Canada·Coronavirus Brief

The latest on the coronavirus outbreak for Sept. 9

The latest on the coronavirus outbreak for September 9th.
School was back in session Thursday for the first time in several months in some of the largest school districts in Canada, including Toronto and surrounding areas. Here, primary students enter their public school in North York while trying to physically distance. (Paul Smith/CBC)

Average cost for a COVID-19 ICU patient in first year of pandemic estimated at more than $50,000

A new report paints a revealing picture of the costs associated with treating Canadian patients who required hospitalization for COVID-19 before vaccines were widely available.

Canadian Institute for Health Information (CIHI) data indicates the average cost for patients being treated for the coronavirus was more than $23,000, which is four times higher than a patient with influenza. A COVID-19 patient who needs intensive care treatment on average led to a cost of $50,000 — not including the cost for doctors — compared to slightly more than $8,000 for a heart attack patient on average.

The average patient care cost of someone who tested positive for COVID-19 was highest in Alberta ($29,300), Nova Scotia (about $27,100) and Manitoba ($25,000).

Dr. Philippe Lagacé-Wiens, a medical microbiologist at St. Boniface Hospital in Winnipeg, told CBC News a reason the Prairie provinces seem to be near the top of several categories may be rooted in socioeconomic factors.

All three Prairie provinces have higher rates of obesity, diabetes and heart disease suffered in Indigenous populations that face barriers accessing health care, among many historical disadvantages. Those chronic illnesses are considered risk factors for COVID-19, and Lagacé-Wiens said the higher rates in some groups point more to socioeconomic factors than determinants of health.

"Those populations were also grossly overrepresented in hospitalizations and grossly overrepresented in COVID-19 cases."

The CIHI said the average COVID-19 patient requiring intensive care stayed in hospital for 21 days. Dr. Donald Redelmeier, a professor at the University of Toronto's faculty of medicine, said costs spiral quickly for any patient receiving intensive care.

"The one major distinction about COVID patients in the ICU is they stay a long time. They take a long time to recover, if they recover at all," he said.

As previously reported, the capacity issues caused by waves of coronavirus hospitalizations have also led to the costs associated with postponed surgeries and delayed diagnoses for some cancer sufferers.

Walter Wodchis, a health economist at the University of Toronto's Dalla Lana School of Public Health, said care for a patient with cardiovascular disease based on years of poor eating habits can cost $80,000 over a decade. While some COVID-19 sufferers have experienced lingering symptoms, with vaccination, many of those who required admission will likely have experienced a one-time hospital stay.

The report covers hospitalizations through March 2021. A report from CIHI covering Canada's fourth wave is expected in December.

From The National

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Moderna, Novavax developing combined COVID-19, flu shots 

According to a report earlier this year in the journal Science, the National Intsitute of Allergy and Infectious Diseases in the U.S. decided in 2017 to reject an otherwise impressive application for a vaccine, noting "the significance for developing a pan-coronavirus vaccine may not be high."

The COVID-19 pandemic has changed the game in terms of vaccine priority, and efforts to combat more than one malady.

Moderna Inc. said on Thursday it was developing a single-dose vaccine that combines a booster dose against COVID-19 and a booster against flu. That announcement came the day after another American vaccine marker, Novavax, said it had initiated an early-stage study to test its single-dose combined flu and COVID-19 vaccine.

"Combination of these two vaccines … may lead to greater efficiencies for the health-care system and achieve high levels of protection against COVID-19 and influenza with a single regimen," Gregory Glenn, president of research and development at Novavax, said in a statement.

In Novavax's Australia trial, hundreds of healthy adults between the ages of 50 and 70 who were previously infected with the coronavirus or given an authorized COVID-19 vaccine at least eight weeks prior to the study will receive a combination of the company's COVID-19 vaccine candidate, NVX-CoV2373, and its influenza shot NanoFlu, along with an adjuvant or vaccine booster. The company expects trial results for the first quarter of 2022.

Moderna, in a briefing to investors, said the benefits of a pan-respiratory vaccine would be immense, pointing to Centers for Disease Control data that indicates there were more than 400,000 hospitalizations because of influenza in the U.S. in the last pre-pandemic year, with the seasonal flu representing an average economic burden of $11 billion US annually. The company also pointed out that traditional flu vaccines have much lower efficacy rates than what the company has brought to market for COVID-19 with its mRNA vaccine.

The drugmaker already had several influenza vaccine candidates in development. The new vaccine combines the experimental flu shot that is furthest along with its COVID-19 vaccine.

Read the full story

World roundup: A devastating fire in eastern Europe, a major U.S. vaccine, testing push

In North Macedonia, 14 people were killed and 12 were seriously injured when a fire broke out in a makeshift hospital for COVID-19 patients in the town of Tetovo, the Balkan country's Health Ministry said on Thursday.

Prime Minister Zoran Zaev said the fire late Wednesday was caused by an explosion, and that an investigation was underway into the cause.

The country of two million reported 701 new coronavirus infections and 24 deaths in the past 24 hours.

In Africa, World Health Organization Africa director Matshidiso Moeti said slightly more than three per cent of people across the African continent have been fully vaccinated. That coverage drops to around 1.7 per cent in sub-Saharan Africa.

The Africa CDC said 145 million vaccine doses have been procured across the continent of 1.3 billion people, and 111 million of them, or 77 per cent, have been administered.

In Britain, few people CBC News spoke to in London's Soho district said they saw significant cause for concern, much less a reason to start imposing restrictions again, even as COVID-19 cases have been averaging nearly 40,000 per day recently.

In the U.S., President Joe Biden on Thursday evening is expected to lay out a six-part plan to get more people vaccinated, enhance protection for those who already have had shots and keep schools open. An executive order to require federal employees and government contractors to get vaccinated as a condition of employment is expected.

With 160,000 new infections a day, the country is "still in pandemic mode.... That's not even modestly good control," Biden's chief medical adviser, Dr. Anthony Fauci, told Axios. Concerns about the delta variant and various vaccine mandates around the country helped lead to an uptick in U.S. vaccinations in August compared to July. (See graph below)

The Washington Post reported that Biden's announcement could include calls for a global summit soon to address vaccine inequity, possibly to be held during the United Nations General Assembly session two weeks from now. While the U.S. has received criticism for pushing ahead with additional COVID-19 booster shots while continents like Africa lag in inoculation, the administration has countered by claiming it has donated more vaccines for the developed world than all other countries combined.

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