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Canada’s health care system overwhelmed with steep rise in respiratory viruses

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A person draws out Moderna vaccine during a drive through COVID-19 vaccine clinic at St. Lawrence College in Kingston, Ont., on Jan. 2, 2022.Lars Hagberg/The Canadian Press

A steep rise in respiratory viruses across the country, combined with low vaccine uptake and busy holiday get-togethers, are raising alarm among medical leaders and experts who say the spread of preventable illness is going to add more strain to an already overwhelmed health care system.

“There’s just a myriad of viruses that are under way right now,” said Kathleen Ross, president of the Canadian Medical Association. “There’s no question at all that our emergency departments and our hospitals are full to the gunwales.”

Influenza, respiratory syncytial virus (RSV) and SARS-CoV-2, which causes COVID-19, are all on the upswing across Canada. Theresa Tam, Canada’s Chief Public Health Officer, said the spread of seasonal viruses is “already posing significant challenges to hospitals.”

This week, the World Health Organization declared the rapidly spreading JN.1 subvariant as a “variant of interest” separate from its BA.2.86 parent lineage.

The JN.1 variant appears to be more easily transmissible than other circulating Omicron strains, given how fast it is growing. According to data from the Public Health Agency of Canada, JN.1 accounted for 0.2 per cent of all COVID-19 cases detected in the country as of mid-October. Forecasted estimates suggest that by Dec. 10, JN.1 would account for nearly 30 per cent of cases.

While there is no evidence that JN.1 causes more severe illness in those infected, the rapid spread will add pressure to hospitals, said Anne Gatignol, professor in the departments of medicine and of microbiology and immunology at McGill University.

“When more people are infected, the consequence is more people will go to the hospitals, even if the proportion of infected vs. hospitalized remains the same,” she wrote in an e-mail.

The good news is that there are now three updated COVID-19 vaccines in Canada that offer good protection against JN.1 and other circulating strains, Dr. Gatignol said.

According to PHAC, only 14.6 per cent of Canadians have received an updated COVID-19 vaccine this fall.

Hospitals are already dealing with overcrowding and long emergency waits, which experts say will likely worsen unless more people start to take protective measures to prevent the spread of illness, including mask wearing in public places, staying home when sick and getting vaccinated.

Spread of the flu has also been increasing across the country in recent weeks. According to the latest data released by PHAC, which go up to Dec. 9, rates of the flu are within expected levels for this time of year.

Alberta has been hit hard by the flu, with many sick individuals, particularly older adults and children, requiring hospital admission. According to the province’s flu dashboard, there have been 134 children under age five admitted to hospital as a result of the flu so far this year, and 541 admissions in people 60 and older. The province has recorded 34 flu-related deaths.

“We’re inundated with influenza,” said Mohit Bhutani, a respirologist based in Edmonton and president of the Canadian Thoracic Society.

Dr. Bhutani said he’s had a “steady stream” of patients admitted as a result of the flu, adding that most of them had not been vaccinated.

Only 22 per cent of the province’s population has been vaccinated against the flu this year, according to statistics provided on a provincial website. Comparable data for other jurisdictions are not readily available.

RSV, a common virus that can cause serious illness in children under two and in older adults, is also circulating, but within expected levels for this time of year, according to PHAC. There is a new treatment available for seniors to help prevent severe illness, but it costs several hundred dollars and is not covered in most areas.

Experts say they are hopeful that by late 2024, there will be wider availability and easier access to the vaccine to prevent serious illness in both seniors and young children.

 

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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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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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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.

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