Tag Archives: causing

Coronavirus variants causing growing alarm in B.C. as cases surge, hospitalizations rise

Experts are growing increasingly concerned about the spread of more transmissible coronavirus variants in B.C. and a consequent spike in serious COVID-19 cases that they fear could overwhelm hospitals in the province.

Doctors say they’re seeing younger patients with the disease — aged 20 to 50 — requiring critical care, in contrast with predominantly elderly people who got badly sick during the first year of the pandemic.

“We do know that a lot of that is the variant[s], and it does seem like it is a more transmissible strain and it also seems that people do get sicker with some of these variants,” said Dr. Gerald Da Roza, head of medicine at Royal Columbian Hospital in New Westminster, B.C.

Da Roza says intake at the intensive care unit (ICU) has increased in the past few weeks at the hospital, where he reported that patients have spilled over into other departments.

“Some people say this is the busiest we’ve been in 15 years,” he said.

WATCH | How the P1 variant is taking hold in B.C.:

The P1 COVID-19 variant, first seen in Brazil, is creating a big problem for health officials because of how quickly it spreads. Currently concentrated in the Vancouver area, modelling shows it could spread out of control by late April. 2:06

The variants of concern in B.C. are B117, first detected in the U.K., and P1, associated with Brazil. Cases of both have so far been concentrated in the Fraser Health and Vancouver Coastal Health authority regions, B.C. Health Minister Adrian Dix said Monday.

He said the number of cases of the P1 variant close to doubled over the Easter weekend.

“The most transmissive variants of COVID-19 are ultimately going to take over,” the minister said.

Dix said 60 of the current 320 coronavirus cases in B.C. hospitals are related to variants of concern. He also confirmed there are pressures on ICUs, especially at Royal Columbian and Lions Gate Hospital in North Vancouver.

‘Worrisome’ spread of P1

B.C. is now being identified by epidemiologists across the world as a notable hotspot for the P1 variant that has spread unchecked through Brazil, where COVID-19 has killed more than 300,000 people.

Dr. Eric Feigl-Ding, a Washington, D.C.-based epidemiologist and health economist, says the accelerating community spread of mutations in B.C. is “worrisome.”

He said that the P1 variant is more than twice as transmissible as the original coronavirus and initial data suggests it causes higher mortality rates and affects younger people more than the initial strand.

Feigl-Ding, a senior fellow at the Federation of American Scientists, raised the alarm a few weeks ago when he compared B.C. to Florida, where variants are also growing in number.

Health Canada reported 379 cases involving variants of concern in B.C. on April 1, up from 84 on March 22. As of Monday, Dix said there are now a total of 588 of the two primary variants in the province: 373 of B117 and 215 of P1.

Staff at Royal Columbian Hospital say the hospital is the busiest it’s been in 15 years. (Ben Nelms/CBC)

Canucks off ice 

The fact that many Vancouver Canucks players have been affected — despite strict NHL safety protocols, testing and the use of personal protective equipment — should serve as an alarm bell, Feigl-Ding said.

“I think this has woken people up because people think … young people are healthy, especially if you’re an athlete. You train well, you shouldn’t have any problems,” he said.

As of Monday evening, a total of 17 Canucks players — most of the team’s active roster — were officially being kept off the ice under the league’s COVID protocols, though that does not necessarily mean all 17 have tested positive for the coronavirus.

Several sources say an unnamed player from the team’s reserve “taxi squad” is quarantining and three members of the coaching staff have tested positive.

While health officials and the NHL have refused to confirm that the team outbreak involves one of the coronavirus variants, hockey insiders at media sources including The Sports Network and The Province have said it is suspected.

One of the players affected, Jayce Hawryluk, contracted COVID-19 last year. 

Da Roza said it’s now a race to get people vaccinated to offset the increased infections he’s seeing in younger British Columbians. 

B.C. is rolling out its vaccine largely based on age, starting with the oldest. As of Tuesday, all residents born in 1950 or earlier are now eligible for their first shot.

Da Roza urges people to be vigilant so that the variants don’t draw out the pandemic any longer.

“Hang in there for a few more months, and be smart about things,” he advised.

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CBC | Health News

What’s causing N.B.’s mystery neurological disease? Worried residents want answers

News this week that a cluster of more than 40 cases of an unknown neurological disease have been identified and found only in New Brunswick has residents of several communities on edge.

The mystery illness has similarities to Creutzfeldt-Jakob disease, a rare and fatal brain disease.

First diagnosed in 2015, according to an internal Public Health memo sent this month to medical professionals, the disease affects all age groups and appears to be concentrated in the Acadian Peninsula in northeast New Brunswick and the Moncton region in the southeast.

