April 14, 2021 Ottawa, ON Public Health Agency of Canada
The COVID-19 pandemic continues to create stress and anxiety for many Canadians, particularly those who do not have ready access to their regular support networks. Through the Wellness Together Canada online portal, people of all ages across the country can access immediate, free and confidential mental health and substance use supports, 24 hours a day, seven days a week.
The Public Health Agency of Canada (PHAC) has received a report of a case of an individual in Canada who has experienced a very rare but serious medical event involving blood clots (thrombosis) with low levels of blood platelets (thrombocytopenia), following immunization with COVISHIELD (the Serum Institute of India version of the AstraZeneca COVID-19 vaccine). This is the first reported case of this rare adverse event in Canada. Global evidence indicates that reports of blood clots with low platelets in people following immunization with the AstraZeneca COVID-19 vaccine are very rare.
Since these rare adverse events were first signalled as a possible safety issue in March 2021 in Europe, Health Canada has been working with international regulators and AstraZeneca manufacturers to review emerging data and evidence. As a precautionary measure, while Health Canada and international regulators were assessing information relating to these reports in Europe, the National Advisory Committee on Immunization (NACI) and the Chief Medical Officers of Health recommended a pause in the use of AstraZeneca COVID-19 vaccine in all individuals less than 55 years of age in Canada. Today, Health Canada updated the AstraZeneca and COVISHIELD COVID-19 vaccine labelling information and requested the manufacturers update risk management plans for the AstraZeneca vaccine. Based on all evidence available worldwide to-date, Health Canada considers that the benefits of the AstraZeneca and COVISHIELD vaccines, in protecting against the severe outcomes of COVID-19, continue to outweigh the potential risks. As information emerges from Health Canada’s ongoing assessment, including information on the adverse event reported in Canada, NACI will consider these findings and assess its recommendation in the broader public health context.
Detection and timely reporting of the first case of blood clots with low levels of blood platelets following immunization with COVISHIELD in Canada demonstrates that our vaccine safety monitoring system is working and is part of the ongoing global vaccine safety monitoring system. Together Health Canada, PHAC, NACI and the Chief Medical Officers of Health are working with experts across the country and around the world to continuously review the evolving evidence in the Canadian context and to alert health care professionals and the public on symptoms to be aware of that can aid in rapid detection and treatment available to mitigate this event.
As COVID-19 activity continues in Canada, we are tracking a range of epidemiological indicators to monitor where the disease is most active, where it is spreading and how it is impacting the health of Canadians and public health, laboratory and healthcare capacity. At the same time, the Public Health Agency of Canada is providing Canadians with regular updates on COVID-19 vaccines administered, vaccination coverage and ongoing monitoring of vaccine safety across the country. The following is the latest summary on national numbers and trends, and the actions we all need to be taking to reduce infection rates, while vaccination programs expand for the protection of all Canadians.
Since the start of the pandemic, there have been 1,078,562 cases of COVID-19, including 78,293 active cases and 23,392 deaths reported in Canada; these cumulative numbers tell us about the overall burden of COVID-19 illness to date. They also tell us, together with results of serological studies, that the vast majority of Canadians remain susceptible to COVID-19. As vaccine delivery ramps up at an accelerated pace, there is cause for optimism that widespread and lasting immunity can be achieved through COVID-19 vaccination. We now have multiple safe and effective COVID-19 vaccines with unique advantages that are authorised for use in Canada. Vaccine coverage is increasing across Canada, with benefits being seen in prioritized high-risk populations. Ramp up of vaccine supply and acceleration of vaccination programs will return further benefits to protect more Canadians, over the coming weeks and months.
However, with the current acceleration of COVID-19 activity and a concerning rise in the proportion of cases that involve more contagious variants of concern, strong public health measures and individual precautions must be sustained where COVID-19 is circulating. The latest national-level data show a 7-day average of 8,238 new cases daily (April 7 to 13). Sustained high infection rates are also impacting COVID-19 severity indicators, particularly in areas with elevated disease activity. The rise in severe and critical illnesses is placing renewed strain on the health system and healthcare workforce. Provincial and territorial data indicate that an average of 3,206 people with COVID-19 were being treated in Canadian hospitals each day during the most recent 7-day period (April 7 to 13) representing a 33% increase over last week. This includes, on average 993 people who were being treated in intensive care units (ICU). This is 23% higher than last week, exceeding the peak treated in ICUs daily during the first and second waves. If the increase in severe illnesses persists, the concern is that we could see a gradual increase in the mortality trend. Over the past week, there were an average of 36 deaths reported daily, which is 17% higher than last week.
While COVID-19 continues to impact people of all ages in Canada, infection rates are highest among those aged 20 to 39 years of age. As well, we are seeing an increased number of adults under the age of 60 years being treated for COVID-19 in hospital, including in ICUs. This is a reminder that serious illness can occur at any age and evidence indicates that variants of concern can be associated with more severe illness and increased risk of death. In addition, circulation of COVID-19 in younger, more mobile and socially-connected adults is an ongoing risk for spread into high-risk populations and settings and several jurisdictions have highlighted social gatherings as an important driver for spread. As of April 13, a total of 41,818 variant of concern cases have been reported across Canada, including 39,663 involving B.1.1.7 variants, 1,780 P.1 variants and 375 B.1.351 variants. Although B.1.1.7, continues to account for the majority of variants of concern in Canada and has likely replaced the original virus in some areas, there has been a concerning rise in P.1 cases in recent weeks. Early evidence suggests that the P.1 variant may reduce the effectiveness of vaccines, making it even more important to control its spread.
Canadians are urged to remain vigilant, continue following local public health advice, and consistently maintain individual practices that keep us and our families safer: stay home/self-isolate if you have any symptoms, think about the risks and reduce non-essential activities and outings to a minimum, avoid all non-essential travel, and maintain individual protective practices of physical distancing, hand, cough and surface hygiene and wearing a well-fitted and properly worn face mask as appropriate (including in shared spaces, indoors or outdoors, with people from outside of your immediate household).
Canadians can also go the extra mile by sharing credible information on COVID-19 risks and prevention practices and measures to reduce COVID-19 in communities and by downloading the COVID Alert app to break the cycle of infection and help limit the spread of COVID-19. Read my backgrounder to access more COVID-19 Information and Resources on ways to reduce the risks and protect yourself and others, including information on COVID-19 vaccination.