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BEYOND LOCAL: Here's some of the biggest medical breakthroughs of the last decade – SooToday.com

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The last 10 years have seen an onslaught of new medical discoveries and technologies, with many of them bordering on science fiction.

These discoveries have changed the way people live now and how they will live in the future.

Here are some of the biggest advances in medical science in the last decade — though this is by no means a complete list.

CRISPR gene editing

CRISPR is the name of a technique used to quickly and easily edit DNA — either snipping off genes entirely or replacing them with different ones.

The basic mechanism was discovered decades ago, but the technology has taken off in the last few years after it became more precise and easier to use. Right now, scientists are experimenting with editing the DNA of mosquitos to make them resistant to malaria or to make all offspring male, meaning they’re less likely to pass the disease on to humans.

Scientists have also treated sickle-cell anemia in mice and are testing a cure for an inherited form of blindness, and these are just some of many, many experiments underway.

Yes, we’re editing DNA now. Experts warn this won’t be without consequences. Studies have already shown that some CRISPR-edited cells get damaged and are missing a gene, leading to a potentially higher risk of cancer.

Then there are the ethical issues.

In 2018, a Chinese researcher claimed to have edited the genes of two unborn twin girls with the goal of immunizing them against HIV.

His experiments were not published in journals, nor were full results ever released, raising questions about the experiment. His claim was also roundly denounced by pretty much every medical body as well as the Chinese government.

But can we shut the door on human DNA editing? We’ll find out over the next decade.

PrEP

Medications to treat HIV have been around for a while, and they’re very effective: drugs can actually reduce a person’s “viral load” — the amount of virus circulating in their blood — to undetectable levels. This means that it’s very unlikely, even impossible, for them to pass the virus on to others if the medication is used correctly. It’s also vastly extended the expected lifespan for someone following an HIV diagnosis.

In 2012, the U.S. Food and Drug Administration approved the use of an HIV drug for prophylactic purposes — meaning people could use it to actually keep from catching HIV in the first place. The drug, Truvada, which was approved by Health Canada for HIV prevention in 2016, and subsequent generic versions are now being used by high-risk populations across Canada.

So far, prescriptions for PrEP have lagged behind public health officials’ hopes — which might be due to spotty drug coverage and the high cost of the medication — but it has made a difference. A recent study found that PrEP use was associated with a significant reduction in the number of new infections in an Australian state.

Ebola vaccines and treatments

While we’re talking about infectious diseases, it’s definitely worth noting another big one: Ebola.

Ebola outbreaks are ongoing in a few African countries, mostly the Democratic Republic of Congo and Uganda. In 2014, a huge outbreak across West Africa killed more than 11,000 people.

It’s a nasty disease. It kills more than half of people who catch it, often through internal and external hemorrhagic bleeding.

However, over the last decade, we’ve seen clinical trials for various vaccines and even treatments for the disease, which are showing promising results. One vaccine, Ervebo, has even passed the clinical trial phase and was approved for use in November. It’s now being stockpiled for use in future outbreaks.

Although Ebola generally occurs far away from Canada, there is a Canadian connection: some vaccines and treatments were actually developed by researchers at the National Microbiology Lab in Winnipeg.

Artificial pancreas

The term “artificial pancreas” is a bit of a misnomer, according to Diabetes Canada, but it’s the popular term for a device approved in the U.S. in 2016 and in Canada in 2018 to help treat patients with Type 1 diabetes. It’s more formally called a “closed-loop” system.

People with Type 1 diabetes no longer produce insulin. They used to have to take injections of insulin throughout the day to regulate their blood sugar and cut their risk of developing longer-term health problems like nerve issues that can lead to amputation or retinal problems leading to blindness.

Many patients have since moved on to more modern insulin pumps and testing devices.

This device makes things even easier. It first reads a patient’s insulin level, then decides via algorithm how much insulin to give them, shooting “microdoses” of the drug into their bloodstream automatically. The patient still has to add extra insulin in a few other circumstances, such as before a meal, but studies report these systems often lead to better control of blood sugar levels.

Diabetes advocates are looking forward to the development of a fully automatic system or a true “artificial pancreas” that requires no intervention from the patient, and also for better insurance coverage of these advanced devices.

3D-printed prosthetics

One of the coolest new technologies is 3D printing, in which an object is created bit by bit from a computer pattern. And it didn’t take long for medical researchers to see the potential.

Doctors have created a handful of 3D-printed organs and body parts, but over the last decade, 3D-printed prosthetics have really taken off.

