Health Security: The return of measles — and a smartwatch for everyone?

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PPF’s report The Next One: Preparing Canada for Another Health Emergency outlines the lessons learned from the pandemic and how Canada can safeguard against future health emergencies. 

To keep the discussion going — and to keep Canadians informed – this newsletter looks at what’s happening in the world of health security each week.  

Here’s what we’re following: 

Measles multiply

The World Health Organization is warning of an “alarming rise” in measles across Europe. Another 70 suspected cases were reported in the U.K. this week, where the Health Security Agency issued a “national incident” alert signaling a growing health risk.

Data released this week showed 144 suspected cases reported in the two weeks leading up to Jan. 14. Across Europe, 42,200 cases were reported in 2023, up exponentially from just 941 in 2022. “Urgent vaccination efforts are needed to halt transmission and prevent further spread,” a WHO spokesperson said this week. The organization estimates that more than 1.8 million babies missed their measles vaccine between 2020 and 2022, when the COVID pandemic interfered with regular vaccine schedules.

Measles is also spreading in the U.S., with at least three states recording a jump in cases (though not to the same levels, yet, as those in the U.K. and Europe). Meanwhile, in Canada, where rates of infant MMR immunizations actually rose slightly between 2019 and 2021, there have been a handful of reported measles cases this winter, including most recently one this week in Saskatchewan.

As with COVID-19 detection, some research is currently being carried out to trace measles in wastewater. While little work has been done in the area so far, some early testing shows promise. One Nova Scotia study tested wastewater seeded with a measles surrogate and was able to pick up evidence of it. That said, measles is rarely asymptomatic, so the actual value of wastewater testing is still in question.

Healthy opinions

Survey data from the Alberta Medical Association released this week paints a grim picture of the state of family medical practices. The survey, which polled over 1,300 Alberta family doctors, found that “most of Alberta’s family medical practices are in disastrous financial condition,” with 91 percent of family doctors in the province saying they’re concerned about the continued financial viability of their practices (with 20 percent saying they believe their medical practice is unlikely to be financially viable beyond six months). The bleak financial outlook has many family doctors (61 percent) saying they’re thinking about leaving the Alberta health-care system. More than a third said they were either thinking of retiring early or looking for work in another province or country. As the pollster, ThinkHQ, opined in its report, the results could have “huge implications for patients (particularly in rural settings).”

Nationally, too, patients feel that the health system is in trouble. A separate poll of Canadians released this week revealed that 70 percent of people are worried about not being able to receive good quality medical attention if they need it. Atlantic Canadians polled (87 percent) were the most worried, and the survey found that suburbanites are generally more worried than urbanites or rural Canadians.

Just over a quarter of Canadians say the health care in their province is good (notably, Albertans were most likely to endorse their system), while more than a third rated their provincial system as either poor or very poor. And respondents’ outlook for the future is similarly poor. Forty percent of respondents told the pollster, Leger, they think Canada’s health-care system will remain the same as it is now (that is, “stressed’ and “failing”), while nearly the same proportion (36 percent) think it will get worse.

What’s to be done? Respondents broadly agreed (67 percent) that poor working conditions in hospitals, including long hours, are the primary driver of staffing shortages. But funding cuts (40 percent), COVID-19-prompted retirements (39 percent), and low pay (34 percent) were also considered top reasons. So, what to do? The majority (70 percent) of those polled still think that Canada should “focus its efforts on our public health-care system and limit the development of private health care…so that it does not limit access to quality services in the public…system.”

Setting health care free

Every Canadian should have access to wearable technology (like a smartwatch) that’s incentivized either through tax measures or consumer rebates. That’s one of the findings of a new Public Policy Forum report calling for the urgent modernization of the data and digital infrastructure that underpins Canadian health care.

