Wednesday, August 04, 2021

Canadian Medical Association, nurses association call for mandatory COVID-19 vaccines for health-care workers

Christy Somos
CTVNews.ca Writer
 Tuesday, August 3, 2021 

TORONTO -- The Canadian Medical Association (CMA) and the Canadian Nurses Association (CNA) are calling for COVID-19 vaccines to be mandatory for health-care workers.

In a news release, the CMA and CNA stated jointly that in the face of the highly contagious COVID-19 variants and the plateauing of Canada’s vaccination rate, the mandatory vaccination of health-care workers is “an additional measure to protect patients, the health workforce and health-care system capacity.”

“What we're seeing is that these variants of the COVID virus are much more contagious and that makes the cry for vaccination even stronger,” said CMA president Dr. Ann Collins in a telephone interview with CTVNews.ca Tuesday. “And at the same time, we're seeing a plateauing in vaccine uptake and we know that vaccines are what are going to get us through and out of this pandemic. So we felt it was important, along with our nursing partners, to bring this forward.”

Collins said that so far, reaction to the announcement has been positive because the public recognizes that the organizations are “putting patients at the centre of their call-to-action.”

The organizations are also calling on all levels of government and employers to implement strategies to lower barriers to vaccine access, the statement says.

“While vaccines are readily available across Canada, we recognize that the history of inequity within the health-care system impacts trust,” the statement continues. “Therefore, governments and employers must continue to support and address vaccine hesitancy and system barriers to achieving the highest rate of vaccination among the public and health workforce.”

Health-care workers were among the first to receive COVID-19 vaccines to protect them and their patients from infection and to prevent outbreaks, but specific data on how many chose to get inoculated is not readily available.

As of Tuesday, 67 per cent of Canada’s eligible population has been fully vaccinated against COVID-19.

Requiring vaccinations as a condition of employment in health-care settings like hospitals and long-term care homes is not a new phenomenon, as many workplaces require doctors, nurses and support staff to be fully immunized against diseases like tetanus and hepatitis B.

In Europe, France has ordered all health-care workers to get vaccinated by mid- September, with Greece and Italy following suit with their own mandates in the face of the Delta variant driving COVID-19 cases up.

Ontario Premier Doug Ford told reporters in July that health-care workers have a “constitutional right” to opt out of vaccination, saying he doesn’t “believe in forcing anyone to get a vaccination that doesn’t want it.”

Alberta Premier Jason Kenney also flatly dismissed the idea of mandatory vaccines, going so far as to amend Alberta’s Public Health Act and removing a century-old order that allows the government to force people to be vaccinated.

“We have an incredibly powerful tool at our disposal to combat this virus and its variants,” Collins said. “We should be using everything that we can to get people vaccinated.”



A woman wears a face mask as she walks by a COVID-19 vaccination sign in Montreal, Sunday, August 1, 2021, as the COVID-19 pandemic continues in Canada and around the world. (THE CANADIAN PRESS/Graham Hughes)


Research Letter 
Infectious Diseases
July 28, 2021

Effect of Targeted Behavioral Science Messages on COVID-19 Vaccination Registration Among Employees of a Large Health SystemA Randomized Trial

Henri C. Santos, PhD1; Amir Goren, PhD1; Christopher F. Chabris, PhD1,2; et alMichelle N. Meyer, JD, PhD1,3
Author Affiliations Article Information
JAMA Netw Open. 2021;4(7):e2118702. doi:10.1001/jamanetworkopen.2021.18702
Introduction

The first opportunities to field test interventions to increase COVID-19 vaccination were among health care workers (HCWs), who were among the first to be offered COVID-19 vaccines. After 1 large Pennsylvania health system sent 36 vaccine-related mass emails to employees over 5 weeks (eAppendix in Supplement 1), 9723 of 23 700 HCWs (41%) had still not scheduled their vaccination. We sought to determine whether individually addressed emails designed with behaviorally informed features1-5 could increase vaccination registration compared with a delayed control group.

Methods

This project followed the Consolidated Standards of Reporting Trials (CONSORT) reporting guideline. The Geisinger institutional review board determined that this health care operations project did not constitute human participants research and that a follow-up research analysis was exempt from review or the requirement for informed consent under 45 CFR §46.104(d)(4)(iii). The trial protocol is available in Supplement 2.

In this randomized trial, we assigned 9723 employees (eFigure in Supplement 1) who had not scheduled a COVID-19 vaccination to a delayed control condition (3241 [33%] randomized; 3179 [33%] received intervention) or to receive 1 of 2 individually addressed emails with 3 components. Both emails explained that Pennsylvania would soon expand vaccine eligibility beyond HCWs, reducing employees’ access to appointments, and encouraged them to schedule an appointment. The 6482 employees in these intervention groups were assigned to receive an email that framed the decision to be vaccinated either by noting that many US residents and fellow employees had chosen to be vaccinated, ie, social norms2 (3241 [33%] assigned; 3198 [33%] received intervention) or by favorably juxtaposing the vaccine’s risks with those of COVID-19, ie, reframing risks3 (3241 [33%] assigned; 3190 [33%] received intervention). Both emails asked employees to make an active choice4 to receive a vaccine (hyperlinked to a scheduling portal) or not (hyperlinked to a survey soliciting their primary reason for declining). Employees in the delayed condition were randomly assigned to receive 1 of these emails (social norms: 1589 [50%]; reframing risks: 1589 [50%]) 3 days later. The primary outcome was registration on the vaccination scheduling portal during the 3 days after the first emails were sent.