Need a new hand? Just visit a website and you can download a blueprint for free, along with detailed instructions on how to size and build it. Seriously. There has been an open-source community for years, run largely by volunteers. The organization e-NABLE estimates that thousands of people around the world are now using these prosthetics.

They’re not perfect: the devices can break, and e-NABLE recommends that people work closely with a health-care provider as they use their new prosthetic. But they’re much cheaper than traditional models and can be made much faster, putting prosthetics in reach for more people around the world.

Experts imagine that the medical applications for 3D printing will continue to expand, with complex organs like a replacement heart possibly coming down the road.

– Global News

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What you need to know about COVID-19 in Ottawa on Tuesday, Jan. 26 – CBC.ca

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Recent developments:

What’s the latest?

If you’ve made the trip to downtown Ottawa recently, you’ve likely noticed the desolate streets and empty storefronts.

CBC asked an architect, an urban planner and geographers what would bring people back to the city’s core after the pandemic.

Officials from that city are giving an update on their vaccine plan starting at 9 a.m. ET. The prime minister and Quebec’s premier are also expected to speak later in the day.

Officials are debating whether additional public health measures are needed to rein in a more contagious coronavirus variant that is now spreading in Ontario, including Ottawa and Kingston.

How many cases are there?

As of Monday, 12,977 Ottawa residents have tested positive for COVID-19. There are 869 known active cases, 11,689 resolved cases and 419 deaths from COVID-19. 

Public health officials have reported more than 24,100 COVID-19 cases across eastern Ontario and western Quebec, including more than 20,900 resolved cases.

One hundred and fourteen people have died of COVID-19 elsewhere in eastern Ontario and 150 people have died in western Quebec. 

CBC Ottawa is profiling those who’ve died of COVID-19. If you’d like to share your loved one’s story, please get in touch.

What can I do?

Ontario says people must only leave home when it’s essential to avoid more COVID-19 cases, hospitalizations and deaths. Some places, like Kingston, Ont., have started taking on patients from other regions struggling with hospital capacity.

People who leave home for non-essential reasons can now be fined, though police won’t stop people just for being outside.

Travel within Ontario is not recommended. Residents who leave the province should isolate for 14 days upon returning.

Private indoor gatherings are not allowed, while outdoor gatherings are capped at five. It’s strongly recommended people stick to their own households and socializing is not considered essential.

People who live alone are still allowed to interact with one other household.

Only a few people stroll the area connecting the Rideau Centre mall to the ByWard Maket area in downtown Ottawa on Jan. 14, during Ontario’s stay-at-home order. (Francis Ferland/CBC)

Students in areas covered by four of eastern Ontario’s six health units can return to the classroom, but not in Ottawa or the area covered by the Eastern Ontario Health Unit (EOHU).

Most outdoor recreation venues remain open, although Ottawa has closed one of the most popular sledding hills. The Rideau Canal Skateway is expected to open this week under pandemic rules.

In-person shopping is limited to essential businesses. Others can offer pickup and delivery.

The lockdown rules are in place until at least Feb. 11. Health officials say there are signs they have slowed COVID-19’s spread and there’s been talk about what it will take to lift them.

WATCH | Where the lopsided economic impact of COVID-19 goes from here:

More than a million Canadians are still under- or unemployed as a result of COVID-19, but the crisis also allowed others, who were easily able to work from home, save more money. 2:34

In western Quebec, residents are also being asked to stay home unless it’s essential and not see anyone they don’t live with to ease the “very critical” load on hospitals and avoid more delayed surgeries.

An exception for people living alone allows them to exclusively visit one other home.

Quebec’s 8 p.m. to 5 a.m. curfew is now in effect, with fines of up to $6,000 for breaking the rules.

The province has shut down non-essential businesses, but has brought students back to classrooms. Like in Ontario, travel from one region of Quebec to another is discouraged.

Those rules are in place until Feb. 8.

Ottawa Morning6:34Try the Winter Play Challenge

Robin Andrew’s photography business is not keeping her very busy, during the pandemic. So she decided to create a 30-day Winter Play Challenge to bring some fun to herself – and other people feeling the stay-at-home winter blahs these days. 6:34

Distancing and isolating

The novel coronavirus primarily spreads through droplets when an infected person speaks, coughs, sneezes, or breathes onto someone or something. These droplets can hang in the air.

People can be contagious without symptoms.

This means it’s important to take precautions like staying home while symptomatic, keeping hands and frequently touched surfaces clean and maintaining distance from anyone you don’t live with — even with a mask on.