Forty-three cases have been identified, and five people have died.

Since that news was reported on Wednesday, people in those communities have been wondering how alarmed they should be.  

“People are wondering, what is it? Why is it only here? We are hoping that somebody will tell us,” Anita Savoie Robichaud, the mayor of Shippagan, a town on the peninsula, said Friday.

Bertrand Mayor Yvon Godin says residents are ‘very, very worried’ about the disease identified in the Acadian Peninsula and Moncton area. (Radio-Canada)

Yvon Godin, the mayor of Bertrand, a village further north on the peninsula, who also chairs the Forum of Acadian Peninsula Mayors, agrees.

“We are very, very worried about it,” Godin said. “Residents are anxious, they’re asking ‘Is it moose meat? Is it deer? Is it contagious?’ We need to know, as fast as possible, what is causing this disease.”

Dr. Neil Cashman understands the concern.

Cashman, a professor in the University of British Columbia’s faculty of medicine, is a neurologist with a special expertise in prion diseases — a group of neurodegenerative diseases caused by proteinaceous infectious particles, or prions — including Creutzfeldt-Jakob disease.

When Cashman first heard about the cases in New Brunswick, he says his first thought was, “We have a problem on our hands.”

Clearly, he said, “this was a call to arms to identify the cause.”

Those efforts are already underway.

Teams of researchers, scientists and epidemiologists began assembling about a year ago, both at the national level at Health Canada’s Creutzfeldt-Jakob Disease Surveillance System, to which Cashman is acting as an adviser, and at the provincial level with a research team headed by Moncton neurologist Dr. Alier Marrero.

Having this news put under “the active scrutiny of the public” this week has been a good thing, Cashman said, because it has pulled in clinical and scientific expertise from across Canada.

“There are people offering to help, and these people would not be doing that unless they were aware of this cluster.”

But their work is just beginning.

‘This is something new’

Cashman has a pretty good idea what this mystery disease is not.

All the evidence, he said, points to this not being a prion disease such as Creutzfeldt-Jakob disease. 

“There is no evidence, not a hint — even in the three autopsies that have been performed — of a human prion disease. That came as a surprise to me, frankly,” he said. “So in essence, this is something new, and we need to get on the stick and figure out what this is.”

Cashman said he’s tapping into his expertise in neurology and environmental toxins to look for other explanations.

The fact that the cases are limited to certain regions “fits with the notion of an environmental toxin,” he said.

A possible culprit might be B-methylamino-L-alanine (BMAA), an environmental toxin made by certain bacteria that can accumulate in fish and shellfish.

Domoic acid, another toxin produced by bacteria and that accumulates in shellfish, sardines and anchovies, is another possibility. So is lead, which can be responsible for clusters of neurodegeneration.

Dr. Neil Cashman, an expert in neurology, says an environmental toxin could be the cause. (Submitted by Neil Cashman)

“All of these are speculation at this point,” Cashman stressed. “A lot of scientific acumen will be required to pin it down to a cause.”

That will take time, and no one can say for sure how long.

“It’s possible ongoing investigations will give us the cause in a week, or it’s possible it will give us the cause in a year,” he said.

“There’s no sensible timeline I can provide on when we’ll have an answer. It’s just something that has to be the focus of scientific attention, and as rapidly as possible.”

In the meantime, he said, he’d advise residents to continue doing what they have been doing, try not to be consumed by anxiety and have faith that a solution will be found.

“I know it sounds like a tired statement, but I would say stay calm, carry on,” he said. “We’ve got to figure it out and the Public Health Agency of Canada is in a good position to do that and come up with a cause … and then of course it can be ameliorated.”

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CBC | Health News

Early wallop of snow causing pandemic-related woes in Northeastern U.S.

A major snowstorm rolled into the U.S. Northeast on Wednesday at a key moment in the coronavirus pandemic: days after the start of the U.S. vaccination campaign and in the thick of a virus surge that has throngs of people seeking tests every day.

Snow was falling from northern Virginia to points north of New York City by late afternoon. The storm was poised to drop more than 60 centimetres of snow in some places by Thursday. And the pandemic added new complexities to officials’ preparations — deciding whether to close testing sites, figuring out how to handle plowing amid outdoor dining platforms in New York City streets, redefining school snow days to mean another day of learning from home, and more.

“Our theme today ought to be, ‘If it’s not one thing, it’s another,’ ” New Jersey Gov. Phil Murphy said as he gave residents storm guidance that’s new this year: mask up if you help your neighbours shovel.

Officials said they didn’t expect the winter blast to disrupt vaccine distribution, which began Monday for front-line health-care workers, the first group of Americans to get the shots. The first three million shots are being strictly limited to those workers and nursing home residents.

