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OTTAWA — The latest wave of COVID-19 is bringing health-care resources in some remote communities in Canada to the breaking point as case numbers explode.
OTTAWA — The latest wave of COVID-19 is bringing health-care resources in some remote communities in Canada to the breaking point as case numbers explode.
Record-breaking cases have been documented across much of southern Canada in recent days, and while many hospitals are reporting smaller numbers of critically ill patients than in previous waves, they are struggling with a higher absentee rate because health workers are getting sick in much higher numbers.
Those strains are exacerbated in remote communities where access to health care is already quite limited.
Bearskin Lake First Nation, a fly-in community in northern Ontario, declared a state of emergency on Dec. 30 when 43 residents tested positive for the virus. By Sunday, 169 people had confirmed or suspected cases of COVID-19, more than 40 per cent of the total population.
“That’s a crisis,” Nishnawbe Aski Nation Grand Chief Derek Fox said in an interview.
Bearskin Lake has no hospital and is usually served by a nursing station with two nurses. An emergency evacuation would take more than three hours for a plane to get in and out from Sioux Lookout or Thunder Bay, and that’s only if weather permits it to land.
A federal rapid response team with three primary care nurses, a paramedic and two environmental health officers landed in Bearskin Lake on Dec. 30, bringing more testing capacity with them. Two public health nurses were sent by the Sioux Lookout First Nations Health Authority as well.
Fox said it’s not enough for a community that has no hospital and no capacity to even determine how sick any of the infected residents are.
“The federal government and the provincial government need to acknowledge this is a crisis,” Fox said. “They’re not treating this like a crisis. They’re waiting to see what happens.”
He said about a dozen of the 49 communities in the Nishnawbe Aski Nation have confirmed COVID-19 cases right now, including the 169 in Bearskin Lake, and roughly 80 more in 11 other First Nations.
Indigenous Services Minister Patty Hajdu spoke with Fox by phone Sunday and said Ottawa is there to help.
“I reiterated that we’ll be there for them, to support them, and that they just need to kind of keep telling us what they need and we’ll work really hard to make sure those resources are in place,” she said.
On Sunday, Hajdu said $483,000 had been approved to help Bearskin Lake with food security, personal protective equipment, funding for local community COVID workers, and supplies like wood cutting and collection.
She said when so many people are sick, and homes are only heated with wood stoves, even ensuring there is wood to burn is a challenge.
Outbreaks in remote communities are also affecting Nunavut, northern Quebec and Labrador.
Nunavut confirmed another 22 cases of COVID-19 Sunday, bringing the total to 196 in just 10 days.
That’s more than one-fifth of the confirmed cases of COVID-19 in the territory since the pandemic began almost two years ago, and the territory’s chief public health officer Dr. Michael Patterson says it is putting immense strain on health care.
“Please remain patient and kind, as there will be continued delays,” he said in a statement issued Sunday.
“Please stay home as much as possible and please don’t take any unnecessary chances.”
Nunavut is discouraging all non-essential travel within the territory and has banned non-essential travel to and from several communities, including Iqaluit, Rankin Inlet, Arviat, Igloolik and Pangnirtung.
Travel bans are also in place now in Nunavik in northern Quebec until mid-January, with only critical or essential travel allowed into or out of the region’s 14 villages.
The Nunavik Regional Board of Health and Social Services reported 33 new cases of COVID-19 in the week leading up to Christmas, and 131 between Dec. 27 and Dec. 31.
“The situation is serious,” the health board warned in a statement to the community on New Year’s Eve.
On Labrador’s remote northern coast, where COVID-19 showed up for the first time last week, leaders are pleading with residents to be cautious and imposing tight travel restrictions into local communities.
Innu Nation Deputy Grand Chief Mary Ann Nui said in a Facebook post Sunday that the inability to get confirmed test results quickly is adding to the stress.
The community of Natuashish locked itself down eight days ago after exposures to potential cases on flights into the town and a bar at Trapper’s Cabin, just before Christmas. Nui said the presumptive cases still haven’t been confirmed.
“Living in the northern area takes longer I guess, but it shouldn’t be like that,” Nui wrote.
In Nain — Labrador’s northernmost community — there are 14 presumptive cases, found through rapid testing, but confirming them with PCR tests is slow because of a lack of supplies.
Newfoundland and Labrador’s Health Minister said tests were being deployed to the region, but said the uptick in demand couldn’t have been predicted.
Nui said the local health region should have been more prepared.
Newfoundland and Labrador was one of several provinces recording drastic spikes in COVID-19 case counts on Sunday, logging 466 new infections and toppling a single-day record set just 24 hours earlier.
Nova Scotia also marked a new one-day peak on Sunday, recording 1,184 cases and eclipsing the 1,000 daily case mark for the first time since the onset of the pandemic. The province reported 1,893 new infections over the past two days.
