government will deal appropriately with “compelling and compassionate cases,” such as people receiving medical treatment abroad.

Blair said Muise’s case had been brought to his attention already by her local member of Parliament and he was talking to the Public Health Agency of Canada and British Columbia’s health authority about her situation.

“We want to make sure that that woman can receive her treatment and put in measures that can protect her, protect her family and protect her community, but also deal with the exceptional circumstances that that woman is experiencing in an appropriate way,” he said.

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Rioting youths in Dutch village torch COVID-19 testing centre

Rioting youths protesting on the first night of a Dutch curfew torched a coronavirus testing facility and threw fireworks at police in a Dutch fishing village.

Police said Sunday they fined more than 3,600 people nationwide for breaching the curfew that ran from 9 p.m. Saturday until 4:30 a.m. Sunday and arrested 25 people for breaching the curfew or for violence.

Video from the village of Urk, 80 kilometres northeast of Amsterdam, showed youths breaking into the coronavirus testing facility near the village’s harbour before it was set ablaze.

The police and municipality issued a statement Sunday expressing their anger at rioting, “from throwing fireworks and stones to destroying police cars and with the torching of the test location as a deep point.”

“This is not only unacceptable, but also a slap in the face, especially for the local health authority staff who do all they can at the test centre to help people from Urk,” the local authorities said.

Police in Amsterdam also were bracing for another protest Sunday, sending officers to a square where demonstrators clashed with police a week ago.

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New COVID-19 testing rules for air travellers will start Jan. 7

New rules requiring air travellers to test negative for COVID-19 before entering Canada will kick in on Jan. 7, Transport Minister Marc Garneau said today.

The new requirement, announced Wednesday, covers all air passengers five years of age or older.

Under the new rule, travellers must receive a negative result on a polymerase chain reaction (PCR) test — the standard nose swab test for detecting active COVID-19 infections — within 72 hours of boarding a flight to Canada.

There are two possible outcomes for passengers who fail to obtain PCR tests prior to departure, Garneau said.

“One is, if they haven’t got the test result and there are clinics available, they will have to reschedule their departure because they won’t be allowed on board,” he said. “If, on the other hand, they can demonstrate … that there was no facility, then they can be admitted onboard.”

Travellers who can prove that they were unable to get a test abroad will have to quarantine at a federally-approved facility upon their return for 14 days.

Documentation of a negative test result must be presented to the airline prior to boarding a flight to Canada, Garneau said in a media statement.

The minister said the timing of the new policy will give foreign and domestic airlines “adequate” time to comply with the new requirements.

Mike McNaney is president and CEO of the National Airlines Council of Canada, which represents the country’s largest carriers. He said a week isn’t enough time.

“Our primary concerns are the timeframe, the extremely tight timeframe, and the lack of information and guidance as to what we are going to be obligated to do,” he told CBC News.

“Implementation of a broad policy like this is a very complex activity. You obviously have to have communication to your own front line employees around the world. You have to work with regulators and other jurisdictions.

“We do not know what will be deemed to be properly certified testing labs to provide results. We do not know the acceptable format for passengers to provide the information and be in compliance with the government policy. We do not have regulation and we do not have guidance material at all.”

It’s frustrating, said McNaney, because the airline industry has been pushing for more testing. 

“There’s a great level of frustration within the industry in terms of how we are now proceeding in this very rushed fashion,” he said. 

John Gradek, a former Air Canada executive and lecturer at McGill University’s global aviation leadership program, said the swift introduction of a new testing policy is likely adding pressure to an already strained relationship between the federal government and the airline industry — which has been pleading for a pandemic bailout.

“While [the government hasn’t] said it’s forbidden by law, they strongly recommend people not travel. And industry is basically saying, come on down, the flights are open, weather’s nice, it’s nice and warm in the sunny Caribbean,” he said.

“Christmas is a very, very important time of year for carriers to be able to fill their airplanes and make some money and that’s what they’re doing.”

Minister of Transport Marc Garneau is expected to reveal more details about the testing changes today. (Sean Kilpatrick/Canadian Press)

Gradek said more communication with the airlines could have helped to smooth things over.

“You’re seeing a lot of angst and … a lot of potential distrust between the carriers and Transport Canada and that’s got to stop,” he said.

“We’ve got to really make sure that we’re looking at doing this thing as an industry, as a regulator, and making sure we’re both looking at the same issue and talking on the same sides of our mouth when we talk about policy. We can’t keep going with this … tussle going on between Transport Canada and the aviation industry.”

Bloc pushes for more tests

Intergovernmental Affairs Minister Dominic LeBlanc said Wednesday that it will be up to travellers to arrange for PCR tests themselves, given that those embarking on non-essential trips overseas have chosen already to flout public health guidelines.

“The government of Canada obviously is not in a position to set up in hotels or all-inclusive resorts or Canadian consulates,” he told CBC News.

