From TVO The Agenda with Steve Palkin
When the world was hit with a novel coronavirus two years ago, it was one of the handful of times this pathogen has been present. Or was it? Epidemiologist Dan Werb, author of “The Invisible Siege: The Rise of Coronaviruses and the Search for a Cure,” discusses the world’s history with the coronavirus, the intersection of outbreaks, science, and the business of finding vaccines and treatments.
From the CJRU 1280AM radio show
Toronto harm reduction workers magnify the need for additional supports in their roles and for a regulated, less toxic drug supply
Juno Zavitz, program coordinator of Breakaway Community Services’ grief, loss, and wellness initiative (GLoW) discusses additional support for harm reduction workers.
Haley Thompson, project manager of Toronto’s Drug Checking Service, highlights policy-related barriers to harm reduction present in the city. Last episode we heard that drug checking revealed high levels of contamination in the unregulated drug supply. Contamination refers to the addition of a drug to the original substance that drug using people do not expect to be present. The program informs those drug using people who submit samples what is in their drugs and alerts clinicians who treat drug using patients to potentially harmful substances in the drug supply.
Thompson calls on the need for regulation and decriminalization of the unregulated drug supply to combat the opioid poisoning crisis.
“There are a few safer supply programs popping up across the country but they tend to have rather stringent eligibility criteria. We’re supportive of the decriminalization of drugs for personal use because it separates drug use from criminality. But it’s definitely not sufficient because it does nothing to address the toxic drug crisis or the toxic drug supply, which is what we know is harming people,” says Thompson.
Op-ed in TIME Magazine by Dr. Dan Werb
In 1985, the first HIV vaccine trial was launched with great fanfare. The previous year, Margaret Heckler, the U.S. Secretary of Health and Human Services, confidently declared that an HIV vaccine would be created within two years. But almost four decades after the initial discovery of the HIV virus, there is still no viable HIV/AIDS vaccine. That doesn’t mean, though, that there is no cure. The grueling and largely thankless work of trialing an HIV/AIDS vaccine has continued steadily over the past four decades (the most recent one launched in January 2022, using Moderna’s mRNA technology), making it the longest-running modern pandemic.
But failure, in the hands of scientists, doesn’t mean the end. Instead, it is a sturdy foundation for scientific discovery. Rather than giving up, the failure to create a viable HIV vaccine spurred scientists to develop a whole new strategy to end the AIDS pandemic. Without vaccines available to teach human immune systems to kill the virus, scientists were forced to find other ways to keep infections at bay. And here’s where four decades of scientific failure was transformed into a radical approach to pandemic control, with direct implications for the future of the global effort to end COVID-19.
From the CBC News article
Ontario’s chief coroner is investigating several cold-related deaths among Toronto’s homeless population and evaluating whether to hold an inquest on the issue.
An advocacy group has requested an inquest, Dr. Dirk Huyer said. At least two homeless people have died as a direct result of the cold in Toronto this winter, but advocates believe there are more.
“The inquest request is being evaluated by our regional supervising coroner,” Huyer said in an interview.
Health experts and advocates say there’s a lack of centralized data on homeless cold-related deaths and injuries, which they say makes it harder to push for changes to support those who live outside.
Those deaths and cold-related injuries don’t currently go into any central repository, said Dr. Stephen Hwang, a physician and researcher at the MAP Centre for Urban Health Solutions at the Unity Health Toronto hospital network.
There’s also currently no legislation that mandates systematic reporting of hypothermic injuries, unlike COVID-19 or tuberculosis cases, he said.
“I’m not sure if the problem of hypothermic injuries and deaths has got better or worse over the last year compared to previous years,” he said.
Hwang sought to get a better sense of hypothermic injuries and deaths in Toronto on his own several years ago. He had to comb through records of emergency departments and coroner records between 2005 and 2015.
He found 79 hypothermic injuries, such as severe frostbite, and 18 deaths in Toronto during that stretch.
Together, we will discuss and explore the scientific evidence and real-world solutions that we believe have the potential to transform our country. Our vision is a Canada where everyone has the opportunity to thrive.
In this first season of MAPmaking, we are exploring the recommendations from MAP’s Equity Roadmap Report, a set of 13 recommendations for a more equitable COVID-19 pandemic recovery in Canada.
