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A Plan For Covid-19 The Next Normal: Part 1 – A Roadmap – Forbes

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Getting to and Sustaining the Next Normal: A Roadmap for Living with COVID is a blueprint written by a who’s who of health, scientific, and policy experts as a comprehensive report to set us on the path to the “next normal” with Covid-19. The group, assembled and orchestrated by Dr. Ezekiel Emanuel, is the most detailed attempt to once and for all confront the threat that Covid-19 still presents. This report comes not a moment too soon, as we are hungering for a return to pre-pandemic times. And lest we develop a collective amnesia during this Omicron wave respite, this is a must read for not only our political leaders, but every person whose life has been altered by this deadly virus.

Following both President Biden’s State of the Union address and the Covid-19 White House Response Team press briefings, this 136-page report examines everything from future Covid-19 scenarios to the health and morale of our healthcare workforce. This Covid-19 Strategic Roadmap, is the brainchild of Dr Emanuel, who said in an interview, “this report hopes to influence critical decisions that must be made to positively affect the future of US security, economic and healthcare planning.”

This is all juxtaposed in a global environment where we are experiencing the greatest possible super-spreader event of this pandemic. I refer to the mass evacuation of more than 1.5-million people from Ukraine. Very few, if any of these refugees are wearing masks or practicing social distancing as they stand in endless lines or cram into packed shelters and trains.

The report is very quick to raise two serious pandemic complications. The first is fatigue. People are tired of Covid-19 and its attendant restrictions. The second is the ability of the virus to surprise the experts, making it challenging to anticipate what lies ahead, especially as new variants evolve, making it virtually impossible to foresee the consequences to schools and the negative economic realities we could face.

Again, infections and deaths in the US have declined from their February highs. But as one of the authors, Dr. Rick Bright reminds us, “some think that we are finished with this pandemic, but with 1,500 deaths a day – we are not. Many of us are done with the virus, but the virus is certainly not done with us. This is the moment when we need to identify the right tools and approaches to address this pandemic and any future pathogen threat.”

In recognizing the realities of previous Covid-19 missteps, the report also calls for establishing a Deputy Assistant to the President for Biosecurity (DAP-B). The Deputy Assistant would manage national pandemic policy coordination and prevention efforts, including communications. If the past two years have taught us one thing, it is the importance of clear and consistent messaging. Misinformation and disinformation, not only cause confusion, they also spawn conspiracy theories and pseudo-medical claims that thwart coordinated responses.

In its Executive Summary, the report outlines twelve fundamental elements. Here is an outline of five of them giving a multi-faceted approach for the next normal:

  1. We know extraordinarily little about Post-Acute Covid-19 Syndrome (PACS) also known as long-Covid. A significant percentage of patients who recover from acute infection (including those who did not require hospitalization and those who were asymptomatic) develop long-term symptoms. Persistent symptoms of fatigue, respiratory difficulties, and cognitive difficulties (brain fog) limit one’s ability to perform daily activities. Such patients may be unable to return to work. Those affected by long-Covid represent a new category of patients, requiring chronic care and support. The toll on our workforce and economy has yet to be calculated.
  2. Creating an infectious diseases dashboard to guide both the public and policymakers at the national, state, and local levels on the need to introduce, modify, or lift public health measures. Such a dashboard would provide “guidance on the distribution of therapeutics and other special protections for the immunocompromised, elderly, and other vulnerable populations.”
  3. Accurate, transparent, and accessible data is essential to reaching the next normal. To this end, the report delineates the need for a robust data infrastructure with information gathered through increased testing and surveillance. Key to this element is standardization.” With standardization we will be able to analyze and compare region to region and sub-population to sub-population. This is essential to achieve better health equity and avoid creation of health care deserts.
  4. Viruses are often transmitted through the air we breathe. To address this reality the report asks the Environmental Protection Agency (EPA) and the Occupational Safety and Health Administration (OSHA) to develop standards to improve indoor air quality.” Again, standardization is essential. Such measures would apply to schools, childcare facilities, private and public buildings. Improved air quality will not only reduce viral transmission, but will also offer the potential to reduce the severity of conditions such as asthma and seasonal allergies caused by airborne irritants.
  5. Vaccines, monoclonal therapeutics, anti-inflammatory therapeutics and now anti-virals have given us considerable defense in this pandemic. Yet, they are not panaceas to forever lead us into the next normal. More effective therapeutic designs must be supported, and we must be creative in developing these new therapeutics. Additional damage caused by illnesses like Covid-19 results from a disruption of our immune system. An out-of-control immune response is as damaging as a deficient immune response. Interrupting or preventing immune system hyperactivation through therapeutics will mitigate the damage of not just Covid-19 but also a host of other diseases. The development of new therapeutics will require a collaborative effort between the public and private sectors. Innovation comes from such undertakings. Although, availability is different from access and access for all at-risk groups is a fundamental aspect of new discoveries which must be considered.

Other chapters outline specific action plans for implementation of the fundamentals. To date, we have not seen a clearer presentation. It is the result of collaboration of authorities from multiple areas of expertise. This report does not take the form of a fiat but that of a consensus. Consensus on best practices will lead to the next normal; anything less will keep us riding one wave of infection after the other.

This might be considered an expensive proposition. One might justifiably ask where is all this money to come from to support this effort? The answer is simply that this investment is the only way to safeguard our present and future existence. We cannot afford to do otherwise, lest we continue to repeat the experiences of the last two years. We cannot be blasé and assume that this will pass and that there will not be another threat to our health and well-being. We cannot afford to do otherwise.

The next installment will be: A Plan For Covid-19 The Next Normal: Part 2 – Therapeutics.

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B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

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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

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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.

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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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