Canada·Coronavirus Brief

The latest on the coronavirus outbreak for Oct. 13

The latest on the coronavirus outbreak for Oct. 13.
Students in Buenos Aires attend the first day of in-person classes amid the COVID-19 pandemic. (Agustin Marcarian/Reuters)

What pausing another big COVID-19 vaccine trial means

Another front-running team in the race to develop a COVID-19 vaccine has put a late-stage trial on hold after a reported "unexplained illness" in one of the trial volunteers. Both pauses included Phase 3 clinical trials for the same class of vaccine, non-replicating viral vector vaccines. Phase 3 is the largest type of clinical trial, requiring thousands of volunteers, and is the last of three stages of human testing before a vaccine can be approved for use. Here's a look at the two pauses and what they mean for the quick development of a COVID-19 vaccine.

Janssen Pharmaceutical Companies, a subsidiary of Johnson & Johnson, announced their pause on Monday, while the University of Oxford and pharmaceutical company AstraZeneca announced theirs on Sept. 8. The AstraZeneca trials have since resumed in the U.K., Brazil and South Africa, but regulators have not yet approved them to resume in the U.S. Canada has deals to purchase tens of millions of doses of vaccine from each of the two companies if they make it through clinical trials and are approved.

Both companies blamed an "unexplained illness" in one of the volunteers. That would have triggered a "standard review process," intended to ensure safety when that happens. The pause allows the incident to be investigated by independent reviewers not involved in the trial. Because trials like these are typically double-blinded, the researchers don't know whether a given volunteer received the vaccine or a placebo. That's one of the reasons why the review needs to be conducted by an independent committee that is not doing other analyses in the study, writes CBC's Emily Chung. Even if the volunteer received the vaccine, the timing of the illness could still be coincidental and unrelated to the vaccine.

Following the September pause, AstraZeneca disclosed that it had briefly paused a COVID-19 vaccine trial in July after a study volunteer was found to have multiple sclerosis. An independent review panel concluded the illness was not related to the vaccine. Dr. Samir Gupta, associate professor of medicine at the University of Toronto, said that "it's not a routine thing to stop a massive trial mid-course like this. However, AstraZeneca CEO Pascal Soriot said Thursday that such pauses are "very common actually." "Many experts will tell you this," he said. "The difference with other vaccine trials is that the whole world is not watching them of course so they stop, they study and they restart."

But how worried should people be about these pauses? Dr. Michael Gardam — an infectious disease specialist at Women's College Hospital in Toronto — said in some ways, a pause should ease people's concerns, as it shows that the system is working and highlights the importance of Phase 3 clinical trials to ensure the safety of vaccines. "The fact that this has been stopped appropriately, it'll be investigated. We'll learn about it and then presumably the trial will start up again," Gardam said in September. "That's exactly what's supposed to happen."

Click below to watch more from The National

COVID-19: The potential fallout from Thanksgiving weekend

The National

5 months ago
3:57
Infectious disease specialists discuss what could happen with the COVID-19 pandemic from the Thanksgiving weekend depending on how Canadians celebrated. They also talk about some new information about COVID-19 transmission on surfaces. 3:57

IN BRIEF

Dr. Tam says Halloween can go ahead — as long as everyone follows the rules

Canada's top public doctor said there's no need to cancel Halloween this year — as long as trick-or-treaters respect the new realities of the pandemic. "I think finding that balance of trying to provide some degree of normality, even though it is actually different from any other year, most public health leaders think that that is actually important," Chief Public Health Officer Dr. Theresa Tam told a briefing in Ottawa this morning. Tam advised parents and kids to maintain physical distancing while trick-or-treating outside, to stick to pre-packaged treats and to have hand sanitizer readily available.

Tam also said that a creative use of "different fabrics" can turn a day-to-day face mask into part of a costume. "There's some really interesting ideas where people are handing out treats at the end of a hockey stick or something, using a pool noodle to tell your kids how far they should be standing apart from each other," she said. "So there are ways to actually manage this outdoors." Both Tam and her colleague, Deputy Chief Public Health Officer Dr. Howard Njoo, said more tips will be posted to the Public Health Agency of Canada's website soon.

Tam stressed that parents and children should follow guidelines set by local health authorities, as some local COVID-19 caseloads are far larger than others. Tuesday's briefing came as Ontario reported 746 additional cases today, along with 807 from yesterday, as the number of confirmed, active cases in the province reaches a new record high. Manitoba also announced a new record of 124 cases, the province's first triple-digit tally and the third record-breaking day in less than a week. Authorities also announced one new COVID-19 death, the eighth since Friday and the 35th in Manitoba since the pandemic began. The province also set a new record for its highest test positivity rate on Tuesday, as it reported a rate of 3.5 per cent.

Read more about the situation

School food programs pivot to keep feeding students during pandemic

Along with drastically changing the classroom experience, COVID-19 has affected how school food programs are being delivered across the country. Recent research by a Toronto-based policy group found that 12.7 per cent of households in Canada (about 4.4 million people) experienced some level of food insecurity — meaning a lack of access to enough safe and nutritious food — in 2017 and 2018, including more than 1.2 million children under the age of 18. A Statistics Canada examination of the subject this past May found COVID-19 is already having an impact, with 14.6 per cent of survey respondents indicating they live in a household that experienced food insecurity in the previous 30 days.

