In the wake of the United States’ declaration of monkeypox as a public health emergency Thursday, questions are being raised about whether Canada should follow suit as case numbers continue to rise.
The American move follows a similar announcement late last month by the World Health Organization declaring monkeypox a global health emergency — and in both cases, these developments trigger more attention and, in the U.S., more money and other resources to fight the virus.
Dr. Don Vinh, an infectious diseases specialist at McGill University Health Centre, says he believes Canada, as a member state of the WHO, has an obligation to follow suit now that the UN agency has declared the monkeypox outbreak a public health emergency of international concern.
“We do need to respond accordingly,” he said. “I think formally declaring an emergency response helps sort of shepherd or steer administrations, which may be a bit ambivalent.”
Such a declaration in Canada wouldn’t have to look like the response to the COVID-19 pandemic, the most recent event to prompt a Canadian declaration of a health emergency, he said.
But he said it could trigger a deployment of additional resources that would be helpful to those fighting the virus where it is spreading in Canada now — and prevent it from becoming harder to contain in the future.
“We have a window of opportunity right now where we have some control,” Vinh said.
“I think that what we have seen with COVID is that, if we have sort of a hodgepodge approach to this — some cities or provinces do it one way and others do it a different way — we’re going to lose our opportunity to control it.”
Canada has confirmed 931 cases of monkeypox as of Aug. 5, up from 890 two days earlier, according to Public Health Agency of Canada (PHAC) data. Ontario is now leading the country in case numbers, taking over from Montreal, which had been the hot spot for the virus in Canada until recently.
The number of cases is higher in the U.S. with more than 6,600 people infected with the zoonotic disease that had, until recent months, never been seen outside central and west Africa.
Canada's monkeypox response
State governments and the Biden administration have faced criticism for their slow response to the outbreak in the U.S., with clinics in major cities such as New York and San Francisco saying they haven’t received enough of the two-shot vaccine to meet demand, and some have had to stop offering the second dose to ensure supply of first doses.
Canada has not faced the same scrutiny and, experts say, can be lauded for acting swiftly to address the outbreaks, especially in Toronto and Montreal — the two main areas of infection in the country.
The Canadian response has been notably effective in targeting the population that, to date, has happened to be the most affected — men who have sex with men — ensuring they are getting prompt and easy access to vaccines and receive education about the virus through trusted sources in their communities, says Dr. Isaac Bogoch, an infectious diseases specialist at the Toronto General Hospital.
That’s why an emergency declaration may not make much of a difference, except perhaps in technical terms, he said.
“We have been treating this as an emergency,” Bogoch said.
“We had a very relatively swift, but very co-ordinated response that’s ongoing and other places didn’t do that to the same extent.”
However, there is still room for improvement in Canada, especially in lowering barriers to care, testing and diagnostic capacity and expanding access to preventive measures such as vaccines, Bogoch added.
“But we’re doing OK relative to other places. We really are.”
Asked whether Canada was imminently considering declaring a public health emergency on Thursday, a PHAC official said Canada “acknowledges the WHO’s determination and recognizes that the global monkeypox outbreak requires an urgent global response” and stressed that the federal government has treated monkeypox as a priority since the beginning of the outbreak in May.
Questions sent to federal Health Minister Jean-Yves Duclos’ office asking whether government was considering an emergency declaration were deferred to PHAC.
The agency has deployed more than 80,000 doses of Imvamune vaccine to provinces and territories and is supporting decentralized testing by providing control material and protocols to lab partners around the country, PHAC said in a statement.
“PHAC also continues to work closely with international, provincial and territorial health partners to gather information on this evolving outbreak and to determine the best course of action to stop the spread of monkeypox in Canada,” Anna Maddison, a spokeswoman for PHAC, said in an email to Global News.
“Canada will also continue to work with the WHO and international partners to strengthen the global response to the current monkeypox outbreak.”
While Canada’s actual case numbers remain lower than those in the U.S., the rate of infection per capita is higher in Canada than south of the border, which is a data point that should be kept in mind, says Dr. Sameer Elsayed, an infectious disease physician and professor of epidemiology and biostatistics at Western University.
That’s why he says it could be reasonable for Canada to consider declaring monkeypox a public health emergency in the near future, especially if case numbers continue to rise at current rates, he said.
But with such a declaration would come a necessity to pour resources and additional funds toward this virus for such things as vaccine clinics, contact tracing, testing, education and other measures, Elsayed said.
At a time when health systems in every province and territory are facing what virtually every health practitioner has called a “crisis” in staffing and resources, Elsayed says he believes a declaration of an emergency in health care more generally in Canada is more urgent and should go hand in hand with any such declaration for a single virus.
That way, more resources and a greater sense of urgency would go to many areas of the health system crumbling under the weight of major backlogs in care, patient surges and a mass exodus of health-care workers across the country, he said.
“We don’t have enough money in the system. So, we need money for monkeypox, but we also need money for other conditions as well,” Elsayed said.
“It would be reasonable to declare a state of emergency, but only if we’re declaring a state of emergency for our health-care system in general that is in shambles.”