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Richmond woman, 20, experienced hallucinations from 'laughing gas' misuse: report – Richmond News

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A Richmond ER doctor is warning about the dangers of inhaling nitrous oxide (N2O) after treating a 20-year-old woman who experienced hallucinations stemming from daily use of “whippits.”

According to a report published this month in the B.C. Medical Journal, Dr. Matthew Mo Kin Kwok — one of the report’s authors — treated a young Asian woman who came to emergency at Richmond Hospital because she was worried for her safety.

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The woman was experiencing auditory and visual hallucinations, agitation and had issues walking, according to the report.

The high from whippits, which produces a dissociative state, typically lasts one to two minutes, according to the report.

As a result of her hallucinations, she was also concerned about an imaginary “transmitting” device in her throat, which she believed was making her legs weak and from which she heard voices telling her to kill herself.

N2O easily accessible

Commonly known as “laughing gas,” N2O is used in a medical setting for purposes such as anaesthesia or sedation.

It’s also commercially available in canisters known as whippits, which are used as a foaming agent in whipped cream dispensers. Whippets can be purchased over-the-counter or online regardless of age, medical history or intended use.

The N2O in over-the-counter whippits is the exact same as what’s used for medicinal purposes.

The woman had no history of psychiatric or medical illness, according to the report, had stable vital signs and showed no sign of head trauma. Other medical tests came back normal.

However, said the report, she told doctors that she inhaled nitrous oxide on a daily basis.

“She had increased her use recently and was inhaling gas from approximately 100 whippits per day,” reads the report.

The patient told doctors she bought the canisters legally using a shopping app and showed the physician the website she used when making the purchases. She did not report any other prescription or recreational drug use.

“A psychiatrist, a neurologist and an addiction medicine physician assessed the patient in consultation and agreed that she was psychotic as a result of N2O use,” reads the report.

And according to the report, the authors found that a package of 100 canisters could be purchased online for less than $100, or $1 per canister.

Lack of reporting a concern

According to the report, there were multiple barriers when it came to reporting the woman’s case.

First, it was difficult to determine which authority to report the case to. For example, if the use of the chemical was medicinal, health care providers would need to report to the Canada Vigilance Program.

But if the chemical comes from a product used for whipped cream, the case should be reported to Health Canada Consumer Products and Cosmetics.

But the response from those authorities was also an issue.

“In response to our report, a Health Canada representative explained that consumer products and cosmetics would document the misuse but only take further action if the (nitrous oxide) canister had faults or hazards regarding its intended use, which is making whipped cream,” reads the report.

The report’s authors were “surprised” to learn that no cases of nitrous oxide misuse had been reported to Health Canada and only one case of substance abuse was reported to the Canada Vigilance Program.

The authors also contacted the B.C. Drug and Poison Information Centre, which informed them that the organization had received 14 calls about nitrous oxide toxicity from misuse of whippets or similar commercial products between 2015 and 2019.

“Since our investigation determined that Health Canada received only one report of N2O misuse in this period, many incidents appear to have gone unreported,” reads the report.

In 2017, the News reported how a 23-year-old Richmond man was almost paralyzed after overdosing on N2O, having bought the gas on WeChat.

At the height of his addiction, the man inhaled more than 1,000 eight-gram cartridges of nitrous oxide every day for two months.

He also said he experienced delusions, such as someone chasing him while he was driving or someone was going to hurt him.

According to Kwok’s report, Health Canada considers N2O to be an “unscheduled non-prescription professional use” product.

“This raises an important question,” reads the report. “If N2O used medicinally is deemed to require health care provider involvement, why is the purchase of N2O used commercially not restricted in any way given the potential impact on consumers?”

Some possible solutions to a lack of awareness around N2O toxicity and its possible serious effects, according to the report, are adding safeguards to minimize harm and encouraging intervention from authorities to prevent misuse.

In a release from Vancouver Coastal Health, Kwok also said both doctors and the public need to be more aware of the possible outcomes of inhaling whippits. 

