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2018 — A year of change in Canadian public health

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2018 was the year Canadians were allowed to begin freely self-medicating with cannabis and nicotine vaping products.

It was a year when a study revealed unproven stem cell procedures were available across the country.

And it was a year that continued the explosion in home genetic testing, with DNA-testing kits topping this season’s gift lists once again.

“2018 feels to me like there has been a lot of changes,” said Kerry Bowman, bioethicist at the University of Toronto. “And I see the changes as more of a movement towards people deciding for themselves what they will do in health care.”

Legal cannabis a ‘national uncontrolled experiment’

When cannabis became legalized in October, a commentary in the Canadian Medical Association Journal called it a “national uncontrolled experiment” because the long-term health effects are unknown.

The Canadian Medical Association (CMA) is not convinced that there is enough evidence for doctors to prescribe medical cannabis to their patients.

“The CMA remains concerned about the lack of clinical research, guidance and regulatory oversight for cannabis as a potential medical intervention,” the CMA states on its website.

But the hesitation by health professionals to embrace medicinal cannabis was not a surprise to medical historian Heather MacDougall at the University of Waterloo.

“We have no scientific foundation for this because it has been an illegal substance, and therefore no genuine research could be conducted on it.”

Now the research on the health effects of cannabis will be happening in real time.

“What about the precautionary principle?  Do we really understand this drug?” – Kerry Bowman, bioethicist , University of Toronto

“It’s ironic,” MacDougall said. “With most other things in the past, the research came first.”

“It’s a powerful chemical,” said Timothy Caulfield, University of Alberta professor and Canada Research Chair in Health, Law and Policy. He is researching the impact of many of the recent changes in Canadian health care.

“I suspect, once we start doing good research on this, good clinical trials, that we are going to see benefit, hopefully. But right now it’s so premature and you’re seeing this market just take off.”  

In 2018 Canada became the second country in the world to legalize cannabis. (CBC)

Bowman said he’s not opposed to cannabis legalization as a bioethicist. But it raises interesting questions from a scientific perspective.

“What about the precautionary principle?” he said. “Do we really understand this drug?”

Will legalization of cannabis lead to the legalization of other illicit drugs?

“From a historian’s standpoint it’s going to be important when we look back on this,” MacDougall said. “Is it the first step toward an actual recognition of drug use as part of the social determinants of health?”

Prof. Kerry Bowman, a bioethicist at the University of Toronto, said 2018 developments showed Canada putting less focus on evidence-based, randomized controlled trials. (Craig Chivers/CBC)

Year of Big Vape

2018 was also the year of Big Vape, when it became legal in Canada to sell nicotine vaping products, creating a dilemma for public health officials. On one hand, vaping can be a harm-reduction policy aimed at smokers trying to quit.

But it’s also exposing teenagers who might never have sampled a cigarette to a potential nicotine addiction.  

A University of Waterloo public-health researcher released data to Health Canada two weeks ago showing that Canadian teen vaping has reached levels comparable to the U.S. And just this week, the U.S. surgeon general announced that teen vaping has become “epidemic.”

After it received the new teen vaping data, Health Canada said in an email it “will assess what additional actions are warranted, and leverage additional authorities in the Tobacco and Vaping Products Act.”

On Thursday tobacco giant Altria, maker of Marlboro cigarettes, announced it was buying a 35-per-cent stake in the vaping giant Juul Labs Inc.

Juul’s popular vape stick officially went on sale in Canada in September.

Canadians pay for unproven cell therapies

In another uncontrolled national experiment, a study in September revealed that 43 clinics across Canada are selling so called “stem cell” procedures, even though they’re technically not stem cells, and they have not been proven to be either safe or effective.  

You could characterize it as a massive collective of anecdotes and testimonials. It just  legitimizes  something that’s unproven.– Timothy Caulfield , University of Alberta

Still, Canadians are paying thousands of dollars to have their own bone marrow or fat cells extracted and then reinjected into various parts of their body to treat pain, injury, and other conditions including lung disease and hair loss.

“You could characterize it as a massive collective of anecdotes and testimonials. It just legitimizes something that’s unproven.” Caulfield said.

“I know people who are having stem cell injections,” said Bowman. “They’re not particularly concerned about what the evidence says, and I find this surprising because the evidence isn’t there yet.”

U.S. health regulators have launched court action against some clinics using patient-derived cells to treat a variety of conditions.