"There is no single [federal] policy measure like a national school food program to meet all these social needs," said Debbie Field, co-ordinator of the Montreal-based Coalition for Healthy School Food. "A school food program doesn't replace adequate wages or adequate social assistance, but it's one support to working families." Field praises the "incredible resilience" of the community-based groups delivering Canadian school food programs, but said the fact that Canada is the only G7 country without a national school food program means that the current patchwork of program providers in each jurisdiction must now struggle with how to continue operations amid COVID-19.

Here's a look at one program: Newfoundland and Labrador's School Lunch Association, which continues to add locations after more than 30 years of operation, is slowly getting used to a new normal amid COVID. John Finn, executive director of the registered charitable organization, said his team spent a good chunk of the summer consulting on school reopening plans and brainstorming how to adapt their pay-what-you-can hot lunch program, which last year served about 6,300 meals daily across approximately three dozen schools. The School Lunch team also committed to creating delivery plans following pandemic protocols (such as increased sanitation, PPE and physical distancing) that would work for every school. "The service delivery model ... it varies vastly from every school," Finn said. "We've had to get creative with some new equipment."

Read more about the programs

Facing steep fines, Nova Scotians with COVID-19 tickets are trickling into court

Nova Scotians attempting to challenge tickets handed out in the spring for COVID-19 offences are beginning to get their day in court, including more than 30 who have been successful in having their tickets tossed. But those who analyze constitutional law say the process could be difficult and expensive, which could lead to many people simply choosing to pay the fine even if they believe they were ticketed unfairly. "It puts the burden on individuals to go through this," said Abby Deshman, director of the criminal justice program with the Canadian Civil Liberties Association.

The bulk of the more than 700 tickets issued in Nova Scotia under the Emergency Management Act and the Health Protection Act — the two laws used to govern COVID-19 offences in the province — were handed out in April, according to data from police agencies. Infractions ranged from not properly self-isolating to walking in parks closed by emergency order. In many cases, fines were between roughly $700 and $1,000, although both acts stipulate they can be significantly higher. Deshman said the civil liberties group has been tracking situations across the country and believes there were some circumstances where COVID-19-related laws were unconstitutional because they weren't clear or were too zealously enforced.

As of Sept. 24, Nova Scotia's Justice Department said police agencies in the province had issued at least 715 tickets. As of late September, 163 people had chosen to take their Health Protection Act tickets to court instead of paying the fine, although 119 of those cases were still pending, according to numbers from the Nova Scotia Judiciary. However, in 31 of the 44 cases that had been heard, the ticket was dismissed. The rest were sentenced to fines. Joshua Nodelman, a lawyer with Nova Scotia Legal Aid, said the organization is providing free advice appointments to those who wish to fight tickets, although it generally doesn't represent people in court on summary offence tickets. "It may yet be early days for a number of these tickets in terms of [them] actually coming to court," he said.

Read more about the tickets

Stay informed with the latest COVID-19 data.

THE SCIENCE

Reinfection cases raise concerns over immunity

The case of a man in the United States infected twice with the virus that causes COVID-19 shows there is much yet to learn about immune responses and also raises questions over vaccination, scientists said on Tuesday. The 25-year-old from Reno, Nev., tested positive in April after showing mild symptoms, then got sick again in late May with a more serious bout, according to a case report in the Lancet Infectious Diseases medical journal.

The report was published just hours after U.S. President Donald Trump, who was hospitalized with COVID-19 earlier this month, said he felt "so powerful" and believes he now has immunity. Scientists said that while known incidences of reinfection appear rare — and the Nevada man has now recovered — cases like his were worrying. Other isolated cases of reinfection have been reported around the world, including in Asia and Europe.

"It is becoming increasingly clear that reinfections are possible, but we can't yet know how common this will be," said Simon Clarke, a microbiology expert at Britain's Reading University. "If people can be reinfected easily, it could also have implications for vaccination programs as well as our understanding of when and how the pandemic will end." World Health Organization spokesperson Tarik Jasarevic concurred that the U.S. case underlined what was unknown about immunity. "This also really is an argument against what some have been advocating, and that's building naturally what is called herd immunity. Because we don't know," Jasarevic told a briefing.

AND FINALLY...

How this Whitehorse choir is rehearsing during COVID-19

The soprano section of the Whitehorse Community Choir smiles during a Zoom rehearsal. (Laura Howells/CBC)

The Whitehorse Community Choir is largely rehearsing over Zoom this year as a result of the pandemic. Members sing from their own homes, with their microphones on mute to avoid the time lag — an experience director Barbara Chamberlin says is "really strange." She plans on starting to record singers, then providing individual feedback. "We're not used to this at all," said Chamberlin. "But it's been pretty successful so far."

New guidelines from Yukon's chief medical officer mean a few people can now sing together again. At the soprano sectional on Monday, four singers sat in Chamberlin's home wearing masks and sitting at a distance, while she lead the rest of the choir over Zoom. "It's a bit more of a choir experience," said Chamberlin. Only one section rehearses at a time, and a volunteer helps sanitize the room.

The choir stopped rehearsals this spring and was on hiatus until September. More than 60 people signed up for virtual choir practice. Rehearsals began with online sectionals, so Chamberlin can work with smaller groups. Socializing is such a big part of choir, said Chamberlin, who noted some previous members didn't sign up for virtual practices. Their holiday performance will be pre-recorded, with Chamberlin mixing the choristers' recordings together.

Read more about the choir here

Find out more about COVID-19

Still looking for more information on the pandemic? Read more about COVID-19's impact on life in Canada, or reach out to us at covid@cbc.ca if you have any questions.

If you have symptoms of the illness caused by the coronavirus, here's what to do in your part of the country.

For full coverage of how your province or territory is responding to COVID-19, visit your local CBC News site.

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

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