N.B. COVID-19 roundup: Doctors call for mandatory vaccination of health-care workers

The New Brunswick Medical Society is calling for COVID-19 vaccinations to be mandatory for all health-care workers.

It comes after the two national organizations representing physicians and nurses issued a joint statement Tuesday, seeking mandatory vaccinations for health-care workers.

The Canadian Medical Association and the Canadian Nurses Association cited mounting concerns over highly contagious COVID-19 variants and "levelling-off" vaccination rates across the country.

"The New Brunswick Medical Society agrees with the recent call for mandatory COVID-19 vaccinations for health-care workers by the Canadian Medical Association and Canadian Nurses Association," Dr. Jeff Steeves, president of the professional association that represents more than 2,000 physicians across the province, said in an emailed statement.

"COVID-19 is still present in New Brunswick, as indicated by the number of new cases over the past few days. The Delta variant is highly contagious and can cause serious illness, especially for the unvaccinated population.

"Health-care workers who are in close contact with vulnerable patients are at risk of exposure due to the high degree of transmission."

Physicians urge all New Brunswickers to get their first and second doses as soon as possible, "especially now that the province has lifted all restrictions," Steeves added.

The Nurses Association of New Brunswick does not have a formal position statement on mandatory vaccinations, said spokesperson Jennifer Whitehead.

"However, we do support vaccinations of all health-care providers."

The province does not plan to make vaccinations mandatory, according to Department of Health spokesperson Bruce Macfarlane.

At this time, we will continue to encourage vaccination uptake through educational information, focusing on the safety and effectiveness of the vaccines.- Bruce Macfarlane, Department of Health

"At this time, we will continue to encourage vaccination uptake through educational information, focusing on the safety and effectiveness of the vaccines," he said in an emailed statement.

Macfarlane noted 82 per cent of Horizon Health Network's staff had received one dose of a vaccine, while 74 per cent were fully vaccinated, as of July 21, exceeding the vaccination rates among the general population "and reflecting significant commitment from our health-care community in preventing the spread of COVID-19."

Public Health will continue to manage the presence of COVID-19 through surveillance, testing, and by retaining and promoting the use of key protective health measures, he said.

"Over time, with increasing vaccination rates and as surveillance and monitoring by Public Health continues, the level of risk will inform any future easing, maintenance or enhancement of requirements."

In May, Premier Blaine Higgs did seek a legal opinion on whether it could make COVID-19 vaccination mandatory for health-care workers, including long-term care home employees.

A week later, Higgs said the province was advised it could make vaccines mandatory and that the best way to proceed would be under employment standards, to make it a condition of employment.

But in the end, the province decided "the best way to move forward" was to to make COVID-19 tests mandatory for some long-term care workers. The social development minister cited their "unacceptable" low vaccination rates.

At that time, the vaccination rates at 99 of the province's roughly 550 homes remained below 50 per cent, meaning more than 1,000 workers had not yet received one dose.

Unvaccinated long-term care home workers who work in a facility where fewer than half the staff have received at least one dose of a vaccine must take a rapid COVID-19 test every other day.

The Department of Social Development also launched a website, posting vaccination rates for staff in long-term care homes by region. As of July 29, the last time the site was updated, 12 homes still had fewer than 50 per cent of their staff vaccinated.

The Horizon Health Network has not made any decisions regarding whether the COVID-19 vaccine will be mandatory for physicians and staff, said acting chief human resources officer Erin Arsenault.

"We are continuing to engage in discussions with our partners on this matter," Arsenault said in an emailed statement.

"At this time, we are continuing to strongly encourage our staff to get the vaccine and we fully expect our health care employees to be ambassadors for health and scientific advancements to stop the spread of COVID-19."

The Vitalité Health Network did not immediately respond to a request for comment.

To date, no government in Canada has made vaccines mandatory. The governments of France, Italy and Greece have introduced legislation that effectively mandates COVID-19 vaccinations for health-care workers.

"As health providers, we have a fundamental duty of care towards our patients and the public," Canadian medical Association president Dr. Ann Collins said in Tuesday's statement.

"There is significant evidence that vaccines are safe and effective and as health professionals who are leading the vaccination campaigns, it is the right call and an appropriate step."

According to an article published in the Canadian Medical Association Journal by three University of Ottawa law professors, making COVID-19 vaccines mandatory for health-care workers would be an effective public health policy that likely would stand up to any legal challenges.

"Governments should be able to successfully defend such a challenge" as long as provisions are made for people with underlying health conditions and those who oppose vaccination on the grounds of "bona fide religious or conscientious objection," the article says.

Mandates issued by individual employers could be more vulnerable to legal challenges, which could be made under labour laws rather than the charter, it found.

2 new cases, 41 active cases

New Brunswick has two new cases of COVID-19 on Wednesday, bringing the province's total active case count to 41, according to the dashboard.

A total of 258 people, including the infected people and their direct contacts, are self-isolating. The isolation period has dropped to 10 days from 14.

