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Winnipeg lupus patients on edge amid shortage of drug at centre of COVID-19 trials – CBC.ca

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An unproven claim a drug used to treat lupus can combat COVID-19 is causing an increase in prescriptions of the drug, creating shortages and putting Winnipeggers who rely on it on edge. 

Elena Anciro was diagnosed with lupus eighteen years ago and relies on taking hydroxychloroquine daily in order to function without being in intense pain, and to reduce the flare-ups that make it hard to get out of bed.

“People have called this medication ‘lupus life insurance,'” Anciro said. “It is vital.”

While the drug was created in the 1950’s to treat malaria, it is commonly prescribed to control inflammation and pain for those with lupus and rheumatoid arthritis. 

However, it came to the forefront in the fight against COVID-19 thanks to a famous tweet by U.S President Donald Trump.

The tweet sent earlier this month heralded it as a possible way to treat COVID-19.

It sent people scrambling to get their hands on the drug, causing a spike in prescriptions in Manitoba and a dire warning from the province’s health regulators — it was being over-prescribed and now they are facing “serious shortages.” 

“Due to the recent yet-to-be-proven claims of effectiveness of hydroxychloroquine sulfate against COVID-19 and the growth in prescribing for it, we are now faced with a very serious shortage (and some brands, outages) of the product,” read a March 26 notice co-authored by the College of Physicians and Surgeons, Nurses and Pharmacists.

“This presents very serious challenges for long-term continuity of care for patients suffering from rheumatoid arthritis and lupus.”

Manitoba reports spike in prescriptions of hydroxychloroquine

According to the notice there has been a “significant increase” in Manitoba over the past two weeks in the number of prescriptions written and dispensed for hydroxychloroquine and Kaletra — an antiretroviral used to treat HIV.

As part of mandatory reporting requirements, a drug shortage report was given to Health Canada on March 19 by the drugs’ manufacturer, Apotex Inc. It cited the shortage was due to “demand increase” for the drug.

Anciro is just one of the 15,000 Canadians who have lupus, an autoimmune disease that cause severe inflammation of the joints among other symptoms. A further 300,000 Canadians have rheumatoid arthritis, many of whom also rely on the drug to function in their lives. 

“When Trump announced that and this all happened, to have to not only worry about getting this sick from this highly contagious virus, [but also] having to worry about the pills that allow me to be well, is very stressful,” said Anciro.

Stephanie Corbett has lupus and says if she wasn’t able to take the drug, she would have to be hospitalized and would be in immense pain. (Supplied)

Stephanie Corbett is another Winnipegger who takes hydroxychloroquine daily to treat lupus. The mother of five was diagnosed with lupus nine years ago and says without the drug, she’d likely end up in the hospital.

So far, both have been able to fill their prescription without any issues. Both say it would take weeks for the drug to leave their system, but when it does, it’ll be devastating.

“It will be life-threatening for people like me,” said Corbett. 

“I’ll end up in the hospital. The rashes will start. The pain will get worse. You know, every symptom will start rearing.”

Clinical trial at U of M

While a clinical trial is currently underway at the University of Manitoba to see if hydroxychloroquine can be repurposed to reduce the severity of COVID-19, there are currently no approved treatments or vaccines for the virus.

Virologist Jason Kindrachuk says the key message for Manitobans is they need to wait and see the outcomes of these trials before jumping to conclusions.

“The data is simply not there. I’m not arguing for or against it. I’m just saying that right now we don’t have data to support that it is actually truly beneficial for patients,” said Kindrachuk, an associate professor at the University of Manitoba and Canada research chair in emerging viruses.

Jason Kindrachuk of the University of Manitoba says the scientific community needs to explain that they are still studying these drugs and don’t know all their benefits or possible negative affects. (Jaison Empson/CBC)

He says the scientific community needs to do a better job of communicating to the public the proven benefits of a drug.

“Our biggest concern is that we don’t want to give people false hope if we truly don’t know whether or not there’s a benefit, because, again, we can have a position where people are demanding hydroxychloroquine,” Kindrachuk said 

CBC reported last week that medical regulators across the country were seeing overprescription of drugs such as hydroxychloroquine and azithromycin, another drug being studied as part of the fight against COVID-19.

Regulators reported an increase in orders for the drugs from doctors who list it as “for office use.” These requests are typically from doctors who want to keep a supply on hand for future use, raising concerns that stockpiling was occurring. 

The Manitoba College of Physicians and Surgeons cautioned its members against stockpiling, warning that it may be reviewing prescriptions of these drugs and “prescribers must be able to demonstrate good medical care.”  

“These drugs have an intended use and prescribing these drugs as a precautionary measure leads to drug shortages and is compromising care for other patients,” the College wrote on Thursday.

Chief provincial public health officer Dr. Brent Roussin talks about a new Manitoba clinical trial looking at the effectiveness of using hydroxychloroquine, which has been used for malaria and other conditions, to treat COVID-19. 1:16

A warning was only given to nurses from their regulator, warning them not to prescribe Hydroxychloroquine or azithromycin to treat COVID-19.

