Canada’s health minister is calling on the Alberta government to reconsider the closure of its injectable opioid agonist treatment program, which Premier Jason Kenney says will end in the spring when the province stops funding it.
The service provides patients with severe opioid use disorder, a recognized condition, with injections of pharmaceutical-grade heroin, known as diacetylmorphine, or hydromorphone.
“We are disappointed by this decision from the Alberta government, and we urge them to reconsider,” a spokesperson for Patty Hajdu said.
The health minister’s call comes one week after a group of patients benefiting from Alberta’s injectable opioid agonist treatment (iOAT) pilot program filed a lawsuit seeking an injunction to stop Alberta’s provincial government from ending it.
If the three Alberta clinics that offer the treatment close, few people east of British Columbia would have access to the program, which is a cornerstone of the federal government’s latest strategy to combat the opioid crisis.
“Many people are struggling with substance use, and in too many communities, the COVID-19 pandemic is compounding this ongoing public health crisis,” the minister’s statement said.
From January 2016 to March of this year 16,364 Canadians died from opioid overdoses according to figures from the federal government. The numbers have shown an increasing trajectory, with 3,799 deaths last year, and over 1,000 in the first three months of 2020.
The federal government began opening the door to community-based iOAT treatments in 2018 and has provided funding for pilot projects.
The move followed decades of research — first in Europe, then in British Columbia. Multiple studies suggested that providing daily access to pharmaceutical grade injectable opioids allowed long-term chronic users to stabilize their lives, find homes and stop engaging in criminal activity many relied on to support their addictions. Most stuck with the program long term, and some were able to stop using injection drugs altogether.
Alberta’s previous NDP government launched the pilot program in late 2017. Premier Jason Kenney is giving the 60 patients currently enrolled one year to transition to other programs that do not involve injecting opioids. He has called the federal government’s approach “facilitating addiction.”
“Handing out free narcotics to addicts is not compassion,” the premier said in response to questions from CBC News in September.
Patients file lawsuit to keep Alberta program operating
Patients enrolled in the program have have filed 11 affidavits in a lawsuit that is attempting to put a human face on the treatment. People who had focused their entire lives on the pursuit of drugs described awakening to a new world free of the stress and danger on the streets.
Among them a once nationally ranked swimmer. Taylor Maxey began taking opioids following an injury in his late teens. He was soon homeless, panhandling on the streets and committing petty crimes.
Maxey’s drug habit was costing $900 a day. He watched friends die around him. He attempted suicide. He tried and failed multiple treatment programs.
Today, at the age of 32, he says in an affidavit that he has stable housing, a new network of supportive friends, and hopes of becoming an outreach worker. Instead of hustling for street drugs, he is injected with opioids at the Calgary clinic slated to close in the spring.
Maxey is terrified of what will happen.
“My life would be shorter and much harsher if I returned to the streets and were denied access to iOAT,” he says in an affidavit. “I would be subject to the violence of the streets and the unsafe and precarious world of opioid use. I would be exposed to unsafe supplies of opioids.”
The Alberta government has not filed a statement of defence in the case. The injunction application will be heard in November.
What the research shows
Beyond personal testimonials, iOAT is supported by a range of clinical research that began in Switzerland in the 1990s. on what was then known as heroin assisted treatment, or HAT. A two-year study of 1,000 people across several centres in Switzerland found “substantial improvements for illicit heroin use, health status and crime among HAT patients,” according to a published review of the evidence. It also found a positive cost-benefit ratio because those provided with drugs had fewer medical issues and committed less crime.
A groundbreaking study published in 2009 in the New England Journal of Medicine concluded heroin-assisted treatment was safe and effective. Researchers followed 251 people in Vancouver and Montreal over 12 to 15 months. They found 88 per cent of patients receiving heroin stayed with the program, and among them, there was a 67 per cent decrease in criminal behaviour.
Overdoses and seizures were the most common adverse events recorded, though the study noted that since the patients were under close medical supervision, the overdoses were treated and the patients recovered.
As fentanyl and carfentanil have increasingly tainted the illicit drug supply, creating an overdose crisis, the provision of pharmaceutical heroin has increasingly been seen as a potential solution.
In 2019, the federal government formalized regulations, and the Canadian Research Initiative on Substance Misuse added clinical practice guidelines. At the time, Theresa Tam, Canada’s chief public health officer, said expanding the availability of pharmaceutical-grade heroin “will save lives.”
Availability limited as overdose deaths increase
But in spite of expectations the therapy would expand across Canada, it remains limited to a handful of sites in B.C., mostly in Vancouver. If the Alberta program shuts down, the only other places in Canada offering it will be Ottawa’s Managed Opioid Program, which treats a maximum of 25 people in a residential setting, and a newly opened program in Fredericton, which currently serves seven patients.
