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A look at how provinces plan to emerge from COVID-19 shutdown – Burnaby Now

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Provinces have been releasing plans for easing restrictions that were put in place to limit the spread of COVID-19.

Here is what some of the provinces have announced so far:

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Newfoundland and Labrador

Newfoundland and Labrador lifted some of the public health restrictions imposed to slow the spread of COVID-19 on May 11. The province has entered “alert level four” in its five-level reopening plan, allowing some businesses such as law firms and other professional services to reopen along with regulated child-care centres, with some restrictions. Small gatherings for funerals, burials and weddings are also permitted with a limit of 10 people following physical distancing rules. Municipal parks, golf courses and driving ranges can open and recreational hunting and fishing are permitted. Officials are reminding people that the new rules do not allow for parties or other social gatherings.

The province is loosening restrictions in a series of “alert levels” descending from five. The current alert level is to remain in place for at least 28 days. At Level 3, private health clinics, such as optometrists and dentists, are to be permitted to open, as well as medium-risk businesses such as clothing stores and hair salons. At Level 2, some small gatherings will be allowed, and businesses with performance spaces and gyms are to reopen. Level 1 would represent “the new normal.”

Nova Scotia

Nova Scotia Premier Stephen McNeil has announced there will be no return to school this year. He also says a decision on whether daycares will reopen will be made by June 8. Nova Scotia has eased some public health restrictions, however, directives around physical distancing and social gatherings remain in place. Trails and provincial and municipal parks can now reopen, but playground equipment is still off limits. Garden centres, nurseries and similar businesses can open, and while golf driving ranges can open, courses remain closed. Sportfishing is permitted and people can attend boating, yacht or sailing clubs for the purpose of preparing boats for use. Drive-in religious services are now allowed, as long as people stay in their cars, park two metres apart and there are no interactions between people.

Prince Edward Island

P-E-I is accelerating its Renew PEI Together plan. Phase two of the plan will still begin May 22 as scheduled, but the third phase will now begin June 1 instead of June 12. Phase three will allow gatherings of up to 15 people indoors and 20 people outdoors, organized recreational activities and the opening of child care centres and in-room dining. Members of a household can currently gather indoors with up to five other people. Other precautions, such as physical distancing remain in place. Screening also continues at points of entry into the province and all people coming into P.E.I. are required to isolate for 14 days. Priority non-urgent surgeries and select health-service providers, including physiotherapists, optometrists and chiropractors, resumed on May 1. The Renew P.E.I. Together plan also allows outdoor gatherings and non-contact outdoor recreational activities of no more than five individuals from different households.

New Brunswick

New Brunswick’s education minister says licensed daycares can begin reopening May 19. Children won’t have to wear masks or maintain physical distancing, but they will be in small groups. Anyone who has travelled outside of New Brunswick will not be allowed to visit early learning and child-care facilities for 14 days. Meanwhile, the province has allowed more businesses and services to reopen. Retail businesses, offices, restaurants, libraries, museums and seasonal campgrounds can do so under certain conditions. Those include having an operational plan that explains how they are meeting public health guidelines including physical distancing, hand hygiene and allowing staff to remain home when ill. Outdoor gatherings of up to 10 people are also allowed if physical distancing is respected. The resumption of elective surgeries is also part of the province’s phase two of its reopening plan.

The third phase will allow regular church services, dentistry work and the reopening of fitness centres. The final phase, which will probably come only after a vaccine is available, will include large gatherings. Phase one, which started on April 24, allowed limited play on golf courses as well as fishing and hunting. Post-secondary students were allowed to return if it was deemed safe by the school, and outdoor church services were again permitted, providing people remain in their vehicles and are two metres apart.

Quebec

Quebec reopened retail stores outside Montreal on May 11. Lottery terminals are also reopening after being shut down on March 20 with sales moving to online only. Quebec’s construction and manufacturing industries have resumed operations with limits on the number of employees who can work per shift. Elementary schools and daycares outside Montreal reopened on May 11, but high schools, junior colleges and universities will stay closed until September. Elementary schools in the greater Montreal area will remain closed until late August. Premier Francois Legault says public health conditions haven’t been met in the area hardest hit by the coronavirus, so Montreal daycares will also remain closed until at least June 1. Officials haven’t made a firm decision about retail businesses, which are scheduled to reopen May 25. Meanwhile, checkpoints set up to slow the spread of COVID-19 are coming down on May 18 in various parts of Quebec, including between Gatineau and Ottawa.

