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Local hospitals could face strain as early viral infections swamp pediatrics

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An early surge in viral infections could indicate tough months ahead for already-struggling local hospitals, the Canadian Paediatric Society said Thursday, as some children’s hospitals are running over capacity and reporting high wait times.

Dr. Sam Wong, the association’s director of medical affairs, said pediatric units across Canada are seeing increased admissions and heavier workloads as hospitals report an earlier than usual season of common respiratory illnesses, combined with influenza and COVID-19.

In communities without dedicated pediatric centres, Wong said local hospitals that are already strained by long waits and staff shortages could see more children coming through their emergency departments.

“So, I’m quite concerned that as we move further into the viral season that things are going to get worse,” he said.

“If you don’t have a pediatric emergency and you’re running a general emergency in a smaller centre, those increased numbers of kids coming through will stress the system.”

The Yellowknife-based pediatrician said some doctors believe the increase in admissions could be linked to a large number of kids, previously shielded by COVID-related public health restrictions, now being exposed to some viral infections for the first time.

CHEO, the Ottawa pediatric hospital, said Wednesday it had to cancel some surgeries as it reports a higher number of patients with respiratory syncytial virus, on top of flu and COVID admissions. The hospital said its intensive care and inpatient units were at 129 per cent and 134 per cent capacity, respectively, on Tuesday.

Montreal’s two dedicated children’s hospitals were alsorunning well over capacity on Thursday afternoon, with Quebec leading the country in reported test positivity rates for respiratory syncytial virus, a common respiratory illness.

It’s concerning to see a surge of those infections hitting hospitals in October, Wong said, when those infections typically “really start up in December.”

“Honestly, I hope I’m wrong, but I have a bad feeling that we will have a rough, rough viral season this year,” he said.

The Quebec government announced this week it was setting up a crisis unit in the Montreal region to deal with overflowing emergency rooms.

At the Montreal Children’s Hospital, where some patients are waiting 16 hours to see a doctor, staff have been redeployed and some surgeries are being cancelled to help alleviate ER pressures, said Dr. Suzanne Vaillancourt.

“Something we have to do, which is hard on everybody, is temporarily reduce the number of children that are going for surgery, because post-op, they take up beds as well, so the trickle-down effect is huge,” said Vaillancourt, associate director of the emergency department.

“It’s really the RSV that seems to be giving us a run for our money now and that’s mostly just because a lot of these children need support, they need breathing support, they need hospitalization to be hydrated or help with oxygen needs.”

Vaillancourt said the hospital is prepared to help general hospitals in other parts of the province treat sick kids. Pediatric emergency physicians are available 24 hours a day to give colleagues advice, she said, and the two children’s hospitals in Montreal are able to take young patients who need more complex care than can be provided.

“It’s a system that’s well used, and hopefully, they really feel that they can get the advice and care that they need and when the child needs an escalation of care, then they come to us,” she said, adding that hospitals outside of Montreal may not have the ability to put a child on a ventilator.

ERs across Canada, and especially in smaller communities, have had to reduce hours and temporarily close, sometimes for days at a time, in recent months as the health-care system contends with labour shortages.

Data released Thursday by Statistics Canada said health-care and social assistance sectors hit a record-breaking 152,000 job vacancies in August.

“I don’t think any of the systems, in particular acute care, have had a moment to even take a breath since the last two years of COVID,” said Nancy Walton, a professor at Toronto Metropolitan University’s nursing school.

—Jordan Omstead and Jacob Serebrin, The Canadian Press

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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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.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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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.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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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.

The Canadian Press. All rights reserved.

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