Rob Boyd, the program director of another Ottawa treatment centre, would like to offer iOAT but says he can’t, because the drugs are not adequately covered by Ontario’s health plan.
“Lots of places want to do it,” he said. “We would fill up right away.”
As overdose deaths increase — there have been more than 1,000 in British Columbia alone this year — Canada’s health minister is urging provinces and regulatory bodies to adopt the treatment.
“Do all you can to help provide people who use drugs a full spectrum of options for accessing medication,” she wrote in a letter to her provincial counterparts and regulatory bodies on Aug. 24.
“We need immediate action from all levels of government and health care practitioners to prevent further deaths from the contaminated illegal drug supply and COVID-19.”
Source: – CBC.ca
The latest news on COVID-19 developments in Canada – moosejawtoday.com
The latest news on COVID-19 developments in Canada (all times Eastern):
British Columbia’s top doctor is cracking down on the spread of COVID-19 with a new public health order that restricts gatherings in private homes to a maximum of six guests.
The so-called “safe six” rule came as provincial health officer Dr. Bonnie Henry reported the highest-ever three-day jump in infections in B.C. with 817 cases confirmed between Friday and Monday.
Henry is also upping what she called her “expectation” that people wear non-medical masks or face coverings in public spaces at all times, though it’s not an order.
She says two schools have been closed temporarily after cases of COVID-19 were detected and there is a new community outbreak associated with the Surrey Pretrial Services Centre.
Alberta is imposing a mandatory 15-person limit on social gatherings in Edmonton and Calgary.
Voluntary measures are also being recommended in the two cities, with people being advised to wear masks at work and limiting their circles to three cohorts.
Dr. Deena Hinshaw, the province’s chief medical health officer, says the warning bell is ringing.
She says she’s concerned about increasing case numbers.
The province is reporting 1,440 cases over the last three days.
Quebec is extending its partial lockdown order for another four weeks.
Premier Francois Legault told a news conference today that the rates of new, daily COVID-19 cases and deaths linked to the virus are too high.
Legault said gyms, bars and most entertainment venues will remain closed until Nov. 23 in the province’s biggest cities.
The premier said businesses that refuse to obey lockdown orders will be fined.
Nova Scotia public health officials are warning passengers on an Air Canada flight from Toronto to Halifax of a potential exposure to COVID-19.
Air Canada Flight 626 on Oct. 24 left Toronto at 9:30 p.m. and landed in Halifax at 12:15 a.m. on Oct. 25.
Officials are asking passengers who sat in rows 18 to 24 and in seats A, B and C to call 811 for advice and to continue to self-isolate.
Officials say anyone exposed to the virus on this flight may develop symptoms up to and including Nov. 7.
New Brunswick is reporting three new cases of COVID-19 and 60 active cases overall.
Two of the new cases are in the Fredericton region and one is in the Campbellton region, where public health officials are battling an ongoing outbreak.
Officials say the two cases in the Fredericton region are travel-related, and the case in Campbellton is under investigation.
New Brunswick has had 331 confirmed COVID-19 cases since the onset of the pandemic, including six deaths.
Health officials have announced a woman in her 80s is the latest death connected to Manitoba’s deadliest outbreak at a care home.
Eighteen people at Parkview Place in Winnipeg have died.
There were 100 new infections announced Monday, the vast majority in the capital city, which is under enhanced restrictions after a stark increase in infections during recent months.
Dr. Brent Roussin, the chief provincial public health officer, says the increasing numbers have put pressures on the health-care system.
There are 80 people in hospital and 15 people in intensive care.
There have been 4,349 cases in Manitoba, and 2,117 are currently active.
Fifty-five people have died.
Newfoundland and Labrador is reporting one new case of COVID-19, and five active cases overall.
The new confirmed case is a woman in her 50s who returned to the province from work in Alberta.
Public health officials say she has been self-isolating and contact tracing is underway.
Newfoundland and Labrador has now had 291 cases of COVID-19 since the onset of the pandemic, including four deaths.
All of the Alberta politicians who came into contact with a provincial cabinet minister infected with COVID-19 have tested negative for the virus.
Municipal Affairs Minister Tracy Allard tested positive for COVID-19 last Wednesday.
She had interacted during the previous week with Premier Jason Kenney, Transportation Minister Ric McIver and United Conservative MLAs Angela Pitt, Peter Guthrie and Nathan Neudorf.
Kenney received his negative test result last Thursday, but has said he would continue to isolate at home for a week as a precaution.
Christine Myatt, a spokeswoman for Kenney, says the other four have also tested negative and will continue to self-isolate.
