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Nunavut admits to large tuberculosis outbreak in Pangnirtung months later – The Globe and Mail

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St. Luke’s Mission Hospital, in Pangnirtung. The Nunavut Department of Health said on May 26 that 139 cases of TB have been identified in Pangnirtung in the past 18 months.Pat Kane/The Globe and Mail

Pangnirtung, a small hamlet on Baffin Island, is grappling with the largest tuberculosis outbreak in Nunavut since 2017, according to data the territorial government released on Thursday after refusing for months to reveal the extent of the disease’s spread.

The Nunavut Department of Health said on Thursday that 139 cases of TB have been identified in Pangnirtung in the past 18 months, 31 of which were active, meaning the patients were sick and infectious. The rest were cases of latent or “sleeping” TB, an asymptomatic version of the bacterial infection that isn’t contagious, but that puts patients at risk of developing active TB in the future.

The Globe and Mail travelled to Pangnirtung earlier this month as part of a continuing investigation into health care in Canada’s youngest territory. In interviews, community leaders have expressed frustration at the lack of official information about the TB outbreak, which Michael Patterson, the territory’s chief public-health officer, first declared on Nov. 25 without providing a tally of cases.

The size of the outbreak came as a surprise to Pangnirtung Mayor Eric Lawlor who, along with the rest of the hamlet’s elected council, wasn’t privy to official statistics on the ballooning health problem in his own community.

“The information should have been provided to us regularly to begin with,” Mr. Lawlor said on Thursday. “This is more concerning than COVID, actually. With the numbers being so high, it’s kind of worrisome and bothersome that we haven’t been addressing it more seriously from the government side.”

The Nunavut Department of Health published the figures in a news release a week after receiving a list of questions from The Globe about the ongoing tuberculosis outbreak in Pangnirtung, a community of about 1,600 people an hour’s flight north of Iqaluit, the territorial capital.

“I don’t know why they’re so secretive,” said Madeleine Qumuatuq, Pangnirtung’s community wellness co-ordinator. “You can’t be secretive and then do prevention. I mean, they’ve got to be truthful to us.”

Ms. Qumuatuq was one of several Pangnirtung residents who raised concerns about the pace of the government’s response to the TB outbreak. She pointed out that the health department rented the community hall – one of Pangnirtung’s few public spaces – beginning March 1 for a satellite TB clinic that still isn’t up and running.

“We’re missing out on a lot of age groups that would normally be coming here to play checkers, pool, whatever it might be. And the teenagers hang out here,” she said. “All that is taken away because they’ve rented the space. But they’re not even here yet.”

Danarae Sommerville, a spokesperson for the Nunavut Department of Health, said by e-mail that the delay has been caused by a shortage of skilled workers “required to ensure the Hamlet building has the appropriate wiring and network to set up workstations for staff.” Those workers were waylaid responding to the aftermath of a fire that consumed a government building in another hamlet, she added.

In responses to earlier questions about the outbreak, she pointed out that the Department of Health sent extra nurses and other front-line staff to Pangnirtung to help manage the outbreak – no easy feat during a national nursing shortage exacerbated by the pandemic.

Active tuberculosis infections, which are caused by bacteria that spread through the air and usually lodge in the lungs, can cause fever, weight loss, night sweats, fatigue and a chronic, sometimes bloody cough. Antibiotics can cure active TB and prevent latent cases from turning into serious disease. The infection can be fatal if left untreated.

Tuberculosis is a disease that most Canadians think of as a scourge of the past. But it remains a scourge of the present in Indigenous communities, particularly Inuit communities, where deep-seated poverty, overcrowded housing and limited access to medical care make residents particularly vulnerable.

The federal Liberal government, along with Inuit Tapiriit Kanatami, a national Inuit organization, promised in 2018 to eliminate TB in Inuit communities by 2030.

The most recent data from the Public Health Agency of Canada show there were 72.2 active cases of TB per 100,000 population among Inuit people in 2020, compared with a national case rate of 4.7 per 100,000.

Despite being 15 times higher than the national average, the TB rate among Inuit in 2020 was down significantly, from 188.7 cases per 100,000 in 2019 and from a 10-year annual average of 184.14 per 100,000 from 2010 to 2019. The decline likely reflects cases of TB going undiagnosed in the first year of the pandemic, experts on the disease have said.