Ontario

Ontario is set enter its first stage of reopening on May 19 including lifting restrictions on retail stores and surgeries. The province says workplaces can begin to reopen, but working from home should continue as much as possible. All construction can resume and limits will be lifted on maintenance, repair and property management services, such as cleaning, painting and pool maintenance. Most retail stores that have a street entrance can reopen with physical distancing restrictions, such as limits on the number of customers in a store and providing curbside pickup and delivery. Golf courses can reopen though clubhouses can only open for washrooms and take-out food. Marinas, boat clubs and public boat launches can also open, as can private parks and campgrounds for trailers and RVs whose owners have a full season contract, and businesses that board animals. Other businesses and services included in the stage one reopening include regular veterinary appointments, pet grooming, pet sitting and pet training; libraries for pickup or deliveries; and housekeepers and babysitters. Ontario has previously announced that publicly funded schools will be closed until at least May 31.

Saskatchewan

The Saskatchewan government’s five-phase plan to reopen its economy started May 11 with dentists, optometrists and other health professionals allowed to resume services. Phase 1 also includes reopened golf courses and campgrounds. Phase 2 will give the green light to retail businesses and salons. Restaurants and gyms could open in Phase 3, but with limited capacity. Phase 4 could see arenas, swimming pools and playgrounds opening. In Phase 5, the province would consider lifting restrictions on the size of public gatherings.

Manitoba

The Manitoba government has lifted its one-month limit on people’s prescription drug supplies, allowing people to again get prescriptions filled or refilled for 90 days. Its health offices, including dentists, chiropractors and physiotherapists can also reopen. Retail businesses can reopen at half occupancy providing they ensure physical spacing. Restaurants can reopen patios and walk-up service. Museums and libraries can also reopen, but with occupancy limited to 50 per cent. Playgrounds, golf courses and tennis courts reopened as well, along with parks and campgrounds. A second phase is to begin no earlier than June 1. That’s when restaurants would be allowed to open indoor dining areas and non-contact children’s sports would resume. Mass gatherings such as concerts and major sporting events will not be considered before September. Meanwhile, Manitoba has extended a province-wide state of emergency until mid-June, to help prevent the spread of COVID-19.

Alberta

Alberta has increased the limit for outdoor gatherings to 50 people — up from 15. The province allowed stores, restaurants, daycares and hair salons to reopen across much of the province on May 14. But hair salons and restaurant dining rooms can’t reopen in Calgary and Brooks until May 25. Restaurants can only open at half capacity. Premier Jason Kenney says if the first stage of reopening goes well, the next phase — which includes movie theatres and spas — could go ahead on June 19. Alberta allowed some scheduled, non-urgent surgeries to start on May 11. Service provided by dentists, physiotherapists and other medical professionals are also permitted. Golf courses reopened May 2, though pro shops and clubhouses remain shuttered.

British Columbia

The provincial government is allowing a partial reopening of the B.C. economy starting May 19. The reopening plans are contingent on organizations and businesses having plans that follow provincial guidelines to control the spread of COVID-19. Hotels, resorts and parks will follow in June. Parents in B.C. will be given the choice of allowing their children to return to class on a part-time basis in June. The government says its goal is for the return of full-time classes in September, if it’s safe. Under the part-time plan, for kindergarten to Grade 5, most students will go to school half time, while grades 6 to 12 will go about one day a week. A mix of online and classroom post-secondary education is planned for September. Conventions, large concerts, international tourism and professional sports with a live audience will not be allowed to resume until either a vaccine is widely available, community immunity has been reached, or effective treatment can be provided for the disease.

Northwest Territories

The Northwest Territories announced on May 12 a reopening plan that contains three phases, but the government didn’t say when it would be implemented. The plan includes more gatherings and the possible reopening of some schools and businesses. However, the territory’s borders remain closed indefinitely to non-residents and non-essential workers. There are several requirements that must be met before any measures are relaxed: there must be no evidence of community spread until today; travel entry points in the territory are strong and secure; risks are reduced from workers coming into the territory; and expanded community testing is available.

Yukon

The territory’s reopening plan outlines five phases including a period after a vaccine is available. The plan’s “restart” phase began May 15, with businesses that were ordered to close allowed to reopen as long as they submit an operational plan. Two households of up to 10 people in total are also able to interact with each other as part of a “household bubble.” But bars and restaurants that offer dine-in services won’t be allowed to reopen until the chief medical officer of health lifts restrictions. The territory’s borders also remain closed but residents are allowed to travel throughout Yukon more easily.

