Bolstered by early successes, drugstores are accelerating their push into traditional health care amid the COVID-19 pandemic.
Loblaw Companies Ltd., which began offering COVID-19 testing for patients at a handful of its Alberta pharmacy locations in June, plans to expand the program to all 234 of its pharmacies in the province by Sept. 1.
The company says it has reached out to all 10 provinces to discuss in-store testing outside Alberta, with Ontario Premier Doug Ford this week acknowledging the possibility.
The swab tests are only for those with no symptoms or any known contact with coronavirus patients and may be useful for teachers returning to school or Canadians who take care of an older family member, said Theresa Firestone, head of health and wellness at Shoppers Drug Mart. Loblaw-owned pharmacy locations include Shoppers stores as well as Independent Foods and No Frills.
“It’s very convenient. We’re in every community. The other plus is they don’t have to line up with people who may have symptoms. We’ve shared that with Ontario and with other provinces, so at this point we’re looking forward to what they may decide,” Firestone said.
London Drugs also conducts COVID-19 tests in Alberta. It began offering the service at six locations during the past two weeks and plans to roll it out at nine more by October. Like Shoppers, it bills Alberta Health Services for testing costs.
The service builds on other responses to the pandemic such as online pharmacist consultations and a pilot program where patients consult virtually with doctors in a private room in the store.
London Drugs, whose 82 stores are located across all four Western provinces, is among the pharmacy retailers beefing up their role in a health-care system grappling with an aging population.
“With the extended hours of operation, you can basically go in when our stores are open and be able to find a pharmacist to ask a question. So what we’re able to do at that point is basically help triage the system,” said Chris Chiew, head of pharmacy at the Richmond, B.C.-based retailer.
London Drugs has also hired diabetes educators to test blood sugar and cholesterol levels and assist patients with weight management and diet.
Shoppers has stepped even further into the realm of physicians, opening one of three planned medical clinics with doctors who cater to a roster of patients and walk-in services.
“There are a number of Canadians who don’t have access to a family physician. And we thought there was an opportunity for us to really play a role here in terms of access,” Firestone said.
Drugstores can also handle the bureaucratic side of health care, freeing up doctors to spend more time with patients, she said.
“Looking for PPE (personal protective equipment), sorting out their waiting rooms so that people are socially distanced, managing virtual care…we’re able to take that burden on for them,” Firestone said.
Community access and convenience are a critical advantage drugstores can cultivate as thinning profit margins prompt them to look beyond over-the-counter sales for income.
“Drugstores have faced tighter margins for generic drugs in recent years and have been looking for alternative sources of revenue,” said University of Calgary economics professor Aidan Hollis.
Some provinces now allow pharmacists to vaccinate patients — flu shots, for example — and write prescriptions for certain medication, such as birth control, as well as extend prescription refills for chronic medications.
“In addition, pharmacies find it attractive to draw patients in for health care even if they don’t earn profits on supplying health care: once the patients are there they may purchase other goods,” Hollis said.
Drugstore chains under the umbrella of McKesson Canada, including Rexall, Guardian and I.D.A., have also started to offer the tests and have conducted more than 6,000 to date.
Metro Inc. declined to comment on any attempts to provide COVID-19 testing. The bulk of the company’s Jean Coutu drugstores are located in Quebec, which unlike some provinces does not allow pharmacists to conduct testing via nose and mouth swabs.
B.C., Saskatchewan and Manitoba have not expressed particular interest in asymptomatic testing in pharmacies, according to London Drugs, which has reached out to all three provinces.
“They have the capacity right now to be able to do the number of tests that they want to do,” Chiew said.
Ontario conducted 24,353 tests last week and can process up to 33,000 weekly through its provincial lab network, the health ministry said.
“We are looking at ways of enhancing access to testing. Having pharmacies function as testing centres is currently under consideration,” spokeswoman Miriam Mohamadi said in an email.
“How to integrate pharmacies into the COVID-19 diagnostic network, specifically how they would function and for whom they would be appropriate, is being explored.”
Christopher Reynolds, The Canadian Press
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Nearly 20 per cent of COVID-19 infections among health-care workers by late July – Powell River Peak
VANCOUVER — Health care workers in Canada made up about 20 per cent of COVID-19 infections as of late July, a figure that was higher than the global average.
In a report released earlier this month, the Canadian Institute for Health Information said 19.4 per cent of those who tested positive for the virus as of July 23 were health-care workers. Twelve health care workers, nine from Ontario and three from Quebec, died from COVID-19, it said.
