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Nearly 1,000 health providers urge PM Trudeau to deliver on regularization promise

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OTTAWA, October 12, 2022  – In a detailed open letter, released by Health for All Network, nearly a thousand health workers across Canada, are prescribing permanent resident status for all to save lives. The letter comes a few days before the ten-month mark since Prime Minister Trudeau promised to create a regularization plan that would provide permanent residence to undocumented and temporary immigrants.

Ontario family physician, Dr. Vanessa Redditt, one of signatories says, “Without secure immigration status, many migrants are denied basic rights and essential services, with extremely damaging impacts on their health and well-being. We need to see immediate action from the federal government to fulfill their promise to ensure permanent residency for the 1.7 million migrants living and working in Canada with precarious, temporary, or no immigration status.”

The letter, also signed by organizations including Canadian Doctors for Medicare, Canadian Federation of Nurses Unions, National Union of Public and General Employees as well as the Manitoba, New Brunswick, Saskatchewan and British Columbia Health Coalitions urges Prime Minister Trudeau to “consider the negative health impacts of precarious immigration status and ensure that no one is left behind. Ensuring equal rights and access for all migrants is critical for closing systemic gaps in health inequities.”

Yasmin Beydoun, a speech-language pathologist in Toronto, shares, “I have had patients with significant swallowing impairments leave the hospital without community follow-up because they had no status and therefore no health coverage. This is a huge health risk, if they can’t safely eat and drink, they are at a higher risk for choking, lung infections, and even malnutrition. These patients do not get the same access to care as citizens. Saving lives means ensuring permanent residency for all migrants, including undocumented people.”

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Not only are migrants patients of health providers, they are healthcare workers themselves. Akinwumi Yemi is undocumented immigrant from Nigeria and member of Migrant Workers Alliance for Change, who has been working in the long-term care department of a public hospital near Kahnawake since 2018. He says, “I have been committed and dedicated since the outbreak of the COVID-19 virus, taking care of the elderly in Canada and putting the lives of my own family and loved ones at risk. I have no access to good and quality medical care and other opportunities because I am an undocumented immigrant. All we are asking for is equal rights and permanent residence for all without exception.”

The letter explains, “while all levels of government have responsibilities for the health, safety, and security of migrants, the federal government’s role in determining immigration status is critical, including through accords it has with individual provinces.” In addition to calling for immigration changes, letter signatories are also calling on provinces to provide healthcare for all regardless of immigration status.

A recent review of existing research in Canada confirmed that immigration status is a foundational determinant of health for people without status in Canada. Dr. Monika Dutt, a public health physician in Nova Scotia and Newfoundland & Labrador says, “Health providers are asking Prime Minister Trudeau to fix a historic wrong by delivering a comprehensive and inclusive regularization program.”

On October 16, 2022, health workers across Canada will join the Migrant Rights Network at actions at Cabinet Minister constituency offices demanding full and permanent immigration status for all immediately.

“Our patients cannot afford any more delays. Prime Minister Trudeau needs to move fast and ensure full and permanent immigration status for all migrants,” adds Dr. Dutt

 

Background:

 

Available for interviews:

  • Ontario: Dr. Vanessa Reddit, family physician

  • British Columbia: Dr. Mei-ling Wiedmeyer, family physician; Nesa Hamidi Tousi, nurse practitioner

  • Quebec: Dr. Arnold Aberman, general practitioner, Quebec

  • Nova Scotia: Dr. Monika Dutt, family physician and public health specialist

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Young and old more likely to face severe flu. Here’s why doctors think it happens

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Canadians have been getting sick enough with seasonal flu to land in hospital, say doctors with suggestions on who is most at risk and what it could mean for festive gatherings.

“We’re starting to now see the effect of flu on certain populations, particularly very young children and very older people, in making them sick enough that they need to come into hospital,” said Dr. Gerald Evans, chair of the division of infectious diseases at Queen’s University and Kingston Health Sciences Centre.

During the depths of the COVID-19 pandemic, air travel declined. It’s one of the suspected reasons that influenza all but disappeared, Evans said.

Flu viruses need human hosts travelling between the southern and northern hemispheres to gain a foothold during winter on both ends of the planet, according to influenza experts.

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Dr. Upton Allen, head of infectious diseases at Sick Kids Hospital, said the H3N2 strain of influenza might be associated with more severe disease than other strains. (SickKids)

For about 100 years, doctors have known that the youngest and oldest are most at risk for serious flu. Why hasn’t been nailed down, but there are a few possible reasons — including what strains were circulating when you were first exposed.

