CANMORE, ALTA. —
The emergence of a new coronavirus variant has fuelled concerns of a fifth wave of COVID-19 in Canada, prompting renewed interest in both vaccine availability and therapeutic treatments for those who fall ill.
Several different types of therapies for COVID-19 have been approved for use in Canada, including a number of treatments that are being experimented with as part of clinical trials across the country.
Here are some of the treatments that are available in Canada.
REMDESIVIR
In July 2020, Health Canada authorized the use of remdesivir, an antiviral medication originally used to help treat Ebola, to treat COVID-19 patients with severe symptoms such as pneumonia, or those who require extra oxygen to breathe.
It was the first drug authorized to treat COVID-19 in Canada.
According to Health Canada, remdesivir is recommended for use in Canadians aged 12 years and older who weigh at least 40 kilograms. The treatment is to be administered through an IV and be used only in health-care facilities where patients can be closely monitored.
“This is a medication that works to inhibit the virus itself; many of the other therapeutics we’ve seen used or attempted for use in the treatment of COVID-related disease have been around the immune system,” infectious disease expert Dr. Lisa Barrett of Dalhousie University in Halifax explained to CTV News Channel at the time.
“However, this one is designed to directly inhibit the virus itself, and has been used or tested for use in other viral infections previously.”
In November 2020, the World Health Organization (WHO) updated its ongoing guidance on COVID-19 medications to advise against the use of remdesivir, citing a lack of evidence to suggest that the drug affects the risk of dying from COVID -19 or needing mechanical ventilation. However, this did not affect Health Canada’s decision to authorize the use of the drug.
Some of the latest research into remdesivir, published in April 2021, suggest that it appears to be as safe and effective for use in children with COVID-19 as in adults, with a low incidence of serious adverse events.
The drug mimics the immune system’s ability to fight off the virus and was developed by AbCellera Biologics Inc. in Vancouver with the support of the federal government.
It is recommended for treating adults and children aged 12 and older who weigh at least 40 kg. It’s used to treat those who are at high risk of progressing to severe COVID-19 complications or hospitalization, but not those with severe respiratory disease.
However, in April 2021, Health Canada issued a warning about the “potential risk of treatment failure” for the Canadian-made drug, saying it may not protect against infection from some variants.
According to Health Canada, bamlanivimab “exhibited reduced activity against SARS-CoV-2 variants” with the E484K and L452R mutations. This includes the B.1.351 variant first identified in South Africa, the P.1 variant first found in Brazil, the B.1.427/B.1.429 variant reported in California, and the B.1.526 variant first identified in New York.
While countries around the world have been using the drug, almost none of Canada’s 26,000 doses have been used. Doctors say this is because a plan on how to administer the drug was never made due to the fact that it must be administered intravenously within the first 10 days of infection.
CASIRIVIMAB AND IMDEVIMAB
In June 2021, Health Canada authorized the use of casirivimab and imdevimab to be administered together as a monoclonal antibody therapy. Similar to bamlanivimab, the drugs are used to treat mild to moderate COVID-19 in adults and children aged 12 and older who are at high risk for hospitalization or COVID-related complications.
The WHO has backed the use of the antibodies in select high-risk patients and they are used widely in the U.S. to treat COVID-19. But the use in Canada has been spotty.
Quebec received a small delivery of the monoclonal antibody cocktail in October.
Doctors in Hamilton, Ont. are also piloting the province’s first monoclonal antibody therapy clinic for outpatients using casirivimab and imdevimab, referencing data that shows the therapy reduced hospitalization by 71 per cent and death by seven per cent in high-risk COVID-positive patients.
SOTROVIMAB
Another monoclonal antibody treatment, sotrovimab, was approved for use in Canada in July 2021. The injectable drug is used to treat mild to moderate COVID-19 in adults and children aged 12 and older who are at high risk for hospitalization or COVID-related complications.
On Wednesday, health officials in Alberta revealed they have been administering sotrovimab to COVID-19 patients aged 65 and older who are unvaccinated.
“The treatment is being rolled out across the province in a phased approach, starting with those with the highest risk of severe outcomes, like hospitalization,” the province’s chief medical officer of health Dr. Deena Hinshaw said during a press conference.
“Let me stress that sotrovimab is not a replacement for COVID-19 vaccines… as vaccines are the most effective method to prevent serious outcomes from the disease.”
This comes amid news that lab tests and a study on hamsters suggest the sotrovimab antibody cocktail works against viruses that were bio-engineered to carry a number of hallmark mutations of the newly discovered Omicron variant.
PENDING TREATMENTS
Molnupiravir
Health Canada says it is still reviewing data regarding an experimental pill from drug maker Merck, which the company says can reduce hospitalizations and deaths by half in patients sick with COVID-19.
Molnupiravir, a twice-daily oral antiviral agent taken within five days after the onset of symptoms, has shown modest benefits and potential safety issues in trials. Most experts backing the treatment stress that it shouldn’t be used by anyone who is pregnant and suggest extra precautions before the drug is prescribed, such as pregnancy tests for women of child-bearing age.
The drug targets an enzyme the coronavirus uses to reproduce itself, inserting errors into its genetic code that slow its ability to spread and take over human cells – leading some independent experts to question whether the drug could potentially cause mutations leading to birth defects or tumours.
The drug has not been tested in those who are vaccinated.
On Nov. 30, the U.S. Food and Drug Administration backed the use of the drug in adults with mild-to-moderate COVID-19 who face greater risk of complications, including older people and those with conditions like obesity and asthma. The U.K. has also authorized its use.
Health Canada has offered no timeline for completion of the review process.
