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British government on the defensive over COVID-19 testing data gaps

British Prime Minister Boris Johnson sought on Monday to play down a failure in England’s COVID-19 testing data system that delayed 15,841 results, saying the much higher updated figures were more in line with forecasts of the outbreak’s spread.

But the glitch is likely to cast further doubt over Johnson’s handling of the coronavirus pandemic: His Conservative government’s response has been cast by political opponents as slow, poorly organized and confusing.

On Sunday, authorities reported a jump in daily COVID-19 cases to a record 22,961, after saying a technical issue had meant that thousands of test results had not been transferred into computer systems on time, including for contact tracers.

“The incidence that we’re seeing in the cases really sort of corresponds to pretty much where we thought we were,” Johnson said, speaking to reporters.

“To be frank, I think that the slightly lower numbers that we’d seen didn’t really reflect where we thought that the disease was likely to go, so I think these numbers are realistic,” said Johnson, who was hospitalized with a serious case of COVID-19 in the spring.

Health Secretary Matt Hancock told Parliament the technical problem had not yet been resolved. “This incident should never have happened,” he said.

Johnson, who earlier this year promised a “world-beating” test-and-trace system, has more recently said there have been missteps but that the government has been confronted with the biggest health crisis since the 1918 influenza outbreak.

The Labour Party’s health critic blasted the government in a statement, saying the missed data led to people not self-isolating.

“This is not just a shambles, it’s so much worse than that,” said MP Jonathan Ashworth.

“And it gives me no comfort to say it — it’s putting lives at risk, and he should apologize,” Ashworth added, referring to Hancock.

Hospitalization level not seen since June

Data published on Monday showed there were 12,594 new positive COVID-19 test results — suggesting the upward trend of cases seen before the discovery of the technical snag continues unabated.

The number of COVID-19 patients in English hospitals also rose to the highest level since late June, at 2,593.

“Now more than ever with winter ahead, we must all remain vigilant and get this virus under control,” Hancock said.


People wearing face masks walk in the city centre in Middleborough, Britain on Oct. 2. (Lee Smith/Reuters)

Public Health England said all people whose tests were the subject of the glitch had been given their results in a timely fashion, and that those who had tested positive had been told to self-isolate.

Asked about a vaccine, Johnson said it felt like an AstraZeneca project must be on the verge of one.

“We are working very, very hard to get one,” Johnson said. “We are not there yet.

“I went to see the scientists at Oxford at the Jenner Institute, the AstraZeneca team — incredible what they’re doing,” he said. “You know, you really feel they must be on the verge of it, but it’s got to be properly tested.”

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Canadian hospitals join fundraising efforts to close COVID-19 ‘gaps’

Canadian hospitals facing urgent COVID-19 needs are banding together to close funding “gaps” for their institutions and embattled health-care workers.

Dubbed The Frontline Fund, the national campaign seeks donations on behalf of more than 100 institutions across the country for supplies, staff support and research.

Organizers say the money would help hospitals source personal protective equipment and ventilators, fund drug trials and vaccine research and provide mental-health support to exhausted staff. Ten per cent of funds will also go toward the northern territories and Indigenous health.

Steering committee member Caroline Riseboro, also CEO of the Trillium Health Partners Foundation, said COVID-19 has raised unique needs that “wouldn’t necessarily be addressed through government funding.”

WATCH | Go behind the scenes in a hospital:

The National’s Adrienne Arsenault gets rare access inside a Toronto hospital during the global COVID-19 pandemic to see first-hand what staff are up against. Some of what our team saw and captured on camera may be difficult to watch. 9:56

Examples of how the money could be spent include extra scrubs so caregivers can change their clothes before going home or hotel rooms for front-line staff with immune-compromised relatives so they don’t have to fear bringing the virus home with them.

The three main ways relief will be distributed are:

  • Supplies: From personal protective equipment (PPE) like masks, disinfectants and disposable clothing to life-saving ventilators and testing equipment to the digital infrastructure needed to enable virtual patient care, front-line health-care workers need more tools. 
  • Supports: Being directly involved in patient care in a pandemic takes a huge toll. Gift cards and peer-to-peer mental health support will also help health-care workers protect their families, get much-needed rest and prepare themselves for the effort ahead. 
  • Research: Hospitals need funding to conduct vital research like clinical drug trials to discover therapeutic breakthroughs and intense vaccine development efforts.