Nunavut, which is home to the majority of Inuit in Canada, recorded 34 active cases across the territory in 2020, or 86.40 per 100,000, down from an average of 66 active cases per year territory-wide over the previous four years.

In February, Nunavut’s privacy commissioner ruled in The Globe’s favour after the newspaper appealed the territorial government’s refusal to release TB case counts by community, age and gender.

But privacy commissioner decisions aren’t binding in Nunavut. Health Minister John Main rejected the call to release community-level data, saying at the time that doing so could risk identifying patients and stigmatizing entire communities.

Neither Mr. Main nor Dr. Patterson were available for interviews Thursday.

Chris Puglia, another spokesperson for the Nunavut Department of Health, said in an e-mail that the department doesn’t plan to release TB data by hamlet, except during outbreaks. “Community level data outside an outbreak does not offer additional protection to public health and could further stigmatize the disease and create hesitancy in people seeking testing,” he wrote.

He added that Dr. Patterson’s office decided to compromise in the case of Pangnirtung and release updates every three months that “might assist in outbreak management.” The Department of Health released community-level data during Nunavut’s last major TB outbreak, in Qikiqtarjuaq in 2017-2018. A 15-year-old girl died in that outbreak.

Nunavut Privacy Commissioner Graham Steele said the government should go further and follow his ruling on TB data.

“I continue to believe that the law requires that community-level numbers be released, and not only at a time and place selected by the government,” he said Thursday. “It’s hard to hold the government to account for tuberculosis policy when it holds all the numbers in secret.”

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Health Minister Adrian Dix must come clean on why B.C. is restricting fourth COVID-19 vaccinations – The Georgia Straight

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Former senior civil servant and diplomat Norman Spector shared a fascinating article with me this weekend from the Ottawa Citizen.

A family physician in the national capital, Dr. Nili Kaplan-Myrth, hoped to conduct mass vaccinations for people who want a fourth dose of COVID-19 but don’t qualify under Ontario’s rules.

She reportedly wanted to create a large outdoor “jabalooza” clinic but health officials refused to provide her with vaccines.

Ontario restricts access to fourth shots of COVID-19 vaccines to those who are 60 years of age or older.

Next door in Quebec, people can get fourth shots if they are 18 and older.

“I am receiving lots of individual requests for help,” Kaplan-Myrth tweeted on Sunday (June 26). “I can’t give you the vaccine at this time, but hands up (and DM) if you as plaintiffs want to bring this to court as a group. Would require a litigation team.”

There’s a tremendous amount of scientific data showing that COVID-19 vaccines lessen the severity of COVID-19. They reduce the likelihood of dying or being hospitalized from the disease.

However, COVID-19 vaccine effectiveness wanes over time. This is why Kaplan-Myrth is such a strong advocate for booster shots. She believes that these boosters are particularly important when so many people are not wearing masks indoors.

Keep in mind that COVID-19 initially presents as a respiratory infection.

In some cases, however, it causes serious brain injuries and cardiovascular problems. It’s especially dangerous for the immunocompromised, who are at higher risk of suffering severe COVID-19.

That’s because the virus that causes COVID-19 not only damages blood vessels and triggers blood clots, but also disrupts the immune system. Researchers have even linked immune dysfunction to serious brain injuries, which is explained in the video below.

Video of Here’s what we know about COVID-19’s impact on the brain

Video: Here’s what we know about COVID-19’s impact on the brain.

B.C. doesn’t want most under-70s to get fourth shots

In the face of all of this, B.C. continues adopting a hard line on the distribution of fourth vaccine doses.

This is the case even after Global News B.C. reporter Richard Zussman revealed that 226,000 doses intended for the vaccine-hesitant will expire at the end of July.

In B.C., you have to be 70 years of age or older and have gone six months since a previous COVID-19 vaccination to qualify for a fourth dose.

There are exceptions: Indigenous people, for example, can get a fourth dose if they’re 55 or older.

Below, you can read other exceptions listed by the B.C. Centre for Disease Control for those between the ages of 60 and 69.