Nova Scotia is reporting one new case of COVID-19 and now has five active cases of the virus.
Health officials say the new case is in the central health zone and the person is a close contact of a previously reported travel-related case.
Nova Scotia has confirmed 1,101 COVID-19 cases and 1,031 cases are now resolved.
There have been 65 deaths since the onset of the pandemic.
Officials say an outbreak of COVID-19 at a Manitoba jail began with a guard who worked for two days before developing symptoms.
The outbreak at Headingley Correctional Centre, just west of Winnipeg, now includes 33 inmates and six staff members.
Justice officials say five staff at other facilities and one inmate at a youth correctional facility have also tested positive.
Justice Minister Cliff Cullen says the pandemic is being taken very seriously and the province has developed comprehensive plans, including instructional videos for inmates and staff, to deal with the situation.
He says inmates and guards are required to wear masks and interactions between people has been limited.
The opposition New Democrats and union leaders have been critical of the provincial response to the pandemic behind bars, saying it puts inmates and guards at risk.
Quebec is reporting 808 new COVID-19 cases and 10 additional deaths linked to the virus.
Two of those deaths were in the past 24 hours, while six were from last week and the two others were from an unknown date.
The number of hospitalizations dropped by eight from a day earlier to 543, and the number of patients in intensive care cases decreased by four to 93.
The province has now recorded 100,922 COVID-19 infections and 6,153 deaths — the highest in the country.
Ontario is reporting 851 new cases of COVID-19 today, and six new deaths due to the virus.
Health Minister Christine Elliott says 281 cases are in Toronto, 215 in Peel Region, 90 in York Region and 76 in Ottawa.
The province says it has conducted 28,652 tests since the last daily report, with an additional 17,603 being processed.
In total, 295 people are hospitalized in Ontario due to COVID-19, including 78 in intensive care.
Meanwhile, Premier Doug Ford’s office says it will not announce today whether the province will impose stricter COVID-19 restrictions on two Toronto-area regions.
Ford had said Friday that the experts would look at the caseload in Halton and Durham regions over the weekend to determine whether they need to roll back to a modified Stage 2 of the province’s pandemic recovery plan.
A coalition of about 200 Quebec gym, yoga, dance studio and martial arts business owners say they intend to reopen their doors on Thursday in defiance of provincial health restrictions.
The businesses are calling on Quebec Premier Francois Legault to lift COVID-19 restrictions that were imposed on fitness facilities Oct. 8.
In a statement, they say their facilities were not the source of COVID-19 outbreaks and they contribute to the overall physical and mental health of the population.
They say the lockdown measures will force them out of business after they’ve made significant investments to comply with health rules.
They plan to reopen across the province, but will back down if health authorities are able to demonstrate by Thursday that their operations are sources of outbreaks.
This report by The Canadian Press was first published Oct. 26, 2020.
The Canadian Press
Health unit reporting Monday's second new case of COVID-19 – Sudbury.com
Public Health Sudbury & Districts is reporting a new case of COVID-19, the second new case of the day for Oct. 26.
This is the 125th case overall that has been reported in Greater Sudbury and Manitoulin since March.
The latest case has been determined to have been in close contact with another known case of COVID-19. The person was tested on Oct. 24 and is currently self-isolating.
According to the Public Health Sudbury & Districts website, there are currently 13 known active cases in our area.
Public Health Sudbury & Districts is reminding everyone that the safest options are to avoid non-essential travel, limit indoor gatherings to your own household, and otherwise be outdoors or go virtual, practise physical distancing, masking, and handwashing, and of course, stay away if you have any symptoms.
As much as possible, Ontarians are encouraged to limit outings to essentials like going to work or school, picking up groceries, attending a medical appointment, or engaging in outdoor physical activity. For all outings, continue to practise COVID-safe behaviours like distancing and wearing a face covering.
As of October 3, 2020, the Province of Ontario is pausing social circles and advising that all Ontarians allow close contact only with people living in their own household and maintain two metres physical distancing from everyone else. Individuals who live alone may consider having close contact with another household.
In any instance where a positive case is identified in a school setting, Public Health Sudbury & Districts will work directly with the individual who tested positive, the school board, and school, and conduct timely case and contact follow up and provide direction. To protect the privacy of individuals, Public Health will not routinely identify the school if a case is confirmed in a school setting. Schools boards and schools will communicate directly with the school community in the event of a positive case in a school setting.
In the instance of a confirmed COVID-19 outbreak in a school, Public Health Sudbury & Districts will publicly report the outbreak, identify the affected school, and describe any closures that have resulted from the outbreak. An outbreak in a school will be declared if there are two or more cases of COVID-19 in a 14-day period that have some link with each other, and with evidence that infection occurred at the school.
