N.B. COVID-19 roundup: 111 new cases, booster wait cut to 5 months over fear of holiday wave

New Brunswick reported 111 new cases of COVID-19 on Wednesday and announced it's reducing the time people 50 or older have to wait to get their COVID-19 vaccine booster shot to five months.

Premier Blaine Higgs told reporters the decision was prompted in part by fears of an "unmanageable" wave of cases after Christmas holiday gatherings.

"If people don't get vaccinated with their booster, then the most vulnerable, which are, you know, the 50-plus, are going to be in a situation after Christmas, or during Christmas, that does give us concern," he said, referring to waning two-dose protection.

Until now, people have only been eligible for a booster dose of an mRNA vaccine if six months have passed since their second dose.

But in a news release Wednesday, Public Health said people 50 and older who are due for a booster any time in December can book an appointment now, even if a full six months have not passed.

More booster dose clinics have also been added provincewide, in an effort to reduce the number of people hospitalized with COVID-19, it said.

"There's no harm done by getting it earlier," said Higgs, and the province has "lots of vaccines."

Officials discussed the six-month rule during a meeting Tuesday night, he said. "We were talking about, well, all right, what if it's less than that? Are we worried about that? If we're worried about the age and demographics and the vulnerability, are we worried if they get it in five months, or they get it sooner than six months?

"And really the response I got was, 'No, we're not.' So I think what you're going to see is something that just says, pharmacies can book people that are 50-plus. It's not like they're going to say, 'Well, you're not six months yet, you're shy of that by about a week. So you've got to wait.' I think we'll see more pharmacies say, 'No, come on in, get vaccinated.'"

Huh. That would be news to immunizers.- Jake Reid, New Brunswick Pharmacists' Association

The announcement came as a surprise to Jake Reid, executive director of the New Brunswick Pharmacists' Association.

"Huh. That would be news to immunizers," he posted on Twitter.

A total of 82.1 per cent of eligible New Brunswickers are fully vaccinated against COVID-19, up from 82 per cent, and 87.8 per cent have received their first dose, up from 87.6.

That includes 10,544 first doses of the pediatric COVID-19 vaccine that have been administered to children aged five to 11 since appointments opened on Nov. 26, Public Health said.

The province's goal is to get at least 90 per cent of the total population fully vaccinated.

According to the CBC vaccine tracker, 78.1 per cent of the total population is double-dosed, while 83.5 per cent have received at least one dose.

In the coming weeks, eligibility for booster doses will be expanded to people in their 40s, followed by all other New Brunswickers.

Appointments for booster shots for those eligible and for first and second doses can be scheduled for a regional health authority community COVID-19 vaccination clinic through the online booking system or at a participating pharmacy.

A list of upcoming walk-in clinics is available online.

A detailed list of those eligible for a booster dose is available online.

Higgs backtracks on ventilation as cause of hospital outbreaks

Premier Blaine Higgs tried Wednesday to allay fears he created that ventilation systems caused the COVID-19 outbreaks at three of the province's hospitals, and the Horizon Health Network issued a statement to set the record straight.

"There is no evidence that our hospital ventilation systems have, in any way, played a role in the transmission of COVID-19 among inpatients in any of our facilities," Dr. Gordon Dow, Horizon's regional infectious diseases medical director, wrote.

Horizon's outbreak management team has identified "short range [within two metres] person-to-person transmission as the likely cause" of the outbreaks at the Moncton Hospital, the Saint John Regional Hospital and the Miramichi Regional Hospital.

Of the 43 people currently hospitalized with COVID-19, including 18 in intensive care, eight were initially admitted for other reasons and contracted COVID-19 because of the outbreaks, Public Health said. Most of these people are exhibiting "mild to moderate" symptoms, it said.

For two days, Higgs made statements in the legislature that indicated the hospitals' ventilation systems had caused the outbreaks.

Then, on Wednesday afternoon, he told reporters he has asked the CEOs of the Horizon and Vitalité health networks to issue a statement to "identify the actual situations and what caused them and what remedies they've done.

But "as I understand, it wasn't like the entire hospital ventilation, it wasn't at all," he said.

"It was actual procedures that were being administered within a hospital setting — in a room, or in a ward."

