The number of people who died from opioids in Canada increased by 592 per cent between 2000 and 2017, a new University of Waterloo study indicates.
Using data from the Public Health Agency of Canada (PHAC), researchers in the university’s school of pharmacy found there were 20 opioid deaths per million people in 2000. That rose to 118.3 deaths per million people in 2017.
The study was published online on June 25 in Addiction, the journal for the Society for the Study of Addiction.
“After 2015 … things exploded. So we had huge increases between 2015 and 2017,” Wasem Alsabbagh, a pharmacy professor and lead author of the study, said in an interview. “But before that, it was happening gradually and we did not [pay] a lot of attention to it.”
Alsabbagh said other studies have looked at media stories on the opioid epidemic, but it wasn’t really reported on before 2013.
“We were not seeing how many people were dying increasingly in all Canadian provinces over the years from 2000 to 2013,” he said.
“This just did not make it to the headlines unfortunately.”
Hospitalizations rose ‘significantly’
The researchers said it was important to look at data from 2000 because assessments on opioid-related deaths, hospitalizations and emergency department visits in Canada “have relied mainly on provincial databases, while national assessments generally do not provide information before 2016.”
Hospitalizations rose “significantly” between 2000 and 2012, from 159.7 opioid hospitalizations per million people in 2000 to 325.3 hospitalizations in 2012, the study indicates.
Visits to the emergency department also rose by 188 per cent, from 280.6 per million people in 2000 to 810.1 in 2012. Alsabbagh said the researchers are still waiting for updated numbers for post-2012 hospitalizations and emergency department visits.
Increased overdoses and deaths
Suspected opioid overdoses and deaths remain high across the country.
In Waterloo region, paramedics said they responded to 39 overdoses from June 27 to July 3, 2021, with 11 of those calls on July 2. As of June 4, the region had reported 49 suspected opioid-related deaths.
On Tuesday, the Wellington Guelph Drug Strategy reported three deaths in the past month were suspected to be from opioid overdoses, and there had been seven suspected overdoses in the previous five days.
A news release from the drug strategy pointed to red fentanyl, which is “believed to be especially toxic.”
In B.C., on average, six people die each day of opioid use, and the province is on track to record more than 2,000 deaths this year. They include a 12-year-old girl from Vancouver Island who died in April. Her family said her death happened during her fourth overdose.
The pandemic may also be playing a big role in increased opioid overdoses and deaths. A national report last October found the overall health of Canadians deteriorated during the first eight months of the pandemic and showed more people turned to drugs, alcohol, tobacco and screen time rather than physical exercise to cope with the stress.
In the report, front-line workers told PHAC that social restrictions led to people using opioids alone, “decreasing the chance of intervention if they overdose and contributing to the increase in overdose-related fatalities.”
CBC Kitchener-Waterloo reached out to federal Health Minister Patty Hajdu for comment on the University of Waterloo study, and asked what the government would do to address the opioid epidemic, but did not receive a response.
In April, Hajdu announced $1.7 million in funding for projects led by Community Addictions Peer Support Association and Moms Stop the Harm to help them combat stigma related to substance use to help people impacted by a family member living with an addiction.
In May, Hajdu also announced funding to expand the safe supply program in Guelph.
“We have to do more to reach those most at risk,” Hajdu said in a news release about the Guelph safe supply program.
Alsabbagh said the researchers also noted that between 2000 and 2011, the number of people dying for any reason in the year after they were discharged from the hospital for treatment for an opioid-related reason rose from 3.9 per cent to 7.4 per cent.
He said this shows there’s a need for support for people who survive opioid-related hospitalizations.
“What is happening to those people, we don’t know exactly, but we know that we should offer them more care, more support, more linkage to programs to help them with the opioid-use disorder.”
It’s a complex issue, he noted, with many medical and social aspects to it, so there needs to be a multi-disciplinary team that works together to help the person. That can include pharmacists who can work with patients and the people prescribing medications, to ensure opioids are only prescribed when necessary, Alsabbagh said.
He added the opioid epidemic doesn’t just hurt the individual — it can hurt the community.
“No one is immune to the opioid epidemic. We tend to think this only happens to marginalized people … well, it is happening everywhere.”
Delta variant spreads 'like wildfire' as doctors study whether it makes patients sicker – CP24 Toronto's Breaking News
LOS ANGELES, Aug 2 (Reuters) – With a new wave of COVID-19 infections fueled by the Delta variant striking countries worldwide, disease experts are scrambling to learn whether the latest version of coronavirus is making people – mainly the unvaccinated – sicker than before.
The U.S. Centers for Disease Control and Prevention warned that Delta, first identified in India and now dominant worldwide, is “likely more severe” than earlier versions of the virus, according to an internal report made public on Friday.
The agency cited research in Canada, Singapore and Scotland showing that people infected with the Delta variant were more likely to be hospitalized than patients earlier in the pandemic.
