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Albertans to wait another week for bivalent COVID-19 boosters – Global News

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Albertans looking to get more Omicron-specific vaccine coverage will have to wait another week until they can book or get a bivalent shot.

On Wednesday, the Alberta government announced their rollout plans for the new doses.

Albertans aged 18 and older who have completed a primary series of COVID-19 vaccination are eligible, but must wait five months between doses. “A shortened interval can be considered” for individuals at higher risk of severe outcomes, a press release from the province read.

Read more:

Alberta should brace for fall flu and COVID-19 waves: Hinshaw

Bookings for and administration of doses begins on Sept. 21. Bookings can be made online or through Health Link at 811.

The province also noted a bivalent COVID-19 vaccine for Albertans aged 12-17 is expected in late September or early October.

And starting the week of Oct. 3, the bivalent booster will be offered with the influenza vaccine to residents in senior congregate care facilities.

News of the bivalent vaccine came after weeks of Albertans wondering when they might have access to doses tailored to better fit the Omicron BA.1 variant.


Click to play video: 'Learning about the bivalent vaccine'



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Learning about the bivalent vaccine


Learning about the bivalent vaccine

Health Canada and the National Advisory Committee on Immunization approved the Moderna Spikevax Omicron-specific vaccine on Sept. 1.

According to the Public Health Agency of Canada, 32,300 doses were sent to Alberta on Sept. 8.

Documents obtained by Global News, McKesson, a pharmacy distributor in Canada, showed pharmacies were told they could start ordering the bivalent doses on Tuesday, information the Health ministry confirmed on Wednesday.

The distributor advised pharmacies to await official notification before administering doses.

“Please do not vaccinate until this is confirmed,” the McKesson memo stated.


A memo sent to Alberta pharmacies from supplier McKesson announcing orders for doses of Moderna’s bivalent vaccine opened on Tuesday, Sept. 13, 2022.


Global News

A frustrating wait

Sarah Mackey with Vax Hunters Alberta called the weeks-long wait for the rollout plans “frustrating.”

“People have been waiting for a booster. They’re a long way past their last one and we’re also now back at school. People are more exposed, you’ve got high risk family members. There’s so many reasons that people want these bivalent boosters. They want to be protected and they don’t even know when they’re going to be able to get access,” she said.

Mackey questioned why the province doesn’t have a refined COVID-19 vaccine rollout plan, 20 months after initial vaccines were approved in December 2020.

Read more:

Study co-authored by B.C.’s top doctor says 80% of kids, youth have had COVID-19

“They should have a process in place for this where they say, ‘Okay, this is a limited quantity. So we’re going to go to version A where it’s the most high risk people first’ or, ‘Oh, we know that there are a lot of outbreaks happening in long-term care facilities. So we’re going to start there.’

“They’ve done this before. This is no longer winter of 2021 where we’re trying to figure out who needs to be the priority process,” Mackey said.

Benefits to bivalent

University of Alberta infectious disease professor Dr. Lynora Saxinger said the bivalent vaccine could provide a clearer path through the ongoing pandemic.

“There is a really strong reason to believe that the Omicron booster could help reduce infection more – because we’re not reducing infection as much with our vaccines now, we’re reducing disease more. So if we reduce infection more, we can reduce transmission more, and we can maintain a more normal level of functioning across the health-care system, across society.”

Saxinger said booster shots formulated from the original strain of COVID-19 still reduce the risk of severe outcomes, “which is pretty significant and important, especially if people are older, more frail, or have multiple medical conditions.”

“At the moment, people who had two doses really do have a disadvantage in terms of prevention of severe disease,” she said, noting the more time that’s elapsed since a vaccine dose, the less effective the immune response.

Slow roll out

Alberta is one of the last provinces to announce its rollout of the vaccine specially formulated to better address the Omicron variant that remains dominant in Canada.

Neighbouring Saskatchewan started booking bivalent doses on Monday for citizens 18 and older who are living in long-term care, personal care homes and other congregate living facilities.

On Sept. 6, British Columbia announced it was kicking off its fall COVID-19 booster campaign with the bivalent doses.

On Sept. 8, Quebec started rolling out bivalent doses for everyone 30 and older.

Read more:

Alberta needs to change tactics to improve 5-11 COVID vaccination rate: study

Ontario and Nunavut started booking and providing doses to their most-vulnerable populations: people 70 and older, long-term care residents and healthcare workers on Monday.

