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Ontario considers further expanding pharmacists’ scope to include more minor ailments

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TORONTO – Ontario is proposing to further expand pharmacists’ scope of practice by adding to the list of minor ailments they can assess, allowing them to administer more vaccines and order some lab tests.

But while pharmacists see the proposal as an overdue solution to easing the burden on other aspects of the health-care system by leaning more on their professional expertise, doctors are raising concerns.

The government in early 2023 granted pharmacists the ability to assess and treat 13 minor ailments, including pink eye, hemorrhoids and urinary tract infections. In the fall of that year six more were added to the list, including acne, canker sores and yeast infections.

Now, the government is proposing to expand the list to include sore throat, calluses and corns, mild headaches, shingles, minor sleep disorders, fungal nail infections, swimmers’ ear, head lice, nasal congestion, dandruff, ringworm, jock itch, warts and dry eye.

As well, the Ministry of Health is looking for feedback on what lab tests and point-of-care tests might be required for pharmacists to order and perform as part of assessing and treating those conditions.

The government is also considering funding pharmacists to administer tetanus, diphtheria, pertussis, pneumococcal, shingles and RSV vaccines for adults, in addition to COVID-19 and flu vaccines. The province is proposing to allow pharmacy technicians to administer the same vaccines as pharmacists.

“Our government is focused on improving access to care in communities across the province and we have seen the success of our minor ailment program, connecting over 1 million people to treatment for minor ailments,” Hannah Jensen, a spokesperson for Health Minister Sylvia Jones, wrote in a statement.

Justin Bates, CEO of the Ontario Pharmacists Association, said the minor ailments program has been going well so far, and further expanding pharmacists’ scope can help avoid visits to family doctors and emergency rooms.

“We want to build health-care capacity through looking at pharmacies as a health-care hub and the pharmacists’ trusted relationship with their patients and to leverage that, because they are underutilized when it comes to what scope they can do,” he said.

But doctors are pushing back on the scope expansions.

“The bottom line here is that pharmacists are not doctors,” said Dr. Dominik Nowak, president of the Ontario Medical Association. “Doctors are trained for years and thousands of hours to diagnose and treat conditions.”

Nowak said that sometimes the symptoms that would seem to suggest one of those minor ailments are really a sign of a more serious condition, and it takes a doctor to recognize that.

“When I look at a lot of the minor ailments list, I think to myself, there’s nothing minor about many of these,” Nowak said.

“Many of these ailments rely on the patient … one, knowing the diagnosis themselves, so the patient’s own opinion. And last I heard, most of my patients haven’t been to medical school. And then two: it also relies on the patient’s own opinion about whether this is something minor or something serious.”

Bates said he has been “disappointed” at some of the messaging from doctors, and added that any notion that there is an increased risk to patient safety is “misinformation.”

“I want to support OMA and primary care, and I do – in hiring more doctors, solving some of their issues – but it shouldn’t come at the expense of other health professions gaining their … appropriate scope of practice,” he said.

“So it’s not a zero sum game here. We want to have physicians be comfortable with this, but … the way that some of these doctors are responding, it’s almost like hysteria.”

The government’s proposal on its regulatory registry is open for comment until Oct. 20.

This report by The Canadian Press was first published Sept. 16, 2024.

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Canadiens’ Matheson exits in loss to Kings, Hutson logs big minutes

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MONTREAL – The Montreal Canadiens fell 4-1 to the Los Angeles Kings on Thursday. They also lost their top minute-muncher in the process.

Matheson logged 7:35 in ice time during the first period but did not return for the second because of an upper-body injury. When or how Matheson sustained the injury was not clear. The Canadiens said he would be re-evaluated on Friday.

The game was tied at 1 before he exited, forcing the Canadiens to play with five defencemen for 40 minutes.

“Mike is one of the biggest parts of our D core, and I think losing him — he’s playing against top line, playing power play and we want him on the ice — definitely losing him was a big loss,” teammate David Savard said. “We got to figure out a way to get the two points, even if a player goes out.”

The 30-year-old Matheson of Pointe-Claire, Que., led all Canadiens defencemen with 62 points and a 25:33 average ice time last season.

With his absence, rookie sensation Lane Hutson played a whopping 30:05 in only his seventh NHL game. The next closest player? Kaiden Guhle at 23:09.

Head coach Martin St. Louis was impressed with how the 20-year-old Hutson handled the challenge.