Random assignment (with the randomizr package) and logistic regression analyses were conducted using R version 4.0.2 (R Project for Statistical Computing). For all analyses, odds ratios (ORs) from logistic regressions were calculated, along with asymptotic 95% CIs; 2-tailed P < .05 was used to determine statistical significance. Detailed methods appear in the eAppendix in Supplement 1.

Results

The overall employee population of 23 700 HCWs comprised 17 362 (73%) women and 21 168 (89%) White employees, with a mean age of 43 years. Of the 9723 targeted employees, 9457 (97%) had valid email addresses. Both emails (ie, social norms and reframing risks) led to more registrations in the first 3 days than the delayed condition (delayed control group: percentage of participants registering: 3.17%; 95% CI, 2.62%-3.85%; social norms: percentage of participants registering, 6.47%; 95% CI, 5.67%-7.38%; OR, 2.11; 95% CI, 1.65-2.69; P < .001; reframing risks: percentage of participants registering, 6.90%; 95% CI, 6.07%-7.83%; OR, 2.26; 95% CI, 1.77-2.87; P < .001) (Figure 1). There was no significant difference in registrations between the 2 email conditions (OR, 1.07; 95% CI, 0.88-1.30; P = .50). Among the 1229 HCWs who declined to register and then completed the survey, the most common reasons were unknown vaccine risks (430 [35%]) and pregnancy-related concerns (165 [13%]) (Figure 2).

Discussion

During the 3-day study period, an individual email nudge caused more than twice as many HCWs to register for a COVID-19 vaccination compared with HCWs in the control condition, with no significant difference between the 2 emails. A limitation of this trial is that due to the imminent closure of employee-only vaccination clinics, we could only delay the intervention in the control group by 3 days. Moreover, by choosing to compare 2 behaviorally informed emails, we are unable to exclude the possibility that a plain reminder might have had the same effect. Furthermore, we could not measure actual vaccination, as appointment slots were unexpectedly unavailable for many who registered for one.

Given the large volume of previous COVID-19 vaccine promotion to HCWs, it may seem counterintuitive that a single additional reminder could increase vaccination by late adopters. However, competing demands on attention, behavioral inertia, and unwieldy processes that make it hard to follow through on intentions likely conspire to make a single, timely, targeted reminder helpful.2-5 The emails’ behavioral features—active choice, appeal to authority, and emphases on scarcity, social norms, and risk recalibration (eAppendix in Supplement 1)—may have contributed to their effect. The 3.17% absolute increase in vaccination appointments we observed is larger than many real-world nudges6 and may be greater among recipients who are less hesitant about receiving the vaccine. Sending targeted emails, patient portal messages, or text messages designed with behavioral science is inexpensive, scalable, and easily implemented and could be an effective way to encourage vaccination by HCWs and the general public.

Back to top
Article Information

Accepted for Publication: May 24, 2021.

Published: July 28, 2021. doi:10.1001/jamanetworkopen.2021.18702

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Santos HC et al. JAMA Network Open.

Corresponding Author: Michelle N. Meyer, JD, PhD, Center for Translational Bioethics and Health Care Policy, Geisinger Health System, 100 N Academy Ave, Danville, PA 17822 (michellenmeyer@gmail.com).

Author Contributions: Dr Santos had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Drs Chabris and Meyer contributed equally.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Santos, Chabris, Meyer.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Santos, Goren.

Obtained funding: Meyer.

Administrative, technical, or material support: Chabris.

Supervision: Goren, Chabris, Meyer.

Conflict of Interest Disclosures: None reported.

Trial Registration: ClinicalTrials.gov Identifier: NCT04728594

Data Sharing Statement: See Supplement 3.

Additional Contributions: We thank Marguerite Macpherson, BS, Elizabeth S. Humphrey, BA, and Peter Rowe, BA, for administering the emails; Greg Strevig, AAS, for help in obtaining data for analysis; and Daniel Rosica, BA, Tamara Gjorgjieva, BS, and Maheen Shermohammed, PhD, for research assistance. All contributors are affiliated with Geisinger Health System, and none received compensation for this work other than their usual employment salary.

Additional Information: The data, materials, and reproducible code used in this study will be deposited to OSF: https://osf.io/qg5m6/.

References
1.
Milkman  KL, Patel  MS, Gandhi  L,  et al.  A megastudy of text-based nudges encouraging patients to get vaccinated at an upcoming doctor’s appointment.   Proc Natl Acad Sci U S A. 2021;118(20):e2101165118. doi:10.1073/pnas.2101165118PubMedGoogle Scholar
2.
Moehring  A, Collis  A, Garimella  K,  et al.  Surfacing norms to increase vaccine acceptance.   psyArXiv. Preprint updated March 19, 2021. doi:10.31234/osf.io/srv6tGoogle Scholar
3.
Tversky  A, Kahneman  D.  The framing of decisions and the psychology of choice.   Science. 1981;211(4481):453-458. doi:10.1126/science.7455683PubMedGoogle ScholarCrossref
4.
Patel  MS, Volpp  KG, Small  DS,  et al.  Using active choice within the electronic health record to increase influenza vaccination rates.   J Gen Intern Med. 2017;32(7):790-795. doi:10.1007/s11606-017-4046-6PubMedGoogle ScholarCrossref
5.
Bakr  O, Afsar-Manesh  N, Raja  N,  et al.  Application of behavioral economics principles improves participation in mailed outreach for colorectal cancer screening.   Clin Transl Gastroenterol. 2020;11(1):e00115. doi:10.14309/ctg.0000000000000115PubMedGoogle Scholar
6.
DellaVigna  S, Linos  E.  RCTs to scale: comprehensive evidence from two nudge units.  NBER Working Paper. July 28, 2020. Accessed June 22, 2021. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3661086



