COVID-19: NACI says its up to every person to decide how much they risk they can tolerate when choosing viral-vector vaccines; Fullerton vows to ‘do right’ by LTC staff …
NACI #NACI
The Johnson & Johnson vaccine should be limited to people over the age of 30 who don’t want to wait for Pfizer-BioNTech or Moderna, the National Advisory Committee on Immunization said Monday.
The advice is almost identical to that issued by the expert panel for the Oxford-AstraZeneca vaccine last month and comes as both are suspected of causing a new and exceedingly rare blood-clotting syndrome.
“The viral-vector vaccines are very effective vaccines, but there is a safety signal, a safety risk,” NACI vice-chair Dr. Shelley Deeks told a virtual news conference.
“And the issue with the safety signal is that although it’s very rare, it is very serious. And so individuals need to have an informed choice to be vaccinated with the first vaccine that’s available, or to wait for an mRNA vaccine. They need to be aware that those are the options available to them.”
Deeks said the issue is not whether one vaccine is better at preventing COVID-19, but the fact that two vaccines have this known safety risk, and the mRNA vaccines do not.
She said it is up to every person to decide how much they can tolerate the extra risk the viral-vector vaccines bring, their risk of getting COVID-19, and whether the risk of waiting to get an mRNA vaccine outweighs the risk of potentially getting a blood clot from the vaccines by AstraZeneca or J&J.
“If someone’s working from home, not really going out, in a province or territory where there’s not much disease, then they’re in a very different situation than somebody that works in, let’s say, a manufacturing plant, has some difficulty wearing PPE, and in a province that has a very high burden of disease,” said Deeks.
Health Minister Patty Hajdu said Canadians should speak with their doctor if they aren’t certain what to do.
The risk of vaccine-induced thrombotic thrombocytopenia, or VITT, is estimated to be anywhere from one case in 100,000 doses given, to one in 250,000, but the syndrome is so new, there is still little known about why it is happening and who might be more likely to develop that syndrome than others.
Seven cases have been reported to date in Canada, all in people who received the AstraZeneca vaccine. About 1.7 million doses have been given out as of April 24. Canada’s first 300,000 doses of J&J are being stored at a Toronto-area warehouse pending investigation to ensure they are safe after discovering they were partly made at an American facility cited for safety and quality-control violations.
Ontario’s Dr. Barbara Yaffe was asked about the suggestion that mRNA vaccines are the preferred vaccines. She said people need to look at what vaccines are available to them at this time.
“If you’re going to get a mRNA today, great, but if you have to wait, and you can get another vaccine, get the other vaccine,” said Yaffe.
“Any vaccine that’s approved and regulated as safe and effective in Canada that’s available, is the one you should be getting, if it’s available to you.”
Meanwhile, faced with a dwindling supply of AstraZeneca vaccine, Yaffe said they’ve asked NACI to come back in mid-May with recommendations on the potential of mixing vaccines used for first and second doses. This has been done in the UK and other countries, she noted.
Yaffe said it’s likely NACI will recommend that it’s safe and effective to use a different vaccine for the second shot, if you can’t get the same one you received initially.
THE LATEST COVID-19 NEWS IN ONTARIO
Ontario minister Merrilee Fullerton vowed to “do right” by long-term care staff and residents after the release of a damning final report by a commission that probed the devastating spread of COVID-19 through Ontario long-term care homes.
Fullerton, the minister for long-term care, said in a Monday press conference that the suffering experienced by LTC staff, residents, and their families would not be in vain, and committed to making long-term care a better place for residents to live and staff to work.
She has yet to announce in any detail new measures being implemented in response to the commission’s recommendations.
In its 322-page report, the commission said the province failed to learn from the SARS epidemic of 2003, that the LTC sector was completely unprepared for the pandemic, and long-festering challenges (underfunding, staffing shortages, out-of-date infrastructure, inadequate oversight) played a part in COVID-19 deaths in long-term care homes.
To date, 3,760 LTC residents and 11 staff have lost their lives to the disease.
Many of the commission’s final recommendations reflect measures the provincial government has already initiated, said Fullerton, such as investing in stronger infection prevention and control measures in homes, urgently implementing an LTC staffing plan, and creating thousands of new beds.
