1. Back to school and COVID data
Yesterday, Education Minister Becky Druhan announced that Nova Scotia’s public schools will resume with in-person classes on January 10.
“We know that the best place for students is in school where they have continued access to learning and the supports and services they need for their emotional and mental well-being,” said Druhan in a press release and again in person at a briefing with reporters yesterday afternoon.
The announcement comes as the province is dealing with unprecedented COVID case numbers because of the Omicron variant.
“Our approach to returning to schools is about balance,” explained Chief Medical Officer of Health Dr. Robert Strang at the briefing. “One of our key priorities has always been to keep children in school whenever possible. The concerns about controlling the spread of what is generally a relatively mild disease in children need to be weighed against the clear harms and risks associated with children not being in school and learning at home. School is so important in so many ways, for some children, it’s their safe place where they get the most support physically and emotionally. And many children are not able to learn effectively online, from home. I know this shift will be difficult, but it is the right path forward.“
“With COVID presenting now, it’s become clearer and clearer that for children and youth, it is by and large a relatively mild disease,” continued Strang.
More broadly, Strang said his top concern is protection of the hospital system. “Our hospitalizations have moderately increased, but so far the health system is managing, despite [that] many health care workers are sick or isolating,” he said. “However, we are seeing a trend in increasing hospitalizations across the country and we need to keep a close eye on that over the coming weeks. There is often a delay of two to three weeks between cases and hospitalizations.”
I asked Strang specifically about that:
Bousquet: Dr. Strang, you said there’s been a moderate increase in hospitalizations, but you didn’t put a figure on that. I’m curious, have any children been hospitalized?
Strang: We have not, to date throughout the pandemic, had children hospitalized directly as a result of COVID.
I don’t know what “directly” means in that context.
It’s difficult to understand what the hospitalization situation is now, and predict what it will be in coming weeks.
Lots of people are sending me news articles about Omicron hospitalizations in other countries, but the disease and vaccine situations vary so much that’s it’s impossible to make direct comparisons.
For example, South Africa has a low vaccination rate, and a relatively young population. Complicating it further, that country has seen a shifting vaccination program, starting with AstraZeneca, moving to Johnson & Johnson, and then to Pfizer.
Great Britain has a relatively high vaccination rate for adults over 18, but very low (close to zero) for children, and the adults mostly received two doses of AstraZeneca, which appears to provide less protection against Omicron than do two doses of an mRNA vaccine.
New York has high rates of mRNA vaccination, but there are large pockets of unvaccinated people, including among poor people in particular racial categories, who may have more difficulty accessing the privatized health system in the US.
And Florida is, well, Florida.
I’m not saying that Nova Scotia won’t face the same sort of hospitalization challenges other jurisdictions have faced. Rather, I’m saying we just don’t know. There’s isn’t enough information to make an informed prognosis.
What’s needed is more data specific to Nova Scotia.
Unfortunately, due in part to the Christmas holidays, but mostly due to a Public Health system overburdened by Omicron cases, those data are lacking. The Department of Health hasn’t even released hospitalization figures since last Friday, when there were 15 people in hospital with COVID, four of whom were in ICU; Strang said yesterday that hospitalizations have increased “moderately” but didn’t put a number to them.
Additionally, the province has stopped reporting the vaccination status of new cases, hospitalizations, and deaths. Since June, that information has been reported every Friday, but last week, citing the delays in inputting case data into the province’s database, it was not reported.
But exactly now, in a severe outbreak situation, is when we need that information the most. As I explained in an email to the Department of Health:
Understand that I fully appreciate that Public Health is overwhelmed with thousands of new cases, that contact tracing is behind, and that workers are working overtime and more. It probably is in fact too much of an ask to request that the vaccination status of new cases be recorded and made public.
However, I don’t see it that way for hospitalizations and deaths. We haven’t seen hospitalization numbers since Friday, but since the Omicron outbreak, there have been fewer than 10 new hospitalizations (four is what Dr. Strang said last briefing), and there’s been one death.
