By late October, B.C. could be gripped by both a second wave of COVID-19 and seasonal influenza – something that could strain the health care system.
Fortunately, B.C. is in a much better position to manage potential surges in hospitalizations than it was in the spring.
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It has more available hospital beds, ventilators, N95 masks, COVID-19 testing capacity, and better contact tracing.
And it may be that this year’s flu season is comparatively mild, thanks to a society that has become accustomed to social distancing, frequent hand-washing, and the wearing of masks. It is also hoped that citizens will take advantage of increased flu vaccine availability.
But the province is still preparing for a worst-case scenario, which would be a major second wave of COVID-19 converging with a bad flu season.
“We’re preparing for the challenges that the influenza season will bring to an already challenging pandemic situation,” said Premier John Horgan at a press conference Wednesday.
B.C. Health Minister Adrian Dix and provincial health officer Bonnie Henry on Wednesday outlined the province’s fall pandemic plan, which is based on four scenarios, from best to worst-case.
The plan includes additional funding for health care — $1.6 billion in total – and thousands more front-line health care workers. It includes:
increased testing for COVID-19 increased contact tracing enhanced influenza immunizations up to 5,000 new hires for cleaners, food servers and aids for hospitals 2,000 additional workers for long term care and assisted living a new Hospital At Home program
The province is earmarking $42 million for the Hospital At Home program, a new program which will offer 24-7 medical care for eligible patients. By treating them in their homes, the risk of them spreading flu or COVID-19 to others in hospital is reduced.
The government is allocating $44 million for the recruitment and training of 7,000 new health care workers, through the new Health Career Access Program.
Hospitalizations due to influenza typically begin to rise in September and peak in December and into January. In the past, hospitalizations for respiratory illnesses have been as high as 126 during the peak of flu season in December and January.
The fear is that, in a worst-case scenario, large numbers of people could become ill with either influenza or COVID-19, or both. A worst-case scenario would be 400 patients in hospital and 219 in intensive care.
“The B.C. health system is well-placed to meet the demand with the backstop of knowing that we can successfully implement more extreme hospital access control measures, if they are required,” Dix said.
In March, to prepare for a worst-case scenario, the province cancelled all elective surgeries, and designated some hospitals for COVID-19 patients. B.C. health officials do not plan to resort to a blanket, system-wide cancellation of surgeries and other hospital services this fall.
Rather, it would be more targeted according to regions experiencing the worst surges. It is expected that the Lower Mainland would experience the worst surge.
Health officials also plan to maintain current visitations for residents of long-term care homes.
Health officials are crossing fingers that the flu season will be comparatively mild, as a result of all the measures that people have become accustomed to: social distancing, limiting social interactions, frequent hand-washing, the wearing of masks and increased immunization.
In terms of equipment, like ventilators and N95 masks, the province is better situated than it was in the spring. For example, the province has stockpiled 6.3 million N95 or equivalent masks.
Flu immunization will not be mandatory. But based on the experiences of Australia and New Zealand, the province expects an increase in voluntary immunization.
“Their immunization rates were very high,” Henry said.
Both countries have had relatively mild flu seasons.
The province has ordered 450,000 additional doses of flu vaccine, bringing the total to 2 million.
“Our fall influenza campaign is going to be on a scale we have not yet seen, to further protect people who are vulnerable in this province,” Henry said. “We encourage everybody who is over the age of six months to be immunized for influenza.”
As for testing for COVID-19, about 5,000 tests per day are now being done, with a capacity to do 8,000 to 10,000 per day. The province will try to double that capacity to 20,000 tests per day by late October.
Since the elderly are most vulnerable, the province will take steps to beef up the immune systems of care home residents and front-line staff.
The province has purchased 45,000 doses of Fluzone High-Dose vaccines, which contains higher levels of antigens. It is typically given to the elderly to increase their immunity even more than regular flu vaccines. An additional 2,000 workers will be hired for long-term care homes.
Asked about sick pay for people who develop flu or COVID-19 symptoms and need to stay home from work, Horgan said a national sick pay program is being launched this fall.
While British Columbians are being asked to once again start limiting their social interactions, it may that some of the extraordinary measures that were put in place in March will not have to be repeated.
For example, Henry said one of the questions she gets asked by children is whether they can still go trick-or-treating at the end of October.
“Yes, absolutely I think we can have Halloween this year,” she said. “It’s just going to look different, just like everything looks different during this pandemic.”
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.
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.