“Many of the recommendations require further investigation,” said Fullerton, committing herself to providing regular public updates on their progress.
“To everyone impacted by this tragedy, especially to long-term care staff, residents and their families, our government hears you and we will do right by you,” she said.
Fullerton urged every long-term care operator to immediately offer counselling to their residents and staff (a report recommendation), and said her government is actively working on changes to the LTC inspection regime (failings were highlighted by the commission).
As for the recommendation that the development and building of LTC homes be separated from who runs them, Fullerton said she’s spoken with operators and developers who are interested in pursuing this type of model, which has “many positives, with very few negatives.”
“This is an interesting model, and the ministry will continue to explore it,” she said.
She also stated that “wages and working conditions matter,” and pointed to the need to attract and retain workers in the LTC sector.
“And we fully acknowledge that more needs to be done. And with the commission’s final report to inform us, we’re going to move forward on these issues.”
Fullerton also teased an announcement expected later this week, coming in response to the vaccine-facilitated drop in COVID-19 infections, outbreaks, and death in LTC homes. The changes will improve resident quality-of-life and address their emotional well-being, according to Fullerton.
The minister did not directly address a number of questions posed during the media availability that followed her prepared remarks, including when people working in long-term care can expect better wages, and when she first learned that LTC residents were dying due to neglect.
According to the final report, the commission was told that residents experienced malnutrition and dehydration and that in some cases, residents died because there weren’t enough staff available to tend to their needs.
Asked whether she or the province will apologize for what happened in long-term care, Fullerton did not address the question specifically, but said: “I think collectively, as a society, we need to do some soul-searching and understand why, you know, it took a pandemic to address the capacity issues in long-term care, the staffing issues in long-term care.
“This thing, this virus, it has been collectively devastating, including for residents and staff and family members and everyone who’s been working around the clock to alleviate the pressures on long-term care. But we have to move forward. We have to move forward,” she said at one point during the media availability.
“And I came to politics because of long-term care, the neglect of this sector, and I came to fix it. Our government is fixing it. And we will move forward, understanding the insights and the recommendations from the commission.”
The province now has more than 20,000 new and 15,000 upgraded LTC spaces in the development pipeline, according to Fullerton – more than 60 per cent of the 30,000 new spaces they’re aiming to create within a decade. She also said training programs the province is investing in will see up to 16,000 new personal support workers graduate in the next year, which is more than 2.5 times greater than pre-pandemic levels.
At a Monday afternoon media briefing, Ontario’s Chief Medical Officer of Health Dr. David Williams, was asked about the commission’s report criticizing his slowness to move on matters such as the implementation of a universal mask mandate in long-term care, and recognizing asymptomatic spread of COVID-19.
Williams said that if you look at the data, the number of outbreaks after the mask mandate were the same, if not more than before the April 8 directive, and the second wave was higher than the first. “It tells you it’s a complex issue,” he said.
Williams also shared his view that asymptomatic spread “was not a very major factor” during the first wave of COVID-19 in Ontario. “Variants of concern, I think it’s a different issue,” he said.
Barbara Yaffe, associate chief medical officer of health, said work has been ongoing with the ministries of long-term care and seniors and accessibility, as well as with local public health units, to determine how they can modify the restrictions on long-term care homes to improve quality of life while maintaining health and safety.
“We anticipate that some changes will be announced later this week. Will they be everything that people want? Probably not. But I think we have to be doing this in a careful way.”
There are variants of concerns, and there are still some outbreaks and cases involving vaccinated people — though it’s a very low number, said Yaffe.
NEW CORONAVIRUS CASES IN OTTAWA AND ONTARIO
Ottawa Public Health reported 139 new cases of COVID-19 and one additional death on Monday.
There are now 1,912 active cases across the city, a figure that’s been on the decline since surpassing 3,800 in mid-April. The previous seven days saw a total of 1,168 new cases reported locally (an average of 167 daily).
The number of Ottawans hospitalized with COVID-19 now sits at 107, while those in ICU number 30. Hospital occupancy by local COVID-19 patients has levelled off, and started to fall recently, while the number of ICU beds filled with local COVID-19 patients has hovered around 30 for more than a week.
