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More investment needed to counter COVID-19 misinformation, Canada’s top doctor says

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After a year that saw the highest number of COVID-19 deaths and a massive increase in infections, Canada’s top doctor says more investments are needed to combat misinformation about vaccines and pandemic measures to ensure Canada is ready for possible new variants of concern.

“This is the pandemic that is occurring in (a) full-on social media age, and all of us had to learn how to deal with that as the pandemic evolved. And it’s not easy,” Dr. Theresa Tam said in a year-end interview with Global News.

Misinformation is false or inaccurate information, which can be spread innocuously by those who may not be fully informed of the truth. Disinformation is considered more deliberate and can include malicious content such as hoaxes, phishing and propaganda, according to a definition provided by the United Nations.

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Tam called 2022 the “Omicron age,” after the variant arrived in late 2021 and quickly became the dominant variant for the remainder of the year.

Omicron and its hundreds of subvariants have taught the world that SARS-CoV-2 could be much more contagious than previously thought and that the virus is cunningly adept at evading immunity, Tam said.

For example, more than 70 per cent of Canadians have likely been infected with COVID-19 since Omicron arrived, compared to less than five per cent of the population before Omicron, according to blood test studies funded by the federal government through the national COVID-19 Immunity Task Force.

But the virus has also proved it is capable of presenting new surprises and challenges, which is why Tam says it will continue to be a public health concern in 2023.

Communicating this ongoing uncertainty has been a challenge, Tam says, especially when Canadians are “fed up” with the pandemic.

But the rise of mis- and disinformation about COVID-19 vaccines and pushback against public health measures has made that task even more difficult, Tam admitted.

The lessons learned over the last three years of the pandemic have allowed Canada and the world to be better equipped to weather future waves or new variants of the virus, Tam said.

For example, the world now has bivalent vaccines that can prevent severe outcomes, antivirals like Paxlovid to treat symptoms and global surveillance systems to measure increases in cases and mutations of the virus — all of which were not available in 2020.

“We have these tools, and they can be rapidly deployed should we see a significant variant of concern,” Tam said.

“And of course, the personal protective measures and systemic changes like improving ventilation (are) always going to be good in terms of better preparedness for future infections.”

But one of the other lessons learned has been that collective action among populations is key to reducing risk — actions like seeing as many people vaccinated and boosted as possible, Tam said.

And when the advice keeps shifting over time as more information becomes known, it can be challenging, she said.

“I think there is a lot of misunderstanding … (among) people who actually enthusiastically took up the initial vaccine that (now wonder), ‘Why do I need to get boosted, especially if I just had an infection?’” Tam said.

“I just think that collectively we understand that this virus keeps throwing us curveballs.”

That’s why she says more money is needed to counter narratives that could erode the progress Canada and the world have made when it comes to COVID-19.

“I think we need to invest more in countering mis- and disinformation,” Tam said.

“Public health needs to be better at communicating in a way that resonates with people as much as those who may be against the vaccinations (resonate) with people always concerned about safety and effectiveness.  

“That’s the information that people need to know.”

One of the best ways to counter false or misleading narratives is to engage with grassroots leaders and communities that people know and trust, Tam said.

She pointed to the success Canada has seen in decreasing the number of mpox (formerly called monkeypox) cases in the country over the last eight months since that virus first began to spread in Canada in May.

Hundreds of mpox cases were reported at a steadily increasing rate through the spring and summer, until a dedicated public health information campaign was launched tailored to populations who were at the highest risk of infection during the height of the outbreak: men who have sex with men.

This campaign included partnerships with key community stakeholders and vaccine clinics and pop-ups that were accessible and timely for the most at-risk populations.

The rate of new mpox cases has since slowed considerably. No new cases have been reported in Canada in the last three weeks, according to federal data.

This success was only possible through those community partnerships, Tam said.

Similar efforts are needed when it comes to countering misinformation about COVID-19 vaccines, she added.

