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Naloxone kits being carried by more people to help strangers

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Kym Porter has been carrying a naloxone kit in her purse since her son died of an overdose more than six years ago.

 

Porter, a retired school teacher in Medicine Hat, Alta., was trained to use both the syringe and nasal versions of the overdose reversal drug, but never ran into an emergency situation until May.

“I saw this fellow lying under a tree and he wasn’t moving,” Porter said.

She approached the man, looked for any drug paraphernalia, called out to him and shook his shoulders. No response.

Porter dialed first responders and reached for her naloxone kit.

“But for some reason, I don’t know why, I hesitated,” she said. “I didn’t administer it.”

Emergency crews arrived and brought back the man who confirmed to her that he had overdosed.

Naloxone kits are easily available, over-the-counter antidotes that block the effects of opioids such as fentanyl, heroin, morphine or cocaine.

More people are carrying naloxone kits with them on the streets as drug poisoning-related fatalities break records every passing year in Canada.

In Alberta, the latest numbers show April was the deadliest month, with 179 deaths from opioid overdoses.

Caitlin Shane, a drugs policy lawyer with Pivot Legal Society in Vancouver, said she sees people in the community, as well as health professionals on and off the job helping others who may have overdosed on opioids.

“Oftentimes, it’s people who just happen to be walking by (and) have naloxone attached to their bag or backpack,” she said.

Shane said it is crucial to know the signs of an overdose to ascertain when to administer naloxone.

“That way, you can feel more comfortable doing it.”

The signs could be shallow breathing, blue or grey lips or nails, small pupils, the inability to wake up despite calling out or shaking the person, and choking or snoring sounds.

“If you believe someone is overdosing and you’re not sure if it’s an opioid or stimulant overdose, Health Canada recommends administration (of naloxone),” she said.

“The outcome will most likely be better than not administering it.”

The U.S. Food and Drug Administration says injecting naloxone into a person who may be unconscious for other reasons such as diabetic coma or cardiac arrest would not cause them additional harm.

Shane said the Emergency Medical Aid Act protects people who administer naloxone outside of a health or medical setting, or when the person is not being compensated for their help.

“If you’re walking down the sidewalk and you see someone has overdosed and you administer naloxone, and in doing that, you injure the person or cause their death, you will not be legally liable,” she explained.

The only exception is if the injury or death is caused by “gross negligence,” Shane added.

Candice Chaffey, a nurse at a Toronto-area hospital, was on her way to pick up a takeout pizza when her eyes caught a man lying unconscious on the pavement.

The man was surrounded by bystanders in Brampton, Ont., as they waited for paramedics to arrive.

Chaffey approached the man and began with sternal rubs on the chest to wake him up. She knew it was an overdose.

“I ran home and got back with my naloxone kit within 30 seconds,” Chaffey recalled of the evening last summer.

She opened the kit, pulled out the ampoule, pulled it through the syringe and injected naloxone into the man.

“He immediately started to get up and said, ‘Why did you poke me?”’ she recalled.

The man passed out again so Chaffey repeated the steps with a second dose and helped him get up. But the man wasn’t happy with the intrusion.

Chaffey said things could get violent. It didn’t in this case.

“That is a risk you take,” she said.

She warned that people shouldn’t put themselves at risk if they are not comfortable approaching a person who is potentially overdosing.

“The best thing to do is just wait for a paramedic to arrive,” Chaffey said.

For Porter, the hesitation wasn’t coming from safety or legal concerns. Instead, she felt she was “overdramatizing” the situation when she came across an unconscious man.

“I questioned myself,” Porter said. “Am I just wanting to do this because I know how to do this? Am I making too big of a deal about this?”

Looking back at the day, Porter said she wouldn’t hesitate to administer naloxone if it happens again.

She recalled her 31-year-old son’s last interaction with a neighbour before he died of drug poisoning.

“The woman upstairs came down. (My son’s) door was open. She saw him lying on the floor, snoring and didn’t realize he was dying,” she said.

“She kindly covered him with a blanket, thinking he was asleep.”

Porter said if the neighbour knew the signs, her son could have lived.

“I’m not an expert, I’m not a nurse, I’m not wise enough to know how sick a person is,” she said.

“But naloxone is a life-saving tool.”

 

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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.

The Canadian Press. All rights reserved.

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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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