The COVID-19 pandemic is on the retreat locally, but the “shadow pandemic” of opioid-related deaths requires continued attention, according to discussions undertaken by the Board of Health (BOH) for Kingston, Frontenac, Lennox & Addington (KFL&A) on Wednesday, Feb. 23, 2022.
Members of the Board of Health met in person on Wednesday, Feb.23, 2022, with viewers tuning in from home. Screen-captured image.
To begin the meeting, Dr. Angela Ma, Public Health Preventative Medicine Resident, provided the BOH with a COVID-19 update detailing the latest modifications to provincial requirements in Ontario. These upcoming changes, scheduled to come into effect on Tuesday, Mar. 1, 2022, include further lifting of capacity limits for business and venues, as well as no longer requiring individuals to provide proof of vaccination when attending events or patronizing businesses.
The majority of COVID-19 cases locally and provincially continue to be infections of the Omicron variant of the virus, though the Delta variant is still being seen among those who are hospitalized, Dr. Ma explained. Wastewater data shows that the percent positivity in KFL&A has stabilized, she detailed, and “our hospitalizations are low… [both] are consistent with what we’re seeing in terms of trends across the province, as well,” she said, noting that percent positivity is the proportion of positive results among those who have been tested.
Dr. Ma acknowledged that testing for COVID-19 has significantly changed in 2022, with only higher-risk populations being tested through professionally-administered PCR tests. “But overall,” she noted, “since our last update [in January], we’re seeing this downward trend and present positive progress.”
Also, KFL&A is seeing a downward trend in total hospitalizations, she said. “And in fact, our hospitalization numbers are at the lowest seen since [the end of the] Delta [outbreak]. So overall, again, this is reinforcing less severe burden [on our hospitals].”
A slide from Dr. Ma’s presentation shows that between January 6 and February 4, 2022, vaccinations and boosters dramatically decreased the likelihood of severe disease, hospitalization, ICU admission, and death in those who contracted the COVID-19 virus. Screen-captured image.
Dr. Ma added that there are encouraging trends to note regarding local long-term care residents. “We saw positive news with residents who were infected with COVID-19 mostly having asymptomatic or mild disease, and many of them were at least double vaccinated. And in fact, most of the cases we saw in long-term care were staff, and we saw good infection prevention and control, in that those cases were not being transmitted to residents.”
This data, she explained, reinforces the overwhelming effectiveness of being fully vaccinated. “Those with one or no doses are certainly over-represented in the hospitalized population, and that trend is more and more apparent as we get older and age. And then we can see… that two doses protect against hospitalization. And even more so, three doses [protect against] ICU admissions, as well as in the deaths.”
When asked if these positive trends are indicating a potential end to mask-wearing requirements, Dr. Piotr Oglaza, Medical Officer of Health for KFL&A Public Healtrh, responded, “There’s a light at the end of the tunnel; eventually every pandemic in history [came to an end] and so will this one. And this particular pandemic will end with the virus retreating, and it will have that seasonality pattern [like other endemic respiratory viruses].”
“There may be subsequent waves,” Dr. Oglaza continued, “but as we move forward, these waves will be less intense and create less impact on acute care, [and] less severe impact on hospitalization rates, because most of the population will have already been exposed to it or are protected by vaccine, which will reduce suffering and illness. So, that’s something that we anticipate will eventually happen with COVID-19.”
Further to that, Dr. Hugh Guan, Associate Medical Officer of Health, explained that, in the future, it will be likely that individuals will be able to receive a yearly COVID-19 booster along with the currently available flu shot. “Hopefully, it can be combined into one shot,” he noted. “That will make it easy for everyone.”
Integrated Care Hub
The discussion moved on to the topic of the Integrated Care Hub (ICH) on Montreal Street, which is facing an end to their municipal funding at the end of March 2022. The ICH provides 24/7 low-barrier and wrap-around services to vulnerable citizens with immediate needs such as safety, food, and rest, and provides support for longer-term needs such as addiction and mental health services. It was proposed that the BOH members pen a letter to the Ontario Minister of Health, Christine Elliot, recommending that the Provincial Ministry of Health should take over funding the ICH (the following day, local residents staged a rally at the downtown Ministry of Health office in Kingston regarding the lack of funding for the ICH).
Kingston’s Integrated Care Hub on Montreal Street. Image from Google Maps.
Before agreeing to the motion, City Councillor and BOH member, Jeff McLaren, asked if there was supporting data indicating the ICH was creating a significant benefit to the community.
Dr. Oglaza explained the importance of the ICH to Mr. McLaren and the other BOH members, noting that an important pillar of the ICH mandate is harm reduction, and one of the ways the ICH fulfills this mandate is through providing a safe, supervised injection site.
“A statistic that’s really important to put into this perspective is that the Integrated Care Hub has responded to more than 600 overdoses on-site since it opened, and these overdoses, it’s fair to assume, if they were not happening in a controlled environment [like the ICH], would have resulted in opioid-related deaths,” Dr. Oglaza stated.
He continued by putting this statistic starkly in perspective. “In KFL&A, there were 42 opioid-related deaths in 2020 alone [outside the ICH’s purview]. Let’s compare that to the 31 COVID-19 deaths since March 2020 – over two years. So in one year, we had more opioid overdoses than [two years of] COVID-19 deaths combined.”
VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.
Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.
In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.
The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.
Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”
Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”
This report by The Canadian Press was first published Sept. 16, 2024
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.
