CHARLESTON, W.Va. — West Virginia Gov. Jim Justice said the rate of COVID-19 cases in his state is “probably going to continue to get tougher in the weeks ahead.”
Justice has said he will not consider reinstating an indoor mask mandate and has continued to urge residents to be vaccinated.
The number of active cases statewide has reached at least 4,010, after bottoming out at 882 cases on July 9, according to state health figures.
School began Monday in West Virginia’s largest county. Schools in many other counties are set to open their fall terms this month.
About 57% of state residents ages 12 and up are fully vaccinated, while about 69% have received one dose.
MORE ON THE PANDEMIC:
— Canada begins allowing vaccinated US citizens to visit again
— France widely introduces a virus pass that is needed to enter restaurants, trains
— The pandemic’s impact on Tokyo Games is making Olympians dream of Paris
HERE’S WHAT ELSE IS HAPPENING:
MIAMI — The superintendent of the school district in the capital of Florida said Monday that he will require masks amid an increase in COVID-19 cases and hospitalizations fueled by the delta variant.
Leon County Schools Superintendent Rocky Hanna said children from pre-kindergarten through eighth grade will be required to wear masks when classes resume in Tallahassee on Wednesday. He said students who want to opt out need a note from a physician or a psychologist.
Republican Gov. Ron DeSantis issued an order in late July for the education and health departments to come up with ways of punishing school districts that mandate mask-wearing in classrooms.
The Florida Department of Health issued a rule last week that districts must allow parents to decide. And the Florida’s Board of Education approved an emergency rule granting private school vouchers for children who feel they are being harassed by a district’s COVID-19 safety policies, including mask requirements.
MONTGOMERY, Ala. — The number of COVD-19 patients in Alabama hospitals topped 2,000 Sunday, the highest figure the state has seen since January.
Medical officials have blamed low vaccination rates for a rapid rise in cases and hospitalizations as the highly contagious delta variant of the virus spreads throughout the region.
On Sunday, there were 2,047 patients with COVID-19 in state hospitals, including 581 in intensive care units and 300 patients on ventilators, according to numbers provided by the Alabama Hospital Association.
Decatur Morgan Hospital is treating 26 COVID-19 patients, up from 15 last week, hospital president Kelli Powers said Monday. She said the ill included a 38-year-old person who is on a ventilator in intensive care and that the sickest patients infected by the virus aren’t vaccinated.
“We have a lot of people who are on their deathbeds begging for the vaccine, but at that point it’s too late,” she said.
JACKSON, Miss. — Mississippi’s top public health official said Monday that as COVID-19 cases continue to surge with the highly contagious delta variant, no intensive care beds were available in 35 of the state’s top-level hospitals.
Dr. Thomas Dobbs also said that more than 200 people were waiting in hospital emergency rooms to be admitted. The wait times affect not only people with COVID-19 but also those with other health conditions.
The state Health Department said Monday that more than 6,900 new cases of COVID-19 were confirmed in Mississippi from Friday through Sunday.
“Keep in mind – this will translate into around 500 new hospitalizations in coming days,” Dobbs wrote on Twitter.
He said the intensive care units were full in Level 1, 2 and 3 hospitals in the state’s acute care systems. Those include the University of Mississippi Medical Center in Jackson; North Mississippi Medical Center in Tupelo; Forrest General Hospital in Hattiesburg; Memorial Hospital in Gulfport and Singing River Health System in Pascagoula.
Lee Bond, chief executive officer of Singing River Health System, in a statement Thursday said Mississippi is experiencing a “hellacious wave” of COVID-19 cases that are stretching hospitals’ resources and causing extreme stress for health care workers.
RALEIGH, N.C. — One of North Carolina’s most vaccinated areas is instituting a mask mandate for indoor public places, regardless of one’s vaccination status.
Durham’s city and county-wide emergency order, which takes effect at 5 p.m. Monday, is an effort to combat the rapid spread of the highly contagious COVID-19 delta variant.
Durham Mayor Steve Schewel on Monday said it’s time to go “back to the basics” to combat what he views as a “pandemic of the unvaccinated.” He called face masks “a common-sense, non-economically damaging way of limiting transmission.”
Schewel said Durham typically enforces such orders “with a light touch” by having the city attorney write a letter notifying a business or person of their noncompliance before sending a police officer and sheriff’s deputy to further address the situation.
“We do have the power to cite someone, but we’ve had to do very little of that,” Schewel said.
Those who are under 5, who are actively eating or drinking or who have medical or behavioral conditions do not need to wear masks in Durham County while in “any indoor public place, business or establishment.”