“Lane doesn’t take a shift off,” head coach Martin St. Louis said. “I love the consistency of his compete level, and he drives possession. For a guy who played 30 minutes, I think he gave everything he could to try and help the team.

“I’m not surprised. I know it’s challenging at this level, losing Mike definitely made him play many minutes, chasing the game made him play many minutes, but I just love his compete level.”

Canadiens fans have been clamouring for Hutson — a five-foot-nine, 162-pound defenceman with world-class skill — to take Matheson’s spot on the No. 1 power play.

The Canadiens, however, went 0-for-3 with Hutson running the show after Matheson went down. In the first instance, Kirby Dach took a hooking penalty early in the man-advantage to end it. On the second, the Canadiens failed to generate any zone time.

The third came in the final minutes, but the Kings buried an empty-netter.

“It wasn’t a lack of opportunity, lots of ice time, lots of shifts,” Hutson said. “It was good, it was fun, but obviously you want to be on the other side of it, winning.

“Means a lot (to get that opportunity), but obviously, you want to get more out of that opportunity. It’s a lot of ice, and you want to keep taking steps in the right direction.”

‘IMMATURE EFFORT’

The Canadiens fell to a Kings team that had lost three straight games and was coming off a 6-2 loss to the Toronto Maple Leafs on Wednesday night.

Under those circumstances, the Canadiens were brutally honest with themselves after the game.

“Definitely disappointed,” captain Nick Suzuki said. “It was an immature effort from us, especially with them playing yesterday and getting in late, so I think we gave them too much life, and let them feel comfortable in the game. It’s on us to be a lot better than that.”

Before the game, St. Louis stressed the need for a good first period against a fatigued Los Angeles side. That’s not what he saw Thursday night.

“I think we had 14 turnovers in the first period. It’s unacceptable. It gives them life,” he said. “Then you’re chasing the game for the second half of it — we didn’t play to our standard.

“I’m really disappointed. Really disappointed.”

BIG SAVE DAVE

Kings goalie David Rittich played his second game in two nights — an unusual occurrence in this day and age of the NHL. He made 25 saves after allowing four goals on 14 shots in Toronto.

“We always believe in him anyway, but he performed today pretty well and bounced back,” defenceman Vladislav Gavrikov said. “It’s probably like most important for himself, that’s huge, and for the team. He played outstanding today.”

LONG ROAD

The Kings are opening the season on a seven-game road trip because of renovations at Crypto.com Arena. They’ve collected six of a possible 10 points so far.

“Pretty much worse (than expected),” forward Phillip Danault said. “We’ve been on the road for three weeks … It’s good team-bonding, whether we should do it again I’m not sure, but it has turned out well let’s say with six points out of 10.”

This report by The Canadian Press was first published Oct. 17, 2024.



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Police watchdog investigating after bodies of mother, son found in Montreal vehicle

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MONTREAL – Quebec’s police watchdog says it has opened an investigation after the bodies of a mother and her son, both of whom went missing earlier this week, were discovered in a vehicle in Montreal.

Montreal police confirmed Thursday that the bodies of Lucia Giovanna Arcuri, 76, and Giuseppe Arcuri, 59, were found earlier in the day in an Infiniti SUV belonging to the man. They had been reported missing on Tuesday.

Since Montreal police were looking into their disappearance, the province’s police watchdog — Bureau des enquêtes indépendantes — has opened a file into how police conducted their investigation. The watchdog is mandated to investigate cases in which people die or are injured during interventions by Quebec police.

Montreal Const. Véronique Dubuc says the watchdog will investigate the work of city police, and provincial police will investigate the two deaths.

First responders were called at around 12:30 a.m. on Thursday to the vehicle in a parking lot. Despite attempts to revive the two people inside, both were pronounced dead at the scene, and Montreal police have described the deaths as suspicious.

Arcuri and his mother lived together in the city’s St-Leonard borough.

Giuseppe Arcuri was last seen Tuesday at around 9:30 a.m. in a restaurant in eastern Montreal. “Mr. Arcuri made disturbing comments before his disappearance,” police said in a bulletin announcing their disappearance.

The last contact with Lucia Giovanna Arcuri was also Tuesday morning. She was suffering from memory loss and rarely left her home. She disappeared without her medication or the cane she needs to walk.

Later, police put out a description of Giuseppe Arcuri’s SUV, which matched the vehicle in which the two bodies were found Thursday.

This report by The Canadian Press was first published Oct. 17, 2024.