Asked whether he was referring to ventilators, he said, "With ventilators, or aspirators, or a situation like that. But the health authorities will clarify that."

Just hours earlier, in response to a question from Jean-Claude D'Amours, the Liberal MLA for Edmundston-Madawaska Centre, Higgs indicated to the legislature that health officials told him the hospital outbreaks were linked to ventilation.

"I can't speak to the technicalities of it, Mr Speaker, but I can speak that there was a situation that determined that there was a spread through airborne spread and ventilation and that was corrected in both networks," he said.

"The health authorities have told us that they went through their protocols in relation to patients with COVID and treated them with ventilators and how to minimize the kind of, the airborne diffusion of the virus. And that was learned through different hospitals in the province and similar situations. And then it was implemented in Vitalité and later implemented in Horizon," said Higgs.

"So I think the message here today, Mr. Speaker, is simply that the health authorities have implemented changes to their protocols. They feel very comfortable now, and as their patients should feel comfortable that when they come to the hospital, for whatever reason, they should be safe and not have to worry about any infection of COVID."

D'Amours said it was "shocking and inexcusable" that the government was "idly watching" as the outbreaks occurred.

"Will the premier publicly and transparently state exactly how many citizens [have] fallen ill with COVID because of the ventilation system in our hospitals?"

"Will the premier be transparent and tell us exactly how many New Brunswickers have died as a result of the outbreaks in our hospitals?"

He also demanded to know where else in the province ventilation systems have been identified as a cause of transmission.

Higgs replied that he's not a medical professional, but said he will ask the Horizon and Vitalité CEOs to "communicate in effective manner to the public so that they can be assured that this has been addressed."

Interim Horizon CEO Dr. John Dornan told CBC News a thorough investigation has been done, and direct contact or droplet interaction has been identified as the cause.

"We have looked at how this is acquired," he said. "We know which people are infected and we know who they have been in touch with. We have done testing of those folks, and we found out that in every instance, it's not because of any ventilation problems, it's because of direct contact."

Asked whether that's because it's not possible for COVID to spread through ventilation systems, or because contact is a more effective way for the virus to spread, Dornan replied, "I would never say never, but we have not seen in our health-care system COVID being contacted through a ventilation system."

The virus requires relatively close proximity and doesn't survive over the pipes and tubing for ventilation, he said.

Asked how the premier would have gotten the idea ventilation played a role, Dornan said when someone acquires COVID in hospital, officials "scramble" to find out how it happened and how it can be prevented from happening again.

With the type of filtration and ventilation that we have, it's not been seen. Not likely. ​​​​​​- John Dornan, interim president and CEO of Horizon

"It's intuitive to think that, you know, if it's contact and droplet, well, could it not be air as well? And so this is why our government and even folks in our hospital raised an alarm, could it be? We need to look at this carefully.

"So when we looked at it, we find out that no, with the type of filtration and ventilation that we have, it's not been seen. Not likely. And we have an explanation for all those folks that have become infected."

Hospital ventilation systems have not played a role in the transmission of COVID-19 among inpatients in Vitalité facilities, microbiologist Dr. Christine Bourque said in a statement.

"We know that COVID-19 is transmitted mainly through close contact between people," she said in French. "Transmission occurs primarily through respiratory droplets and upon contact with contaminated surfaces.

"The role of preventive measures such as hand hygiene, respiratory etiquette, mask wear, cleaning and disinfection, and physical distancing is fairly well recognized in limiting the transmission of the SARS-CoV-2 virus."

As of Tuesday, 32 patients and eight staff have tested positive for COVID-19 in connection with the outbreaks on the Moncton Hospital's family medicine and palliative care unit, Unit 3600, rehabilitation unit, Unit 4400, stroke and family medicine unit, Unit 4600, and family practice and geriatric unit, Unit 5100, which started on Nov. 22.

The two new positive cases confirmed since the last update Friday have been one patient and one staff member, both on Unit 4600, said the hospital's executive director Christa Wheeler-Thorne.

There have been no new cases on Unit 5100 since Dec. 2 and on Unit 3600 since Nov. 26.

Patients on outbreak units were tested on Monday and will be tested again on Thursday, said Wheeler-Thorne.