Timothy Caulfield is University of Alberta professor and Canada Research Chair in Health, Law and Policy. He is researching the impact of many of the changes in Canada’s health-care landscape. (CBC/Sam Martin)

But so far Health Canada has not taken action to stop Canadian clinics from performing the procedures.

In an email to CBC News this week, Health Canada said it has contacted all 43 clinics identified in the study “to gather information,” and it is assessing it “to determine whether compliance and enforcement actions are warranted. Any incidents of non-compliance with federal regulatory requirements will be prioritized, and appropriate action will be taken.”

Giving the gift of genetic tests?

Many Canadians are likely to find personal genetic testing kits under the Christmas tree this year. And soon they will be spitting their DNA into an envelope and waiting to receive potentially life-changing information.  

Caulfield has a study underway right now investigating the marketing of home genetic tests.

DNA test kits are on seasonal gift lists again this year.

“You have this sort of premature commercialization that really doesn’t have the kind of health benefits that are promised.

“They’re about empowerment and providing you with information which is somehow going to be valuable to you and allow you to live a healthier life. And there’s very little evidence to support that.”

One genuine public health experiment cancelled

There was one formal public health experiment about to get underway in Canada this year to investigate one of the country’s most serious health problems — poverty.

But in July, just as a team of Ontario researchers had finished enrolling people for the basic income pilot project, the experiment was abruptly cancelled by the new provincial government, shortly after the election.

The three-year program was supposed to study the effect of income-support payments on quality of life, food security and other health indicators.

“This was a brilliant experiment,” said MacDougall. “It’s highly unfortunate this was cancelled.”

She pointed to a similar experiment in Manitoba in the 1970s. When the data from that study was analyzed decades later, researchers concluded that providing income support improved the health of the entire community.

In October, Canada’s chief public health officer warned that poverty is shortening the lives of people in the poorest neighbourhoods, where life expectancy is about three years lower than the Canadian average.

Disturbing data on public health ’emergency’

In the final weeks of 2018, there was new and disturbing data released about the impacts of another uncontrolled public health experiment — the widespread exposure to powerful opioid drugs that came on the market two decades ago. The drugs were heavily marketed to doctors who were encouraged to write opioid prescriptions to treat chronic pain.  

The Public Health Agency of Canada released statistics showing that in the first six months of 2018 opioids killed more than 2,000 Canadians. There have been more than 9,000 opioid-related deaths in Canada over the last 2½  years.

“Canada continues to experience a serious opioid crisis,” the agency said in a news release last week. “Across the country, it is having devastating effects on the health and lives of many Canadians, their families and their communities.”

On Thursday, an Ontario coroner’s jury investigating the opioid overdose death of 43-year-old Brad Chapman called on the province to declare the opioid epidemic a “public health emergency.”

This week the Journal of the American Medical Association published a review of almost 100 studies showing that opioids were not much more effective than ordinary over-the-counter drugs in relieving chronic pain.

So how will future historians see 2018?

“I think they will probably be struck by the number of different health-related events that took place in 2018,” said MacDougall. “And by the fact that some of the fundamentals are still not being recognized or dealt with.”

“A lot of this is about making money by selling products,” said Caulfield. “All of these things are being portrayed to the public as if they’re efficacious. They’re not even being portrayed as if they’re experimental, as if we need to do more research.

“You do want to have an honest portrayal of the science so that people can make informed decisions about the true value of this stuff. And once it’s out there it’s so hard to pull it back in.”

Bowman said the changes are a sign that Canada is putting less focus on evidence-based, randomized controlled trials and a little less focus on the precautionary principle.

“The strongest driving ethical principle in Canadian health care has been autonomy, the rights and choices of the individual. And perhaps that very principle is deepening from a cultural point of view.”

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Health Ranger posts new microscopy photos of covid swabs, covid masks and mysterious red and blue fibers

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(Natural News) What follows is a series of microscopy photos of covid swabs (a synthetic swab, then a cotton swab), a covid mask and some zoomed-in photos of mysterious red and blue fibers found in the masks.

The magnification range for these photos is 50X to 200X. Most were taken with white light, but several (as indicated) were taken with UV light.

The images shown here are 600 pixels wide. We have higher resolution images available to researchers and indy media journalists; contact us for those hi-res images.

More microscopy investigations are under way, and new images will be posted as they are finalized.

