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Category "British Columbia"

9Mar

Daphne Bramham: Canada’s other public health crisis also needs urgent attention

by admin

There is a very real and deadly health crisis in B.C. from which two people died yesterday and two more will likely die today, tomorrow and the days after that.

It’s not COVID-19, and no news conference was hastily called to talk about it.

Most of those dead and dying are blue-collar guys in what should be the prime of their lives.

This is the reality as B.C. lurches into the fifth year of an opioid overdose crisis. It’s a seemingly unending emergency that by the end of 2019 had already killed 5,539 people here and more than 13,900 across Canada.

Five years in, this crisis has become normalized, with the only certainty as we face another day is that first responders are now better at resuscitating victims because, year over year, the calls have only continued to increase.

Last week, Prime Minister Justin Trudeau appointed his top ministers to a committee tasked with responding to the COVID-19 crisis. At that point, Canada had only 30 confirmed cases. Of the 21 B.C. cases, four of the patients have fully recovered.

Not to belittle the concerns about COVID-19 becoming a global pandemic, but with nearly 14,000 dead already, no committee — high-level or otherwise — has yet been struck to devise a national addictions strategy that would deal not only with opioids, but also the biggest killer, which is alcohol. A 2019 report by the Canadian Institute for Health Information found that 10 Canadians die every day from substance use, and three-quarters of those deaths are alcohol-related.

During the 2019 election, the issue flared briefly after Conservatives placed ads — mainly through ethnic media — claiming that Trudeau’s Liberals planned to legalize all drugs, including heroin.

Already beleaguered, Trudeau not only denied it, he quickly disavowed the resolution overwhelmingly passed at the party’s 2018 convention that called on the Canadian government to treat addiction as a health issue, expand treatment and harm reduction services, and decriminalize personal-use possession of all drugs, with people diverted away from the criminal courts and into treatment.

Trudeau disavowed it again this week when a Liberal backbencher’s private member’s bill was put on the order paper.


Liberal member of Parliament Nathaniel Erskine-Smith (in front) pictured in 2018.

Adrian Wyld/The Canadian Press

Depending on how you read Bill C-236, it’s either calling for decriminalization or legalization. Regardless, the fact that Nathaniel Erskine-Smith’s bill will be debated at least gets it on the political agenda because unless there are some major changes, Canadians are going to continue dying at these unacceptably high rates that have already caused the national life expectancy to drop.

Erskine-Smith, an Ontario MP from the Beaches-East York riding, favours a Portugal-style plan of which decriminalization plays only a small part.

But parliamentary rules forbid private member’s bills from committing the government to any new spending, so he said his bill could only narrowly focus on decriminalization.

The slim bill says charges could be laid “only if … the individual cannot be adequately dealt with by a warning or referral (to a program agency or service provider) … or by way of alternative measures.”

Erskine-Smith disagreed with the suggestion that it gives too much discretionary power to police — especially since in B.C., it’s prosecutors, not police, who determine whether charges are laid.

Still, what he proposes is quite different from what happens in Portugal.

There, police have no discretionary power. People found with illicit drugs are arrested and taken to the police station where the drugs are weighed, and the person is either charged with possession and sent to court or diverted to the Commission for the Dissuasion of Drug Use to meet with social workers, therapists and addictions specialists who map out a plan.

Since private members’ bills rarely pass, Erskine-Smith doesn’t hold out much hope for his.

It created a firestorm on social media, with some recovery advocates pitted against advocates for harm reduction, including full legalization.

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Federal Conservatives also repeated their trope that drug legalization is part of Trudeau’s secret agenda.

Meanwhile, Alberta’s United Conservative government inflamed some harm-reduction advocates with the release of a report on the adverse social and economic impacts of safe consumption sites, even though it didn’t recommend shutting them down.

The report acknowledged that they play an important role in a continuum of care, but it also called for beefed-up enforcement to lessen the chaos that often surrounds them.

The committee questioned some data provided to them that suggested Lethbridge — population 92,730 — may be the world’s most-used injection site.