Ottawa Morning5:32New Ottawa delivery app slashes hidden fees for businesses

Ben Lacroix launched a delivery app called “Getit Local.” The app charges businesses less than bigger food delivery services like Uber Eats and Skip the dishes 5:32

Masks, preferably with three layers, are mandatory in indoor public settings in Ontario and Quebec.

OPH says residents should also wear masks outside their homes whenever possible.

A person walks their dog in Major’s Hill Park on Jan. 25, during the COVID-19 pandemic. (Andrew Lee/CBC)

Anyone with COVID-19 symptoms should self-isolate, as should those who’ve been ordered to do so by their public health unit. The length varies in Ontario and Quebec.

Health Canada recommends older adults and people with underlying medical conditions and/or weakened immune systems stay home as much as possible and get friends and family to help with errands.

Anyone returning to Canada must go straight home and stay there for 14 days. Air travellers have to show recent proof of a negative COVID-19 test.

WATCH | Federal government considering more rules around international travel:

The federal government keeps hinting at stricter travel restrictions to curb the spread of new coronavirus variants inside Canada. 1:58

Symptoms and vaccines

COVID-19 can range from a cold-like illness to a severe lung infection, with common symptoms including fever, a cough, vomiting and loss of taste or smell. Children can develop a rash.

If you have severe symptoms, call 911.

Mental health can also be affected by the pandemic, and resources are available to help.

WATCH | Are there pandemic habits worth keeping?

Canadians have all adapted to change to some degree since the pandemic started one year ago. Four Canadians reflect on whether some of those changes will be worth keeping after it’s over. 7:11

COVID-19 vaccines have started being given to health-care workers and long-term care residents in most of the region. Renfrew County expects its first doses in early February.

Local health units have said they’ve given more than 33,600 doses, including about 23,900 in Ottawa and more than 8,400 in western Quebec. 

The fact Pfizer is temporarily slowing its vaccine production to expand its factory, however, means some jurisdictions can’t guarantee people will get the necessary second dose three weeks after the first. It may take four to six weeks.

Ontario is giving its available doses to care home residents and delaying them for health-care workers.

Its campaign is still expected to expand to priority groups such as older adults and essential workers in March or April, with vaccines widely available in August.

Ottawa believes it can have nearly 700,000 residents vaccinated by then.

Quebec is also giving a single dose to as many people as possible, starting with people in care homes and health-care workers, then remote communities, then older adults and essential workers and finally the general public.

Before Pfizer’s announcement, the province said people would get their second dose within 90 days.

It has had to delay vaccinating people in private seniors’ homes.

Where to get tested

In eastern Ontario:

Anyone seeking a test should book an appointment.

Ontario recommends only getting tested if you have symptoms, if you’ve been told to by your health unit or the province, or if you fit certain other criteria.

The KFL&A health unit says people that have left southeastern Ontario or been in contact with someone who has should get a test as they track one of the new COVID-19 variants.

People without symptoms but part of the province’s targeted testing strategy can make an appointment at select pharmacies. Travellers who need a test have very few local options to pay for one.

Ottawa has 10 permanent test sites, with mobile sites wherever demand is particularly high.

A person inside Rideau station on OC Transpo’s Confederation Line Jan. 25, 2021. (Andrew Lee/CBC)

The Eastern Ontario Health Unit has sites in Alexandria, Casselman, Cornwall, Hawkesbury, Rockland and Winchester.

People can arrange a test in Picton over the phone or Bancroft, Belleville and Trenton, where online booking is preferred.

The Leeds, Grenville and Lanark health unit has permanent sites in Almonte, Brockville, Kemptville and Smiths Falls and a mobile clinic.

Kingston’s main test site is at the Beechgrove Complex, another is in Napanee.

Renfrew County test clinic locations are posted weekly. Residents can also call their family doctor or 1-844-727-6404 with health questions.

In western Quebec:

Tests are strongly recommended for people with symptoms and their contacts.

Outaouais residents can make an appointment in Gatineau at 135 blvd. Saint-Raymond or 617 ave. Buckingham. They can check the wait time for the Saint-Raymond site.

There are recurring clinics by appointment in communities such as Maniwaki, Fort-Coulonge and Petite-Nation.

Call 1-877-644-4545 with questions, including if walk-in testing is available nearby.

First Nations, Inuit and Métis:

Akwesasne has had more than 140 residents test positive on the Canadian side of the border and six deaths. More than 280 people have tested positive across the community.

