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Tuesday, January 4, 2022

N.B. COVID-19 roundup: 3 deaths, 746 new cases - CBC.ca

COVID-19 has claimed the lives of three more New Brunswickers and infected 746 more people, Public Health reported Tuesday.

But the actual number of COVID-19 cases in the province is likely even higher, says Health Minister Dorothy Shephard.

"Really, we have to begin to consider that Omicron is everywhere because it transmits so quickly," she said. "We know that our cases double every two to three days."

"I believe that, you know, realistically, there are going to be people who are asymptomatic. I believe that our case counts are probably higher than we're able to report."

Starting at 11:59 p.m. Tuesday, the province will "reserve" diagnostic PCR (polymerase chain reaction) lab tests for those considered at the highest risk of being hospitalized with COVID-19, while everyone else will have to rely on less accurate at-home rapid tests and self-report positive results.

Until now, all COVID cases in New Brunswick have been identified with a PCR test, or by a rapid test followed by a confirmatory PCR test.

In addition, the province announced last Friday that contact tracing among the general public is "no longer feasible," given the rapid spread of the highly transmissible Omicron variant. Instead, people who test positive are being asked to notify their close contacts.

On Monday, the province hit a new single-day record-high of 922 new cases of COVID-19. The province could see 1,000 new cases a day by mid- to late this week, Shephard has said.

A person 70 to 79 years old in the Moncton region, Zone 1, and two people in their eighties in the Saint John region, Zone 2, have died as a result of COVID-19, Public Health said in a news release. This raises the province's pandemic death toll to 165.

There are now 571 health-care workers isolating at home due to because of COVID-19, up from 500 on Monday. Of these, 460 are from the Horizon Health Network, 70 are from the Vitalité Health Network, and 41 are from Extra-Mural/Ambulance New Brunswick.

The breakdown of the new COVID cases includes:

Moncton region, Zone 1 — 166
Saint John region, Zone 2 — 351
Fredericton region, Zone 3 — 90
Edmundston region, Zone 4 — 44
Campbellton region, Zone 5 — six
Bathurst region, Zone 6 — 37
Miramichi region, Zone 7 — 52

PCR tests will be limited to:

People in areas at highest risk, including health-care workers and those who live or work in long-term care facilities, homeless shelters and correctional facilities.
People who are symptomatic and aged 50 or over.
People who are symptomatic and immunocompromised or pregnant.
People who need a PCR test for travel.
People who are identified as a priority by Public Health.

For everyone else, a positive rapid test will be treated as a positive result for COVID-19, and people will be asked to register their result through a new form that will be available online this week, Public Health has said. Department of Health officials did not immediately respond Tuesday to a request for more information about when the new online registration system will be up and running.

These changes are expected to increase the demand for rapid-test kits.

"We certainly need more," said Shephard.

The free test kits have been in short supply in the province in recent weeks as COVID case number have risen.

Some people have expressed frustration about lining up for hours at distribution sites, only to be told the sites had run out of kits.

On Tuesday, the Horizon Health Network announced its weekly mobile pickup locations in Sackville, St. Stephen, Minto and Baie-Sainte-Anne would not be taking place.

‼️Horizon’s mobile rapid screening pick-up locations scheduled for Tuesdays in <a href="https://twitter.com/hashtag/Sackville?src=hash&ref_src=twsrc%5Etfw">#Sackville</a>, <a href="https://twitter.com/hashtag/StStephen?src=hash&ref_src=twsrc%5Etfw">#StStephen</a>, <a href="https://twitter.com/hashtag/Minto?src=hash&ref_src=twsrc%5Etfw">#Minto</a> and <a href="https://twitter.com/hashtag/BaieSainteAnne?src=hash&ref_src=twsrc%5Etfw">#BaieSainteAnne</a> will not take place on Jan. 4. See a full list of rapid test pickup locations: <a href="https://t.co/m6l5A54Niy">https://t.co/m6l5A54Niy</a> <a href="https://t.co/GNaT2ABIdC">pic.twitter.com/GNaT2ABIdC</a>
—@HorizonHealthNB

"We had some delays in deliveries last week. There is one today. So there are four locations that won't be receiving rapid test supply," Shephard said. "But that is all being replenished and we will get back to a norm in the next few days."