The committee also questioned why some operators report all adverse events, including non-life-threatening ones as overdoses, leaving the impression that without the sites “thousands of people would have fatally overdosed.”

Among its recommendations are better data collection using standardized definitions as well as better tracking of users to determine whether they are being referred to other services.

More than a year ago, Canadians overwhelmingly told the Angus Reid Institute that they supported mandatory treatment for opioid addiction.

Nearly half said they were willing to consider decriminalization. Nearly half also said that neither Ottawa nor the provinces were doing enough to ease the epidemic.

It seems Canadians are eager for change even if they’re not yet certain what it should look like. The only ones who seem reluctant are the politicians.

dbramham@postmedia.com

twitter.com/bramham_daphne

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5Mar

Two B.C. post-secondary schools close over COVID-19 case

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A student tries to enter University Canada West in Vancouver on Thursday. The school is closing for three days for disinfection after two students were potentially exposed to the new coronavirus.


Jason Payne / PNG

COVID-19 could be a “gut shot” to B.C. schools and universities that rely on fees from international students, an immigration expert said Thursday, as two private post-secondary schools in Vancouver closed their doors because of a case of the novel coronavirus.

University Canada West said a student is in quarantine after being visited by her father. The father tested positive for COVID-19 after arriving from overseas for a visit and developing symptoms, according to Dr. Bonnie Henry, the provincial health officer. The student’s roommate is also in quarantine.

The business school and an arts and design school in the same building on West Pender Street will be closed for three days to do a deep cleaning.

“Students and staff who may have been in close contact with the affected students have been identified and contacted with information and advice,” said a UCW media release.

B.C. schools and universities said the coronavirus outbreak hasn’t significantly affected their international student programs, but administrators are monitoring the situation with an eye toward September enrolment.

At Simon Fraser University, a university-wide planning group is looking at possible impacts from the virus, including finances, said Angela Wilson, senior director of media relations and public affairs. SFU has not seen declining enrolment since visa offices have been closed in China and Iran, but they are monitoring the situation closely.

UBC has not seen any enrolment drops, but the situation is constantly evolving, said the director of university affairs, Matthew Ramsey.

UBC is working with prospective international students on a “case by case basis” to help those who may be experiencing difficulties getting their applications together, extending some deadlines to the end of March.

Ramsey could not say how many applications have been affected. UBC typically doesn’t have solid enrolment numbers until November.

“We are watching this really, really carefully,” he said about the virus, adding the university is following the advice of Canadian health authorities, including the B.C. Centre for Disease Control.

In January, UBC created a working group of people from across campus to discuss issues related to the virus, including how classes and exams might be offered using technology if attendance was no longer advisable.

Impacts on the Vancouver school district’s international student program “are minimal at present,” according to a statement provided to Postmedia.

“VSB programs are linear and the majority of international students arrive in August to study here. Given our enrolment timelines, it’s too early to provide enrolment details (for the) next school year.”

But Vancouver immigration lawyer Richard Kurland said the coronavirus should be a concern for schools and universities as the closure of some Canadian visa application centres abroad will make it difficult for students hoping to attend school here.

“Canadian schools are about to experience a cash crunch,” he said. “Stopping the visa application centres is like shutting off the water flow. They might not feel it yet, but it’s coming.”

Kurland said international students who are currently studying in Canada may not be able to return home. Students are not allowed to work more than 20 hours per week off campus.

“That should be lifted immediately. They should be entitled to work to support themselves,” he said.

Several school districts have cancelled field trips because of the virus, including Vancouver, Surrey and Burnaby. Overseas trips have been cancelled as well as those to New York City, Seattle, Burlington and Vancouver, Washington.

Also this week, the annual Asia-Pacific Association for International Education conference scheduled to be held in Vancouver later this month was postponed to March 2021. More than 2,500 people were registered to attend, said a news release.

In 2018, the B.C. government said the province had attracted more foreign students per capita than anywhere else in Canada — 130,000 in total — stating they inject $2 billion each year into the economy, creating 29,000 jobs.

In 2016, 28 per cent of UBC’s first-year contingent were foreign students.