The new rule does not replace Canada’s mandatory 14-day quarantine period for international travellers, which remains in force.

Garneau also said Thursday the government will be boosting its surveillance efforts to make sure travellers are following the rules. The penalties for breaking the Quarantine Act can include six months in prison or $ 750,000 in fines.

Bloc Québécois Leader Yves-Francois Blanchet said Thursday that the testing requirement should apply to all travellers, not just those arriving by air.

In a media statement, he also said the government should reimburse those who have had to cancel vacations due to the pandemic. 

The federal change came a day before Ontario Finance Minister Rod Phillips resigned after returning from a controversial Caribbean vacation while the province is under strict lockdown measures that discourage non-essential travel.

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Amazon’s Satellite Internet Antenna Pulls 400Mbps During Testing

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For years, satellite internet has been a last resort for people living in remote areas. SpaceX has made waves offering its new Starlink service to select regions with much higher speeds than traditional satellite connections — testers are reporting as much as 150Mbps down. Amazon thinks it can do better with its new antenna technology. The company says its prototype for satellite internet is managing 400 Mbps right now, but we don’t know when consumers will be able to put it to the test. 

You’ve probably heard from people stuck with satellite internet from companies like HughesNet and Viasat. Most likely, they were not happy with the multi-second latency and anemic speeds, but it’s better than nothing. That’s actually what SpaceX called its Starlink beta this year: Better Than Nothing. Starlink is currently limited to the northern US and southern Canada, and it requires a hefty $ 500 setup fee. That includes the company’s satellite dish, which connects to the network over the Ka wireless band.

Amazon’s upcoming Project Kuiper service will be similar to Starlink, but the company claims its prototype Ka phased-array antenna will give it the edge. Amazon’s goal is to reduce the size and cost of the hardware — after all, every customer will need one to access the Kuiper network. However, that’s difficult with Ka-band equipment, which needs more physical separation between transmission (27-30GHz) and reception (17-20GHz) hardware due to the wide range frequencies.

Amazon’s new prototype antenna uses wireless elements overlaid on each other, something that has never been possible with Ka-band hardware before. The entire apparatus is just 12 inches in diameter, a third the size of legacy Ka dish designs. It makes up for the diminutive size by electronically steering Ka beams toward satellites passing overhead. That’s how Amazon is managing such high speeds in its tests. If it can keep real-life speeds anywhere close to the 400 Mbps seen in this test, Kuiper could be a viable alternative even for users in urban areas who have access to wired internet.  

Moving beyond the prototype phase will be no easy feat. Last summer, Amazon got FCC approval to launch 3,236 low-Earth orbit satellites for Project Kuiper. SpaceX, meanwhile, is already closing in on 1,000 thanks to its easy access to Falcon 9 rockets. Amazon hasn’t announced a timeline for launching its satellite constellation, but its regulatory approval calls for the full network to be operational by 2029. Amazon would need just 578 satellites to begin offering service, it claims. Perhaps Jeff Bezos’ Blue Origin space firm can help with that. 

Now read:

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Provinces should adopt surveillance testing to battle COVID-19, long-term care home review says

One of the largest operators of Canadian seniors’ residences and long-term care homes is calling for provinces to adopt widespread surveillance testing as part of an internal review set to be released on Monday.

The review for Revera was chaired by Dr. Bob Bell, former deputy health minister in Ontario and a former hospital CEO.

Bell was not paid to serve as chair of the review, which was carried out by international and national public health experts who volunteered their time.

Surveillance testing in Ontario involves testing symptomatic and asymptomatic staff, the frequency of which depends on where each community stands within Ontario’s provincial framework. Ontario also actively screens residents and staff.

“The most important factor depends on how much virus is in the community,” he said during an interview that aired on Rosemary Barton Live on Sunday.

“These folks unknowingly, in the best interest of their patients, come to work, and if they are not tested, [the risk] of them unknowingly bringing disease into the home during a time when they’re infected but asymptomatic is high.”

Bell said Ontario has adopted surveillance testing and has since been able to protect long-term care residents more effectively.

It has yet to be adopted elsewhere in Canada, where thousands of COVID-19 deaths have been reported at care homes.

“The government has not mandated mandatory testing,” Bell said. “Revera itself is actually contracting with private testing companies to actually do tests for their staff, and this is one of the most important things, our report says, to protect residents.”

WATCH | Dr. Bob Bell discusses some findings with Rosemary Barton prior to the report’s release on Monday:

A report looking into Revera’s response to the first wave of COVID-19 in long-term care homes will be made available to the public. Dr. Bob Bell, the chair of the review, says that the lessons from the first wave were being applied in the second. 2:03

Revera operates more than 70 long-term care homes in British Columbia, Alberta, Manitoba and Ontario, and more than 500 properties across North America and the United Kingdom. It also operates nearly 100 retirement residences in the same provinces, as well as in Saskatchewan.

