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The latest on the coronavirus outbreak for June 3

The latest on the coronavirus outbreak from CBC News for Wednesday, June 3.

 

Passengers carry their luggage at Rome's Termini train station as Italy officially ended its long COVID-19 lockdown, opening regional and international borders in a bid to boost summer tourism. (Guglielmo Mangiapane/Reuters)

COVID-19 can still find its way into your home — even if you're following public health guidelines

Early on in the pandemic, the message from Dr. Eileen de Villa, Toronto's medical officer of health, was: "If you can stay home, do." Since then, there's been growing awareness that while hunkering down can keep you safe, households are also COVID-19 transmission zones once one person gets infected — particularly in a city like Toronto where crowded apartment units and multi-generational housing are common facets of life in certain neighbourhoods, writes CBC's Lauren Pelley.

That's what happened with the Comries, who from a public health standpoint did everything right but still tested positive for COVID-19. Ashley Comrie worried she was at a higher risk of catching COVID-19 since she's on medication that suppresses her immune system. So, as the pandemic dragged on, she stayed put in her roughly 950-square-foot apartment while her husband, Kirk, made rare but necessary trips to the grocery store wearing both a face mask and gloves. But like many households in Toronto, there was little they could do to steer clear of each other in their one-floor unit while sharing the same bed, bathroom and apartment entrance. In early May, just days after one of Kirk's grocery runs, both he and his wife felt feverish and started coughing. The store wound up being the site of a COVID-19 outbreak. Ashley has been hospitalized for the last month — ever since getting tested — which included a nerve-wracking stint in intensive care.

"We see patients coming to the ICU from the same apartment complex, from the same unit, from the same area," said Dr. Michael Warner, medical director of critical care at Michael Garron Hospital. Recently released data from the City of Toronto shows high case counts in many neighbourhoods known for apartment communities, which are often home to essential workers who face a two-fold dilemma: Their jobs may expose them to COVID-19, and they may in turn expose entire households. "It's absolutely impossible in a 600-square-foot apartment with one bathroom and six people to protect your family," Warner said. There's also a growing consensus among researchers that spending time in close quarters in a variety of indoor settings, from workplaces to restaurants, helps facilitate the transmission of COVID-19.

So what can people do to protect themselves at home in densely populated cities like Toronto? Dr. Abraar Karan, a clinical fellow at Harvard Medical School and an internal medicine doctor at the Brigham and Women's Hospital, said it's crucial to remember how easily the virus can spread between people in close contact. "Low-risk situations can turn into high-risk situations quite fluidly and easily," says Karan, who's also working on the state's response to COVID-19 in Massachusetts. With that in mind, health experts say you can do your best to take precautions by maintaining space if one member of the household has a high-risk job where they could be exposed to COVID-19 on a regular basis. But Warner said what's more crucial is better support on a broad scale for people who can't isolate safely in their households. "That could be COVID hotels. That could be food delivery. That could be child and elder care," he said.

In the meantime, Ashley and Kirk Comrie aren't sure they could have done anything else to protect themselves. "If it decides it's coming home with you, it's coming home with you," Ashley said from her hospital room. What was clear, both agree, is how the illness wreaked havoc on their lives once it arrived in their home. "It remains very stressful and emotional," Kirk said during a call from the couple's apartment, where he's been living alone since Ashley was admitted to the hospital in early May. Ashley's illness led to major breathing difficulties, which required time in the ICU on oxygen, where she also suffered a double lung collapse and started coughing up blood. Kirk's respiratory illness lasted slightly more than two weeks, but he's still struggling with fatigue, even when doing basic tasks like video editing at his desk. Although Ashley is still testing positive for the virus, she's finally on the mend at Bridgepoint Health's rehabilitation centre and hopes to be back home soon.

Click below to watch more from The National

As more economies reopen during the pandemic, public transit services are trying to figure out how to handle an increase in riders while keeping passengers safe. 4:18

IN BRIEF

Military must test more soldiers deployed to long-term care homes, health expert warns

Canadian troops serving in long-term care facilities are not being uniformly tested for the novel coronavirus — an omission that alarms a leading health and safety policy expert. In response to questions from CBC News, the Department of National Defence (DND) said that soldiers, sailors and aircrew throughout the Canadian Forces are tested if they show symptoms of the virus. Those personnel on deployment providing support to seniors homes in Quebec and Ontario are administered the test — but only in certain circumstances.

