Flu infections are raging among children and hospitalizing them across Canada, say pediatricians who are calling for urgent and longer-term solutions.
On the weekend, hospitals across the country were forced to scale back regular service to deal with a surge in influenza illnesses:
CHEO in Ottawa said the Red Cross will be deployed to help out with its surge of cases.
A respite care facility in Calgary closed to redeploy staff to a children’s hospital.
BC Children’s Hospital declared an emergency for 30 minutes on Saturday to quickly boost capacity and resources.
Newfoundland and Labrador’s children’s hospital cancelled some scheduled surgeries and appointments.
Doctors say the moves reflect a surge in influenza on top of long-standing pressures on both pediatric hospitals and care providers in the community. Cases of respiratory syncytial virus (RSV) have, in the meantime, stabilized after spiking earlier this season.
For the week ending Nov. 26, the Public Health Agency of Canada’s FluWatch reported 223 influenza-associated hospitalizations among children 16 and under.
That’s up from an average of 11, with a maximum of 35, at pediatric hospitals from 2014-15 to 2019-20, says Dr. Jesse Papenburg, a pediatric infectious-disease specialist at Montreal Children’s Hospital.
“This shows that we have had an early and intense influenza season so far this year, hitting the pediatric population particularly hard,” he said in an email.
A clown entertains a child who has just received a flu vaccine in a military hospital, in Milan, Italy, in November 2020. Canadian health officials are encouraging more uptake of influenza vaccines by children this season. (Flavio Lo Scalzo/Reuters)
Similarly in the U.S., Rochelle Walensky, director of the Centers for Disease Control and Prevention, said Monday that flu is at its highest level the U.S. has seen for a decade. So far this season, 14 youth in the U.S. have died.
Federal health officials haven’t released the exact number of influenza deaths among those aged 16 and under so far this season but say it’s fewer than five. The number of deaths for that age group were in the single digits annually before the COVID-19 pandemic.
Bend the curve with flu shots
Influenza is “overwhelmingly … causing a lot of problems,” particularly for children under five, said Dr. Fatima Kakkar, a pediatric infectious diseases specialist at Ste. Justine’s Hospital in Montreal.
But it’s not necessarily the flu, alone, that’s the problem, she says.
Rather, kids catch the flu, which leaves them prone to “really significant bacterial infections,” like pneumonia — and that’s when they land in hospital.
Kakkar says she’d like to see an emphasis on influenza vaccination for children, including publicity campaigns.
Cases of respiratory syncytial virus have stabilized after spiking earlier this season. (Martha Irvine/Associated Press)
“I say this because I think it’s not too late and especially in parts of the country where influenza hasn’t taken hold, I would really like to see people encouraging and making it easier for parents and their children to be vaccinated.”
Whitehorse-based pediatrician Dr. Katharine Smart called it “immensely concerning” that children who are acutely ill and need attention quickly are having trouble receiving it.
But there are other, bigger-picture problems throughout the pediatric health-care system that deserve attention, she says.
Smart, past president of the Canadian Medical Association, cites wait-times for surgery for young people with scoliosis, or curvature of the spine, as an example.
“I’ve had patients that had to put off their post-secondary school planning because they don’t know when they’re going to get the operation and the recovery,” Smart said. “They say, ‘Well, how do I go off to college if I don’t know that I’m going to now have to have a massive spine surgery and be out of commission for weeks or months?'” she said. “Some of these [teens] have been waiting three to four years for this operation.”
Effective vaccine
Other health-care needs for children are provided outside of the hospital, which is especially important in the first years of life, such as autism services. Some kids aren’t able to access services to improve their speech, social skills and cognition. Once a child is in kindergarten, they may no longer be eligible for certain help because the developmental window to intervene has closed.
“These are problems that we’re seeing across the country,” Smart said. She suggests bolstering nurse staffing and retention.
She also wants to see more uptake of the flu vaccine among children and adults, to “bend the curve” for overwhelmed health-care systems.
The good news, Papenburg says, is that the influenza A H3N2 strain that is mainly circulating in Canada now is genetically the same as the strain in this year’s influenza vaccine. “That bodes well for good vaccine effectiveness, although that needs to be assessed in field studies now underway.”
In the long term, researchers are evaluating newer vaccine technologies for better, longer-lasting flu immunization, he said.
Like Smart, Papenburg suggested governments “invest in our child health care systems capacity, so that we can better handle these types of unpredictable surges of infections in our pediatric population.”
“When you look at Canada, we rank 30th out of 38 countries for childhood well-being,” Smart said. “It’s really shocking to think a country, as wealthy as ours, is doing that poorly for our kids, but it’s because we do not have a strategy for children.”
Health officials also recommend that people mask in indoor public places, screen daily for respiratory symptoms, stay home when sick, practice hand hygiene and keep surfaces clean to reduce the spread of respiratory illnesses such as RSV and flu.
VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.
Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.
In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.
The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.
Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”
Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”
This report by The Canadian Press was first published Sept. 16, 2024
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