U.S. Health and Human Services Secretary Alex Azar said Wednesday that the government is tracking the vaccine shipments precisely, has staffers already in place to receive them and believes the companies transporting the doses can navigate the storm.

“This is FedEx, this is UPS express shipping. They know how to deal with snow and bad weather. But we are on it and following it,” he told Fox News Channel’s Fox & Friends.

A front loader works at a large pile of road salt, Wednesday, Dec. 16, 2020, in Chelsea, Mass., as preparation continues for a winter storm expected to dump a foot or more of snow throughout the Northeast. (Elise Amendola/The Associated Press)

‘Overabundance of hazards’

With 35 vaccine deliveries to New Jersey hospitals expected over the next day or two, Murphy said his administration was focused on making sure they continued, including by exempting vaccine delivery trucks from a storm-related prohibition on commercial traffic on some highways.

New York Gov. Andrew Cuomo said his state’s first-round vaccine shipment had already been distributed to some 90 hospitals, with the next delivery not due until roughly Tuesday, well after the storm.

The National Weather Service said the storm was “set to bring an overabundance of hazards from the mid-Atlantic to the Northeast,” including freezing rain and ice in the mid-Atlantic, heavy snow in the New York City area and southern New England, strong winds and coastal flooding, and possibly even severe thunderstorms and some tornadoes in North Carolina’s Outer Banks.

In Virginia, the combination of snow, sleet and freezing rain knocked out power to several thousand homes and businesses by Wednesday afternoon. The state police said that as of 3 p.m. ET, troopers had responded to approximately 200 crashes, including a wreck on Interstate 81 that killed a North Carolina man.

A man shovels snow on the Villanova University campus during a winter storm, Wednesday, Dec. 16, 2020, in Villanova, Pa. (Matt Slocum/The Associated Press)

‘Take this seriously,’ NYC mayor warns

The heaviest snowfall was expected in central Pennsylvania, where forecasters in the state capital of Harrisburg said a six-decade-old record for a December snowfall could potentially be broken.

But some areas from West Virginia to Maine could get 30 centimetres of snow — for some, that’s more than they saw all last winter. In New York City, officials braced for the biggest storm in about three years.

“Take this seriously,” Mayor Bill de Blasio warned residents.

In addition to the usual rolling out of plows and salt spreaders, the nation’s most populous city was adding some pandemic-era preparations to its list, such as closing city-run testing sites Wednesday afternoon and suspending outdoor dining in the sometimes elaborate spaces that now occupy parking spaces outside some restaurants.

Restaurants weren’t being required to break down their wooden enclosures and other structures for outdoor dining, currently the only form of restaurant table service allowed in the city, but they were told to secure outdoor furniture, remove heaters and take other steps to make way for plows.

The city’s snow-removal chief, acting sanitation commissioner Ed Grayson, said the agency had been planning and training since summer to manoeuvre around the structures.

Cars move along the roads as snow starts to fall Wednesday, Dec. 16, 2020, in the Queens borough of New York. (Frank Franklin II/The Associated Press)

De Blasio also announced that Thursday would be a snow day — 2020-style — for the nation’s largest school district. School buildings will be closed, but students will be expected to go to class online (many would anyway, as middle and high schools are currently all online, and many families have chosen remote learning).

“I know we all grew up with the excitement of snow days, but this year is different,” the mayor tweeted.

Rhode Island, meanwhile, closed state-run coronavirus testing sites for Thursday.

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CBC | World News

Fun to watch, almost impossible to defend, ‘lacrosse’ goal causing fits for NHL goalies

Johnny Gaudreau stood on the Calgary Flames bench in a state of shock after Andrei Svechnikov scored the first lacrosse goal in NHL history against David Rittich.

It was Oct. 29, and the left-shooting Svechnikov had cradled the puck on the blade of his stick, wrapped around the right side of the Calgary net, and whipped it through the tiny gap between the post, the cross bar and Rittich’s head.

Sure, Gaudreau hoped the goal would be waved off because of a high stick. And sure, he bemoaned the fact that Svechnikov pulled off the seemingly impossible in a game Calgary would go onto lose 2-1. 

But at the same time, he couldn’t help but realize he was witnessing the start of something the NHL had never before seen.

“That’s a very hard thing to do,” Gaudreau said with admiration. “When you try it in summer or practice — even without a goalie — it’s tough to do. So to see him pull it off in the NHL, and against an NHL goaltender, it’s pretty cool to see.