PAXLOVID
Pfizer also recently submitted clinical data to Health Canada regarding an oral medication it is hoping can be used to treat mild to moderate cases of COVID-19 in adults.
Similar to molnupiravir, the pill is designed to block the activity of an enzyme in the COVID-19 virus that is essential to its replication. Part of the pill uses ritonavir, an existing drug that has been used in combination with other antiviral medications before.
The drug maker said that in a randomized, double-blind study of more than 380 patients, there was an 89 per cent reduction in the risk of being hospitalized or dying of COVID-19 in patients that received Pfizer’s pill within three days of displaying COVID-19 symptoms, compared to the study group that received a placebo.
It’s unclear how long it could be before Health Canada passes judgement on whether or not Pfizer’s pill meets their standards or not.
– With files from Alexandra Mae Jones, Brooklyn Neustaeter, The Canadian Press and The Associated Press
VANCOUVER – Contract negotiations resume today in Vancouver in a labour dispute that has paralyzed container cargo shipping at British Columbia’s ports since Monday.
The BC Maritime Employers Association and International Longshore and Warehouse Union Local 514 are scheduled to meet for the next three days in mediated talks to try to break a deadlock in negotiations.
The union, which represents more than 700 longshore supervisors at ports, including Vancouver, Prince Rupert and Nanaimo, has been without a contract since March last year.
The latest talks come after employers locked out workers in response to what it said was “strike activity” by union members.
The start of the lockout was then followed by several days of no engagement between the two parties, prompting federal Labour Minister Steven MacKinnon to speak with leaders on both sides, asking them to restart talks.
MacKinnon had said that the talks were “progressing at an insufficient pace, indicating a concerning absence of urgency from the parties involved” — a sentiment echoed by several business groups across Canada.
In a joint letter, more than 100 organizations, including the Canadian Chamber of Commerce, Business Council of Canada and associations representing industries from automotive and fertilizer to retail and mining, urged the government to do whatever it takes to end the work stoppage.
“While we acknowledge efforts to continue with mediation, parties have not been able to come to a negotiated agreement,” the letter says. “So, the federal government must take decisive action, using every tool at its disposal to resolve this dispute and limit the damage caused by this disruption.
“We simply cannot afford to once again put Canadian businesses at risk, which in turn puts Canadian livelihoods at risk.”
In the meantime, the union says it has filed a complaint to the Canada Industrial Relations Board against the employers, alleging the association threatened to pull existing conditions out of the last contract in direct contact with its members.
“The BCMEA is trying to undermine the union by attempting to turn members against its democratically elected leadership and bargaining committee — despite the fact that the BCMEA knows full well we received a 96 per cent mandate to take job action if needed,” union president Frank Morena said in a statement.
The employers have responded by calling the complaint “another meritless claim,” adding the final offer to the union that includes a 19.2 per cent wage increase over a four-year term remains on the table.
“The final offer has been on the table for over a week and represents a fair and balanced proposal for employees, and if accepted would end this dispute,” the employers’ statement says. “The offer does not require any concessions from the union.”
The union says the offer does not address the key issue of staffing requirement at the terminals as the port introduces more automation to cargo loading and unloading, which could potentially require fewer workers to operate than older systems.
The Port of Vancouver is the largest in Canada and has seen a number of labour disruptions, including two instances involving the rail and grain storage sectors earlier this year.
A 13-day strike by another group of workers at the port last year resulted in the disruption of a significant amount of shipping and trade.
This report by The Canadian Press was first published Nov. 9, 2024.
The Royal Canadian Legion says a new partnership with e-commerce giant Amazon is helping boost its veterans’ fund, and will hopefully expand its donor base in the digital world.
Since the Oct. 25 launch of its Amazon.ca storefront, the legion says it has received nearly 10,000 orders for poppies.
Online shoppers can order lapel poppies on Amazon in exchange for donations or buy items such as “We Remember” lawn signs, Remembrance Day pins and other accessories, with all proceeds going to the legion’s Poppy Trust Fund for Canadian veterans and their families.
Nujma Bond, the legion’s national spokesperson, said the organization sees this move as keeping up with modern purchasing habits.
“As the world around us evolves we have been looking at different ways to distribute poppies and to make it easier for people to access them,” she said in an interview.
“This is definitely a way to reach a wider number of Canadians of all ages. And certainly younger Canadians are much more active on the web, on social media in general, so we’re also engaging in that way.”
Al Plume, a member of a legion branch in Trenton, Ont., said the online store can also help with outreach to veterans who are far from home.
“For veterans that are overseas and are away, (or) can’t get to a store they can order them online, it’s Amazon.” Plume said.
Plume spent 35 years in the military with the Royal Engineers, and retired eight years ago. He said making sure veterans are looked after is his passion.
“I’ve seen the struggles that our veterans have had with Veterans Affairs … and that’s why I got involved, with making sure that the people get to them and help the veterans with their paperwork.”
But the message about the Amazon storefront didn’t appear to reach all of the legion’s locations, with volunteers at Branch 179 on Vancouver’s Commercial Drive saying they hadn’t heard about the online push.
Holly Paddon, the branch’s poppy campaign co-ordinator and bartender, said the Amazon partnership never came up in meetings with other legion volunteers and officials.
“I work at the legion, I work with the Vancouver poppy office and I go to the meetings for the Vancouver poppy campaign — which includes all the legions in Vancouver — and not once has this been mentioned,” she said.
Paddon said the initiative is a great idea, but she would like to have known more about it.
The legion also sells a larger collection of items at poppystore.ca.
This report by The Canadian Press was first published Nov. 9, 2024.
