Canada·Coronavirus Brief

The latest on the coronavirus outbreak for Nov. 4

The latest on the coronavirus outbreak for November 4th.
People enjoy a drink in a bar in Bangkok on Thursday. The Thai government recently gave licensed establishments the approval to sell alcohol again after restricting the practice in the spring because of rising coronavirus numbers. (Jack Taylor/AFP/Getty Images )

Quebec, Ontario not imposing COVID-19 vaccine mandate for health-care workers 

Quebec and Ontario this week have both decided the challenges of a vaccine mandate for health-care workers outweigh the benefits.

Ontario Premier Doug Ford pointed to high vaccination rates in hospitals and the "potential departure of tens of thousands of health-care workers" for the government's decision not to make COVID-19 shots compulsory.

NDP Leader Andrea Horwath said she's skeptical of Ford's description of the scale of the potential worker shortage.

"If the government's making decisions based on facts, then they should be showing people what it is that they're making their decisions on," Horwath said.

Doris Grinspun, head of the Registered Nurses' Association of Ontario, called the decision "a disgrace to patients and to the great majority of health-care workers who desperately are supporting mandatory vaccination."

The Ontario Hospital Association (OHA) had written to Ford in support of a provincewide mandate — a position it said was endorsed by 120 of 141 member hospitals.

Currently, hospital workers in Ontario must get vaccinated or regularly get tested for the virus, although many hospitals have gone ahead with stricter policies. Hospitals that have placed unvaccinated employees on leave or terminated them have reported staff losses of between one and three per cent. Several hospitals, including those with Toronto's University Health Network, have already put mandatory vaccination policies in place.

Quebec Public Health Director Dr. Horacio Arruda said public health arrived at their decision after weighing the health-care network's ability to withstand losing unvaccinated employees against enforcing regular testing — three times a week — for those who aren't adequately protected.

Quebec officials said 97 per cent of active health-care employees have received at least one dose.

Out of the 17,140 unvaccinated health-care workers, Health Minister Christian Dubé said 5,000 are likely to be in direct contact with patients.

"It's exceptional, but it still isn't perfect," Dubé said.

The decisions have left some in the industry shaking their heads.

Dr. Joseph Dahine, intensive care specialist at Cité-de-la-Santé Hospital in Laval, called it "disheartening" and said plans were already afoot where he worked to adjust staffing to address any holdouts.

"We're supposed to promote safety of our patients," Pointe-Clare, Que., emergency nurse Nathan Friedland told CBC News. "Health care workers who are not vaccinated at this point in time are not doing that."

New employees will be required to get vaccinated and all unvaccinated health-care workers will be ineligible for retention bonuses.

For now, British Columbia is pressing on with its vaccine mandate for health-care workers.

New Brunswick Health Minister Dorothy Shephard said Thursday she is "reviewing" the decisions of Ontario and Quebec. New Brunswick's current policy requires that by Nov. 19, all government employees provide proof they are fully vaccinated or have a medical exemption. Otherwise, they'll be placed on unpaid leave.

"The area that is the biggest concern is in the health-care field, where we haven't seen the same uptake to get vaccinated as we have in those other areas," said Premier Blaine Higgs.

From The National

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How Montreal could lead the way to Canada's first domestically produced COVID-19 vaccine

We wrote earlier this week about Novavax, which has stumbled with myriad issues in getting its COVID-19 vaccine before regulators for consideration, although that process is picking up, including in Canada.

With Novavax filing for approval of its vaccine with Health Canada, Montreal is poised to be the first Canadian city to manufacture a COVID-19 vaccine, although domestically produced shots won't be available until next year. Canadian production should start in 2022 at the National Research Council of Canada's Biologics Manufacturing Centre in Montreal.

Once it is up and running, federal officials say the facility should be able to produce 24 million doses of vaccine per year. It would be a welcome development after decisions by federal governments led by Liberals and Conservatives in recent years left the country without domestic production capabilities early in the pandemic.

"Having that type of effective vaccine within our borders is going to really allow us to roll this out to the population in a way that can take a bite out of the numbers," said Dr. Sumon Chakrabarti, an infectious diseases specialist at Trillium Health Partners in Mississauga, Ont.

With 74 per cent of the entire Canadian population vaccinated and an expectation that children ages five to 11 could be eligible in the coming weeks, Novavax is definitely late to the table. But there's an expectation most people will need third shots, and according to one estimate, just 49.9 per cent of the world and 3.9 per cent of those in low-income countries have received a first dose of a COVID-19 vaccine.

"This pandemic is not going away any time soon," said John Trizzino, the chief commercial officer and business officer for Novavax in an interview with CBC News in June when the facility was announced. "We expect that there's going to be a circulation of this continuing through 2022 and 2023. And so therefore, we think it's important that we have enough production capacity in Canada to satisfy that."

Chakrabarti concurs and said if there are "major outbreaks happening in different parts of the world it will affect us in the end, indirectly and directly."

Construction is set to be complete in summer 2022 for the Biologics site in Montreal. It will then go through an inspection and approval process.

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Britain becomes 1st country to authorize use of Merck's coronavirus antiviral pill 

Britain on Thursday became the first country to give a green light to Merck's coronavirus antiviral pill, granting it a conditional authorization.

The pill was licensed for adults 18 and older who have tested positive for COVID-19 and have at least one risk factor for developing severe disease. The drug, known as molnupiravir, is intended to be taken twice a day for five days by people at home with mild to moderate COVID-19.

An antiviral pill that reduces symptoms and speeds recovery could prove groundbreaking, easing caseloads on hospitals and helping to curb outbreaks in poorer countries with fragile health systems. It would also bolster the two-pronged approach to the pandemic: treatment, by way of medication, and prevention, primarily through vaccinations.

It was not immediately clear how quickly the pill would be available.

"We are working at pace across the government and with the NHS to set out plans to deploy molnupiravir to patients through a national study as soon as possible," Health Minister Sajid Javid in a statement, referring to the U.K.'s National Health Service.

Initial supplies will be limited. Merck has said it can produce 10 million treatment courses through the end of the year, but much of that supply has already been purchased by governments worldwide.

In October, U.K. officials announced they secured 480,000 courses of molnupiravir and expected thousands of vulnerable Britons to have access to the treatment this winter via a national study.

Among 775 patients in the Merck study, 7.3 per cent of those taking molnupiravir within five days of COVID-19 symptoms were hospitalized at the end of 30 days, compared with 14.1 per cent of those getting the dummy pill. There were no deaths in the drug-taking group after that time period compared with eight deaths in the placebo group, according to Merck.

Health Canada has been reviewing molnupiravir data since August as part of its rolling review of potential treatments.

While Merck appears to be an early leader, just this week an Israeli company said it had received clearance to begin a trial with its COVID-19 pill in South Africa, one of several companies across multiple countries that are pursuing convenient oral treatments. Late last month, Boston-based Atea reported disappointing trial results for its pill developed with Roche.

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With files from Reuters, The Canadian Press, The Associated Press