Thanksgiving Weekend Update

October 8th, 2022

Canadian Situation:

Canadians could be in a better position ahead of this holiday weekend. Unfortunately, the premature lifting of public health protections like masking and the failure to invest in indoor air quality has led to higher rates of infection compared to Thanksgiving weekends of past years.

Bill Comeau updates on twitter, see link below.

More cases compared to Thanksgiving weekend 2020 & 2021

Cases are currently much higher, which is concerning as we usually see cases take off after the Thanksgiving weekend (see graph above). With no protections in place, kids in school, less testing/surveillance, and with new variants being detected, this may set us up for a difficult fall. This coming at a time where more kids than ever are getting sick, healthcare/frontline workers are exhausted, and hospitals across the country are above capacity with some emergency rooms shutting down. Every resident in Canada needs access to health services at some point: preventing Covid infection/related illness is one of the best things we can do to keep healthcare running and support our healthcare professionals.

Shorter re-infection time with omicron variants.

There had been some information sent to some schools in Atlantic Canada suggesting that reinfection wasn’t possible or likely within 90 days: THIS IS INCORRECT FOR OMICRON. We know re-infections can occur with several weeks and a recent study has shown that these quick re-infections aren’t a rare occurrence.

https://www.medrxiv.org/content/10.1101/2022.09.13.22279912v1

The graph above shows that a significant number of re-infections occur less than 10 weeks following the last Covid-19 infection. It also shows that the BA.2 variant represents a lot of these quick re-infections. The weekly variant breakdown in the table below shows that BA.2 is the fastest growing variant in Canada right now. While it represents a smaller proportion in this table, it is important to remember that this represents swabs collected 3-4 weeks ago. There is usually a 3 week turn around when sending samples to the National Lab in Winnipeg to be sequenced.

The good news is that having this information means that we are in a better position to take what precautions we feel necessary for ourselves and our families.

Atlantic Provinces:

New Brunswick
New Brunswick has seen infections go up to about 1250 per day with a slight decrease in daily hospital admissions, no change in ICU admissions, and 2 people are dying every 3 days. About 50 people a day get infections which will prevent them from engaging in normal daily activities for at least a month: in total, this represents about 1.3% of the population. Hospitals are about 2% overcapacity, Covid-related health expenses are about $127,000 a day, and about $108,000,000 has been spent so far this year.

The Covid Risk Index is currently MODERATE.
Newfoundland & Labrador
Newfoundland and Labrador has seen infections go up to about 350 per day with an increase in daily hospital admissions, an increase in ICU admissions, and 1-2 people are may die this month. About 32 people a day get infections which will prevent them from engaging in normal daily activities for at least a month: in total, this represents about 0.2% of the population. Hospitals are less than 1% overcapacity, Covid-related health expenses are about $36,000 a day, and about $72,000,000 has been spent so far this year.

The Covid Risk Index is currently ELEVATED
Nova Scotia
Nova Scotia is in a far worse position with infections increased to about 4,500 per day with a slight decrease in daily hospital admissions, an increase in ICU admissions, and about 3 dyning every 2 days. About 162 people a day get infections which will prevent them from engaging in normal daily activities for at least a month: in total, this represents about 2.5% of the population. Hospitals are about 5% overcapacity, Covid-related health expenses are about $435,000 a day, and about $127,000,000 has been spent so far this year.
Despite having similar issues with staffing challenges, residents without a family doctor, and resource management issues as other Atlantic provinces, NS consistently shows the worse infections rates extended over the last 6 months (even compared to the rest of Canada).

The Covid Risk Index is currently ELEVATED.

Prince Edward Island
PEI has seen infections go up to about 1028 per day with an increase in daily hospital admissions, an increase in ICU admissions, and 1 people dying every 5 days. About 33 people a day get infections which will prevent them from engaging in normal daily activities for at least a month: in total, this represents about 2.2% of the population. Hospitals are 6% overcapacity, Covid-related health expenses are about $88,000 a day, and about $18,000,000 has been spent so far this year.

The Covid Risk Index is currently ELEVATED

Actions we can take to stay safe this Thanksgiving Weekend.

Harvard’s School of Public Health put out a great guide to gathering safely during Thanksgiving which can be found HERE.