The province is "looking at different mechanisms" to expand and improve the distribution system and will make some announcements within the next week, she said, acknowledging the "inconvenience and the difficulty" with the current system.

"What I can say is that we're going to be also going back to a drive-thru system so that people don't have to get out of their cars. It will be easier."

Dr. Jennifer Russell, chief medical officer of health, said people will also need to register to pick up the rapid-test kits.

"We want to avoid those long lines in the winter, so people will be given a time to pick them up."

Vehicles lined up for 2 km along William Bell Drive, down Hall Road, and for another kilometre along Main Street in Hampton last Thursday morning for rapid-test kits. (Roger Cosman/CBC)

On Tuesday, people picking up rapid-test kits in Fredericton were being told that as of Wednesday, they will need to book an appointment and arrive at the site with a voucher to claim the kits.

Department of Health officials did not immediately respond to a request for more information.

More rapid-test kits are on the way, added Shephard.

Federal Health Minister Jean-Yves Duclos "sent me a note that said, 'I wanted to inform you my senior officials will be in contact with yours soon to give you specific information on rapid test deliveries for January. The expected numbers are significant, several times the deliveries received in December.'"

More than 3.8 million rapid tests have been distributed to New Brunswickers since Dec. 1 through schools, workplaces, airports and pickup sites, she said.

Shorter isolation periods

New isolation guidelines take effect Tuesday at 11:59 p.m.

Vaccinated people who test positive with a rapid test, as well as their close household contacts, who are vaccinated and asymptomatic, will need to isolate for five days.

Unvaccinated people who test positive, as well as their household contacts, who are unvaccinated and asymptomatic, will need to isolate for 10 days.

Close contacts outside of a household will be asked to mask continuously, avoid vulnerable settings and people, and limit their contacts as much as possible for at least 10 days.

After isolation, people must wear a mask continuously and avoid vulnerable settings and gatherings for the next five days.

If a close contact develops symptoms, they will be directed to take a rapid test, unless they meet the criteria for a PCR test.

Asked whether there should be more PCR testing to provide a more accurate picture of case counts, Shephard said people need to change the way they think about COVID-19 and Omicron.

"We need to assume, just like the common cold, it is everywhere, and it's not common to us to have this kind of mindset with COVID-19, but the fact is, is that, you know, we're looking at transitioning to a different mindset and a different perspective with regards to how we live with COVID.

"And so I'm not saying that we don't need to be concerned because we do. We need to protect our over-50 population. We need to keep in mind, always, our vulnerable communities and those who are at risk. And I think that that's the kind of the pivot that we're going to need to make in the near future."

The chief medical officer of health acknowledged the posted number of cases will be "an underreporting."

"We absolutely will miss some" by relying on rapid tests, said Russell.

"It's about utilizing our resources as effectively and as efficiently as we possibly can."

Although the province's daily case counts will no longer paint a full picture, it's still "really important" to continue to report them, Russell said.

"With the numbers rapidly increasing, we're going to see that translate into hospitalizations, as I said, about the one per cent. So that's what we're preparing for."

56 people hospitalized, 16 in ICU

In addition to the 746 new cases of COVID-19 recorded Tuesday, Public Health reported 73 recoveries "based upon information available from PCR tests."

There are now 6,112 active cases across the province.

Fifty-six people are in hospital with the virus, an increase of five, including 16 in intensive care, down one. Eleven of them are on ventilators.

Of those in hospital, 37 are over the age of 60. No one under 19 is hospitalized.

A total of 83 per cent of eligible New Brunswickers are fully vaccinated against COVID-19, up from 82.9 per cent, 90.3 per cent have received their first dose, unchanged, and 21.3 per cent have received a booster dose, up from 21.2 per cent.