A report on B.C. international students published in 2018 found that 13.7 per cent of post-secondary students in B.C. in 2016-17 were from outside Canada, as well as 7.7 per cent of the graduating Grade 12s. China (38 per cent) and India (21 per cent) were the two main sources of international students studying in B.C.

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With Postmedia files

gluymes@postmedia.com

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29Feb

Eighth case of COVID-19 recorded in B.C., say health officials

by admin



The patient is a woman in her 60s who is visiting family from Tehran.


Dr. Bonnie Henry, provincial health officer, gives an update on coronavirus, COVID-19, in this file photo.


Francis Georgian / PNG

B.C. now has eight cases of COVID-19.

Provincial health officer Dr. Bonnie Henry and Adrian Dix, B.C.’s health minister, gave the update at 10:15 a.m. on Saturday.

The patient is a woman in her 60s who is visiting family from Tehran.

The woman is in isolation at home with a relatively mild case, said Henry.

She is in the Vancouver Coastal Health region. A small number of her close contacts are also in isolation.

More to come…

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28Feb

B.C. seniors residences taking steps to prevent COVID-19

by admin


The coronavirus family includes COVID-19 and SARS-CoV, both of which can infect humans.


Genome BC / PNG

Seniors residences are among the B.C. health care facilities taking “robust steps” to prevent the spread of COVID-19 as the risk of severe illness increases sharply for people in their 70s or older.

In a statement, the B.C. Centre for Disease Control said that while the risk remains low at this time, those interacting with people at seniors residences should be aware of the “particular risks” and take precautions to protect the elderly from all respiratory viruses, including COVID-19 and influenza.

B.C.’s senior advocate Isobel Mackenzie told Postmedia she has “complete confidence” in the way B.C.’s health system is managing the virus, adding she wouldn’t hesitate to speak out if she was concerned.

“I don’t think we need to be fearful for seniors in care homes,” she said. “We need to have perspective.”


B.C.’s seniors advocate, Isobel Mackenzie.

RICHARD LAM /

PNG

Mackenzie pointed to the small number of cases of COVID-19 in B.C. despite the high number of people who have been tested. She said the higher risk for seniors right now remains influenza.

In the case of an outbreak of the virus in a seniors residence, disease outbreak protocols would “kick in,” she said. In the past, some B.C. residences have experienced norovirus and influenza outbreaks prompting them to close to visitors and requiring staff to don gloves, gowns and masks.

Echoing the messaging from the BCCDC, Mackenzie said B.C. has a “robust set of protocols” that could be put in place in care homes to deal with an outbreak of COVID-19.

But she said people should avoid visiting loved ones in a care home if they are feeling under the weather.

The BCCDC said all B.C. health care facilities are engaged in identifying those who meet the criteria for possible COVID-19 infection, ensuring they do not pose a risk to others. They are also supporting staff and visitors to follow proper handwashing guidelines and hygiene etiquette.

The centre also had a special message for people who interact with those living in seniors residences saying they should “be aware of the particular risks of respiratory illnesses to older people.”

Precautions to protect residents from all respiratory viruses include regular handwashing, coughing or sneezing into your elbow and staying home if you are unwell, have travelled to affected areas in the previous 14 days, or been in contact with someone who has tested positive.

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26Feb

Coronavirus in B.C.? Life with COVID-19 is going to look very different

by admin


Dr. Essam Hamza, a family doctor and pioneer in telemedicine, is shown in the CloudMD app he helped develop for doctor-patient consultations. CloudMD and Telus Babylon video consultations are covered by the Medical Services Plan for British Columbians.


NICK PROCAYLO / PNG

You have a fever, a cough and feel short of breath, but when you arrive at your family doctor’s office something doesn’t look quite right.

A sign on the door describing your symptoms sends you to another entrance and advises you to wear a surgical mask. The receptionist is wearing a mask and sitting behind a plexiglass shield. All the magazines and stuffy toys are gone.

The seats are covered with plastic sheets, but many of them have been removed altogether to create separation between people with flu-like symptoms and other patients. A sheet is hung from the ceiling to complete your isolation.