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Opinion: Alberta playing Russian roulette by removing public health measures

Author of the article: Ubaka Ogbogu, Lorian Hardcastle

Publishing date:Aug 03, 2021

Effective August 16, 2021 mandatory masking orders on public transit, taxis and ride sharing will be lifted in the province of Alberta. Alberta is the first province in Canada to end these orders. PHOTO BY LARRY WONG /POSTMEDIA

Last week, Dr. Deena Hinshaw, Alberta’s chief medical officer of health announced that by mid-August, Alberta will remove public health measures, including contact tracing, masking in public transit, isolation for those who test positive, and testing for those who are asymptomatic or with mild symptoms. This announcement comes at a time when the province is riding a fourth wave of the pandemic, with cases and hospitalizations rising and a significant proportion of the population partially vaccinated or unvaccinated, including children under 12.

This latest move is nothing like the earlier easing of restrictions such as limits on gatherings, business closures, and physical distancing. The latter were controversial largely because they affected economic and personal well-being. Now that the more contentious restrictions are gone and the province is “open for summer” and beyond, it is unclear why the government chose to abandon basic public health measures like contact tracing and isolation, which do no more than serve to detect and stop the spread of COVID-19 and which have limited impact on the economy and individual liberties.

Alberta is the only jurisdiction in North America, and perhaps even globally, that has eliminated all of these “boots-on-the-ground” public health measures. The approach makes zero sense for a virus that has killed or affected millions and which has the potential to mutate into deadlier, more contagious variants. Worse, it is even more nonsensical from a public health surveillance perspective. By not tracking and mitigating spread, the government has given a deadly virus free rein to live undetected and undisturbed among us. Bluntly, it is government-approved Russian roulette.

The government rationalized this decision based on our vaccination rate. However, Alberta is among the provinces with the fewest number of people who have received their first dose and we are nowhere near achieving herd immunity. There are many who remain unvaccinated, including children under the age of 12. Several American jurisdictions are currently struggling under the weight of pediatric COVID cases following the relaxation of public health restrictions, which could be a sign of things to come in Alberta. There are also questions surrounding the efficacy of available vaccines against variants.

Yet, the government is blazing a trail that other jurisdictions with similar vaccination rates and lower disease incidence have not even considered. This is not just irresponsible and irrational, it reflects utter disregard for the well-being of many, including children and those ineligible for vaccination, and businesses, which rely on these basic public health measures to meet their legal responsibilities to provide safe workplaces.

Besides, even if we achieve herd immunity through vaccination, it makes eminent sense to keep tracking the disease for public health surveillance purposes, to prevent spread to those who cannot be vaccinated, and to detect the emergence of variants.

Another interesting development has been a passing of the baton from the minister of health and premier to the CMOH to manage the pandemic. While they have all insisted throughout the pandemic that Dr. Hinshaw is merely an advisor and that final decisions on public health measures and restrictions are made by the government, Minster Shandro did an about-face at a press conference last week.

He repeatedly referred to Dr. Hinshaw as independent and stated that the decision to remove public health measures was hers. This appears to be an attempt to present the decision as scientific rather than politicized, albeit a needless distinction for a decision that is evidently contrary to common sense and to well-established fundamentals of public health science.

Many public health experts are understandably outraged by the government’s decision to eliminate basic public health measures. This is because we all understand one thing: you cannot manage a global pandemic with little more than hubris and a role of the dice. The government must reverse course, or the consequences will be dire for Albertans.

If there is a lesson the pandemic has taught us, it is that we do not do enough to protect the most vulnerable in our society. The UCP government has clearly missed the class and lesson, and has shown repeatedly that it is unfit to lead the province through and past this pandemic.

Ubaka Ogbogu is an associate professor in the Faculty of Law at the University of Alberta. Lorian Hardcastle is an associate professor in the Faculty of Law and Cumming School of Medicine at the University of Calgary.


EVEN RIGHT WING TALK RADIO CHALLENGES KENNEY
Breakenridge: Why the rush in casting aside Alberta's remaining COVID-19 safety net?

Author of the article: Rob Breakenridge 
 • for the Calgary Herald
Publishing date: Aug 03, 2021 • 
Dr. Deena Hinshaw, Alberta's chief medical officer of health, gives a COVID-19 pandemic update from the media room at the Alberta legislature in Edmonton, on Wednesday, July 28, 2021. PHOTO BY IAN KUCERAK /Postmedia

While no one expected last week’s reappearance of Alberta’s chief medical officer of health to signal new restrictions, it still came as a surprise to hear of the further repealing of public health measures.