This report by The Canadian Press was first published May 17, 2020

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Migrant women workers continue to face abortion access barriers: advocates

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OTTAWA — While she has helped several migrant workers access abortion services in Canada, Evelyn Encalada Grez said one woman comes to mind.

“The migrant woman was so afraid of being found out that she needed to be taken by somebody else outside of the farm for a medical appointment,” said Encalada Grez, a transnational researcher and advocate for migrant workers who has been studying the subject for more than 20 years.

On the day she came to pick the woman up to bring her to Toronto to meet health-care workers who could perform the procedure, it was raining.

Because the woman was so worried about being seen, she met Encalada Grez far away from the farm in the Niagara region where she worked.

“When I met her in the designated place where we agreed to meet, she was soaking, soaking, soaking, and I’m like, ‘Why does it feel like I’m doing something wrong?’” Encalada Grez recalled.

“What if she didn’t have a friend or know anyone that does this type of grassroots work, what would have happened to her and her life?”

This experience is similar to many others Encalada Grez has had taking migrant workers to access an abortion. Moving in secrecy off farm property feels like organizing a heist.

Migrant women in Canada face profound barriers in accessing health care, especially when it comes to pregnancy. They often hide their pregnancies because if employers find out, they may send them home or refuse to hire them next season. Workers typically live on their employer’s property and lack the privacy to discreetly seek care. Many live in remote, rural areas where abortion access is already sparse and transportation is hard to come by. And they face the added challenge of being unable to receive health care in their first language.

Another major barrier is cost, said Elene Lam, executive director of Butterfly, an organization of sex workers, social, legal and health professionals that advocates for the rights of Asian and migrant sex workers.

The migrant workers Lam advocates for typically lack provincial health-care coverage, and are required to pay out of pocket, she said. Depending on the stage of pregnancy, that can cost anywhere between a few hundred dollars and up to $1,500.

While many migrant workers can access public health care, not all of them can, said Lindsay Larios, assistant professor at the University of Manitoba, who studies precarious migration and reproductive justice.

This can be a result of having to wait the three-month period after arrival, during which time they must rely on private insurance. To get it, their employers have to file paperwork that sometimes doesn’t get filed.

If they face issues with renewing work permits or visas, that can also mean a lapse in their immigration status.

When it comes to abortion, there is a lot of stigma around migrant workers having intimate or sexual relationships, said Larios.

She cited research that shows migrant workers are told by officials in their home countries or in Canada, or by their employers, that they should abstain from sexual relationships.

“Workers themselves feel that there’s a real risk to their job — for example, not being hired back the following year — if they are seen as problematic employees who are transgressing this accepted unofficial policy,” she said.

Despite the fact that the abortion pill, mifepristone, became available in Canada at the beginning of 2017, this has not necessarily translated into better access to abortion for migrant workers, said Larios and Lam.

The treatment, also known as medical abortion, can be done safely at home rather than requiring a trip to a clinic or hospital, but still requires a prescription from a doctor and costs hundreds of dollars if a patient has to pay out of pocket, Larios said.

Mohini Datta-Ray, executive director at Planned Parenthood Toronto, pointed out that medical abortion has very uncomfortable effects. It causes a lot of cramping, bleeding and pain, and is very debilitating for about a week or so, she said.

Given the few protections migrant workers have around their health, and how little it can take to deport them for an illness, disability or other scenario that makes them less valuable in the eyes of the employer, “it’s just not the solution that you would think at first glance, if you’re not in caught in this very impossible situation,” said Datta-Ray.

If the federal government cares about abortion access, it could grant “status for all,” a campaign to grant permanent residency for all temporary migrant workers and families with precarious legal status, said Frederique Chabot, director of health promotion at Action Canada for Sexual Health and Rights.

Action Canada supports the call because it knows without that, people will continue to go without abortion, Chabot said.

Encalada Grez echoed this and added that the government must reform temporary foreign worker programs so that employees are not tied to one employer and can have the freedom to go elsewhere, reducing the likelihood of exploitation.

“We need to be more accountable to the people that Canada brings in,” she said.

The office of Carla Qualtrough, minister of employment and workforce development, has not yet responded to a request for comment.

This report by The Canadian Press was first published May 28, 2022.