When you get to the exam room, it is stripped of all supplies and equipment save an exam table and the blood-pressure cuff that is bolted to the wall.

You’ve seen the images from China of empty streets and first responders wearing head-to-toe hazmat suits picking up the sick and the dead and wonder if it can happen here.

It can, and our health authorities are ready for it.

The changes to your doctor’s office are described in detail in B.C.’s Pandemic Influenza Response Plan, a collection of 14 documents that include instruction on everything from contagion surveillance to mass antiviral distribution.

Most if not all of the protocols and strategies prescribed by the influenza plan will be applied to fighting the COVID-19 coronavirus if a pandemic is declared.

“Since the severity of a virus can change throughout the course of a pandemic, and no one can say for certain how a pandemic will unfold, it is essential that planning and response measures be in place to mitigate its impact,” the plan notes.


Dr. Essam Hamza uses the CloudMD app he helped develop for doctor-patient consultations.

NICK PROCAYLO /

PNG

A multi-ministry overhaul of the plan has been underway for a month, according to the ministry of health.

Novel viruses spread more quickly than recurring flu viruses, which are limited by some level of immunity in the population. COVID-19 is encountering little to no immunity.

“There is no inherent immunity, there’s no vaccine and there is no crossover protection from previous flus,” said family doctor Essam Hamza.

Pandemics have been recorded about every 10 to 40 years since the 1600s. The Spanish flu outbreak of 1918 killed 55,000 Canadians and 20 to 100 million people worldwide.

The most recent pandemic was the H1N1 influenza outbreak of 2009 that saw nearly 9,000 people hospitalized in Canada.

The mortality rate of COVID-19 — based on preliminary statistics from China — is around 2.3 per cent, ranging as high as 15 per cent for the very elderly. The typical mortality rate for influenza A is lower, between 0.1 to 0.4 per cent.

“One of the first lines of defence in a pandemic is protecting health care workers and a big part of that is telling people not to come in to the clinic,” said Hamza, who is CEO of Premier Health Group, which recently released the CloudMD app.

“Telemedicine is going to be a big part of that, especially for determining who should come in for treatment and who should just stay home,” he said.


The coronavirus family includes COVID-19 and SARS-CoV, both of which can infect humans.

Genome BC /

PNG

Even if people do have coronavirus, doctors won’t necessarily want to see mild cases during a pandemic.

“For most people it will be a like a bad cold or the flu, but you have to reassure those people because they will be scared,” he said.

CloudMD and Telus Babylon video consultations are covered by the Medical Services Plan for British Columbians. CloudMD has about three million registered users and enables patients to see doctors, consult with pharmacists and get followup checks with nurses.

Both apps work on your smartphone, and CloudMD is also available via the web.

Videoconferencing is particularly useful for reviewing symptoms and lab results, refilling prescriptions and the 70 per cent of doctors’ work that doesn’t involve touching patients.

Bluetooth-based stethoscopes and otoscopes developed for use in remote First Nations communities by Premier Health’s Livecare can be used for a more hands-on-style remote exam.

“You can listen to the heart and lungs, or see an ear drum in high definition,” said Hamza.

rshore@postmedia.com

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24Feb

COVID-19: Here are all the B.C. cases of the novel coronavirus

by admin


As of Feb. 24, B.C. health officials had announced seven cases, only one of which has recovered so far.


THE ASSOCIATED PRESS

Health officials are currently tracking COVID-19, which has made its way to B.C.

The novel coronavirus is transmitted through large liquid droplets such as when a person coughs or sneezes and can enter your system through the eyes, nose or throat if you’re in close contact with an infected individual.

Symptoms include a fever, cough and difficulty breathing, according to the B.C. Centre for Disease Control. Those who think they’re infected should call a health-care professional before visiting a doctor’s office.

Here’s an updated list of cases confirmed in B.C.


RECOVERED — Case 1: Man, 40s, Vancouver resident

B.C.’s first COVID-19 patient was a man in his 40s. Officials said the man was first confirmed to have the novel coronavirus on Jan. 27, 2020. He had travelled to Wuhan and was put into isolation for recovery upon diagnosis here in the Vancouver Coastal Health region.

