Latest news with #StThomasElginGeneralHospital
The Guardian
2 days ago
- Health
- The Guardian
A massive outbreak has made Ontario the measles epicentre of the western hemisphere
Outside the emergency room of the St Thomas Elgin general hospital, about 200km (125 miles) south-west of Toronto, a large sign with bright yellow block letters issues an urgent warning: 'NO MEASLES VAX & FEVER COUGH RASH – STOP – DO NOT ENTER!' To see such an imperative in the 21st century might have been previously unimaginable for Canada, which in 1998 achieved 'elimination status' for measles, meaning the virus is no longer circulating regularly. Now, however, Canada is at risk of losing that status – mainly because of an explosive outbreak of the highly infectious and sometimes deadly disease in south-western Ontario, where the St Thomas hospital is located. Since October, the province has reported a staggering 2,009 cases of measles associated with the current outbreak – more than all of those in the United States combined in 2025, and making Ontario the measles epicentre of the western hemisphere. Cases have been climbing by the hundreds over the last month, and three-quarters of cases are in unvaccinated children, according to Public Health Ontario. This week saw the first fatality from the outbreak: a premature baby who contracted measles in utero from their unvaccinated mother. Ontario's chief medical officer of health, Kieran Moore, said that the infant faced other unrelated medical complications, but confirmed that measles may have been a contributing factor in both the premature birth and death. 'We have not had a measles outbreak in the community, of this size, for as long as I have practiced. Lots of doctors have never seen measles before now,' said Asmaa Hussain, a doctor who is head of paediatrics at the St Thomas Elgin general. Hussain said that the true scale of the outbreak may be even larger. 'There are likely lots and lots of children and families at home who had measles, who never presented to the hospital,' she said. 'The tested cases do not capture even a fracture of what has happened in the community.' Nearly 40% of cases in Ontario have been reported by the Southwestern Public Health Unit, which services Oxford county, Elgin county and the city of St Thomas, all about a two-hour drive south-west of Toronto. Shocking though the scale of the outbreak may seem, doctors on the frontline and scientists who study public health say that the return of measles was grimly predictable. A confluence of antiquated local public health vaccination strategies, sparse access to family doctors, delays in routine immunization due to Covid-19 and a surge in vaccine hesitancy propelled by online misinformation since the pandemic all have contributed to the crisis. South-western Ontario is also home to populations of close-knit vaccine-hesitant religious communities who are less exposed to public health messaging, such as Mennonites. The current outbreak has been traced to a Mennonite wedding in New Brunswick, from which a guest returned to Ontario with the virus. Meanwhile, case numbers have also been creeping up in the western province of Alberta, which this week reported a total of 710 confirmed cases, making it the worst year for measles since 1986, when 843 cases were reported. Measles is characterized by fever, cough, and a blotchy red, purple or brown widespread rash, and it can result in brain damage, blindness and death in severe cases. It is highly preventable through vaccination, however, and Canada's goal is for 95% of the population to be immunized against the disease to prevent community spread. But the country has dropped below that as first-dose coverage for measles nationally fell from 2019 to 2023, from 90% to 83%, according to the Public Health Agency of Canada. In St Thomas, Hussain said that this year she has treated many babies younger than 12 months old with measles. Babies under a year are not eligible for the measles vaccine, and Hussain said that in many cases they are infected by unvaccinated older siblings who have picked up the virus from school. Hussain also said she had treated an unvaccinated woman who caught the disease from her children before transmitting it to her newborn baby after delivery. It is illegal to send an unvaccinated child to school in Ontario unless they are immunized against various illnesses, including measles. But, exemptions are possible for valid medical reasons and when vaccination goes against personal religious belief. Also, when unvaccinated families present with measles at healthcare centres, doctors sometimes struggle to even discuss vaccination with the parents, Hussain said. 'It's really hard to even approach the conversation. I would ask: 'How come you aren't [vaccinated]?' And they will say: 'Oh, we're exempt' or 'We've had this discussion before and we just don't want to,'' she said. Dawn Bowdish, an immunologist and professor at McMaster University in Ontario, said while distrust of vaccines has increased, Canada's family doctor crisis also precipitated the measles outbreak. About 20% of Canadians have no family doctor at all, and many more have irregular access to clinicians, so parents do not have easy access to a trusted healthcare professional to discussion vaccinations. Furthermore, the lack of a national vaccine registry means that it can be challenging to know your own vaccination status, she said. Bowdish also warned that vaccine exemptions were too easily obtained. 'One of the challenges is that there's been a loosening of exemptions as well, so people may not have that faith-based reason, or a reason that's actually supported by their religion, but just a general sense that they don't get their kids vaccinated. It's really hard to balance personal freedoms with public health,' she said. Ontario's Ministry of Health did not respond to a query about vaccine exemptions and strategies to reach religious minority communities. The Southwestern Public Health Unit referred queries to Public Health Ontario, who in turn referred the question to the Southwestern Public Health Unit. Various vaccine clinics have been launched across south-western Ontario to ramp up the measles immunization status in the region, though they have not been held at schools. The Ontario government has previously said its teams are on the ground with local public health units, but that convincing vaccine-hesitant people is difficult. Kumanan Wilson, a doctor and professor at the University of Ottawa who studies public health policy, said the Covid pandemic heightened anxieties about perceived government overreach – and simultaneously resulted in many people losing direct, frequent access to medical care. But, he said, focusing on religious communities in the current outbreak could obscure broader concerns that previous methods used by public health agencies to manage illness have lost efficacy. 