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Category "Health"

21Mar

COVID-19: Ministers announce supports for people struggling and poor

by admin

He said they are working closely with about 2,000 agencies and non-profits delivering social services to make sure they have what the need to operate through the pandemic.

The B.C. government will use a “crisis supplement model” to support people in income and disability assistance, and is reducing bureaucracy that slows down the delivery of services, Simpson said.

He said they are also forming a plan for assistance cheque-issue day next week. Drug overdoses and deaths spike on the last Wednesday of each month.

“We know this is a challenging time for all British Columbians,” Simpson said.

“It’s a challenging time around the anxiety that’s created by this virus, and the anxiousness, and that is even more challenging for people who are living vulnerable. For people who are poor, people with disabilities, people who are on the street, the homeless, it’s an extremely challenging time for that population in particular.”

11Mar

Daphne Bramham: Searching for happiness in the novel coronavirus era

by admin

This is a particularly joyless March and what have we got to look forward to? April, which T.S. Eliot called the cruelest month.

There’s angst all around. It’s impossible to have even a casual conversation with a stranger without the dreaded COVID-19 virus being raised, let alone dinner with friends or a few hours on social media.

We don’t know whether to be afraid or whether to risk being reckless by going to a restaurant, hockey game or pick up a friend at the airport.

We’re worried about the unknown ‘what next’ because even when there is a lull in the seemingly endless news coverage of all things viral, there’s so much more bad news.

The stock market collapse, the joyless battle of the American grandpas for president, the oil shock caused by a seemingly crazed prince, continuing migrant crises in Europe and the Americas, riots in India and so on and so on.

I want to run away from it all. Except for the virus, I would literally have been packing my suitcase right now for Bhutan — the first place on Earth to put happiness before the economy.

But COVID-19 put a stop to that.

My trip was postponed because of the turmoil of changed and cancelled flights, not fear of catching the virus. Ironically, it was only in cancelling that we discovered we’d been rebooked on a return flight that left a day later, took 35 hours with three stops and landed us in Detroit with no indication of how we’d get home.

I’m relieved, but grounded and surrounded with fear of the unknown. How do I — how do any of us — find happiness now when it seems there’s nowhere safe to go?

Naturally, I turned to Google. It’s perhaps a sign of the times that among the first quotes that came up was this misanthropic one: “Happiness comes from peace. Peace comes from indifference.”

That misanthropic recipe from tech entrepreneur Naval Ravikant belies the research, which says the opposite. Happiness comes from engagement, social contact, a feeling of belonging.

Then, up popped Marie Kondo’s exhortation to “spark joy” by decluttering. I nixed that as an immediate solution. But it’s something to keep in mind if ever the time comes for self-isolation.

Beyond that are dozens of others advising that the route to happiness is to find one’s “authentic self” or one’s “inner awesomeness.”

I retreated to the kitchen and put on a pot of soup. But rather than the usual Zen of chopping vegetables as the stock bubbled, it reminded me that I couldn’t find any lentils on the grocery store shelf Monday. Should I join the panicked rush? What if the crisis is real?

Most of us are urban-dwelling, just in time people. Grasshoppers, not ants. We’re a frail lot too when you consider the Inuit and Dene in the north, Andean highlanders in the south, nomadic Mongolians or our ancestors.

That’s why I travel, to see how others live. It’s how I’ve come to be on six of the seven continents and travelled in more than 40 countries. It’s why Bhutan beckoned and not a Caribbean beach.

It’s why on a gloomy, rainy day with a case of fake jet lag from the time change, I went looking and found happiness at the Museum of Anthropology. Pulling open drawers, there are small things of beauty and purpose. Towering poles are testament to survival and renaissance against astounding odds.

Wandering aimlessly, it’s impossible not to see the interconnectedness of human imagination and endeavour from the fearsome to the sublimely decorative to the practical.

(If fear or the virus keeps you home, you might want to try it virtually. The collection is online at http://collection-online.moa.ubc.ca/)

There were spears, swords, fertility figures, wedding dresses, bowls, spoons, as well as religious objects and necklaces with charms meant to ward off the unforeseen, the unpredictable and the deadly that have always stalked us.

On a recent trip to Edinburgh, I took a tour of Mary King’s Close where in 1645 the pneumonic or ‘black’ plague stalked the residents of the crowded underground tenements.

Their doctors dressed in long leather cloaks with large brimmed hats and wore grotesque, beaked masks made of tin and filled with herbs to repel the evil smells that were thought to carry disease. The sight of today’s health-care workers in HAZMAT suits, N-95 masks, visors and gloves are not less disturbing, albeit far more effective.

Humans understand science better now than in the past. With every new outbreak from HIV/AIDS to Ebola to SARS, the time from first detection to getting it under control has improved. Yet, the unseen and the unknowable remains no less frightening to us than it was to a 17th century Scot or a 19th century Haida.

