If you normally skim through this column, slow down today and read this one carefully. What's happening in Canada could soon come to the US.  Email not displaying correctly?
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** As a new COVID-19 wave arrives in Canada, 2nd boosters begin right away for some
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A masked pedestrian walks through downtown Toronto, Friday, Sept. 10, 2021. (AP Photo/Chris Pizzello)

This development may make Americans sit up and pay attention, even though COVID-19 cases spiking in Asia and Europe did not. If you normally skim through this column, slow down today and read the following carefully, and keep this in mind as you read: The United States is reporting its lowest rate of new COVID-19 cases since last summer. But …

Canada is now facing a fourth COVID-19 wave, possibly recording 100,000 new cases daily ([link removed]) , which would be the highest rate since the pandemic began two years ago. The CBC summarizes the situation this way ([link removed]) :

By every available measure — hospitalizations, officially confirmed cases and the presence of the virus in sewage — Ontario's latest wave of COVID-19 infections is showing exponential growth.

Estimates from the viral count in wastewater suggest about 100,000 people are now getting infected daily ([link removed]) in Ontario, according to the COVID-19 Science Advisory Table. That is a faster infection rate than at any previous time in the pandemic.

All of this leaves no doubt that Ontario is in a sixth wave, even though the province's Chief Medical Health Officer Dr. Kieran Moore has yet to declare it officially. Moore hasn't held a news conference or done any media interviews in four weeks, despite repeated requests from a range of media outlets, including CBC News.

This week ([link removed]) , Canada's National Advisory Committee on Immunization strongly recommended the “rapid deployment” of second booster shots for seniors aged 80 and up who live in nursing homes or other group settings. But various provinces have different guidelines. In Manitoba, for example ([link removed]) , First Nations, Inuit and Metis people aged 50 or older, regardless of where they live, are urged to get second booster shots. Ontario plans ([link removed]) to offer fourth doses of vaccines to residents aged 60 and older very soon.

Here is what we do not know:
* How severe will the infections be? Canadian hospitals are not overrun with cases at the moment, but should that be the way we measure an outbreak or its potential? Ontario hospitals reported 1,126 patients with COVID-19 on Thursday, a jump of 36% in a week. It is the highest hospitalization figure since mid-February. But the number of COVID-19 patients requiring intensive care dropped a little on Thursday.
* How concerned should we be about BA.2? That variant is moving through Canada and has become the majority strain in the U.S. and Europe. Current vaccines seem to be effective in preventing severe illness, but don’t provide perfect protection against mild infection. CTV reports ([link removed]) , “According to data released by the Ontario Science Table on Wednesday, which takes into account population sizes, people who are fully vaccinated with at least two doses are 75.6 per cent less likely to end up in hospital and 84.9 per cent less likely to end up in ICU compared to people who are unvaccinated.” Israeli researchers recommended a second booster to protect against the new wave but, this week, the FDA’s expert panel on vaccinations did not agree that the data is convincing enough to make that recommendation.
* Is home testing and ramped-down data collection masking the infection rate in the U.S.? The answer is almost certainly yes. But we cannot know what we are not counting. Let me give you an example. The Centers for Disease Control and Prevention just issued its newest predictions ([link removed]) of what is ahead for the United States. Read this closely and notice the CDC’s estimate is somewhere between 400 and 10 times that number. Deaths will be around 1,200 per week but could be three times that high.

The CDC says:

“This week’s national ensemble predicts that the number of new daily confirmed COVID-19 hospital admissions will remain stable or have an uncertain trend, with 400 to 4,300 new confirmed COVID-19 hospital admissions likely reported on April 29, 2022.

As of April 4, 2022, national forecasts predict 1,200–4,000 new#COVID19 ([link removed]) deaths will likely be reported during the week ending April 30.

Dr. Lisa Salamon-Switzman ([link removed]) , an emergency physician in Toronto, said her hospital colleagues are getting infected and children are bringing the virus home from school.
[link removed]
(Twitter)

She said, “We can’t fourth-dose our way out of this,” meaning millions of people who are fully vaccinated are not eligible for a fourth dose because they are not five months past their third dose.

The CBC reports ([link removed]) :

Anthony Dale, the president of the Ontario Hospital Association, says Elliott's call not to panic is appropriate, but adds a caveat.

“Panic doesn't solve anything. But in saying, 'Don't panic,' that also doesn't mean 'Look away. there's absolutely nothing to see here, everything's fine,'” Dale said in an interview. “Our number one message is that this pandemic is not over.”


A NOTE FROM POYNTER
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** Is the ‘XE’ variant the next thing?
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Health Canada announced Thursday ([link removed]) that, “As of April 6, 2022, the Public Health Agency of Canada (PHAC) is aware of six detections of the XE recombinant lineage of Omicron ([link removed]) in Canada.”

COVID-19 XE is a combination of omicron’s BA.1 and BA.2 subvariants, two viruses rolled into one infection. This combination virus has shown up in the U.K., China and Thailand, but has not broken out as a dominant infection yet. Health experts say these so-called recombinant viruses are not all that unusual when a virus hangs around as omicron has and has time and plenty of unvaccinated potential hosts.


** The D.C. outbreak now includes Speaker Pelosi, D.C. mayor, Sen. Collins
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House Speaker Nancy Pelosi, Washington, D.C. Mayor Muriel Bowser ([link removed]) and Sen. Susan Collins are the latest high-profile public figures to test positive for COVID-19.
[link removed]
(Twitter)

The list of new cases this week also includes Attorney General Merrick Garland ([link removed]) , Commerce Secretary Gina Raimondo ([link removed]) , and Reps. Adam Schiff and Joaquin Castro.