First, this series shows the carbon fiber layer of a covid mask, illuminated with UV light:

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5,800 test positive, 74 die of coronavirus at least 14 days after getting fully vaccinated

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(Natural News) The Centers for Disease Control and Prevention (CDC) on Thursday, April 15, confirmed some 5,800 breakthrough coronavirus (COVID-19) cases in the U.S.

A breakthrough COVID-19 case is defined as someone who has detectable levels of SARS-CoV-2 – the virus that causes COVID-19 – at least 14 days after getting fully vaccinated against the disease.

Nearly 400 breakthrough cases required treatment at hospitals and 74 died. A little over 40 percent of the infections were in people 60 years and above and 65 percent were female. About 29 percent of the vaccine breakthrough infections were reportedly asymptomatic. The figures were for cases through April 13.

CDC Director Rochelle Walensky told a congressional hearing on Thursday that the causes of the breakthrough cases are being probed. “Some of these breakthroughs are, of course, failure of an immune response in the host. And then some of them we worry might be related to a variant that is circulating. So we’re looking at both,” she said.

The CDC is monitoring reported cases “for clustering by patient demographics, geographic location, time since vaccination, vaccine type or lot number, and SARS-CoV-2 lineage.” It has created a national COVID-19 vaccine breakthrough database, where state health departments can enter, store and manage data for cases in their region.

Where available, respiratory specimens that tested positive for COVID-19 will be collected for genomic sequencing “to identify the virus lineage that caused the infection.”

Positive test less than two weeks after getting fully vaccinated is not a breakthrough case

The number of cases the CDC has identified does not include people who contracted COVID-19 less than two weeks after their final dose. The two-week marker is important, said infectious disease expert Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security.

A human body should have enough time to develop antibodies to SARS-CoV-2 after that timeframe. Before then, a person won’t necessarily have the built-up immunity needed to fight off an infection. According to Dr. Adalja, cases that occur before the two-week mark are not considered breakthrough cases.

Dr. Adalja also noted that more research is needed to determine if highly infectious variants of the virus are behind the breakthrough cases. “It is crucial to study breakthrough cases to understand their severity, their contagiousness and what role variants may be playing,” Dr. Adalja said.

More than 78 million people have been fully vaccinated against COVID-19 in the U.S. as of April 15.

“To date, no unexpected patterns have been identified in case demographics or vaccine characteristics,” the CDC said in a statement. “COVID-19 vaccines are effective and are a critical tool to bring the pandemic under control.”

But the CDC conceded that “thousands of vaccine breakthrough cases will occur even though the vaccine is working as expected.”

Dr. William Schaffner, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, agreed with the CDC. “These vaccines that we’re using are fabulous but they’re not perfect,” he said. “At best, they’re 95 percent effective in preventing serious illness, but minor illnesses can occur.”

According to U.S. drug regulators, Pfizer’s COVID-19 vaccine is 95 percent effective in preventing infection. Moderna’s was shown in a clinical trial to be 94.1 percent effective while Johnson & Johnson’s was 66.9 percent effective. Only Johnson & Johnson vaccine, which received its emergency use authorization from the Food and Drug Administration (FDA) on Feb. 27, was tested when variants were circulating.

The percentages are based on results from vaccine recipients two weeks after the final vaccination.

Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, stated in a briefing last week that the breakthrough cases are not a cause for concern.

“I think the important thing is to look at what the denominator of vaccinated people is. Because it is very likely that the number of breakthrough cases is not at all incompatible with the 90-plus percent vaccine efficacy,” he said. “So I don’t think that there needs to be concern about any shift or change in the efficacy of the vaccine.”

More info needed before drawing conclusions from breakthrough cases

The percentage of vaccine breakthroughs in a population depends on multiple factors, including vaccine efficacy, the amount of virus circulating and the length of time since vaccination, according to Natalie Dean, an assistant professor of biostatistics at the University of Florida.

“I love to see small numbers as much as anyone, but know that numbers like this cannot be directly interpreted as a measure of vaccine efficacy (although I have a feeling they will be). We can only interpret them against a background rate in unvaccinated people,” Dean wrote on Twitter.

“Similarly, ‘most breakthroughs have been in elderly adults’ should not be read as the vaccine is less effective in elderly adults. The majority of vaccinations (and the longest amount of follow-up time) have been in elderly adults. Again, we need more info to interpret.”

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More people died from fentanyl overdose than coronavirus in San Francisco last year

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(Natural News) More people died from fentanyl overdose than coronavirus (COVID-19) in San Francisco last year, a microcosm of a larger nationwide problem coinciding with the pandemic.