Where once people flocked to church looking for benediction and salvation, these days they head to Costco.

But for some peace and perspective? Try some homemade soup and some quiet time at a museum … Just don’t touch your face and make sure to wash your hands for at least 20 seconds before you leave.

dbramham@postmedia.com

twitter:@bramham_daphne

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

by admin


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

twitter.com/glendaluymes

2Mar

Watching, wiping and waiting: How our institutions are protecting us from coronavirus

by admin

As the COVID-19 coronavirus spreads, you will be increasingly unwelcome in public with a cough or the sniffles as transit users and shoppers are actively avoiding people with respiratory symptoms.

Six people have now died in the Seattle area as the global death toll tops 3,000, and it’s making people edgy.

“I jumped off a bus” after a woman coughing and sniffling behind a surgical mask got on with suitcases, said transit rider Tom Sewid. “I asked if she just arrived from China and she said yes, Wuhan.”

“Bus driver, let me off,” he said. “He stopped and others got off as well and we waited for the next bus.”

People responding to questions on social media admitted to running away from symptomatic people in Costco, avoiding people wearing surgical masks and recounted seeing bus drivers scold passengers to “please cough into your sleeve.”

“TransLink is following the lead of health officials when it comes to response to COVID-19,” the company said. “Provincial Health Services says the risk to our customers and staff remains low and it has not directed us to make any operational changes at this time.”

Buses and trains are disinfected “regularly.”

Provincial health officer Bonnie Henry suggested more frequent cleaning on public transit and increasing the availability of hand sanitizer “so, if there is a lot of virus in the environment, it can be cleaned up before people touch their faces and (infect) themselves.”

B.C. Ferries is taking advice from the Public Health Agency of Canada and B.C. Centre for Disease Control regarding COVID-19 coronavirus.

“We have standard procedures in place to mitigate the spread of illness on our ferries and at our terminals,” said a spokesperson. “As a precaution, crews at our terminals and on board our vessels are taking extra measures to clean all touch points.”


Students at UBC take precautions and wear surgical masks on Monday. Building operations staff are cleaning touch surfaces such as door knobs and faucets on a daily basis.

Jason Payne /

PNG

People who are experiencing cold or flu symptoms should probably avoid transit and self-isolate to do what they can to avoid spreading COVID-19 coronavirus, said Stephen Hoption Cann, a clinical professor in the School of Population and Public Health at UBC.

“When I teach, I notice a lot more students are deciding not to come to class with cold symptoms, because it’s just unwelcome to be coughing,” he said. “Before they might have just toughed it out.”

As COVID-19 is detected in more countries, the virus will become harder to contain, he said. New cases are leaking out of Egypt, which hadn’t been thought to have widespread infection until now.

UBC has installed additional hand-sanitizing stations in high traffic areas across campus, said Matthew Ramsey, UBC’s director of university affairs. “We are reminding everyone in our community again today what the proper procedures are for limiting the spread of illness.”

Building operations staff are cleaning touch surfaces such as door knobs and faucets on a daily basis.

“The cleaning protocols were changed after the SARS outbreak to recognize the need to be more vigilant,” he said.

The car-sharing firm Evo has warned its members not use their cars when they are ill and launched a feature this week allowing members to rate the cleanliness of vehicles to determine which cars need extra cleaning.

Evo cleans each vehicle once a week, but has started using “extra disinfectant,” said Richard Gaspar, Evo’s senior manager of business operations.

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The provincial health officer is reviewing the criteria for managing crowd events.

“They are cancelling sporting events in Italy and that’s something you do if you aren’t sure whether (a virus) can be contained,” said Henry.

The H1N1 outbreak of 2009 came close to imperilling the 2010 Winter Olympic and Paralympic Games, she noted.

“We weren’t preparing for a pandemic necessarily, but if the Olympics had been scheduled for November 2009 we would have been in serious danger of cancelling or postponing,” she said. “You need a lot of (Intensive Care Unit) capacity to support the Olympics and that is what Tokyo is looking at right now.”

As COVID-19 outbreaks spread beyond the 50 countries already reporting confirmed cases, containment will become increasingly difficult, said Theresa Tam, chief public health officer for Canada.

“As the number of countries that are affected increase, border measures actually become less effective … and less feasible,” she said. “We are trying to identify individual travellers linked to affected countries, so public health is spending a lot of attention and been very effective taking on individual cases.”

Border entry points provide a moment for education of travellers and those messages are already “expanding and shifting as we speak,” she added.

Travellers are being asked to present themselves to border service agents if they have any symptoms so they can be assessed.

“So far in Canada, this approach has worked very well,” she said.

rshore@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

Ian Mulgrew: Marathon medicare trial finally ends

by admin

The interminable constitutional trial over the provision of private health care in B.C. — dubbed The Flying Dutchman of the B.C. Supreme Court by lawyers — finally made it back to harbour Friday.