The order has no expiration date, but Schewel said the city and county will reevaluate the order every week or two.
MEXICO CITY — Mexico will ask the United States to send at least 3.5 million more doses of COVID-19 vaccine as the country faces a third wave of infections, President Andrés Manuel López Obrador said Monday.
The president said he planned to discuss a transfer of vaccine with U.S. Vice President Kamala Harris during a call scheduled for later Monday.
López Obrador said the U.S. government had initially offered the Moderna vaccine, but Mexican health authorities could not get the necessary approvals in time so now they are considering Pfizer or another approved vaccine.
Mexico has vaccinated more than 50 million people with at least one dose, representing about 56% of the adult population. It has received 91.1 million doses of five different vaccines.
In June, the U.S. donated 1.3 million doses of Johnson & Johnson vaccine.
Mexico is seeing more than 20,000 reported infections per day.
BATON ROUGE, La. —Hospitalizations for COVID-19 have hit a record high again in Louisiana, with the state health department reporting 2,720 hospitalizations on Monday.
That’s 299 more hospitalizations than were reported in Friday’s figures.
The state hit a record number of coronavirus pandemic hospitalizations Tuesday, and the number has grown each day.
Monday’s report from the state health department says there have been 16,541 new cases reported since Friday and 50 more deaths. A spokesperson for the governor’s office said the new infection figures include 3,106 children under age 18 since Friday.
The highly contagious delta variant of COVID-19 is being blamed for the spread.
Rising case numbers have prompted the cancellation of the New Orleans Jazz and Heritage Festival, which was set for this fall, and this weekend’s annual Red Dress Run charity fundraiser in New Orleans.
According to the state health department, nearly 45% of Louisiana residents have had their first shot of vaccine and nearly 38% are fully vaccinated.
BATON ROUGE, La. — Louisiana Gov. John Bel Edwards, a devout Catholic, on Monday began three days of prayer and lunch fasting in honor of the state’s health care workers and those sick with COVID-19.
The Democrat urged others to join him.
“I will be praying that our sick may fight this illness, that the medical professionals caring for them can remain strong and safe, that our children, teachers and school support staff can safely begin the school year and that our people will do everything they can to help us slow the spread of this terrible virus,” he said in a statement.
Louisiana has the nation’s highest per capita rate of new COVID-19 cases over the last week, according to the U.S. Centers for Disease Control and Prevention, with 693 new cases per 100,000 people over the last seven days.
NICOSIA, Cyprus – Cyprus authorities are investigating at least five instances where doctors allegedly issued false “SafePass” certificates that show the holder to have been vaccinated against COVID-19, recovered from having contracted the virus or to have recently tested negative.
Cypriot Attorney General George Savvides said an arrest warrant was issued for one physician suspected of issuing a false certificate.
Savvides on Monday chaired a meeting bringing together the health minister, chief of police and Cyprus Medical Association officials to look into legal amendments that would empower the association to take action against members before any court proceedings to determine wrongdoing. Savvides pointed to a “legal void” among professional organizations, including the association, that prevents them for revoking their members’ licenses for any misconduct prior to a criminal conviction. He said his office would help draft legislation aimed at addressing that.
Some in Cyprus protest what they see as authorities’ attempts to limit where they go by making them display a “SafePass” in any place where people gather in numbers. That includes bars, restaurants, nightclubs, shopping malls and supermarkets.
Over 66% of Cyprus’ 900,000 people have been fully vaccinated, while 74% have received at least the first shot.
DURHAM, N.C. — Face coverings will be required again starting Monday in indoor public places and businesses in Durham County, North Carolina, and the city of Durham due to the rapidly spreading coronavirus.
City and county leaders issued a new state of emergency that takes effect at 5 p.m. Monday in the county of more than 300,000 people northwest of Raleigh. The mask mandate also applies to those who are fully vaccinated.
Gov. Roy Cooper’s statewide mask mandate ended July 30, but local governments and school systems can still enact restrictions.
State health data shows there were 4,500 new cases reported in North Carolina on Friday. More than 1,700 people with COVID-19 were hospitalized statewide as of Thursday, more than double the number from two weeks earlier.
The Durham city and county mask mandate provides exceptions, including for small children and people who shouldn’t wear one due to a medical condition.
PARIS — France is now requiring people to show a QR code proving they have a special virus pass before they can enjoy restaurants and cafes or travel across the country.