The B.C. Centre for Disease Control listed these exemptions, which qualify someone from 60 to 69 years old for a fourth COVID-19 vaccination.

However, when the Georgia Straight asked the Ministry of Health about who qualified for a fourth COVID-19 vaccination, it did not include what’s written after the letter “d”: “Caregiver of a frail elderly or moderately to severely immunosuppressed person”.

So it remains unclear in B.C. if a person between 60 and 69 who is a caregiver for either a frail elderly person or a moderately to severely immunosuppressed person is able to receive a fourth COVID-19 vaccination.

Yet it seems pretty clear from the exemptions above that if you are a cancer survivor or have kidney disease or have heart disease or have multiple sclerosis or have had a transplant and you’re under 70 in B.C., you will not qualify for a fourth COVID-19 vaccination under existing rules.

Why is B.C. being more restrictive with COVID-19 booster shots than Ontario, Quebec, Saskatchewan (where you only need to be 50-plus), as well as the entire United States?

Health Minister Adrian Dix needs to come clean on that.

What possible justification is there for withholding a fourth COVID-19 shot for British Columbians under 70, especially the immune-compromised, when 226,000 vaccine doses are set to expire next month?

Why is Dix so convinced that he knows better than the governments of Ontario, Quebec, and Saskatchewan?

We don’t know the answer.

That’s in part because our pusillanimous B.C. Liberal MLAs refuse to hold the provincial NDP government accountable for its COVID-19 policies.

Some on social media are speculating that the booster shots are being withheld as part of a population-level experiment—conducted without the people’s consent—on the efficacy of delaying second booster shots.

Dix and provincial health officer Dr. Bonnie Henry, through their actions, are giving oxygen to this hypothesis.

Who knows? There might even be a scientific justification for withholding booster shots.

But in the absence of evidence provided by the B.C. government, the health minister must get in front of a microphone on Monday (June 27) and provide a coherent explanation.

Failure to do so will only fuel more suspicion about the motives behind the government’s policy.

Perhaps it’s worth noting that in January 2021, Science published a study involving 188 people, which offered a glimmer of hope.

It showed that more than 95 percent of those who had recovered from COVID-19 had immune systems demonstrating “durable” memories of the virus, lasting up to eight months.

This prompted speculation on the National Institutes of Health website that the immune systems of those who are vaccinated would have lasting memories of the virus.

But a study of 188 people is insufficient as the basis for an entire provincewide policy.

Some might wonder if the government isn’t making fourth doses of COVID-19 vaccines available to those under 70 because of the cost of distribution or due to the labour shortage in the health-care sector.

Others might suspect it’s because the B.C. government thinks everyone is going to get COVID-19 anyway, so why bother?

If that’s the real reason, it’s a monumental disservice to those with compromised immunity. This should demand a response from Human Rights Commissioner Kasari Govender that goes well beyond writing a letter to Henry. Like by holding a public inquiry under section 47.15 of the B.C. Human Rights Code.

In the meantime, show us the evidence, Minister Dix, for why so many British Columbians are being denied a fourth COVID-19 vaccination.

And if you’re unwilling to do that, then please step aside so another health minister can do this in your place.

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Frank Bures: COVID shots for tots | Column | winonadailynews.com – Winona Daily News

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They are finally here! Vaccinations against COVID-19 were at last approved for the youngest people ages 6 months to 5 years old. Studies in children have been done showing definite protective benefits and no major adverse reactions occurring. The first step was the FDA approval after an advisory panel deliberated the week of June 13 — only 2 days — to vote unanimously to recommend authorization, stating the benefits outweigh any risks for young kids.

The CDC signed off on the vaccines June 18 with another unanimous vote. The two vaccines consist of the Pfizer mRNA version in adults, but a much-reduced dose of 3 micrograms instead of 30 micrograms, given in three doses to induce a high level of antibodies equivalent to young adults. The first two doses are spaced three weeks apart, and the third at least two months later. The study found only 10 COVID cases in the three-dose group and seven in the placebo group for an efficacy of 80%. The study included only a small number of patients. Most of the infectious disease and pediatrician experts cautioned not to lose sight of the fact that the vaccines were saving children’s lives.