“When people present at the emergency department with unexplained neurological symptoms it’s important for clinicians to consider nitrous oxide as a possible cause,” said Kwok.

“It’s also important for users to know that using this product outside a supervised medical setting can cause serious health effects.”

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Ontario reports 2417 new cases of COVID-19 and 102 more deaths related to the virus – Bowen Island Undercurrent

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TORONTO — The Canadian military is set to help with COVID-19 vaccine distribution in northern Ontario, as officials investigate the death of a teenager who had the virus and worked at a long-term care home in the province’s southwest.

Federal Public Safety Minister Bill Blair tweeted Sunday that the Canadian Armed Forces will support vaccine efforts in 32 communities of the Nishnawbe Aski Nation. The move came after a request from the province for assistance in getting vaccine to First Nations communities, he wrote. 

“Our government will always be there to support the fight against #COVID19,” he wrote on Twitter. 

The Nishnawbe Aski Nation, whose territory comprises 49 remote communities in northwestern Ontario, did not immediately comment on the pending deployment.   

Meanwhile, officials in Middlesex-London said Sunday that a male teen who worked in a long-term care facility in the region was among the three deaths reported on the area’s COVID-19 case site earlier in the weekend. 

Dr. Alexander Summers, associate medical officer of health for the Middlesex-London Health Unit, said he couldn’t provide the exact age or any other details about the teen.

But he said the person was a staff member of the long-term care home who was recently diagnosed with COVID-19 and died earlier in the week.

“Through the course of our investigation, the potential exposures could be many, but certainly the long-term care home is a potential exposure for this individual,” Summers said in an interview. 

Summers said to his knowledge, the teen was not hospitalized with COVID-19.

He is the youngest person to have died after contracting the virus in the county, Summers said, noting the majority of deaths they’ve seen among COVID-19 patients have been in an older demographic. 

“It can have severe impacts on people of all ages and this story and this unfortunate and tragic situation as a reminder of that,” Summers said. 

“Certainly, this is a very rare occurrence. It’s a rare event. And the investigation continues as to understanding what exactly might have happened. However, regardless, it’s a sad day.”

The Roberta Place Retirement Lodge long-term care home in Barrie, Ont., north of Toronto, also made headlines over the weekend after health officials said a U.K. variant of COVID-19 was behind a deadly outbreak there.

On Sunday, the Simcoe Muskoka District Health Unit said it had learned of an additional individual with the U.K. variant within the region.

The unit said that individual had close contact with a person who is also part of a COVID-19 outbreak at Bradford Valley Care Community, a long-term care home in Bradford West Gwillimbury, south of Barrie. 

Officials are now investigating whether that outbreak is also due to the U.K. variant.

Ontario reported 2,417 new cases of COVID-19 and 50 more deaths related to the virus on Sunday.

The numbers were slightly up from Saturday’s 2,359 cases, though deaths declined by two from previous figures. 

Health Minister Christine Elliott said there were 785 new cases in Toronto, 404 in Peel Region, 215 in York Region and 121 in Niagara.

Over 48,900 tests had been completed in Ontario over the past 24 hours.

The province reported that 4,427 doses of a COVID-19 vaccine were administered since the province’s last report, and 1,436 are hospitalized with the virus.

A total of 280,573 doses of the COVID-19 vaccine have been administered in Ontario so far.

Since the pandemic began, there have been 255,002 confirmed cases of COVID-19 in Ontario. Of those, 225,046 have recovered and 5,803 people have died.

On Monday, the province plans to issue the results of a weekend-long expansion of its “inspection blitz” of big-box stores to ensure they were following COVID-19 guidelines.

The workplace inspections, which started in the Greater Toronto and Hamilton areas last weekend, stretched out to Ottawa, Windsor, Niagara and Durham regions.

Preliminary figures from Saturday showed inspectors went into 310 big-box stores and issued 34 tickets and 53 orders, Labour Minister Monte McNaughton said Sunday.

