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Climate Changed: Canada’s health system isn’t ready for new reality, say doctors

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Montreal family doctor Claudel Pétrin-Desrosiers sees climate change as an all-encompassing “risk amplifier.”

She says it raises the potential for hazard across the board, from threatening the most basic health determinants, such as air quality and access to food and water, to exacerbating seasonal allergies and tick-borne Lyme disease.

Pétrin-Desrosiers, president of the Quebec chapter of the Canadian Association of Physicians for the Environment, is among a group of doctors who say Canada’s health-care system isn’t prepared for the worsening effects of climate change.



A man jumps on a skimboard while riding on tidal pools at Spanish Banks as smoke from wildfires hangs over the downtown core, in Vancouver, B.C., Thursday, Oct. 6, 2022. A group of doctors says Canada’s health-care system is not prepared for the worsening effects of climate change and failing to adapt would mean more lives lost. THE CANADIAN PRESS/Darryl Dyck

Finola Hackett, a locum physician working in rural communities throughout southern Alberta, said ignoring the “climate crisis when it comes to health, long-term, it’s going to be very costly, not just in terms of dollars, but in lives.”

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Both say acting now has the potential to save lives.

“That’s motivating enough for us to do the work,” said Pétrin-Desrosiers.

Hackett and Pétrin-Desrosiers are the lead co-authors of a policy brief on Canada released last week alongside a global report produced by the Lancet Countdown on health and climate change, which is published by the Lancet medical journal.

The Lancet report underscores the health risks of global heating, pointing to the heat dome that settled over British Columbia in summer 2021 as an example.

The heat dome, which caused more than 600 deaths in B.C., would have been “virtually impossible” without the influence of climate change, the peer-reviewed report says.

The Canadian policy brief says the health-care system has the potential to increase resilience to such extreme heat and other climate-related health risks, but it’s far from ready, especially given the COVID-19 pandemic.

It says heat waves may increase the number of emergency room visits by 10 to 15 per cent, further straining health-care capacity and reducing quality of care.

In Alberta, Hackett said she sees patients with asthma and chronic obstructive pulmonary disease, or COPD, during periods of air pollution from wildfire smoke.

Both Hackett and Pétrin-Desrosiers said they’re also concerned about the effects of climate change on mental health, having seen evidence of increasing instances of post-traumatic stress disorder following extreme weather events, such as flooding.

That’s worrying, Pétrin-Desrosiers said, because access to mental health care in the public system is already lacking, with long waiting lists across the country.

Health Canada’s own assessment of climate change and health published earlier this year says global heating is “already affecting the health of Canadians, and, without taking concerted action, will continue to result in injury, illness and death.”

Greater warming will bring greater risks, but many impacts could be avoided “if Canada rapidly and substantially scales up efforts now to adapt,” the report says.

The linkages between climate change and health are also the focus of the annual report from Canada’s chief public health officer, Theresa Tam, released last week.

The report says “urgent public health action is required to prepare for, protect against, and respond to current and future health impacts of climate change.”

Both the Health Canada and public health officer’s reports emphasize the importance of involving people who are most affected by climate change in adaptation planning, noting vulnerability is often linked with additional social inequities, such as low income, inadequate housing and food insecurity.

Such reports, along with some actions at the provincial level, show there is increasing recognition of the health risks posed by climate change, Hackett says.

“But in terms of, actually, do we have measures in place in our clinics, in our hospitals, in our health organizations, we’re just in the early stages,” she says.

The Canadian policy brief notes the governments of B.C., Ontario and Quebec have taken steps to assess links between climate change and health, but Hackett said such initiatives are “fragmented” without some kind of national co-ordination.

Similarly, Pétrin-Desrosiers said Health Canada committed on paper to improving resiliency in the health-care system, but that hasn’t yet translated into action at the pace needed to address the growing risks.

The doctors’ policy brief recommends that provincial and territorial health authorities undertake climate-resilience analyses to identify priority actions, and calls on Ottawa to create a national secretariat “to co-ordinate the transformation of Canada’s health system” into one that’s resilient to the effects of climate change.

