Making The Right Choice

Pharmacist talking to patient

As a pharmacist I meet people every day that have made the wrong choices about their health. Yet, I try to treat them with compassion and understanding. I try my best to help them and to educate them in ways to improve their health. This is the same when I deal with patients that are unvaccinated. I try to explain the benefits of getting vaccinated and try to allay their fears about the vaccines. I try to educate them and direct them to resources that will let them see for themselves the benefits of vaccination as well as the dangers on not getting vaccinated.

I agree. It’s a social responsibility to get vaccinated. However, the omicron variant is highly contagious and vaccines are not fully effective at stopping you from contracting it. This means that most of us are going to get it anyway whether we are triple vaccinated or not. The main benefit of vaccines is to reduce the severity of the symptoms and to hopefully keep you from getting very sick and dying.

Elderly man holding a young childs hand walking

The fact is that in Ontario, almost 90% of us are vaccinated. However, 10% of the unvaccinated population take up 50% of ICU beds. This clearly demonstrates that the unvaccinated are at a greater risk of getting very sick. There is ample evidence from all over the world that the virus can start replication before the immune system can stop it. The vaccines prime our immune system and help prevent severe disease, but they cannot stop the spread; they can only limit it. The same is true about Vaccine Inequity. Until, we vaccinate the whole world instead of just selfishly vaccinating Canadians, we will not get out of this Pandemic. Until we vaccinate the world, there will be another variant and another variant and… And speaking of variants, a new variant can develop from anywhere, variants can come from Canada just as easily as they can come from South Africa or Denmark. We have to be realistic and treat this pandemic as being endemic and INCREASE OUR HEALTH CARE CAPACITY and increase our ICU capacity and increase the number of trained healthcare workers that we have.

Using simple math, if you catch Omicron, you probably caught it from one of the 90% of vaccinated individuals that you socialize with, rather than one of the 10% of unvaccinated individuals that by now you probably don’t socialize with anyway. Let’s stop demonizing individuals for making their own life choices (even is they are the wrong choices). Let’s instead direct our anger to the politicians who starved the hospitals for funding, threw out our strategic PPE stockpile before the pandemic, and refused to provide sick days and rapid tests. Let’s never forgive administrators that prevented nurses in COVID wards from accessing N95 masks. Blaming individuals for systemic problems is not right. In other words, blaming a small minority of people who have not gotten vaccinated and allowing our governments to get away with not funding our health system responsibly for years is not the right thing to do. Politicians that did not responsibly fund health care should be the ones getting the blame. CALL YOUR MPP AND MP AND ASK THEM WHAT THEY ARE DOING TO EXPAND HEALTHCARE CAPACITY. Give THEM and earful instead of ostracizing your neighbor.

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Hormone Therapy

Nurse checking labels on hormone therapy medication

Hormonal therapy is sometimes given in conjunction with radiation to boost the effectiveness of prostate cancer treatment. Hormonal therapy may also be used to shrink the size of large prostate glands to ensure the proper placement of the radioactive seeds.

Combination hormonal/radiation therapy is now a standard option for men with cancer that has extended beyond stage T3 or T4 or whose cancer is considered high-risk. Studies show that it reduces the risk of dying from prostate cancer and other causes more than with either treatment given alone.

patjient on an MRI getting scanned

Studies also show that patients who have advanced prostate cancer have better outcomes if hormonal therapy continues for at least two years after radiotherapy and that hormonal therapy and radiation given together were more effective than radiation by itself at treating recurring prostate cancer after prostatectomy.

Combined treatment is more likely than radiation alone to cause erectile dysfunction (ED). Until more is known, be aware that side effects do occur with combined therapy and that it’s important to discuss this issue with your doctor.

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New Insecticide That Reduces Cases of Malaria

mosquito net over someone reading outdoors

A mosquito net coated with a new insecticide that makes the insects unable to move or fly has reduced cases of malaria in children by about 40 per cent, according to a new study conducted in Tanzania involving Canadian researchers. The two-year study involved 39,000 Tanzanian households.

mosquito repellant candle

In randomized trials with over 4,500 children aged six months to 14 years, mosquito nets coated with the new insecticide chlorfenapyr and with pyrethroids — traditional chemicals that kill insects — reduced the prevalence of malaria by 43 per cent in the first year and 37 per cent in the second. Traditional mosquito nets are only coated with pyrethroids. The double-coated netting also reduced clinical episodes of malaria by 44 per cent over the two-year study period.

