WHO decision on COVID-19 emergency won’t effect Canada’s response: Tam
By Mia Rabson in Ottawa
On Monday, exactly three years from the day he declared COVID-19 to be a global public health emergency, World Health Organization director-general Tedros Adhanom Ghebreyesus will decide whether to call it off.
But declaring an end to the “public health emergency of international concern” would not mean COVID-19 is no longer a threat. It will also not do much to change Canada’s approach.
“In Canada, we’re already doing what we need to do,” chief public health officer Dr. Theresa Tam said in her most recent COVID-19 update.
She said the WHO discussion is important but COVID-19 monitoring and public health responses are not going to end. That includes continued surveillance of cases, particularly severe illness and death, and vaccination campaigns.
The WHO’s emergency committee, which was struck in 2020 when COVID-19 first emerged as a global health threat, voted Friday on whether to maintain the formal designation of a public health emergency.
Tedros will make the final call Monday based on the advice the committee gives him.
He warned earlier this week that he remains concerned about the impact of the virus, noting there were 170,000 deaths from COVID-19 reported around the world in the last two months.
“While I will not pre-empt the advice of the emergency committee, I remain very concerned by the situation in many countries and the rising number of deaths,” he said Jan. 24.
“While we are clearly in better shape than three years ago when this pandemic first hit, the global collective response is once again under strain.”
He is worried not enough health-care workers or seniors are up to date on vaccinations, that access to antivirals is limited and that health systems around the world remain fragile following three years of pandemic strain.
In Canada, there was a noticeable rise in cases, hospitalizations and deaths over Christmas and early in January but all are trending down again. Tam said there were no surges of the virus anywhere in Canada, though the latest variant of Omicron was being watched closely.
Federal surveillance data shows more than 30 people are still dying of COVID-19 every day, and hundreds of people are still hospitalized.
The formal designation of the global public health emergency was made on Jan. 30, 2020, when 99 per cent of confirmed COVID-19 cases were still restricted to China.
The decision was made to declare an emergency because human-to-human transmission was starting to occur outside China, and the hope was that by designating an emergency it could prompt a public health response that could still limit the impact of COVID-19.
That did not happen. On March 11, 2020, Tedros declared a global pandemic, practically begging countries to do more to slow it down.
The declaration of a pandemic meant that there was exponential growth in the spread of the virus.
By WHO terminology, a “public health emergency of international concern” is the highest formal declaration and the one which triggers a legally binding response among WHO member countries, including Canada.
It is what is done when a health threat is “serious, sudden, unusual or unexpected,” when it carries global public health implications and may require “immediately international action.”
A designation prompts the WHO director-general to issue recommendations for member countries including increased surveillance to identify new cases, isolating or quarantining infected people and their close contacts, travel measures such as border testing or closures, public health communications, investments in research and collaboration on treatments and vaccinations.
Dr. Sameer Elsayed, an infectious diseases physician and the director adult infectious diseases residency training at Western University in London, Ont., said to his mind the WHO should end the global emergency designation even though the pandemic itself is not over.
“I don’t know that we should continue to call it an emergency,” he said. “I hope they say that we’re going to bring it down a notch.”
Elsayed said for vulnerable populations, including the elderly and those with compromised immune systems, COVID-19 continues to pose a serious threat, but for most people there are far bigger threats, including suicide. He said with limited health resources, COVID-19 needs to be put in its proper place alongside other health issues.
Children, in particular, said Elsayed, are much more at risk from influenza and RSV than COVID-19 in wealthy countries, and from food insecurity and the lack of access to clean water in many developing nations.
Tam said regardless of what WHO decides, Canada won’t stop monitoring the evolution of the virus that causes COVID-19, including for new variants that may require adjustments to vaccines or other treatments.
She also said we must continue to monitor the ongoing developments in long COVID.
“We mustn’t, I think, let go of the gains that we’ve had in the last several years,” she said.
“I think whatever the decision is made by the director-general of WHO, I think we just need to keep going with what we’re doing now.”
This report by The Canadian Press was first published Jan. 27, 2023.
Eye Protection Wasn’t Misdirection
From the Brownstone Institute
“If you have goggles or an eye shield, you should use it.” ~ Anthony Fauci, July 30th, 2020
We had heard enough from Fauci by the time this comment was made in mid-2020 to begin automatically tuning out his frequently contradictory advice. What if we had given weight to this comment and explored why he began recommending goggles (yet never donned them himself)?