Some of the long-term care homes where troops are deployed "are also mass testing all personnel working in these facilities and therefore some of our asymptomatic CAF members are subject to these mass testing activities," said Dan Le Bouthillier, DND head of media relations, in an email. It all amounts to a patchwork policy that fails to recognize the extraordinary uncertainty surrounding the transmission of COVID-19, Mario Possamai, a former senior adviser to the Ontario government's SARS Commission, told CBC News. While he acknowledged the military is following the established health protocol, he argued that the military's approach ignores mounting evidence of symptom-free transmission as a vector for the spread of the disease.

"One of the surprising characteristics of COVID-19 is the importance of asymptomatic transmission," said Possamai, an occupational health and safety expert. "The military should ensure all of our personnel, whether they are symptomatic or not, are regularly tested," he said, pointing to a recent New England Journal of Medicine article that described asymptomatic transmission as "the Achilles heel of current strategies to control COVID-19." Since Canadian Forces members were asked to backstop faltering seniors homes, 40 of them have tested positive for the virus — 25 in Quebec and 15 in Ontario. The figures are current as of June 1. CBC News requested an interview with the Canadian Forces surgeon general last week but received no response. Without exception, troops who do test positive are isolated in the hotel rooms where they're being billeted while on deployment.

Read more about the military's presence in long-term care homes

Calgary Sikh community mourns after couple stranded in India because of COVID-19 found dead

A Calgary couple trying to get home after being stranded in India during the COVID-19 pandemic was found dead on the weekend, leaving family and friends in northeast Calgary in shock. Kirpal Minhas, 67, and his wife, Davinder Minhas, 65, were visiting Phagwara in the Punjab region of northern India, where they owned property. They'd been there since November. Family members say the two — who were permanent residents of Canada and had been living in Calgary since 2016 — were victims of a violent robbery at one of their properties on May 29. They were trying to get back to Calgary but flights had been cancelled because of the COVID-19 pandemic.

"The family is devastated. We all are," said the couple's son-in-law Kam Rathore, who lives in Calgary. Adding to the pain, Rathore said, is the family not being able to travel to India for the last rites and cremation because of pandemic travel restrictions still in place. "There's not closure," he said. "This is something we never expected." The couple had two daughters in Calgary and two sons living in the United States and were well-known and respected figures in Calgary's Sikh community. COVID-19 is impacting well-wishers, too, with messages of condolence coming online and via phone calls rather than in person, as would usually happen.

The volunteer group Bring Canadians Back Home says the deaths could have been prevented if there were more repatriation flights to bring Canadians stranded in India back home. The couple were registered with the group and were waiting for a chance to fly home after eight flights due to bring them back in April were cancelled when the group's permit was revoked. "We asked the government to support us but we got no support," said Gina Takhar, who created the group. She said she has a list of thousands of individuals and families still stuck in Mumbai, south India and the state of Punjab. Takhar said she received an email from the Canadian High Commission this week saying there are now two Canadian-assisted repatriation flights scheduled to leave Delhi, on June 12 and 15, to bring Canadian citizens and permanent residents home.

Read more about the situation

'Serious' questions raised about hydroxychloroquine study, medical journal says

The Lancet medical journal said "serious scientific questions" had been brought to its attention about the validity of the data behind a widely cited and already corrected study on the dangers of the use of the anti-malarial drug hydroxychloroquine in hospitalized patients with COVID-19. Tuesday's "expression of concern" from the journal follows the May 22 publication of a study that found hydroxychloroquine, which U.S. President Donald Trump took and has urged others to use, was tied to an increased risk of death in hospitalized COVID-19 patients. Several clinical trials, including in Canada, were put on hold after the study was published.