The report, titled, Unlocking Health Care: How to free the flow of life-saving health data in Canada, sounds the alarm on Canada’s “chronic, subpar performance on data, the vital currency of a digital-age system.” It calls for a “giant leap forward” in the use of health data. The report points to other jurisdictions where every patient has a single electronic medical record accessible at all health institutions and where personal wearables have been deeply integrated into day-to-day health-care system use — with marked improvements in both personal and overall public health.

“Electronic records are the cornerstone of any credible human-centred health system. Yet, incredibly, they are neither standard nor standardized across Canada,” the report says. Without good data, “referrals become cumbersome, diagnoses slow and unsafe treatments all too common,” As well, data shortcomings are contributing to the burnout of health-care workers.

Other report recommendations include the elimination of faxes for the transmission of medical data by the end of this year and a commitment to paperless health-care systems — interoperable and with seamless user access — by 2028.

The report was written by award-winning journalist Christina Frangou and informed by a panel of experts.

HPV

Public Health Scotland released findings this week showing that not a single case of cervical cancer has been found in any woman who has been fully vaccinated against HPV (human papillomavirus) and who were given their first dose at age 12-13. Scotland introduced an HPV vaccination program in 2008. The news is less encouraging in England, where the UKHSA reported this week that HPV vaccine rates have dropped among key groups of schoolchildren.

Meanwhile, in the U.S., the American Cancer Society reported this week that rates of cervical cancer in women aged 20 to 24 dropped by 65 percent between 2012 and 2019. However, rates rose slightly (by around two percent) for women between the ages of 30 and 44 — perhaps due to women allowing regular cancer screenings to lapse during their late 20s. In Canada, efforts to broaden the reach of the HPV vaccine continue: last week, B.C. extended free vaccines to men born in 2005. While the HPV vaccine is free to those under 26 in some provinces, including Alberta and Quebec, it still requires a prescription in Ontario.

Malaria vaccine

Cameroon began the world’s first malaria vaccine program this week. Malaria kills nearly half a million under the age of five every year in Africa and Cameroon is hoping to vaccinate 6.6 million children in the next two years. However, according to health workers who spoke to Reuters, the program may be marred by a lack of knowledge about it, as well as vaccine hesitancy.

Some have questioned the real potential impacts of the vaccine, which only has a 40 percent efficacy rate — far below other vaccines delivered to children, such as those for measles. “Would a four-dose regimen of the vaccine be feasible in the real world of sub-Saharan Africa?” Jonathan Jarry, with the McGill Office for Science and Society, asked in 2021, when the WHO first recommended the vaccine. Jarry continued, “would vaccine recipients assume they were fully protected and dismiss other protective measures, like insecticide-treated bed nets?”

Preventing even 40 percent of deaths from malaria would be significant, but the vaccine might do even more. During a pilot program in Ghana, Kenya and Malawi, where over 2 million children between the ages of five months and two years have received the vaccine since 2019, the WHO found the vaccine decreased deaths of all kinds in children by 13 percent. The pilot program also revealed that “vaccine uptake is high, with no reduction in use of other malaria prevention measures or uptake of other vaccines.”

February:

• Feb. 1: 2024 Whittington Lecture with Dr. Anthony Fauci. McCourt School of Public Policy, Georgetown University. Washington, D.C.

• Feb. 3-4: International Conference on Medical and Biological Engineering. Toronto, Ont.

• Feb. 3-7: SLAS2024 International Conference and Exhibition. Boston, Mass.

• Feb 9: Global Conference on Biotechnology, Bioengineering & Biomedical Engineering. Vancouver, B.C.

• Feb. 11-14: SCOPE Summit 2024. Orlando, Fla.

• Feb. 21: Wall Street Journal Health Forum. Boston, Mass.

• Feb. 22-23: GENAP Summit 2024. Geneva, Switzerland.

• Feb. 25-28: ViVe 2024. Los Angeles, Calif.

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This newsletter is produced by journalists at PPF Media and it maintains complete editorial independence.