Itsuggests adaptation measures could include climate risk training for health workers and creating health-care contingency plans for extreme weather events.

The federal government is set to finalize a national climate change adaptation strategy by the end of this year, with health and well-being as one of five key areas.

This report by The Canadian Press was first published Oct. 30, 2021.

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Measles case reported locally turns out to be negative: health unit

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NEWS RELEASE
SIMCOE MUSKOKA DISTRICT HEALTH UNIT
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On March 26, the Simcoe Muskoka District Health Unit (SMDHU) was notified by Public Health Ontario’s (PHO) laboratory that due to laboratory error, the case of measles that had been lab-confirmed positive on March 12, based on symptoms and a positive urine measles laboratory result by PHO’s laboratory, is in fact negative for the measles virus.

“With this new information of the negative lab result, we believe that that individual was not infected with measles and that there has not been any public exposure to measles resulting from this individual’s illness,” said Dr. Charles Gardner, medical officer of health. “We recognize that notifying the public of what we believed to be a positive measles case in our area created worry, anxiety and disruption for some, and we regret this.

“We do know that, despite best efforts, on rare occasions laboratory errors can occur. We are working closely with the PHO’s laboratory to do all that we can to ensure that such an incident does not occur again.”

Measles is a highly contagious viral infection that spreads very easily through airborne transmission. The measles virus can live in the air or on surfaces for up to two hours.

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Symptoms of measles begin seven to 21 days after exposure and include fever, runny nose, cough, drowsiness, and red eyes. Small white spots appear on the inside of the mouth and throat but are not always present. Three to seven days after symptoms begin, a red, blotchy rash appears on the face and then progresses down the body.

The risk of transmission to those vaccinated with two doses is low, and when it does occur tends to show a reduction in the severity of these symptoms.

“Although we are relieved for the individual involved, and for all Simcoe-Muskoka residents, that this case has now been confirmed as negative, we know that measles is still active in Ontario at this time and the potential remains for new cases to arise, especially given the increase in Ontarians travelling to areas in the world that have higher numbers of measles cases,” said Dr. Gardner. “This is why we continue to advise individuals to keep up to date with their routine immunizations, including measles, mumps and rubella (MMR) vaccination.”

The risk of measles is low for people who have been fully immunized with two doses of measles vaccine or those born before 1970; however, many children have been delayed in receiving their routine childhood immunizations and people who have not had two doses of measles vaccine are at higher risk of contracting the disease.

People who do get sick usually recover without treatment, but measles can be more severe for infants, pregnant women, and those with compromised immune systems. Possible complications include middle-ear infections, pneumonia, diarrhea, or encephalitis (swelling of the brain) and occasionally death in the very young. Even individuals who are up to date with the measles vaccine should watch for symptoms of measles for 21 days after exposure.

For more information about measles, please visit smdhu.org or call Health Connection at 705-721-7520 or 1-877-721-7520, Monday to Friday between 8:30 a.m. and 4:30 p.m. to speak with a public health professional.

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Kate Middleton Not Alone. Cancer On Rise For People Under 50, Say Experts

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Kate Middleton revealed on Friday that her cancer was discovered after she received abdominal surgery

London:

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When Catherine, Princess of Wales, revealed she was being treated for cancer last week, part of the shock was that an otherwise healthy 42-year-old has a disease that mostly plagues older people.

However, researchers have been increasingly sounding the alarm that more and more people under 50 are getting cancer — and no one knows why.

Across the world, the rate of under-50s diagnosed with 29 common cancers surged by nearly 80 percent between 1990 and 2019, a large study in BMJ Oncology found last year.

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The researchers predicted the number of new cancer cases among younger adults will rise another 30 percent by the end of this decade, with wealthy countries particularly affected.

The increase in cases — and soaring global population — means that the number of deaths among under 50s from cancer has risen by nearly 28 percent over the last 30 years.

This occurred even as the odds of people of all ages surviving cancer have roughly doubled over the last half century.

Shivan Sivakumar, a cancer researcher at the UK’s University of Birmingham, called it an “epidemic” of young adult cancer.

