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Joanne Laucius

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Jun 03, 2021  •  5 days ago  •  10 minute read  •  11 Comments

Files: COVID-19 vaccines Photo by DADO RUVIC /REUTERS Ontario residents who received the first dose of the AstraZeneca vaccine and who have not yet received their second dose can mix COVID-19 vaccines if they want, starting Friday.

The decision, made in consultation with Dr. David Williams, the province’s chief medical officer of health and other health experts, is in line with updated guidance from the National Advisory Committee on Immunization (NACI) released on Tuesday, said the province in an announcement.

“We are providing individuals who have received only their first dose of the AstraZeneca vaccine with two recommended options based on the available data and evidence and will continue to work with Health Canada to monitor the quality and efficacy of all COVID-19 vaccines being used in Ontario,” said Williams in the statement

Those who received AstraZeneca COVID-19 vaccine can receive a second dose of the AstraZeneca vaccine or one of the two mRNA vaccines, Pfizer or Moderna, for their second dose.

All provinces paused the use of AstraZeneca for first doses in May as reports of rare, but potentially serious, vaccine-induced blood clots rose.

Almost 2.2 million Canadians received the vaccine for their first dose, out of 21.8 million people now vaccinated with at least one dose. There have been 41 confirmed or suspected cases of vaccine-induced blood clots following an AstraZeneca vaccination in Canada, including five deaths.

The NACI report also said when the same mRNA vaccine product is not readily available, or is unknown, another mRNA vaccine recommended for use in that age group can be considered interchangeable and should be offered to complete the vaccine series.

On Tuesday, Canada’s Chief Public Health Officer Dr. Theresa Tam acknowledged that the NACI report noted there was no data for the interchangeability of the two mRNA vaccines, Pfizer and Moderna. However, there are ongoing studies supporting the replacements that have not yet been published, she said.

Tam said mixing vaccines is not a new concept and has been used in the past with other vaccines, depending on availability. The mixed schedule has a good safety profile, but there is the possibility of short-term side-effects such as headaches and fatigue, she said.

The second dose options will be provided at the recommended 12-week interval, according to the statement.

Those who would like their second dose of the AstraZeneca vaccine, can contact the pharmacy or primary care provider where they received their first dose to book an appointment. Those who received their first dose of the AstraZeneca vaccine and are opting to receive an mRNA vaccine can schedule the second dose appointment at a participating pharmacy where the Pfizer or Moderna vaccines are administered.

Primary care settings and pharmacies may also be reaching out to eligible Ontarians.

Starting on Monday, those who received their first dose of the AstraZeneca vaccine and want to receive an mRNA vaccine for their second dose can register for a “second dose only” at a 12-week interval through the provincial booking system, or to schedule their second dose appointment directly through public health units that use their own booking systems.

Meanwhile, Dr. Williams noted the number of confirmed daily cases has climbed to 870 since Tuesday’s low of 699.

That may be attributed to the Victoria Day long weekend, but Williams believes daily case numbers may be up to 900 or more on Friday.

The B.1.617.2 variant — also known as the “delta” variant, first identified in India — is common in some areas, particularly large urban centres, and medical experts still lack an understanding on how it behaves, said Williams.

At the same time, the average number of daily deaths in the province has dropped from 21 last week to 15 this week, he said. The effective reproduction number, which represents, on average, how many other people an individual with COVID-19 will infect, has also dropped from 0.82 last week to 0.74.

On Wednesday, Premier Doug Ford speculated it might be possible to enter Stage 1 of reopening the province before June 14, but said it was up to Williams to make the call.

Speaking to reporters on Thursday, Williams said the province is at a “critical time.”

Earlier in the week, decision-makers had been buoyed by the numbers, but the recent increase in cases has been more than anticipated. Williams also said he will have another look at the question next week.

Ford said on Wednesday he would like to see outdoor graduation events for students at all grade levels to help them re-connect with classmates.

Williams said that would be a “major undertaking.” He noted there would be a lot of logistics to work out and people have appeared apprehensive about the idea.

In a letter to parents sent only hours after Ford’s announcement, Ottawa-Carleton District School Board director of education Camille Williams-Taylor said the board was “surprised” by Ford’s plan and that it will “need time to consider the operational and health requirements to ensure the continued safety of our community as we move optimistically into the summer.”

Meanwhile, good news! Long-term care residents are being permitted more visits, visitors and even hugs.

With 97 per cent of LTC residents fully immunized and 89 per cent of staff with at least one vaccine — two-thirds have been fully immunized — the province says residents can now enjoy more social connections with family and friends.

Residents who have been fully immunized can now leave their LTC homes for day and overnight social outings and trips, said the province.

Residents who have been able to get outside for outdoor visits for mobility or health reasons can also now have one indoor visitor, aside from an essential caregiver.

Brief hugs are also allowed, regardless of the visitor or the resident’s vaccination status.

“Where both the resident and visitors are fully immunized, close physical contact, including handholding, can now take place safely,” said Ontario’s ministry of long-term care.

Public health measures in LTC homes including hand hygiene and masks still apply.

Meanwhile, a pair of memos from the provincial government suggest that constraints for hospitals are being loosened.

The first memo, from Ontario Health, says non-emergent and non-urgent surgeries and procedures can be resumed as long as hospitals are ready to accept COVID patient transfers when necessary.

A directive (“Directive #2”) was issued on April 19 to maintain health-care capacity. When it was lifted on May 19, hospitals were allowed to proceed with non-emergent and non-urgent surgeries and procedures that were not expected to require inpatient resources such as overnight stays.