On Feb. 19, 2020, officials confirmed the man had been cleared of the virus after testing negative in two tests set 24 hours apart.

First coronavirus case in B.C. confirmed
One coronavirus patient in B.C. has recovered, no new cases
Official health authorities’ statement on first case

Case 2: Woman, 50s, Vancouver resident

The second B.C. case of COVID-19 was announced Feb. 3 in a woman in her 50s who lives in the Vancouver area. Officials believe the woman contracted coronavirus from two relatives who had been visiting her from the Wuhan area.

Second case of coronavirus reported in Metro Vancouver area
Official health authorities’ statement on second case

Cases 3 and 4: Man and woman, both in their 30s, visitors from Hubei province

The third and fourth cases of COVID-19 were reported Feb. 6 in a man and a woman in their 30s, both visiting from the Hubei province in China. The pair was visiting a Vancouver-based relative, who had earlier been announced as B.C.’s second case of COVID-19.

All three individuals in the household were placed on quarantine at home for recovery.

Third and fourth cases of presumptive coronavirus reported in Metro
Official health authorities’ statement on third and fourth cases

Case 5: Woman, 30s, B.C. Interior resident

The fifth case was announced Feb. 14 and was found in a woman in her 30s who had recently returned from Shanghai. The woman, who lives in B.C.’s Interior, remained in isolation at home while recovering.

Fifth case of coronavirus reported in B.C.
Official health authorities’ statement on fifth case

Case 6: Woman, 30s, Fraser Valley resident

B.C.’s sixth case of COVID-19 was announced Feb. 20 in a woman in her 30s who lives in the Fraser Health region. The woman had recently returned from a trip to Iran, where concerns are high over transmission after a sudden rash of cases in that country.

A number of close contacts of the woman were identified by health officials, including those on-board her flight to Vancouver, and were being monitored for symptoms.

B.C. woman diagnosed with COVID-19 after returning from Iran
Official health authorities’ statement on sixth case

Case 7: Man, 40s, Fraser Valley resident

The province’s seventh case of COVID-19 was announced Feb. 24 in a man in his 40s. Officials say the man had been in contact with the woman in B.C.’s sixth case, though the man’s symptoms began before the woman had been officially diagnosed.

The man’s close contacts have been identified and officials are monitoring them for symptoms.

B.C. heath officials say seventh case of COVID-19 confirmed
Official health authorities’ statement on seventh case

More to come …

sip@postmedia.com
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‘Working in a pressure cooker’: Violence against B.C. nurses linked to heavy workload

by admin


In September, a nurse at Abbotsford Regional Hospital was ambushed by a patient who struck her with an exercise weight, leaving her with a broken jaw and fractured cheekbone.


The heavy workload faced by B.C. nurses put them at higher risk of experiencing violence at the hands of their patients, according to new research from the University of B.C.

The study, published in the journal Nursing Open and funded by the B.C. Nurses Union, “validates” anecdotal evidence from nurses on the front lines of the health care system, BCNU president Christine Sorensen said Thursday.

“Nurses are working in a pressure cooker,” she said. “That pressure in the system transfers to patients … which can sometimes lead them to take it out on the first person who helps them.”

According to the union, 26 nurses each month suffer a violent injury at work, accounting for 31 per cent of all injuries from acts of violence in B.C.

Nurses report being verbally assaulted, which includes yelling, swearing and racial slurs, as well as physical abuse, which ranges from throwing food or bed pans to sexual and physical assault.

In September, a nurse at Abbotsford Regional Hospital was ambushed by a patient who struck her with an exercise weight, leaving her with a broken jaw and fractured cheekbone.

The UBC study found complaints from patients or their families are sometimes a precursor to emotional or physical violence.

Complaints can be part of the “spiral of aggression” that eventually leads to violence, said study author Farinaz Havaei, an assistant professor of nursing at UBC.


‘We need to address the root cause of the problem, which is the heavy workload,’ says Farinaz Havaei, an assistant professor of nursing at UBC.