The measure is part of a government plan to encourage more people to get a COVID-19 vaccine shot and slow down a surge in infections, as the highly contagious delta variant now accounts for most cases in France. Over 36 million people in France, or more than 54% of the population, are fully vaccinated.
The special pass is issued to people who are vaccinated against COVID-19, or have proof of a recent recovery from the virus or who have a recent negative test. The measure also applies to tourists visiting the country.
In hospitals, visitors and patients who have appointments are required to have the pass. Exceptions are made for people needing urgent care at the emergency ward.
The pass is also required on high-speed, intercity and night trains as well as on long-distance travels by plane or bus.
MIAMI — A federal judge has temporarily blocked a Florida law that prevents cruise lines from requiring passengers to prove they’re vaccinated against COVID-19, saying the law is appears unconstitutional and won’t likely hold up in court.
The “vaccine passport” ban signed into law in May by Republican Gov. Ron DeSantis fails to protect medical privacy or prevent discrimination against unvaccinated people, but it does appear to violate the First Amendment rights of Norwegian Cruise Lines, U.S. District Judge Kathleen Williams wrote.
In a nearly 60-page ruling issued late Sunday, the judge said Florida failed to “provide a valid evidentiary, factual, or legal predicate” for banning requirements that passengers prove they’ve been vaccinated. Norwegian has shown that suspending the requirement will jeopardize public health, potentially causing “superspreader” events wherever passengers disembark, she wrote.
Florida separately sued the U.S. Centers for Disease Control and Prevention seeking to block federal cruise ship vaccination requirements. The CDC lost on appeal, but then made its guidelines non-binding, and all cruise lines operating in Florida have agreed to keep following the CDC’s instructions on a voluntary basis, the judge wrote.
The CDC’s current guidelines, in effect until Nov. 1, say cruise lines can sail again with confirmation that at least 95% of passengers and crew have been vaccinated, the judge noted.
ROME – Italian police have cracked down on sales of fake Green Passes needed in the country to access gyms, theaters, cinemas, bingo parlors or dine indoors.
The Italian postal police corps that specializes in internet and other cybersecurity crime said on Monday that the passes, which certify that holders have had at least one COVID-19 vaccine, recovered from the illness in the last six months or tested negative in the previous 48 hours, were being sold for prices ranging from 150 to 500 euros ($180-600).
The police said four suspects, including two minors, are under investigation. The suspects allegedly used the communications app Telegram to offer fake certifications.
Italy announced last month the virus rule would take effect on Aug. 6. The certification can also facilitate travel among European countries honoring the system. The postal police said the investigation was continuing to identify those who bought the phony passes.
Authorities noted that real Green Passes have QR codes that link up with health ministry data.
BERLIN — German pharmaceutical maker BioNTech, which developed the first widely used coronavirus vaccine with Pfizer, saw its profits surge in the second quarter of 2021.
The Mainz-based company said Monday that it made a net profit of almost 2.8 billion euros ($3.3 billion) from April to June. This boosted first-half net profits to over 3.9 billion euros, compared with a net loss of almost 142 million euros in the first six months of 2020.
The company has said the windfall from its mRNA-based coronavirus vaccine will help it to develop drugs against cancer and other diseases.
LAGOS, Nigeria — Nigeria has postponed the rollout of its second batch of COVID-19 vaccine due to “unforeseen circumstances,” a setback for Africa’s most populous nation as it faces a major surge in confirmed cases.
The Presidential Steering Committee on COVID-19 made the announcement Sunday night, without providing further details about why the Tuesday launch was being delayed.
Less than 2 percent of the country’s 200 million citizens have been vaccinated against the coronavirus, according to the National Primary Healthcare Development Agency.
Nigeria initially received about 4 million doses of AstraZeneca donated through COVAX, but exhausted its supply in mid-July. The country now has received 4 million doses of the Moderna vaccine donated by the United States.
There has been a 553% increase in confirmed monthly infections since the delta variant was detected in the country in early July, according to data from the Nigeria Center for Disease Control.
RIYADH — Saudi Arabia is reopening Islam’s holiest sites in Mecca and Medina to pilgrims from abroad to perform the smaller pilgrimage known as “umrah.”
State media reported that for the first time since the pandemic prompted the government to seal off Mecca to international travelers, the kingdom will begin gradually receiving requests for umrah pilgrims from various countries of the world starting Monday.
Travelers will need to prove they have been vaccinated and will need to quarantine if they are traveling from nations still red-listed by the kingdom, which include many of the countries that once sent the most pilgrims annually. The government plans to increase the capacity of pilgrims to 2 million per month.