Chlorfenapyr is the first new class of insecticide approved to fight malaria in 40 years.
Mosquito nets covered with insecticide have contributed greatly to reducing the impact of malaria in sub-Saharan Africa for the past decade. But there’s been a slowdown or reversal of that trend more recently, particularly because the Anopheles mosquitoes responsible for the spread of malaria have become increasingly resistant to the pyrethroid insecticides.

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Moderna Approval on Children Aged 6 to 11

Male youth getting vaccinated

On March 17th, Health Canada authorized the use of the Moderna Spikevax COVID-19 vaccine in children 6 to 11 years of age. This vaccine was previously authorized for use in patients 12 years of age and older. NACI recommends that a complete series with an mRNA COVID-19 vaccine should be offered to children in the authorized age groups without contraindications to the vaccine, with a dosing interval of at least 8 weeks between the first and second dose. (Strong NACI Recommendation)

child wearing a mask doing crafts

For children 6 to 11 years of age (which is the age group in which the Moderna Spikevax 50 mcg primary series vaccine is authorized):

Moderna Spikevax (50 mcg dose) may be offered as an alternative to PfizerBioNTech Comirnaty (10 mcg dose), however the use of Pfizer-BioNTech Comirnaty (10 mcg dose) is preferred to Moderna Spikevax (50 mcg dose) to start or continue the primary vaccine series.

Recommendations on the use of Moderna Spikevax COVID-19 vaccine in children 6 to 11 years of Age Although risk of myocarditis/pericarditis with the Moderna Spikevax (50 mcg) in children 6 to 11 years of age is unknown, with a primary series in adolescents and young adults the rare risk of myocarditis / pericarditis with Moderna Spikevax (100 mcg) was higher than with Pfizer-BioNTech Comirnaty (30 mcg).

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Canada’s First COVID-19 Manufactured Vaccine

COVID-19 Radit Test Kit

The first COVID-19 vaccine manufactured by a Canadian company will “very likely” not get the green light for emergency use by the World Health Organization (WHO) due to its ties to the tobacco industry.

The Quebec-based biopharmaceutical company Medicago’s vaccine marks the world’s first-ever plant-based jab for human use. The vaccine, called Covifenz, It’s also owned by tobacco company Philip Morris International — so the process is put on hold because it’s well known that the WHO and UN have a very strict policy regarding engagement with tobacco and arms industries. It’s very likely that it will not be accepted for emergency list using by WHO. Medicago’s COVID-19 vaccine is listed as “not accepted” in the WHO’s expression of interest phase.

COVID-19 Blood Vials

Canada has a contract for 20 million doses and an option for up to 56 million more, but Canada does not need them. More than 85 per cent of Canadians over the age of five are now fully vaccinated and going forward Canada is relying almost solely on the mRNA vaccines from Pfizer-BioNTech and Moderna.
Canada had promised to donate any excess vaccines it purchased to COVAX. If the WHO rejects Medicago’s vaccine, Canada won’t be able to donate any of its doses to the Covax alliance, which is desperate for doses to reach its goal of vaccinating 70 per cent of people in every country by July.

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Travel Mandates Changed For COVID-19

nearly empty airport

Fully vaccinated travellers entering Canada will not have to show proof of a negative COVID-19 test as of April 1.

Passengers may still be subjected to random PCR testing at the airport though they will not be required to isolate while awaiting their results.

Unvaccinated Canadians and other travelers who are exempt from the vaccine mandate will still need to provide a negative rapid antigen or molecular test, or an accepted form of proof of recent infection to enter the country. Unvaccinated travelers will also be tested on arrival, again eight days later, and will be required to quarantine for 14 days.

Air Traffic Workers confiscating contents

All travelers will still have to use the ArriveCAN app or online form to enter their proof of vaccination and other required information within 72 hours before their arrival in Canada. Travelers who do not complete this submission may face testing and isolation requirements, regardless of vaccination status, according to the government.

The requirement to be fully vaccinated in order to board federally regulated air, rail, and marine transportation remains in effect. Cruise ship passengers will still need to provide a negative antigen test taken within 24 hours before the scheduled boarding time, but will no longer need to be tested again to get off the ship.

