When the COVID-19 pandemic hit Canada mid-March, health experts feared Vancouver’s impoverished Downtown Eastside would be decimated — the coronavirus expected to tear through its vulnerable population.
That didn’t happen, and now a B.C. medical sleuth is trying to find out why only a handful of residents have tested positive for the virus in one of Canada’s poorest neighbourhoods.
It’s a medical mystery given there are an estimated 15,000 people crammed into 30 square blocks around Vancouver’s infamous Main and Hastings intersection.
Many residents have mental health issues, are infected with HIV or hepatitis C, and have compromised immune systems.
The answer to the apparent low infection count could benefit all Canadians in the fight against the spread of the coronavirus, says Dr. Brian Conway, medical director of the Vancouver Infectious Diseases Centre.
“The thrill of the chase is exciting,” says Conway. “The more we learn, the more we will be able to help.”
Dr. Brian Conway has previously conducted HIV and hepatitis C screening on Vancouver’s Downtown Eastside, and now he’s turning his attention to COVID-19. (Martin Diotte/CBC)
‘Pop-up clinics’ test for antibodies
Conway has launched a series of free community “pop-up clinics” to test blood for telltale coronavirus antibodies among Downtown Eastside (DTES) residents.
Antibodies are formed when a person’s body attempts to fight off infection.
They are an indication that the individual was, at some point, infected with the virus, even if there were no symptoms of illness or only mild symptoms.
Conway says if antibodies are found in a large percentage of volunteer test subjects, that would mean the virus has been more common in the Downtown Eastside than previously thought.
Symptoms of COVID-19, the illness caused by the virus, could have been masked by underlying health and addiction issues.
There are approximately 15,000 residents crammed into 30 square blocks in Vancouver’s poorest neighbourhood, but only a handful of confirmed COVID-19 cases. (Ben Nelms/CBC)
“It is possible that certain cases were missed since opioid withdrawal might look a little bit like an acute [coronavirus] infection,” Conway said. “So we want to just make sure that we understand exactly what happened in that community since the middle of March.”
‘Is there something here … protecting them?’
If antibodies aren’t found, Conway says, that could mean the coronavirus has skipped over an easy target, perhaps due to the community’s social isolation from the rest of the Vancouver area.
There’s another intriguing possibility: that Downtown Eastside residents have some form of resistance to the potentially deadly virus.
“Is there something here that is protecting them against becoming infected?” Conway said. “This is a thing that we need to learn.”
Conway says the clinics have been approved by Health Canada, and are staffed and funded by his non-profit centre, independent from local health authorities.The centre’s stated mission is to provide expert diagnosis and treatment of chronic infectious diseases in Vancouver. Conway says that now includes COVID-19.
He hopes to test approximately 20 DTES residents at each pop-up, to be held once a week throughout the summer. Conway says the blood samples taken at the clinics will be analyzed for coronavirus antibodies in the weeks ahead, likely by the B.C. Centre for Disease Control (BCCDC).
The presence or absence of antibodies against coronavirus could help researchers understand infection rates as compared to illness rates. But, Health Canada cautions, it’s not yet clear how long antibodies stay in the body, and it’s not yet know whether people with antibodies are immune to re-infection or if they are still infectious to others.
Social advocates on Vancouver’s Downtown Eastside say they, too, have been baffled by the lack of reported COVID-19 cases.
“It may be that the people who live in the Downtown Eastside tend not to travel outside of the country,” says Janice Abbott, CEO of Atira, which operates social housing in the neighbourhood. “Many of them spend all of their time [here], so maybe there’s a protective factor in geography — I don’t know.”
A 60-room Downtown Eastside hotel converted into a COVID-19 recovery centre in April had just three patients, and closed in June. (B.C. Housing/Twitter)
In April, Atira joined forces with the B.C. government and Vancouver Coastal Health to convert a local hotel into a 60- room recovery facility for local residents who become sick with COVID-19.
It was quietly closed in June — after housing just three patients.
‘I don’t think it should have taken this long’
Downtown Eastsiders who spoke with CBC News welcome the antibody testing.
They, too, want answers.
Randy Hyman describes himself as a former resident and frequent visitor to the neighbourhood.
Randy Hyman, 40, welcomes news that coronavirus antibody testing will be done in his old neighbourhood. (Martin Diotte/CBC)
“It’s great that it’s finally arrived that the testing will be done,” said Hyman, 40. “Despite the fact that some people may not feel they have a voice and cannot advocate for their own health … I’m sure they would appreciate the opportunity to be tested.”
Selling plastic jewellery from her central spot on East Hastings Street, Edith Delmo wonders why the apparent absence of COVID-19 on the Downtown Eastside wasn’t investigated sooner.
“I don’t think it should have taken this long,” said Delmo, 60.
Edith Delmo, 60, wants to know why it took so long to start testing for coronavirus antibodies in DTES. (Eric Rankin/CBC)
Through his pop-up clinics — building on similar testing he’s done for HIV and hepatitis C on the Downtown Eastside since the 1980’s — Conway hopes to find out why COVID-19 seems to have passed over this community, and how that information could help fight the pandemic in the rest of the country.
“I think we need to understand exactly how much the virus has penetrated in the [DTES] population,” says Conway.
“That’s going to help us plan better on how to deal with this going forward … [and] that’s going to be very useful to the general public.”
CBC Vancouver’s Impact Team investigates and reports on stories that impact people in their local community and strives to hold individuals, institutions and organizations to account. If you have a story for us, email impact@cbc.ca.
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.
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.