Some safety tips:

  • Used Rapid Antigen Tests (RATs) before attending any event. #Test2Protect
  • Do not attend events if ill, even if RATs are negative.
  • Consider reducing you number of contacts, especially if attending multiple events.
  • Eat outside if possible.
  • Offer masks if staying indoors. #CovidIsAirborne
  • Increase Ventilation by opening windows.
  • Check indoor air quality with a CO2 monitor if possible, more info HERE.
  • Use HEPA or CR Boxes to filter the air.
  • Considering virtual or a mix of virtual/in-person so that everyone can feel safe and included.
  • Try to respect that we don’t all have the same risk factors of severe outcome or comfort level. Whatever you believe, I’m sure everyone wants their family and friends to feel comfortable and safe during gatherings. We’ve lost enough to Covid-19 already.
  • If you have concerns, try to bring them up with family before an event and discuss in terms of how you feel about your personal risk and comfort level. Try to find common ground because family gatherings shouldn’t be political. You don’t need to believe all the same things to connect: it’s just about respecting the concerns of vulnerable family members and adapting.
  • Let’s make finding common ground the #NewNormal in this era of “living with Covid”. Clean air, staying home if sick, and staying socially connected with loved ones is something most everyone can agree on. #StaySafe!

Finding unity in a ‘New Normal” in issues that impact everybody.

Featured

#MLAMonday & #peopleB4politics & #NovaScotiaStrong

There has been little political discussion on Covid-19 and impacts to health and social resources despite increasing rates of illness, hospital overcapacities, and concerns on indoor air quality.  Our elected representatives have been mostly silent while over 1 person a day in Nova Scotia loses their life to a preventable infection.  It’s impacting education, employment, financial resources, and access to healthcare with an estimated 2.5% of residents currently affected by Long Covid. Covid is now the 2nd leading cause of death in Canada.

And yes, there are many issues of concerns these days, but all of them have been impacted by Covid-19, related business continuity (or lack thereof), and governments refusal to promote our collective resilience by adapting to a New normal.  There are few who would argues that kids need to be in school, that normal healthcare operations must be a priority, and that economic stability for both business and families is of critical importance.  Frankly MLA’s will discuss all these things without ever pointing to a failure to adapt to Covid-19 as the larger systemic issue. 

Instead, fingers are pointed at the Feds on issues that are in provincial jurisdiction (and despite Federal dollars provided to address Covid-19), while launching some excellent PR on the $351,000,000 surplus that was originally a -$585,000,000 deficit.  That is almost a Billion dollars that the NS government magically found in 6 months.  Where did that even come from?  Why has it not been invested in health or social resources for many falling through the gaps?  Why can’t we guarantee sick days?  Why are people paying out of pocket for healthcare that is supposed to be covered by MSI?   Why aren’t we better supporting small business owners that continue to close due to economic hardship?

What is particularly brilliant about this divisive PR and public discourse is that it is causing rifts amongst residents, as if we are somehow competing for resources funded by our own tax dollars.  I struggle with the concept that there is so much available surplus while Nova Scotians have been living through the worst wave of Covid-19 in terms of deaths, longer hospitalizations, rates of infections, even more precarious housing, interest rate increases, and inflation.  So instead of collectively looking for solutions that address multiple problems or asking our elected reps to lead, we are debating with each other.  It sure makes being a politician easier in some troubling times.

But what if these times didn’t have to be so troubling? 

What if people had the basic information to make informed choices on what kind of measures were good for their family?  What if people could afford to stay home while sick without being afraid of losing their housing? How is better indoor air ever quality a bad thing? How has housing, poverty, and healthcare issue gotten even worst while government claims these billion dollars to be an indication of a better economy?  Why aren’t we spending some of this $350,000,000 to help with these issues?  What happened to getting through this together and #NovaScotiaStrong?

What no one is saying is that good social health is good public health is good economic health.  These are not separate issues: they are all social determinants of health which is supposed to be the underlying premise of public health.  And all these important issues have been impacted by the pandemic and current refusal of government to stop testing Einstein’s theory of insanity.  The things we have all been doing in the last 6 months are not producing the results that we need to move forward as a community.  Our elected leaders need to step up to meet that challenge, and that starts with some hard conversations.

So, are you concerned about the impact Covid-19 has had on any of these issues?

  • Housing and food costs
  • Interest rate increases
  • Hospital overcapacities and backlog of critical health service
  • Insecure employment
  • Childcare issues
  • Lack of sick days
  • Air quality in public spaces
  • Inclusion and accessibility of services for those at high-risk
  • Impacts to mental health services
  • Repeated infections in frontline workers
  • Long Covid as a disability
  • Covid-19 and racial disparities
  • Critical issues with supply chains
  • The impact of climate change on emerging infectious diseases

Then email or call your MLA as part of #MLAmonday and tell them your concerns.  Ask them to start working on the critical issues that matter most to your community.  Their job is to put #peopleB4politics.