If you’re 12 or older, you’ll need to be fully vaccinated in order to board domestic flights, VIA Rail and Rocky Mountaineer trains, and cruise ships.

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The Dominance of Omicron

covid hot spot map of the world

Health experts have warned since omicron took over as the dominant strain that everyone is likely to get COVID-19 at some point. Yet all of the data we have at this point suggests there are still millions of Canadians who haven’t been infected.

How can it be that two years into a pandemic marked by increasingly contagious variants, so many people remain COVID-free? What separates those of us who have tested positive from those who haven’t?

mask, gloves, and headphones with a note saying "Keep calm and protect your friends"

Reason 1: Because vaccines, masking and distancing works
Reason 2: Because you’ve remained totally isolated
Reason 3: Because you did actually have it, you just didn’t know
Reason 4: Because household transmission is not a given
Reason 5: Because, well, luck

While there are clear, well-established mitigation strategies that have helped lower individual risk of contracting COVID-19, a lot of it comes down to a hefty dose of just good luck. There’s a lot of randomness to COVID. There are people who seem to have minimal exposure who come down with it, and there are people who have heavy exposure who seem to do OK.

The truth is that experts are still learning about COVID-19.

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Two Years of COVID-19 Pandemic

hands pressing on hand sanitizer pump

https://theconversation.com/covid-pandemic-2nd-anniversary-3-things-we-got-wrong-and-3-things-to-watch-out-for-177618
Exactly two years ago, on March 11 2020, the World Health Organization (WHO) declared COVID-19 a global pandemic.

This was two months after there were reports of a mystery virus infecting people in Wuhan, the most populous city in central China. Early reports said the virus didn’t appear to be readily spread by humans. Well, the SARS-CoV-2 virus could indeed be spread by humans. It quickly travelled around the world, and has so far infected more than 450 million people. COVID-19, the disease it causes, has to date caused more than six million deaths, making it one of the most deadly pandemics in history. In those early days we knew very little about the virus and COVID.

Here are three things we realised were wrong as the pandemic wore on, and three things we need to keep a close eye on as we approach the endemic phase, where the virus continues to circulate in the population at relatively stable levels

 

1. Many were worried we wouldn’t get a vaccine
In early 2020 we didn’t know whether a vaccine against SARS-CoV-2 was possible. There had been previous attempts to develop vaccines against severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), two similar coronaviruses that also caused outbreaks this century. A few of these vaccines entered clinical trials, but none were approved.

Before COVID, the fastest developed vaccine was for mumps which took four years. But in under 12 months, Pfizer/BioNTech developed a successful vaccine. Now we have 12 vaccines approved for full use in different parts of the world, 19 for emergency use, and more than 100 still in the clinical trial stages. Both Pfizer and Moderna have also commenced clinical trials of an Omicron-specific vaccine. There are also several research groups around the world developing vaccines aiming to work against all SARS-CoV-2 variants.

2. Some thought we didn’t need face masks
In the early days, without a vaccine, to reduce transmission we had to rely on individual preventative measures such as hand hygiene, social distancing and face masks. Although there was widespread acceptance hand washing and social distancing protected against infection, face masks were much more controversial. Before April 2020, the US Centers for Disease Control and Prevention (CDC) advised against the wearing of face masks by the public. There were apparently two reasons for this. First, the CDC was afraid there wasn’t a sufficient supply of surgical and N95 masks, which were essential in high-risk settings. Second, it was thought at the time asymptomatic and pre-symptomatic people could not transmit the virus (we now know they can).Health authorities initially held off recommending face masks, but this quickly changed. However, on April 3 2020, the CDC changed its advice and recommended the general public wear multi-layered cloth face masks.

This has now been updated to wearing a well-fitting mask that is consistently worn. With the advent of Omicron, some experts say cloth face masks aren’t up to the task and people should at least wear surgical masks, or even better respirator masks like a P2, KN95 or N95.

Doctors in Hazmat suits treating patient

3. We worried a lot about surface transmission
In the early days of the pandemic, it was thought contaminated surfaces were a major means of COVID transmission.

People wore gloves when going to the supermarket (some still do), and washed food packages once they got home. However, we now know the virus is spread primarily through aerosol and droplet transmission. When a person coughs or sneezes, droplets containing mucous, saliva, water and virus particles can land on other people or drop onto surfaces. Larger droplets tend not to travel very far and fall quickly. Smaller droplets called aerosols, can stay airborne for an extended period of time before settling. Scientists now believe transmission through touching contaminated surfaces is quite rare.