The kingdom has allowed its own citizens and residents to perform the umrah since October of last year under certain conditions, and held dramatically downsized hajj pilgrimages last year and this year due to the pandemic.
COLOMBO, Sri Lanka — Sri Lanka has started a program to home-manage asymptomatic COVID-19 patients, abandoning its policy of hospitalizing almost everyone who tests positive, as the number of daily infections surges.
People aged between 2 and 65 will be observed by doctors manning call centers. Doctors will assess the patients daily and recommend admission if needed.
However, those who are obese or with a history of chronic heart, kidney or other major ailments will be hospitalized immediately.
Until recently, most people testing positive for COVID-19 were hospitalized in Sri Lanka. However, the country has seen a sharp surge in patients since late July with the emergence of the delta variant. The number of new daily cases is approaching 3,000, with almost 100 deaths daily on average.
Photos have circulated on social media over the past week showing crowded hospital wards with many patients on the floor, along corridors and even outdoors. The government says it has reserved more wards to help ease the congestion and refer asymptomatic patients for home care.
Sri Lanka has reported 329,994 COVID-19 positive cases so far including 5,111 deaths.
TEHRAN — For the second straight day, Iran has shattered its single-day record for new coronavirus deaths and infections.
Iranian authorities on Monday reported 588 new fatalities, surpassing the previous day’s record by nearly four dozen. Another 40,800 new virus cases were recorded, with more than 6,500 people in critical condition.
Over a year and a half into the worst coronavirus outbreak in the Middle East, Iran is in the midst of its deadliest wave yet, fueled by the rapid spread of the delta variant.
The pandemic has killed more than 94,000 people in Iran, overwhelming hospitals in major cities as mass vaccination remains far off. Roughly 4% of Iran’s more than 80 million people have been fully vaccinated.
KATHMANDU, Nepal — Nepal has begun a campaign to fully vaccinate all over-65s in the country Monday against COVID-19 following the arrival of AstraZeneca vaccines donated by Japan.
The 1.4 million citizens over 65 had been given the first dose of the vaccine in March but they had to wait for many months for the second one because of India’s refusal to export any vaccine made there. Japan’s donation follows Nepal government’s desperate appeals to foreign governments for AstraZeneca vaccines.
Nepal is attempting to boost its vaccination campaign, which struggled for months due to a shortage of all vaccines. It received 4 million Sinopharm doses from China last month and 1.5 million Johnson and Johnson jabs gifted by the United States.
The government is warning of the possibility of a new wave of infections in the Himalayan country. The number of confirmed COVID-19 cases in Nepal is 714,877 since the pandemic began last year.
CANBERRA, Australia — The Australian government says Moderna next month will become the third COVID-19 vaccine available in Australia.
Prime Minister Scott Morrison said the Australian vaccine regulator approved the Moderna shot Monday for adults.
The first million doses will arrive in Australia in late September and 10 million Moderna shots are scheduled to be delivered to Australia this year, Health Minister Greg Hunt said.
Australia has a shortage of the Pfizer vaccine and a glut of locally manufactured AstraZeneca, which many are refusing to take because of the slight risk of blood clotting. New South Wales and Victoria states, where cities are in lockdown due to virus outbreaks, have stockpiles of more than a million unwanted doses of AstraZeneca, media reported.
Only 22% of adults among an Australian population of 26 million people had been fully vaccinated by Monday. The government expects to have provided a vaccine to every Australian adult who wants one by the end of the year.
BEIJING — More than 30 local officials have been fired or received other punishments for shortcomings in handling China’s latest virus surge.
Among the officials fired for failing to fully implement anti-pandemic measures were a vice mayor, heads of city districts and health commissions, and staff from hospital management, airport and tourism departments.
China’s National Health Commission said Monday 94 new cases of domestic transmission had been recorded over the previous 24 hours. Of those, 41 were in the central province of Henan, which has been slammed by deadly flooding in recent weeks.
Another 38 cases were reported in Yangzhou, a neighboring city to Nanjing, where China’s widest outbreak since the beginning of the pandemic was traced. The highly contagious delta variant spread among Nanjing airport workers and has since spread from tropical Hainan province in the south to Inner Mongolia in the far north.
While the number of total cases in the outbreak hovers around 1,500, a small number relative to those occurring in other countries, Chinese authorities have renewed travel restrictions, locked down communities and sealed off the entire city of Zhangjiajie, with a population of 1.5 million.
China has administered more than 1.7 billion doses of vaccine domestically, although it doesn’t disclose how many of its 1.4 billion people are now fully protected. Questions have been raised about the efficacy of the domestic jabs as the delta variant continues to spread.