This story was produced with the financial assistance of the Meta and Canadian Press News Fellowship.

 

Erika Ibrahim, The Canadian Press

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More Canadians could face late-stage cancer tied to diagnosis delays during COVID pandemic – CBC News

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It all started with a stomach bug.

That’s what Cheryl-Anne Labrador-Summers thought, anyway. It was October 2020, not long after she’d moved to the tranquil lakeside Ontario community of Georgina, and instead of relaxing with her family like she’d planned, the mother of three was struggling to figure out why she kept experiencing strange, unexplained stomach cramps.

Labrador-Summers tried to visit her family physician, but the office was shuttered because of the COVID-19 pandemic. So she searched for another clinic — only to be offered a phone appointment rather than an in-person assessment. She wound up being told that her grumbling digestive system was likely caused by a mild gastrointestinal illness.

By January, the 58-year-old had a distended stomach, looking — in her own words — “about nine months pregnant.” Again, she reached out to a physician, went for some tests, then headed to the nearest emergency department.

After finally seeing a doctor face to face for the first time in months, she learned the real cause of her discomfort: an intestinal blockage caused by cancer.

“It ended up being a nine-centimetre tumour, and it had completely blocked off my lower bowel,” she said.

An emergency surgery left Labrador-Summers with 55 staples along her torso and a months-long recovery before she could begin oral chemotherapy. Her question now is unanswerable but painful to consider: Could that ordeal have been prevented, or at least minimized, by an earlier diagnosis?

“Had I maybe been able to see the doctors earlier, I would not be in Stage 3,” she said. “I might have been a Stage 2.”

Photos show Labrador-Summers with a distended stomach before her emergency surgery, left, and the 55 staples along her torso following the procedure. (Supplied by Cheryl-Anne Labrador-Summers)

951,000 fewer cancer screenings in Ontario

More Canadians could experience late-stage cancer diagnoses in the years ahead, medical experts warn, forecasting a looming crisis tied to the ongoing COVID-19 pandemic. 

“We expect to see more advanced stages of presentation over the next couple of years, as well as impacts on cancer treatments,” said oncologist Dr. Timothy Hanna, a clinician scientist at the Cancer Research Institute at Queen’s University in Kingston, Ont.

“We know that time is of the essence for people with cancer. And when people are waiting for a diagnosis or for treatment, this has been associated with increased risks of advanced stage and worse survival.”

One review of Ontario’s breast, lung, colon, and cervical cancer screening programs showed that in 2020 there were 41 per cent — or more than 951,000 — fewer screening tests conducted compared with the year before.

Screening volumes rebounded after May 2020, but were still 20 per cent lower compared to pre-pandemic levels.

WATCH | Late-stage cancer being diagnosed in Canadian ERs:

ERs faced with late-stage cancer diagnoses amid pandemic

4 days ago

Duration 2:11

Hospital emergency rooms are seeing a wave of patients being diagnosed with late-stage cancer after the COVID-19 pandemic forced many doctors’ offices to close or pivot to virtual appointments, leading to fewer cancer screenings.

That drop in screenings translates into fewer invasive cancer diagnoses, including roughly 1,400 to 1,500 fewer breast cancers, wrote Dr. Anna N. Wilkinson, an assistant professor in the department of family medicine at the University of Ottawa, in a May commentary piece for the journal Canadian Family Physician.

“The impact of COVID-19 on cancer is far-reaching: screening backlogs, delayed workup of symptomatic patients and abnormal screening results, and delays in cancer treatment and research, all exacerbated by patient apprehension to be seen in person,” she wrote.

“It is clear that there is not only a lost cohort of screened patients but also a subset of missed cancer diagnoses due to delays in patient presentation and assessment,” leading to those cancers being diagnosed at a more advanced stage. 

Tough accessing care in a ‘timely way’

The slowdown in colonoscopies may already be leading to more serious cases of colorectal cancer in Ontario, for instance, suggests a paper published in the Journal of the Canadian Association of Gastroenterology.

“Patients who were treated after the COVID-19 pandemic began were significantly more likely to present emergently to hospital. This means that they were more likely to present with bowel perforation, or severe bowel obstruction, requiring immediate life-saving surgery,” said the study’s lead author, Dr. Catherine Forse, in a call with CBC News.

“In addition, we found that patients were more likely to have large tumours.”