Handout

The complaints often stem from workload issues, which affect the quality of patient care. The study looked at several factors to determine workload, including common measures such as staffing and patient load, as well as the number of interruptions, number of admissions and how sick or how much assistance patients required.

“The evidence shows that when nurses are overworked, they get more complaints. If they don’t have time to deal with the complaints, the situation can escalate,” said Havaei.

Nurses said they received an average of one complaint per month and experienced emotional or physical abuse from patients or their families at about the same frequency.

“We need to address the root cause of the problem, which is the heavy workload,” said Havaei, adding that a system to better track patient complaints would only be a “bandaid approach” to preventing violence.

Sorensen called on the provincial government to provide additional nurses to provide better patient care and help with workload, as well as protection safety officers to ensure safety.

In December, the provincial government announced a new agency to tackle workplace safety for health care workers, earmarking $8.5 million over the next three years.

The province’s health-sector bargaining associations, health employers and the provincial government will lead the new non-profit organization, which was born out of a working group of the same stakeholders.

In 2018, injury claim costs from health care workers totalled more than $107 million, an increase of about $11 million from the previous year, according to the province. It is expected the new agency will be operational by late spring.

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18Feb

Most parents believe kids will leave Metro Vancouver due to cost: poll

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More and more B.C. parents believe their children will have to leave Metro Vancouver one day due to the high cost of living.


Getty Images

More and more B.C. parents believe their children will have to leave Metro Vancouver one day due to the high cost of living.

According to a new Research Co. poll, 66 per cent of B.C. parents who participated in the survey said they expected their child or children would have to move away in the future due to the financial constraints of living in Metro Vancouver. That percentage is up 24 points to a similar poll conducted in 2019.

The newly released poll also found that the majority of B.C. parents struggle with stress due to work and finances, with 58 per cent of respondents saying they experienced work-related stress “frequently” or “occasionally” and 57 per cent saying they experienced finance-related stress “frequently” or “occasionally.”

Still half of parents (51 per cent) say they deal with housing-related stress, while 40 per cent say it is “moderately difficult” or “very difficult” to make ends meet.

Financial stress appears to affect more parents in Northern B.C., with 60 per cent saying they have a hard time getting by financially. Meanwhile, 45 per cent on Vancouver Island, 40 per cent in the Fraser Valley, 39 per cent in Metro Vancouver and 28 per cent in Southern B.C. put themselves in that same category.

The survey also found that three-in-five parents say it is “very difficult” or “moderately difficult” to put away savings, while two-in-five parents struggle with paying for day-to-day expenses (44 per cent), paying for childcare (42 per cent) and paying for transportation (39 per cent).

The survey was conducted online from Feb. 4 to 7, 2020 among a representative group of 623 B.C. parents between the ages of 0 to 18 years. The margin of error is +/-3.7 percentage points, 19 times out of 20.

13Feb

Virtual walk-in clinics increase access to doctors in rural B.C. communities

by admin


Fort St. John resident Candace Marynuik saw a doctor through the Babylon app by Telus Health.


Submitted photo / PNG

For weeks, Candace Marynuik hadn’t felt like herself.

She might have told a doctor about her “weird symptoms,” but since moving to Fort St. John in 2017 she had been forced to rely on the local walk-in clinic, lining up in sub-zero weather before sunrise to be turned away when every space was filled.

“I hadn’t seen a doctor in over two years,” she said. “Something didn’t feel right, but I didn’t know what to do about it.”

In September, a friend suggested an app she had used to get a prescription refilled.

Within hours, Marynuik had a virtual appointment with a B.C. doctor, and within a week she had done blood tests and an X-ray. She even had a suspected diagnosis — multiple sclerosis. She would need an MRI and a visit to the University of B.C.’s MS clinic in Vancouver to confirm the diagnosis, but doctors she had never met in person connected her with the right specialists.

“I don’t know how long I would have waited (to go to the hospital in Fort St. John),” she said. “By the time I got on the plane to Vancouver, my brain was in a fog.”


Fort St. John resident Candace Marynuik saw a doctor through the Babylon app by Telus Health.