The number of vaccinations continues to drop, with only 1,258 doses recorded as being administered Tuesday, including 941 second shots and 317 first. 

The number of New Brunswickers aged 12 or older who are fully vaccinated now stands at 472,959, or 68.2 per cent of the eligible population, up from 68.1, while 571,193 people, or 82.4 per cent of the eligible population, have had at least one dose, up from 82.3.

That means 72,715 people who had their first vaccine at least 28 days ago and are eligible to get their second dose still haven't done so.

New Brunswick's chief medical officer of health stands by the province's decision to move to the green phase early and lift restrictions last Friday at 11:59 p.m., before reaching the original goal to have 75 per cent of the eligible population double-dosed.

But Dr. Jennifer Russell is once again urging residents to get vaccinated after a recent spike in COVID-19 cases and a growing list of public exposure notifications.

Since last Saturday, 31 new cases have been reported, the bulk of them in the Moncton region, Zone 1. This comes after a lull in new cases.

Russell  said most of the new cases are the Delta variant, which is more contagious and potentially deadlier.

Higher vaccination rates mean lower hospitalizations, however, which is something the province is focused on.

"Now that we have a large part of our population vaccinated, we're really focused on the burden of disease on the health-care system," she told CBC's Information Morning Moncton.

"So while the number of cases going up is somewhat expected because we again, we did expect case numbers to go up, we were just hopeful that we would make sure that if we have enough people vaccinated, that it wouldn't translate into hospitalizations, ICU admissions, et cetera."

Still, since July 1, the first 55 of the 63 cases recorded were not considered fully immunized, said Russell, meaning they either had only one dose or they hadn't had their second dose long enough for it to take full effect.

"So that is a problem in the sense that people who aren't immunized are at a higher risk for becoming hospitalized or needing an ICU admission," she said.

"So far, that's not happening. We have no hospitalizations."

But "the sooner, the better" to get as many people vaccinated as possible, Russell said.

There have been 2,396 confirmed cases of COVID-19 in the province since the pandemic began, with 2,308 recoveries so far and 46 COVID-related deaths.

A total of 383,147 COVID tests have been conducted, including 593 on Tuesday.

Long-term effects study

New Brunswick plans to track the long-term health effects and health-care concerns of people who contracted COVID-19.

All positive COVID-19 cases who have expressed a willingness to participate in research are being asked to enrol in the TripleC-NB registry, a collaborative effort between researchers in the Horizon and Vitalité Health Networks, said Department of Health spokesperson Bruce Macfarlane.

"This registry aims to track COVID-19 cases to determine what, if any, ongoing health changes are experienced by these individuals, how long they persist, and what specific changes from their baseline health have been noted," he said in an emailed statement.

About 280 people have signed up so far.

Each participant will be telephoned monthly until that person reports no ongoing health changes during two consecutive follow-ups, Macfalane said.

As more people are diagnosed with COVID-19 and recover, they too will be contacted, "as the more individuals that participate in the study, the more accurate the results."

A recent review by the Public Health Agency of Canada found more than half of COVID-19 patients might suffer from "post-COVID syndrome" for more than three months after testing positive. These people are sometimes referred to as long-haulers.

The review looked at more than two dozen studies from around the world which asked confirmed COVID-19 patients to report at least one long-term symptom.

Fatigue, pain, shortness of breath and sleep disturbances were the most common issues, followed by anxiety, cough and hair loss.

The pandemic and collective trauma

How do you think COVID-19 has impacted your life? It likely had a deeper effect on all of us than we think, says a  psychotherapist.

Laura Cavanagh, a registered psychotherapist and professor of behavioural sciences at Seneca College in Toronto, said we're likely all recovering from collective trauma brought on by the pandemic. 

For over a year, important events and chances to gather, including weddings, graduations and funerals, have been cancelled. Non-essential medical care has been made more difficult to access. 

"The good thing is we're all in this together, we have the shared experience and people who know what we're going through, but in a way that's also the bad news," Cavanaugh told Information Morning Fredericton.

Cavanagh said these circumstances have taken away relationships and institutions that people lean on for support because we're all being affected. 

• The end of an order: A timeline from N.B.'s first COVID case to life in green

We often don't feel the emotional after-effects of trauma until it's over, she said.

Now that the pandemic is nearing the end and restrictions are lifting, Cavanagh said, a lot of people are just now coming to terms with what has happened and dealing with the psychological impacts. 

Cavanagh said collective trauma is a well-known condition that has been studied in the field of psychology and sociology for a long time. 

She said individual trauma affects all aspects of our functioning and often makes people fatigued and want to be isolated, can cause insomnia and a shorter temper and impacts cognitive functioning.  

"With collective trauma, the injury is not just to the individual, but really to the fabric of society itself," she said. 

"So what happens with collective trauma is, not only do individuals suffer, communities and society as a whole suffer."  

Cavanaugh said the impact of collective trauma can often be passed down through generations.  

She said rates of drug overdoses across Canada have increased significantly this year, up about 120 per cent over the same period in 2019. 