There is no doubt that vaccination has fundamentally changed the impact of COVID-19 and how we respond to it. But the Alberta government is being unnecessarily hasty in casting aside the measures we have in place to contain the virus.

We are only a month into this phase of no health restrictions and we are only about two weeks into this period of Delta establishing itself as the dominant variant in Alberta. It’s really hard at this point to make assumptions about what the next few months are going to look like. Nonetheless, we are pressing ahead with changes that seem rooted more in hubris than in common sense.

As of last week, we are no longer requiring isolation for close contacts of those who test positive for COVID-19. That was already the case for close contacts who are fully vaccinated, but it’s hard to understand why we’d be so indifferent about unvaccinated individuals exposed to a more contagious variant.

Later this month, however, we’ll be going much further. Never mind close contacts, there will no longer be a requirement for those who test positive for COVID-19 to isolate. This is baffling. Mind you, with the changes coming to testing, many infected with the virus won’t know for sure whether they have COVID-19.

In fact, we’re going to be ending most COVID-19 testing. All assessment centres will close by month’s end and testing will only be made available to those with severe symptoms. This is in stark contrast to efforts underway in the United Kingdom to sharply increase its testing in response to its current Delta wave.

It’s certainly the case that hospitalizations and severe outcomes are much more important metrics at this point. However, the case count, the R-Value and the positivity rate are all reliable indicators as to where things are headed.

We know that thanks to vaccines we will see fewer hospitalizations than we would have previously on a certain number of cases. But with enough infection, those numbers can still creep into problematic territory. Hospitalizations in Florida, for example, have now matched the peak from this past winter.

As much as Hinshaw was pleading last week for folks to get vaccinated, it’s somewhat at odds with the notion here that vaccine protection is sufficient enough to shed most remaining pandemic response measures.

It would have been much more sensible to link these plans to a target. There would have been much more buy-in if Hinshaw had announced, for example, “once we hit 80 per cent of eligible Albertans fully vaccinated, then we can drop most remaining testing and isolation measures.”

This would significantly bolster the odds of success of such a plan and also provide some additional incentive to ensure we can increase our vaccination rate.

There’s also some legitimate concern over timing here. We’ll be sending kids to school, unmasked (and unvaccinated for those under 12), just a couple of weeks after all of these changes have taken effect. At the very least, we should get a clear sense of how the return of school is going amid the spread of the Delta variant before making such decisions. Why is it so important that these changes occur in August rather than, say, October?

It’s not as though we can look to other jurisdictions to see how such an approach has worked, because it doesn’t seem like anyone else has gone down such a path. Maybe there’s a reason for that.

This is not to argue for the re-introduction of restrictions or lockdowns. That case simply isn’t there at the moment. Neither, though, is there a case for flying blind when it comes to this virus right now.

“Afternoons with Rob Breakenridge” airs weekdays 12:30-3 p.m. on 770 CHQR rob.breakenridge@corusent.com Twitter: @RobBreakenridge


THE CONSERVATIVE MIDDLE
Braid: With end to isolation and other measures, UCP takes risks for no good reason

In effect, the government is abandoning speedy pre-emptive effort to control local outbreaks
Author of the article:Don Braid • Calgary Herald
Publishing date:Aug 03, 2021 • 3 hours ago • 3 minute read • 36 Comments
Calgarians protesting the recent Alberta Health Services changes ending testing and restrictions for COVID-19 rallied at the McDougall Centre on Sunday, Aug. 1, 2021. PHOTO BY GAVIN YOUNG/POSTMEDIA

This is a COVID-19 story I know to be true because it happened to a close relative.

Several months ago he was working on a job site in Edmonton.

A fellow employee came to work one day after being tested. He received a positive result while still on the job — but stayed at work.

The majority of workers on the night shift caught COVID-19. The job was shut down.

Our relative was extremely sick for two months. Even now he has significant symptoms and has not been able to return to work.

That’s the cost of one inconsiderate person who ignored all the mandatory rules on self-isolation.

By Aug. 16, everything he did — and didn’t do — will be quite proper.

There will no longer be a mandatory 10-day order for self-isolation — just a limp encouragement to stay at home if sick.

The very thought goes against everything the government has been preaching for 16 months.

Even in the vaccine era, this strikes me as absurdly dangerous. It’s also unnecessary because the isolation rule does nothing to slow economic recovery.

In fact, mandatory isolation probably helps the economy by keeping work sites from shutting down. With the exception of characters like that employee, most people adhere to the rule as best they can.

The effectiveness of vaccines is the UCP government’s rationale for lifting all but a few very limited restrictions on Aug. 16.

But hundreds of thousands of Albertans are not vaccinated. They are vulnerable to a possible fourth wave of Delta variant infections that the government suddenly seems determined to discount and even ignore.

Young adults are among the least vaccinated. Eager for some enjoyment after all this (who isn’t?), many behave as if there’d never been a pandemic at all.

The watering holes along 17th Avenue S.W. were jammed shoulder-to-shoulder every night over the long weekend. It’s the busiest I’ve ever seen these familiar spots.

But why not, when the UCP normalizes COVID-19 as equivalent to seasonal flu because it has been tamed by vaccine? On Tuesday, Premier Jason Kenney called it “COVID flu.”

Starting Aug. 16, mass testing will also stop, even though it’s the only way to effectively keep track of daily cases.