The World Health Organization said in July that health-care workers made up 10 per cent of global COVID-19 infections.
A national federation of nurses’ unions blames the infection rate on a slow response to the pandemic, a shortage of labour and a lack of personal protective equipment.
Mahi Etminan, a registered oncology nurse who was working at a hospital in Vancouver in mid-March, says she doesn’t know how she was infected by COVID-19.
“It could have been anywhere in the hospital,” she said.
“In March, we weren’t required to really wear any masks or anything.”
Etminan said she has tested negative for the virus twice but still feels the after-effects of her illness. She tires easily, has lost her sense of taste — even salt — and is losing chunks of her hair.
She agrees with the Canadian Federation of Nurses Unions that proper precautions weren’t put in place to deal with COVID-19.
“I think we were behind in putting a proper protocol in place,” Etminan said.
Linda Silas, president of the 200,000-member nurses’ federation, said Canadian hospitals approached COVID-19 based on the findings of a 2003 Ontario government commission into SARS.
“I thought we were ready,” Silas said in an interview.
“And then mid-March, early March, we realized how unready we were. And that’s one of the reasons that we have one of the highest levels of health-care workers getting infected.”
She said with the routes of transmission for the virus being uncertain — and later research showing it was possible the virus could be airborne — it was critical that health care workers get full protection.
The Ontario government convened the commission to investigate the origin, spread and response to SARS. One of the key recommendations of the report was improving the safety of health-care workers.
Ontario Health Ministry spokesman David Jensen said lessons learned from SARS have been implemented, including giving more powers to the chief medical officer of health to issue directives to workers and organizations.
The province recommends health-care workers use appropriate precautions when conducting clinical assessments, testing and caring for patients who are suspected or confirmed to have COVID-19, he said.
The approach to the novel coronavirus was taken on a precautionary basis because little information was available about its transmission and clinical severity, Jensen said in an email response to questions.
“The majority of cases are linked to person-to-person transmission through close direct contact with someone who has COVID-19. There is no evidence that COVID-19 is transmitted through the airborne route.”
The World Health Organization acknowledged in July the possibility that COVID-19 might be spread in the air under certain conditions.
It said those most at risk from airborne spread are doctors and nurses who perform specialized procedures, such as inserting a breathing tube or putting patients on a ventilator.
Michael Brauer, a professor at the University of British Columbia’s school of population and public health, said COVID-19 doesn’t fit the traditional airborne model where viruses remain infectious over long distances and time periods.
“There’s been a little bit of an evolution in our understanding of the transmission,” he said, adding there was evidence as early as March that showed the virus can be transmitted via air.
While early on more attention was paid to surface transmission, it now seems as though the airborne route is more prominent, he said.
Health Canada spokeswoman Tammy Jarbeau said long-term care facilities and retirement homes were among the hardest hit during the peak of COVID-19 in the spring, likely affecting health-care workers.
The federal government is working with the Canadian Institute for Health Information to better understand the virus, including expanding case data for health-care workers.
The Quebec government said the high rate of community contamination in the province coupled with a labour shortage at the beginning of the pandemic affected health-care workers who were working in several long-term care homes to maintain essential services.
“In recent months, Quebec has gone through an unprecedented health crisis,” said Robert Maranda, a spokesman for the ministry of health and social services.
The plan to deal with COVID-19 was based mainly on the experience gleaned from the 2009 swine flu pandemic, he said.
“However, H1N1 influenza is not the same virus that we are currently fighting against,” Maranda said.
“A person with COVID-19 can transmit the virus without having any symptoms, which is not the case with the flu.”
But as more is known about the new coronavirus, he said the province’s response has changed, including no longer allowing health-care workers to work in different places.
Silas said the nurses’ federation has started an investigation led by a former senior adviser to the SARS commission into why Canada didn’t better protect health-care workers from COVID-19. The report is expected later this year.
The Public Health Agency has done a poor job of gathering data about health-care workers infected with COVID-19, she said, adding that the federation has relied on data collected by Statistics Canada.
“There’s this lack of information flowing,” Silas said.
Natalie Mohamed, a spokeswoman for the Public Health Agency, said 25 per cent of all reported cases were among people who describe themselves as working in health care and it has been collecting data from the provinces and territories since March.