A two-day count from Prince Edward Island came in at 137. Public health officials on the Island say the total number of infections has nearly tripled over the past two weeks.
Ontario’s daily tally fell short of Saturday’s record high , but still came in at 16,714, and the province is now showing more than 100,000 active infections.
Newfoundland and Labrador’s top doctor is warning people to stay up to date on whooping cough vaccinations after a small increase in cases this year.
The province usually sees three to four cases of the disease annually. Up to 10 cases have been reported already since January, however, prompting the province’s chief medical officer to raise the issue publicly.
The increase “generally means there’s a little bit more circulating in the community than what’s presenting for care and testing,” Dr. Janice Fitzgerald said Tuesday.
While officials aren’t overly concerned about a future spike in cases, Fitzgerald said, higher infection rates place infants in particular at risk.
Children under the age of one aren’t yet old enough for the whooping cough vaccine and don’t have immunity to the disease, Fitzgerald said. Infections in small children can be more severe and lead to pneumonia, neurological issues and hospitalization.
Fitzgerald said parents, grandparents and caregivers should check to ensure their vaccinations are up to date.
Whooping cough, also known as pertussis, causes a persistent nagging cough that’s sometimes severe enough to cause vomiting. Vaccines for the disease are offered in early childhood, during high school and in adulthood. Booster shots should be given 10 years after the high school dose, Fitzgerald said.
“Immunity can wane over time,” she said. “Pertussis does circulate on a regular basis in our community.”
The small increase in cases isn’t yet ringing alarm bells for undervaccination within the general population, she added, noting the province still has a vaccination rate over 90 per cent.
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A study in the Canadian Medical Association Journal (CMAJ) said the opioid drug crisis has reached such a critical level that a public safety response is urgently required and that includes the need for expanded supervised consumption sites.
The report was published by the medical journal Monday and was authored by Shaleesa Ledlie, David N. Juurlink, Mina Tadrous, Muhammad Mamdani, J. Michael Paterson and Tara Gomes; physicians and scientists associated with the University of Toronto, Sunnybrook Research Institute and the Li Ka Shing Knowledge Institute at St. Michael’s Hospital.
“The drug toxicity crisis continues to accelerate across Canada, with rapid increases in opioid-related harms following the onset of the COVID-19 pandemic,” the authors wrote. “We sought to describe trends in the burden of opioid-related deaths across Canada throughout the pandemic, comparing these trends by province or territory, age and sex.”
The study determined that across Canada, the burden of premature opioid-related deaths doubled between 2019 and 2021, representing more than one-quarter of deaths among younger adults. The disproportionate loss of life in this demographic group highlights the critical need for targeted prevention efforts, said the study.
The researchers found that the death rate increased significantly as fentanyl was introduced to the mix of street drugs that individuals were using, in some cases, unknowingly.
The authors said this demonstrates the need for consumption sites, not only as overwatch as people with addictions consume their drugs, but also to make an effort to identify the substances and inform those people beforehand.
“The increased detection of fentanyl in opioid-related deaths in Canada highlights the need for expansion of harm-reduction programs, including improved access to drug-checking services, supervised consumption sites, and treatment for substance use disorders,” the authors wrote.
The study said a more intense public safety response is needed.
“Given the rapidly evolving nature of the drug toxicity crisis, a public safety response is urgently required and may include continued funding of safer opioid supply programs that were expanded beginning in March 2020, improved flexibility in take-home doses of opioid agonist treatment, and enhanced training for health care workers, harm reduction workers, and people who use drugs on appropriate responses to opioid toxicities involving polysubstance use.
In conclusion, the authors wrote that during the height of the COVID pandemic in 2020 and 2021, the burden of premature death from accidental opioid toxicities in Canada dramatically increased, especially in Alberta, Saskatchewan, and Manitoba.
“In 2021, more than 70 per cent of opioid-related deaths occurred among males and about 30 per cent occurred among people aged 30–39 years, representing one in every four deaths in this age group. The disproportionate rates of opioid-related deaths observed in these demographic groups highlight the critical need for the expansion of targeted harm reduction–based policies and programs across Canada,” said the study.
The full text of the report can be found online here.
A business plan for a new BC Cancer Centre at Nanaimo Regional General Hospital has been approved by the province.
Health Minister Adrian Dix says the state-of-the-art cancer facility will benefit patients in Nanaimo and the surrounding region through the latest medical technology.
The facility will have 12 exam rooms, four consultation rooms and space for medical physicists and radiation therapists, medical imaging and radiation treatment of cancer patients.
The procurement process is underway, and construction is expected to begin in 2025 and be complete in 2028.
Upgrades to NRGH have also been approved, such as a new single-storey addition to the ambulatory care building and expanded pharmacy.
Dix says Nanaimo’s population is growing rapidly and aging, and stronger health services in the region, so people get the health care they need closer to home.
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