WATCH | The evolution of the lacrosse goal:

We first saw it done by Mike Legg in 1996 at the University of Michigan. It took 24 years to be done in the NHL, but now the lacrosse goal has happened three times this season. How’d the unique move reach hockey’s highest level? 2:43

“We were just in shock and awe when that happened. Not many guys can pull that off. It’s fun to watch.”

Fun to watch for forwards, perhaps. But for goalies — and the defencemen paid to protect them — the lacrosse goal is a problem to be solved.

It’s a new threat to consider when certain players are parked in the area known as Wayne Gretzky’s office behind the net.

“It’s tough,” says St. Louis Blues netminder Jordan Binnington. “It’s a new play, and I think it’s kind of fun for coaches to find a way to adapt and for goalies to figure out a new way to stop. You just use your hockey sense and trust your reads to try and handle it.”

In truth, the lacrosse goal is nothing new. In the 1996 NCAA West Regional semifinal, Michigan forward Mike Legg shocked the hockey world when he scooped the puck and whipped it behind Minnesota goalie Steve Debus.

Legg’s stick on the play ended up residing for a time in the Hockey Hall of Fame for its part in what is simply known as “The Michigan.”

Flash forward 26 years. Svechnikov scored the first NHL lacrosse goal on Oct. 29. He repeated the feat on Dec. 17 against Connor Hellebuyck and the Winnipeg Jets. 

On Jan. 14, Nashville’s Filip Forsberg proved the lacrosse goal is not a one-man phenomenon, lifting the puck on his blade and shovelling it under the glove of Edmonton netminder Mike Smith.

“The young kids are super skilled coming up now,” says Vancouver goalie Jacob Markstrom. “With social media and YouTube, they learn new tricks and all that stuff is going to be more creative.

“Players are getting more creative and more confident to pull it off in games. It’s obviously fun for the fans.”

The lacrosse goal is clearly fun, but debate rages around the actual legality of the play — especially considering Rittich took a stick through the face mask on the Svechnikov marker.

Stick must be below shoulders, crossbar

Under the current rules, a lacrosse goal is legal as long as the stick of the shooter is below the shoulders and the crossbar. As for the safety issue, “accidental contact” on a high stick is permitted “if the act is committed as a normal windup or follow through of a shooting motion.” 

“I really think it’s just the risk you have to take playing the position,” says Calgary goalie Cam Talbot. “I know more guys are trying it now they’ve seen it done. It’s not going to change the way I play on my post or anything like that.

“They’re exciting goals. If you’re skilled enough to pull that off, all the power to you.”

Talbot is also relying on his defencemen to read the play in real time and, if possible, hack the would-be attacker’s stick before the puck is launched.

Defencemen are becoming aware that it’s an option for some players– Calgary’s Noah Hanifan

“The more you see it, the more D-men are becoming aware of it,” says Calgary rearguard Noah Hanifin. “You’re aware of what players tend to do those things. It’s pretty unique, but defencemen are becoming aware that it’s an option for some players.”

Option or not, Vancouver goalie Thatcher Demko isn’t about to reinvent his playing style in the name of preventing lacrosse goals.

“It’s kind of one of those in-game reads where whatever you’re seeing might help you stop the puck,” Demko says. “You just do it, whether it’s throwing your head or maybe using your opposite hand and knock it down. It’s just a quick read. 

“I don’t think it’s a thing where you need to change your system of play. You have to have some awareness for it, like ‘oh this guy has a little bit more time than normal, what are his options?’ That kind of thing, but you’re not going to change anything really.”

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CBC | Sports News

Previously unknown virus may be causing pneumonia outbreak in China, WHO says

A cluster of more than 50 pneumonia cases in China’s central Wuhan city may be due to a newly emerging member of the family of viruses that caused the deadly SARS and MERS outbreaks, the World Health Organization (WHO) has said.

While the United Nations health agency said it needed more comprehensive information to confirm precisely the cause of the infections, it said a new coronavirus was a possibility.

China’s official Xinhua news agency said on Thursday that preliminary lab results conducted by a team of experts showed the pathogen was a new type of coronavirus.

Fifty-nine cases of the pneumonia had been reported as of Sunday.

Coronaviruses are a large family of viruses that can cause infections ranging from the common cold to Severe Acute Respiratory Syndrome (SARS). Some of the virus types cause less serious disease, while some — like the one that causes Middle East Respiratory Syndrome (MERS) — are far more severe.

“Chinese investigators conducted gene sequencing of the virus, using an isolate from one positive patient sample,” Dr. Gauden Galea, WHO Representative to China, said in a statement on Thursday. He commended the preliminary identification of a new virus as a demonstration of “China’s increased capacity to manage new outbreaks.”