While I’m not surprised that the inner anatomy of the face including ocular ducts and connectivity within structures aren’t common knowledge, I expected more of a reaction from the medical community regarding Fauci’s push for eye protection. Not only do medical professionals take extensive coursework on human anatomy — they are required to meet annually with an Industrial Hygienist for fit tested, hazard-specific kit for each exposure setting , including ocular protection. This testing process requires going into detail about each exposure setting and required donning and donning practices within the scope of their professional duties.
Instead of elaborating on his recommendation, Fauci just publicly hushed on the issue and folks carried on, obediently masked up yet entirely neglectful of their nasolacrimal ducts. Shame, shame.
These are the structures of the lacrimal apparatus connecting ocular and nasal pathways. Basically, the eye drains into the nasal cavity. None of the talking heads of the medical community ever seem to bring up that these parts of the body connect with one another, and while we hear about masks ad nauseam three entire years after the onset of the SARS-CoV-2 pandemic, no one is arguing with strangers on the internet about goggles.
Bernie Sanders was recently praised for being the only person at the February, 2023 State of the Union donning a (sub-grade, non-mitigating) respirator, but eye spy something fishy. It was noted that he kept removing his glasses, as they were fogging up.
Those who have donned respirators have experienced that exhale emissions are generally redirected out of the nose bridge (or out of side gaps if improperly sealed). This is the exhale emission plume create by a fitted, unvalved N95 respirator:
This plume of warm, moist respiratory emissions is what causes glasses to fog. This is precisely why I continue to argue that masks are NOT source control for respiratory aerosols, because these apparatuses are not designed nor intended to protect others from your emissions, but solely for protection of the wearer. The ASTM agrees with me on this matter:
The American Society for Testing and Materials (ASTM) Standard Specification for Barrier Face Coverings F3502-21 Note 2 states, “There are currently no established methods for measuring outward leakage from a barrier face covering, medical mask, or respirator. Nothing in this standard addresses or implies a quantitative assessment of outward leakage and no claims can be made about the degree to which a barrier face covering reduces emission of human-generated particles.”
Additionally, Note 5 states, “There are currently no specific accepted techniques that are available to measure outward leakage from a barrier face covering or other products. Thus, no claims may be made with respect to the degree of source control offered by the barrier face covering based on the leakage assessment.”
So does it matter if your neighbor’s exhale emissions are directed in your face for the duration of your 6-hour flight?
Absolutely. Imagine sitting between these two fine fellas with your eyes exposed, and their emission plumes directed right in your face.
In mitigation of aerosol hazards, eye protection is a standard part of required kit, because those from the correct domain of expertise, Industrial Hygiene, know enough about human anatomy to remember the interconnectivity of facial structures.
Ocular transmission of SARS-CoV-2
There has been a great deal of focus on respiratory protection since the start of the pandemic, but ocular transmission was already established for SARS-CoV-1.
“SARS-CoV-1 has been shown to be transmitted through direct contact or with droplet or aerosolized particle contact with the mucous membranes of the eyes, nose and mouth. Indeed, during the 2003 SARS-CoV-1 outbreak in Toronto, health care workers who failed to wear eye protection in caring for patients infected with SARS-CoV-1 had a higher rate of seroconversion.”
We are beginning to see mounting research on ocular transmission for SARS-CoV-2 emerge, as well, traveling through the nasolacrimal duct from the eye, draining into the sinus cavity.
“There is evidence that SARS-CoV-2 may either directly infect cells on the ocular surface, or virus can be carried by tears through the nasolacrimal duct to infect the nasal or gastrointestinal epithelium.”
“The nasolacrimal system provides an anatomic connection between the ocular surface and the upper respiratory tract. When a drop is instilled into the eye, even though some of it is absorbed by the cornea and the conjunctiva, most of it is drained into the nasal cavity through the nasolacrimal canal and is subsequently transferred to the upper respiratory or the gastrointestinal tract.”
“SARS-CoV-2 on the ocular surface can be transferred to different systems along with tears through the nasolacrimal route.”
Seldom did ocular exposure result in eye infection, while systemic infections occurred regularly. Ocular exposure cannot always be determined as the point of contact for this reason, as an eye infection does not always coincide with systemic infection.
The nasolacrimal duct is often discussed in ocular transmission research, but this is not the sole ocular transmission pathway discussed.
