Health
PHAC urges gay, bisexual men to practise safe sex as monkeypox spreads – CBC News


The Public Health Agency of Canada is urging gay and bisexual men to practise safe sex and limit the number of their sexual partners as it confronts the monkeypox outbreak.
Dr. Theresa Tam, Canada’s chief public health officer, told a news briefing Wednesday that while the “global monkeypox outbreak is of serious concern,” public health officials and governments have a “window of opportunity to contain the spread.”
So far, Tam said, the disease has been limited almost exclusively to men — 99 per cent of infected individuals in Canada are male and the median age is 36. Most of the cases reported in Canada have been among men who have sex with men, she said.
Tam said the outbreak Canada is experiencing can be stopped by employing strategies that target the right groups of people.
Those strategies, she said, could include a public awareness campaign that focuses on gay and bisexual men through community organizations, educational settings and dating apps like Grindr.
“At this time, to lower the overall risk of getting infected and spreading the monkeypox virus, PHAC recommends practising safer sex,” Tam said. “Having fewer sexual partners, particularly anonymous partners, even when they don’t have symptoms, can also reduce your risk of getting infected.”
Tam said little is known about how monkeypox spreads, how people can protect themselves and whether asymptomatic carriers can spread it to others.
“Learning from the HIV pandemic is very important, which is why engaging with communities who were impacted right at the start to find solutions will be our best weapon against the spread of this virus,” she said.
Tam said that learning more about the disease, including how to recognize its symptoms, is critical in the fight against its spread.
“We need to remain vigilant,” she said. “Front line health care professionals, if they think they are seeing patients with rashes or others potential risk factors, then get them tested.
“That’s the most important thing — remaining vigilant on the front line.”
Praney Anand, executive director of the Alliance for South Asian AIDS Prevention, praised Tam for avoiding the stigmatization of gay men that occurred during the early response to the HIV/AIDS pandemic.
Her remarks, Anand said, “are slightly more comforting than just very prescriptively saying, ‘Oh, gay men should watch out, gay men should not do this.’
“They’ve tried to strike the right balance.”
A global emergency
Last week, the chief of the World Health Organization said the monkeypox outbreak is an “extraordinary” situation that qualifies as a global emergency.
“We have an outbreak that has spread around the world rapidly through new modes of transmission about which we understand too little, and which meets the criteria in the international health regulations,” Tedros Adhanom Ghebreyesus said.
A global emergency is WHO’s highest level of alert, but the designation does not necessarily mean a disease is particularly transmissible or lethal.
Tam said there are 745 cases in Canada now — 346 cases in Quebec, 326 in Ontario, 58 in B.C., 12 in Alberta, two in Saskatchewan and one in Yukon. More than 16,000 cases have been reported worldwide; Tam said she thinks that figure is lower than the true number of cases.
The number of cases globally has increased 48 per cent over the previous week and the disease has now spread to 75 countries, PHAC said.
We have enough vaccines for now, says Tam
In Africa, where the disease has existed for decades, monkeypox mainly spreads to people from infected wild animals like rodents in limited outbreaks that typically have not crossed borders. In Europe, North America and elsewhere, monkeypox is now spreading among people who have no links to wild animals and haven’t travelled to Africa recently.
PHAC officials said that 70,000 doses of the Imvamune vaccine have been sent to the provinces and about 27,000 have been administered.
Tam said that Canada has a sufficient supply of the vaccine for now. She urged vulnerable groups, such as men who have sex with men, to get vaccinated to curb the spread.
“We need to see a greater emphasis on supporting people with monkeypox.”
Men who have sex with men are already lining up to receive the vaccine, said Michael Kwag, a policy director at the Community-Based Research Centre, a Canadian non-profit focused on health in the LGBTQ community.
“We’re already seeing members of the community step up to get the vaccine, to get more informed, to educate their sexual partners about the risks,” Kwag said.
Health
High-risk places affected by respiratory outbreaks


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A respiratory virus outbreak has been declared at Southbridge Lakehead long-term care home.
The outbreak is facility-wide at the Vickers Street home. Restrictions are in place on admissions, transfers, discharges, social activities and visitation until further notice.
There are now four active respiratory outbreaks in high-risk settings in the Thunder Bay district, including at Hogarth Riverview Manor on the first floor and 2 North and on Plaza 1 at Pioneer Ridge.
A facility-wide COVID-19 outbreak is also ongoing at the Manitouwadge Hospital.
There are no active influenza outbreaks in the district.
The Thunder Bay District Health Unit reports that emergency department visits because of respiratory-related complaints have decreased and are at seasonal levels in its catchment area and the influenza A surge overall has subsided with the peak in cases and hospitalizations having taken place in November of 2022.
COVID-19 does continue to circulate with 104 new lab-confirmed cases in the last seven days.
Hospitalization numbers are stable with 23 people in the hospital with COVID in the district, including three in intensive care units.
The health unit continues to stress the importance of precautions like getting the annual flu vaccine and latest COVID booster as well as wearing a face mask, particularly indoors and crowded places. Also, stay home when sick.