The day after the federal approval for the Moderna-manufactured bivalent vaccine, Manitoba and the Northwest Territories said they would do a phased rollout of the Omicron-targeted vaccine.

Previously, the only COVID-19 vaccines available in Canada were monovalent — tailored solely to the original novel coronavirus.

In addition to defending against this earlier strain, the new shots from Moderna are designed to recognize specific mutations in the spike protein of the Omicron BA.1 subvariant.


Click to play video: 'Expectations for 2022/23 flu season in Alberta'



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Expectations for 2022/23 flu season in Alberta


Expectations for 2022/23 flu season in Alberta

Health Canada’s chief medical advisor Dr. Supriya Sharma told a news conference on Sept. 1 that the BA.1-targeted vaccine authorized Thursday also generates a “good” immune response against the BA. 4 and BA. 5 strains.

Hospitalizations climb on younger admissions

In the weekly COVID-19 data release, the province revealed there are now 819 people in hospital — an increase of 20 from the week before — and 26 are in ICU — six more than last week.

Of the 20 new hospitalizations, 15 were of people younger than 20.

Sixteen more Albertans had COVID-19 attributed as their cause of death in the last week, bringing the pandemic death toll to 4,848. Thirteen of those deaths came in people aged over 80 years old.

The seven-day average positivity rate on PCR tests administered by the province rose a quarter of a percent to nearly 17 per cent. The province restricted PCR tests to individuals at clinical risk of severe disease or who live and/or work in high-risk settings.

— With files from Lauren Pullen, Breanna Karstens-Smith and Brody Langager, Global News, and The Canadian Press.


Click to play video: '‘The Healing Project’ art installation reflects COVID-19 experiences in St. Albert'



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‘The Healing Project’ art installation reflects COVID-19 experiences in St. Albert


‘The Healing Project’ art installation reflects COVID-19 experiences in St. Albert – Sep 6, 2022

© 2022 Global News, a division of Corus Entertainment Inc.

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‘Debilitating’ heart palpitations could be sign of Long Covid – do you have the condition? – Express

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Heart palpitations can be a sign of several different problems – both mental and physical. Often, they’re caused by stress and anxiety. But over the course of the last few years, Long Covid has reportedly caused palpitations. A recent study has explored why this might happen.

Long Covid is when people suffer ongoing symptoms of Covid, 12 weeks after infection.

Some people with the condition have struggled with heart palpitations, chest pain, dizziness, or feeling faint.

Researchers, observing their patients, have concluded that these symptoms could be caused by problems with the autonomic nervous system – the part of your nervous system that monitors automatic activities such as heart rate, breathing, and blood pressure.

Doctors and nurses at Hammersmith Hospital and Imperial College London believe that the “debilitating” palpitations and other symptoms were caused by “orthostatic intolerance syndrome”.

READ MORE: Princess Beatrice’s ongoing difficulty with ‘muddled’ thoughts swirling in her head

Orthostatic intolerance syndromes are when moving from a sitting or lying position to an upright position causes a low blood pressure in your arteries.

The British Heart Foundation explains: “When a healthy person stands up, some of the blood in the body will flow downwards with the pull of gravity.

“The body responds to prevent blood pressure falling – blood vessels narrow and there is a slight increase in heart rate.

“But in people with orthostatic problems, these automatic changes don’t happen.

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“Moving to an upright position causes a drop in the blood supply to the heart and brain and a fast heart rate as the body tries to compensate.”

For people that struggle with these issues with moving to an upright position, the study by Hammersmith Hospital and Imperial College London made recommendations.

It suggested: “Non-upright exercise such as cycling on a recumbent exercise bike and swimming are encouraged.”

It added: “The patient should be advised on rising cautiously from a lying or seated position and avoiding exacerbating factors such as prolonged standing, warm environments, and dehydration.”

READ MORE: Princess Beatrice’s ongoing difficulty with ‘muddled’ thoughts swirling in her head

Shingles, memory loss, tinnitus, itchy skin, and tremors were among the more abnormal symptoms experienced.

Some studies have suggested that long Covid is an autoimmune disease, similar to Parkinson’s disease. An autoimmune disease is when the body’s immune system attacks itself.