“This is a very difficult area because people are just fed up with COVID-19, full stop, and yet the virus hasn’t left us and we’ve had to keep updating our vaccine recommendations as well as updating the vaccines themselves, so that’s understandable,” she said.

“But I think we need to provide information in an as accessible way as possible to people to explain why vaccines are needed. But also, I think, engage trusted voices, community leaders, people that different communities trust in order to increase uptake.”

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Health Canada reviewing safety of controversial breastfeeding drug – CBC.ca

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Health Canada has launched a safety review of the psychological withdrawal symptoms associated with stopping or reducing use of a drug commonly prescribed to help women breastfeed.

The agency confirmed the review in an email to CBC News.

“A safety review is currently under way for domperidone and drug withdrawal symptoms after stopping or reducing the dose of domperidone used to stimulate lactation,” the statement said. 

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Domperidone is approved in Canada to treat gastrointestinal disorders. Health Canada has never authorized its use as a lactation aid, but it is widely prescribed off-label for this purpose. 

The Health Canada review follows a CBC News investigation into severe psychological effects that can occur when some women stop taking the drug. Women who spoke to CBC described anxiety, lack of sleep and thoughts of self-harm severe enough that in some cases they became incapable of caring for their children or returning to work. One woman described multiple attempts to take her own life. 

CBC’s investigation also found domperidone is prescribed by some doctors to stimulate lactation at doses three to five times higher than what is recommended by both Health Canada and the drug manufacturer. Because this is not an approved use or dosage anywhere in the world, there are no large-scale clinical trials that shed any light on how often these side effects occur. 

This makes it challenging for regulators like Health Canada to evaluate the safety of a drug for an off-label purpose, said Mina Tadrous, an assistant professor at the Leslie Dan Faculty of Pharmacy at the University of Toronto who specializes in drug safety.

Toronto pharmacist Mina Tadrous says it is challenging for regulators to evaluate the safety of a drug used for off-label purpose. (CBC)

“The company may not have intended it for that, so the original clinical trials were not designed for that. And so it means that they have to look at different mechanisms to be able to evaluate the safety of these drugs,” he said.

That can include looking at data from other countries with larger populations, according to Tadrous.

Case studies document concerns

There are, however, case studies documenting the withdrawal effects, including three published in November 2022 in the peer-reviewed journal Breastfeeding Medicine. Domperidone blocks dopamine receptors in the brain, which stimulates the release of prolactin. This causes lactation, the authors note, but can also cause domperidone to act as an antipsychotic. The authors also noted withdrawal symptoms are typically less severe when women taper off the drug slowly.

The most recent case studies are from the United States, where domperidone is not approved by the Food and Drug Administration for any purpose. CBC’s investigation found some American women get the drug from doctors in Canada.

Health Canada will review “all relevant domestic and foreign case reports,” the statement said.

Reviews can result in Health Canada requesting more information, studies or monitoring by the manufacturer. They can also result in warnings to patients and health care providers, changes to how a drug is labelled or, if necessary, the withdrawal of a drug from the market “if the benefits no longer outweigh the risks of the product,” according to the statement released by the department.

“The decision to take action, including issuing a warning, is not based solely on the number of case reports, but on a comprehensive assessment of the information contained in these case reports,” Health Canada’s statement said. 

“Should new safety risks be confirmed, Health Canada will take appropriate action and continue to keep Canadians informed.”

WATCH | Women report alarming withrawal effects after taking domperidone as a lactation aid:

Women report alarming withdrawal effects from drug prescribed for breastfeeding

2 months ago

Duration 7:08

WARNING: This story contains distressing details about suicidal thoughts and attempts. Correction: A previous version of this video included inaccurate Health Canada data about the number of domperidone prescriptions that were filled in 2020. That publicly available data has since been updated to show that 1.7 million prescriptions were filled that year.

The distinction between quantity and quality of reports is important, Tadrous said, because large numbers of reports, especially from non-clinicians, may only indicate people believe there’s a connection between a drug and a reaction. 