Episode one features Gautam Mukherjee, Executive Director of Houselink and Mainstay Community Housing. Gautam has worked in the housing and homelessness sector for 20 years and is a passionate advocate for social justice, inclusion and housing for all. In this episode, Gautam and MAP Director Stephen Hwang discuss and explore a recommendation from MAP’s Equity Roadmap Report: the expansion of permanent supportive housing programs with high fidelity to the Housing First approach.
Dr. Tara Kiran speaks with CBC White Coat, Black Art’s podcast The Dose
The pandemic interrupted routines for health, work and family — including regular checkups.
So if you haven’t been to see your family doctor since before March 2020, now may be the time.
“There’s a lot of diseases still going on,” Dr. Peter Lin, a Toronto-based family doctor and a director at the Canadian Heart Research Centre, told CBC podcast The Dose.
“If you have diabetes, high blood pressure, all of those things need some fine-tuning.”
Those who have a chronic illness or new pain should see their health-care provider right away, he said.
And if you’re overdue for an age-related cancer screening test, like a Pap smear, colonoscopy or a mammogram, get in touch with your family doctor.
If you’re unsure whether you need a checkup, several physicians told The Dose about what to consider before making an appointment.
Contrary to its name, an annual checkup isn’t something most people need every year, said Dr. Tara Kiran, a family physician at St. Michael’s Hospital.
“That’s a little bit of a misnomer.”
Instead, most practitioners and their staff look at several factors before seeing someone.
“What we do is really try and target preventive care based on people’s health history and their age, sex and the [medical] history of their family,” said Kiran, who is also the Fidani Chair for improvement and innovation at University of Toronto’s department of family and community medicine.
From the CBC News article
Health-care practitioners say this is the second difficult winter in a row for those who live outside. Pandemic pressures on an already-stretched shelter system as well as restrictions prohibiting eating — and getting warm — in fast-food restaurants have left many with nowhere to go on cold nights.
Toronto’s shelter system has been full or near capacity for years. This winter, Harrison and others say they have often called the city’s central intake office only to be told no beds are available.
Emergency departments have become ad hoc warming centres, says Dr. Stephen Hwang, a physician and researcher at the MAP Centre for Urban Health Solutions at the Unity Health Toronto hospital network.
He says the network has an outreach worker who calls intake on cold nights in an effort to find spots inside shelters.
“There’s just been not enough space for people,” he says.
The city says it has added 400 new shelter spaces and 165 spots in warming centres this winter. It has also kept warming centres open since Jan. 7, instead of only during extreme cold weather alerts.
Advocates say that’s not enough.
At least two homeless people have died as a direct result of the cold, although data on the subject is hard to come by.
Op-ed in The Globe and Mail by Zoe Dodd, Eris Nyx, Corey Ranger, and Mark Tyndall
In December, the Alberta government set up a committee to consider the merits of providing access to a regulated supply of pharmaceutical-grade drugs, also called safe supply, in response to the continuing drug-poisoning crisis.
This crisis has killed more than 27,000 Canadians since 2015, and there is no end in sight. The introduction of fentanyl, unpredictable drug combinations and other deadly contaminants into the drug supply has resulted in a protracted massacre of people who were already being left behind.
As a group, we have declined the invitation to appear before the Alberta government’s committee. We feel that this is a deeply flawed process and that the conclusions have been predetermined. While we remain committed to saving lives through providing access to a safer drug supply, we refuse to lend any credibility to the process.
While governments across Canada have largely been sitting on the sidelines as this crisis has unfolded, Alberta’s United Conservative Party has taken an aggressive stance against people who use drugs by actively opposing harm-reduction interventions, targeting both evidence-based supervised injection sites and injectable opioid agonist treatment programs. The government has instead promoted abstinence-based treatment programs and tougher law enforcement.
Further, its safe-supply committee clearly lacks impartiality: It consists of only MLAs from the UCP. Members of the Opposition NDP walked away from the legislative committee. The party’s mental-health and addictions critic, Lori Sigurdson, described it as a “rigged process” after reviewing the list of more than 20 “experts” who were invited to present.