People feeling sick will be urged to stay home but “testing will no longer be recommended for those with mild symptoms for whom a result will not change their treatment.”

By Aug. 31, public testing centres will shut down and responsibility will shift to “primary care centres including doctors’ offices.” Hospitals will continue to test acute cases.

Daily case numbers will obviously shrink along with the lower count. Useful comparisons between previous mass testing and the new counts (if they’re even released) will be impossible.

The only meaningful indicators will be COVID-19 hospital and ICU admissions. Those lag weeks behind infections.

Contact tracing has already been sharply curtailed. Those in close contact with sick people are no longer notified — the infected themselves are asked to do this. Tracing will only occur in high-risk settings.

In effect, the government is abandoning speedy pre-emptive effort to control local outbreaks.

The NDP is calling for a public inquiry. The startling changes have prompted four days of a new phenomenon — demonstrations in favour of continued measures.

Every one of these actions — cuts to testing and tracing, the end of mandatory isolation — could be reversed without hurting the economy or the drive to open society.

The government is embarked on a flat-out effort to diminish the pandemic in the public minds. Every question about the moves is dismissed as an effort to deny the science, even though many scientists are appalled.

And if the UCP turns out to be wrong, there will be far less public information to prove it.

Everyone wants this dreadful time to end. But ignoring and forgetting at a critical moment will only increase risks that are still with us.

Don Braid’s column appears regularly in the Herald
dbraid@postmedia.com


 DOUBLE TROUBLE

Alberta, Saskatchewan removing public health restrictions 'a bad mistake' right now, experts say

Neither province has reached herd immunity, lifting restrictions sends message pandemic is over


Nicholas Frew · CBC News · 
Saskatchewan lifted all public health restrictions on July 11. Alberta plans to phase out its restrictions by Aug. 16. (Graham Hughes/The Canadian Press

Getting rid of provincial COVID-19 restrictions and protocols is a mistake right now, public health experts say.

Saskatchewan was the first Canadian province to lift all public health restrictions last month, while Alberta plans to phase them out by mid-August.

But neither province has reached herd immunity, and the move sends the message that the pandemic is over — despite children not being immunized and data showing the delta variant is spreading among vaccinated people in other jurisdictions, experts say.

"This is a bad mistake at this time," said Dr. Ali Mokdad, professor and chief strategy officer of population health at the University of Washington.

Saskatchewan lifted all public health rules on July 11. Premier Scott Moe went all in on vaccines, saying his government doesn't want to control the spread of the novel coronavirus through government regulation.

Saskatchewan's health minister backed the move and urged residents to hold themselves accountable when it comes to self-isolating.

Saskatchewan Premier Scott Moe, left, and Chief Medical Health Officer Dr. Saqib Shahab, right, shake hands at the final regularly scheduled COVID-19 update on July 7, 2021. (CBC)

Alberta, meanwhile, lifted most of its public health restrictions on July 1. Since then, COVID-19 cases have increased and the R-value — rate of people infected per infected person — has eclipsed the peak of the third wave.

Last week, Alberta's chief medical officer of health Dr. Deena Hinshaw announced the province plans to phase out COVID-19 rules by Aug. 16 in order to prepare the health-care response for the flu and other communicable diseases in the fall.

The transition started Thursday. Quarantine is now recommended instead of mandatory for close contacts of a positive case, and people who test positive are now the ones who have to notify close contacts — not contact tracers.

Quarantine may be required in some high-risk settings or for outbreak management. Contact tracers and outbreak management will focus on high-risk settings, while community outbreaks will be addressed as needed.

Testing asymptomatic close contacts is no longer recommended. Mask mandates for acute- and continuing-care facilities — as well as public transit, taxis and ride-share vehicles — are still in effect.

Saskatchewan and Alberta are the only places in North America taking these actions right now, said Mokdad.

Alberta chief medical officer of health Dr. Deena Hinshaw says the province is phasing out regulations and protocols in order to prepare health care for seasonal illnesses in the fall. (Chris Schwarz/Government of Alberta)

Decision-makers looking at fully reopening ought to consider how to improve ventilation in buildings, as the novel coronavirus is transmitted through the air, said Mario Possamai, a SARS researcher who worked on several reports and investigations related to COVID-19.

Precautions implemented to prevent airborne transmission have been effective in controlling the spread of the virus, and those efforts should focus on high-risk settings and ensuring people working there have proper respirators, he said.

"If you do that, you have a better opportunity to safely reopen," Possamai said, adding that the cost of improving ventilation is cheaper than a lockdown.

Herd immunity not yet reached: experts

Dr. Nazeem Muhajarine was surprised to hear Hinshaw's announcement last week.

"It is premature," said Muhajarine, professor of community health and epidemiology at the University of Saskatchewan.

"We haven't reached that level of collective immunity that we want to see before we can be thinking about an endemic situation."

Upward of 80 per cent of the population has to be immune from COVID-19, either through infection or vaccination, before herd immunity occurs, according to Mokdad and Muhajarine.

COVID-19 vaccines have only been approved for people aged 12 and up in Canada, so most children cannot be protected yet.

As of July 30, about 65 per cent of eligible Albertans have received both doses of a COVID-19 vaccine. Only 63 per cent of eligible people in Saskatchewan have received both doses.