New Brunswick has had 17,566 confirmed cases of COVID-19, with 11,287 recoveries so far.

A total of 626,853 PCR tests have been conducted to date, including 2,299 on Monday.

Border vaccine mandate for truckers could cause supply chain problems

The head of the Atlantic Provinces Trucking Association says U.S. border changes for unvaccinated truckers could bring supply chain headaches.

Starting on Jan. 15, truck drivers crossing the Canada-U.S. border will have to show proof of vaccination.

And unvaccinated drivers will be unable to cross.

Association executive director Jean-Marc Picard says the restriction could have a substantial impact for workers and the supply chain.

"The industry is faced today with an immense driver shortage, and these restrictions will probably add a layer to that issue," he said.

"We estimate that we could lose between 10 and 20 per cent of drivers going cross-border."

Jean-Marc Picard, the head of the Atlantic Provinces Trucking Association, predicts vaccination requirements for truckers will lead to empty shelves and the cost of goods going 'through the roof.' (CBC)

Truckers have been among the few people allowed to cross the land border into the United States throughout the pandemic but they will now need to be vaccinated against COVID-19.

Picard estimates the number of unvaccinated truckers is similar to the number of unvaccinated people overall. According to the province, 90.3 per cent of the population has received at least one dose of a COVID-19 vaccine.

"Most companies have like 10 per cent of their fleet parked because they can't find drivers," he said. "So, you know, add another 10 per cent of driver loss in there — significant impact to the supply chain.

"We're going to start to see empty shelves and cost of goods is going to go through the roof."

Atlantic COVID roundup

Newfoundland and Labrador reported 493 new cases of COVID-19 on Tuesday, raising the active caseload to a new high of 3,254 as the province entered a modified version of Alert Level 4, tightening public health restrictions to slow the spread of the fast-moving Omicron variant. One person is in hospital because of the virus.

Prince Edward Island announced 198 new cases of COVID-19 on Tuesday, bringing the total number of active cases to 1,159.

Nova Scotia reported 1,020 new COVID-19 cases on Monday. Thirty-six people are hospitalized with the virus, including four in intensive care. The active case count on the dashboard hasn't been updated since last Friday, when it stood at approximately 5,117.

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N.B. COVID-19 roundup: 3 deaths, 746 new cases - CBC.ca
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Monday, January 3, 2022

How will pandemic end? Omicron clouds forecasts for endgame, experts say - CBC News

Pandemics do eventually end, even if Omicron is complicating the question of when this one will. But it won't be like flipping a light switch: the world will have to learn to coexist with a virus that's not going away, experts say.

The ultra-contagious Omicron variant of the coronavirus is pushing cases to all-time highs and causing chaos as an exhausted world struggles, again, to stem the spread. But this time, we're not starting from scratch.

Vaccines offer strong protection from serious illness, even if they don't always prevent a mild infection. Omicron doesn't appear to be as deadly as some earlier variants. And those who survive it will have some refreshed protection against other forms of the virus that still are circulating — and maybe the next variant to emerge, too.

The newest variant is a warning about what will continue to happen "unless we really get serious about the endgame," said Dr. Albert Ko, an infectious disease specialist at the Yale School of Public Health.

"Certainly COVID will be with us forever. We're never going to be able to eradicate or eliminate COVID, so we have to identify our goals."

At some point, the World Health Organization will determine when enough countries have tamped down their COVID-19 cases sufficiently — or at least, hospitalizations and deaths — to declare the pandemic officially over. Exactly what that threshold will be isn't clear.

Some parts will struggle

Even when that happens, some parts of the world still will struggle — especially low-income countries that lack enough vaccines or treatments — while others more easily transition to what scientists call an "endemic" state.

In this photo released by Xinhua News Agency, residents line up for COVID-19 tests at a mobile testing site in Xincheng District of Xi'an, in northwestern China's Shaanxi Province, on Sunday. (Tao Ming/Xinhua/The Associated Press)

They're fuzzy distinctions, said infectious disease expert Stephen Kissler of the Harvard T.H. Chan School of Public Health. He defines the endemic period as reaching "some sort of acceptable steady state" to deal with COVID-19.