'They're going to have to learn to navigate this new world of people not trusting government as much and more populist tendencies. And that's going to take an adjustment in how we communicate,' he said. Twenty years ago, Wilson carried out a study that found providing accurate public health information actually increased mistrust among the vaccine-hesitant, who said they found it 'manipulative'. 'You need to find champions within those communities, who believe in what the public health people are telling them, and can communicate that message,' he said. He said Canadian public health has previously focused on shaming those who do not vaccinate. 'And in this era, that doesn't work,' he said. A study by the Angus Reid Institute published at the end of May found that a quarter of Canadians overall do not trust their provincial governments to respond to the measles outbreak adequately. That number was higher in Ontario, at 27%. That study also found that one in five Canadians with children under 18 are hesitant to vaccinate their children. Hussain fears that other previously dormant illnesses may return. Measles, when mild, can be managed by physicians like herself. But an illness like polio could result in more dire consequences, including higher rates of death, she said. 'My worry is about the next outbreak. Because there will be a next one coming, right?' she said.
CBC
29-05-2025
- Business
- CBC
St. Thomas area doctor incentive program funds 7 physicians so far this year
A financial incentive program offered by the City of St. Thomas and Elgin County to attract and retain family doctors has doled out funds this year to seven physicians, including at least three new to the region. It's among financial incentives on offer across Ontario from municipal and county governments with the aim of curtailing growing doctor shortages and retaining family physicians. In St. Thomas, the city and county have offered $33,000 in interest-free, forgivable loans for years as part of a Health Recruitment Partnership involving local politicians and other community stakeholders, including St. Thomas Elgin General hospital and the area Home Builders' Association. The loans can be used for office expenses and medical equipment, among other things, and are forgivable on condition the doctor provide at least four years of service in the county. Last week, St. Thomas council endorsed providing funding to two new doctors — Dr. Wallace Ordiah and Dr. Aghogho Nathaniel Oyibo — who plan to begin practising in the city this year. The city and county also offer a scholarship awarding $1,000 per year to up to 10 people enrolled in accredited medical schools, with an emphasis on those pursuing a career as a family doctor locally. Urgent need for family doctors There are many reasons for the shortage of doctors plaguing Ontario municipalities, said Lori Baldwin-Sands, a St. Thomas city council member and chair of the Health Recruitment Partnership. One challenge is the large patient rosters of retiring doctors, which sometimes number as many as 5,000 patients, she said. New doctors coming out of medical school are looking for a better quality of life, and smaller rosters of between 1,000 to 1,500 patients, she said. "This has created an urgent need in communities everywhere, because the doctors that are retiring are leaving a lot of their patients orphaned," by not being able to have a new doctor take on their full patient roster, she told CBC's Afternoon Drive on Tuesday. "The last statistics that we had show about 10,000 orphaned residents without a family doctor within our community, and we know that the numbers are higher," she said referring to both St. Thomas and Elgin County. "We've heard the number can go as high as 15,000, 20,000." At least 13 per cent of Ontarians didn't have access to a regular health care provider in 2023, Statistics Canada data shows. Doctor shortages are more acute in rural communities, and one study by the Ontario College of Family Physicians found at least 670,000 Ontarians travel 50 km or more to see their doctor. In neighbouring London, the idea of municipalities offering financial incentives to attract doctors has garnered criticism from Mayor Josh Morgan, who believes they should be illegal, calling them a race to the bottom which pits municipalities against one another. In March, London councillors voted to provide $50,000 for one year to the Middlesex-London Ontario Health Team, which is leading doctor recruitment efforts in the county. The health team had requested $80,000 over three years. Other Ontario cities offering incentives includes Welland, which provides $100,000 to doctors who moved to the city to launch or take over an existing practice, with the promise they stay in the city for five years. The $1 million program has attracted at least 14 doctors to the city since its 2023 launch. In Huntsville, doctors are lured with an $80,000 signing bonus if they agree to work there for at least five years, while in Marmora and Lake near eastern Ontario, doctors have been offered riverfront housing and clinic space at zero cost. "Some of them are very different. I have talked to some doctors that said they were offered a house for a five-year period. Some doctors are told they would have their tuition paid," Baldwin-Sands said. "We have, in St. Thomas and Elgin County, a quality of life that we feel is second to none. That's why, next week, we're hosting a group of medical students here in the community and showcasing some of the beautiful gems that we have."