The body cannot tell the difference between your own cells and foreign cells so causes the body to attack healthy cells.

According to one small study from 2021, 44 percent of long Covid patients involved had high levels of a type of antibody connected with other autoimmune diseases and lupus.

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Genomic testing and medico-legal risk | InSight+ – MJA Insight

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INTEGRATING genomics into mainstream health care has many benefits, but also presents challenges. One challenge is ensuring that doctors and patients can safely and sustainably benefit from genomic medicine without increased medico-legal risk.

While the number of legal cases in Australia is still relatively small, this moment in time represents an opportunity to develop tools, training and support so doctors and their patients can safely and sustainably benefit from the advancing capabilities without increased medico-legal risk.

Over the past 2 years, we have been exploring the practical and medico-legal risks associated with genomic medicine, particularly in the context of antenatal care. Through our work, we identified that informed consent to test and workforce and funding issues are significant barriers to more effective use of genomics in health care. What we are seeing and how these medico-legal risks can be addressed through tools, training and support are explored below.

Informed consent to test

At the centre of consultations involving genomic medicine are individuals and families grappling with complex and often life-altering decisions. Many people need support both to understand the issues involved and to deal with the consequences of their decisions.

The consent process for people considering genomic testing presents specific challenges compared with other testing and treatments.

Advancing technologies and the increasing availability of expanded screening and testing mean that the practitioner and the pregnant person need to discuss and understand more complex information and face value-laden choices even before deciding whether to go ahead with a test.

Concepts such as “chance” of a condition developing (and the severity of that condition) or “variants of uncertain significance” are somewhat unique to the field of genomics and can be difficult for doctors to explain and for patients to understand.

To put this issue into the antenatal context, guidelines from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and the Royal Australian College of General Practitioners (RACGP) state that information on carrier screening for the most frequent autosomal or X-linked genetic conditions should be offered to all women planning a pregnancy or in the first trimester of pregnancy. The Colleges also state that all women should be provided with information and have timely access to screening tests for fetal chromosome and genetic conditions.

Guidelines play an important role in outlining the standard of care expected of doctors. Therefore, it is incumbent on practitioners working in this field to be equipped with the knowledge, expertise and tools to have comprehensive and comprehensible consent discussions with their patients about genomic testing.

An additional challenge for the consent process is that technology often develops at a much quicker pace than laws and guidelines. The emergence of expanded screening for autosomal and X-linked conditions and for fetal chromosome conditions can present challenges for doctors and their patients. “Expanded” screening can test for over a thousand conditions, many of which would have very little impact on a person. Explaining the potential impact of a variant of uncertain significance in terms of the chance of a condition developing in a person is inherently difficult.

The well established principles of consent require a doctor to give the person enough information for them to make an informed decision about the test or treatment being offered. This is a patient-centred test, requiring a doctor to discuss not only what a reasonable person in the patient’s position would want to know but also what the particular patient wants to know. The doctor is also ethically and legally obliged to recognise whether the patient has understood this information.

It is also important to ensure that a patient’s choice to have genomic testing is voluntary. An article published in the MJA in 2021 noted that patients may feel foolish to reject a test that is on offer and that a “normalisation” of testing has begun.

This was echoed in a recent Avant webinar, where medical and legal experts discussed issues of genetic testing and pregnancy. There was sentiment from the doctors who attended the webinar that the concept of voluntariness in genetic testing in pregnancy may be eroded by an “expectation” or social “normalisation” that women will accept each test offered. One participant said:

“… practitioners need to be careful to convey respect to women who choose against genetic screening in pregnancy. There is a risk that repeated discussion and repeated offers of testing sends a message that the woman has made an incorrect decision.”

We support the development of standard information and forms to be used as part of the consent process for genetic testing in pregnancy. This would help patients to understand what is involved and assist in their decision making, as well as alleviate some of the medico-legal risk for doctors.

Standard information used in consent discussions also helps to ensure information to patients is balanced, evidence-based and informative. This would lessen the burden on practitioners and means there is less room for allegations of bias in the information they were providing. It also has the potential to make clearer the blurred lines between clinical and research use of genomic test findings, which could, for example, add to the body of information that informs the significance of a rare variant that may have been identified.