Submitted photo /

PNG

The Babylon app by Telus Health was launched in B.C. in March, at that time the only province in Canada with a billing code to pay doctors for virtual visits.

While Telus was reluctant to provide Postmedia News with information on the number of British Columbians who have used the free app so far, the telecommunications company said “tens of thousands” of people have downloaded Babylon and completed consultations. January saw the highest downloads to date, with a 30 per cent increase over December.

“The growth has been significant,” said Juggy Sihota, vice-president of Telus Consumer Health. “Some of the stories people have told us bring tears to my eyes. It’s been used by a 97-year-old who had trouble seeing a doctor because of mobility issues, someone who said the app saved their family’s Christmas (and) people in rural areas who have to drive hours to see a doctor.”

Sihota said the number of doctors registered with the app is growing, with many drawn to the system by the work-life balance it provides. Some work part-time in clinics or their own practices and take calls through Babylon on the side. Like a physical walk-in clinic, the doctors bill MSP for the consultations.

Sihota said “connected care” is at the heart of the Babylon app. While patients receive access to the doctor’s written notes, they can also play back a video of their consultation. The virtual clinic also helps them arrange the necessary tests and followup appointments.

In a short survey conducted for Telus after each appointment, 92 per cent of respondents said their main request was resolved by the end of their consultation. Asked to rate the service, they gave it an average 4.9 out of five stars, a number that hasn’t dropped since March.

The top conditions treated by doctors through the app include mental health, sexual health, skin disorders and respiratory issues. So far, more women have used it than men.

“We should all have equal access to health care,” said Sihota. “We believe technology can make our health-care system better at less cost.”


The Babylon app by Telus Health connects B.C. residents with doctors.

PNG

Babylon isn’t the only example of virtual health care in B.C.

The primary health-care strategy announced by the provincial government in 2018 included an emphasis on technology solutions. At a news conference, Health Minister Adrian Dix said technology would be used to bring health care closer to home for those in rural and remote areas through the use of telehealth services and new digital home-health monitoring.

B.C. Children’s Hospital uses technology to link specialists to doctors and patients throughout the province through 19 telehealth centres, conducting about 140 virtual appointments per month. Specialists also provide advice to adult patients through a program called Rapid Access to Consultative Expertise.

The government paid nearly $3 million for about 43,000 video-conference visits to doctors in 2015-16. The number of virtual visits rose to over one million in 2016-17.

Telus Health has recently made a push into the health-care field, buying a chain of elite medical clinics and reportedly spending over $2 billion on a variety of digital-health tools.

Some doctors have questioned whether virtual health care erodes quality of care by eliminating long-term doctor patient relationships in favour of episodic care, while also making it more attractive for doctors to work for a virtual clinic, making it even harder to see a doctor in person.

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—With files from Postmedia News

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9Feb

‘Back at square one:’ B.C. Crohn’s patient struggles with forced transition to biosimilar medication

by admin

For 10 years, Debbie Aschwanden managed the symptoms of Crohn’s disease with a drug called Remicade.

When the provincial government announced it would no longer fund the drug through Pharmacare, she and about 1,700 patients with inflammatory bowel disease were told to switch to a less-expensive copycat drug before March 5.

For two months after she switched, the Williams Lake insurance broker struggled with “horrible” symptoms that felt like a Crohn’s flare-up or a bad flu.

“I was super sick,” said Aschwanden, who has a 13-year-old son. “I had to miss a few days of work even though I tried to push through.”

She switched to Inflectra first, one of the two biosimilar drugs indicated by the government to replace Remicade. After two infusions, her doctor switched her to another biosimilar called Renflexis, hoping for a better result. So far, she hasn’t had the same symptoms, but she isn’t feeling as healthy as she did while on the original biologic drug.

“After I was diagnosed (with Crohn’s), I was so thankful to find something that helped,” she said. “To have that ripped from under me was really tough. It was like I was back at square one.”

Crohn’s patients were part of a second group of British Columbians who were required to transition their prescriptions to a biosimilar equivalent beginning last year.

In September, the government announced gastroenterology patients across B.C. would have six months to switch their prescription from Remicade to Inflectra or Renflexis.