Or share your concerns and tag us on twitter @Covid19DataNS with the hashtags #MLAmonday and #peopleB4politics. Might as well tag @TimHoustonNS as well!

For anyone interested in how Covid-19 has impacted social determinants of health and health equity, I’ve started a page collecting reports and publications on the this. Feel free to contact our Twitter account if you have a paper to recommend!

Halifax Examiner Article “Leadership Matters”

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How a lack of good leadership in Nova Scotia’s education sector is undermining implementation of public health recommendations – Janice Brown

Screen Shot of NS Public Health Guidance taken directly from their website HERE

Original article published September 27th, 2022 in the Halifax Examiner

It may come as a shock to some students, teachers, and parents to learn that Nova Scotia’s Chief Medical Officer of Health, Dr. Robert Strang, strongly recommended masks be worn in school whenever possible this fall. But he did. 

I know he did because I watched his last press conference before schools reopened, and read the advice posted on Nova Scotia’s Public Health website.

Why is that? Why doesn’t everyone know what Strang and his colleagues have recommended?

To my mind, a big part of the problem is lack of good leadership on the part of Premier Tim Houston, Minister of Education and Early Childhood Development Becky Druhan, and other leaders in the education system itself. 

To the dismay of many, Houston hasn’t acknowledged the existence of the pandemic, let alone offered condolences to families of the 522 Nova Scotians who have been lost to COVID, for many months now. 

In fact, Houston’s last tweet on either topic is dated June 27, when the province announced vaccine boosters would be made available to those 50+ years of age — despite the fact Nova Scotia had some of the highest rates of infection, hospitalization, and death in the country this past summer, and nearly 80% of all COVID deaths in this province have occurred since he took office. 

Given Houston’s stated unwillingness to be a “COVID premier,” his failure to amplify Strang’s recommendations on a regular basis has significantly undermined their implementation. 

Education Minister Becky Druhan adopted a similar strategy. You have to go back to early July to find any reference to COVID on Druhan’s Facebook or Twitter feeds, despite the fact Nova Scotia’s Education Act makes her legally responsible to ensure kids’ classrooms are safe. She too has done nothing to ensure educators and students heed Strang’s warning and recommendation to mask up.  

And what about leaders in the system itself? 

Based on the number of disturbing stories I’ve heard from family and friends over the past week, it appears too many teachers, principals, and administrators aren’t just ignoring Strang’s advice, they’re actively pressuring students and parents to do the same. 

Some teachers report they’ve even been discouraged from explaining to students why masks are still recommended. This is especially disappointing since educational leaders have the same duty as Druhan to keep kids safe. 

Finally, what about the Nova Scotia Teacher’s Union? Surely, it understands that Strang’s recommendation means its members face “unsafe working conditions” when the majority of teachers and students attend school maskless. Unfortunately, aside from very recently raising questions about the sufficiency of school ventilation, it appears the NSTU has done little, at least, publicly, to advocate for the health and safety of its members or encourage them to take the precautions necessary to reduce transmission and protect themselves, their families, and their communities. 

In the past, parents and community members might have been able to bring concerns about such failures of leadership to their elected school board representatives, but school boards were disbanded by the previous government and Houston has taken no steps to re-establish them since taking office, despite promising to do so during the last election campaign. Currently, Regional Centres for Education are headed by civil servants who have little choice but to toe the Conservative party line. 

Some still argue COVID poses less risk to kids and that, therefore, mitigation measures like masking aren’t needed. But that’s not Strang’s view. And it’s not the view of experts around the world who are increasingly raising alarms about the real and substantial danger the virus poses to kids’ health in the short and long term. 

For example, a recent study found that between 5 and 10% of children diagnosed with COVID continued to have symptoms 90 days after infection. Earlier studies suggested a COVID infection significantly increased children’s risk of developing lifelong conditions, such as diabetes, cognitive impairment, and vascular issues.  

Even if one accepts the notion that “most” kids will be okay despite being repeatedly infected, what about those we know are vulnerable? The failure of political and education leaders to support masking and other mitigation measures means those kids face real barriers to education. 