Article d’opinion publié dans le Globe and Mail par Zoe Dodd, Eris Nyx, Corey Ranger et Mark Tyndall
En décembre, le gouvernement de l’Alberta a mis sur pied un comité chargé d’examiner les avantages d’un accès à un approvisionnement réglementé en médicaments de qualité pharmaceutique, également appelé approvisionnement sûr, en réponse au problème persistant des intoxications médicamenteuses.
Cette crise a tué plus de 27 000 Canadiens depuis 2015, sans que la fin ne soit en vue. L’introduction du fentanyl, de combinaisons de médicaments imprévisibles et d’autres contaminants mortels dans l’approvisionnement en médicaments a provoqué un carnage chez des personnes qui étaient déjà marginalisées.
En tant que groupe, nous avons décliné l’invitation à comparaître devant le comité du gouvernement de l’Alberta. Nous pensons que ce processus est profondément déficient et que les conclusions ont été préalablement établies. Alors que nous restons déterminés à sauver des vies en donnant accès à un approvisionnement en médicaments plus sûrs, nous refusons d’accorder une quelconque crédibilité à ce processus.
Alors que les gouvernements de tout le Canada sont restés en retrait face à cette crise, le Parti conservateur uni de l’Alberta (PCU) a adopté une position ferme à l’encontre des personnes qui consomment des drogues en s’opposant activement aux interventions de réduction des risques, ciblant à la fois les sites d’injection supervisés fondés sur des données probantes et les programmes de traitement des agonistes opioïdes injectables. Le gouvernement a plutôt encouragé les programmes de traitement fondés sur l’abstinence et l’application plus stricte de la loi.
De surcroît, son comité d’approvisionnement sûr manque manifestement d’impartialité : il est composé uniquement de députés du PCU. Les membres de l’opposition du NPD ont quitté le comité législatif. La porte-parole du parti en matière de santé mentale et de toxicomanie, Lori Sigurdson, a qualifié le processus de « truqué » après avoir examiné la liste de plus de 20 « experts » invités à faire une présentation.
Who is encouraged to apply?
We strive to create a supportive environment for this work focused on health equity. Panel members will be compensated at a rate of $100 per hour using funding for this project from the Canadian Institutes of Health Research. We estimate that over the coming year, panel members will spend approximately 10 hours reviewing materials and approximately 10 hours participating in meetings that will take place during normal working hours (usually from 1 to 3 pm EST). Panel members will be co-authors of the resulting article presenting the recommendations aimed at promoting health equity through preventative health care during the pandemic recovery period.
Questions? Please contact Dr. Nav Persaud at nav.persaud@utoronto.ca
Op-ed in the Toronto Star by Dr. Sloane Freeman, Dr. Ripudaman Minhas and Dr. Kevin Schwartz
The COVID-19 vaccine is safe, effective, and recommended for children aged 5 years and older, yet, nationwide, COVID-19 vaccine uptake has been low in children 5-11 years of age. To date, only 28 per cent have received two doses.
Increasing vaccination rates in this age group must be our priority. Some provinces have mandatory immunization programs for school-aged children, and questions have been raised about the suitability of this approach for the COVID-19 vaccine.
As pediatricians and child health advocates, our considerations surrounding COVID-19 vaccine mandates in children include: Will they prevent serious disease in the individual? Will they protect the community by decreasing transmission? Will they address the root cause of low uptake in children? There is much debate as to whether mandating the COVID-19 vaccine for school attendance is an ethical and equitable way to increase uptake in this age group.
A key benefit of a mandatory COVID-19 child vaccination policy would be its effectiveness in increasing vaccination rates and preventing serious illness in children. With more children exposed to Omicron each day, increasing vaccination in this age group is essential, especially for children with medical and developmental complexity.
Furthermore, COVID-19 has disproportionately impacted marginalized and racialized communities in Canada, with higher rates of hospitalization in children. Requiring the COVID-19 vaccine for school attendance could increase protection of children in hard-hit communities and accelerate the pace of vaccination in all school-aged children.
A mandate would also improve parents’ perception of the importance of the COVID-19 vaccine. Historically, vaccines that were mandated have been viewed as essential by the public.
Many advocates have suggested that mandating COVID-19 vaccination to increase uptake would reduce transmission. A recent preprint study from Ontario demonstrated that two or three vaccine doses were very effective at preventing hospitalizations and death from Omicron in adults. However, two doses provided only 40 per cent protection from mild infection within two months and no protection after six months.