“There are two pathways by which ocular exposure could lead to systemic transmission of the SARS-CoV-2 virus. (1) Direct infection of ocular tissues including cornea, conjunctiva, lacrimal gland, meibomian glands from virus exposure and (2) virus in the tears, which then goes through the nasolacrimal duct to infect the nasal or gastrointestinal epithelium.”
Additionally, research is being conducted on the usage of ocular secretions in transmitting SARS-CoV-2.
“Then here comes the question, whether SARS-CoV-2 detected in conjunctival secretions and tears is an infectious virus? Colavita et al inoculated Vero E6 cells with the first RNA positive ocular sample obtained from a COVID-19 patient. Cytopathic effect was observed 5 days post-inoculation, and viral replication was confirmed by real-time RT-PCR in spent cell medium. Hui et al also isolated SARS-CoV-2 virus from a nasopharyngeal aspirate specimen and a throat swab of a COVID-19 patient. The isolated virus not only infected human conjunctival explants but also infected more extensively and reached higher infectious viral titers than SARS-CoV.”
According to this study, ocular secretions were highly infectious.
“The ocular surface can serve as a reservoir and source of contagion for SARS-CoV-2. SARS-CoV-2 can be transmitted to the ocular surface through hand-eye contact and aerosols, and then transfer to other systems through nasolacrimal route and hematogenous metastasis. The possibility of ocular transmission of SARS-CoV-2 cannot be ignored.”
This paper also has a focus on aerosols coming into contact with ocular mucosa.
“Once aerosols form, SARS-CoV-2 can bind to the ACE2 on the exposed ocular mucosa to cause infection. In order to prevent aerosols from contacting the eye surface, eye protection cannot be ignored.”
An additional area explored in this analysis discusses rhesus macaques wherein solely those inoculated through the ocular route became infected.
“If the ocular surface is the portal for SARS-CoV-2 to enter, where does the virus transfer after entering? An animal experiment reveals the possible nasolacrimal routes of SARS-CoV-2 transfer from the ocular surface. Five rhesus macaques were inoculated with 1×106 50% tissue-culture infectious doses of SARS-CoV-2. Only in the conjunctival swabs of rhesus macaques inoculated via conjunctival route could the SARS-CoV-2 be detected. Conjunctival swabs of the rhesus macaques that were inoculated via intragastric or intratracheal route were negative. Three days post conjunctival inoculation, rhesus macaques presented mild interstitial pneumonia. Autopsies showed that SARS-CoV-2 was detectable in the nasolacrimal system tissues, including the lacrimal gland, conjunctiva, nasal cavity, and throat, which connected the eyes and respiratory tract on anatomy.”
An additional macaque study had similar findings.
“Deng et al. showed that SARS-CoV-2 infection could be induced by ocular surface inoculation in an experimental animal model using macaques. Although the researchers detected the virus in conjunctival swabs only on the first day after inoculation, they continued to detect it in nasal and throat swabs 1-7 days after the inoculation. Their findings demonstrated that the viral load in the airway mucosa was much higher than that in the ocular surface. They euthanized and necropsied one of the conjunctival inoculated-animals and found that the virus had spread to the nasolacrimal system and ocular tissue, nasal cavity, pharynx, trachea, tissues in the oral cavity, tissues in the lower-left lobe of the lung, inguinal and perirectal lymph node, stomach, duode-num, cecum, and ileum. They also found a specific IgG antibody, indicating that the animal was infected with SARS-CoV-2 via the ocular surface route.”
While the nasolacrimal route is the primary focus in most current research, the blood-retinal barrier (BRB) is also discussed as a possible pathway.
“Once it reaches the ocular surface, SARS-CoV-2 could invade the conjunctiva and iris under the mediation of ACE2 and CD147, another possible receptor for SARS-CoV-2 on host cells. De Figueiredo et al described the following possible pathways. After reaching blood capillaries and then choroid plexus, the virus reaches the blood-retinal barrier (BRB), which expresses both ACE2 and CD147 in retinal pigment epithelial cells and blood vessel endothelial cells. Since CD147 mediates the breakdown of neurovascular blood barriers, the virus can cross the BRB and enter into blood.”
There has been a push recently to bring back masks for Respiratory Syncytial Virus (RSV), especially in schools, as this pathogen largely impacts youth populations, yet ocular transmission is a proven method of infectivity for RSV.
