The number of confirmed cases of monkeypox in Ontario has risen by 47 per cent in the past five days, health officials say, with the bulk of cases still appearing in Toronto.
There are now 230 confirmed cases in Ontario, up from 156 on July 14, 133 on July 11, and 101 on July 6.
Public Health Ontario says all but one confirmed case are in men, and 172 of the cases confirmed so far involve residents of Toronto.
There are eight other probable cases in the province which remain under investigation.
Elsewhere in Ontario, Ottawa is now reporting 16 confirmed cases, Halton is reporting 7, Middlesex-London is reporting 9 and Hamilton is reporting 5 confirmed cases.
Nine people have required hospitalization from infection and all made full recoveries.
All cases in Ontario identified so far involved people between 69 and under 20 years of age.
The most commonly reported symptoms include rash, oral/genital lesions, swollen lymph nodes, headache, fever, chills, myalgia and fatigue.
Monkeypox typically spreads through sustained close contact between people breathing, talking, coughing or sneezing.
It can also spread through skin-to-skin contact with rashes or bodily fluids and can also remain on items such as clothing or bedsheets that have made contact with an infected person.
Symptoms can present anywhere between five to 21 days after exposure.
Infected persons can remain contagious through skin contact for up to four weeks.
Ontario is now testing anyone who shows up to a healthcare provider or emergency room with an “unexplained acute rash or lesion(s).”
Federal guidelines indicate the smallpox vaccine is most effective if administered within four days of exposure to a case, but can help if administered up to 14 days after exposure.
The City of Toronto continues to offer the Imvamune smallpox vaccine to people considered to be at high risk of exposure.
There is also a therapeutic known as TPoxx which has shown to be helpful in cases where patients suffered severe complications from infection.
The World Health Organization (WHO) now says it is aware of 13,436 confirmed cases of monkeypox in 59 countries around the world, including three deaths.
The Public Health Agency of Canada (PHAC) says it is aware of 539 cases across Canada, with most in Ontario and Quebec.
Canadian Blood Services urging people to donate as it faces collection challenges
TORONTO — Canadian Blood Services is calling on donors to book and keep appointments as it faces a decrease in collections.
The organization said Monday it currently has only four days worth of O+ blood type supply and five days worth of O- and B- blood types, along with six days worth of A- blood type and seven days worth of A+ and B+ blood types.
Spokeswoman Delphine Denis said collections have been steadily decreasing since July 1.
Denis said the blood-collecting agency closely monitors the days of the available blood supply.
“While three or four days on hand is challenging, we can turn this around with the help of new and returning donors,” she said in a statement.
“Thanks to the support of donors across the country, we are one of few blood operators around the world that has not experienced a blood crisis or issued a national appeal during the pandemic.”
She said ongoing illness and isolation requirements related to COVID-19, heat-related weather issues and the return of pre-pandemic activities and summer travel that have left many people with less time to donate are all factors contributing to the situation.
“Summer is always a challenging time for collections,” she said, adding this is the first summer since 2019 where there are few restrictions on travel and other leisure activities.
The organization said the number of people who donate blood regularly decreased by 31,000 donors during the pandemic, leaving it with the smallest donor base in a decade.
It says there are 57,000 open appointments that must be filled before the end of August across Canada.
Denis said donors from all blood groups are urged to book appointments to donate blood right away or over the next few weeks leading up to Labour Day weekend.
She said the need for blood, plasma and platelets is constant, as people such as cancer patients, accident victims and those undergoing surgery rely on transfusions every day.
This report by The Canadian Press was first published Aug. 8, 2022.
Maan Alhmidi, The Canadian Press
Northern Ontario gay community wants more vaccines, clear messaging on monkeypox – CBC.ca
Members of the gay community in northern Ontario want clearer messaging surrounding monkeypox and more vaccine access to protect against the virus.
So far, the majority of the 400 people infected in the province are gay men, but anyone can get the virus through any kind of close contact.
Across Canada, provinces and territories have reported 957 cases of monkeypox as of Aug. 5, according to the Public Health Agency of Canada (PHAC).
Only two of those cases are in northern Ontario: one each in the Sudbury-Manitoulin health district and the North Bay-Parry Sound health unit.
Ken Miller, one of the founders of the Northern Ontario Pride Network, said monkeypox is reminding many people of the 1980s AIDS crisis that was incorrectly labelled as a “gay plague.”
“There is a certain amount of hysteria that comes with it,” Miller said.