MELBOURNE, Australia — Victoria state in Australia is lifting its pandemic lockdown beginning Tuesday, except in the city of Melbourne.
Australia’s second-most populous state imposed a seven-day lockdown last Thursday due to concerns about the spread of the delta variant of the coronavirus.
But Victoria Premier Daniel Andrew says all the cases detected in Victoria in recent days have been in Melbourne, with 11 more reported there Monday. So the lockdown will end in the rest of the state at the end of Monday.
Neighboring New South Wales state on Monday reported 283 new coronavirus infections and one COVID-19 death in the latest 24-hour period. The death toll from the latest outbreak that was first detected in Sydney on June 16 is now 29.
Sydney has been in lockdown since June 26 and will remain under tight pandemic restrictions until at least Aug. 28.
NEW ORLEANS — With new coronavirus cases surging in Louisiana, the New Orleans Jazz & Heritage Festival won’t be returning this year.
The festival is traditionally held in the spring but it had been scheduled to run Oct. 8-10 and Oct. 15-17 after being canceled last year because of the coronavirus pandemic.
But organizers on Sunday cited “current exponential growth” of new cases in the city and region in announcing that the festival will not occur as planned.
They say next year’s dates are April 29-May 8.
Jazz Fest celebrates the indigenous music and culture of New Orleans and Louisiana. The music encompasses nearly every style imaginable: blues, R&B, gospel, Cajun, Zydeco, Afro-Caribbean, folk, Latin, rock, rap, contemporary and traditional jazz, country, bluegrass and everything in between.
The Associated Press
Canada Facing Difficult Battle with Mental Health Struggles
Mental health is an important health issue that affects us all, and unfortunately, it’s an issue that is rarely discussed openly. According to the World Health Organization, approximately 20% of Canadians will experience a mental illness.
This makes mental health one of the most pressing issues facing Canadians today. Let’s take a closer look at why mental health is such an important issue in Canada.
The Need for Better Mental Health Care
In Canada, access to quality mental health care can be costly and difficult to obtain. Many Canadians are unaware of what services are available or how to access them due to a lack of public education about mental health.
Additionally, there is still a stigma attached to seeking help for mental illness, which can make it difficult for those who need help to get it. As a result, many people cannot access the care they need in order to live happy and healthy lives.
This deficiency can have severe consequences; untreated mental illness can lead to increased risk for suicidal behavior, substance abuse, homelessness, unemployment, and other serious problems.
Additionally, research shows that early diagnosis and treatment can help prevent long-term complications and reduce the overall costs associated with mental health treatment.
Mental health services are especially important for marginalized populations such as Black Canadians, Latinx individuals, LGBTQ+ individuals, immigrants, and individuals with low incomes who have been underserved when it comes to healthcare access.
These communities often experience higher rates of poverty and discrimination which results in an even greater need for quality mental health services but also fewer resources available to them.
Given these facts, it is clear that there is a great urgency for better access to mental health services. To make meaningful progress towards addressing this issue we must first focus on breaking down barriers such as stigma against seeking help as well as lack of information about available services among vulnerable populations.
Furthermore, a greater investment must be made into training more providers so there are enough qualified professionals available who understand how to provide culturally competent care.
Particularly when working with traditionally underserved communities – while also ensuring accessibility through reduced cost or free options for those with limited insurance coverage or financial resources.
Mental Illness as an Invisible Disease
Unlike physical illnesses, mental illnesses are often invisible and difficult to diagnose. This makes it difficult for those living with a mental illness to get the help they need as well as understand what they are going through.
It also means that many people do not realize the severity of mental illnesses and the impact they have on the lives of those living with them until they experience it firsthand or hear stories from someone who has gone through similar struggles.
Mental illness affects more people than most realize. It can be difficult to comprehend the depth of mental health disorders, as they are often invisible and misunderstood. Mental illness is a disease, yet it can remain hidden while still having a profound effect on a person’s life.
The Impact on Society
Mental illness has far-reaching effects on society as a whole. Untreated mental illness can lead to substance abuse, homelessness, unemployment, and even suicide in some cases.
All of these have ripple effects throughout our communities, from increased crime rates and lower productivity at work to higher healthcare costs and fewer resources available for those in need, making this an issue that affects us all regardless of our personal situations.
We need to create a friendly environment in which those with invisible diseases feel comfortable sharing their stories and seeking help without fear of judgment or rejection.
Mental illness should not be ignored; rather it should be treated with respect and understanding just like any other type of medical condition.
