A group of more than 430 Alberta physicians and three major health-care unions will send a letter to Premier Jason Kenney Thursday endorsing the idea of a “circuit-breaker” lockdown as cases of COVID-19 continue to surge in the province.
“There is no more time. We have to act now,” said Dr. Tehseen Ladha, who co-authored the letter. “We need something strong and mandatory in order to bend the curve.”
Though restrictions were not final as of Wednesday, officials said the measures were expected to be in line with the premier’s messaging over the past few weeks, involving modest and targeted measures — moves that officials emphasized do not constitute a lockdown.
Thursday’s letter also comes on the heels of a separate letter signed by more than 70 physicians earlier this week, which warned that the province’s acute-care system could be overburdened if strict restrictions weren’t implemented.
Doctors warn of health system crisis
In the letter, the signatories say they feel it is their duty to warn of the “impending health system crisis” resulting from the spread of COVID-19 in Alberta.
“We have reached a juncture where only strong and decisive mandatory measures can prevent our hospitals from becoming overwhelmed,” the letter reads.
Alberta Premier Jason Kenney is being urged in the letter to implement a ‘circuit-breaker’ lockdown, on the heels of a similar call made by dozens of doctors earlier this week. (Jason Franson/The Canadian Press)
Those measures, which the letter says should be time-limited, include:
Directives to work from home for those who are able.
The limiting of contacts to those within the household or a support bubble.
Restrictions on group recreation and sports activities.
The suspension of group indoor activities, including indoor dining, bars, casinos, religious services and theatres.
Schools should be kept open for in-person learning, the letter says, “due to their vital importance.”
The letter goes on to cite Alberta’s rise in cases, high levels of test positivity and intensive care unit (ICU) admissions.
“Even if transmissions drop today, hospitalizations, ICU admissions and deaths will continue to rise for weeks as current infections progress,” the letter reads.
Circuit-breaker lockdown
In the view of the doctors, a circuit-breaker lockdown would consist of strict, time-limited measures that would help prevent a complete lockdown should the health system become overwhelmed.
“The time for incremental measures has passed, and voluntary measures, requested October 9, have not blunted the rise in cases,” the letter reads. “Our testing system is strained, and contact tracing [capabilities] have collapsed.
“We see no other way to break chains of transmission and decrease cases, than to implement a ‘circuit breaker’ of short, strict measures.”
As COVID-19 cases continue to surge across Canada, provinces are implementing the short, sharp “circuit-breaker” lockdowns to fight the spread of the virus and prevent health-care systems from being overwhelmed. 1:58
“We’re not going to be sending out police to monitor this,” Kenney said. “As much as what we’ve done, this is appealing to people to exercise personal and collective responsibility, so that we can avoid having to use more stringent measures.”
On Wednesday, officials told CBC News that new measures set to be announced on Thursday by Dr. Deena Hinshaw, the province’s chief medical officer of health, could include capacity limits on worship services and fitness classes.
Businesses could also see reduced capacity or operating hours, but one official said no business closures are expected to be announced.
The letter released Thursday indicates it recognizes that suggested restrictions under a circuit-breaker lockdown would also present their own harms, and urges the government to provide support to impacted businesses.
“The evolving evidence suggests that strong, time-limited measures will not only minimize the second wave but could prevent the need for the complete lockdowns that become inevitable when the health system becomes overwhelmed,” the letter reads.
“A failure to control COVID-19 spread means we cannot expect our economy to recover quickly or strongly.”
Dr. Jim Kellner, an infectious disease specialist in Alberta, is concerned about rising COVID-19 case numbers and their impact on hospitals two to three weeks from now. 0:29
3 health-care unions endorse letter
Ladha said the letter had also been endorsed by the United Nurses of Alberta, the Health Sciences Association of Alberta and the Alberta Union of Provincial Employees, which together represent more than 100,000 health-care workers.
“We think it’s imperative that action is taken now,” said Heather Smith, president of the United Nurses of Alberta. “We think it would be a responsible thing, for the premier to show leadership.”
Ladha said part of the purpose of the letter is to get the word out to the public.
“The majority of people that actually work in the health-care system that are seeing these numbers, that are seeing the strain that we’re under in the hospitals, know that this is an impending crisis,” she said.
Heather Smith, president of the United Nurses of Alberta, says she thinks that it is ‘imperative’ that action be taken now as COVID-19 cases continue to surge in Alberta. (CBC)
At Monday’s press conference, Hinshaw said the idea of a circuit-breaker lockdown was an interesting one, adding the province would continue to consider all its options.