Dr. Lisa Salamon, an emergency room physician with the Scarborough Health Network, is pictured outside Birchmount Hospital, in Scarborough, Ont. (Evan Mitsui/CBC)

In some cases — like Labrador-Summers’s situation — Canadians learned alarming news about their health in hospital emergency departments after struggling to receive in-patient care through other avenues.

Shuttered family physician offices, a shift to telemedicine, and some patients’ fears surrounding COVID-19 may all have played a role.

“It became harder for patients to access care and to access it in a timely way,” Hanna said.

“At the same time, there were real risks — and there are real risks for leaving home to go anywhere, particularly to go to an outpatient clinic or a hospital in order to get checked out.”

Dr. Lisa Salamon, an emergency physician with the Scarborough Health Network in Toronto, said she’s now diagnosing more patients with serious cancers, including several just in the last few months.

“So previously, it may have been localized or something small, but now we’re actually seeing metastatic cancer that we’re diagnosing,” she explained.

Lessons for future pandemics

Health policy expert Laura Greer is dealing with Stage four, metastatic breast cancer herself after waiting more than five months for a routine mammogram she was initially due for in the spring of 2021 — a precautionary measure given that her mother had breast cancer as well.

Unlike an early-stage diagnosis, Greer’s cancer is only treatable, not curable.

“It was an example of what happens when you don’t have the regular screening, or those wellness visits,” said the Toronto resident and mother of two. 

“I most likely would have had earlier-stage cancer if it had been sooner.”

Health policy expert Laura Greer is dealing with Stage 4, metastatic breast cancer after waiting more than five months for a routine mammogram she was due for in the spring of 2021. (Esteban Cuevas/CBC News)

Pausing access to care and screenings for other health conditions can have dire impacts on patients, according to Greer, offering lessons for how policy-makers tackle future pandemics.

“We need to make sure that we’ve got enough capacity in our health system to be able to flex, and that’s what we really didn’t have going into this,” she said.

For Labrador-Summers, it’s hard to forget the moment her life changed while she was alone in an emergency department, learning a terrifying diagnosis from a physician she’d just met. Her mind raced with questions about the future and concerns for her family.

Labrador-Summers’s husband and one of her sons kiss her on the dock near their lakeside home in Georgina, Ont. (Ousama Farag/CBC News)

“My older son had just told us they were expecting a child, and I just wanted to be there for them. And I didn’t know what next steps were. And we had lost my mom to cancer a few years back — to us, cancer was always terminal,” she recalled.

“So again, I’m alone, trying to process all of this.”

A screening following Labrador-Summers’ surgery and chemotherapy treatment wound up finding more cancer. 

“It’s now life-threatening,” she said.

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U.S. CDC publishes guidelines on monkeypox vaccine – Financial Post

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The U.S. Centers for Disease Control and Prevention (CDC) on Friday published recommendations by its group of independent experts on a smallpox vaccine that limit its use to only people who work closely with viruses such as monkeypox.

The Jynneos vaccine, made by Bavarian Nordic, will be available for certain healthcare workers and laboratory personnel at a time when monkeypox infections has spread in Europe, United States and beyond.

The vaccine was approved in the United States in 2019 to prevent smallpox and monkeypox in high risk adults aged 18 and older.

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CDC officials earlier this week said they were in the process of releasing some doses of the Jynneos vaccine for people in contact with known monkeypox patients.

Officials said there were over 100 million doses of an older smallpox vaccine called ACAM2000, made by Emergent BioSolutions , which has significant side effects.

Monkeypox is a mild viral infection that is endemic in certain parts of Africa, but the recent outbreak in countries where the virus doesn’t usually spread has raised concerns.

So far, there are about 300 confirmed or suspected cases in around 20 countries where the virus was not previously circulating. The World Health Organization has called for quick action from countries to contain the Monkeypox spread.

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The CDC said its experts’ recommendations are meant for clinical laboratory personnel performing diagnostic tests for orthopoxviruses such as smallpox and monkeypox, laboratory people doing research on the viruses and healthcare workers who administer the ACAM2000 vaccine or care for patients infected with orthopoxviruses.

The publication of the vote by the CDC’s Advisory Committee on Immunization Practices, which took place in November last year, formalizes the recommendations.

Both ACAM2000 and Jynneos are available for prevention of orthopoxvirus infections among at-risk people, the CDC said on Friday. (Reporting by Manas Mishra and Amruta Khandekar in Bengaluru; Editing by Krishna Chandra Eluri and Shailesh Kuber)

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