The Omicron crisis shows we're not there yet, but "I do think we will reach a point where SARS-CoV-2 is endemic much like flu is endemic," he said.

For comparison, COVID-19 has killed more than 800,000 Americans in two years while flu typically kills between 12,000 and 52,000 a year.

Exactly how much continuing COVID-19 illness and death the world will put up with is largely a social question, not a scientific one.

"We're not going to get to a point where it's 2019 again," said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. "We've got to get people to think about risk tolerance."

British Columbia Provincial Health Officer Dr. Bonnie Henry said last week that she believes the province will eventually see the end of the pandemic.

"The way the virus is changing with Omicron — that is leading us to that place sooner," she said in a year-end interview. "The type of illness it's causing, with most of us being protected through vaccination, means that we are going to get to that place."

Dr. Anthony Fauci, the top U.S. infectious disease expert, is looking ahead to controlling the virus in a way "that does not disrupt society, that does not disrupt the economy."

Already the U.S. is sending signals that it's on the road to whatever will become the new normal. The Biden administration says there are enough tools — vaccine boosters, new treatments and masking — to handle even the Omicron threat without the shutdowns of the pandemic's earlier days. And the Centers for Disease Control and Prevention just reduced to five days the time that people with COVID-19 must stay in isolation so they don't sicken others, saying it's become clear they're most contagious early on.

Cases on the rise again

India offers a glimpse of what it's like to get to a stable level of COVID-19. Until recently, daily reported cases had remained below 10,000 for six months but only after a cost in lives "too traumatic to calculate" caused by the earlier Delta variant, said Dr. T. Jacob John, former chief of virology at Christian Medical College in southern India.

Omicron now is fuelling a rise in cases again, and the country in January will roll out vaccine boosters for front-line workers. But John said other endemic diseases, such as flu and measles, periodically cause outbreaks and the coronavirus will continue to flare up every so often even after Omicron passes through.

Omicron is so hugely mutated that it is slipping past some of the protection of vaccinations or prior infection. But Dr. William Moss of Johns Hopkins Bloomberg School of Public Health expects "this virus will kind of max out" in its ability to make such big evolutionary jumps. "I don't see this as kind of an endless cycle of new variants."

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How will pandemic end? Omicron clouds forecasts for endgame, experts say - CBC News
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Sunday, January 2, 2022

Remote communities locking down, banning outsiders as COVID-19 spreads - CFJC Today Kamloops

“That’s a crisis,” Nishnawbe Aski Nation Grand Chief Derek Fox said in an interview.

Bearskin Lake has no hospital and is usually served by a nursing station with two nurses. An emergency evacuation would take more than three hours for a plane to get in and out from Sioux Lookout or Thunder Bay, and that’s only if weather permits it to land.

A federal rapid response team with three primary care nurses, a paramedic and two environmental health officers landed in Bearskin Lake on Dec. 30, bringing more testing capacity with them. Two public health nurses were sent by the Sioux Lookout First Nations Health Authority as well.

Fox said it’s not enough for a community that has no hospital and no capacity to even determine how sick any of the infected residents are.

“The federal government and the provincial government need to acknowledge this is a crisis,” Fox said. “They’re not treating this like a crisis. They’re waiting to see what happens.”

He said about a dozen of the 49 communities in the Nishnawbe Aski Nation have confirmed COVID-19 cases right now, including the 169 in Bearskin Lake, and roughly 80 more in 11 other First Nations.

Indigenous Services Minister Patty Hajdu spoke with Fox by phone Sunday and said Ottawa is there to help.

“I reiterated that we’ll be there for them, to support them, and that they just need to kind of keep telling us what they need and we’ll work really hard to make sure those resources are in place,” she said.