“I think there are people that are afraid and there are specifically people that are scared of the gay community over this, as well as people in the gay community afraid of getting it.”
He is pleased to see the vaccine for monkeypox being made more available in the region.
At first, you could only get immunized against the virus in areas that have had confirmed cases.
But the Thunder Bay health unit has now agreed to make the vaccine available to gay, bisexual and trans men who have multiple sexual partners or are otherwise at high risk of contracting monkeypox.
Miller would like to see the province allow anyone to get vaccinated against monkeypox and be clearer in public health messaging that anyone can contract the virus through any kind of close contact.
“Prolonged contact, right? So it’s like cuddling, I mean, even wrestling, playing sports. Yes, sexual contact and all that. But just being mindful of who they’re getting that close to and for how long,” he said.
Public Health Sudbury and Districts notes it’s “important not to stigmatize others based on sex, gender or sexual orientation as this can lead to a misunderstanding of risks.”
The health unit has given out 21 doses of the monkeypox vaccine since July 18.
Why is the Aids conference still held in the Global North? – Mail and Guardian
The world’s largest Aids gathering, the International Aids Society’s bi-annual International Aids conference, should never be held in Europe or the United States again, says Ayoade Alakija, co-chair of the African Union’s African Vaccine Delivery Alliance, an organisation set up during the Covid-19 pandemic that works towards the equitable delivery of immunisations.
Alakija was speaking in an interview on the first episode of Bhekisisa’s new television show Health Beat.
Most people with HIV live in the Global South, so that’s where the gathering of the most important new HIV research should be held, she says. The Global South is a catch-all term for low- or middle-income nations, usually in Africa, Asia, Oceania, Latin America and the Caribbean.
Researchers, who reviewed more than 20 years of global health conferences, found that 96% of such events happened in high- or middle-income countries. Fewer than four out of every 10 delegates come from poorer nations — despite the fact that the diseases discussed at such conferences are far more common in Global South countries.
This year, the Aids conference was held in Montreal, Canada, but African delegates struggled to get visas to enter the country — so much so that most of the speakers for the closing session of the conference had to participate virtually.
Even those who had the right documents battled to get to the conference.
Winnie Byanyima, who heads up the Joint United Nations Programme on HIV/Aids (UNAids), was only allowed to board her plane to Canada after airport officials made several calls and “scrutinised [her visa documents] over and over again”.
And the South African activist, Tian Johnson, spent more than R330 000 on visa applications and flights, but only got as far as the United States border before flying back home after he was blocked from boarding a plane to Montreal.
The next gathering will be held in Brisbane, Australia.
The drama is the latest in a slew of slights African researchers have faced during the Covid-19 pandemic. In 2021, for instance, South African researchers who identified the Omicron Covid-19 variant were shocked that their transparency was met swiftly with travel bans on South Africa and other African countries, but not on other nations in the Global North where the variant was already circulating.
Alakija spoke to Bhekisisa about what she sees as a dangerous double standard in the world of public health.
- Pharmaceutical company ViiV healthcare has issued a voluntary licence (so that cheaper, generic versions of the product can be made) for their two-monthly HIV prevention injection cabotegravir. It will take years for generics to be made but in the meantime they’ll sell the branded jab to 90 countries at a lower price. But history tells us that pharmaceutical companies aren’t transparent about money. What happens now?
We welcome the fact that they have caved into pressure, because really that’s what it is. It’s a caving in to pressure that reminds us why we put pressure on the health injustices of this world. But it’s also very blurry, [ViiV healthcare] said they will provide it at a [lower] price. But how affordable is that price? They’ve given a list of 90 countries that they will make the patent available to through the Medicines Patent Pool, an organisation that works with drug companies to make medicines more affordable. It’s a step in the right direction, but the basic issues around the inequities and the fact that we have to beg, scream and shout, for the right to basic healthcare is something we still need to interrogate.
- Drug companies have priced low-income countries (where they trial their medications), out before when antiretrovirals first became available. Do you think African governments should do more to negotiate with pharmaceutical companies?
I absolutely do. It’s not just about negotiating with pharmaceutical companies. I’ve called for this before when high-income countries like the UK and others shut South Africa and others out when [the] Omicron [variant] was first detected.