Its curfew from 11 p.m. to 5 a.m. is back and it has a COVID-19 test site by appointment only.

Anyone returning to the community on the Canadian side of the international border who’s been farther than 160 kilometres away — or visited Montreal — for non-essential reasons is asked to self-isolate for 14 days.

Kitigan Zibi logged its first case in mid-December and has had a total of 20. The Mohawks of the Bay of Quinte had their only confirmed case in November.

People in Pikwakanagan can book a COVID-19 test by calling 613-625-2259. Anyone in Tyendinaga who’s interested in a test can call 613-967-3603.

Inuit in Ottawa can call the Akausivik Inuit Family Health Team at 613-740-0999 for service, including testing, in Inuktitut or English on weekdays.

For more information

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Canadian provinces push back vaccination plans as Pfizer deliveries grind to a halt – Toronto Sun

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Article content continued

Some provinces have used up nearly all their vaccine supply and have been forced to push back their vaccination schedules.

Saskatchewan announced Sunday that it had exhausted all the doses it received. However, even after technically running out, the province still managed to vaccinate another 304 people as it continued to draw extra doses from the vials it received. It had administered 102 per cent of its allotted doses by Monday, and it expected the remaining excess doses to be gone this week.

Quebec has used up more than 90 per cent of its supply. It confirmed that the delivery delay would force it to postpone its vaccination rollout in private seniors’ residences, which had been scheduled to start Monday.

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“Let’s be realistic: our vaccination momentum will be reduced as of this week,” Marjaurie Cote-Boileau, press secretary to Health Minister Christian Dube, said in a text message.

“Given the important reduction of Pfizer doses we’ll receive in the next two weeks, we have had to review our vaccination calendar.”

Quebec finished giving first doses to long-term care residents last week and has vaccinated some 9,000 seniors in private homes by using leftover doses. The province gave less than 2,000 shots Sunday, compared to an average of more than 9,600 a day over the previous week.

In British Columbia, the provincial health officer said the government is extending the interval between the two doses of the COVID-19 vaccine. Dr. Bonnie Henry said further delays in the production and delivery of the Pfizer-BioNTech vaccine over the next two weeks caused the time period between the shots to be extended from 35 days to 42.

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Can Employers Require COVID-19 Vaccinations? – Coronavirus (COVID-19) – Canada – Mondaq News Alerts

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COVID-19 may have brought Canadians together in many ways, but a
number of issues surrounding the pandemic have proven to be
divisive on some level. Masking policies, stay at home orders, the
forced shut down of many businesses, government compensation
schemes or the lack thereof, testing rates, and delays have brought
on many a heated debate. The rollout of vaccines – who gets
them first, how they are administered, and the shortage of this
highly in-demand product – is the issue dominating press
conferences and front pages at this point. As we see COVID vaccines
deployed across the Province of Ontario, the emerging debate is
whether or not employers can mandate that employees be vaccinated.
An important question, so far without a clear answer.

Like so many legal issues raised with COVID, there is no clear
precedent.  Helpful, though not determinative, is the caselaw
dealing with “Mask or Vaccinate” influenza policies in
the health care setting.  Employers implemented policies
mandating that workers either get the flu vaccine or wear a mask
throughout their shift. Unions challenged these policies and a
number of arbitral decisions addressed whether such policies were
in violation of the collective agreement. Unfortunately, these
decisions are divided.

Some arbitrators (see  Health Employers Assn. of
British Columbia
v. the Health Sciences
Assn
1 and North Bay General Hospital v
ONA2) found the employer’s policy
compliant, citing provisions of the collective agreement that
specifically addressed vaccinations during an outbreak, directions
from the Ministry of Health to employers to implement an influenza
protocol, expert evidence supporting vaccination rates amongst
health care workers and transmission of influenza to the patients,
and the existence of the alternative of masking. In other decisions
(see Sault Area Hospital and Ontario Nurses’
Association
3, St Peter’s Health System v
CUPE, Local 778
4 and  St. Michael’s
Hospital
v Ontario Nurses’
Association
5), arbitrators found the policy in
violation of the collective agreement citing a lack of
“consensus” on vaccinating and masking and the prevention
and control of influenza, a lack of mandating of the policy by a
Medical Officer of Health or regulatory body, and that the
scientific evidence available was insufficient to support a
requirement for employees to wear masks for up to six months every
year. In the St. Michael’s Hospital case, the
Arbitrator stated that the evidence supporting a masking mandate
was “insufficient, inadequate, and completely
unpersuasive”.