On Sunday, Hajdu said $483,000 had been approved to help Bearskin Lake with food security, personal protective equipment, funding for local community COVID workers, and supplies like wood cutting and collection.

She said when so many people are sick, and homes are only heated with wood stoves, even ensuring there is wood to burn is a challenge.

Outbreaks in remote communities are also affecting Nunavut, northern Quebec and Labrador.

Nunavut confirmed another 22 cases of COVID-19 Sunday, bringing the total to 196 in just 10 days.

That’s more than one-fifth of the confirmed cases of COVID-19 in the territory since the pandemic began almost two years ago, and the territory’s chief public health officer Dr. Michael Patterson says it is putting immense strain on health care.

“Please remain patient and kind, as there will be continued delays,” he said in a statement issued Sunday.

“Please stay home as much as possible and please don’t take any unnecessary chances.”

Nunavut is discouraging all non-essential travel within the territory and has banned non-essential travel to and from several communities, including Iqaluit, Rankin Inlet, Arviat, Igloolik and Pangnirtung.

Travel bans are also in place now in Nunavik in northern Quebec until mid-January, with only critical or essential travel allowed into or out of the region’s 14 villages.

The Nunavik Regional Board of Health and Social Services reported 33 new cases of COVID-19 in the week leading up to Christmas, and 131 between Dec. 27 and Dec. 31.

“The situation is serious,” the health board warned in a statement to the community on New Year’s Eve.

On Labrador’s remote northern coast, where COVID-19 showed up for the first time last week, leaders are pleading with residents to be cautious and imposing tight travel restrictions into local communities.

Innu Nation Deputy Grand Chief Mary Ann Nui said in a Facebook post Sunday that the inability to get confirmed test results quickly is adding to the stress.

The community of Natuashish locked itself down eight days ago after exposures to potential cases on flights into the town and a bar at Trapper’s Cabin, just before Christmas. Nui said the presumptive cases still haven’t been confirmed.

“Living in the northern area takes longer I guess, but it shouldn’t be like that,” Nui wrote.

Ten cases in Nain, one of five fly-in Inuit communities in the Nunatsiavut region of Labrador, were found through rapid tests but confirmation with PCR testing came slowly because of a lack of supplies.

Newfoundland and Labrador’s Health Minister said tests were being deployed to the region, but said the uptick in demand couldn’t have been predicted.

Nui said the local health region should have been more prepared.

Newfoundland and Labrador was one of several provinces recording drastic spikes in COVID-19 case counts on Sunday, logging 466 new infections and toppling a single-day record set just 24 hours earlier.

Nova Scotia also marked a new one-day peak on Sunday, recording 1,184 cases and eclipsing the 1,000 daily case mark for the first time since the onset of the pandemic. The province reported 1,893 new infections over the past two days.

A two-day count from Prince Edward Island came in at 137. Public health officials on the Island say the total number of infections has nearly tripled over the past two weeks.

Ontario’s daily tally fell short of Saturday’s record high, but still came in at 16,714.

Quebec, meanwhile, logged 15,845 new infections on Sunday.

This report by The Canadian Press was first published Jan. 2, 2022.

Mia Rabson, The Canadian Press

by Canadian Press

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Flushing out COVID spread: wastewater signals can be useful tool as testing declines – Prince Rupert Northern View - The Northern View

With some jurisdictions limiting PCR testing for COVID-19 and others increasingly overwhelmed by diagnostic demands, experts have stressed that daily case counts no longer paint the full picture of viral levels within communities.

But what we flush down the toilet may give us a better understanding of COVID-19’s prevalence.

Researchers across the country have been undertaking wastewater surveillance since early in the pandemic, looking for trace amounts of the virus in sewage to see how it’s spreading.

Those involved in the laborious process say it’s not a perfect measurement of COVID-19 levels, but it can help show where viral activity is propagating.

And when testing capacity is overrun and cases are underreported, wastewater surveillance becomes particularly beneficial, they say.