In interviews with Reuters, disease experts said the three papers suggest a greater risk from the variant, but the study populations are limited and the findings have not yet been reviewed by outside experts. Doctors treating patients infected with Delta described a more rapid onset of COVID-19 symptoms, and in many regions an overall increase serious cases.
But the experts said more work is needed to compare outcomes among larger numbers of individuals in epidemiologic studies to sort out whether one variant causes more severe disease than another.
“It’s difficult to pin down increase in severity and population bias,” said Lawrence Young, a virologist at the UK’s Warwick Medical School.
In addition, it is likely that the extraordinary rate of Delta transmission is also contributing to a greater number of severe cases arriving at hospitals, the experts said.
Delta is as contagious as chickenpox and far more contagious than the common cold or flu, according to the CDC report.
Shane Crotty, a virologist at the La Jolla Institute for Immunology in San Diego, said the clearest indication that the variant may cause more severe disease comes from the Scotland study, which found that Delta roughly doubled the risk of hospitalization compared to an earlier version.
The majority of hospitalizations and deaths from coronavirus in the United States are occurring in people who have not been vaccinated. But there is evidence that the shots are less effective in people with compromised immune systems, including the elderly.
For vaccinated, otherwise healthy individuals, the odds are that if they contract COVID-19 they will only experience asymptomatic or mild disease, said Dr. Gregory Poland, infectious disease expert at the Mayo Clinic.
“But they can pass it on to family members and others who may not be so lucky,” Poland said. “We have to be vaccinated and masked or we will, for the fourth time now, endure another surge and out of that will come worse variants.”
The rate of severe illness, especially in regions where vaccination rates are low, is again straining healthcare workers on the front lines of the pandemic.
“This is like a wildfire, this is not a smoldering campfire. It is full-on flames right now,” said Dr. Michelle Barron, senior medical director of infection prevention and control at Colorado’s UCHealth.
Research from China suggesting that the Delta variant replicates much faster and generates 1,000 times more virus in the body compared to the original strain highlights the biggest danger of this new wave, Barron said.
“It is hard to tell if they are more sick because of the Delta variant or if they would have been more sick anyway,” she said.
Other doctors said patients infected with Delta appear to become ill more quickly, and in some cases with more severe symptoms, than those they treated earlier in the pandemic.
“We are seeing more patients requiring oxygen sooner,” said Dr. Benjamin Barlow, chief medical officer at American Family Care, a 28-state chain of urgent care clinics.
At his clinic in Birmingham, Alabama, Barlow said that around 20% of patients are testing positive for COVID-19, compared with 2-3% a few weeks ago. Patients are assessed at that time for potential hospital admission and oxygen support.
David Montefiori, director of the Laboratory for AIDS Vaccine Research and Development at Duke University Medical Center, said the Delta variant is more infectious and leads to faster onset of illness – particularly for the unvaccinated.
“Frankly there’s a severity that comes from this variant that is a little more severe,” Montefiori said on a webcast last week. “It’s not just easier to transmit, it makes you sicker.” (Reporting by Deena Beasley in Los Angeles, Josephine Mason in London and Julie Steenhuysen in Chicago; Editing by Michele Gershberg and Daniel Wallis)
Calgary councillor pushing for emergency council meeting on COVID-19 data – Globalnews.ca
With Alberta’s health measures set to be scaled back in two weeks, a Calgary city councillor wants her colleagues to step up to look into what options the City of Calgary has in terms of its own health measures.
Testing and isolation requirements implemented by the province during the COVID-19 pandemic are among the health protocols being lifted on Aug. 16.
“That data is essential. That data is all we have,” University of Calgary developmental biologist Dr. Gosia Gasperowicz said.
“If we know how fast the virus is growing, we know how fast we should react.”
Speaking at a fourth-straight day of protests against the public health changes outside McDougall Centre in Calgary, Ward 3 councillor and mayoral candidate Jyoti Gondek said she’d like to see the city take action on COVID-19 data collection and to look at other options.
“We’re not doctors but we are in fact able to understand what the evidence and the data is telling us,” Gondek said.
“To deny the public, and to deny policymakers access to the data is a big mistake.”
In lieu of COVID-19 testing data, Gondek is calling on the city to begin daily updates through Calgary’s emergency management agency to share data through the University of Calgary’s wastewater sample testing.
The sampling and testing of wastewater began in July 2020, and researchers said the samples can detect areas with a rise in COVID-19 cases faster than provincial testing could.
“That data is awesome information — it’s probably the earliest signal that something is going wrong — so we absolutely should use it,” Gasperowicz said. “Because we’ll know not only if something is going bad in Calgary, we’ll know even where it is because you can trace where the wastewater comes from.”
Rally organizer and emergency room physician Dr. Joe Vipond said the wastewater data is helpful with providing broad data, but isn’t able to provide specific data to pinpoint exactly where there are outbreaks of the virus.