About five per cent of Alberta's population — including children — have contracted COVID-19, while just over four per cent of Saskatchewan's population has tested positive for the illness, according to provincial data.

Neither province is near the herd-immunity threshold.

At some point, society will have to learn to live with COVID-19. But evidence suggests now is not the time for policy changes seen in Saskatchewan and that are planned to occur in Alberta, said Muhajarine.

Public health experts are concerned about completely reopening, in part because vaccinated in places like the United States are spreading variants of concern. (Evan Mitsui/CBC)

Part of the concern is that variant strains of the novel coronavirus — namely the delta variant — are more transmissible, and vaccinated people are contracting those strains of the virus in places such as the United States and United Kingdom, said Mokdad.

The Centers for Disease Control and Prevention in the U.S., for example, has changed its messaging for vaccinated people as a result. Fully-vaccinated people in COVID-19 hotspots are now advised to wear masks when inside public places, as they could spread the novel coronavirus.

"We need to be very careful," said Mokdad.

Vaccinated people who do test positive for COVID-19 are rarely admitted to hospital or die.

Reopening could lead to 4th wave, projections suggest

The Institute for Health Metrics and Evaluation (IHME), an independent population health research centre at the University of Washington, offers COVID-19 projections for countries around the world based on available data and factoring in public health measures.

COVID-19 cases in Saskatchewan are rising again, and 578 residents have died from the illness to date, provincial data shows.

But the province's complete reopening could lead to a fourth wave and the number of deaths could increase to about 657 to 690 by the end of October, IHME projections suggest.

If Alberta lifts restrictions as planned, projections suggest the province will be in a fourth wave in September, and deaths could spike to about 2,504 to 2,753 by the end of October.

There have been 2,328 Albertans who have died from COVID-19 as of July 29.

ABOUT THE AUTHOR

Nicholas Frew

Reporter

Nicholas Frew is an online reporter with CBC Edmonton. Hailing from Newfoundland, Frew moved to Halifax to attend journalism school. He has worked for CBC newsrooms in Manitoba and Saskatchewan. Prior to joining the CBC, he interned at the Winnipeg Free Press.







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Alberta NDP call for public inquiry into government's handling of pandemic as Shandro agrees to release report

Author of the article: Ashley Joannou
Publishing date:Aug 03, 2021
NDP deputy leader Sarah Hoffman, left, at a press conference in Edmonton on Wednesday, April 28, 2021. PHOTO BY GREG SOUTHAM/POSTMEDIA

The Alberta NDP is calling for a public inquiry into the UCP government’s handling of the COVID-19 pandemic, saying Albertans deserve an arm’s-length and open look into the effectiveness of the decisions that were made.

At a Tuesday press conference, NDP deputy leader Sarah Hoffman said an independent review led by a retired judge and modelled after the Walkerton inquiry into contaminated drinking water in Ontario is necessary to look into the Alberta government’s recent decision to end isolation requirements, contact tracing and asymptomatic testing even as cases climb in the province.

She said it’s clear that Albertans can no longer trust their own government to keep them safe.

“A full public inquiry is necessary because it allows Albertans to understand what happened over the course of this pandemic and to plan for the future, so we don’t make the same deadly decisions again when we face another pandemic or another public emergency.”

The proposed inquiry would also look at the effectiveness of the government’s public health restrictions, contact tracing, modelling and public communication, Hoffman said.

It would also look into the circumstances that caused deaths in continuing-care facilities and a large number of cases at meat-packing plants.

The opposition has promised to hold its own inquiry if it becomes government next election.


The call came after Postmedia reported over the weekend that the government would not be releasing its third-party review into the pandemic’s first wave, with Alberta Health saying the information “was not particularly relevant to the evolving situation.”

Health Minister Tyler Shandro reversed course Tuesday morning, agreeing to release the report this week. He tweeted that the report in question would have been considered for release together with future reviews of the entire pandemic response.

“Given the interest in the report, the full report will be posted earlier than planned in the interest of full transparency,” he said.

In an email Tuesday, Premier Jason Kenney’s deputy press secretary Harrison Fleming accused the NDP of attacking the credibility of chief medical officer of health Dr. Deena Hinshaw and seeking a “witch hunt.”

“The NDP’s only objective is to politicize the pandemic with witch hunts that would stretch out for months, even years,” he said.

“What the NDP wants is a backward-looking, political circus that serves nobody. We’re focused on moving on from COVID, rebuilding the economy, and creating jobs and opportunities for all Albertans.”

The government has faced heavy criticism since announcing its plans to remove most COVID-19 protocols. The move has been questioned by the Alberta Medical Association, the Canadian Pediatric Society and five consecutive days of protests including outside the legislature in Edmonton.





Long-awaited report into Alberta COVID-19 response to be released this week: Shandro

By Kirby Bourne 630CHED
Posted August 3, 2021 
WATCH: With Alberta phasing out pandemic protocols despite a resurgence in COVID-19, concerns are growing about a fourth wave and the consequences for the rest of Canada.

A long-awaited third-party report into Alberta’s handling of the first wave of the COVID-19 pandemic will be released “later this week,” Tyler Shandro tweeted Tuesday morning.

Alberta’s health minister made the comments after media reports that the report wouldn’t be released.

“The media response to the reporter said the interim report only reflected the pandemic response to the first wave,” Shandro tweeted.

