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Being on the East Coast a double-edged sword in COVID-19 pandemic medical battle – HalifaxToday.ca

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HALIFAX — Being a small East Coast province in the pandemic is a double-edged sword: there are fewer critically ill patients, but the supply of hospital beds is limited if the worst-case scenario materializes.

“We will have fewer beds, but we will have a lower population density too,” said Dr. Ward Patrick, the head of critical care at the Nova Scotia Health Authority — the biggest health agency in Atlantic Canada.

The 60-year-old veteran of intensive care medicine said in an interview his teams have access to an existing supply of 120 intensive care beds provincewide — each equipped with ventilators and staffed by specialized health workers.

In addition, the province’s intensive care units have been emptied by 50 per cent to prepare for COVID-19 patients, and Patrick says Nova Scotia could surge to over 200 intensive care beds as the pandemic progresses.

However, he also acknowledged there are “wild cards,” ranging from unanticipated jumps in infections to finding replacements for sick staff.

His health authority has created scenarios where 7,000 of its 23,400 staff are off due to self-isolation or illness, and Patrick said he’s aware of estimates that could go higher.

Janet Hazelton, the president of the Nova Scotia Nurses’ Union, said she believes the Atlantic provinces could face some of Canada’s biggest staffing issues.

“We don’t have enough that we can move them all over, as in some of the biggest provinces,” she said during an interview.

An outbreak from two gatherings at a funeral home last month in St. John’s, N.L. — which has generated nearly three quarters of the province’s 195 infections — illustrates another key risk when ICU beds are at a premium.

Gilles Lanteigne, the chief executive of the Vitalite Health Network in New Brunswick — which serves the province’s francophone population — says intense outbreaks in one location are the most worrying scenario for smaller health agencies like the one he oversees.

“The average age of our population is very old, and we have some regions where people are not as healthy when compared to the average region in the country,” he said in a telephone interview.

“Clustering, if that ever happens … it could cause almost a disaster. It could increase significantly the cases.”

His agency has 33 intensive care beds prepared for COVID-19 patients, with a capacity to surge in two stages to a total of 116, he said. Horizon Health Network, New Brunswick largest health authority, has 98 intensive care unit beds in place, 53 of which are currently occupied.

Newfoundland and Labrador has 98 such beds, and four COVID-19 patients were in intensive care Friday.

Dr. John Haggie, the minister of health in the province, has said repeatedly he believes his province can cope, but this week he added: “Whether we’re right, ask me in three weeks’ time.”

Javier Sanchez, an epidemiologist at the University of Prince Edward Island’s faculty of veterinary medicine, sees some hope emerging for smaller jurisdictions.

Though he’s a veterinarian, Sanchez’s expertise has been called upon to help with COVID-19 modelling for the Island’s population of 156,000. He said with just 22 positive cases and no community transmission as of Friday, P.E.I. may be exhibiting “a unique situation.”

He said there’s little doubt a concentrated outbreak could challenge the Island’s two hospitals, which have just 17 intensive care beds and a capacity to bring on 46 additional units if needed.

However, Sanchez said unlike large urban centres, the Island, with a single bridge linking it to the mainland, has the advantage of being able to tightly restrict entry of people from other jurisdictions.

He also suggests a rural population is likelier to succeed in social distancing than large cities, and breaking the rules would be more quickly detected.

“In P.E.I., everyone knows everyone, so if you have to self-isolate and you’re going around, somebody will know you,” he said.

Lanteigne says New Brunswick’s Acadian population’s advantage is “the population is dispersed.” With the exception of Moncton, “we don’t have very large cities with high-rise buildings,” he said. 

To date, there’s little clear indication of when the Atlantic provinces expect their critical care capacity will face its greatest test.

Nationally, figures cited by the chief public health officer of Canada have suggested about three per cent of the current infected population will become critically ill.

But in the region, only New Brunswick has committed to releasing models showing the best- and worst-case scenarios it is working with, and when the peak of the pandemic is forecast.

Dr. Robert Strang, the chief medical officer of health in Nova Scotia, has said technical expertise is in short supply to create the models.

Meanwhile, Patrick, the Nova Scotia critical care director, says he hopes people realize their respect of public health directives will help determine whether intensive care systems in the region are overwhelmed.

“It’s a busy time. But we’re going to see this through,” he said.

This report by The Canadian Press was first published April 3, 2020

Michael Tutton, The Canadian Press

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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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.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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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.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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