In many ways, what should have been an intellectual cruise involving a few months of written argument and data from the medical system became a veritable Royal Commission that has generated a library of evidence. It involved 194 days of proceedings over 3 1/2 years that mocked timely justice and badly bruised the belief that the courts can act as an effective brake on bad government by providing a remedy to unconstitutional law-making.

The length of time and cost of the case are an argument that the courts are no longer capable of efficiently resolving such thorny questions of social policy.

As intervener lawyer Joseph Arvay said: “This case would appear to be, at least in my experience, the most complex Charter case I’ve ever seen. And one that truly does test the institutional competence of the court.”

At a time when more and more Canadians think the country isn’t working, the dysfunctional legal system must be considered a primary reason. Indigenous people have run into the same problem trying to hold governments to account through litigation — they too have found themselves bogged down in endless process that pours millions-of-dollars into lawyers’ pockets.

The duration brought its own risks and demands on memory — the constitutional challenge of two provisions of the Medicare Protection Act was nearly derailed late last year when B.C. Supreme Court Justice John Steeves required health care. This week Steeves couldn’t remember what prevented the government from enforcing the law.

“There is in place a consent order allowing private surgical services to continue,” Dr. Brian Day’s lawyer, Robert Grant, explained — issued by Justice Janet Winteringham following an injunction she granted in November 2018 after Victoria amended the law and planned enforcement, though its validity was in question.

“Did I sign 
that (order)?” the justice asked.

“No, it carries on from Justice 
Winteringham,” Grant replied.

“So, it has to do with the amendments, as I say, that occurred during my trial,” Steeves said.

“Exactly,” Grant said. “And what it did is effectively to 
confirm they won’t be employed until your lordship 
ruled, so that allowed the status quo to continue.”

“Maybe (government lawyer Jonathan) Penner can give the minister my 
compliments for making my job easier,” the justice quipped.

Two private clinics and a handful of patients launched the litigation roughly a decade ago because the constraints on dual practice by doctors and private health insurance would force private clinics and diagnostic centres across the province to close. No evidence or data was offered by either government to support the assertion that the private clinics cause harm to the public system and B.C. has not measured the impact or effect of the clinics that have existed for a generation.

“They would have welcomed an opportunity for an impartial objective empirical study,” Grant said. “It might have made this litigation unnecessary as it would have confirmed that private surgeries did not have any adverse effects on public surgeries.”

The Vancouver lawyer accused the government of grossly mischaracterizing and misrepresenting evidence in closing statements he said were little more than fearmongering. He pointed out B.C. has had de facto private health care for 20 years and the sky hasn’t fallen.

To end that status quo, he added, would make the public health system even more overcrowded as the 65,000 private surgeries done annually join already historically long waiting lists.

“Nobody gets 
ahead in the public queue by having private 
surgery,” Grant explained. “What happens is you leave the queue. 
You’re not jumping the queue, you’re leaving the 
queue.”

Instead of relevant data, the federal and provincial governments resorted to fervid rhetoric about the prospect of U.S.-style health care and the poor languishing in dirty beds at the mercy of greedy, unscrupulous physicians. At one point they accused a respected neurosurgeon of having “scaled back public work because he wanted more time to smell the roses and read a book.”

“This is an egregious mischaracterization of the evidence,” Grant told Steeves. “In fact (the doctor) suffered a family tragedy. His wife developed terminal cancer — and he needed to scale back his public on-call commitments as he couldn’t be operating all night due to his family’s needs … With his wife’s illness and passing, he could not do this with four children.”

Grant swept the broader accusations aside too:

“If there was one shred of 
evidence that doctors practising 
in the private system, just one piece, one example 
of a doctor performing private pay surgery, 
shirking a commitment to the public system or 
causing any problem at all for the public system, 
we can be certain they would have called that 
evidence, but they didn’t.”

He urged Steeves to draw an adverse inference from the government’s failure to call a single doctor or senior administrator to give evidence about problems the public system had experienced as a result of private surgeries.

“The evidence in this trial shows thousands of British Columbians wait too long past government-mandated medically maximum acceptable waits for their condition, risking progression of disease and in some cases shortened lifespan or death,” Grant concluded. “In evidence in this trial, is the fact that in one year, in just one health region in B.C., Fraser Health, 308 patients died waiting for medically necessary surgery. B.C. patients need a ‘safety valve’.”

Before the courtroom emptied, Steeves said: “I’m looking forward to completing my judgment and setting my name on it, and, once I’ve done that, I’ll join the rest of the world watching the progress of this case with great interest.”

He is expected to take several months, perhaps longer, on his ruling. Appeals are expected to follow, which means a final decision could be two, three or more years away.