Generational effects explored

Canadian and international research on humans as well as in animal models suggest that the first strain of flu virus you’re infected with tends to prime or shape the immune system. The result is that our immune system responds best to the original type of flu infection it faced.

“That’s why we believe that older people who are mostly primed with H1N1 don’t do very well during an H3N2 year like we’re having this year,” Evans said.

Staff at pediatric hospitals like Sick Kids continue to face pressures from pandemic backlogs of surgeries. (Michael Wilson/CBC)

The 2009 H1N1 pandemic also continues to affect how younger ones do with flu.

Those aged 13 and under were probably primed to H1N1 after 2009, just as their grandparents were in their childhoods, Evans said.

If so, today’s kids could be more vulnerable to severe disease from flu now than their parents’ generation who first encountered an H3N2 strain.

Evans added it’s also thought that older people may have more severe outcomes from flu because of underlying problems such as heart disease, lung disease or treatments for cancer.

Youngest hadn’t been exposed

Another reason why young children are being hit hard by flu and RSV this year: recent pandemic public health measures meant those under two haven’t seen flu at all and preschoolers haven’t experienced it or another respiratory virus known as respiratory syncytial virus, or RSV, for a couple seasons.

“The boost of immunity they get from having had some prior exposures in the year before are missing and so they’re tending to get infected more,” Evans said.

Dr. Upton Allen, chief of infectious diseases at the Hospital for Sick Children in Toronto, pointed to a few other possibilities.

One is the strain of flu virus that’s mainly circulating. It’s officially called Influenza A H3N2, which Allen said might be associated with more severe disease.

Also, our immune system is considered weakest at the extremes of life.

“The overwhelming majority of kids who get the flu will get it mild, but some people can get it severe,” Allen said.

 

 

Health experts in Canada and the U.S. are recommending people start wearing masks again with a ‘perfect storm’ of respiratory diseases on the rise, a strain on our hospital systems and a shortage of medication. But is that enough to get us to wear masks again? Dr. Susy Hota joins About That with Andrew Chang to take us through it all.

If a child is breathing very quickly, having trouble breathing, weak, doesn’t wake up or respond then those might indicate a more severe bout. “Call 911 or go to the nearest emergency department,” Allen said.

The Public Health Agency of Canada reports fewer than five influenza-associated deaths among those aged 16 and younger for the week ending Nov. 19.

“Each year the number of deaths generally are in single digits,” for that age group in Canada, Allen said.

Doctor’s holiday flu forecast

Marie Tarrant, a professor in the nursing school at the University of British Columbia Okanagan, is concerned about the uptick in hospitalizations from flu for patients and health-care systems.

“The other side of that is just the burden that is putting on a healthcare system that has been maximally strained for the last 2 ½ years.”

A lab technician at work.
A lab technician works in the H1N1 laboratory at the British Columbia Centre for Disease Control in Vancouver in 2009. This year’s flu season started earlier than the norm. (Darryl Dyck/The Canadian Press)

People with flu, RSV and other infections have a “compounding effect” of burdening hospitals, she said. Like Canada’s National Advisory Committee on Immunization, Tarrant recommends those aged six months and older who are eligible get a flu shot.

“Flu vaccines prevent about 40 to 60 per cent of serious illness and hospitalization,” she said. “They do work.”

Evans has similar advice.

“Get your flu shot,” he said. “It’s not going to be for everybody, but it’s going to prevent a lot of people getting infected and that’s going to help of course alleviate the stresses that we’re seeing in trying to provide care to everybody.”

It’s also not too late to get a flu shot, clinicians say.

Plus, flu season started earlier than it typically does this year, which could (eventually) offer a yuletide bright spot. Evans said seasonal flu usually disappears after a period of about six weeks. Canada is now about two weeks into a surge.

“By the time the holidays come around, we should be seeing a waning down of numbers of influenza infections, if it follows the pattern that we have seen now literally for decades.”

The good news? “As long as you’re feeling OK and you don’t have signs and symptoms of a cold, I think gathering together is fine.”

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St. Joe's opens Hamilton Mountain flu, COVID and cold clinic – Hamilton Spectator

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St. Joseph's West 5th Campus has opened a flu, COVID and cold clinic.

With the cold and flu season now in full swing, St. Joseph’s Healthcare Hamilton has opened a flu, COVID and cold clinic at their West 5th (and Fennell) campus.

St. Joe’s officials say the goal of the dedicated clinic is to provide both adults and children with timely care, while reducing the number of patients visiting emergency departments for respiratory illnesses commonly seen throughout the fall and winter.

Clinic visits are by appointment only.

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See stjoes.ca/FluCOVIDCold to book an appointment.