Cavanaugh said post-traumatic growth is also a possibility following the pandemic, where people feel a deeper sense of capability and resilience.

New possible public exposures

Public Health has identified new possible exposures of COVID-19 in the Moncton region, Zone 1. They include:

• July 30 between noon and 11:30 p.m., July 31 between 10 a.m. and 6 p.m. – La Coast, 358 Main St., Shediac
• July 30 between 8 p.m. and 10 p.m., July 31 between 6 p.m. and 8 p.m. – Gahan House Hub City, 55 Queen St., Moncton
• July 30 between 8 p.m. and 10 p.m. – The Keg Steakhouse, 576 Main St., Moncton
• July 30 between 10 p.m. and 2 a.m.- Angie's Show Palace, 187 Champlain St., Dieppe
• July 30 between 7 p.m. and midnight - Osaka Hibachi, 599 Main St., Moncton
• July 30 between 10 p.m. and 2 a.m. - Cassi Lounge, 212 St. George St., Moncton
• July 30 between 10 p.m. and 2 a.m. - Kings Club, 841 Main St., Moncton
• July 28 between 3 p.m. and 8:15 p.m. – Pizza Delight, 188 Mountain Rd., Moncton

People who may have been exposed to the virus at the growing list of possible locations across the province are now being urged to request a COVID-19 test online or call Tele-Care 811 to get an appointment.

Public Health's advice on the website for people who have been at any of the locations at the dates and times specified has been to self-monitor for symptoms for 14 days after the potential exposure and, only if any symptoms develop, to immediately self-isolate and book a test.

But the most recent news releases issued by the province indicate "anyone with symptoms of the virus, as well as anyone who has been at the site of a possible public exposure" should get tested.

Previous exposure notices

Public Health has identified positive cases in people who may have been infectious while travelling on the following flights:

• July 26 – WestJet Flight 3404 – from Toronto to Fredericton, departed at 4 p.m.
• July 25 – Air Canada Flight 8904 – from Montreal to Moncton, departed at 7:54 p.m.
• July 25 – Air Canada Flight 7546 – from Toronto to Fredericton, departed at 2:27 p.m.
• July 19 – WestJet Flight 3461 – from Ottawa to Toronto, departed at 10:00 a.m. 
• July 19 – WestJet Flight 3404 – from Toronto to Fredericton, departed at 3:40 p.m. 

Moncton region:

• July 23 between 10 a.m. and 11 a.m., July 25 between 9 a.m. and 4 p.m., July 28 between 9 a.m. and 4 p.m. July 29 between 3 p.m. and 7 p.m. and July 30 between 3 p.m. and 4:30 p.m. – Tony's Bistro & Patisserie, 137 McLaughlin Rd., Moncton
• July 30 between 7:30 p.m. and 9 p.m. – Cannabis NB, 40 Wyse St., Moncton 
• July 30 between noon and 2 p.m. – Atlantic Superstore, 65 Main St., Moncton 
• July 30 between 12:30 p.m. and 2:15 p.m. – H&M, 1477 Paul St., Dieppe 
• July 30 between 1:30 p.m. and 3 p.m. – Chapters,  499 Paul St., Moncton 
• July 30 between 11:30 a.m. and 1:30 p.m. – Tokai Ramen,  823 Main St., Moncton 
• July 29 between 6 p.m. and 8:30 p.m.  – St. James Gate, 14 Church St., Moncton 
• July 29 between 8:30 p.m. and 10:30 p.m. – Magic Mountain Mini Putt, 150 Magic Mountain Rd., Moncton 
• July 28 between 5 p.m. and 11 p.m. – Pump House – Brewpub & Restaurant,  5 Orange Lane, Moncton
• July 28 between 3 p.m. and midnight and July 29 between 4 p.m. to 1 a.m. – Cheers' Beverage Room and Catering, 63 Brandon St., Moncton

Saint John region, Zone 2:

• July 27 between 5:30 p.m and 7:30 p.m. – Saint John Ale House, 1 Market Sq., Saint John
• July 27 between 7 p.m. and 8:30 p.m. – Hopscotch, 4 Canterbury St., Saint John
• July 27 between 8 p.m. and 10:30 p.m. – Italian By Night, 97 Germain  St., Saint John
• July 27 between 10:15 p.m. and midnight – Churchill's Bar and Pub, 8 Grannan St., Saint John
• July 27 between 11:30 p.m. and 1:30 a.m. – Uptown Pub Down Under Bar, 88 Prince William St., Saint John

Fredericton region, Zone 3:

There is a single exposure notice for the Fredericton area on July 26 for Maritime Bus Coach 1908, from Moncton to Fredericton, which departed at 4:20 p.m.

Atlantic COVID roundup

Nova Scotia reported two new cases of COVID-19 on Wednesday and has 11 active cases.

Newfoundland and Labrador has one new case and six active cases.

Prince Edward Island reported three new travel-related cases Wednesday and now has three active cases.

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.