“Nurses have an obligation to ensure that their practice and any treatment they prescribe is evidence-informed,” wrote the College of Nurses. 

Both Corbett and Anciro say they understand Manitobans are gravitating to the drug because they are scared. 

“But as of right now, there is nothing saying that the public should to be taking it,” said Corbett.

“So leave the drug for the people with the diseases that are taking it and that need it to survive.”

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N.S. reports no new COVID-19 cases, gathering limit increased to 10 – CBC.ca

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With no new case of COVID-19 being reported for the first time since March 15 in Nova Scotia, the province is increasing the number of people allowed to gather from five to 10.

“Today we come before you with good news. No new cases to report. Zero. That’s exciting,” Premier Stephen McNeil said at a press briefing on Friday.

Dr. Robert Strang, Nova Scotia’s chief medical officer of health said zero cases is a “significant and encouraging milestone.”

The new gathering limit is effective immediately, but physical distancing — except among members of a household or family bubbles — is still required.

The limit is the same indoors and outdoors, with an exception for outdoor weddings and funeral services, which can have 15 people.

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“I hate to be a damper on these joyous events, but at this time we need to make sure that the numbers are limited so the officiant is the only extra person and if you want a photographer or a DJ or something like that, they would be included in your number of 10 indoors and 15 outdoors,” Strang said.

The 10-person limit applies to:

  • Social gatherings.
  • Arts and culture activities like theatre performances and dance recitals.
  • Faith gatherings.
  • Sports and physical activities.

Strang said for faith gatherings, safety precautions are required. He said passing around a collection plate is not allowed. Strang said singing is highly discouraged because “people singing can significantly increase the spreading of respiratory droplets, [which] increases the risk of transmitting the virus that causes COVID-19.”

It also applies to businesses that are too small to ensure physical distancing.

Reopening timelines announced for campgrounds

The province also announced timelines for the reopening of more businesses:

  • Starting June 5, private campgrounds can open for all types of campers. But they can only operate at 50 per cent capacity and must ensure public health protocols are followed.
  • Provincial campgrounds will open to all Nova Scotians June 15, with the reservation line opening June 8. Those campgrounds will operate at a reduced capacity.
  • Pools can begin maintenance work to prepare for reopening, likely in time for summer.
  • Sleepover camps are not permitted this year.

Two things not changing are the requirement of self-isolating for 14 days when people visit Nova Scotia, and the household bubble is not expanding.

Nova Scotia Chief Medical Officer of Health Dr. Robert Strang called the announcement of zero new COVID-19 cases a ‘significant and encouraging milestone.’ (CBC)

“I know some of this is confusing. People say, ‘I can go to a restaurant and there will be 10, 20, 30 people in that restaurant as long as the tables are kept apart.’ That seems to be OK, but they can’t go hug their grandparents or they can’t go practise with their soccer team,” Strang said.

“It’s important that people understand we recognize those, but this is about taking measured steps so we can reopen the economy, loosen restrictions in a carefully, measured way.”

In a news release Friday, the province said the microbiology lab at the QEII Health Sciences Centre completed 1,034 tests on Thursday.

Why daycares are reopening later

McNeil addressed why daycares aren’t reopening at the same time as many other businesses on June 5.

He said he wanted daycares to reopen at the same time as everything else, but public health made a recommendation against it, so the date was moved from June 8 to 15.

“When public health comes to me and says the plan is not ready and they need another week, why would I go against that? That is about the safety of our children,” McNeil said.

Nova Scotia Premier Stephen McNeil said the decision to push back the reopening of daycares from June 8 to June 15 was made based on a recommendation from public health. (CBC)

He said “too many provinces” reopened daycares too soon and “look what’s happened in those provinces.”

“Some of you are saying, ‘Why didn’t you change the date of the economy?’ Because people have to get back to work to pay the bills and take care of their families,” he said.

McNeil acknowledged the 10-day difference “will be long for people going back to work right away and [who] need child care.”

Respect employees having child-care issues

McNeil asked businesses to “please respect” employees who have “issues with child care” over that 10-day period.

“We need to take care of each other, we need to be kind to each other, we need to support each other as our province tries to come back from COVID-19,” he said.

McNeil closed the briefing by addressing people who are asking about expanding their household bubble and “get the long-awaited hug.”

Provincial campgrounds, such as Rissers Beach Provincial Park in Lunenburg County, will open to all Nova Scotians June 15. (Submitted by the Department of Natural Resources)

“A hug is a beautiful and dangerous thing,” McNeil said. “Close contact means so much to us, but it is the very thing that could set our province back.”

McNeil said people can “hang out” now and grandparents can “watch your grandchildren play.” But to protect everybody, he said hugs, kisses and handshakes are off limits.

“Stay six feet apart a little longer,” he said. “If we continue to flatten the curve, we’ll be able to lift up your spirits by taking down more restrictions.”