The outbreak comes ahead of the Lunar New Year holidays in late January, when many of China’s 1.4 billion people will be traveling to their home towns or abroad. The Chinese government expects passengers to make 440 million trips via rail and another 79 million trips via airplanes, officials told a briefing on Thursday.

The WHO statement said that, according to Chinese authorities, the virus behind the Wuhan cases can cause severe illness in some patients but does not appear to pass easily from person to person.

Jeremy Farrar, a specialist in infectious disease epidemics and director of British-based global health charity the Wellcome Trust, said that while “a cluster of patients with an unusual respiratory infection is, and should always be, a worry… if the infection is not passing person to person, the level of concern is somewhat reduced.”

Wang Yang, the Chinese transport ministry’s chief engineer, told the briefing that authorities will step up efforts to prevent the pneumonia outbreak from spreading further during the holiday period, including ensuring proper disinfection in major public transportation hubs.

The Canadian government’s travel health notice for pneumonia of unknown cause in China recommends travellers to Wuhan: 

  • Avoid high-risk areas such as farms, live animal markets, and areas where animals may be slaughtered.
  • Avoid contact with animals (alive or dead), including pigs, chickens, ducks and wild birds.
  • Avoid surfaces with animal droppings or secretions on them.

Travellers are also advised to take precautions against respiratory and other illnesses, such as handwashing and cough and sneeze etiquette

The WHO noted that coronaviruses emerge periodically — including in 2002 to cause SARS and in 2012 to cause MERS — and said more information was required to confirm the pathogen and understand the epidemiology of the outbreak and its progress.

In 2003, Chinese officials covered up a SARS outbreak for weeks before a growing death toll and rumors forced the government to reveal the epidemic. The disease spread rapidly to other cities and countries. More than 8,000 people were infected and 775 died.

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CBC | Health News

Patients stuck in hospital waiting for home care causing ‘ripple effect’

Delays accessing home-care supports are keeping thousands of Canadians in hospital longer than required, which is creating added pressure on a hospital system already under strain from people waiting to get into long-term care facilities.

The lags in setting up supports for people’s own homes are tying up beds in hospitals that are already full, said Mélanie Josée Davidson, director of health system performance with the Canadian Institute for Health Information.

“Even though a person might be waiting for home care, that might have a ripple effect all the way down to waiting for emergency department services,” she said.

The Canadian Institute for Health Information compiled data from all provinces and territories related to access to home and community care, as well as mental health and addictions services in 2017-2018.

Across Canada, one in almost 12.7 people who are capable of returning to their homes with supports such as help with bathing or changing the dressing on a wound are being kept in hospital while those services are put in place.

Home-care supports may include someone to assist with buying groceries or bathing. On any given day, CIHI says there are 1,320 people in hospital who could go home if those services were in place. (Robert Short/CBC)

This amounted to 27,717 Canadians who needed the extended stays, 295 of which were Nova Scotians.

Nationally, the median length of an extended stay was one week. In Nova Scotia, it was 13 days.

The hope is the data will help paint a picture of what community and social services are needed. The numbers will be tracked for the next decade.

“We are providing this information really as a baseline to see how we’re doing as a country and where we might need improvement and to help us track over time how we’re improving in these services,” said Davidson.

Across Canada, about 400 people are hospitalized each day due to drugs and alcohol. CIHI says this accounted for a total of two million days in hospital in 2017-2018. (Robert Short/CBC)

The CIHI report, Common Challenges, Shared Priorities, found many of the patients waiting in hospital to go home are complex cases — such as people with dementia, diabetes with complications or congestive heart failure. Half of the cases involved people older than 82 and women were more likely than men to be affected.

Davidson said there are solutions that are working in some parts of the country. She said it helps if staff look at what patients will need to carry on at home as soon as they’re admitted.

“In some places, we have home-care workers in the hospitals who are there to learn about the patients and ensure that the services that they will need will be ready at the same time that they will be,” she said.

Other things, such as ensuring family members or friends can transport patients home, can also cut down on delays, she said.

Drugs and alcohol use analysis

The report also analyzed why people are being hospitalizated for substance use and who is most affected.

It found 10 people every day die from issues related to drugs and alcohol while in hospital, which is in addition to people who die in their homes and communities.

For its report, the Canadian Institute for Health Information compiled data from all provinces and territories related to access to home and community care, as well as mental health and addictions services in 2017-2018. (Canadian Institute for Health Information)

“About 400 people [are] hospitalized each day because of harm caused by substance use and overall that’s more than for heart attacks and stroke combined, so quite a significant number,” said Davidson.

The report found alcohol contributed to 2,740 — or 70 per cent of — hospitalizations for substance use in Nova Scotia, the highest percentage of any province and well above the national average of 53 per cent.