Clinic hours are Monday to Friday 4:30 p.m. to 9 p.m., Saturday/Sunday 8 a.m. to 4 p.m.

The clinic is a collaborative effort between St. Joseph’s Healthcare Hamilton, Hamilton Health Sciences (HHS) and primary care doctors

St Joe’s official say adults and children experiencing flu, COVID or cold symptoms, who are unable to seek timely care from their family doctor or do not have a family doctor, should book an appointment if their symptoms are not improving after a few days, despite using common over-the-counter medications as indicated on the label, such as ibuprofen (Advil), acetaminophen (Tylenol), nasal rinses and cold/flu medications or if they are particularly worried about any of their symptoms.

Common symptoms include fever, cough, sore throat, runny or stuffy nose, chills, loss of taste or smell, headache, and muscle aches.

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World AIDS Day: HIV activists hopeful for end to backsliding on infections, stigma

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HIV activists are marking World AIDS Day by urging Ottawa to help stop a global backslide in progress on stemming infections and stigma.

“It’s clear to us that this government is seized of the issue, but the truth of the matter is, no movement is happening quickly enough for people with HIV living in Canada,” says Janet Butler-McPhee, who co-leads the HIV Legal Network in Toronto.

The Public Health Agency of Canada estimated that 62,790 people in Canada were living with HIV in 2020, and that 10 per cent of them didn’t know they had the virus.

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That represented a slight drop in overall cases from 2018, but an increase among the most vulnerable.

Indigenous people accounted for nearly one-fifth of new HIV infections in Canada in 2020, the data say. That year, women and people who inject drugs made up an increasing share of infections, while men who have sex with men made up a smaller share.

Advocates argue that the numbers reflect the uneven effects of the COVID-19 pandemic.

Butler-McPhee noted that the Harper and Trudeau governments both pledged funding for grassroots groups that serve people with HIV that hasn’t fully materialized, despite the added factors of a toxic drug crisis and the COVID-19 pandemic.

“You’re talking about organizations who have had to pivot pretty significantly and take on new work without funding that has been long-promised,” she said.

Meanwhile, Canada continues to trail its peers in criminalizing HIV non-disclosure. Canadians living with the virus can be prosecuted for not disclosing their status to sexual partners, even when prescription drugs make it impossible to transmit the virus.

“Criminalization can lead to the stigmatization of people living with HIV, which can often discourage individuals from being tested or seeking treatment,” the Department of Justice noted in October.

The Liberals have been promising to fix the issue since 2016, but only launched a national consultation in October. They have also asked prosecutors to avoid criminalizing people with HIV in the territories, while suggesting provinces follow suit, with mixed success.

“For the last six years, there has been a recognition by this federal government that HIV criminalization is an issue in Canada, but there has been not as much movement as we’d like to see,” said India Annamanthadoo, a lawyer with the HIV Legal Network.

Abroad, the World Health Organization reported disruptions in HIV patients accessing treatments that suppress symptoms and stop the virus from progressing to AIDS, as countries targeted their health care systems at stemming COVID-19 infections.

That’s put a dent in progress toward the United Nations sustainable development goal of ending the epidemic of HIV-AIDS by 2030.

Before the pandemic, the UN’s joint program on AIDS reported that AIDS-related deaths had gone down by 68 per cent since the peak in 2004, and by 52 per cent since 2010.

Thursday marks World AIDS Day, which the United Nations has marked every year since 1988. The disease has killed roughly 40 million people, including 650,000 in 2021.

In a report this week, the agency said inequalities will make it impossible to reach global targets, whether it’s the presence of girls and women in school or continued stigma against men who have sex with men.

Girls and women in sub-Saharan Africa aged 15 to 24 are acquiring HIV at rates three times that of males in the same age group, the agency reported.

 

Gay men and people engaged in sex work are more likely to avoid HIV testing when the country they live in criminalizes their behaviour, the agency says.

In September, Canada was praised for pledging $1.2 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria, after months of concern that Ottawa would pull back its funding.

The move came after the Liberals cancelled a ministerial address to the International AIDS Conference in Montreal this summer, a summit clouded by controversy after African delegates were refused visas.

Back home, the Canadian Aboriginal AIDS Network argues that mainstream public-awareness campaigns and access to HIV-preventing drugs are not reaching Indigenous communities, particularly women.

Trevor Stratton, an Ojibwa activist with the group, told an online panel on Wednesday that Ottawa ought to launch an inquiry into the disproportionate rates of HIV among Indigenous peoples.

“It’s a national embarrassment; when I travel internationally I am actually embarrassed to be a citizen of Canada,” he said.

&copy 2022 The Canadian Press

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