Organizers say $ 8.5 million has already been promised by lead corporate partners. That includes $ 5 million from the Canadian Medical Association Foundation, $ 2.5 million from Maple Leaf Foods and $ 1 million from TD Bank Group.

‘Unprecedented crisis’

The goal is to raise $ 50 million. Canadians can donate at www.frontlinefund.ca.

“All of our hospitals in Canada are just facing an unprecedented crisis here,” Riseboro said.

“We know that there’s the desire out there by Canadians to help, but Canadians are unsure of who to support so we created this national initiative. It is historic in nature. Never have all of these hospitals across the country come together to fundraise in concert for what is probably one of the most significant health crises facing us in a generation.”

Money will stay within the province in which it is donated and be allocated according to the number of beds at each institution. Each hospital foundation will decide how to spend the funds on its unique needs, said Riseboro.


A health-care worker is seen outside the emergency department of the Vancouver General Hospital on March 30. (Jonathan Hayward/The Canadian Press)

“This initiative is really meant to close some gaps on the response to COVID, particularly when it comes to our front-line health-care workers.”

The CMA Foundation said its $ 5-million contribution to the Frontline Fund is part of a broader $ 20-million commitment to the medical system.

It’s also setting up a $ 5-million fund to benefit community hospitals and giving another $ 5 million to a COVID-19 grant program by the Foundation for Advancing Family Medicine.

Another $ 5 million will help medical students and residents with financial hardships, and $ 250,000 will go to Doctors without Borders’ COVID-19 crisis fund.

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Doctors, nurses demand government fill ‘unacceptable’ gaps in protective gear on front lines

Canada’s doctors and nurses are demanding that the federal government do more to protect front line workers against COVID-19, calling a critical lack of personal protective equipment (PPE) “outrageous and unacceptable.”

Organizations representing front line workers delivered a blunt warning Tuesday that lives are at stake, and pleaded for more transparency and urgent federal action during a virtual meeting of the House of Commons health committee. 

MPs on the committee are holding regular hearings via teleconference on the government’s response to COVID-19.

Dr. Sandy Buchman, president of the Canadian Medical Association, said Canada was caught flat-footed by the pandemic and now everyone is scrambling to ensure public health capacity can meet an expected surge in demand.

Calling it a “dark reality,” he said he’s hearing from physicians that the inadequate supply of surgical masks, N95 respirators, face shields, gowns and gloves is even more alarming than initially thought.

“The toll that is paid for this uncertainty weighs heavily on health care workers across the country,” he said. 

“They are scared. They are anxious. They feel betrayed. They don’t know what supplies are available.”

Buchman said he’s concerned about the problem of keeping enough doctors and other health professionals on the job, given the heightened threats they face of sickness and physical and mental burnout, and the risk they might refuse to work due to a lack of protective gear.

Physicians working in hospitals handling COVID-19 cases don’t know how long current supplies will last, and many are being asked to ration or re-use supplies, he said, adding that anxiety is heightened by a lack of information and transparency around inventories.

‘Lives are on the line’

“Asking health care workers to be on the front lines of this pandemic without the proper equipment is unacceptable. Shortages must be addressed immediately and information about supplies must be disseminated. People’s lives are on the line,”  he said.

“Would we expect a firefighter to enter a burning building, risking his or her life, without adequate protective equipment to keep them from harm? Physicians and other front line health care workers have a call to duty. They are willing to place themselves in harm’s way. But they have rights too – and that is their right to be protected when they put themselves at risk of harm.”

Dr. Alan Drummond of the Canadian Association of Emergency Physicians also conveyed “disturbing” reports about shortages and rationing of protective equipment.

“The pandemic has not peaked and the virus will be with us for some time. We need to continue to build our supply and distribution chains coast to coast so all front line staff have the appropriate PPE to provide care safely,” he said. 

Preserving masks per shift

Drummond said “preservation” measures, such as limiting nurses to two masks per shift, might be considered rationing.

