Medications show that it's time to pivot in our approach to COVID-19 - San Francisco Examiner | Canada News Media
Connect with us

Health

Medications show that it's time to pivot in our approach to COVID-19 – San Francisco Examiner

Published

 on


By Jeffrey D. Klausner
Special to CalMatters

Americans love a medicalized approach to treating disease. So, we must accept the fact that many Americans would rather take a pill than exercise or follow a diet to prevent disease.

Similarly, there has been tremendous push back against non-pharmaceutical interventions like masking, physical distancing or avoiding indoor gatherings to prevent the spread of COVID-19. However, we can update our response to the pandemic and follow the typical American path toward treating disease with medication.

With every newly reported case of infection among those with risk factors for severe disease – age greater than 65 years, obesity, chronic lung or kidney disease – public health workers could facilitate timely treatment with medical interventions such as monoclonal antibodies and fluvoxamine, which has shown to have a “potential therapeutic role.”

Fluvoxamine is safe, inexpensive and widely available by prescription. A recent study showed that among COVID-19 patients who took at least 80% of their medication, mortality was reduced by 90%. New formulations of monoclonal antibodies allow for rapid infusion or injection under the skin by a nurse or pharmacist. Combination monoclonal antibody use lowered the risk of hospitalization or death by 70%.

To make those treatments quickly available, public health authorities could create standing protocols and county or statewide medical orders bypassing the need for a costly or difficult to obtain medical visit that would delay the initiation of therapy. Pharmacy chains could also offer direct medical treatment based on certain criteria.

Additionally, large commercial clinical testing laboratories that detect new cases could join the response. Laboratories could prioritize cases by age or other risk factors for immediate direct notification from the laboratory to the patient. Laboratory personnel could help with linkage to treatment sites with an electronic message or telephone call.

Many laboratories might say that such notification and treatment facilitation is not within their scope of work, however, in a public health emergency we must break down the existing silos to optimize our epidemic response. Our failure to work across systems has been a key factor in our inability to control the pandemic.

When I was a public health official in San Francisco we had standing protocols for testing and treatment that accelerated notification and therapy for serious conditions. One example was field delivered therapy where under my physician orders the public health staff could deliver medications to new cases of curable infections. Another was a program whereby those age 18 years or older could download a completed and signed prescription for emergency contraception.

Given the continued high death rates due to COVID-19 – which is now a highly preventable outcome – we must pivot our public health approach away from the controversial and poorly-adhered to mask mandates and physical distancing orders to the pharmaceutical interventions proven to work.

We have been very successful with vaccination – creating the largest vaccination program in modern times reaching more than two-thirds of the U.S. population. We have created new evidence-based policies to increase vaccination further in different settings but have probably reached a plateau.

New innovative approaches are necessary. With the anticipated authorization of additional new antiviral medications, the time to shift our focus is now. To make that shift, health officials and political leaders will have to update their response adopting the new treatments for this pharmaceutical phase of dealing with COVID-19.

Dr. Jeffrey D. Klausner is a clinical professor of medicine, population and public health sciences at the University of Southern California Keck School of Medicine.

Adblock test (Why?)



Source link

Continue Reading

Health

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

Published

 on

 

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.

Source link

Continue Reading

Health

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

Published

 on

 

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.

The Canadian Press. All rights reserved.

Source link

Continue Reading

Health

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

Published

 on

 

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.

Source link

Continue Reading

Trending

Exit mobile version