“It does not identify outbreaks,” Vipond said. “You can look at quadrants of the city and how bad it is in different areas of the city, but you can’t say Western Canada High School has an outbreak, that the Agape Hospice has an outbreak, that the McDonald’s on 4 Street has an outbreak.”
If cases continue to rise, Gondek said she will call on Mayor Naheed Nenshi to call an emergency meeting of council to discuss re-establishing some public health measures.
Masks are still required on public transit, in taxis and rideshare vehicles, but those requirements will also be lifted on Aug. 16.
Nenshi said he isn’t recommending bringing back the mask bylaw but would recall council over councillors’ August break to discuss the issue if cases dramatically rise.
“We have the power to continue requesting people to wear masks on transit. We regulate the taxi industry so we have the power to do that,” Nenshi told Global News on Friday. “But if there is a point that I need to recall council from their summer vacation because we have to put back the masking bylaw because we’re looking at an outbreak, I won’t hesitate to do that.”
Other councillors are also in favour of reinstituting some measures, including Ward 7 councillor Druh Farrell, who tweeted that she would would support reinstating the mask bylaw.
“I also support reinstating the mask bylaw,” Ward 9 councillor Gian-Carlo Carra tweeted. “Unfortunately, we will need to wait for the numbers to get worse before we’ll have the political support on (city council) to get it over the line.”
Meanwhile, Ward 13 councillor Diane Colley-Urquhart tweeted that she would be opposed to bringing back the mask bylaw, and added that it wouldn’t be enforcible.
Mayoral candidate and Ward 6 councillor Jeff Davison also took to social media to weigh in on the province’s decision to scale back measures.
“Are we really about to become the first place in the world to abandon test-trace-isolate practices?” Davison tweeted Monday. “Getting the world to take us seriously is hard enough — I worry this policy by the province is about to do us irreparable harm.”
City council is currently on summer break until September.
Duane Bratt, a political scientist at Mount Royal University, said due to the lack of power the city has in terms of health measures, the Oct. 18 municipal election should be noted when analyzing what council decides to do with health measures.
“When we look at the COVID restrictions that the city has the capacity to do, they can’t be viewed independently of that ongoing election,” he said.
© 2021 Global News, a division of Corus Entertainment Inc.
Spahn wants to offer supplementary vaccinations – The Germany Eye
Federal Health Minister Jens Spahn (CDU) wants to enable booster vaccinations for groups particularly at risk from the coronavirus from September onwards. In addition, all those who have been fully vaccinated and have received vaccines from Astra Zeneca or Johnson&Johnson in recent months will also be able to receive a booster with an mRNA vaccine from Biontech or Moderna from September. This is provided for in a draft resolution of the Federal Ministry of Health for the conference with the health ministers of the states, which will take place this Monday. The paper has been made available to the South German Newspaper.
Study results indicated “that there may be an increased incidence of a reduced or rapidly declining immune response in certain groups of people after a full COVID-19 vaccination,” the health ministry’s draft states. This applies in particular to the group of relevantly immunocompromised patients as well as the very elderly and those in need of long-term care. For this reason, the states are to send mobile teams to nursing homes, institutions providing integration assistance and other facilities with so-called vulnerable groups. For vulnerable persons still living at home, family physicians should offer appropriate vaccinations.
The health ministers also want to pass a resolution on the vaccination of adolescents between the ages of 12 and 17. This issue has recently been the subject of intense debate between politicians and the Standing Commission on Vaccination (Stiko). It is true that the mRNA vaccines from Biontech and Moderna have now been approved in the European Union for this age group. However, the Stiko has so far refused to issue a general recommendation for immunization of adolescents aged 12 years and older due to insufficient data. Recently, Health Minister Jens Spahn and Bavaria’s Minister-President Markus Söder (CSU) had clashed with the Stiko because they feared an unnecessary delay in the vaccination campaign. The Stiko, in turn, had defended itself against political pressure.
In the draft resolution for the conference with the states, the Ministry of Health now refrains from making a clear recommendation for the vaccination of adolescents and thus opposes the Stiko. Instead, it simply states, “All states will now offer vaccinations for 12- to 17-year-olds at vaccination centers.” Medical information, as well as a necessary agreement of the custodial parents, would be ensured thereby. In addition, children and adolescents could also be vaccinated by pediatricians and family doctors in private practice, as well as by company physicians.
Anyway, the inoculations of young people come in the meantime apparently well forward. As Spahn announced on Twitter over the weekend, 900,000 of the 4.5 million young people in this age group, i.e. around 20 percent, have already received at least one initial vaccination since the Biontech vaccine was released for young people exactly two months ago.New entry regulations have also been in place at German borders since Sunday. Drivers and train passengers must now also show proof of vaccination or testing. However, these are only checked on a random basis.
Image by Gerd Altmann
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