“That’s the lesson we’ve learned with vaccines, for example, where these adverse event systems are flooded,” he said.

“And so if you base something just on the number of reports without doing a thorough investigation and a different type of study design that reduces bias … you might reach a false conclusion.”

Health Canada has conducted multiple safety reviews of domperidone, most recently in 2021. Previous reviews confirmed the risk of serious abnormal heart rhythms and sudden cardiac death related to domperidone use. These reviews resulted in Health Canada introducing a maximum daily dose recommendation of 30 mg and restricting its use in patients with certain cardiac conditions or taking other drugs.

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The Holocaust strikes our very being

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Holocaust

To be a Jew is not something special,
being a human being is normal.
Dealing with prejudice, hatred, and oppressive action,
now that’s something special for the Jewish Nation.

Oppression, hatred, and genocide besides,
is not just a Jewish person’s situation.
Armenian, Cambodian and Jewish Peoples deal,
with a national eradication event.

People of the world unit,
genocide is an international delight.
Oppress your people, crush opposition too.
The elites of the world are making exceptions for you.

Don’t be weak, allowing excuses to be made,
but lift your hands in justice’s cruel wave.
Hatred knows no reasonability, it knows no mercy.
Hatred, oppression, and prejudice need no exception.

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Long ago Jews were murdered by the millions,
Cambodians died at the hands of their neighbors.
Palestine still walks within the borders of other nations,
and peace is nowhere to be found, my friend.

If your arms are in righteous ways demand justice for all,
for the people who hate will not see our peaceful ways.
A gun, a bayonet, and a saber be brought,
for the right to justice begins today,
and ends with blood if the opposition has any say.

Gandhi spoke of peaceful ways,
while Martin Luther Jr surrendered his life. to the cause.
Young blacks die each and every day,
while the power of prejudice wins the day.

My first lifts in anger that is for sure,
while the average person just shrugs this day.
But the goose-stepping troops may one day march on,
and the ignorance that prevails will let them carry on.

Open our eyes to the wrongs before us,
clear our minds and accept what bothers us.
Injustice is a prevailing horrid thing,
and ONLY YOU CAN BRING IT TO AN END.

Steven Kaszab
Bradford, Ontario
skaszab@yahoo.ca

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Parliamentarians kick off return to House of Commons with debate on child care

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Parliamentarians kick off return

The economy was top of mind for members of Parliament as they returned to the House of Commons Monday, with the Liberal government kicking off the new sitting with a debate on child care.

Families Minister Karina Gould tabled Bill C-35 last December, which seeks to enshrine the Liberals’ national daycare plan into law — and commit Ottawa to maintaining long-term funding.

The federal government has inked deals with provinces and territories in an effort to cut fees down to an average of $10 per day by 2026.

During a debate today, Gould said all parties should support the bill, and the national plan has begun saving families money.

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But Conservative MP Michelle Ferreri said the plan is “subsidizing the wealthy” while failing to reduce wait times for child-care spaces and address labour shortages in the sector.

Ferreri told MPs that the Conservatives would be presenting “strong amendments” to the legislation.

The debate comes amid concerns about a possible recession this year, with both Prime Minister Justin Trudeau and Conservative Leader Pierre Poilievre saying their focus will be on the cost of living.

But Poilievre’s Tories may have little room to manoeuvre in the legislature.

NDP Leader Jagmeet Singh told reporters upon his return to the House of Commons that he does not believe there is any room to work with the Conservatives during the upcoming sitting.

Instead, the NDP says it plans to push the Liberals to fulfil the terms of the parties’ confidence-and-supply agreement, such as the planned expansion of federal dental care.

Under the deal signed last March, the NDP agreed to support the minority government on key House of Commons votes in exchange for the Liberals moving ahead on New Democrat policy priorities.

This report by The Canadian Press was first published Jan. 30, 2023.

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