He also cautioned against “excessive anxiety” and said he hopes the government will deliver on its promise to deliver more protective gear and supplies.

Linda Silas, president of the Canadian Federation of Nurses Unions, said she finds it “striking” that, just a few months ago, governments and managers deferred to the clinical and professional judgment of health care workers to decide what’s needed to keep patients and workers safe — yet now they’re “locking up personal protective equipment to keep it away from health care workers.”

“When faced with this level of uncertainty around a new coronavirus, especially around something so fundamental as how it spreads, we should start with the highest level of protection for health care workers – not the lowest,” she said.

“Front line workers across the country who are directly involved in the care of presumed and confirmed COVID-19 patients are not being provided with the PPE they need to do their jobs. That’s simply outrageous and unacceptable in a world-class health system like ours.”

Silas said that, since its inception in the wake of the SARS outbreak, the Public Health Agency of Canada has not made workplace safety a primary focus and has “failed over and over to consider and appropriately protect the health and safety of health care workers. “

She said the government should invoke the Emergencies Act to ensure supplies and equipment are deployed where needed across the country.

Buchman said he salutes the government’s call to enlist retired professionals and others to help in the battle against COVID-19, but he also warned that older people are at greater risk of experiencing severe symptoms if they become infected. He said that must be considered in the context of a shortage of PPE supplies.

“We do have to be careful about what we’re asking,” he said.

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CBC | Health News

'Fiscally responsible' pharmacare plan will fill in gaps, finance minister says

Federal Finance Minister Bill Morneau says a new national pharmacare program will be “fiscally responsible” and designed to fill in gaps, not provide prescription drugs for Canadians already covered by existing plans.

Speaking at the Economic Club of Canada in Ottawa to kick off a post-budget sales job, Morneau said many Canadians are without coverage, including people who are self-employed. Some parts of the system are working well but others are not, he said.

“We need a strategy to deal with the fact not everyone has access, and we need to do it in a way that’s responsible, that deals with the gaps, but doesn’t throw out the system that we currently have,” he said.

Eric Hoskins, Ontario’s former Liberal health minister, will chair a council that will consult with stakeholders and make recommendations to government on how to proceed with a national plan.

Morneau said the committee will need time to carefully study the issue because Canada’s workforce and the cost of pharmaceuticals have both changed dramatically over the last two decades.

In an interview with CBC Radio’s The House, which will air Saturday, Morneau said the government has a goal of ensuring all Canadians get the medication they need, but it does not yet have all the answers on how to get there.

For example, income levels may not necessarily determine need, he said.

“Sometimes those pharmaceuticals are so expensive that even … people that are above the middle income band will find themselves in a very difficult situation,” he told host Chris Hall.

Finance Minister Bill Morneau says the proposed pharmacare strategy in yesterday’s budget will not mean free medicine for all Canadians but will look at ways to augment the current system by filling in gaps for those who are not covered by health plans and are unable to afford them.1:30

Ontario adopted a pharmacare plan this year that offers free medication to babies, children and youth aged 24 and under who have OHIP coverage.

Called OHIP+, the program is expected to cost about $ 450 million a year and affect about four million people provincewide. It expands a program already providing coverage for Ontario’s seniors and those on Ontario Works, a provincial program that offers financial and employment help to residents of the province.

No cost estimate for a national pharmacare program was provided in the budget, prompting NDP Leader Jagmeet Singh to declare the strategy a “fantasy.”

Singh believes limiting eligibility would fall short of the full-fledged pharmacare program Canadians want. 

“We need a universal program so we will all be a more healthy, and vibrant society,” he said.

‘Cruel sleight of hand’

The Canadian Health Coalition, which represents health advocates across Canada, was critical of the government’s plan to stop short of a universal public drug plan, calling it a betrayal of Canadians’ desire for what has been called by some the “unfinished business” of medicare.
 
“This is a cruel sleight of hand. Millions of Canadians have been waiting decades for life-saving medications and were ecstatic by the Liberals announcement yesterday,” said James Hutt, the CHC’s interim national director for policy and advocacy in a statement. “Now today they clarify that the Liberals want only partial drug coverage — not for everyone.”  
 