Outside of court, Day, the face of the litigation, said he was relieved that the trial was over.

“Suffering patients — the more than 30,000 a year who wait past the government’s own maximum acceptable wait times, and the 18-a-week who die on public wait lists in B.C. — need the justice system to rescue themselves from their plight,” he said. “It’s astonishing that we are the only country on earth that outlaws private health insurance.”

imulgrew@postmedia.com

twitter.com/ianmulgrew

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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25Feb

Daphne Bramham: It’s not enough to just keep overdose victims alive

by admin

There was some good news in the 2019 data from the B.C. Coroners Service. Overdose deaths in the province declined for the first time since fentanyl-tainted drugs hit the streets and a public health emergency was declared in 2016.

The decrease was significant — down 36 per cent from 2018 — even though the death toll remains heartbreakingly high. As B.C. enters its fifth year of the crisis, nearly three British Columbians are dying every day.

It does mean that all of the money poured into this crisis — for naloxone kits, the training for paramedics, medical professionals and laypeople in how to use naloxone, more supervised consumption sites, and more people now on prescriptions for drugs like methadone and Suboxone to staunch addicts’ opioid cravings — is keeping more people alive.

But that’s really where the good news ends.

Alarmingly, the number of 911 calls has continued to climb.

Paramedics and other first responders took more than 24,000 calls last year, with calls spiking to more than 130 overdose alerts on “cheque days” or “welfare Wednesdays.”

Being revived from an overdose or living with an opioid addiction comes at a high cost.

Opioids affect the receptors in the brain, causing breathing to become dangerously slow, which in turn slows the heart and sometimes causing cardiac arrest. When the hearts doesn’t pump at capacity, less oxygenated blood makes it to the brain. Without oxygen, brain cells die — and they don’t regenerate.

It’s called toxic brain injury.

Within the coming weeks or months, the B.C. Centre for Disease Control will release data on the prevalence of brain injury among opioid users, including those who have been successfully restored to life with naloxone.

“We know that many hundreds of people will need a lifetime of care,” said Dr. Perry Kendall, who raised the alarm during the coroner’s news conference earlier this week. “It will be a tremendous burden.”

It’s far from the only one.

The burden carried by first responders is different and no less costly. They are burning out and checking out of the system, unable to cope physically, mentally or emotionally with the constant stress of being called to deal with all the overdoses.

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This is not to say that harm-reduction measures aren’t working. No one disputes that they are keeping many people alive.

But until now, little attention has been focused on the quality of their lives, post-overdose.

Five years into the public health emergency, Chief Coroner Lisa Lapointe said B.C. still doesn’t have a comprehensive system that includes prevention, treatment and recovery.

The lack of a seamless system is particularly problematic and even deadly for people in rural areas and those coming out of jails and prisons, according to Dr. Nel Wieman, senior medical officer at the First Nations Health Authority.

The numbers back that up. The death rate in the Northern Health Authority, at 22.5 per 100,000, trails Vancouver Coastal, which has the highest rate, by a mere half a percentage point.

Regardless of where they live, Lapointe said families frequently tell coroners how their loved ones managed through detox only to come out and die while on the waiting list for a recovery bed.

The problem isn’t necessarily that there aren’t enough treatment beds. On most days, some lie empty because the government only funds treatment for welfare recipients. Everyone else has to pay their own way. And except for those with generous employee benefits, many can’t afford treatment that comes at a cost of $900-plus a day.

Lapointe also decried the lack of provincial treatment standards. Different operators have different approaches. Some aren’t evidence-based. Some are strictly abstinence-based and refuse to accept people on drug therapies such as methadone and Suboxone, even though without that, they are more vulnerable to overdose if they relapse.

Decriminalization is touted by some as the answer. Without fear of criminal charges, the theory is that people would be more willing to seek help.

They point to Portugal, where decriminalization was brought in as part of a massive overhaul of its drug treatment system.

But decriminalization has only worked there because Portugal also boosted spending on the other three pillars — prevention, enforcement and treatment.

Here, the crucial elements are missing. With a minority government in Ottawa, the Liberals already have enough problems on their plate to risk raising the controversial idea of decriminalization.

Meanwhile, most provinces, including B.C., haven’t invested enough in the infrastructure to put a Portugal-style model in place.

This week, Mental Health and Addictions Minister Judy Darcy agreed that there are enormous gaps in B.C.’s fragmented system.

When the New Democrats were elected less than three years ago, she said the drug treatment system had been neglected for so long that it was not able to cope with regular tasks, let alone a public health emergency.

The government is taking steps to fix that. But whether it’s moving fast enough is a conversation that both the coroner and chief medical health officer are pushing British Columbians to have because the lives of many loved ones depend on it.

dbramham@postmedia.com

Twitter: @bramham_daphne

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