On Wednesday ([link removed]) , Pelosi and many other members of Congress appeared maskless with President Joe Biden and, on Tuesday, gathered with former President Barack Obama. WTOP Radio reports ([link removed]) that two universities in the D.C. area — Georgetown University in D.C. and Johns Hopkins University in Baltimore — have reimposed mask mandates as COVID-19 cases among students are increasing:

The indoor mask requirement will go into effect on the Main and Medical Center campuses, with exceptions for eating and drinking or when students or staff are in their “personal residence or private office.”

Ranit Mishori, Georgetown’s Chief Public Health Officer, said the measures ([link removed]) are in response to a “significant” increase in COVID-19 cases, mainly among undergraduate students. The masking requirement will remain in place for the foreseeable future.

WTOP says:

Georgetown will also require all undergraduate students to take a PCR test before returning to campus from Easter break on April 18. Masks at Johns Hopkins University will now be required in residence and dining halls, with an exception for eating and drinking. This is in addition to masking requirements in all classrooms. Johns Hopkins will also test all undergraduate students twice-weekly through April 22.


** Mandatory masking again, maybe next week
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Philadelphia’s Department of Public Health says ([link removed]) as COVID-19 cases rise, it is likely that indoor mask mandates will start again, maybe even next week. The Philadelphia Inquirer reports ([link removed]) :

“What we see and know is cases are rising,” said James Garrow, a spokesperson for the department. “People should start taking precautions now.”

The Inquirer analysis isn’t predictive, and it is possible that key metrics triggering the return of the mask mandate could decrease by Monday. It’s “certainly possible,” Garrow said, but the city has not yet reached the peak of the case increase that appears to be building now. The city will review Monday’s hospitalization numbers and the last seven days of case counts to decide whether to change policies.


** States with the highest COVID-19 rates now
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If you trust the data coming from states, Alaska ([link removed]) currently has the highest new case rate (26 per 100,000 people), but hospitalizations are low.

Vermont has one of the highest vaccination rates in the country but currently is recording ([link removed]) the second-highest number of new COVID-19 infections (24 per 100,000). But again, hospitalizations are low.

Rhode Island, Colorado and New York round out the top five infections list, all above the 18 per 100,000 rate.

Under the old CDC rating system, those rates would have been listed as “moderate,” but using the CDC’s most recent rating system, nearly all of the country is considered to be at “low” COVID-19 levels because the updated rating system includes hospitalizations and deaths and is less reliant on new case figures.
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(CDC data, April 7, 2022)


** Life expectancy drops, again
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Thanks, of course, to the pandemic, life expectancy in America shortened, again. The data still has to undergo peer review but falls in line with other studies. Life expectancy dropped to 76.60 years in 2021 compared to 76.99 in 2020 and 78.86 in 2019.

The drop was bigger in the U.S. than in many other European countries ([link removed]) . The researchers blame vaccine hesitancy.


** Bird flu spreading through wild populations, zoos scramble
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A sign is seen instructing visitors of a closed bird exhibit at the Blank Park Zoo, Tuesday, April 5, 2022, in Des Moines, Iowa. Zoos across the country are closing down bird exhibits and bringing their animals inside where possible to protect them from the bird flu. (AP Photo/Charlie Neibergall)

The avian flu, which is not a great threat to humans, has spread to half of U.S. states. At least 23 million birds have been killed to try to limit the spread. This is the worst bird flu outbreak in five years, and it is not contained by a long shot.

NPR says ([link removed]) zoos are scrambling to protect their birds. Soon, zoo visitors may have a small number of species to watch because others will be kept away from everyone:

Penguins may be the only birds visitors to many zoos can see right now, because they already are kept inside and usually protected behind glass in their exhibits, making it harder for the bird flu to reach them.

Nearly 23 million chickens and turkeys have already been killed ([link removed]) across the United States to limit the spread of the virus, and zoos are working hard to prevent any of their birds from meeting the same fate. It would be especially upsetting for zoos to have to kill any of the endangered or threatened species in their care.

Wildlife biologists have detected the virus in birds across the entire eastern U.S., including infected geese and even bald eagles.
[link removed]
(U.S. Department of Agriculture)

The map is important partly because we are approaching peak duck and goose migration ([link removed]) on the flyways of the Midwest. Migrating ducks and geese often carry the virus even while not showing symptoms. Because they cover so many miles so fast, they can spread the virus far and wide.


** Bird flu affecting poultry and egg prices
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Typically when even one case of the bird flu is found in a flock of chickens or turkeys, agriculture and health officials order the entire flock to be killed because the virus is so infectious.

When farmers destroy more than 23 million birds, it causes yet one more problem for supply: driving up prices for both poultry meat and eggs. And Easter typically is a time when egg prices rise as people buy them up to decorate. USA Today ([link removed]) reports:

Often, the holiday is when retailers discount eggs. But the average weekly price ([link removed]) for large eggs is 44% higher than this time last year, according to USDA data.

Eggs prices were up 11.4% in February from a year earlier and were up 2.2% from January, according to the latest Consumer Price Index data ([link removed]) published in March.

The wholesale cost for a carton of eggs in the Midwest jumped 60% from March 25 to April 1 to $2.47.

That's still below the peak price in late March 2020, when pandemic and Easter demand collided and caused wholesale egg prices to more than triple to an all-time high of $3.07 a dozen.

NPR points out ([link removed]) :

Officials emphasize that bird flu doesn't jeopardize the safety of meat or eggs or represent a significant risk to human health. No infected birds are allowed into the food supply, and properly cooking poultry and eggs kills bacteria and viruses. No human cases have been found in the U.S., according to the Centers for Disease Control and Prevention.

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