I don’t think it’s at all unreasonable to ask for the vaccination status of five people.
I’m not asking out of idle curiosity. This information will give the public a better understanding of the risks associated with Omicron — how many (and at what rate) are vaccinated people being hospitalized? This is information that can better inform people’s decision-making about how to behave in the world.
Additionally, there’s a matter of democratic oversight of Public Health — without the data on vaccination status of hospitalizations and death(s), there is no way to assess how well (or not) Public Health directives and policies are working. It’s gets right to trust of Public Health, which has previously been evident in Public Health’s openness, so it’s unfortunate to see the pull-back of such data right at this crisis moment.
Again, I can appreciate that asking for the vaccination status of four or five thousand recent cases can be too much of an ask at this moment, but asking for that data for fewer than 20 hospitalizations and deaths does not seem unreasonable.
I sent that email on Monday; I’ve yet to receive a response.
I think Strang is right about kids: the harm done by not going to school probably does exceed the risk to them from contracting COVID at school. (This isn’t true for all kids — some are themselves immunocompromised.) But kids aren’t an isolated population — they go home and interact with siblings, parents, grandparents, people at the grocery store, and so forth, and some of those people are much more at risk from the virus. Some are elderly. Some are immunocompromised. Some can’t get vaccinated for legitimate health reasons. And so on.
As is, without more data, it’s impossible for the public to assess the risk to others of sending children to school.
2. Contact tracing and testing
“On December 28, in a hotly anticipated press conference concerning the post-Christmas return to school, Dr. Robert Strang, Nova Scotia’s beloved and much-memed Chief Medical Officer of Health, explained that schools would return to in-person classes on January 10, but would no longer be part of Public Health’s contract tracing efforts. Furthermore, PCR testing — the gold standard for detection of COVID-19 virus — will only be available for certain groups of people, with teachers and students not on the list,” writes Martha Paynter:
Social media was swiftly ablaze with comments decrying the chief medical officer of health’s decisions as having left us all behind, destroying the legacy that has set Nova Scotia apart during the pandemic — so significantly apart that our population grew to more than one million people this year, and our housing market is literally on fire.
But as a nurse working in the system — and a critical, political opponent of every ill-advised government announcement — I want to offer my support for this latest decision and explain why: We simply do not have enough human resources to keep going on as was.
At this point in the pandemic, we need the public to do their part. Yes, this is asking more of a public already stretched beyond what they can handle. But some of us are in a position to step up and step up we must. For over a year, volunteers have made Nova Scotia’s asymptomatic testing program possible. Volunteers continue to staff several rapid testing sites daily and assemble rapid antigen testing kits for people to administer at home. We need the public to do those tests when they are worried, and definitely when they are symptomatic. We need them to self-report results to Public Health. And we need them to do their best to contact trace on their own and ask those contacts to test themselves and hunker down for public safety.
3. Trolling Public Health
Some private person out there in the world filed a Freedom of Information request with the province for the following:
With respect to the vaccinations administered to the people of Nova Scotia for COVID 19, please provide me with a copy of every single page, without exception, of every single INFORMED CONSENT form, without exception, depersonalized to protect the recipient, executed by the signature of the recipient for every injection administered. In addition provide all information otherwise for each instance that the above INFORMED CONSENT was obtained, that evidence was made detailing 1) that the experimental substance received was described in full, 2) that the risks were described in full, 3) that the recipient comprehended the risks, that the benefits were explained in full, 5) that the benefits were comprehended by the recipient, 6) that shows that the recipient stated that the the recipient was not subjected to any form of coercion, 7) the name of the clinical trial coordinator, 8) the name of the person who informed the recipient of the risks and benefits, and 9) the age of the recipient. Craig Beaton, the Associate Deputy Minister, has testified that ALL of this information exists. I want it all with the exception of the personal information pertaining to the recipient. (Date Range for Record Search: From 12/31/2019 To 09/14/2021)
For context, there have been over 1.7 million doses of vaccine administered. Should the consent information for each dose administered be contained on a single 8 1/2 x 11 sheet of paper, that would result in a stack of paper about 172 meters tall — almost two Fenwick Towers’ worth of paper. Or, should the pages be put end to end, they’d stretch 475 kilometres, about the distance from Halifax to Bathurst, New Brunswick.