By recognizing the reality of invisible diseases such as depression, anxiety, PTSD, bipolar disorder, and more we can begin to create a world where everyone gets the help they need regardless of whether or not their condition is visible on the surface.
With understanding comes empathy, and empathy leads us toward meaningful change for ourselves and our communities alike.
Five things to know about health-care talks Tuesday between Trudeau, premiers
OTTAWA — On Tuesday in Ottawa, Canada’s 13 premiers and Prime Minister Justin Trudeau will sit around the same table in person for the first time since COVID-19 hoping to find a path toward a new long-term health-care funding deal.
Both sides are optimistic a deal will emerge but there are some big divides to overcome, including how much more money Ottawa is willing to put on the table, and how much accountability the provinces are willing to put up in return.
The premiers have been asking for a new deal for more than two years. Trudeau kept punting until the COVID-19 crisis was largely over.
That time has come.
Trudeau has been clear a deal is not going to be finished this week. But here’s a snapshot of how we got to this point, and what they’re going to be talking about.
Money, Money, Money, Money
This year Canada expected to transfer almost $88 billion to the provinces and territories for health, education, social supports and equalization. The Canada Health Transfer, or CHT, is $45.2 billion, or 51 per cent of that.
In their 2022-23 budgets, the provinces collectively forecast to spend $203.7 billion on health care. Ottawa’s transfer accounts for 22 per cent of that. The provinces want that increased to 35 per cent, which would mean $26 billion more this year alone.
“There’s been continual demands for an increase in the CHT although I’ve never seen quite as large a demand for an increase as this one,” said Gregory Marchildon, a professor emeritus at the Institute of Health Policy, Management and Evaluation at the University of Toronto.
Trudeau intends to put an offer on the table Tuesday. It will not be an immediate increase of $26 billion, but Ottawa has been silent on where it will land.
While it has existed in its current form only since 2004, some sort of federal health transfer dates from 1957, when Ottawa offered 50-50 funding for health care to provinces that agreed to provide public hospital services based on national standards.
It has evolved and changed at least five times since then, including splitting the federal share between cash and a transfer of tax points — when the federal government cut its income tax rates and the provinces could raise their own in exchange.
In 1995, then-finance minister Paul Martin, desperate to turn around Canada’s debt problems, slashed the health and social transfer by 20 per cent, followed by a 15 per cent cut in 1996. Some provinces have said their health systems have never recovered.
In 2004, a new deal was reached between the premiers and Martin, who by then was prime minister, to see the Canada Health Transfer increased six per cent a year for a decade.
The Conservatives under prime minister Stephen Harper kept that in place, but told the provinces that in 2017-18, the CHT increase would be based on a three-year average of economic growth, but with a minimum increase of at least three per cent.
Trudeau and the Liberals have maintained that.
With economic growth, the annual CHT increase has averaged five per cent since 2017-18.
Over the last 10 years, the CHT has increased 67 per cent, to $45 billion from about $27 billion in 2012-13.
An attempt in 2016 to negotiate a new CHT deal mostly failed, resulting in one-on-one agreements between Ottawa and the provinces and territories to share $11.5 billion over 10 years, beginning in 2017-18, to improve mental-health and home care.
Angling for Accountability
In the split jurisdictional world Canada’s governments live in, provinces are the ones who control health-care delivery. So for the most part, the federal government helps fund it and the provinces get to say how it’s spent.
The Canada Health Act, passed in 1984, sets out the guiding principles for recipients of the Canada Health Transfer, including that health-care systems must be universally accessible. Failing to abide by the principles can, and has, resulted in Ottawa clawing back some transfers.
Trudeau has made clear any increase to federal health transfers must be met with provincial accountability to show results. The federal government has been frustrated at the lack of accountability from provinces over transfers for health care made during COVID-19.
It is adamant that will not be the case with a new funding deal, and is looking at a combination of an annual increase to the CHT and separate deals to target specific problem areas, like health-care worker retention and training, access to family doctors, surgical backlogs, and data collection and sharing.
The 2017 deals on mental-health and home care will be a bit of a model. Those deals saw Ottawa promise $11.5 billion over 10 years for the two areas, but in exchange provinces had to agree to a common set of principles and goals, and to report results.
The Canadian Institute for Health Information was tapped to help collect and publish data. The most recent report in December is still laden with gaps and incomplete data. The reports note it will take time for the reporting to lead to change, and that provinces need to harmonize their data collection in order to better compare statistics across provincial lines.