Since Kate Middleton revealed on Friday that her cancer was discovered after she received abdominal surgery earlier this year, Sivakumar and other doctors have spoken out about the uptick in younger cancer patients they have been seeing at their clinics.

While breast cancer remains the most common for people under 50, the researchers expressed particular concern about the rise of gastrointestinal cancers — such as of the colon, pancreas, liver and oesophagus — in younger adults.

Colon cancer is now the leading cause of cancer deaths in men under 50 in the United States, according to the American Cancer Society. For women, it is number two — behind only breast cancer.

One high profile case of colorectal cancer was “Black Panther” actor Chadwick Boseman, who died at the age of 43 in 2020.

Why is this happening?

“We just don’t have the evidence yet” to say exactly what is causing this rise, Sivakumar told AFP, adding it was likely a combination of factors.

Helen Coleman, a cancer epidemiology professor at Queen’s University Belfast who has studied early onset cancer in Northern Ireland, told AFP there were two potential explanations.

One is that people in their 40s were exposed to factors known to cause cancer — such tobacco smoke, alcohol or being obese — at an earlier age than previous generations.

She pointed out that the “obesity epidemic” did not start until the 1980s.

Sivakumar felt that at least part of the puzzle could be explained by obesity.

However, there is “another wave” of under-50 patients who are neither obese nor genetically predisposed still getting cancer, he emphasised, adding that this could not be put down to “statistical chance”.

The other theory, Coleman said, is that “something different” has been going on with her generation.

Fingers have been pointed out a range of possible culprits — including chemicals, new drugs and microplastics — but none have been proven.

Some have suggested that so-called ultra-processed foods could be to blame. “But there’s very little data to back any of that up,” Coleman said.

Another theory is that the food we eat could be changing our gut microbiome.

While there is nothing conclusive yet, Coleman said her own research suggested that cancer causes changes to the microbiome, not the other way around.

Anti-vaxx conspiracy theorists have even tried to blame Covid-19 vaccines.

This is easily disproven, because the rise in young adult cancer has taken place over decades, but the vaccines have only been around for a few years.

What can be done?

To address the rise in younger colorectal cancer, in 2021 the US lowered the recommended age for screening to 45. Other countries have yet to follow suit.

But the researchers hoped that Catherine’s experience would remind people at home that they should consult their doctor if they sense anything is wrong.

“People know their bodies really well,” Sivakumar said.

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“If you really feel that something isn’t right, don’t delay — just get yourself checked out.”

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Almost 3,000 students suspended in Waterloo Region over immunization issues

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Close to 3,000 children attending elementary school across Waterloo Region were suspended from school on Wednesday morning for not having up-to-date immunization records.

The region says Waterloo Public Health suspended 2,969 students under the Immunization of School Pupils Act (ISPA).

For several months, the region has been campaigning for people to get their children’s vaccinations up to date, including sending letters home to parents on a couple of occasions, warning that students’ records needed to be up to date or they would be suspended.

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It announced in January that 32,000 students did not have up-to-date records: 22,000 elementary students and 10,000 high school students.


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“We have made remarkable progress from the original 27,567 immunization notices we sent to parents in November and December 2023,” Dr. Hsiu-Li Wang, medical officer of health, stated.

“Since that time, we have resolved more than 24,500 outdated vaccination records, providing students with valuable protection against these serious and preventable diseases.”

The high school students still have a few weeks to get their records up to date or else face suspension.

The ISPA requires students to have proof-of-vaccination records for diphtheria, polio, tetanus, pertussis, measles, mumps, rubella, varicella (chickenpox) and meningitis, which must be on file with public health.

Public health says caregivers whose children are suspended will need to book an appointment at regionofwaterloo.ca/vaccines for clinics, which will be held in Cambridge and Waterloo on weekdays.

“Given the high number of suspensions, it may take several days before you can be seen at an appointment and return your child to school,” a release from the region warns.

“Record submission and questions must be done in person to ensure immediate resolution.”

The last time suspensions over immunizations were issued was in 2019, when 1,032 students were suspended.

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