It is therefore pleasing to see the National Model of Consent for Clinical Genomics Testing developed by the NSW Ministry of Health in accordance with Action 4A of the implementation plan for the National Health Genomics Policy Framework, on behalf of the Australian Health Minister’s Advisory Council Project Reference Group on Health Genomics. The Clinical Genomic Testing Consent Form developed to support the model can be adapted across jurisdictions and can be used in conjunction with patient information materials to assist patient understanding during the consent discussion. Consent material has also been developed by Australian Genomics.

Workforce and funding issues

Avant has also identified significant workforce pressures and gaps in funding for timely and sustainable care in genomic medicine.

We welcome the Medicare funding announced for genetic carrier screening for all couples, testing for carriers of cystic fibrosis, spinal muscular atrophy and fragile X syndrome from 2023. However, as genetic carrier screening becomes more accessible, there are some practical and medico-legal issues to consider.

With Medicare-funded testing available, the standards for carrier screening could change, with testing becoming the standard professional practice of doctors. More doctors will need to be equipped with the knowledge and communication skills to discuss carrier screening with their patients.

The complexity of these discussions should be reflected in appropriate Medicare item numbers for the consultations. The RACGP is calling for Medicare Benefits Schedule amendments to better support longer consultations for antenatal care that would support the use of time-based level C and D Medicare items for longer antenatal consultations. Such changes would better allow time for the detailed discussions that are required to take place around genetic screening. An alternative would be to introduce an additional cobilled item number specific to genomic testing and counselling which would recognise the complexity of these discussions with patients.

We believe Medicare-funded testing is likely to lead to more testing and, therefore, more people receiving positive results. Doctors we spoke with noted the importance of being able to engage with genetic specialists and counsellors. They reported that patients may need genomic expertise and mental health support. Currently, there can be lengthy delays and challenges accessing these practitioners. Time is of the essence in pregnancy, and workforce constraints could add pressure and stress to patients and doctors. Also, it is not clear that the newly announced funding for carrier screening includes costs associated with genetic counselling to discuss the results.

Research from the Deeble Institute has found that the workforce shortages in clinical genetics and genetic counselling are partly due to constraints on numbers of professionals being trained, which in turn are linked to limited workplace rotations available. While this may be the case with many specialties, particularly following the COVID-19 pandemic and workforce shortages due to burnout, the increased availability of and funding for genomic testing means that workforce shortages in clinical genetics and genetic counselling need to be addressed as a matter of urgency. This will help ensure that patients are given the information they need and alleviate doctors’ concerns about medico-legal risk.

The potential for genomic medicine is great, but the challenges it presents are also significant. Keeping up to date with rapidly advancing knowledge and ensuring patients have enough information so they are making informed decisions about testing are key concerns of doctors practising in this area.

Now is the time to develop tools, training and support so doctors and their patients can safely and sustainably benefit from the advancing capabilities without increased medico-legal risk.

Rocky Ruperto is a solicitor and Legal and Policy Adviser at Avant.

Dr Sally Parsons is a Medical Advisor and Claims Manager at Avant and Clinical Director and GP in Adelaide. Avant is Australia’s largest medical defence organisation.

Disclaimer: This article is intended to provide commentary and general information. It does not constitute legal or medical advice. You should seek legal or other professional advice before relying on any content, and practise proper clinical decision making with regard to the individual circumstances.

The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.

Subscribe to the free InSight+ weekly newsletter here. It is available to all readers, not just registered medical practitioners.

If you would like to submit an article for consideration, send a Word version to mjainsight-editor@ampco.com.au.

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COVID Outbreak at Meno-Ya-Win in Sioux Lookout – ckdr.net

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Sioux Lookout’s Meno Ya Win Health Centre has declared a Covid-19 Outbreak after two patients were diagnosed with the virus.

Both patients have been in-patients for a long period of time, which indicates they contracted COVID-19 while at the hospital.

Effective immediately, visitation will be limited at SLMHC to two (2) designated visitors per patient.

Contact tracing is also underway at SLMHC. Anyone who is identified as a risk has been contacted.

“We have processes in place to provide the safest possible environment for our patients, staff and physicians. Our priority is to see this outbreak contained quickly,” says Douglas Semple, SLMHC President and CEO.

In addition to continuing daily screening and adherence to personal protective equipment standards, such as masks and eye protection,

SLMHC’s housekeeping department is following policies relating to increased cleaning and proper handling of an outbreak.

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