Across Canada, a higher percentage of men sought help.

Young people land in hospital due to cannabis

However, people ages 10 to 19 broke that pattern with young people more likely to seek help for cannabis-related issues and a higher percentage of girls ending up in hospital.

The report found “cannabis hospitalizations were often related to symptoms of psychosis or distress.”

“We know that alcohol and cannabis are much more acceptable and socialized in our culture and sometimes we forget that they can have negative health impacts, whether that immediate like an overdose for example, or more long term like cirrhosis,” said Davidson.

Mental-health issues also frequently presented in conjunction with addictions and in 10 per cent of cases, people are considered repeat visitors, landing in hospitals four or more times a year.

The report cautions that the relationship between mental illness and addictions is complex, with some patients self-medicating and others suffering from anxiety, depression or psychosis due to chronic substance abuse. (Shutterstock)

“That really speaks to kind of a rotating through the emergency department,” said Davidson.

Young people were also seeking out help for a combination of mental health and addictions issues.

“The other piece that stood out to us was that it’s actually a very young cohort of people who are frequent users of the emergency department for mental health and addiction. So, half of the patients that we’re seeing were under the age of 35. And that was slightly more men than women, except amongst children in youth where it is more girls than boys,” said Davidson.

Next year, CIHI will also start looking at suicide and self-harm, caregivers distress and the transition between home care and long-term care.


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CBC | Health News

New drug mix causing harder-to-revive overdoses, sparking panic in Vancouver

A new kind of overdose is showing up among Vancouver drug users and it’s challenging front-line overdose prevention workers trying to save lives.

Toxicology reports are revealing a different drug being mixed with fentanyl and other street drugs, which are already adulterated with ever more bizarre and dangerous fillers, according to Dr. Keith Ahamad, an addiction expert.

The unusual chemical — similar to drugs prescribed in Canada for anxiety — is showing up in urine tests, according to health officials.

A few months ago, Ahamad says, he began getting panicked messages from confused colleagues about overdose victims who were not reviving when given overdose antidotes.

The head of Vancouver Coastal Health’s addiction program says he’s seen the phenomenon in the emergency room at St. Paul’s Hospital, and front-line overdose prevention workers notice the same problem at overdose prevention sites.

When they try to revive somebody who is overdosing, health workers use naloxone, a drug that counteracts opioids.

Tim Wilson, 51, says he sees too many people who need help with their mental health and drug dependence who have few choices other than whatever substance they can buy on the street to cope. (Yvette Brend/CBC)

Naloxone or Narcan usually has quite a dramatic effect.

‘With Narcan they would just pop up’

But in these cases, Ahamad says users remain sleepy or stay unconscious for hours.

Sarah Blyth of the Overdose Prevention Society says it’s jarring to see.

“With Narcan they would just pop up. But the way the benzos work, they just remain more sedated, almost unconscious — just more traumatizing for all of us, I’ll tell you that,” she said.

Ahamad says the drug that’s causing this is similar to medications used for anxiety, sleep disorders and depression, and it’s showing up in urine drug screens.

It’s used as a filler or additive, and it makes any overdose more dangerous.

Toxicology tests have revealed that the new additive is etizolam, which is a benzodiazepine-like analog, often called a benzo.

Harm reduction workers say most drugs are laced with fentanyl now, but that’s not the only surprise. Toxicology tests have turned up everything from rat poison and cement to benzodiazepines. (Ben Nelms/Reuters)

Etizolam is described as having 10 times the potency of Valium. It isn’t approved for sale in North America.

It is prescribed in India, Italy and Japan to treat panic attacks and insomnia.

Benzodiazepines also create a high, but can be dangerous when combined with other drugs.

Benzos work on a different pathway in users’ brains, so the naloxone has a reduced effect and the person’s breathing is even more depressed than it would be with an opioid alone, said Ahamad.

“So there’s a total panic around the potential for increased death and harms associated with that additive,” he said.

“People are not really waking up after the Narcan is used for the overdose.”

Public health officials in B.C. issued a warning about carfentanil in March. The drug was originally designed to sedate elephants (CBC)

The new additive also puts users at risk of becoming tolerant of — and chemically dependent on — benzos.

This worsens their overall health and creates challenges, as they would now go through withdrawal for a variety of substances and face even more significant challenges trying to detoxify.

Intense withdrawal can also bring on deadly seizures.

More risk of death

And the opioid crisis has already taken a macabre toll.

This month, the Public Health Agency of Canada (PHAC) said that more than 10,300 Canadians have lost their lives to opioid overdoses between January 2016 and September 2018.

