[Dr. Dina News] Happy Earth Day

Dr Dina News

Hello friends!

I hope you enjoyed the sun this weekend with your family.

Let’s dive in.

There have been more than 507 MILLION cases of confirmed COVID worldwide, with over 6.2 million deaths. In Canada, we have seen almost 3.7 million PCR-confirmed cases of COVID with over 38,500 deaths.

There are nearly 6,300 people hospitalized with COVID in Canada, up about 1,000 from last week.

According to the CDC, the United States’ seven-day moving average for new cases of COVID is up 24% from last week. Omicron BA.2 and subvariant BA.2.12.1 cause 93.4% of COVID-19 cases. Omicron BA.2 subvariant made up 74.4% of all COVID-19 infections the previous week, and BA.2.12.1 accounted for 19% of the cases.

The United States dropped their mask mandate for domestic plane travel in the U.S. However, based on public health guidance, masks will continue to be required when travelling through Canadian airports. Masks will be required for the duration of travel from or to a Canadian airport for domestic and international travel.

Travellers into Canada will require masks when in public places for two weeks after arrival due to federal rules, even in areas when mask mandates have been lifted.

Travel industries argue that HEPA filters on planes decrease the risk of COVID in flight. However, HEPA filters are not active during boarding, deplaning, and refuelling, only during actual flight. Several studies have found that wearing a mask on a plane significantly reduces the risk of COVID spread.

According to the CDC, hospitalization rates for unvaccinated kids aged 5 to 11 were twice as high as those who were vaccinated during the Omicron period. In their study of 397 hospitalized children, 87% were unvaccinated, 30% had no underlying medical conditions, and 19% were admitted to an intensive care unit. Black children accounted for the highest percentage of unvaccinated children (34%), followed by white children (31%) and Hispanic children (19%). Children with diabetes and obesity were more likely to experience severe COVID-19.

A recent study by pediatric emergency medicine colleagues in Ottawa found that children are a significant source of COVID household transmission. Researchers found that children infect at least one-third of household members. They note that children can potentially spread the virus in closed, indoor settings such as schools, especially since masks are no longer consistently used.


Here are the most asked questions of the week

How many people in Canada have had COVID?

Because most people cannot access PCR tests, we do not have accurate data. A new online survey suggests that ¼ of Canadians have been infected with COVID at some point.


Will there be updated booster shots still?

Moderna says they will have an updated booster this Fall, with additional protection against Omicron. The current vaccines are based on the original COVID variant. As the virus mutates, the vaccine is less effective at preventing infection, however, it remains effective at preventing severe illness and death.


Is long-COVID different in women and men?

A new study shows that women with long COVID are ‘significantly more likely to have difficulty swallowing, chest pain, and fatigue than men with long COVID’. Previous studies have shown that men are more likely to have severe disease from COVID, but few studies have looked at the difference between men and women in long-COVID.


Who can use COVID-19 antiviral treatments?

As of April 11, individuals who develop COVID symptoms (even if mild) and are at higher risk of severe COVID-19 are advised to seek testing and care immediately by contacting their primary care provider or visiting a clinical assessment centre.

Treatment with Paxlovid must be started within five days of symptoms, where day 0 is the first day of symptoms.

To initiate treatment, patients must have tested positive for COVID-19 on a rapid antigen test (self-administered or provider-administered), a PCR, or a rapid molecular test. Note that a negative rapid antigen test does not rule out the possibility of COVID infection.

Eligibility is based on clinical judgement. A physician will determine whether a patient is at higher risk of severe COVID-19 and if antiviral treatment is appropriate. The cost of Paxlovid is covered in Ontario at no expense to patients with a prescription.


Why did the CDC issue an alert on liver damage in children?

Researchers are investigating a possible connection between kids infected with hepatitis and adenoviruses and liver damage.

Last week, the CDC advised physicians and public health officials to look for pediatric patients with hepatitis from unknown causes. A cluster of kids in an Alabama developed liver damage with hepatitis and adenovirus infections.

Nine kids who were positive for adenoviruses were identified between October 2021 and February 2022. Adenoviruses cause cold-like symptoms such as fever, sore throat, diarrhea, and pink eye.

These kids also tested positive for hepatitis, liver inflammation that can lead to liver damage and even death. Two of the patients required liver transplants, but no children died.

Similar cases in the United Kingdom were noted earlier this month. Seventy-four cases of severe acute hepatitis with unknown causes were identified in the U.K. The patients tested negative for hepatitis A, B, C, D and E, though some kids tested positive for COVID-19 and adenoviruses.

The CDC and the WHO advise healthcare professionals to test for adenoviruses in pediatric patients diagnosed with hepatitis from unknown causes.


What is Evusheld?

Evusheld is a prophylactic injectable therapy of monoclonal antibodies tixagevimab and cilgavimab; Health Canada has approved it for the prevention of COVID-19 for individuals 12 and older (and at least 40 kg) who are unlikely to mount an adequate immune response to COVID vaccination or for whom COVID vaccination is not recommended.

To receive Evusheld, individuals must not be currently infected with COVID-19 or have been recently exposed to COVID-19.

Evusheld is expected to be effective against the Omicron subvariant BA.2. Evusheld is not yet available for distribution in Ontario, but The Ministry of Health is working through an implementation plan.


My silver lining of the week

The temperature is starting to rise, and we have been able to play tag, go for bike rides and even begin to swim outside (you know you live in Ontario when you are eager to swim in 8 degrees Celsius)! Summer, here we come!

Have a wonderful week, friends,

Dr Dina Kulik - Kids Health

Dr. Dina Kulik, MD, FRCPC, PEM

Written By: Dr. Dina Kulik, MD, FRCPC, PEM

Dina is a wife, mother of 4, and adrenaline junky. She loves to share children’s health information from her professional and personal experience. More About Dr Dina.

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IMPORTANT UPDATE re. VIRTUAL CARE – The Ontario Medical Association and the Ministry of Health agreed that there would be changes made to the way that virtual medicine would continue as of October 1, 2022

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