If individuals are identified as close contacts of a case in a school setting, Public Health Sudbury & Districts will contact them or their parent or guardian directly to provide direction. If you have any questions related to individual schools, please contact the school directly.
For general information on schools and COVID-19, visit phsd.ca/health-topics-programs/diseases-infections/coronavirus/schools/ or call Public Health Sudbury & Districts at 705.522.9200 (toll-free 1.866.522.9200).
Prevent the spread of COVID-19:
- Wash your hands often and when visibly dirty for 15 seconds.
- Cover your cough or sneeze with your arm or a tissue, throw the tissue in the garbage and wash your hands.
- Avoid touching your eyes, nose, and mouth.
- Continue to practise physical distancing, because any close contact could be a possible exposure to COVID-19.
- Masks or face coverings must be worn in all indoor public places in Sudbury and districts, and they should also be worn in other settings where physical distancing cannot be maintained.
- Avoid contact with people who are sick.
- Self-monitor for symptoms of COVID-19.
- Stay home if you are unwell and get tested.
If you have a COVID-19 symptom or have been exposed to the virus as informed by Public Health or the COVID Alert app, get tested. As of September 24, 2020, the Province of Ontario has updated the eligibility and testing criteria for COVID-19 assessment centres. Stay informed and seek testing if necessary.
All residents who are planning to travel should be aware that COVID-19 is still circulating at different levels around the province. The safest options are to stay in the area of your home community or to stay in the region.
For anyone who has recently travelled, visit the Public Health Agency of Canada website for updates on COVID-19 exposures.
Anyone who has travelled outside of Canada is directed to self-isolate for 14 days from their arrival in Canada.
Updates about COVID-19 testing, confirmed cases, and outbreaks in Greater Sudbury, the District of Sudbury, and the District of Manitoulin are posted online.
Visit Ontario’s website to learn more about the province’s response to COVID-19.
Canadian Press NewsAlert: Quebec reaches more than 100,000 total cases of COVID-19 – TimminsToday
MONTREAL — Quebec reached more than 100,000 total cases of COVID-19 on Sunday, becoming the first province in Canada to hit the somber milestone since the pandemic began in March.
But despite remaining the country’s coronavirus epicentre, public health experts say a recent downward trend of infections is an encouraging sign.
“It’s a moment where we all sit up and say wow, 100,000 – that’s a lot of zeroes,” said Erin Strumpf, an associate professor at McGill University specialized in health economics.
“But again I think the more important thing to be paying attention to is the trend that we’ve been seeing recently in the province.”
The province reported 879 new cases on Sunday, bringing the total to 100,114 infections since the start of the pandemic.
The curve of new infections appears to have flattened over the past few weeks though, Strumpf said in an interview.
That downward trend, she said, coincides with stricter public health guidelines that aimed to stem the spread of the virus.
The government ordered the closure of bars and gyms, among other places, in hard-hit areas and advised residents to limit their contact with people who do not live in their households.
Montreal and Quebec City are among several Quebec regions that remain under the highest COVID-19 alert.
Strumpf said it is hard to pinpoint what exact measures are responsible for flattening the curve, however.
She added that she expects to see many public health restrictions remain in place moving forward. “It’s very difficult to know right now or to predict how long those closures may stay in place,” she said.
Still, the high COVID-19 infection numbers bring up painful memories for Quebecers who lost loved ones during the pandemic.
July Mak, whose 68-year-old father Paul contracted COVID-19 in a long-term care home in Montreal and died at the end of March, said the pain of her father’s death has not eased with time.
“To see these numbers this high… it blows my mind,” Mak said in an interview Sunday.
She said she wants the Quebec government to recognize that its COVID-19 data is more than just numbers — and thousands of people across the province have been directly affected.
“They mattered,” Mak said, about the thousands who have died.
On Sunday, Quebec Health Minister Christian Dube said on Twitter that the number of new infections is “stable but remains high.”
Those cases can turn into hospitalizations and deaths, Dube warned, urging Quebecers to remain vigilant to reduce transmission.
Quebec health officials also reported 11 additional deaths attributed to the novel coronavirus, bringing the total to 6,143.
Five of those additional deaths took place in the past 24 hours, five were reported between Oct. 18-23 and one occurred at an unspecified date.
Hospitalizations went up by two across the province, for a total of 551. Of those, 97 people were in intensive care — an increase of four compared to the previous day.
The province said it conducted 25,378 COVID-19 tests on Friday, the last date for which the testing data is available.
This report by The Canadian Press was first published Oct. 25, 2020.
Jillian Kestler-D’Amours, The Canadian Press
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