People are also reading…

The Moderna mRNA vaccine is the same as the adult one but only a quarter of the dose at 25 micrograms in a two-dose series given four weeks apart. Both this and the Pfizer vaccine achieved the same levels of immunity that have protected young adults against severe disease. None of the developed COVID vaccines have achieved the ideal of elimination of the infection. But they have saved many lives.

In children, the risk from COVID is very real, even though hospitalization and deaths are lower than in adults. In children ages 1-4, COVID is the fifth leading cause of death. One source that looked at the period from January 2020 through May 2022 said 202 kids in this age group died from COVID. Another source quoted 480 kids dead from COVID. That’s more deaths per year than hepatitis, meningitis, rotavirus, and other common infectious diseases each caused before routine vaccinations for them were recommended. And the risk wasn’t limited to any particular group. More than half of the youngsters hospitalized due to COVID had no underlying conditions.

These vaccines have proven to be some of the safest of any for adults. In the preliminary studies in this age group the adverse reactions/side effects were mostly mild and short lived, much like those in adults, and similar to those from other vaccines. The main one was pain and redness or tenderness at the injection site. There might be some irritability, fatigue, or sleepiness, loss of appetite, headache, abdominal pain or discomfort, mild diarrhea, vomiting. But everyone got better quickly! Fevers were uncommon and mild in the participants. Those can be treated with acetaminophen.

A pediatric infectious disease specialist at Children’s Hospital, Denver, Colo., said it’s important to keep in mind that COVID-19 is now one of the vaccine-preventable diseases with the highest mortality rate. Hospitalization rates for children with COVID were five times higher during the recent wave than the worst previous points of the pandemic. Katherine Poehling, director of pediatric population health at Wake forest School of Medicine, said, “I am struck by these numbers. I’m also concerned there’s a real underappreciation of the potential severity.” FDA commissioner Robert Califf said, “Any death of a child is tragic, and should be prevented if possible.”

It’s a guarantee that, if a respiratory germ gets into a home, it gets into everyone living there. It may not take hold in each individual to create what we call disease for a host of reasons, but the microbe made the rounds, positive test or not. That includes every kid kissing you or sharing food with you.

The COVID variants currently crawling down our craws are killing fewer Americans daily than during any other period except the summer of 2021. But the country is now recording 10 times as many cases as it was at that time, indicating that a smaller number of cases are causing deaths. But COVID is still killing an average of 314 people a day. These darling little Petri (not “peach tree”) dishes we parents and grandparents love to hug and kiss can be vectors of so many viruses. The vaccines are a tool to help prevent that spread and contagion. It’s an incomplete tool, but it’s part of a larger effort to stop infections, along with hand washing, etc.

Maybe you could liken it to a fork among our eating utensils. We could eat most everything on the plate with that fork, but a knife and spoon sure help us to divide and down the delectables we can’t spear. The vaccines are essentially safe and a valuable tool. One preventable child’s death is one too many. Get your tot shot!

Dr. Bures, a semi-retired dermatologist, since 1978 has worked Winona, La Crosse, Viroqua and Red Wing. He also plays clarinet in the Winona Municipal Band and a couple dixieland groups. And he does enjoy a good pun.

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Moderna COVID-19 shots now an option for older kids in U.S. – CGTN

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A vial of the Moderna COVID-19 vaccine for children six months through five years old is seen, June 21, 2022. /AP

A vial of the Moderna COVID-19 vaccine for children six months through five years old is seen, June 21, 2022. /AP

There is now a second COVID-19 option for kids aged six to 17 in the U.S. 

The U.S. Centers for Disease Control and Prevention (CDC) on Friday announced it is recommending Moderna shots as an option for school-age kids and teens. This group has been able to get shots made by Pfizer since last year.

CDC sets the federal government’s vaccine guidance for U.S. doctors and their patients. 

Last week, the Food and Drug Administration authorized the shots – full-strength doses for children ages 12 to 17 and half-strength for those six to 11. The doses are to be given about a month apart. An expert advisory panel this week voted unanimously to recommend that CDC endorse the Moderna shots, too. 

Moderna officials have said they expect to later offer a booster to all kids aged six to 17.

Source(s): AP

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