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Source: http://www.winnipegfreepress.com/lo...h1n1-strategy-for-first-nations-52753002.html
Winnipeg Free Press - PRINT EDITION
Officials bolster H1N1 strategy for First Nations
By: Aldo Santin
8/08/2009 1:00 AM
THE image of dozens of aboriginal residents being flown to Winnipeg for treatment of the H1N1 virus convinced Manitoba and Ontario to revise how northern native communities will be treated if the outbreak occurs again.
The chief medical officers of health for both provinces said Friday that the Garden Hill and St. Theresa Point experiences in May convinced them the risk factors for treatment should be expanded to include anyone who is aboriginal.
"As soon as we saw a pattern that showed severe disease was more common in people of aboriginal descent, then that became an additional risk factor and we communicated that to health officers very soon after that," Dr. Joel Kettner, the Manitoba's chief medical officer of health, said.
The province's clinical care guidelines for the treatment of H1N1 outbreaks included a list of risk factors that physicians and nurses had to determine before antiviral medication, such as Tamiflu, would be administered to patients. For most patients, antivirals would only be prescribed if they were severely ill.
It was those guidelines that prompted the chiefs of Garden Hill and St. Theresa Point to complain that health officials were ignoring the realities of northern living. The chiefs said their communities lacked simple amenities such as running water and hand sanitizers and that few, if any, of their people were given antivirals until after they were flown to Winnipeg for treatment.
Chiefs David Harper and David McDougall were incensed when they learned that an outbreak on the isolated reserve of Sandy Lake in northwestern Ontario was treated more aggressively than the outbreak in their communities.
When the virus appeared at Sandy Lake, three weeks after it occurred in Manitoba, hundreds of doses of antiviral medication were flown into the community. A Health Canada official said late Friday that 160 Sandy Lake residents were treated with antiviral drugs.
Unlike what happened in Garden Hill and St. Theresa Point, no one from Sandy Lake had to be flown out for treatment.
Dr. Arlene King, Ontario's chief medical officer of health, said she altered her province's care guidelines immediately upon assuming her post in mid-June, adding that the Garden Hill and St. Theresa Point experience played a part in her decision.
Health Canada officials said the Manitoba situation played a key role in Ontario changing its guidelines.
"Following lessons learned in Manitoba... the Province of Ontario adapted their provincial guidelines to increase the antiviral allocation to northern communities," a Health Canada spokeswoman stated in an email to the Free Press.
King said conditions -- lack of running water, lack of extensive medical facilities and overcrowding -- faced by aboriginal residents in northern and isolated communities make them more susceptible to the H1N1 virus.
"The combination of all those factors led us to implement an aggressive early treatment strategy," King said, adding her decision was affected by experiences in other countries as well as what happened in Manitoba.
Kettner said that if an outbreak occurs again, as is expected in the fall, then any aboriginal person showing flu-like symptoms will be prescribed antiviral medication.
Kettner said that even under the old guidelines, doctors and nurses on nursing stations in the north could have prescribed antiviral medication to anyone they believed needed it, adding he's not aware of any incident where the medication was not available if it was prescribed.
Health Canada officials said that since the spring outbreak, additional supplies of antiviral drugs have been purchased for all First Nations communities, adding they believe local health-care workers have access to enough antivirals without having to tap into provincial stockpiles.
St. Theresa Point Chief McDougall said he wasn't aware of a change in the H1N1 treatment strategy but added he is pleased.
"I welcome that kind of aggressive strategy but I don't understand why they're being so secretive about it," McDougall said.
He said residents in the Island Lake communities don't understand why they appear to have received inferior care compared with the Sandy Lake residents, adding provincial and federal health officials need to be more open with First Nations. "All Ottawa would tell us was that everything that could be done had been done and that we should trust them," McDougall said. "We have to work together."
aldo.santin@freepress.mb.ca
Winnipeg Free Press - PRINT EDITION
Officials bolster H1N1 strategy for First Nations
By: Aldo Santin
8/08/2009 1:00 AM
THE image of dozens of aboriginal residents being flown to Winnipeg for treatment of the H1N1 virus convinced Manitoba and Ontario to revise how northern native communities will be treated if the outbreak occurs again.
The chief medical officers of health for both provinces said Friday that the Garden Hill and St. Theresa Point experiences in May convinced them the risk factors for treatment should be expanded to include anyone who is aboriginal.
"As soon as we saw a pattern that showed severe disease was more common in people of aboriginal descent, then that became an additional risk factor and we communicated that to health officers very soon after that," Dr. Joel Kettner, the Manitoba's chief medical officer of health, said.
The province's clinical care guidelines for the treatment of H1N1 outbreaks included a list of risk factors that physicians and nurses had to determine before antiviral medication, such as Tamiflu, would be administered to patients. For most patients, antivirals would only be prescribed if they were severely ill.
It was those guidelines that prompted the chiefs of Garden Hill and St. Theresa Point to complain that health officials were ignoring the realities of northern living. The chiefs said their communities lacked simple amenities such as running water and hand sanitizers and that few, if any, of their people were given antivirals until after they were flown to Winnipeg for treatment.
Chiefs David Harper and David McDougall were incensed when they learned that an outbreak on the isolated reserve of Sandy Lake in northwestern Ontario was treated more aggressively than the outbreak in their communities.
When the virus appeared at Sandy Lake, three weeks after it occurred in Manitoba, hundreds of doses of antiviral medication were flown into the community. A Health Canada official said late Friday that 160 Sandy Lake residents were treated with antiviral drugs.
Unlike what happened in Garden Hill and St. Theresa Point, no one from Sandy Lake had to be flown out for treatment.
Dr. Arlene King, Ontario's chief medical officer of health, said she altered her province's care guidelines immediately upon assuming her post in mid-June, adding that the Garden Hill and St. Theresa Point experience played a part in her decision.
Health Canada officials said the Manitoba situation played a key role in Ontario changing its guidelines.
"Following lessons learned in Manitoba... the Province of Ontario adapted their provincial guidelines to increase the antiviral allocation to northern communities," a Health Canada spokeswoman stated in an email to the Free Press.
King said conditions -- lack of running water, lack of extensive medical facilities and overcrowding -- faced by aboriginal residents in northern and isolated communities make them more susceptible to the H1N1 virus.
"The combination of all those factors led us to implement an aggressive early treatment strategy," King said, adding her decision was affected by experiences in other countries as well as what happened in Manitoba.
Kettner said that if an outbreak occurs again, as is expected in the fall, then any aboriginal person showing flu-like symptoms will be prescribed antiviral medication.
Kettner said that even under the old guidelines, doctors and nurses on nursing stations in the north could have prescribed antiviral medication to anyone they believed needed it, adding he's not aware of any incident where the medication was not available if it was prescribed.
Health Canada officials said that since the spring outbreak, additional supplies of antiviral drugs have been purchased for all First Nations communities, adding they believe local health-care workers have access to enough antivirals without having to tap into provincial stockpiles.
St. Theresa Point Chief McDougall said he wasn't aware of a change in the H1N1 treatment strategy but added he is pleased.
"I welcome that kind of aggressive strategy but I don't understand why they're being so secretive about it," McDougall said.
He said residents in the Island Lake communities don't understand why they appear to have received inferior care compared with the Sandy Lake residents, adding provincial and federal health officials need to be more open with First Nations. "All Ottawa would tell us was that everything that could be done had been done and that we should trust them," McDougall said. "We have to work together."
aldo.santin@freepress.mb.ca