OTTAWA — As Canada takes part in a rapid global test of multiple drugs that might be promising for treating COVID-19, the country’s top public health official is warning not to prejudge outcomes and cautioning against the dangers of using unproven therapies.
One of the best-known of these is hydroxychloroquine, also known more simply as chloroquine, a long-standing staple treatment for malaria.
U.S. President Donald Trump caused a stir last week when he touted chloroquine as a possible treatment for victims of the novel coronavirus. Trump even decreed it has been approved by the Food and Drug Administration.
That turned out not to be true, but it did spark interest in the drug around the world.
Former Alberta Wildrose party leader Danielle Smith pronounced a few days later on social media that a French study had found “hydroxychloroquine cures 100 per cent of coronavirus patients within six days of treatment.”
Those doctors did find that the drug reduced detection of the virus in the upper respiratory tracts of patients treated with it compared to another group. But according to the Centers for Disease Control in the U.S., the study was small, not randomized, and did not look at the eventual outcomes of the patients, including deaths.
The authors acknowledged that some of the people treated with chloroquine were dropped from the study because they stopped taking it, because their conditions had deteriorated.
Smith has since apologized for the tweet, and any undue anxiety and frustration it may have caused.
In the wake of these promising claims about the drug, Canadian drug company JAMP Pharma Group announced plans Monday to donate one million doses to Canadian hospitals as a treatment for COVID-19.
That move sparked a stern warning from the country’s chief public health officer, Dr. Theresa Tam.
“People have to be really, really careful about this. Don’t do it,” Tam said in a briefing Monday.
The CDC said there is no available data from randomized clinical trials to inform the use of hydroxychloroquine against the novel coronavirus.
Using untested medication might not only be ineffective against COVID-19, it could also be dangerous, as all drugs come with side effects, Tam said.
“We need the evidence before you can provide medication to people,” Tam said.
“It is absolutely essential that you do science based treatment.”
Earl Brown, an emeritus professor of virology with the University Ottawa, said the drug works by lowering the acidity inside cells, making it more difficult for the virus to get in.
In a lab setting it works against several strains of virus, he said, but it hasn’t been proven for use in patients with COVID-19.
He said it should be used with caution under the best circumstances.
“The daily dose is around a gram, and a dangerous dose is around two grams,” he said, adding that you don’t typically want the optimal dose and the dangerous dose to be so close.
“It suggests a bit more risk,” he said, which can include death.
Other side effects include blurred vision, nausea, vomiting, abdominal cramps, headache, and diarrhea. Long-term use can cause vision loss. Other drugs have generally taken over from chloroquine as go-to malaria treatments.
Health officials in Nigeria, where chloroquine is more fairly widely available, have reported overdoses in the last few days.
Still, chloroquine is one of a “vast suite” of drugs identified by the World Health Organization that merits further testing, Tam said.
Canada is part of a massive global study started by the WHO to look into the use of chloroquine and other pre-existing drugs that could be repurposed as potential treatments for COVID-19.
The other treatments being evaluated are:
—Remdesivir, a drug that attacks some viruses’ ability to replicate
—Ritonavir/lopinavir, a drug pair developed to fight HIV
—Ritonavir/lopinavir combined with interferon-beta, which affects the body’s inflammation response
Tam said she’s impressed with the large-scale randomized clinical trials. She said it’s simple to sign patients up, and the results can be analyzed in real time.
This report by The Canadian Press was first published March 23, 2020.
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
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.