The article was an observational study — meaning it compiled real-world data, rather than conducting a traditional clinical trial — and used data provided by health-care data analytics firm Surgisphere. The Lancet last week issued a correction to the study regarding the location of some patients following criticism of its methodology, but said the conclusions were not changed. Also last week, nearly 150 doctors signed an open letter to the journal calling the article's conclusions into question and asking to make public the peer review comments that led to it being published. Although it wasn't a rigorous experiment that could give definitive answers, the Lancet study had wide influence because of its size.

The World Health Organization said it would temporarily stop a study of hydroxychloroquine and France stopped allowing its use in hospitals. Health Canada has not paused trials it has authorized on hydroxychloroquine in COVID-19 patients. Instead, the regulator is asking for new safety assessments from the independent committee of experts who regularly review safety data collected during clinical trials. The New England Journal of Medicine also issued an "expression of concern" Tuesday on a study it published May 1 that suggested widely used blood pressure medicines were not raising the risk of death for people with COVID-19. Dr. Mandeep Mehra of Brigham and Women's Hospital in Boston led both studies, which relied on Surgisphere's database of health records from hundreds of hospitals around the world. Editors at the New England Journal of Medicine wrote that they've asked the authors to provide evidence the information is reliable.

Read more about the concerns

THE SCIENCE

Are we weakening our immune systems through excessive handwashing and disinfecting everything?

CBC News readers, viewers and listeners have sent in countless questions about the COVID-19 pandemic, including this one. If you have a question of your own, reach out at covid@cbc.ca.

As for the issue at hand: The answer is probably not. Health Canada told us in an email there's "no scientific evidence" of a direct link between frequent handwashing, sterile environments and a loss of adaptive immunity. "There are some hypotheses that exposure to different and mostly harmless pathogens can help us build up our immunity," said Alain Simard, a professor of immunology at the Northern Ontario School of Medicine. "But I would not say that sanitizing our hands and keeping a certain distance weakens it in our current scenario."

Steve Theriault, a virologist specializing in infectious disease in Winnipeg, said that there are "cases where people who have been away from populations and have had constantly clean areas have not shown that the immune system gets compromised." Theriault used astronauts on the International Space Station as an example. While the experts we spoke to agreed that there are no studies on the impact of fastidiousness and our immunity, they agreed we're probably not hurting our immune systems by practising physical distancing and disinfection.

For one, even while we're sanitizing and distancing, we're still being exposed to pathogens. "Our immune system is still being challenged by what goes in our mouth, by organisms we pick up from surfaces between handwashing episodes and the people and pets we live with," said Bob Hancock, a professor of microbiology and immunology at the University of British Columbia. Given our present situation, Hancock said, our immune systems are not going to be harmed by excessive washing and isolating during this pandemic.

AND FINALLY...

N.L. high school committed to keeping yearbook tradition alive despite pandemic closures

Emma Moores, Holy Spirit High School's student council president, said students and teachers still wanted to produce a complete yearbook amid the pandemic, even with physically distanced prom photos. (Submitted by Emma Moores)

While the last few months may prove to be unforgettable, the Holy Spirit High School class of 2020 in Conception Bay South, N.L., still wanted something hardcover and tangible to look back on. A small team of teachers and students has stuck with the pre-pandemic plan to put together a standard yearbook, despite the graduating class being absent for the last few months of its final school year.

Like schools in the rest of the province, Holy Spirit classrooms were closed, sports tournaments scrapped and the prom put off because of COVID-19 and the ongoing school system shutdown. But students and teachers didn't want to let the circumstances yank their yearbook as well. Instead of meeting in classrooms at lunch and after school, the yearbook committee is co-ordinating everything by email. "It'll be a great memory to have and see all the things we did get to do this year even though it got cut short," Emma Moores, student council president, told CBC News.

Nearly every student in the graduating class of roughly 230 has submitted a fill-in-the-blank biography form answering questions about their favourite saying and high school memory — something students pushed for. They wanted a regular yearbook with all the standard sections, although there will be some differences. Not every sports team had its team photo taken, for example, and the prom pages will show physically distanced celebrations, Moores said. They may have had a shortened senior year, she said, but they can fill out the final few pages of their yearbook and K-12 career from afar.

Read the full story about the yearbook project

​​Send us your questions

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

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 CBC News, The Canadian Press, The Associated Press and Reuters

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