Marchildon said one of the biggest problems for the federal government in demanding accountability is that measuring health outcomes is difficult, and hard targets are rare.
It’s all about the numbers
Of course, it’s difficult to measure progress if you’re not keeping track.
Data — or the lack of it — is a long-standing weakness of Canada’s federalized system, with 13 separate health-care systems working alongside one another but not necessarily in tandem.
In his first public overture to open negotiations with provinces on health funding in November, Health Minister Jean-Yves Duclos told provincial health ministers the federal government would increase the Canada Health Transfer if provinces agree to work together on a “world-class health data system for Canada.”
“It is the foundation for understanding what we’re doing, who’s receiving services, whether we’re making improvements,” said Kim McGrail, a professor with the University of British Columbia School of Population and Public Health.
McGrail was one of several experts the federal government tasked with reporting on what a “world-class health data system” would look like in Canada.
Gaps in Canada’s data tripped up the national health responses in dozens of different ways during the pandemic, from tracking the number of COVID-19 cases to reporting adverse effects from vaccines.
The same is true of tracking surgical backlogs and other information about how well, or not, the health system is working.
“Data informs every part of the way we think about health,” McGrail said, which includes the health of individual patients.
Canadians who move from one province to another can’t easily access their records because the technology isn’t compatible.
It’s a problem that exists even within provinces, as incompatible technology makes records inaccessible between hospitals and clinics.
“We need those technology systems to be able to talk to one another, to be able to to move data back and forth or to send messages back and forth in some way,” she said.
It’s an expensive problem to fix. Just last week, Nova Scotia government signed a $365-million contract to bring new electronic health-care records to the province, which may or may not be compatible with other provincial systems.
McGrail said investments will pay off if important information about the health of Canadians stops falling through the cracks.
The expert panel delivered a report last year that will likely serve as a road map for improving data sharing in Canada. It includes 31 recommendations, starting with provinces, territories and the federal government agreeing on a shared national vision for health data.
Ontario and Quebec have indicated a willingness to work with Ottawa on data, though other provinces have been less firm about it.
Provincial leaders have been able to agree with Ottawa on the need to reform Canada’s long-term care homes, though exactly how to accomplish that is still up for debate.
Duclos has said helping Canadians “age with dignity” is one of Ottawa’s priorities for a new health-care deal, and long-term care plays a major role in that.
So does home care, and the 2017 bilateral deals already began to advance improvements on that front.
Long-term care is an entirely different story.
The pandemic cast a glaring light on the dismal conditions in care homes across the country, when COVID-19 outbreaks led to thousands of deaths and inhumane living conditions for seniors. The military and the Red Cross were summoned to help.
In the early months of the pandemic, Canada had the worst record for COVID-19-related deaths in long-term care of the world’s wealthy countries.
Meanwhile, residents were isolated from the outside world and workers struggled to provide basic care and ensure dignity.
Experts and advocates say the problems long predate the pandemic, and have gone largely ignored until now.
“Given the devastation that we’ve seen in the COVID-19 pandemic and the impacts on our health-care system … we’re seeing this unprecedented moment where finally there’s some hope of collaboration,” said Dr. Amit Arya, a palliative care physician and founder of Doctors for Justice in Long-Term Care, which advocates for an overhaul of Ontario’s long-term care system.
Governments are now scrambling to improve the conditions, as the number of people who need specialized care grows every year and the number of workers willing to provide that care dwindles.
Several provinces have already announced plans to increase the number of hours of care residents receive per day and build new spaces for the growing number of seniors who are living longer with more serious cognitive and physical impairments.
The federal government created a $1 billion “safe long-term care fund” during the pandemic to help pay for immediate infection prevention and control measures to stop the spread of the virus.
The government also set aside $3 billion to help provinces bring homes in line with national standards for the design and operation of long-term care, though specific agreements with provinces haven’t yet been signed to deliver that money.
Those standards were publicly released last week but are unlikely to factor into the health-care talks.
Still, there is plenty of work that needs to be done if provinces have a hope of meeting the standards, especially when it comes to the workforce.
“I think we’re stepping into a crisis,” said Dr. Joseph Wong, the founder of Yee Hong Centre for Geriatric Care, the largest non-profit nursing home in the country.
He said Canada will need upwards of 100,000 new personal support workers to provide care over the next 10 to 15 years in order to provide adequate care to residents.
“It is a time bomb,” he said.
The same could be said of the health system at large.
None of the lofty goals of the federal or provincial politicians will be possible if they don’t find a way to persuade workers to stay in hospitals, clinics and long-term care centres across Canada, said Linda Silas, president of the Canadian Federation of Nurses Unions.