Data from San Francisco’s Office of the Chief Medical Examiner shows that 708 people were killed by fentanyl in 2020, an astonishing 118 times more since the introduction of the drug in the city just five years earlier.

That figure nearly tripled the 254 COVID-19 deaths recorded in the city for the whole of last year. More than 8 in 10 deaths were male, and just under half were white. People aged 55 to 64 made up nearly a quarter of the fatalities. Nearly 40 percent of the deaths occurred in open-air drug markets such as the Tenderloin and South of Market.

The number of overdose deaths in the city could have been far worse as more than 3,000 addicts suffering from an overdose were administered with naloxone, the lifesaving medication that reverses overdoses.

San Francisco’s death rate from fentanyl overdose continues to rise this year as 135 died by overdose in January and February, putting the city on pace for more than 800 deaths by the end of the year.

The city has become a significant part of a larger trend. The Centers for Disease Control and Prevention (CDC) released data on Wednesday, April 14, showing that more than 87,000 Americans died from drug overdose over the 12-month period that ended in September last year – the highest since the opioid epidemic began in the 1990s.

Lockdowns lead to more cases of drug overdose

The surge represents an increasingly urgent public health crisis that may be correlated to the government’s monotonous battle plan against the COVID-19 pandemic.

On March 19 last year, California became the first state in the U.S. to implement a stay-at-home order. It subsequently endured the longest lockdown of any state in the country.

The pandemic and accompanying lockdowns are believed to be partly responsible for the soaring number of drug deaths for obvious reasons. Lockdowns have badly disrupted the social services in the city, including drug addiction treatment. Drug experts say the isolation of the past 12 months is causing vulnerable residents to turn to opioids.

“We see the death and devastation getting worse right in front of us,” said Matt Haney, San Francisco Board of Supervisors member. “It’s an unprecedented spiraling, directly connected to the introduction of fentanyl in our city.”

Fentanyl first appeared on the streets of San Francisco in 2015. There were just six deaths from the synthetic opioid that year, 12 deaths in 2016 and 37 deaths in 2017. The figure skyrocketed when the drugs became widely available in the city in 2018.

Kristen Marshall, manager of the national drug harm reduction DOPE Project, noted the grim irony that while social isolation could save lives from COVID-19, it had undoubtedly contributed to the number of overdose deaths.

“Isolation is also the thing that puts people at the absolute highest risk of overdose death,” she said.

Pandemic exacerbates rise in deaths from drug overdose

The number of deaths from drug overdose started rising in the months leading up to the coronavirus pandemic, making it hard to gauge how closely the two phenomena are linked. But the pandemic unquestionably exacerbated the trend. The biggest jump in overdose deaths took place in April and May when fear and stress were rampant, job losses were multiplying and the strictest lockdown measures were in effect.

Many treatment programs closed during that time while drop-in centers, which provide support, clean syringes and naloxone, cut back services.

The data released by the CDC shows a 29 percent rise in overdose deaths from October 2019 through September 2020 compared with the previous 12-month period. Illicitly manufactured fentanyl and other synthetic opioids were the primary drivers, although many fatal overdoses have also involved stimulant drugs like methamphetamine.

Unlike in the early years of the opioid epidemic, when deaths were largely among white Americans in rural and suburban areas, the current crisis is affecting Black Americans disproportionately.

“The highest increase in mortality from opioids, predominantly driven by fentanyl, is now among Black Americans,” Dr. Nora Volkow, the director of the National Institute on Drug Abuse, said at a national addiction conference last week.

“And when you look at mortality from methamphetamine, it’s chilling to realize that the risk of dying from methamphetamine overdose is 12-fold higher among American Indians and Alaskan Natives than other groups.”

Dr. Volkow added that more deaths than ever involved drug combinations, typically of fentanyl or heroin with stimulants.

“Dealers are lacing these non-opioid drugs with cheaper, yet potent, opioids to make a larger profit,” she said. “Someone who’s addicted to a stimulant drug like cocaine or methamphetamine is not tolerant to opioids, which means they are going to be at high risk of overdose if they get a stimulant drug that’s laced with an opioid like fentanyl.”

The Drug Enforcement Administration (DEA) supported Dr. Volkow’s claim, saying that transnational criminal organizations cause a spike in overdoses by mixing fentanyl into illicit narcotics.

According to the DEA, Mexican cartels often purchase the drug components in China and use human mules to smuggle the narcotics to lucrative drug markets north of the border.

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