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Quebec to open two nurse-run clinics in Montreal to ease emergency room crisis

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MONTREAL — Quebec’s health minister on Tuesday promised that his new three-point plan to ease emergency room overcrowding will show results in a few weeks, as ER doctors warned that the network has reached a “breaking point.”

Christian Dubé said his 20-member health-care “crisis unit” has been meeting frequently, adding that he toured several of the province’s hospitals last week to listen to workers’ concerns. His plan, he said, is to quickly open two clinics in Montreal run entirely by nurse practitioners, to extend the 811 health-care hotline to pediatric patients, and to free up hospital beds more quickly.

The solutions aren’t new, Dubé said, but they just haven’t been implemented over the years for a variety of reasons.

“Our challenge is to implement them throughout the network; it’s all in the execution,” Dubé said, adding that while the situation in Quebec’s ERs isn’t unique in Canada, it’s “not an excuse for not having done what we should have done.”

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Dubé announced his plan the same day a letter was leaked to several media outlets, authored by a group representing the heads of Quebec’s emergency departments, who stated bluntly that ERs in the province have reached a “breaking point.” It was addressed to several people in the Health Department, including Dubé.

The emergency chiefs said that for several months, they had been raising concerns about overcrowding and shortages. “The finding is distressing: the emergency situation in Quebec has reached breaking point,” said the letter, penned by a group calling themselves Regroupement des chefs d’urgence du Québec.

“We have not received the support of our management to better distribute the pressure between the different network structures to mitigate the impact on emergency services and on patient care safety.”

The letter, dated last Friday, said emergency rooms are “the victims of a failing system.”

“Indeed, the persistent and recurrent closures of hospital beds force emergency departments to disproportionately bear the burden of hospital overcapacity,” the letter read. “Emergencies are now condemned to sacrifice their primary mission, which is to treat in a timely manner people whose clinical condition is unstable, or even potentially deadly.”

The ER doctors said hospitals need better protocols to manage overcapacity and the management of resources, such as hospital beds. As well, they said the public should have easy access to data about emergency room capacity and wait time expectations.

Dubé on Tuesday said he agreed with the letter, adding that he was scheduled to meet with some of its authors on Wednesday in Quebec City.

“I think we all appreciate what they’re saying because they’re right: we should act on certain things,” Dubé said. “I’m just saying to those doctors that have signed this letter that we agree with those recommendations.”

According to IndexSante.ca, a website that tracks hospital occupancy, emergency rooms Tuesday afternoon across the province were above capacity in many regions, with the average provincewide occupancy at 125 per cent. Dubé said one out of two patients who end up in an ER could be treated outside the hospital system.

Dubé said he planned to open “in the coming weeks” a pair of clinics in Montreal run entirely by nurse practitioners. The hope, he said, is that such clinics can be widely used to accommodate patients who do not have a family doctor.

The second part of his plan is to extend service of the 811 health-care phone line to pediatric patients, allowing parents to obtain a consultation and avoid going to the emergency room. The new service, based on a pediatric phone line that was operational during the height of the COVID-19 pandemic, is only available in Montreal at the moment, but Dubé said it will be extended soon across the province.

“When in doubt, when you don’t know what to do, 811 is the place,” Dubé said. On Tuesday, Montreal’s two children’s hospitals — Sainte-Justine and Montreal Children’s — were at 163 and 175 per cent capacity, respectively.

Dubé said the third part of his strategy involves moving patients out of hospital who can’t be returned home and don’t have a spot in a long-term care facility.

The government, he said, has put out a call for tender for 1,700 beds outside the hospital network, adding that 58 per cent of that extra bed space has already been found. Dubé said the Health Department is also looking to discharge patients more quickly to their homes, with access to home care. Doing so, he said, would allow people to recover in a familiar, comfortable environment, adding that it would also free up hospital space.

This report by The Canadian Press was first published Nov. 1, 2022.