There’s nothing “inclusive” about forcing students and their families to choose between kids attending school versus staying alive and healthy. Schools have a legal duty to accommodate persons with disabilities to the point of “undue hardship” but the Houston government has refused to direct them to implement even the least costly and intrusive measures (such as mandatory masking and air filters in classrooms) in order to fulfil that duty. 

And what about vulnerable family members whose health is more at risk now that most mandatory mitigation measures have been dropped?

Such utter failures of leadership are deeply disturbing — more so because there seems so little we can do about them. There are no school boards to which parents and others can take their concerns. Houston has made it clear he doesn’t much care what the public thinks of his handling of the pandemic. The vast majority of letters, emails and telephone calls to his office go unacknowledged and unanswered. 

The same is true of Druhan. And the directors of Nova Scotia’s Regional Centres of Education simply repeat the line that they’re “following the advice of Public Health,” which is demonstrably false given they’re ignoring (some might say actively contradicting) its most important advice.

So what would good leadership in education look like? 

To begin, it would be based on sound science, good data and Strang’s advice. It would reflect a strong focus on keeping kids and teachers safe. It would encourage students to exercise personal responsibility to care for other people as well as themselves, and consider how their actions might affect their classmates, teachers, families, and communities. It would model responsible behaviour, inspire good citizenship, and applaud the courage and leadership of students and teachers who choose to do what’s necessary to limit infections — even in the face of mounting social pressure to act as if the pandemic is over. 

Good leadership would consist of Houston, Druhan, principals, teachers, educational assistants, and administrators consistently wearing N95 masks indoors and encouraging students to do the same. 

Good leadership would ensure students aren’t required to remove their masks in order to participate in mandatory school activities. It would require schools to test air quality in classrooms regularly and improve ventilation as needed. It would encourage and support students and teachers eating lunch outdoors or in well-ventilated spaces. 

Good leadership would revise the curriculum to ensure all students understand the dangers posed by communicable diseases and the important role vaccines and other mitigations play in limiting their harmful impacts on individuals and communities. 

Most importantly, good leadership would encourage students to show empathy towards others, and inspire them to do what they can to help limit transmission. 

We truly are all in this together. It’s time Houston, Druhan, and leaders in our education sector began acting like it — by demonstrating personal responsibility and good leadership, and by supporting and encouraging students and their families to do the same. 


Janice Brown is a retired lawyer who worked as a solicitor, senior policy analyst, and cabinet adviser with the Nova Scotia government. She is also a member of the COVID action group PoPNS (Protect our Province NS). You can follow her on Twitter @PoP_NovaScotia

The original article found in the Halifax Examiner can be found HERE

Saltwire Article: Nova Scotia’s ‘living with COVID’ strategy backfires

SHIRA LURIE • Guest Opinion. The original article can be found HERE.

Shira Lurie is an assistant professor of history at Saint Mary’s University in Halifax. Her articles have appeared in The Washington Post and The Toronto Star. You can follow her on Twitter @ShiraLurie.

We once showed the world how to successfully live with coronavirus — so what happened?

In March, when Nova Scotia announced the removal of COVID-19 protections, Premier Tim Houston and Chief Medical Officer of Health Dr. Robert Strang explained that it was “time to move away from two years of crisis response” and learn to “live with COVID.”

Four months into this strategy and it is clearly not working. Half of all Nova Scotian COVID deaths have occurred after the government lifted protections — that’s over 200 people, including 35 primary caregivers. Case counts are up, wastewater levels of the virus are up, hospitals are overcrowded, businesses are short staffed, and we now have the second highest COVID hazard risk in the country.

We are not successfully living with COVID. But we once did.

For the first half of the pandemic, Nova Scotia was one of the few places where life continued in relative normalcy. In November 2020, the New York Times published a piece exalting the province as “a COVID-free world” that showed “beating back the virus is possible.”

“It’s baffling to watch the epidemic in the United States spin wildly out of control, knowing it could easily be different,” observed the author.

Nova Scotia created and maintained this oasis by keeping case rates low. The government utilized protections like mask mandates, widespread testing and quarantines to minimize transmission and so avoid the crushing exponential growth suffered elsewhere.

Rather than curtailing individual freedom, these measures enhanced it. While other provinces locked down, Nova Scotian schools and businesses remained open. While other places saw mass suffering and death, Nova Scotians remained relatively unscathed.

But when the government changed, so did the province’s pandemic approach.

In his first few months as premier, Tim Houston flirted with ending protections, like asymptomatic testing and mask mandates, but ultimately reversed course. Then Omicron hit in December and triggered an unprecedented spike in cases.