 

3 things to watch out for
There are three key issues we need to be aware of as COVID slowly becomes endemic.
1. Waning immunity
Many older and vulnerable people had their third dose in November or December last year, with their immunity now waning fast. We need to provide a fourth vaccine dose as soon as possible to the elderly and vulnerable.

2. New variants
There’s still the potential for new and more severe variants to hit us. One of the main reasons for this is the low rates of vaccination in many developing countries. The more the virus replicates in unvaccinated populations, the greater the chance of mutations and variants.

Vaccine manufacturers Pfizer and Moderna either manufacture the vaccine in their own facilities, or license the right to produce the vaccine in other countries. This puts it out of reach financially for most developing countries, who then have to rely on the COVAX initiative for supplies. COVAX is a worldwide facility funded by developed countries and donor organizations to purchase vaccines to be distributed to developing countries. Researchers at the Texas Children’s Hospital’s Center for Vaccine Development have unveiled a protein-based vaccine called Corbevax. It uses established and easy-to-manufacture technology, and is being provided patent-free to developing countries. It has now received emergency use authorization in India. It has over 80% efficacy against symptomatic disease, though this is against the no-longer dominant Delta variant. Trials are currently under way to determine its efficacy against Omicron. If approved, this should greatly help lift vaccination rates in many developing countries.

3. Long COVID
Politicians are ignoring long COVID. With thousands of cases a day, over the next year we will be getting a tsunami of people suffering from long-term health problems. So, we simply cannot ignore high case numbers and would be wise to retain at least some public health measures (for example, face mask mandates) in order to bring case numbers down.

The beginning of the end,

Governments are now dismantling public health measures such as the use of QR codes, social distancing measures and face mask mandates. Their thinking is that although case numbers are still quite high, hospitalizations are going down – and of course, elections are in sight. Chief public health officers, who used to give daily briefings, are now rarely seen. “Give us our freedom back” is now a commonly heard cry, even if the inevitable consequence means this is at the expense of elderly and vulnerable people.
In a nutshell, many believe we have moved already from epidemic to endemic status. As much as we all wish for this to be over and life to get back to normal, we aren’t quite there yet. But I think with better vaccines and improved treatments on the way, it’s at least the beginning of the end.

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Pfizer-BioNTech COVID

Pfizer-BioNTech Vaccine Bottle

Pfizer-BioNTech COVID vaccine less effective against infection for kids 5 to 11, study suggests

The vaccine’s efficacy against infection among those children declined to 12 per cent at the end of January from 68 per cent in mid-December compared to kids who did not get vaccinated, according the study, which has not yet been peer reviewed.
Two doses of the Pfizer-BioNTech COVID-19 vaccine was protective against severe disease in children aged five to 11 during the recent Omicron variant surge, but quickly lost most of its ability to prevent infection in the age group, according to a study by New York State researchers.

child wearing a mask doing crafts

“These results highlight the potential need to study alternative vaccine dosing for children and the continued importance layered protections, including mask wearing, to prevent infection and transmission,” the researchers said.

“It’s not surprising that protection against mild illness would wane, We know that Omicron is somewhat immune evasive for protection against mild illness. The goal of the vaccine is to protect against severe illness — to keep children out of the hospital.”

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Deer to Human Infection?

Researcher studying COVID-19

Possible case of deer-to human Covid infection identified in Canada
Researchers say its unlikely that the variant found in deer could bypass vaccines, but urge better monitoring of Covid in animals

Canadian researchers believe they have found the first-ever instance of a deer passing the coronavirus to a human, warning that broader surveillance of wildlife is needed to prevent further mutations from developing and spreading undetected.

deer standing in a field

In a paper published last week, but not yet peer reviewed, scientists say at least one case of Covid-19 in humans can be traced to a strain of the virus found in hunted deer.
Biologists have previously found white tail deer populations infected with Covid in northeastern regions of the United States, as well as central provinces of Canada. While deer aren’t typically seen as a species that can easily pass on the virus to humans, experts had nonetheless speculated that transmission was possible.

Researchers say its unlikely that the variant found in deer could bypass vaccines, but urge better monitoring of Covid in animals.

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