"We are continuing to test patients on other units of the hospital to ensure there are no other asymptomatic cases (sentinel surveillance); no cases have resulted from this testing," she said in an emailed statement.

Staff on outbreak units were tested Tuesday and will be tested again on Dec. 14, "or sooner, if needed."

"We have also expanded staff testing through the facility." Results from a pop-up clinic held Tuesday were expected later Wednesday.

There are seven patients on the COVID-19 Unit whose cases are all related to the outbreaks, and two in the intensive care unit. 

Outbreaks at the Saint John Regional Hospital's orthopedic surgery (3CS) and internal medicine (4CN) units stand at two patients, Horizon said Wednesday, and the outbreak at the Miramichi Regional Hospital's intensive care unit and family practice unit (2 West) still stands at one patient.

D'Amours said his biggest fears were confirmed Tuesday when Higgs first mentioned ventilation was connected to the hospital outbreaks in response to his question about whether New Brunswick is "losing ground" in dealing with the fourth wave of the pandemic and what the COVID projections are following the Christmas holidays.

"In some hospitals, we had an outbreak of COVID cases in the hospital itself and that has been addressed by Horizon and Vitalité. So that is under control," replied Higgs.

"They discovered the problem and talked about the ventilation in hospitals and what was causing that outbreak. They found that and they fixed it. So people should not be afraid to go to the hospital if they have other issues and afraid that they might get COVID while they're there."

For weeks, the government, Minister of Health Dorothy Shephard and premier remained silent on the issue and never informed the public, said D'Amours.

Breakdown of new cases

In addition to the 111 new cases of COVID-19 confirmed Wednesday, Public Health reported 82 more recoveries, putting the province's active case count at 781, an increase of 29.

Twenty-nine of the new cases are children under 10. Another 21 are aged 10 to 19.

Forty-three people are hospitalized with COVID-19, down from 47, including 18 in intensive care. Eleven of them are on ventilators.

Of those in hospital, 25 are over 60 and one is under 19.

Hospitalizations continue to trend downwards from a week ago, while the number of cases in intensive care units remains stable, said Public Health. The seven-day rolling average of hospitalizations is now available on the COVID-19 dashboard.

The regional breakdown of the new cases includes:

Moncton region, Zone 1 — eight cases:

• Three people nine or under
• Two people 10-19
• A person 50-59
• Two people 60-69

Six of these cases are under investigation and the other two are contacts of previously known cases.

Saint John region, Zone 2 — 23 cases:

• Three people nine or under
• Four people 10-19
• A person 20-29
• Five people 30-39
• Four people 40-49
• A person 50-59
• Three people 60-69
• A person 70-79
• A person 80-89

Thirteen of these cases are under investigation and 10 cases are contacts of previously known cases.

Fredericton region, Zone 3 — 61 cases:

• 17 people nine or under
• 13 people 10-19
• Five people 20-29
• Nine people 30-39
• 10 people 40-49
• Three people 50-59
• Two people 60-69
• Two people 70-79

Fifty-three of these cases are under investigation and eight are contacts of previously known cases.

Edmundston region, Zone 4 — two cases:

• A person nine or under
• A person 10-19

Both of these cases are under investigation.

Bathurst region, Zone 6 — one case:

• A person 60-69

This case is a contact of a previously known case.

Miramichi region, Zone 7 — 16 cases:

• Five people nine or under
• A person 10-19
• A person 20-29
• Four people 40-49
• Two people 60-69
• Two people 70-79
• A person 80-89

Twelve of these cases are contacts of previously known cases and four cases are under investigation.

New Brunswick has had 9,049 confirmed cases of COVID-19 throughout the pandemic and 8,131 recoveries so far and 136 deaths.

A total of 572,134 tests have been conducted to date, including 1,477 on Tuesday.

2 cases at 2 more UNB Fredericton residences

Two new cases of COVID-19 have been confirmed at the University of New Brunswick Fredericton campus in two more student residences — one in Lady Beaverbrook and one in Neill House.

Public Health is actively investigating the situation, according to a COVID update email the university sent to students late Wednesday afternoon. "UNB is taking all guidance and direction from them," it said.