 

Sidhartha Banerjee, The Canadian Press

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Canada commits $800 million to support Indigenous-led conservation projects

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Ottawa will spend up to $800 million to support four major Indigenous-led conservation projects across the country covering nearly one million square kilometres of land and water, Prime Minister Justin Trudeau announced Wednesday.

Trudeau made the announcement at the Biosphere environment museum in Montreal accompanied by Indigenous leaders and federal Environment Minister Steven Guilbeault as a UN meeting on global biodiversity, known as COP15, takes place in the city.

Trudeau said the four projects — which will be located in British Columbia, the Northwest Territories, northern Ontario and Nunavut — will be developed in partnership with the communities in question.

“Each of these projects is different because each of these projects is being designed by communities, for communities,” he said.

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Chief Jackson Lafferty, of the Tlicho government in the Northwest Territories, said Indigenous groups have long been working to protect their lands and water but have lacked the resources and tools to fully do so.

Lafferty, who attended the announcement, called the funding “a significant step forward on a path to reconciliation across Canada.”

Among the projects to be funded is a marine conservation and sustainability initiative in the Great Bear Sea along British Columbia’s north coast, championed by 17 First Nations in the area.

Another project includes protection for boreal forests, rivers and lands across the Northwest Territories, spearheaded by 30 Indigenous governments.

Funds will also go to an Inuit-led project involving waters and land in Nunavut’s Qikiqtani region and to a project in western James Bay to protect the world’s third largest wetland, led by the Omushkego Cree in Ontario.

Trudeau told reporters that the exact details of the agreements have yet to be worked out — including which portions of the lands will be shielded from resource extraction.

The Indigenous partners, he said, will be able to decide which lands need to be completely protected and where there can be “responsible, targeted development.”

“We know we need jobs, we know we need protected areas, we know we need economic development,” he said. “And nobody knows that, and the importance of that balance, better than Indigenous communities themselves that have been left out of this equation, not just in Canada but around the world, for too long.”

Dallas Smith, president of Nanwakolas Council, said the B.C. funding to help protect the Great Bear Sea would allow Indigenous groups to build on previous agreements to protect the terrestrial lands of Great Bear Rainforest, which were announced about 15 years ago.

“I did media all over the world, and I got home and my elder said, ‘Don’t sprain your arm patting yourself on the back, because until you do the marine component, it doesn’t mean anything,'” he said.

Grand Chief Alison Linklater of the Mushkegowuk Council, which represents seven Cree communities in northern Ontario, said their traditional territory includes ancient peatlands that store “billions of tons” of carbon, as well as wetlands that are home to many migratory birds and fish, and 1,200 kilometres of coastline.

She said caring for the lands is one of her sacred duties as grand chief and one of the main concerns of the people she represents.

“Without our lands and waters we do not exist,” she told the news conference.

In a statement, the federal government said the program would employ a “unique funding model” bringing together government, Indigenous Peoples, philanthropic partners and other investors to secure long-term financing for community-led conservation projects.

The government did not specify how much of the funding would be allocated for each project.

This report by The Canadian Press was first published Dec. 7, 2022.

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B.C. Premier David Eby unveils his new cabinet

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B.C. Premier David Eby to reveal new cabinet with health, safety, housing priorities

Here is a list of British Columbia Premier David Eby‘s ministers following his first major cabinet shuffle since taking over as leader:

Agriculture and Food — Pam Alexis (new to cabinet)

Attorney General — Niki Sharma (new to cabinet)

Children and Family Development — Mitzi Dean (unchanged)

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Citizens’ Services — Lisa Beare

Education and Child Care — Rachna Singh (new to cabinet)

Minister of state for child care — Grace Lore (new to cabinet)

Emergency Management and Climate Readiness — Bowinn Ma

Energy, Mines and Low Carbon Innovation — Josie Osborne

Environment and Climate Change Strategy — George Heyman (unchanged)