The memo issued Thursday allows hospitals to conduct non-emergent and non-urgent surgeries that require inpatient and critical care resources — as long as they meet certain criteria, such as being ready to accept patients, and if they have the human resources available for emergency and emergent care.

“Over the past several weeks, we have continued to monitor new cases, hospitalizations and ICU admission and are encouraged to see that the recent downward trends have been sustained,” said the memo to hospital CEOs.

“Although the number of patients with COVID-19 in hospitals and ICUs remains high, some hospitals now have the capacity to safely resume non-emergent surgeries and procedures to include those that require inpatient and critical care resources.”

The second memo from the deputy minister of health outlines an amendment of two emergency orders under the Emergency Management And Civil Protection Act.

On April 9, the Ontario government issued an emergency order to provide hospitals with the flexibility to transfer patients to other hospitals without consent in situations where a hospital’s resources are at significant and immediate risk of becoming overwhelmed.

On April 28, the government amended the order to allow for transfers of patients designated as alternate level of care to long-term care and retirement homes in case of a major surge. That has been revoked, but the emergency order issued April 9 will remain in effect until June 16, unless it is extended.

The memo notes that there have been no reported cases of alternative level of care patients being transferred to LTC or retirement homes.

NEW CORONAVIRUS CASES IN ONTARIO Ontario reported 870 new confirmed cases of COVID-19 on Thursday, up from the 733 cases reported on Wednesday and the seven-week low of 699 cases reported on Tuesday.

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This brings the total number of confirmed cases in the province to 533,761.

There were 10 new deaths reported across the province, bringing the total number to 8,801 since the pandemic began.

There were 729 patients in Ontario hospitals with COVID-19 symptoms, 546 in ICU and 370 on a ventilator.

In health units in the Ottawa area: Eastern Ontario health, which includes Cornwall and Hawkesbury, had three new cases, Renfrew had two, Kingston & Frontenac health had one, and there were no new cases reported in Leeds-Grenville-Lanark region.

Latest COVID-19 news in OttawaOttawa Public Health reported 40 new confirmed cases Thursday, bringing to 27,179 the number of cases since the pandemic began.

There were two new deaths, bringing the toll to 574.

The agency said there are 560 active cases of COVID-19 in Ottawa, with 29 people in hospital and four in ICU.

There was one new outbreak in a daycare facility. There are 24 other ongoing outbreaks, 18 in health-care institutions, two in child-care settings and four in the community.

Among closely watched indicators: The seven-day rolling average of new cases per 100,000 residents is 35.7, the testing positivity in the community is 3.9 per cent, and the reproductive number (which indicates the number of people a person with COVID-19 can infect is 0.81. A number below 1.0 indicates the virus is receding.

Meanwhile, a “glitch” in the Ontario vaccine booking system which caused Ottawa to pause bookings since Monday has been corrected, the city says.

Officials from Ottawa Public Health are to begin contacting residents 80 and older who do not yet have a second vaccine appointment, to book a new appointment.

COVID-19 news in QuebecQuebec reported 267 new confirmed cases of COVID-19 Thursday.

Hospitalizations and the number of patients in intensive care continue to fall and are at their lowest level since October.

In addition, six new deaths were reported, including one over the previous 24 hours.

There are 317 people in hospital, down 23 from Wednesday’s totals and 68 patients in ICU, down nine from Thursday.

In the Outaouais, there were six new cases, for a total of 12,233 since the pandemic began. For the ninth straight day, there were no new deaths. Thre have been 214 deaths in the region related to COVID-19.

Since the beginning of the pandemic, Quebec has reported 371,082 cases and 11,144 deaths linked to COVID-19.

Quebec reported 85,230 additional vaccine doses were administered on Tuesday.

Latest COVID-19 news in CanadaThe federal government is increasing the fine for air travellers who refuse to quarantine in a designated hotel for three days after arriving in Canada.

Travellers who had faced a $3,000 fine if they didn’t abide by the requirement will instead by liable for a $5,000 penalty starting on Thursday.

The move comes a week after a federal advisory panel raised a number of problems with the hotel quarantine and recommended that the government end it.

The panel instead suggested travellers be required to quarantine in a hotel only if they fail to present a credible quarantine plan.

The Unite States is giving 75 per cent of its surplus COVID-19 vaccines to the international sharing program known as COVAX — and Canada is in line to get some of what’s left over.

All told, some 80 million doses, including 60 million of the Oxford-AstraZeneca vaccine, will be shared around the world by the end of June.

Of the first tranche of 25 million doses, six million will be earmarked for regional priorities and partners, a list that includes Mexico and Canada, as well as the Republic of Korea, the West Bank and Gaza.

It remains unclear whether Canada will even accept the batches. After a slow start, Canada’s vaccine rollout is nearing the best in the world, and at the same time as pressure is mounting on the Canadian government to start sharing some of its COVID-19 vaccines as well.

A coalition of almost three dozen Canadian aid groups, faith-based organizations and global development advocates has called on Prime Minister Justin Trudeau to immediately share four million doses of vaccine — one for every 10 doses Canada expects to receive by the end of June.

“By August, Canada will have enough to fully vaccinate its entire population,” reads the statement signed by 32 groups, including the Canadian arms of One, UNICEF, World Vision, the Mennonite Central Committee, Canadian Council of Imams and the Anglican Council of Indigenous People.

“Canada has ordered more doses per capita (more than 10) than any other country and therefore has a responsibility to share with the world.”

More On This Topic New variant, outbreaks add urgency to push for higher vaccination rates among long-term care staff Ontario students won’t resume in-person classes until September, says Ford With files from Postmedia andThe Canadian Press

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