The group said past polls have shown Canadians are in favour of such a plan and that it could save billions a year by negotiating lower prices and ending payments to insurance companies.

Stephen Frank, president and CEO of the Canadian Life and Health Insurance Association, said there is a need to close the gap for those falling through the cracks but said the government must aim to get the best bang for the public buck.

Call for ‘smart reforms’

Frank said 24 million Canadians already have comprehensive and robust benefit packages that provide them access to everything they need, so he hopes the government will proceed with “smart reforms” to spend public money where the problems are.

“There’s a lot of good, concrete, very easily done ideas that would knit together a public and private system and smooth over some of those gaps, and we think they’re the right way forward,” he told CBC News.

An association representing pharmacists said in a news release that access to critical drugs is a serious problem.

“I see firsthand the difficulties my patients face when they cannot afford the medications they need to be healthy. This is unacceptable, and we are encouraged that the federal government will be looking at options for how to best serve these patients,” said Alistair Bursey, chair of the Canadian Pharmacists Association.

The groups said it is also important for medication to be properly dispensed, and that pharmacists often see patients who are on too many medications, or who aren’t taking them as directed.

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'A tiny Band-Aid on a gaping wound': Why crowdfunding can't fill gaps in U.S. health care

Erin Fisher’s problems began in 2016, when she was pregnant with her second daughter. Her blood pressure had increased to the point where in order to protect both mom and baby, doctors felt it necessary to schedule the delivery three weeks early.

After her daughter was born, Fisher thought the worst was over. But in early 2017, she was hit with a devastating double diagnosis: light chain deposition disease, a rare blood disorder that affects the kidneys, and multiple myeloma, a form of cancer that attacks bone marrow.

“It was scary, because your first thought is, am I going to survive to raise my children?” the 41-year-old Austin, Tex., resident said.

She immediately began chemotherapy and last fall underwent a successful stem cell transplant. With all of the appointments, tests and procedures, the bills piled up. A contract writer with a medical laboratory, Fisher had decent insurance. but she still found herself owing close to $ 75,000.

Watching her daughter cope with a constant stream of treatments and bills, Fisher’s mother, Nan, came up with the idea of turning to strangers for help. She started a page on crowdfunding site GoFundMe, where she told her daughter’s story and set an optimistic goal of $ 25,000.

Erin Fisher 2

Erin Fisher poses with her eight-year-old daughter, Blake, after her successful stem cell transplant. (Erin Fisher/GoFundMe)

“It was very difficult at first,” said Erin Fisher. “It’s really hard to put your name and face out there and say that something’s wrong and ask for help.”

Fisher is not alone. As U.S. President Donald Trump continues to dismantle parts of Barack Obama’s Affordable Care Act (a.k.a. Obamacare), millions of Americans are finding their health care in jeopardy. More and more are turning to friends, family and strangers on crowdfunding sites to help cover medical expenses.

The rise of medical crowdfunding

GoFundMe has become the most popular site for those seeking help with medical bills. The site contains pages and pages of stories of hope, desperation and struggle.

Campaigns on the site range from rare medical procedures to people looking for help with home-care costs. But more and more Americans are looking to fund routine medical expenses that aren’t covered by insurance. Or, in the case of Americans without insurance, to get any help they can.

“I think in a perfect world, it wouldn’t be necessary. But in the imperfect world in which we live, you have to have something,” said Rob Solomon, CEO of GoFundMe, which is based in Redwood City, Calif.

Under Obamacare, the number of Americans without health insurance dropped from 44 million in 2013 to under 28 million by the end of 2016. The Congressional Budget Office has estimated, however, that 13 million could lose their insurance due to health policy changes in the sweeping U.S. tax bill passed in December.

GoFundMe

The CEO of GoFundMe touts the site as a digital safety net for the millions of Americans who can’t cover their medical bills. (Screenshot: GoFundMe.com)

Solomon said a third of the money raised on GoFundMe in 2017 went to cover medical costs, but admitted the estimate is low because many health-care campaigns aren’t posted using the site’s medical category.

While Solomon couldn’t provide an exact number, he said it has been a massive growth area for the site since he joined three years ago. One estimate from a 2016 study found that $ 930 million of the $ 2 billion GoFundMe had raised since 2010 was health-care-related.