There are two confirmed cases of COVID-19 at the Joy-Kidd residence, as of Monday. Students were advised of those cases last Thursday and several possible exposure notices have followed.

"At this time, we do not anticipate any changes to our operations, this includes classroom management or course delivery," Wednesday's email said.

The vaccination rate on campus is 96.7 per cent and higher among the residences, it said.

10 cases in schools, child-care facilities

Ten new cases of COVID-19 have been confirmed in schools and child-care facilities in three zones, with the majority in the Moncton region, Zone 1.

Six schools across the province had operational days Wednesday, which means either all the students or specific groups are learning from home. 

About 80 per cent of active cases within schools are in elementary schools, according to a government news release.

Often the virus was transmitted outside a school setting or when safety measures weren't followed, the release said.

"We all have a role to play in keeping schools healthy and safe," Education and Early Childhood Development Minister Dominic Cardy said in a statement.

"What happens in schools is often a reflection of what is happening in a community. We are counting on individuals, families and businesses to follow Public Health advice and make conscious, healthy choices."

Eight of the new cases are in schools.

At least one positive case has been confirmed at Harvey Elementary School, which is in the Fredericton region, Zone 3, and was not previously affected, the Department of Education and Early Childhood Development's website shows.

The other schools where at least one positive case has been confirmed include:  École Anna-Malenfant, Evergreen Park School, and Maplehurst Middle School, all in the Moncton region, Zone 1, and Centennial School in the Saint John region, Zone 2.

The website does not indicate how many cases are at each school or whether the cases involve students, teachers or staff.

Fifty-three schools are currently affected.

A total of 642 cases of COVID-19 have been confirmed in 167 schools since the beginning of the school year.

The two child-care facility cases are both at Nos Petits Camarades, which is in the Moncton region, Zone 1, and was not previously affected.

The website does not indicate whether that case involves a child, staff member or volunteer.

There have been 109 early learning and child-care centres affected by COVID-19 since Sept. 7. The total number of cases has not been released.

Atlantic COVID roundup

Nova Scotia reported 34 new cases of COVID-19 on Wednesday, bringing the active caseload in the province to 162. Eleven people are in hospital with the coronavirus, including four in intensive care.

Newfoundland and Labrador announced five new cases and has 17 active cases.

Prince Edward Island confirmed five new cases on Tuesday. The province has 23 active cases.

Public exposure notices

The province listed a number of potential COVID-19 public exposure notices on Wednesday, including a bowling alley, Costco and Lions Club in the Saint John region, Zone 2, and sports complex, a fitness centre and a barber shop in the Fredericton region, Zone 3.

For the full list of public exposure notices, visit the provincial government's website.

People who have not been fully vaccinated at least 14 days prior to a possible exposure and who have symptoms should get a COVID lab test. They can book an appointment online or call Tele-Care 811 and must isolate while waiting for their test result.

People who are not fully vaccinated and do not have symptoms are now being instructed to pick up an At-Home COVID-19 Rapid Point of Care Test (Rapid POCT) screening kit. They do not need to isolate if they have not been directed by Public Health to do so.

All positive point-of-care test results must be confirmed with a laboratory polymerase chain reaction, or PCR, test.

It can take up to 14 days to test positive after being exposed to COVID-19, so even if results come back negative, people should continue to self-monitor for any symptoms and get tested immediately if any develop.

They should also avoid visiting settings with vulnerable populations, such as nursing homes, correctional facilities and shelters during that 14-day period.

For people who have been fully vaccinated at least 14 days prior to a possible exposure, Public Health recommends they monitor for symptoms for 14 days after the possible exposure and get a COVID lab test if symptoms develop.

They do not need to isolate while they wait for their test results.

If they do not have symptoms, they can pick up a rapid test kit and do not need to isolate.

What to do if you have a symptom

People concerned they might have COVID-19 can take a self-assessment test online.

Public Health says symptoms of the illness have included a fever above 38 C, a new or worsening cough, sore throat, runny nose, headache, a new onset of fatigue and difficulty breathing.

In children, symptoms have also included purple markings on the fingers and toes.

People with one of those symptoms should stay at home, call 811 or their doctor and follow instructions.