Overall, inspectors found the stores were only at “64 per cent compliance, which the minister said wasn’t good enough.

“The three big issues that we’re finding this weekend: masking protocols aren’t being followed, in some cases; the physical distancing is still an issue in some stores; and this weekend we found that some of these big-box stores don’t have a safety plan that’s required of them to prevent COVID-19 from coming into the workplace,” McNaughton said in an interview.

“Every business should know at this point in the pandemic what’s expected of them.”

This report by The Canadian Press was first published Jan. 24, 2021.

Victoria Ahearn, The Canadian Press

Note to readers: This is a corrected story. A previous version said there had been 102 deaths in Ontario over the past 24 hours. There were, in fact, 50 deaths.

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Dentists, teachers disappointed they won't be prioritized for vaccine in B.C. – BarrieToday

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VANCOUVER — Dentists, bus drivers and teachers are among the essential workers who are disappointed they won’t be given priority to receive the COVID-19 vaccine in British Columbia.

B.C. rolled out its vaccination plan on Friday, revealing that after the most vulnerable groups have been immunized, shots will be given out according to age, with the oldest residents first in line.

That means many people who have not been able to work from home during the pandemic, including grocery store workers, police officers and mail carriers, will have to wait to get the vaccine along with others in their age group.

The British Columbia Dental Association has written a letter to Premier John Horgan strongly urging him to include dentists in Stage 2 of the vaccination plan, alongside family doctors and medical specialists.

“Dentistry is an essential service. More importantly, dental care, including aerosol-generating dental procedures, are provided to patients who cannot wear a mask during treatment,” said association president Dr. Anthony Nadolski in the letter.

“B.C. dentists continue to do everything they can to ensure dental offices are safe for patients and staff. Early access to vaccines will ensure continued access to urgent and emergency dental care.”

Other agencies such as the American Centers for Disease Control and Prevention have included dentists and dental workers in Stage 2 along with doctors and specialists not directly involved in providing care to COVID-19 patients, Nadolski added.

More recently, Ontario included dentistry in its second stage because dentists generally provide in-person care and many dental procedures are urgent and cannot be delayed, he said.

The B.C. Ministry of Health did not immediately respond to a request for comment on Sunday.

The province initially suggested that people delivering essential services such as teachers, grocery store workers and those in law enforcement could be prioritized to get the vaccine. 

But when the finalized plan was released on Friday, Provincial Health Officer Dr. Bonnie Henry said scientific evidence supports an age-based approach because older populations are at much higher risk of infection and death from COVID-19.

Currently, hospital workers, Indigenous communities and long-term care home residents, staff and essential visitors are among those being vaccinated in Stage 1 of the plan.

Stage 2 will begin in February and include people 80 and over, Indigenous seniors over 65, general practitioners and medical specialists.

In April, the province will start vaccinating the general public according to five-year age groupings, starting with seniors aged 75 to 79 before moving on to those aged 70 to 74 and so on.  

However, Henry added that the approval of more vaccines may mean the province’s plan could be revised to vaccinate essential workers between April and June.

Metro Vancouver bus drivers are “very disappointed” they will not be prioritized while they risk their lives to provide transportation to the public, said Balbir Mann, president of Unifor Local 111.

The union is calling on the provincial government to immediately change the plan and include transit operators in Stage 2.

“We’re basically frontline workers, taking people to work and grocery shopping. Our members are real heroes,” said Mann. “They’re putting their lives in front of this to help out the general public.”

Teachers are also disappointed there is no prioritization for front-line workers who have kept schools, public services and the economy open, said B.C. Teachers Federation President Teri Mooring.

“However, the vaccine supply limit is beyond our control and those among us who are most vulnerable of death and serious illness must be vaccinated first,” she said in a statement. 

Hopefully more vaccines are approved and the immunization strategy will be appropriately adjusted and accelerated, she said.