“They don’t have the staff to do the job,” she said.
Staff shortages have been the common theme among some of the most serious issues underlying the public-health crisis in Canada.
Dozens of emergency rooms have been forced to close temporarily or reduce hours because there weren’t enough staff to treat urgent injuries and illnesses. The Canadian Medical Association estimates nearly five million Canadians don’t have a family doctor. And hundreds of thousands of Canadians are sitting on wait-lists for backlogged surgeries and diagnostic tests.
Health unions and professional associations want a national strategy to keep doctors, nurses and personal support workers in their jobs as well as train new staff to bolster their ranks.
Silas said after years of burnout and moral distress over not being able to care for their patients properly, nurses in particular have said, “I’ve had enough.”
Nurses in Ontario have also balked at a law limiting pay increases to one per cent a year.
Data from the Canadian Institute for Health Information shows that because of new graduates, the supply of nurses is still growing. However, many have chosen not to take full-time positions, and existing staff are increasingly eyeing early retirement, Silas said.
The heavier demands of the job since the pandemic, combined with fewer and fewer people to do the work, has created what even the federal health minister calls a crisis.
“We need to stop the bleed,” Silas said.
This report by The Canadian Press was first published Feb. 5, 2023.
Mia Rabson and Laura Osman, The Canadian Press
Governments seek buyer as Quebec COVID-19 vaccine manufacturer Medicago set to close
Quebec Economy Minister Pierre Fitzgibbon said Friday the province has had preliminary talks with potential buyers in the pharmaceutical sector to keep Medicago’s expertise and skilled workforce in Quebec. He said both the Quebec and federal governments would be willing to put in money to secure a deal.
“We can’t operate it ourselves; the government will not be the main shareholder,” Fitzgibbon said. “But if there is a pharmaceutical company that considers it’s worth continuing, we’re ready to help.”
Mitsubishi Chemical said Thursday it would stop marketing the Medicago-produced Covifenz vaccine, which is plant-based and was approved by Health Canada one year ago for adults aged 18 to 64.
The Japanese chemical company said it had been preparing to commercially produce the Covifenz vaccine but decided against doing so because of the “significant changes” in the COVID-19 vaccine environment. The company said it would dissolve Medicago because it is no longer “viable” to continue marketing its products.
“In light of significant changes to the COVID-19 vaccine landscape since the approval of Covifenz, and after a comprehensive review of the current global demand and market environment for COVID-19 vaccines and Medicago’s challenges in transitioning to commercial-scale production, the (company) has determined that it will not pursue the commercialization of Covifenz,” Mitsubishi Chemical said in a statement.
Following the announcement, Medicago issued a statement thanking its employees. “The Medicago team has pushed scientific boundaries and we know that they will continue to make incredible contributions to innovation and biopharmaceutical’s sector.”
Canada invested $173 million in Medicago in 2020 to support development of the Covifenz vaccine and help Medicago expand its production facility in Quebec City.
On Thursday, Innovation, Science and Industry Minister François-Philippe Champagne told reporters the federal government is in “solution mode.”
“Our first order of business is really to try to find a partner who can help us preserve the jobs, preserve the technology and the intellectual property,” Champagne said.
The minister acknowledged that mRNA vaccine technology for COVID-19 became dominant as it “seemed to be most effective.”
But Medicago’s plant-based vaccine was still “promising,” Champagne said.
“Everyone agreed that the plant-based vaccine could very well help in a future pandemic,” Champagne said.
Speaking to reporters on Montreal’s South Shore Friday, Fitzgibbon said the company informed the province at the end of December it intended to pull the plug on Medicago.
In May 2015, Quebec and Ottawa announced loans of $60 million and $8 million, respectively, for the construction of a complex in the Quebec City region to house Medicago’s activities.
“The challenge is not (getting the loan repaid), it’s how we can save the jobs, save this company,” Fitzgibbon said.
While Canada authorized Medicago’s vaccine in February 2022, it was rejected for emergency use by the World Health Organization in March because tobacco company Philip Morris was a minority shareholder in the company, contravening a policy adopted in 2005 by the United Nations agency.
Quebec City Mayor Bruno Marchand said on Twitter he was saddened by the closure of the company.
“My thoughts are with the families who learned some very sad news,” Marchand said Thursday evening. “We have to roll up our sleeves to keep all this expertise in the field of health innovation in Quebec City.”
This report by The Canadian Press was first published Feb. 3, 2023.
Sidhartha Banerjee, The Canadian Press
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