But rather than making a firm commitment to bending the curve, the government articulated a new tolerance for high case rates in the province. They then used this tolerance to lift protections, predictably fuelling further transmission, which they spun as acceptable. “The increase in positive tests and hospitalizations shows the impact of both a highly infectious strain of COVID-19 and the second phase of our reopening,” Dr. Strang acknowledged in March. But while “we have more community transmission,” he insisted that “none of this is unexpected.”

The fallout

The unchecked spread of COVID through the population has resulted in increased death and disease. It has pushed an already strained health-care system to the brink, with hospitals cancelling surgeries and reporting ER overcrowding, long wait times and closures. Staff shortages for other critical services, like transit, have resulted in route cancellations. And these short-term disruptions likely pale in comparison to the future social impacts of long COVID and post-COVID health issues that one in five people will experience, even after a mild case.

“The reality is, the more we let COVID control our daily lives, the longer we will see the negative impacts,” Houston has maintained. But lifting protections has clearly put COVID in control and the negative impacts abound.

Despite the government’s insistence, it’s obvious that life has not returned to normal. That’s because COVID is not the monster under the bed — the danger that recedes the less attention you pay it. It is the forest on fire; ignoring it only makes it less manageable.

Of course, new variants will continue to pose a challenge. But the only way through the pandemic is to return to the strategy of keeping cases low. It will dramatically reduce the excess suffering and death of Nova Scotians. It will relieve the pressure on health care and other services. It will save many people from the long-term consequences of this virus.

We have proven it is possible and we can do it again.

The opposite — the idea that society can function properly amid the unchecked transmission of a highly contagious airborne virus — is a fairy tale. And it won’t come true no matter how hard we wish it.

If we are going to live with COVID, we need to also live in reality.

As taken from the original article

The Nova Scotia Pediatric Pandemic Advisory Group Letter:

An Open Letter to Nova Scotia Parents and Students, September 6th, 2022.

“As we prepare to return to school this fall, we know that questions about how best to protect students, teachers, and families/caregivers are being asked. Schools, like hospitals, provide an essential service. Students and educational staff need to be healthy and able to attend so that all can benefit.

During the past 2 ½ years, we have learned a lot about what works to decrease respiratory illnesses including COVID-19, influenza and the common cold. We need to use what we have learned and work together as we begin another school year to reduce the spread of COVID-19 and other respiratory illnesses.

Masking, vaccination and hand washing have been cornerstones of the pandemic response and have proven effective in reducing transmission of infections. While it is reasonable to relax some of the recommendations that were crucial during earlier waves of COVID-19, masks, vaccines and good hand washing remain our best tools to fight the spread of infection.

Masks: Masks do reduce transmission of COVID and other respiratory viruses. We recommend wearing masks in the school setting when students or teachers:

  • are mildly unwell (i.e. runny nose), but still able to attend school.
  • are in close contact with someone who has respiratory symptoms who can’t wear a mask.
  • are worried about potentially bringing home respiratory viruses to family members or loved ones who are at higher risk of becoming severely ill.
  • feel more comfortable wearing a mask for any reason.

What else can help?

  • Make sure you and your family receive all recommended COVID-19, influenza and other vaccinations.
  • Stay home from school/work if you are sick and/or experiencing cold or flu-like symptoms, including fever, vomiting or diarrhea, or new cough.
  • Use good hand washing practices, including after returning home from being out in public, before eating, and after toileting.

Finally, it is important to ensure that students are not bullied about whether they do or do not wear a mask. Discuss this with your children. Be kind to one another, and tough on viruses.

Nova Scotia Pediatric Pandemic Advisory Group:

Dr. Alexa Bagnell (IWK Chief of Child & Adolescent Psychiatry)

Dr. Tara Chobotuk (IWK Pediatric Emergency Medicine and Chief of Community Pediatrics- Central Zone)

Dr. Jeannette Comeau (IWK Pediatric Infectious Diseases Specialist and Medical Director, Infection Prevention & Control)

Dr. Joanna Holland (IWK General Pediatrics & Hospital Medicine)

Dr. Katharine Kellock (Community Pediatrician- Sydney)

Dr. Mike Nash (Chief of Pediatrics- Valley Regional Hospital, Kentville)

Dr. Sarah Shea (IWK Developmental Pediatrics)

Dr. Andrew Lynk (IWK Chief of Pediatrics)”