Those who identify themselves as health-care workers include physicians, nurses, dentists, physiotherapists, residential home workers, cleaners, janitorial staff and volunteers.
Some health-care workers may also be getting infected outside work, Mohamed said, although exposure data is incomplete.
The associate executive director of the Canadian Medical Protective Association, which provides advice and assistance in medical-legal matters to doctors, said it began fielding concerns from members about a lack of protective equipment when the virus started spreading.
Dr. Todd Watkins said the questions have shifted to how things will be handled in the future.
“Will there be a second wave and how am I going to respond to that? Is my clinic prepared for that? Will there be appropriate protective gear?”
Christine Nielsen, chief executive officer of the Canadian Society for Medical Laboratory Science, said the flow of information is affected by the fact the provinces and territories deliver health care and they could collect data differently.
“There’s room for improvement with how public health has responded,” she said. “Just the scale of the pandemic has really caught everyone off guard.”
This report by The Canadian Press was first published on Sept. 19, 2020.
B.C. to publish a list of school COVID-19 exposures, outbreaks – Prince George Citizen
The B.C. government intends to publish online all COVID-19 school exposure and outbreak events.
The move follows the first of five health authorities to provide its own online list of exposures or outbreaks, a ministry spokesperson confirmed.
Fraser Health announced Wednesday a web page that will list all such events by school district.
The website does not provide any details of a so-called exposure and it’s not yet clear if more details will be provided for an outbreak and whether such details will be updated as cases are confirmed.
An exposure is when someone who attended the school tested positive for COVID-19 and does not mean the disease was transmitted. Only an outbreak notice is an indication public health authorities have determined transmission in a school setting.
Parents do not need to take action if there is an exposure event, unless contacted by a health official (contact tracer) or school official, states Fraser Health.
“We have a responsibility to be transparent, clear, and current in our communication to parents, teachers, and students about COVID-19 exposures in schools in our region, and the launch of our COVID-19 school exposures webpage provides us with an opportunity to do just that,” said Dr. Victoria Lee, Fraser Health president and CEO, via a media statement. “This new page is a tool for us to help keep the lines of communication open and give schools and families the resources they need to feel safe and reassured.”
Fraser Health oversees 11 school districts between Burnaby and Hope, including Delta and Surrey.
The list shows six exposure events, to date. One at Delta secondary school and five others in Surrey.
More details appear to be provided specifically to parents via the school districts, who are in cross communications with the health authority.
In a letter to parents Wednesday, Delta district superintendent Doug Sheppard noted a key point for families to remember is that Fraser Health will connect directly with any individuals who may have been exposed with further instructions via phone call or letter. If someone is contacted by Fraser Health, they’re asked to follow the health authority’s advice carefully.
Sheppard said the protocol in such circumstances includes:
- Fraser Health Authority will initiate contact tracing
- FHA will determine how the individual was infected and who they were in close contact with
- The heath authority will determine if close contacts will be asked to self-isolate for 14 days
- Only public health can determine who is a close contact.
With files from Delta-Optimist
City offering more municipal facilities as COVID-19 testing sites, Mayor Watson says – Ottawa Citizen
Article content continued
Watson said he’s been told by health officials that between 50 per cent and 90 per cent of people in the lines have no symptoms.
“That is putting a strain on the system,” Watson said, and he told Ford that the messaging needs to change so that people without symptoms aren’t going to testing sites.
A few hours later, however, Ford continued to encourage people who don’t have symptoms to get tested if they want to.
“We have the asymptomatic folks that may be anxious, or they want to get tested, and God bless them, get tested, but we’re going to be prepared and we’re ramping up,” Ford said during a press conference.
Much of the anger generated by the long testing lines and overrun assessment sites is rooted in confusion about how this could possibly happen when officials knew when students would be returning to classes.
Watson said Ottawa Public Health has stepped up to help, but the primary responsibility for testing is with the hospital network. The Ottawa Hospital, Queensway Carleton Hospital, Montfort Hospital and CHEO all have roles in the local testing program.
“I think they are now realizing that a lot of the testing capacity should have been dealt with a month ago with the anticipation of school,” Watson said. “To their credit now, and I’ve talked to all four hospital presidents, they understand the urgency and frustration and they have to get this problem fixed.”
The city continues to be in a state of emergency because of the pandemic, but Watson said he hasn’t asked Ford to request military assistance to help with logistical support in testing. There’s no sense bringing in military help if there are no additional sites yet to set up testing facilities, Watson said.
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