Last year, B.C. lost 1,155 people — more than any other province.

The sheer numbers of dead — mostly young people — has created a backlog of toxicology reports, said Ahamad.

“The morgues are full and they’ve had to rent cooling trucks to store bodies. These are all very young people,” he said.

Fentanyl user are often exposed to a mix of fillers as synthetics have taken over the previous heroin market.

While etizolam — a benzo— has not been found by Vancouver police, 120 grams turned up in Alberta in 2017, according to the RCMP.

Adding to the risk, police are seeing a resurgence of carfentanil, which is a potent animal tranquillizer.

“It’s totally insane. We are literally chasing our tails here with the drug supply. It’s impossible to keep up. Weird and unusual and dangerous things will continue to creep into the drug supply,” said Ahamad.

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CBC | Health News

Filling the medical care gap or causing cracks? Telus launches health app

A new health app launched this month is raising questions over whether it will help cure doctor shortages or cause health-care complications.

The free app, called "Babylon by Telus Health" went live March 5, with a promise it will "complement and fill the gap" in Canada's health-care system.

Telus claims the app is vastly superior to the online resource many people resort to — "Dr. Google" — and is aimed at anyone who has a busy schedule, doesn't have a family physician, lives in a rural community or is caught after hours with a health concern.

"The only doctor I'm hoping it might replace is the doctor of the internet," says Juggy Sihota, vice-president of Telus Health.

"We're trying to revolutionize access to health care, to help alleviate some of the burden and pressure that's in the system."

It's the latest foray into the health sector for Telus, which has become the biggest health-care information technology company in Canada.

Last summer, it bought a chain of medical clinics for more than $ 100 million and reportedly spent more than $ 2 billion on digital health ventures, including electronic medical record software used by half the country's doctors.

Telus won't reveal how much it's invested in the app, only saying it will share costs and revenue with its partner, U.K.-based developer and operator Babylon.

It says it's making it available because it's "a socially conscious organization."

Juggy Sihota, VP of Telus Health, says the Babylon app is far superior to 'Dr. Google'. (Nicolas Amaya, CBC)

Symptom checker, virtual house calls

The app has several features, most available to all subscribers, one specific to B.C.

There's an artificial intelligence symptom checker available across Canada, which is a  "chatbot" that asks users a series of questions and provides what Telus calls "information" — not medical advice.

B.C. users have the option of quickly booking a so-called virtual house call, a one-on-one video consultation with a provincially licensed doctor. It's currently only offered in British Columbia, where the province allows physicians to bill for teleconferencing.

Telus says the app also allows users to more easily refill prescriptions, review secure recordings of their appointments, and refer the findings to their regular doctor, if they have one.

"There's so many things you can do with your smartphone, [like] banking," says Sihota. "Why can't you do health care from your phone as well?"

'Not fully tested,' says medical researcher

But a medical researcher who studied the Babylon chatbot after it first rolled out in England in late 2017 says technology has gotten ahead of government regulation.

"I think they are basically assuming that these systems are ready for prime time," says Dr. Hamish Fraser, associate professor of medical science at Brown University in Rhode Island.

Dr. Hamish Fraser co-authored a November report in The Lancet medical journal critical of the Babylon app. (Skype)

Fraser co-authored a November article in the British medical journal The Lancet, challenging Babylon's U.K. claims its symptom checker outperformed a human doctor in an exam.

The analysis found "Babylon's study did not offer convincing evidence that its (symptom checker) can perform better than doctors in any realistic situation."

The article also noted there is a possibility it might perform significantly worse. And it suggested that further clinical evaluation is necessary to ensure confidence in public safety.

Fraser says Canadian health authorities should be closely monitoring the Telus Health app to make sure it's working effectively.

Information vs. advice: 'The danger zone'

Local medical experts also urge the public to be careful when using the app.

"I think it's something that can potentially be helpful," says Dr. Kendall Ho, head of digital emergency medicine at the University of British Columbia, adding, "there's certainly caution we need to watch out for."

Even though Ho is working with Telus on another health initiative, he worries users of the app will take the information provided by the chatbot and consider it medical advice, without following-up in person with a doctor.

"I think that's where the danger zone is," he said.

The College of Physicians and Surgeons of B.C., which regulates doctors in the province, is concerned about the other main feature of the app — virtual house calls.

Emergency medicine expert Dr. Kendall Ho warns users of the app could enter a 'danger zone' (Ken Leedham, CBC)

Virtual walk-in clinics 'discouraged': College

While the college says they can be a powerful tool in remote areas, it "continues to receive allegations of deficient care provided via telemedicine," and notes, "the care of unattached (patients) in virtual walk-in clinic models is to be discouraged."