“The report would be considered for release together with future reviews of the entire pandemic response.


“Given the interest in the report, the full report will be posted earlier than planned in the interest of full transparency.”

Earlier Tuesday, Opposition leader Rachel Notley called on the government in question period to release the report.

“To the premier: where is it?” she asked.

“This report belongs to Albertans and they deserve to see just how badly Jason Kenney mismanaged the pandemic response from Day 1, and how badly they continue to mismanage this response today,” NDP deputy leader and health critic Sarah Hoffman said at a news conference.

Calgary doctors push back against Alberta lifting quarantine rules, COVID-19 testing and contact tracing

But the Official Opposition says releasing the report now is too little too late and is calling for a full public inquiry into the government’s handling of the pandemic.

“Enough is enough,” Hoffman said.

“This is more than a broken promise from Tyler Shandro. This is evidence of a corrupt and secretive government working to deceive the public.”

READ MORE: Coronavirus: Third-party review of Alberta COVID-19 response expected in early 2021







“This government has had an issue with transparency throughout the pandemic,” Dr. Joe Vipond, an ER doctor from Calgary, said while attending a rally outside the legislature Tuesday.

“You don’t know and I don’t know how many people have gotten sick in hospital. You and I don’t know how many people have died from in-hospital-derived infections. We don’t know if there have been assessments of provincial buildings or schools or hospitals to ensure that there’s no airborne transmission. In fact, they won’t even say the words ‘airborne transmission,’ anybody in the government, including our chief medical officer of health.

“We need more transparency from the top to the bottom, including that report.”

The NDP is calling for a public inquiry — led by a retired judge — into the UCP government’s handling of the entire COVID-19 pandemic.

Hoffman went so far as to promise the inquiry will still be done if the NDP wins the next provincial election.

Paramedic says AHS’ COVID-19 rule changes put him and colleagues at risk

Hoffman didn’t have a time or cost estimate for how long an inquiry of this nature would take, but she said that it is “absolutely necessary,” and that it would take longer and cost more “the more they (the UCP) delay.”

“Minister Shandro has committed to releasing the independent first wave report this week and we will continue to review our pandemic response measures,” a statement from Alberta Health to 630 CHED said. “And of course Alberta Health officials will be conducting a fulsome review of the province’s total response.

“However, let’s be clear, the NDP have no real interest in improving anything,” communications advisor Brett Boyden said. “They continue to ignore that the pandemic is global in nature.


“The NDP’s only objective is to politicize the pandemic with witch hunts that would stretch out for months, even years. What the NDP wants is a backward-looking, political circus that serves nobody.”

The $475,000 review was awarded to KPMG last August. The government had originally said it hoped the report would be released in late 2020.

Late last year, that timeline was changed to sometime in early 2021.

In March, Shandro said it was his understanding the authors of the report had completed the first draft.

According to a news release when the review was announced, the province said it would “enhance Alberta’s capacity to respond to a potential second wave of COVID-19 and any future pandemics,” and added that a “strong, coordinated response can help save lives, prevent wide-scale spread of disease and help jobs and the economy bounce back more quickly.”

–with a file from Adam MacVicar, Global News


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5th day of rallies in downtown Calgary calls for health measures to continue past Aug. 16


For the fifth day, protesters gathered in downtown Calgary calling on the province to keep COVID-19 health measures in place past Aug. 16.

CTV News CalgaryStaff
Published Tuesday, August 3, 2021

COVID-19 rallies continue in Alberta

CALGARY -- For the fifth day, a noon hour rally was held in downtown Calgary to protest upcoming changes to Alberta's COVID-19 health restrictions.

Crowds gathered in Alberta's two largest cities once again in the wake of the province lifting all restrictions as of Aug. 16.

That means masks won't be needed anywhere, including in taxis, on transit and in public schools and buildings. As well, Albertans who test positive will no longer need to quarantine.

Protesters have said they will hold daily rallies leading up to Aug. 16, calling on the government to rethink the move.

Health Minister Tyler Shandro said last week that the shift from a pandemic to endemic response in Alberta with regards to COVID-19 is due in part to the increasing amount of fully immunized Albertans.

Calgary Mayor Naheed Nenshi has said he is considering calling a special meeting of council to discuss the role the city can take, including whether to call another state of local emergency.

According to the latest numbers from the province, Calgary is leading in the number of active COVID-19 cases at 990, well ahead of Edmonton at 301.

"We're trying to do whatever we can as a civic government with very, very limited ability and power, but the right thing to do would be for Dr. Hinshaw and the premier to come out and say 'Look, we went too quickly, we can see the case counts are going up. Let's go back and put some measures in place,'" said Coun. Jyoti Gondek, who is running for mayor in October.

"I have zero confidence, we're going to do that."

Another councillor running for mayor, Jeromy Farkas, said protesters need to show why a continuation of health measures is needed.

"We can't pick and choose when to support the scene," he said.

"Dr. Hinshaw has made the call, if people think she and her team have got it wrong then they need to prove it rather than stir people up based on emotional arguments."



For the fifth day, protesters gathered in downtown Calgary calling on the province to keep COVID-19 health measures in place past Aug. 16.