I can clearly see some distinguishing aspects between the
influenza ‘Mask or Vaccinate’ policies and the situation
currently facing employers and workers in health care settings.
COVID is much more infectious and deadly, vaccines are much more
effective (95%6 vs. 20-60%7), and there has
already been considerable research on the transmission of the virus
and the efficacy of the vaccine.

Only one arbitral decision has been released to date dealing
with mandatory COVID testing in a retirement home. Christian
Labour Association of Canada
v Caressant Care Nursing
& Retirement Homes
8 dealt with an
employer’s policy that staff be tested every 2 weeks for COVID.
An employee refused to be tested and was placed on unpaid leave. In
this case, the Arbitrator upheld the policy, finding that the
testing requirement, even though it was intrusive to the
individual, was reasonable in light of all of the
circumstances.

Ontario does have a precedent for mandatory vaccination. The
public school system requires students to submit evidence of their
updated vaccines9, although there are limited exemptions
for medical reasons and religious beliefs. Medical reasons require
a “Statement of Medical Exemption” form to be submitted,
signed by a doctor or nurse practitioner, and submitted to the
local public health unit. The reason for the exemption must be
indicated, such as a medical condition that prevents the child from
receiving the vaccine. The religious belief exemption requires an
education session to be completed at the local public health unit
covering basic information about vaccine safety, immunization and
community health, and immunization law in Ontario. A ‘Statement
of Conscience or Religious Belief’ form must be completed,
signed by a commissioner for taking affidavits in Ontario, and
submitted to the local public health unit. These exemptions act to
accommodate legitimate human rights that arise with such a
mandatory vaccination program for grounds of disability and creed
under Ontario’s Human Rights Code.

So, will Ontario employers be able to mandate COVID
vaccinations? That answer seems clear – no employer can
physically force an employee to be vaccinated. However, where
employers implement mandatory vaccination programs, and employees
refuse to comply, what can be done? Can employees be put on unpaid
leave? Be disciplined? Or terminated? Will employers be expected to
try to find alternative work? Will they allow employees to work
from home?

It will take time, but we will eventually see policy grievances
in a unionized setting and challenges for terminations for a cause
in both unionized and non-unionized settings where employees are
terminated for refusing to vaccinate. While the jury is still out,
I expect decision-makers will try to provide as much of a balancing
act as possible between individual’s human rights, privacy, and
bodily integrity vs. the health and safety needs of the public,
co-workers, and clients/patients/customers.

I expect that mandatory vaccination programs and terminations
will be upheld in workplaces providing direct care, particularly of
a vulnerable population in a congregate living situation, subject
to human rights exemptions. The public school exemption program is
a solid example of the type of protocol that I can see being
followed.

Less clear in my mind is whether close physical workspaces like
those in the manufacturing and construction settings will be
subject to enforceable mandatory vaccination programs and
terminations for cause. Unionized settings will likely face
even greater resistance.

Lastly, much more ‘sterile’ work settings, like offices,
where options exist for many employees to work remotely, offer up
much more room for debate on an employer’s ability to terminate
for cause. While I expect employers may be able to place employees
off on an unpaid leave where an employee refuses to vaccinate in a
working environment where COVID can be transmitted, I am doubtful
cause will be established on terminations. In non-unionized
workplaces, employers may be looking at terminations without cause
if they are not prepared to employ someone who refuses to be
vaccinated, subject to human rights.

Like so many legal issues raised with COVID, we will need to
wait and see if the government enacts any mandatory vaccine
legislation (which it has said it is not intending to do) and the
release of arbitral and court decisions before employers have any
certainty about their right to demand that employees submit to
COVID-19 vaccinations.

Stay tuned!

Footnotes

1 (2013) 237 L.A.C. (4th) 1, [2013] B.C.C.A.A.A. No.
138

2 2008 CarswellOnt 9040 (Ont Arb)

3 2015 CanLII 55643 (ON LA)

4 2002 CarswellOnt 4709 (Ont Arb)

5 2018 CanLII 82519 (Ont LA)

6 Pfizer-BioNTech COVID-19 vaccine: What you should
know
and Moderna COVID-19 vaccine: What you should
know

7 Center for Disease Control, CDC Seasonal Flu
Vaccine Effectiveness Studies
, (accessed December 14,
2020).

8 2020 CanLII 100531 (ON LA) (Randall).

9 Immunization of School Pupils Act

The content of this article is intended to provide a general
guide to the subject matter. Specialist advice should be sought
about your specific circumstances.

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