The news followed a similar announcement in May, when B.C. became the first Canadian province to stop funding three injectable drugs, including Lantus, Ebrel and Remicade, for non-gastroenterology patients. An estimated 20,000 patients were given until Nov. 25 to switch to biosimilar drugs for diabetes, rheumatoid arthritis, plaque psoriasis and several other chronic conditions.

Coverage for the original drugs would only be provided in exceptional cases, decided on a case-by-case basis.


Debbie Aschwanden with her husband Sepp and son Josef.

Submitted photo /

PNG

Biosimilars are similar to generic drugs in that they are manufactured after the 20-year patent expires on the original biologics. But they cost 25 to 50 per cent less than the original.

According to the B.C. Ministry of Health, the province spent $125 million on the three biologic drugs affected by the policy change in 2018, including $84.2 million on Remicade. Since Remicade was approved for sale by the federal government in 2001, the province has spent more than $671 million.

“We know that the use of biosimilars in other countries has worked extremely well in ensuring people get the medication they need, and it’s time we caught up,” Health Minister Adrian Dix said at a news conference in September. “By using biosimilars in B.C., we will be putting about $96.6 million back into health care over the next three years.”

But critics said the financial gains don’t offset the hardship experienced by patients who are sensitive to prescription changes.

“We’ve heard of dozens and dozens of challenges experienced by people in B.C.,” said Mina Mawani, president and CEO of Crohn’s & Colitis Canada.

She said the charity is aware of 140 Crohn’s patients who have applied for an exemption to receive coverage for Remicade, but only two have been approved. Among those denied was a person with Stage 4 cancer who also has Crohn’s disease and someone with a complex history of anxiety. Several nursing mothers are waiting to hear if their exemption requests will be approved.


Mina Mawani.

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“I feel disheartened,” said Mawani. “We’ve been told that patients are simply being emotional about switching. But we know they’re not emotional. This is their life.”

She said Crohn’s & Colitis Canada believes biosimilars are a safe and effective treatment for people with inflammatory bowel disease, but patients and doctors should have a choice.

“The issue is not about starting new patients on the biosimilar drugs. It’s about the government forcing people who are stable to make the switch. What does that do to their health, including their mental health?”

Mawani said the government isn’t able to answer that question because it is not adequately tracking the impact of the switch on individual patients.

The Ministry of Health was unable to provide answers to questions about outcomes for people with Crohn’s disease or the number exceptional requests it has received. Material on its website says B.C. spent nine years studying biosimilars before announcing the switch, consulting with a wide variety of physician and patient groups, as well as regional health authorities and Health Canada.

Figures provided by the Ministry of Health shows that as of Dec. 31, 55 per cent of B.C. patients on Lantus had switched to a biosimilar, while 78 per cent on Enbrel and 73 per cent on Remicade for non-gastrointestinal issues had switched, for a total of 11,930 patients.

Gastroenterology patients were given until March 5 to transition from Remicade to Inflectra or Renflexis. As of Dec. 31, 28 per cent, or 529 people out of 1,858, had switched.

Not everyone is upset about biosimilars, with many B.C. doctors and scientists in favour of them. As a result of thesavings, diabetics now receive coverage for an additional drug, Jardiance, which doctors had long advocated.

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Dix said he made the switch to a 15 per cent cheaper biosimilar to treat his Type 1 diabetes and there were no negative effects.

B.C. Diabetes’s medical director, Dr. Tom Elliott, also characterized the switch as a “non-event” for diabetics, calling the transition “seamless.”

“The big story for me is what the government is going to do with the money saved. It’s led to the approval of another drug, which is a great thing. What else will they do?”

Health Canada has also said it has no concerns about the B.C. policy and there are no differences expected between the categories of drugs when it comes to safety and effectiveness.

Since B.C. made the switch to biologic drugs, Manitoba and Alberta have followed suit, with Ontario considering the change as well. In Alberta, where patients have until July to transition, the Opposition NDP is urging the government to reconsider and Crohn’s patients rallied outside the legislature in December.

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With Postmedia files

gluymes@postmedia.com

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