‘A canary in a coal mine’

But is crowdfunding becoming a crutch for a hobbled system?

“This is something we see as a canary in a coal mine,” said Lauren Berliner, co-author of a 2017 University of Washington Bothell study that looked at inequalities in medical crowdfunding. “I don’t think the general public is really thinking about how medical crowdfunding is signaling more of a problem than it is a solution. A phenomenon like medical crowdfunding is just a tiny Band-Aid on a gaping wound.”

Lauren Berliner

University of Washington Bothell researcher Lauren Berliner says there hasn’t been a conversation in America about the increasing role crowdfunding sites are playing in the health-care system. (Steven D’Souza/CBC News)

The study found more campaigns coming from states that didn’t expand government-funded Medicaid through Obamacare. Berliner worries what will happen with current proposals to replace Obamacare.

“Americans should be paying attention to just how many crowdfunding campaigns they’re seeing and what people are asking for, because that really emphasizes just what kind of desperate need that so many Americans are in.” 

The study also found that those in the worst situations don’t always get the most help. Crowdfunding often rewards users who market their illness most effectively or are lucky enough to have their stories go viral.

Berliner said a good photo of a healthy subject, a well-told story and a catchy social media hashtag all help a campaign meet its goals. She said having a curable illness also helps, because people want to donate to make a difference. “To put it in a really crude way, the possible donors want to feel like they’re getting a return on their investment,” said Berliner.

She said that often puts campaigns where the subjects have multiple, ongoing issues with no clear remedy at a disadvantage. Those who aren’t media savvy, fluent in English or who lack internet access to give ongoing updates also struggle. 

Who gives?

As the CEO of Vancouver-based FundRazr, Darryl Hatton sees that drama unfold on a daily basis. Hatton founded the site in 2010 and has helped raise more than $ 70 million for a variety of causes.

More than 75 per cent of the campaigns on the site are American. He said Canadians raise funds for medical expenses as well, but mostly for costs not covered by provincial health-care plans.

Daryl Hatton

Fundrazr CEO Daryl Hatton says medical campaigns on crowdfunding sites point to gaps in the health-care system and show where improvement is needed in the social safety net. (Fundrazr Handout)

Hatton said media coverage of successful campaigns skews expectations for others. Most people who start campaigns will never find donors beyond their immediate circle. 

“Only if your story is really compelling and it gets some media coverage does it go much beyond friends or friends of theirs and out into a broader marketplace. So it is really unrealistic to expect a high level of funding to happen,” Hatton said. 

The University of Washington study found that 90 per cent of the cases it looked at did not reach their fundraising goal. It also found that more than 10 per cent of campaigns raised less than $ 100.

Through family and connections in New York and Texas, Erin Fisher managed to raise $ 24,000 over nine months. At one point, she had raised her goal to $ 75,000, but as donations slowed to a trickle, she lowered it to $ 65,000. 

It’s a start but it’s not enough. Her doctors estimate her stem cell transplant bought her another three to five years, possibly more if she continues to respond as well as she has. Fisher worries about the future and her children. 

“I have every reason to fight, I have two little people at home who need their mother. I want to see them walk down the aisle and get married.”

Erin Fisher Medical Test

Erin Fisher has had to endure many tests and appointments in the process of treating a rare blood disorder and multiple myeloma, a form of cancer that attacks bone marrow. (Erin Fisher/GoFundMe)

Hatton said the current growth of medical crowdfunding can’t be sustained. Eventually, donor fatigue will set in. 

“There’s only so much we can support friends and family with this kind of crowd insurance around our health care,” he said. “Really, there’s got to be more systemic ways to deal with that.”

A 2017 survey by the Pew Research Center found 33 per cent of Americans favour a single-payer, government-run health-care system. But the issue is still deeply divided along party lines. Senator Bernie Sanders’s proposed “Medicare for All” legislation has some support among Democrats, but nothing across the aisle with Republicans.

Rob Solomon at GoFundMe said we should expect to see even more health-care-related campaigns in the years ahead.

“I think we have a long, long, long way to go in America before anything gets solved. And until that happens, people are going to have to rely on systems like ours.”

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