That’s a lot of reading.
But of course the requestor will not get the documents. It turns out they’ve filed a previous request for something related, and as Associate Deputy Minister Craig Beaton patiently explained in his response to the latest request:
In your previous FOIPOP request (2021-01357-HEA) you were provided with a copy of the blank consent form for the Moderna, Pfizer and AstraZeneca vaccinations. DHW indicated that all individuals receiving vaccinations have signed a consent form. The consent form itself signed by individuals would be considered part of their Personal Health records and therefore subject to the Personal Health Information Act. In order to receive a copy of records of an individual from their Personal Health records you would need the consent of the individual to release this information.
So, alas, we won’t see two Fenwick Tower-sized stacks of paper delivered to the requestor.
Beaton did, however, provide documents detailing “staff roles and responsibilities, the script used by health care providers when the vaccine was administered as well as information regarding informed consent.”
There’s no point to any of this beyond trolling Public Health officials who have better things to do with their time.
4. Muskrat Falls
“Delays in the receipt of hydroelectricity from Muskrat Falls in Labrador have cost Nova Scotian ratepayers more than $200 million over four years to replace it with other sources of energy,” reports Jennifer Henderson:
That information was finally made public by Nova Scotia Power on Friday, December 24, after being ordered to disclose the amount by the regulator, the Utility and Review Board.
Click here to read “Delays in Muskrat Falls project have cost Nova Scotia Power ratepayers $200 million.”
In the harbour
08:30: Onego Maas, cargo ship, arrives at Pier 27 from Esbjerg, Denmark
11:00: CLI Pride, cargo ship, arrives at Pier 42 from Rotterdamn
15:00: NYK Nebula, container ship, arrives at Fairview Cove from Antwerp
15:30: MSC Naomi, container ship, sails from pier 42 for New York
16:00: Oceanex Avalon, arrives at Berth TBD from St. John’s
16:30: Conti Contessa, container ship, sails from Fairview Cove for New York
18:00: CLI Pride moves to Fairview Cove
22:00: ZIM Qingdao, container ship, sails from Pier 41 for New York
08:00: Viktor Bakaev, oil tanker, sails from Point Tupper for sea
15:00: CSL Kajika, bulker, moves from anchorage to Coal Pier (Sydney)
15:00: CSL Tarantau, bulker, sails from Coal Pier (Sydney) for sea
I’ve been working through the holidays, obviously, but just not as much. Last night, I had the deepest, most rewarding sleep I’ve had in years. A guy could get used to this.
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Hey Tim, my best guess is that the children “hospitalized directly due to covid” would mean that they are admitted to hospital due to covid related complications. They would likely be treated in the Pandemic Response Unit. People hospitalized not directly due to covid might be a person who has covid but needs medical care/observation due to another urgent cause (ie. Significant Physical injury, anaphylactic allergy, another urgent care need). Or the person was hospitalized due to another cause and while in care developed symptoms and tested positive (likely infected prior to admission). I suspect outbreaks in hospital might be when a patient or support person spreads it to another patient.
That FOIPOP request exemplifies the challenges associated with trying to do the right thing from a public health perspective and dealing with the growing movement of conspiracy theorists whose tin foil hats are starting to gleam more and more often in the masses of informed/misinformed masses. It is a fine balance to be achieved responding to legitimate requests or dealing with such frivolous and vexatious inquires like this one for all the signed records. As tempting as it is to pass over such silly requests, it is an impossible task to draw the line.