African governments need to understand that our lives are at stake. And it is not just about negotiating with pharmaceutical companies, but it is about using our geopolitical power in a way that we become reckoned with. At the moment the world doesn’t [take us seriously] because we’re not standing up to them. I would say that our leaders need to recognise how important they are, in terms of the wider global quality of nations. We have President [Emmanuel] Macron of France, visiting African countries, because there’s this competition for who Africa is going to lean towards.
- You speak about international relations and Africa’s bargaining power and it seems that you think fixing this inequality needs more than just negotiating with Big Pharma. What needs to change now?
It is about our wider health security, it is about our wider peace and security. It is about our wider food security. We have a problem of leadership which is why the world is taking us as people for granted. It is making it look like a life in Abuja is worth less than a life in Alberta, Canada. That shouldn’t be the case. A life in Cape Town should be worth the same as a life in Connecticut. But at the moment what the world is telling us with these drugs and the withholding of access to medicines is that our lives are not worth the same. And that is not just on pharma, that is on us. It is on our leadership. Activism will go so far but what we need is political change.
- If an African president came to you today and said, “I’m meeting a certain big pharmaceutical company.” How would you advise the president on standing up to the company?
If an African president came to me, I would say, “Mr President, I would advise you to tell these people who are refusing to purchase or refusing to support our own homegrown pharmaceutical industries that until they do that, we no longer want what you are giving to us, we will find our own procurement mechanisms”.
It is not so much what I say, it is what I do. I think our leadership needs to begin to put their foot down in those geopolitical spaces, be it at the United Nations or the various assemblies that they attend. They make a speeches, but they need to start making demands,
The charity model [of international relations] no longer works. We need global multilateral partnerships, not global charities that are mostly controlled by men from the high-income countries of the world, who tell us who must live and who must die. It is wrong.
- As you have pointed out, inequality plays out in many ways. Just last week at the Aids conference in Canada, many people from Africa couldn’t attend because of high travel costs or visas being rejected. How does that influence who the world takes seriously when it comes to global pandemics such as HIV or Covid-19?
I myself have been unable to attend that conference because of the prohibitive cost. I have friends who were denied boarding [after] having paid over $20 000 to get visas and buy tickets so that their voices could be heard. Winnie Byanyima, the executive director of UNAids, who’s from Uganda, was almost denied boarding to attend a conference, which basically is her core business in Canada, because she’s a black woman. Institutional racism is the problem.
One day we’ll have the conversation about why we are still in a pandemic, because institutional racism meant that when the director general of the World Health Organisation, who was a man from Ethiopia named Tedros Adhanom Ghebreyesus, declared that we, the world, had a problem and presidents of high-income countries refused to believe him. Therefore, the rest of the world did not take this seriously. What would’ve happened if Tedros from Ethiopia, was Ted from Colorado, would they have taken Covid-19 more seriously?
- At the 2022 Aids conference we saw a situation where people from the Global South can be locked out of conversations which are about solutions to the problems they face. How do we avoid a repeat of this?
What I am calling for is for people to stop hosting these conferences in these places. You cannot talk about us behind our backs. The majority of the burden of the disease is in our countries — largely, because you refuse to provide us access to drugs; refuse to provide us access to testing for HIV. There is no point in having these conversations behind closed doors with people from high-income countries who will again decide for us what we must do in our own countries.
It’s time that our leadership says “we are not having the conference for Aids in Canada; we’ll have these conferences in the Global South so that we can make decisions together”. It is only when this world acts together as one that we’re going to have equity and justice and true health security for the entire planet.
- Researchers from lower-income countries often help peers from richer countries to do studies on things like new medications, for example. But they don’t get the same recognition as their Global North counterparts. How do we change that?
We have to shake up this world. It’s not about being upset, because then they will call me an angry black woman. We cannot leave this world to our children. I’m the mother of a girl child who I want to not have to fight the [same battles] that I have fought as a woman. And I don’t want to have to walk into the spaces and have to keep my voice down just so that they will let me stay in the room because they must not feel threatened.
It is those institutions that have power, who will say to the likes of me, “what do you think about this?” over a phone call, when they have ten research assistants writing everything that I’ve said down, and then help them to l publish it as their own. People are still doing that, because I don’t have the time or resources.
We’re dealing with power cuts, we’re dealing with security issues, so we don’t have the time and space to reimagine this world. What we need is to reimagine the world of global health and the world of global development. We need to think about what equity looks like and have a conversation about institutional racism that says your voice has more value because you’re a man or because you’re caucasian.
Questions and answers have been edited for length and clarity.
Watch the full interview on Health Beat with Ayoade Alakija
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