There is no indication any complaints have been filed over the Telus app, which already had "thousands of users" in its first week of operation, according to Sihota.

The Telus Health vice-president says more than a dozen doctors have signed contracts to receive virtual calls, "at least three times what they need", and "we're hiring more…as the demand starts to increase."

Sihota says some are practising in areas of B.C. where they don't have full patient loads, while others are willing to make "virtual house calls" after hours or on weekends. 

B.C. reviewing virtual care

The B.C. Ministry of Health says it's preparing a virtual care strategy to catch up with the technology, and is reviewing current policy which allows doctors to bill $ 34 for a teleconference visit — about the same as an in-person consultation.

In a statement to CBC News, the ministry says "Telus Health has committed to share appropriate information," adding it will "monitor the use of virtual care to ensure that it delivers safe and effective care."

Telus Health says it's working with government and doctors.

"I'm listening and we're going to take that feedback and continue to make the service better," says Sihota.

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New Study: 99.9999 Percent Chance Humans Are Causing Climate Change

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A new study from Lawrence Livermore National Laboratory (LLNL) in California says there can no longer be any doubt that humans are responsible for climate change. Technically, there is a tiny amount of doubt, but the scientists cite statistical analysis showing 99.9999 percent confidence that we’re to blame. This so-called “gold standard” is as close to a guarantee as you’ll get in scientific analysis.

Climate change deniers have gone through various stages of disinformation in an attempt to cast doubt on the scientific consensus. In past years, they denied that global temperatures were increasing at all. As the evidence for that became incontrovertible (the last four years have been the hottest on record), they’ve shifted tactics to claim global temperature increases are part of a natural cycle and have nothing to do with human activity.

Virtually all scientists agree that global warming is a direct result of human activity. As we take fossil fuels out of the ground to produce energy, that carbon ends up in the atmosphere where it bottles up heat. The team at LLNL looked at satellite data from the past 40 years to connect human activity to the increase in temperatures.

There are three major climate data sets used by researchers, and the new study evaluated all three. The team says the likelihood of human’s driving climate change has reached five sigma level, which means there’s only a one in a million chance the conclusion is wrong. That’s the same statistical standard used to confirm the discovery of the Higgs boson in 2012.

Based on the historical data, two of the three climate data sets reached five sigma certainty in 2005, and the third more conservative data set hit that level in 2016. Therefore, any alternative explanations for climate change have gotten considerably less likely in the past few decades. The new paper doesn’t pull any punches with its conclusion, warning that “Humanity cannot afford to ignore such clear signals.”

Currently, about 62 percent of Americans accept that climate change is linked to human actions. That’s lower than other countries but higher than US polls in years past. As recently as 2013, only 47 percent of Americans believed humans were responsible for global warming. The United Nation’s Intergovernmental Panel on Climate Change (IPCC) concluded in 2013 that humans were the likely cause of global warming with a 95 percent probability. A new IPCC report is due in 2021, which may recommend major changes in policy based on the LLNL study.

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Indonesian island hit by another quake, causing landslides

A strong earthquake jolted the Indonesian tourist island of Lombok on Sunday, causing landslides and damaging buildings, as the island tries to recover from a temblor earlier this month that killed hundreds of people.

The U.S. Geological Survey measured the latest quake, centred in Lombok's northeast, at magnitude 6.3 with a depth of seven kilometres. It was felt on the neighbouring island of Bali and was preceded a few minutes earlier by a magnitude 5.4 quake, also in Lombok's northeast.

The quake caused landslides on the slopes of Mount Rinjani, an active volcano, and panic in villages, according to an Associated Press reporter on Lombok. Video shot by the Indonesian Red Cross show huge clouds of dust billowing from the mountain's slopes.

Rescuers and police officers walk on debris of a collapsed mosque in northern Lombok on Aug. 9. (Adi Weda/EPA-EFE)

The shaking toppled motorcycles and there was damage to buildings in Sembalun subdistrict, including a community hall that collapsed. The hall had sustained damage in earlier quakes, said National Disaster Mitigation Agency spokesperson Sutopo Purwo Nugroho. Homes and a mosque were also damaged, he said.

So far, there have been no reports of injuries or fatalities, he said, but information was still being collected.

A magnitude 7.0 quake that struck Lombok on Aug. 5 killed 460 people, damaged tens of thousands of homes and displaced several hundred thousand people.

Mount Rinjani has been closed to visitors following a July earthquake that killed 16 people, triggered landslides and stranded hundreds of tourists on the mountain.

Indonesia, a sprawling archipelago that straddles the Pacific "Ring of Fire," is prone to earthquakes and volcanic eruptions.

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