Health
WHO advisers to consider whether obesity medication should be added to Essential Medicines List


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Advisers to the World Health Organization will consider next month whether to add liraglutide, the active ingredient in certain diabetes and obesity medications, to its list of essential medicines.
The list, which is updated every two years, includes medicines “that satisfy the priority health needs of the population,” WHO says. “They are intended to be available within the context of function health systems at all times, in adequate amounts in the appropriate dosage forms, of assured quality and at prices that individuals and the community can afford.”
The list is “a guide for the development and updating of national and institutional essential medicine lists to support the procurement and supply of medicines in the public sector, medicines reimbursement schemes, medicine donations, and local medicine production.”
The WHO Expert Committee on the Selection and Use of Essential Medicines is scheduled to meet April 24-28 to discuss revisions and updates involving dozens of medications. The request to add GLP-1 receptor agonists such as liraglutide came from four researchers at US institutions including Yale University and Brigham and Women’s Hospital.
These drugs mimic the effects of an appetite-regulating hormone, GLP-1, and stimulate the release of insulin. This helps lower blood sugar and slows the passage of food through the gut. Liraglutide was developed to treat diabetes but approved in the US as a weight-loss treatment in 2014; its more potent cousin, semaglutide, has been approved for diabetes since 2017 and as an obesity treatment in 2021.
The latter use has become well-known thanks to promotions from celebrities and on social media. It’s sold under the name Ozempic for diabetes and Wegovy for weight loss. Studies suggest that semaglutide may help people lose an average of 10% to 15% of their starting weight – significantly more than with other medications. But because of this high demand, some versions of the medication have been in shortage in the US since the middle of last year.
The US patent on liraglutide is set to expire this year, and drugmaker Novo Nordisk says generic versions could be available in June 2024.
The company has not been involved in the application to WHO, it said in a statement, but “we welcome the WHO review and look forward to the readout and decision.”
“At present, there are no medications included in the [Essential Medicines List] that specifically target weight loss for the global burden of obesity,” the researchers wrote in their request to WHO. “At this time, the EML includes mineral supplements for nutritional deficiencies yet it is also described that most of the population live in ‘countries where overweight and obesity kills more people than underweight.’ “
WHO’s advisers will make recommendations on which drugs should be included in this year’s list, expected to come in September.
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“This particular drug has a certain history, but the use of it probably has not been long enough to be able to see it on the Essential Medicines List,” Dr. Francesco Blanca, WHO director for nutrition and food safety, said at a briefing Wednesday. “There’s also issues related to the cost of the treatment. At the same time, WHO is looking at the use of drugs to reduce weight excess in the context of a systematic review for guidelines for children and adolescents. So we believe that it is a work in progress, but we’ll see what the Essential Medicines List committee is going to conclude.”





Health
Some pediatric surgeries may be postponed as pediatric ICU faces strain: Shared Health


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Re-emerging levels of respiratory illness have caused increased patient numbers at the HSC Children’s pediatric intensive care unit over the last week, and some non-urgent procedures may be postponed, Shared Health says.
On Thursday morning, there were 17 pediatric patients in the intensive care unit, and a considerable number of which were already experiencing health issues that were aggravated by respiratory illness. The unit’s normal baseline is nine, Shared Health said in a Thursday media release.
The release said patient volumes at the children’s emergency department are stable but more children with flu-like symptoms have been recorded coming in over the last two weeks, going from a low of 22 in mid-March to 47 on Wednesday.
A variety of respiratory illnesses are spreading through the community and have contributed to the increased level of patients in the pediatric intensive care unit, according to Shared Health.
Meanwhile, the number of patients in the neonatal intensive care unit was at 51 on Thursday morning, which is slightly above the unit’s normal baseline capacity of 50.
Ten staff are being temporarily reassigned to the pediatric intensive care unit to deal with the increased level of patients, the release said.
Some staff are being pulled from the pediatric surgical and recovery units, which means non-urgent procedures may be postponed due to the reassignments, Shared Health said.
Families of patients impacted by the postponements will be contacted, they said, and all urgent and life-threatening surgeries will go unhindered.
Families can protect their children from respiratory illnesses by limiting their contact with people exhibiting cold-like symptoms, washing their hands frequently and staying up to date on vaccinations, Shared Health said.
Patient volumes increased last month
While overall wait times at emergency and urgent care centres were stable in February, Shared Health said daily patient volumes in the province went up.
The daily average of patients seeking care was 750 last month, which is an increase from 730.4 in January, according to a separate Thursday news release.
The average length of stay for patients in emergency or urgent care units to be transferred to an inpatient unit went down to 21.77 hours last month, which is an improvement from 22.5 hours in January, the release said.
The overall number of people who left without being seen went down last month, from 13 per cent in January to 12.1 per cent in February, according to Shared Health. It also decreased at the HSC emergency department, from 25 per cent in January to 23.4 per cent last month.
Shared Health is reminding Manitobans to continue to call 911 in case of an emergency, and said the sickest and most injured patients will remain their priority.





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