Finance (includes Columbia River Treaty) — Katrine Conroy

Forests and minister responsible for consular corps. — Bruce Ralston

Health and minister responsible for Francophone affairs — Adrian Dix (unchanged)

Housing and government house leader — Ravi Kahlon

Indigenous Relations and Reconciliation — Murray Rankin

Jobs, Economic Development and Innovation — Brenda Bailey (new to cabinet)

Minister of state for trade — Jagrup Brar (new to cabinet)

Labour — Harry Bains (unchanged)

Mental Health and Addictions — Jennifer Whiteside

Municipal Affairs — Anne Kang

Post-Secondary Education and Future Skills (includes immigration/foreign credentials) — Selina Robinson

Minister of state for workforce development — Andrew Mercier (new to cabinet)

Public Safety and Solicitor General (ICBC) — Mike Farnworth (unchanged)

Social Development and Poverty Reduction — Sheila Malcolmson

Tourism, Arts, Culture and Sport — Lana Popham

Transportation and Infrastructure (BC Transit and Translink) — Rob Fleming (unchanged)

Minister of state for infrastructure and transit — Dan Coulter (new to cabinet)

Water, Land and Resource Stewardship — Nathan Cullen

This report by The Canadian Press was first published Dec. 7, 2022

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Tick-borne germs increasingly widespread in Canada: study

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Researchers from Quebec and Ontario are calling for better testing to track the spread of tick-borne germs as disease-causing bacteria gain new ground in Canada.

Ticks are blood-sucking arachnids that can carry pathogens – bacteria, viruses and parasites – like those that cause Lyme disease. Now, McGill University PhD candidate Kirsten Crandall says pathogens that are local to other regions are beginning to show up across central Canada.

“While the bacteria that causes Lyme disease is the most common tick-borne pathogen in Canada, other tick-borne pathogens are moving in,” she said in a media release published on Nov. 17.

In a study published in the medical journal Vector-Borne and Zoonotic Diseases on Nov. 9, Crandall and her co-authors from McGill and the University of Ottawa warned that two pathogens, Babesia odocoilei and Rickettsia rickettsii, had been detected in Canada outside of their historic geographic range.

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Babesia odocoilei causes a malaria-like parasitic disease called babesiosis. Babesiosis can be asymptomatic or it can cause flu-like symptoms, such as fever, chills, sweats, headache, body aches, loss of appetite, nausea or fatigue.

Rickettsia rickettsii causes Rocky Mountain spotted fever and anaplasmosis, and is normally found in the United States, Western Canada, Mexico, Panama, Costa Rica, Argentina, Brazil, Colombia and Bolivia.

Both bacteria can infect animals and humans, and both were found in ticks and small mammals in Quebec. According to the study, climate change, habitat fragmentation and changes in the abundance of tick populations and their hosts are all driving the spread of emerging tick-borne pathogens like these across Canada.

“The presence of these pathogens changes the risk of disease for Canadians and animals in some densely populated areas of Canada,” Crandall said.

Crandall and her team made the detections using methods that went beyond those normally used in tick monitoring studies. By testing ticks at all life cycle stages, they discovered that female ticks can actually pass pathogens to their larval young. They also tested for pathogens not already listed as nationally notifiable diseases in Canada.

She said the findings demonstrate the need for better testing and tracking to detect the spread and potential risk of tick-borne pathogens to humans and animals throughout the country.

“Only two tick-borne pathogens are listed as nationally notifiable diseases in Canada: Lyme disease and tularemia,” she said. “However, we are seeing increased cases of diseases like anaplasmosis and babesiosis in humans in Canada.”

Jeremy Kerr, a professor and research chair at the University of Ottawa’s department of biology, said the study highlights the importance of funding more research into tick-borne diseases that haven’t historically been common in Canada.

“If we don’t know that pathogens are present, we can’t equip Canadians with the information they need to protect themselves,” he said in a statement released on Nov. 17. “COVID has diverted public health resources away from challenges like this one, and we need to remember that these tick-borne diseases are on the move too.”

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