Calgary mom contemplates leaving Alberta amid changing COVID-19 rules


BY STEFANIE LASUIK

Posted Aug 3, 2021 1:18 pm MDT

CALGARY – A Calgary parent is considering moving her children out of the province due to Alberta’s stance on COVID-19 measures.

Last week the province announced it would no longer require isolation for positive cases, reduce testing and contact tracing, and lift the mask mandate in schools.

“What do we do here?” said Krista Li, who is concerned about the changing COVID-19 rules in Alberta.

“How do we as parents send our child into an environment that we know isn’t safe?”


Li worries about her children ending up in the hospital, developing long COVID, or passing the virus along to their elderly grandparents who live with them.

“It’s bone-chilling to think that my child can be sitting in a classroom with somebody who is COVID positive and they have no requirement to be at home. Parents have no requirement to report that to the school. It’s the stuff nightmares are made of. It’s hard for me to speak about without getting emotional because these are my kids. It is my job to protect them,” she said.

“It is very selfish to minimize and say, ‘Well, kids just get sick.’ This isn’t the flu. I would like our premier to understand that. This isn’t the flu. And I think when scientists and when doctors and when researchers and epidemiologists are telling us this is dangerous, it’s on us to listen.”

Li says she’s left to contemplate the mental health effects of at-home schooling, or taking them back to her hometown in Newfoundland for school, leaving her husband behind

Dr. Ruth Grimes, the president of the Canadian Pediatric Society spoke with CityNews, and said more needs to be done.

“I think that these basic public health measures should not be set aside.”

Cases in younger people have increased in the United States, where some places have re-imposed mask mandates. In Canada, children and teens made up 1.9 per cent of COVID hospitalizations as of Friday.

“Children are a small population of those who have been hospitalized let alone going to ICUs, and thankfully who have died. But that doesn’t mean that we shouldn’t still be concerned about those and the fact is that you don’t have enough information to comment on likely is long COVID symptoms in children and what those mean,” added Grimes.

“It’s a knot in your tummy,” said Li. “And no matter what solution you come up with, it sucks. It’s a buffet of poor choices.”

She says school boards need to release their plans so parents can make informed decisions.

In the meantime, Grimes added that it’s important for parents to keep up the fundamentals and stay positive even as they’re concerned.

“We want adults in our community to protect our children. We want our children to be able to go back and have a good start and a return back to normal contact with their friends, normal play, normal physical activity.”

CHRISTIAN SCIENCE IS NOT SCIENCE
Kenney maintains changes to COVID-19 rules backed by science

BY NEWS STAFF

Posted Aug 3, 2021 

CALGARY – Premier Jason Kenney says he understands concerns from several Albertans over the province’s plan to scale back COVID-19 protections, but maintains the changes are backed by science.

Kenney said Tuesday there has long been a debate about the dangers of the disease and the damage done by restrictions.

But his response to concerns was very similar to what we heard last week from Health Minister Tyler Shandro.

These changes — including removing mandatory isolation requirements, some testing and contact tracing details — have some people concerned it will lead to a fourth wave of the virus and there won’t be enough checks in place to catch it before it takes hold.

When asked about the adjustments, Kenney said it was at the behest of Chief Medical Officer of Health Dr. Deena Hinshaw.

“No, it’s not a direction I asked her to pursue,” Kenney said, as he added the recommendations were accepted without modification in July.

Kenney read off several recent quotes from Dr. Hinshaw during the press conference, including points that this change will allow officials to focus on other public health issues rather than just COVID-19. But on the removal of mandatory isolation, Kenney said this was not in response to resourcing concerns.

“I think Dr. Hinshaw’s concerned that anybody who might have minor symptoms of cold or flu, if all of them are automatically put on two weeks of self-isolation that can be very disruptive,” he said.

But with that said, isolating after a positive COVID-19 test is still heavily recommended and Kenney felt that people will practice personal responsibility and understand the need to isolate in order to protect the wider population.

A common theme during recent protests is people being concerned about what it means for the return of school in fall and the risk posed to children.

Kenney said it should not be much of a concern for people and there are fewer adverse effects for children who catch COVID-19.

“It’s important to highlight that the risks for children posed by COVID-19 are extremely low, they are lower than for the typical annual flu,” he said. “Kids aged five to 14 have 140 times greater risk of emergency department visits for a sports-related injury in 2019 than their risk for COVID-related hospital admission since March 2020.”

The premier did not want to act like COVID-19 is completely a thing of the past, but vaccines are the driving factor in making them consider the changes.

“Dr. Hinshaw and I both have said that we expect to see an increase in cases in the fall based on seasonality, but that will likely be concurrent with an increase in flu and cold cases as well,” he said. “Within the foreseeable future we will have three-quarters (of the eligible population) fully vaccinated, meaning that effectively COVID does not pose a risk for 99.999 per cent of that population.”

Kenney was citing data from the United States in that figure, and said while Alberta is slightly behind the national average on vaccinations we are still far above most other jurisdictions around the world.

The premier also said it was unfortunate to hear people calling for a return to the mask mandate in Calgary, referring to councillor and mayoral candidate Jyoti Gondek, but he does understand why some people would still be holding on to various concerns after dealing with the pandemic for so long.

“I think it’s regrettable that we’ve seen comments attacking the expertise of our brilliant chief medical officer of health,” he said. “It’s time to follow the data. It’s time to listen to the science.”


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