Mooring added if teachers are not prioritized for vaccines, the government must take immediate action to improve safety measures in schools, including mandatory masks, better physical distancing and ventilation upgrades.

“There is no denying that teachers are stressed, anxious and even afraid. We do not have the layers of protection in our schools that exist in other environments.”

This report by The Canadian Press was first published Jan. 24, 2021.

Laura Dhillon Kane, The Canadian Press

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Dentists, teachers disappointed they won't be prioritized for vaccine in B.C. – St. Albert Today

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VANCOUVER — Dentists, bus drivers and teachers are among the essential workers who are disappointed they won’t be given priority to receive the COVID-19 vaccine in British Columbia.

B.C. rolled out its vaccination plan on Friday, revealing that after the most vulnerable groups have been immunized, shots will be given out according to age, with the oldest residents first in line.

That means many people who have not been able to work from home during the pandemic, including grocery store workers, police officers and mail carriers, will have to wait to get the vaccine along with others in their age group.

The British Columbia Dental Association has written a letter to Premier John Horgan strongly urging him to include dentists in Stage 2 of the vaccination plan, alongside family doctors and medical specialists.

“Dentistry is an essential service. More importantly, dental care, including aerosol-generating dental procedures, are provided to patients who cannot wear a mask during treatment,” said association president Dr. Anthony Nadolski in the letter.

“B.C. dentists continue to do everything they can to ensure dental offices are safe for patients and staff. Early access to vaccines will ensure continued access to urgent and emergency dental care.”

Other agencies such as the American Centers for Disease Control and Prevention have included dentists and dental workers in Stage 2 along with doctors and specialists not directly involved in providing care to COVID-19 patients, Nadolski added.

More recently, Ontario included dentistry in its second stage because dentists generally provide in-person care and many dental procedures are urgent and cannot be delayed, he said.

The B.C. Ministry of Health did not immediately respond to a request for comment on Sunday.

The province initially suggested that people delivering essential services such as teachers, grocery store workers and those in law enforcement could be prioritized to get the vaccine. 

But when the finalized plan was released on Friday, Provincial Health Officer Dr. Bonnie Henry said scientific evidence supports an age-based approach because older populations are at much higher risk of infection and death from COVID-19.

Currently, hospital workers, Indigenous communities and long-term care home residents, staff and essential visitors are among those being vaccinated in Stage 1 of the plan.

Stage 2 will begin in February and include people 80 and over, Indigenous seniors over 65, general practitioners and medical specialists.

In April, the province will start vaccinating the general public according to five-year age groupings, starting with seniors aged 75 to 79 before moving on to those aged 70 to 74 and so on.  

However, Henry added that the approval of more vaccines may mean the province’s plan could be revised to vaccinate essential workers between April and June.

Metro Vancouver bus drivers are “very disappointed” they will not be prioritized while they risk their lives to provide transportation to the public, said Balbir Mann, president of Unifor Local 111.

The union is calling on the provincial government to immediately change the plan and include transit operators in Stage 2.

“We’re basically frontline workers, taking people to work and grocery shopping. Our members are real heroes,” said Mann. “They’re putting their lives in front of this to help out the general public.”

Teachers are also disappointed there is no prioritization for front-line workers who have kept schools, public services and the economy open, said B.C. Teachers Federation President Teri Mooring.

“However, the vaccine supply limit is beyond our control and those among us who are most vulnerable of death and serious illness must be vaccinated first,” she said in a statement. 

Hopefully more vaccines are approved and the immunization strategy will be appropriately adjusted and accelerated, she said.

Mooring added if teachers are not prioritized for vaccines, the government must take immediate action to improve safety measures in schools, including mandatory masks, better physical distancing and ventilation upgrades.

“There is no denying that teachers are stressed, anxious and even afraid. We do not have the layers of protection in our schools that exist in other environments.”

This report by The Canadian Press was first published Jan. 24, 2021.

Laura Dhillon Kane, The Canadian Press

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