“Right now we’ve got this problem where we’ve hit the limit for getting tested,” said Mark Servos, a University of Waterloo researcher involved in surveillance at a number of Ontario sites. “But wastewater doesn’t care whether there’s clinical testing occurring or whether people are symptomatic or asymptomatic.

“Everybody who poops into the pipe, we’re going to include them in our analysis.”

Ontario announced Thursday it was tightening eligibility for PCR testing, reserving the publicly funded diagnostic for high-risk individuals who are symptomatic and those most vulnerable to severe disease.

Manitoba this week said it was limiting PCR availability at testing centres, instead handing out take-home tests at those sites and asking people to return only if their self-administered result is positive.

The measures, meant to conserve a finite amount of PCR’s, will lead to underreported cases at a time when the more transmissible Omicron variant is rapidly spreading.

Dr. Christopher Mody, an infectious disease expert with the University of Calgary, said PCR’s may only be uncovering “1 in 6 or 1 in 8” actual cases. But that number could be exacerbated by people relying on results from rapid tests that aren’t officially logged and those not getting tested at all.

“We need to know what that number is,” he said, adding that wastewater may help fill in some gaps.

“What I would say is wastewater is an extremely valuable tool to assess the burden of illness.”

Monitoring weekly trends in wastewater can not only indicate how much virus is circulating, but which variants are driving transmission.

Data from Saskatoon showed an 87.7 per cent increase in viral load in the city’s wastewater last week, including an 808.2 per cent bump in detected traces of Omicron.

Surveillance updated Friday from Ontario’s Waterloo Region, meanwhile, depicted steep rises in COVID-19 signals in Kitchener, Cambridge and Waterloo over the last week.

The process of wastewater surveillance involves collecting samples at water treatment plants and cleaning them to isolate and measure trace levels of COVID-19 particles.

Servos called it a “tricky” and “tedious” endeavour, but results can be turned around within hours.

Samples are collected daily in some jurisdictions, including Ottawa which started its program in April 2020. Others fetch and analyze sewer specimens a few times per week.

“We’re seeing the concentration in the wastewater is increasing,” said Robert Delatolla, a civil engineer at the University of Ottawa who monitors water samples.

Delatolla said similar patterns were seen last fall, when testing capacity was strained following Thanksgiving.

“Daily numbers stopped skyrocketing because we were doing less testing … but the wastewater kept going up,” he said.

“While the number of (PCR) tests we do (tops out), wastewater is unaffected. So in that sense, its value is really being seen right now.”

But as some provinces ramp up wastewater surveillance, Quebec recently scaled back.

Sarah Dorner, a professor at Polytechnique Montreal, said a six-month pilot project funded by Fonds de recherche du Quebec and the Molson and Trottier foundations ended in early December.

“There was no funding to continue,” she wrote in an email, adding that her team had observed a “rapid rise of SARS-CoV-2” in Montreal’s wastewater before the project was halted.

The practise of wastewater surveillance isn’t new in the era of COVID-19, having previously been used around the world to monitor polio.

But while Delatolla and Servos say wastewater surveillance is a useful, additional tool, there are drawbacks to the process. Surveillance can only show what’s happening in the specific locales being monitored, rather than entire provinces.

Wastewater data also can’t indicate the severity of cases, though Delatolla noted there’s been less concentration of COVID-19 in some areas’ sewage compared to the Delta wave last spring, which could reflect lower viral loads being shed by a now highly vaccinated public.

Variation in wastewater due to environmental factors, including melting snow running down sewers, can further dilute samples, Servos said, while analysis can also be hampered by lab capacity.

“We’re not commercial labs. We’re university labs,” he said. “We can do (tests) fairly quickly, but it takes a lot of labour … and it’s difficult to keep up on a routine basis.”

Mody said one positive of monitoring COVID-19 in wastewater is it often gives health officials quick indication of rising cases, making it useful in predicting imminent outbreaks.

“If you start to see a spike in a particular community, you can anticipate that cases will follow fairly quickly,” he said.

Melissa Couto Zuber, The Canadian Press

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