The latest estimate of the R(t) in Ottawa is 0.97 (a seven-day average). A R(t) value that exceeds one indicates that the epidemic is growing and each case is, on average, infecting more than one other person, while an R(t) of less than one means the spread is slowing down. OPH data show the estimated R(t) has been creeping up for more than a week.
A total of 340,121 Ottawa residents have now received at least one COVID-19 vaccine dose. That’s 40 per cent of the population, aged 18 and older. Three per cent of that population has received two doses.
Ontario reported 3,436 new cases of COVID-19 on Monday, the ninth consecutive day with a new case total of less than 4,000. The seven-day average for daily cases is now 3,577, a figure that’s been on the decline since mid-April.
Included in Monday’s total were 15 in Eastern Ontario, 12 in Kingston, Frontenac and Lennox & Addington, and two in both Leeds, Grenville & Lanark and Renfrew County and District.
In terms of active cases, the hardest-hit areas are currently Peel (616 per 100,000), Toronto (452), Niagara Region (302), Durham Region (290) and York Region (281). Ottawa, comparatively, has 214 active cases per 100,000 population.
The number of COVID-19 patients hospitalized in Ontario (1,925), dropped by 36 in the last day, while those in ICU (889) were six fewer. Sixteen more COVID-19 deaths were added to the total in the province, which now sits at 8,118.
On the vaccination front, nearly 5.4 million doses have now been administered in Ontario, including 53,880 Sunday.
THE LATEST COVID-19 NEWS IN OTTAWA
Ottawans aged 18 and older who live in one of three provincially designated “hot spots” — circumscribed by the K1T, K1V and K2V area codes — are now eligible to book COVID-19 vaccine appointments through the provincial system.
The province has elected to lower the age of eligibility for vaccination in 114 hot spots across Ontario. This week and next, the province said it’s looking to allocate 50 per cent of available vaccine doses to hot spots.
The city announced Monday that it has closed a preschooler program at one of its municipal child-care centres for at least 14 days after receiving confirmation that a child at St. Luke’s Child Care Centre at city hall tested positive.
The child’s last day at the daycare was April 30, and Children’s Services received a positive test result on Sunday. No further COVID-19 transmission within the centre has been identified so far, a memo to city councillors said.
The centre’s toddler program was previously temporarily closed in March after two employees and a child tested positive.
The Beer Store location on Merivale Road temporarily closed after an employee tested positive for COVID-19. Their last shift was Saturday, May 1, and The Beer Store said it’s working in consultation with Ottawa Public Health, and sending “positive thoughts and best wishes” to their team member.
Potentially affected employees will self-isolate or symptom monitor, based on circumstances, and the store is being closed until Tuesday to allow for a COVID-19 cleaning protocol to be carried out.
The Beer Store said all employees working at this location were wearing face coverings, as per its mandatory employee mask policy for all stores.
QUEBEC COVID-19 NEWS
Quebec reported 798 new cases of COVID-19 Monday — the lowest one-day case count since March 24.
Two new deaths were reported, neither of which occurred over the previous 24 hours. While the number of COVID-19 patients in hospital rose by 14 in the last day, for a total of 588, those in ICU fell by six, for a total of 151.
Just 15 new cases were reported in the Outaouais (the daily average over the previous seven days was 59). A total of 197 lives have been lost in the region.
COVID-19 Testing and Vaccination in Ottawa
Updated information on COVID-19 testing : www.ottawatestingupdate.ca/
Ontario vaccination portal : covid-19.ontario.ca/book-vaccine
Provincial call centre : 1-888-999-6488. The Vaccine Information Line is open from 8 a.m. to 8 p.m. and is capable of providing assistance in 300 languages.
Vaccine eligibility in Ottawa: Vaccine eligibility screening tool, from Ottawa Public Health https://vers.powerappsportals.com/en-US/
To find a pharmacy vaccine : Eligible adults aged 40 and over who are interested in getting vaccinated via pharmacy can visit ontario.ca/pharmacycovidvaccine to find a participating locations. Contact the pharmacy directly to ask if they’re offering appointments, walk-in vaccination or both.
— With files from The Canadian Press