“We need to look at all options on the table … including what we’re doing now, which is giving Albertans every opportunity to walk along with us, to come alongside and be a part of the solution before we impose restrictions,” she said.
Alberta reported 672 new cases of COVID-19 on Wednesday, and seven more deaths to COVID-19 — the third day in a row the province reported seven new deaths in one day.
Read the full text of the letter below: November 12, 2020
The Honourable Jason Kenney MLA
Premier, Province of Alberta
Office of the Premier
307 Legislature Building
10800 – 97 Avenue
Edmonton, Alberta T5K 2B6
C.C. Honourable Tyler Shandro MLA, Minister for Health; Dr. Deena Hinshaw, Chief Medical Officer of Health
Dear Premier Kenney,
As health-care workers we feel it is our duty to warn of the impending health system crisis resulting from the uncontrolled spread of COVID-19 in Alberta. We have reached a juncture where only strong and decisive mandatory measures can prevent our hospitals from becoming overwhelmed.
We therefore urge the Government of Alberta to institute a set of time limited public health restrictions that would consist of:
Directives to work from home for anyone who is able.
Limiting contacts to those within the household or support bubble.
Restrictions on group recreation/sports activities.
Suspension of group indoor activities (including indoor dining, bars, casinos, religious services, and theatres).
Due to their vital importance, we should aim to keep schools open for in-person learning options.
We are seeing an exponential rise in cases, high levels of test positivity, and already have almost double the number of hospitalizations seen in the first wave. Intensive care unit admissions and deaths have also increased markedly in the past week. Even if transmissions drop today, hospitalizations, ICU admissions, and deaths will continue to rise for weeks as current infections progress.
There are outbreaks in at least nine acute care hospitals, endangering vulnerable patients and resulting in bed and staffing shortages. As staff become ill or must quarantine, we do not have appropriately qualified individuals to fill their roles. Outbreaks in care facilities are also worsening bed shortages in hospitals as patients cannot return to their care facility where there is an outbreak.
The Edmonton zone has already deferred 30 per cent of non-urgent surgeries to account for the burdens on the health system. More delays of foundational health services (surgeries, cancer screenings, and diagnostics) will be imminent and will be severely consequential if we do not act now.
We have witnessed how quickly hospitals in Winnipeg, the United States, Belgium, and Austria have become overwhelmed. The time for incremental measures has passed, and voluntary measures, requested October 9, have not blunted the rise in cases. Our testing system is strained, and contact tracing capacities have collapsed. We see no other way to break chains of transmission and decrease cases, than to implement a “circuit breaker” of short, strict measures. Similar restrictions have been recently implemented in Winnipeg, Toronto, the United Kingdom, and Germany.
We recognize that these restrictions have their own harms, and we would urge the government to provide supports for businesses impacted by these restrictions. The evolving evidence suggests that strong, time-limited measures will not only minimize the second wave but could prevent the need for the complete lockdowns that become inevitable when the health system becomes overwhelmed. A failure to control COVID-19 spread means we cannot expect our economy to recover quickly or strongly.
We are proud of Alberta’s health system and the quality of care we provide, but we believe that it is in grave jeopardy unless urgent action is taken. Please help us continue to care for the people of Alberta safely.
Manisha Khurana, MD, CCFP, FCFP (Family Medicine Care of the Elderly) Jayan Nagendran MD, PhD, FRCSC (Surgical Director of Lung Transplantation and Director of Research, Division of Cardiac Surgery)
Jaime C. Yu, MD, MEd, FRCPC (Physical Medicine and Rehabilitation) Jose Fernandez de Lara Nieto, MD, CCFP, FRCSC (Obstetrics and Gynecology) Lesia R. Boychuk, MD, FRCPC (Infectious Diseases)
Jeffery M Patterson, MD, FRCPC (Oncology)
Samina Ali MD, FRCPc (Pediatric Emergency Medicine)
Jen Riess, MD, CCFP (Family Physician)
Adam Burgess, MD, CFPC (Family Medicine)
Ian M. MacDonald, MD, CM, FRCSC, FCCMG, FCAHS (Ophthalmology) Lovneet Hayer MD, FRCPC (Psychiatry)
Stephen Kwan, MD FRCS(C) (Othropaedic Surgeon)
Pablo Amigo, MD, MCFPC. (Palliative Medicine)
Shelina Jamal MD FRCPC (Pediatric Critical Care Physician) Alexandra McFarlane, MD, FRCPC (Infectious Diseases)
Ernst Schuster, MD, CCFP, FCFP, CCPE (Family Medicine)
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.