From the start of the pandemic in Canada until Aug. 31, there were outbreaks at 87 Revera sites — meaning each of the affected properties, which included 55 long-term care homes and 32 retirement residences, reported at least one case of COVID-19.

The impact of the virus at Revera’s long-term care facilities was significant. There were 874 cases of COVID-19 and 266 deaths, which is a fatality rate of 30 per cent. In Revera’s retirement residences, 104 people were infected and 20 died.

An analysis released by the Canadian Institute for Health Information in June found that the proportion of COVID-19 deaths in Canada in long-term care facilities was around double the average of other developed countries.

Pushing for increased testing

Bell said there’s no question that as the second wave continues and as vaccines arrive, Canadians will continue to examine what has occurred in long-term care homes.

“The most important thing we can do right now is to be testing. In areas of high community spread, we should be testing every day,” he said.

Those tests should not involve deep nasopharyngeal swabs that are uncomfortable for staff, Bell said, but use saliva and other forms of testing.

A spokesperson with Ontario’s Ministry of Long-Term Care said proactive surveillance testing — including testing of all symptomatic and asymptomatic staff — continues to be done in all long-term care homes.

According to the spokesperson, testing in long-term care facilities in Ontario involves:

  • Testing residents at least twice daily for symptoms of COVID-19, and isolating and testing any residents with symptoms.
  • Screening all staff at least twice daily with symptom screening and temperature checks.
  • Adjusting how many times staff are tested based on the status of each individual community.

Frequency of staff testing aligns with the status of the community within Ontario’s provincial framework.

Ontario has also deployed COVID-19 rapid tests to screen staff in long-term care homes. 

Dr. Brent Roussin, Manitoba’s chief public health officer, said the province was working on strategies to implement more routine testing at long-term care homes.

“We certainly don’t have enough rapid tests to do that regularly, but we are looking at an approach to do a pilot in these areas,” Roussin said during a press conference on Thursday.

In Winnipeg, 49 people linked to the Revera-owned Maples Long Term Care Home have died from COVID-19 as of Nov. 30. (Lyzaville Sale/CBC)

Last week, Alberta announced it would soon begin piloting rapid testing at select sites across the province, including at various continuing care facilities.

British Columbia health officials said the province’s recommendation at present was to test asymptomatic individuals only in public health investigations of cases, clusters or outbreaks.

“This recommendation may differ from that of other provinces or countries, and other national or international health professional societies,” reads a statement from the province’s Health Ministry.

Bell said in his view, one of the most important starts of mandatory requirements across the country would be for all provinces to be testing staff.

“If the risk is as high as it currently is, for example, in Alberta or in communities like Toronto or Peel, to be testing every day,” he said. 

“Because staff don’t want to be carrying disease in. They are unknowing that they’re infected. They should be given an easy way to test themselves.”

‘Absolutely horrifying’ experience at Calgary facility

Nanaimo, B.C., resident Renee Laboucane’s two parents were living at the McKenzie Towne Continuing Care Centre in Calgary when the Revera facility experienced a significant COVID-19 outbreak earlier this year.

Laboucane’s mother died as a result of COVID-19, and her father still resides at the facility. She called the experience “absolutely horrifying.” 

Twenty people died at the McKenzie Towne Continuing Care Centre in Calgary, a facility operated by Revera, during the first wave of COVID-19. More than 100 residents and staff tested positive for COVID-19 at the centre. (Jeff McIntosh/The Canadian Press)

“We had zero communication, zero knowledge of what was going on…. We know there wasn’t the resources in the initial few weeks needed to care for the residents at McKenzie Towne,” she said.

As of Sunday, 20 people have died of COVID-19 at McKenzie Towne, and more than 100 residents and staff tested positive for the virus. Laboucane said the experience has been heart-wrenching for family members and friends.

“We’re all dealing with the effects of COVID and how it’s dealing with our lives,” she said.

WATCH | Renee Laboucane discusses outbreak at Calgary long-term care home:

Nanaimo resident Renee Laboucane’s said her two parents were living at the McKenzie Towne Continuing Care Centre in Calgary when it experienced a significant COVID-19 outbreak earlier this year. 0:32

As those like Laboucane are mourning and searching for answers, other Canadian families are concerned about their loved ones living in facilities currently experiencing COVID-19 outbreaks.

In Winnipeg, the Revera-owned Maples Long Term Care Home has had 52 people linked to the home die from COVID-19, as of Dec. 4.

Alvin Cadonic, whose aunt and uncle live in the facility, said he wanted accountability and transparency from Revera, as well as additional government oversight.

“I mean, we’re lucky we haven’t lost them. I don’t want to lose them,” he said. “I dread getting a phone call.”

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