Outdoor weddings are an exception to the gathering limit and are allowed to have 15 people, rather than 10. (Christian Petersen/Getty Images)

There remain 18 active cases of COVID-19 in the province, 14 of which are residents and staff at the Northwood long-term care home in Halifax. There are eight people in hospital, including three people who are in the intensive care unit.

Northwood remains the only long-term care facility in the province with active cases.

In an interview Friday, Northwood CEO Janet Simm said it was the first day “in a number of weeks” the facility had no new cases to report.

The Nova Scotia Health Authority’s COVID-19 map for Friday, May 29. (Nova Scotia Health Authority)

“So we’re celebrating that within the facility,” she said.

Fifty-nine people in Nova Scotia have died from the virus, 52 of those at Northwood.

Simm said 179 residents in Northwood had recovered as of Friday.

The state of emergency declared under the Emergency Management Act on March 22 has been extended to June 14.

Updated symptoms list

The list of COVID-19 symptoms recently expanded. People with one or more of the following updated list of symptoms are asked to visit 811’s website:

  • Fever (chills, sweats).
  • Cough or worsening of a previous cough.
  • Sore throat.
  • Headache.
  • Shortness of breath.
  • Muscle aches.
  • Sneezing.
  • Nasal congestion/runny nose.
  • Hoarse voice.
  • Diarrhea.
  • Unusual fatigue.
  • Loss of sense of smell or taste.
  • Red, purple or bluish lesions on the feet, toes or fingers that do not have a clear cause.
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Testing underway after 8 migrant workers at Elgin County farm test positive for coronavirus – Global News

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Officials with the Middlesex-London Health Unit (MLHU) and Southwestern Public Health (SWPH) say coronavirus testing is underway at a St. Thomas-area farm after at least eight temporary foreign workers tested positive for the virus this week.

An outbreak was declared on Thursday at Ontario Plants Propagation, a greenhouse operation along John Wise Line, days after the MLHU said it first became aware of a case Monday night involving a worker at the farm, health officials said on Friday.


READ MORE:
New Brunswick reverses ban on temporary foreign workers

That initial case led to 16 of the worker’s close contacts being tested on Tuesday, with seven of the tests coming back positive. As those workers live in London, the seven are included in the tally of new cases that was reported on Friday by MLHU.

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According to the health unit, another 40 workers living at the same complex as the first case were tested on Wednesday at London’s Carling Heights Assessment Centre.

The remaining workers in the group, meanwhile, were to be tested on Friday at Ontario Plants Propagation. Test results for all were expected over the coming days.

“The operator of this farm has been tremendously co-operative with us, and we believe that this outbreak is now contained,” said Dr. Alex Summers, associate medical officer of health with the MLHU, during Friday’s coronavirus media briefing.

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“Of course, we will be monitoring that very closely over the next couple of weeks.”






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Coronavirus outbreak: How the pandemic has exposed the vulnerabilities in the food supply chain

Summers said the workers had arrived primarily from Guatemala and Jamaica, and that as far as the health unit was aware, all had quarantined for 14 days upon arriving in Ontario.

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The workers are currently in self-isolation, and none have been admitted to hospital.

Health officials are still working to find the source of the outbreak, but Summers said it was believed they had been in Canada long enough that they either contracted it here, or “one of the other workers may have had mild symptoms that weren’t identified and transmitted it subsequently to their colleagues.”

“We believe that we have readily identified all close contacts and any additional cases,” Summers said. “Of course, we continue to watch for further results. But those tests have been done.”

Health officials stressed there was no risk to the public from the products grown on the farm, and that they didn’t believe there had been any close exposure or close contact outside of the migrant farmworker community.

“The living conditions for these migrant farmworkers were certainly a congregate living setting, but not exceptionally crowded, nor of specific concern for us,” Summers said.

“They were people living together and that would have resulted in the transmission.”


READ MORE:
B.C.’s agricultural sector short 6,000 to 8,000 jobs due to lack of foreign workers

COVID-19 cases have also been reported at other southwestern Ontario farms during the pandemic.

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Fifty-one workers, local and foreign, at Greenhill Produce in Kent Bridge, Ont., tested positive for the coronavirus last month.

In Windsor-Essex, at least 16 workers from three farms in the region had tested positive for the virus as of early this month, the region’s health unit said.

In March, four workers tested positive at Highline Mushrooms in Kingsville, Ont.

Approximately 20,000 migrant workers come to the Ontario each year to work on farms and in greenhouses.

— With files from Shawn Jeffords of The Canadian Press

© 2020 Global News, a division of Corus Entertainment Inc.

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Six people can be added to existing double bubbles, government announces – NTV News

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The provincial government announced Friday that residents can expand their bubbles effective immediately.

Up to six more people can be added to an existing double bubble. The new members do not have to be from the same household, but cannot change once added. The government still advises people to keep their bubbles as small as possible.

More guidance can be found online here: https://www.gov.nl.ca/covid-19/individuals-and-households/expansion-of-household-bubble/

Dr. Proton Rahman is scheduled to release new projections Friday on how the COVID-19 pandemic is unfolding.

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Dr. Fitzgerald announced no new cases of COVID-19 on Friday.

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