Travis Kann, a spokesman for Ontario Health Minister Christine Elliott, seen here on Feb. 11, 2020, said the in-home testing plan, which is in its early stages, is designed to complement out-of-hospital coronavirus assessment centres to ‘ease the pressure on hospitals and emergency rooms.’
Frank Gunn/The Canadian Press
Canada now has nearly 100 cases of the novel coronavirus and provinces are planning to offer more in-home testing as they try to prevent patients with mild symptoms from overloading the country’s emergency departments.
COVID-19 cases continue to increase, with 15 new cases reported across Canada on Tuesday. Those include two new cases in British Columbia that have no clear link to the source of the disease and indicate exposure within the community.
B.C. and Alberta are already testing patients for the novel coronavirus at home. In Toronto, public-health nurses have been providing limited “clearance” testing in the private residences of patients diagnosed with COVID-19, the disease caused by the new virus, to see whether they’ve recovered.
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But in-home coronavirus testing is poised to expand now that Canada’s most populous province intends to offer it more widely.
Ontario’s Ministry of Health sent a memo to health-care organizations on Monday laying out some principles for containing the coronavirus, including making, “services and access to screening more accessible to patients in their homes, to reduce the spread of illness.”
Travis Kann, a spokesman for Ontario Health Minister Christine Elliott, said the in-home testing plan, which is in its early stages, is designed to complement out-of-hospital coronavirus assessment centres to “ease the pressure on hospitals and emergency rooms.”
In parts of Alberta where call volumes are lower, paramedics or public-health nurses conduct tests in people’s homes so they don’t have to visit hospitals or clinics, potentially putting other patients or health-care workers at risk, Alberta’s Chief Medical Health Officer Deena Hinshaw said Tuesday.
Edmonton and Calgary, which have higher call volumes, have set up assessment centres where people can go for testing.
Some B.C. health authorities have also dispatched public-health teams to test the close contacts of confirmed cases in their homes.
Governments and public-health officials have grown increasingly concerned that hospitals won’t have the staff, beds or equipment to care for thousands of patients if the virus sweeps across Canada the way it has across Italy, site of the deadliest outbreak outside of China.
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Air Canada announced Tuesday that it was suspending flights between Canada and Italy.
Canada’s 15 new cases reported Tuesday comprise seven each in B.C. and Alberta and one in Ontario, bringing the total recorded since January to 94.
In B.C., that included two men in the Fraser Health region – one in his 90s, and one in his 40s – who contracted the disease despite having no recent travel history and no clear links to other cases.
“It is these community cases that give us some degree of concern,” Provincial Health Officer Bonnie Henry said Tuesday. “But being able to detect them is really important, because as soon as we detect them, we can start that detailed investigation to find out where they might have come in contact. This helps us uncover where other chains of transmission are in our community.”
The new B.C. cases also include a man in his 90s who had been a passenger on the Grand Princess cruise ship, and two more health-care workers at the Lynn Valley Care Centre in North Vancouver, where an outbreak was declared last weekend and the country’s only COVID-19 death was recorded.
B.C. Health Minister Adrian Dix said the province has opened a new call centre to accommodate calls to the 811 health information line, which have recently tripled to about 3,800 calls a week.
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Testing for the new coronavirus has ramped up significantly in the past week, especially in Ontario, B.C. and Alberta, where most of Canada’s cases have been discovered.
The provinces have moved beyond testing only patients who have travelled to conducting what’s known as sentinel surveillance, largely by adding COVID-19 testing to existing influenza screening programs.
Ontario had tested 2,747 patients as of Tuesday, while Alberta had conducted tests in 1,452 cases as of Monday. B.C. had tested 2,008 people as of Friday.
“I definitely think there could be a role for home testing,” said Jerome Leis, medical director of infection prevention and control at Sunnybrook Health Sciences Centre in Toronto.
Dr. Leis also said that virtual screening and off-site coronavirus assessment centres would be necessary to preserve hospital space for the seriously ill, and to help prevent sick patients from spreading the virus to others.
Dr. Leis was one of the co-authors of a study published in the Canadian Medical Association Journal on Friday that found the vast majority of 135 patients tested for the new coronavirus in the emergency departments of eight hospitals in the Greater Toronto Area between Jan. 20 and Feb. 19 were well enough to be sent home right away.
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Only one tested positive for COVID-19.
“If [the emergency department] was our only system for caring for these patients, we could rapidly be in a very non-sustainable and frankly, unsafe, situation,” Dr. Leis said.
Toronto Public Health has already performed a limited number of at-home tests for patients who have tested positive for the new virus.
Public-health officials do not consider patients to have recovered from COVID-19 until they have tested negative twice; trained tuberculosis nurses have visited patients at home to collect nasal and throat swabs for clearance testing. Tuberculosis nurses are trained to safely put on and take off protective equipment as they care for patients with highly contagious diseases.
Adrian Sebastian, a registered nurse and manager at Toronto Public Health, said the priorities during home testing are protecting the nurses performing the swabs – all of whom are outfitted in full protective equipment – and safeguarding the privacy of patients.
“The worst thing would be … someone sees you donning and doffing in the hallway and thinks, ‘Oh my gosh, what’s going on here?’ They hear the news that there’s coronavirus. It’s just going to cause a panic in that building,” Mr. Sebastian said.
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Mr. Sebastian was on-site supervising another nurse during the at-home testing of Canada’s second confirmed coronavirus patient, a woman who flew home from China with her husband in January. He was the first patient to be diagnosed with the virus in Canada.
Fortunately, Mr. Sebastian said, the couple had a garage they hadn’t entered since returning home.
“We got them to open their garage, we went into their garage, prepped in the garage and we did our business,” he said.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