In this paper, intranasal dosing of the given pathogen resulted in onset of illness for nearly all respiratory pathogens studied. It reviews transmission routes and minimum infective dose for Influenza, Rhinovirus, Coxsackievirus, Adenovirus, RSV, Enteric Viruses, Rotavirus, Norovirus, and Echovirus, including ocular transmission.
“The infective doses of rhinoviruses in the nose and eyes are thought to be comparable because the virus does not infect the eyes but appears to travel from the eyes to the nasal mucosa via the tear duct.”
“Hall et al. (1981) investigated the infectivity of RSV A2 strain administered by nose, eye, and mouth in adult volunteers. They reported that the virus may infect by eye or nose and both routes appear to be equally sensitive. A dose of 1.6 × 105 TCID50 infected three of the four volunteers given either into the eyes or nose while only one out of the eight were infected via mouth inoculation, and this was thought to be due to secondary spread of the virus.”
“RSV A2 had poor infectivity when administered via the mouth but was shown to infect by eye and nose and both routes appear to be equally sensitive to the virus.”
“Bynoe et al. (1961) found that colds could be produced almost as readily by applying virus by nasal and conjunctival swabs as by giving nasal drops to volunteers.”
Would masks save schools from RSV circulation? Most kids have robust immune systems, with a very, very small percentage of the youth population undergoing chemotherapy or taking immunosuppressives, who usually are not on campus for in-person learning. But for those seeming protection and in-person instruction, we must not set them up for immune bombardment by offering a false sense of security while feigning ignorance of other viable transmission routes. Masks are not the answer.
Ocular transmission of respiratory pathogens hasn’t been a focal point of study, but with other pathogens and mounting research on SARS-CoV-2 showing such ease of systemic onset for this transmission route, more attention should be given to this area of research.
Consider all of the people you’ve seen donning masks or respirators over these past three years, assured in the merit of their virtue. How many still got sick? Did you ever once see someone donning goggles? Are we ever going to get around to discussing exhaustion of the hierarchy of controls, or are actual mitigating measures too taboo, too fringe?
TLDR: Ocular transmission is a viable method of transmission for SARS-CoV-2. Masks are not source control. Even N95s aren’t going to fix this. And all child masks are unregulated, untested, unethical, and unsafe, with zero efficacy, fit, term of wear, or medical clearance standards, and with ocular transmission being a proven route of transmission for RSV, masks aren’t going to fix that issue, either.
Dr. John Campbell – The man who explained the pandemic to millions
We’ll get to Dr. John Campbell soon enough. First the back story.
For three years the COVID-19 pandemic has wreaked havoc on families, communities, and entire nations. One could put a pretty good argument together that the psychological, political, and societal toll may in the end, be even more devastating than the death of nearly seven million victims. Of course that likely won’t be true for those who lost a loved one to covid. But think of all those who couldn’t see their beloved family member drift away in a nursing home, or see their family member dying of cancer in the hospital. Think of the business owners and employees who lost their businesses and livelihoods. And think of the millions of families who may never talk again because of brutal disagreements over various controversial decisions made by health officials and governments as the pandemic dragged on and on and on.
At first governments all over locked their citizens down to “flatten the curve” and we all banded together to face the virus together. That was supposed to last for two weeks. As two weeks turned into multiple weeks and then multiple months, millions of people started to drift away.
No doubt a few were simply radically anti-authoritarian. But not the VAST majority. For millions it started when they personally encountered information that contradicted the official line. It was still very early in the pandemic when the advanced age and unhealthy comorbidities of most of the victims became obvious to those who analyzed data. Many couldn’t understand locking down younger people in good health, or closing businesses and schools.
Before long a divide formed in society. On one side, people who consume information through news casts the way we always have. On the other side neighbours, friends, and family members who listened to podcasters and read substack articles. They were learning about doctors who were treating covid against the direction of those in charge, or reading information the regular media simply wouldn’t talk about.
A great example is ivermectin. While the regular media attacked the incredibly common and incredibly cheap treatment, calling it horse dewormer (which is one of the things it does), popular podcast interviewers were talking to doctors who were successfully treating patients with ivermectin and other early treatments. Websites showing
have been slow to take a deep dive into their own responses. With hindsight being 20/20 it would take a brave and rare politician who would be willing to open themselves up to criticism, or something worse.
How did it all happen?
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