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What to know about red tide after Florida’s back-to-back hurricanes

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TALLAHASSEE, Fla. (AP) — Residents of Florida’s Gulf Coast who weathered back-to-back hurricanes now have something else to keep an eye on -– a possible plume of harmful algae in the waters off the state’s southwest coast.

Satellite imagery shows a bloom of algae extending along Florida’s western coastline near Tampa, though researchers caution that Hurricanes Helene and Milton have delayed regular sampling to confirm the findings. Federal officials say there is currently “no risk of respiratory irritation” from red tide in Florida.

Red tides occur when algae — plant-like organisms that live in salt and freshwater — grow out of control and produce harmful toxins that can kill fish and sicken people and pets.

“It’s so dense that it actually discolors the water, right? Hence the red tide name,” said Beth Stauffer, a professor of biology at the University of Louisiana at Lafayette.

According to researchers, the main species responsible for the blooms along Florida’s Gulf Coast is Karenia brevis, a single-celled organism that produces a potent neurotoxin that can be suspended in the air near beaches and make people sick when they breathe it in.

“(It) not only impacts some of the fish and manatees and some of the other marine mammals, but can impact human health through the toxin being aerosolized and hurting folks who have respiratory or autoimmune issues,” Stauffer said.

Scientists say Florida’s back-to-back hits from Hurricanes Helene and Milton could be fueling the growth of toxic algae that was already present before the storms slammed the coast.

Here’s what to know about red tide — and how hurricanes could affect it.

What is red tide?

Red tides, which scientists refer to as harmful algae blooms, occur when aquatic microorganisms grow out of control, producing toxins that can kill fish, make shellfish unsafe to eat and leave the air difficult to breathe.

Many different kinds of microorganisms cause toxic blooms in fresh and saltwater around the world, but researchers say the culprit behind southwest Florida’s cyclical blooms is a species known as Karenia brevis.

Florida typically sees red tide off the state’s southwest coast every year in late summer or early fall when warmer temperatures and wind conditions are more favorable to algae growth.

Hurricanes don’t cause red tide – but they can make it worse

Experts say there are a lot of factors that can influence a harmful algae bloom, from the availability of nutrients to wind conditions to the powerful underwater currents that help power the ocean’s food chains.

While the researchers who spoke with The Associated Press didn’t agree on whether hurricanes can disrupt a harmful algae bloom, they did say that these powerful storms can make them worse by churning up nutrient-rich water that fuels the growth of the microorganisms.

“Hurricanes do bring up deeper water in the Gulf of Mexico, which has more nutrients. They also could produce a lot of rain. You have runoff from the land, which also adds nutrients,” said Richard Stumpf, an oceanographer with the National Oceanic and Atmospheric Administration. “It tends to intensify a bloom that’s already there.”

Hurricanes can also steer blooms ashore, even pushing them hundreds of miles up the coast, according to Stumpf.

“We saw an extreme case with Katrina, which of course didn’t really affect Florida, but it was such a big storm, it actually took a bloom that was off southwest Florida and put it on the Panhandle,” he said.

What are the health concerns?

Harmful algae blooms can pose a deadly threat to aquatic animals, with some causing massive die-offs that choke beaches with rotting fish. People who breathe in the toxins may experience symptoms like coughing, shortness of breath or dizziness.

“It’s like an instant cold. Go down to the beach, start coughing just as you cross over the dune and then eyes start watering and nose running,” Stumpf said.

“Once I leave and 10 minutes later, I’m fine,” he said. “It’s so odd.”

Those with asthma or other respiratory issues may experience more serious health effects or even need medical attention. Some pets that have come into contact with harmful algae have become seriously ill or even died.

What are conditions like now?

According to a red tide monitoring map maintained by the Florida Fish and Wildlife Conservation Commission, medium and high levels of Karenia brevis concentrations were detected in some coastal locations near Pinellas County, home to St. Petersburg, between Sept. 26 and Oct. 3 – just as Hurricane Helene crashed ashore in the Big Bend region and in the week that followed.

A NOAA forecasting tool shows there is currently “no risk of respiratory irritation” from red tide algae in Florida.

Researchers say that some efforts to gather and analyze data have been delayed due to the storms.

“It looks like the hurricane actually helped facilitate what is an evolving red tide bloom along the coastline,” said Robert Weisberg, an emeritus professor of physical oceanography at the University of South Florida. “The caveat is we have not gone out to sample it yet so we don’t know exactly what’s out there.”

___ Kate Payne is a corps member for The Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.



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