Episodios
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â¶ïžð§ðïžPART 2! Tools to use on the frontline and tips to engage your patients in 60 seconds or less. We untangle the complex web of the COVID-19 pandemic and plot a course for the journey ahead with ðð«.Alan Kaplan and Dr.Marla Shapiro who break down all you need to know.
âïžâïžWe take an in-depth look at the unfolding chapter of the COVID-19 pandemic. The World Health Organization (WHO) has declared the global health emergency phase over, yet COVID-19 remains a persistent adversary. . Seems like a contradiction, right? We're dissecting this communique and explore how to break it down on the frontlines. We ask, where are we headed now?
âïžâïžWe delve into the questions on everyone's mind: Do our current vaccines shield us against the elusive XBB.1.16 variant? What does the end of the 'emergency phase' actually mean for us on a day-to-day basis? And with the virus still lurking in our midst, how do we navigate this new landscape of coexistence?
âïžâïžWe examine the WHO's Technical Advisory Group (TAG) proposal to retire the original COVID-19 strain from future vaccines and explore what this could mean for the future of public vaccination strategies.
âïžâïžWe're also talking the latest research on hybrid immunity and how to translate this for your patients in a meaningful way. What happens when natural infection immunity meets vaccine-induced immunity? Does this 'hybrid immunity' offer us an extra layer of protection?
âïžâïžKeeping the conversation light, the information insightful, and the health advice actionable to navigate the road ahead.
Letâs dive in!
Dr.Alan Kaplan
Dr.Alan Kaplan, MD, CCFP(EM), CPC(HC) is a family Physician practicing in York Region, Ontario, Canada.
Regional Primary Care Lead, Central Regional Cancer Program
Chairperson of the Family Physician Airways Group of Canada
Alan is a practicing family physician and the Medical director of LHIN Pulmonary Rehabilitation clinics in Ontario, Canada. Alan chairs the Family Physician Airways Group of Canada (www.fpagc.com) and is also an Honorary Professor of Primary Care Respiratory Medicine of the Observational and Pragmatic Research Institute, Singapore.
Alanâs other positions include Co-Chair of the Health Quality Ontario COPD Community Management standards committee, Member of the Health Quality Ontario Asthma community management standards committee, Vice President Respiratory Effectiveness Group and Senate member of the International Primary Care Respiratory Group
Alan is also a Clinical Lecturer at the University of Toronto in the Department of Family and Community Medicine, while being a Member of the Physician Advisory Panel of the Medical Post, the Medical Advisory Committee of the Pulmonary Hypertension Association of Canada and a Member of Section of Allergy and Respiratory Therapeutics, Health Canada. Alan has authored 136 Peer Reviewed Articles and 104 Conference Abstracts.
Dr. Marla Shapiro C.M., CCFP, MHSc, FRCPC, FCFP, NCMP
Professor, DFCM, University of Toronto
Dr. Shapiro completed medical school at McGill University and trained at the University of Toronto for her Masters of Health Science. She concluded her specialty training in Community Medicine, receiving her Fellowship in Preventive Medicine and Public Health from the Royal College of Physicians and Surgeons of Canada. She also holds a Fellowship in Family Medicine and is currently a Professor in the Department of Family and Community Medicine at the University of Toronto. She is a credentialed expert in Menopause from the North American Menopause Society.
Dr. Shapiro is seen on CTV NewsChannel as the medical expert. She is the author of the bestselling book, Life in the Balance: My Journey with Breast Cancer.
Dr. Shapiro is a member of several advisory boards, having been a member of the Canadian Partnership Against Cancer, Research Canada and the Board of Trustees of the North American Menopause Society. She was the President of the North American Menopause Society in 2017 and the Scientific Chair of the 25th anniversary of NAMS.
Currently she sits on the Board of the Terry Fox Research Institute and the Board of Trustees of the International Menopause Society. She received an Award of Excellence from the College of Family Physicians of Canada, and was awarded the Excellence in Creative Professional Activity by the University of Toronto. Dr. Shapiro was also chosen in the top 10 of the 50 most powerful doctors in Canada by the Medical Post. In 2015 Dr. Shapiro was named a Member of the Order of Canada for her contributions as a family physician and trusted source of health information. One of this countryâs highest civilian honours, the Order of Canada recognizes outstanding achievement, dedication to the community, and service to the nation.
Virological characteristics of the SARS-CoV-2 omicron XBB.1.16 variant
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â¶ïžð§ðïžToday we untangle the complex web of the COVID-19 pandemic and plot a course for the journey ahead with ðð«.Alan Kaplan and Dr.Marla Shapiro who break down all you need to know.
âïžâïžWe take an in-depth look at the unfolding chapter of the COVID-19 pandemic. The World Health Organization (WHO) has declared the global health emergency phase over, yet COVID-19 remains a persistent adversary. . Seems like a contradiction, right? We're dissecting this communique and explore how to break it down on the frontlines. We ask, where are we headed now?
âïžâïžWe delve into the questions on everyone's mind: Do our current vaccines shield us against the elusive XBB.1.16 variant? What does the end of the 'emergency phase' actually mean for us on a day-to-day basis? And with the virus still lurking in our midst, how do we navigate this new landscape of coexistence?
âïžâïžWe examine the WHO's Technical Advisory Group (TAG) proposal to retire the original COVID-19 strain from future vaccines and explore what this could mean for the future of public vaccination strategies.
âïžâïžWe're also talking the latest research on hybrid immunity and how to translate this for your patients in a meaningful way. What happens when natural infection immunity meets vaccine-induced immunity? Does this 'hybrid immunity' offer us an extra layer of protection?
âïžâïžKeeping the conversation light, the information insightful, and the health advice actionable to navigate the road ahead.
Letâs dive in!
Dr.Alan Kaplan
Dr.Alan Kaplan, MD, CCFP(EM), CPC(HC) is a family Physician practicing in York Region, Ontario, Canada.
Regional Primary Care Lead, Central Regional Cancer Program
Chairperson of the Family Physician Airways Group of Canada
Alan is a practicing family physician and the Medical director of LHIN Pulmonary Rehabilitation clinics in Ontario, Canada. Alan chairs the Family Physician Airways Group of Canada (www.fpagc.com) and is also an Honorary Professor of Primary Care Respiratory Medicine of the Observational and Pragmatic Research Institute, Singapore.
Alanâs other positions include Co-Chair of the Health Quality Ontario COPD Community Management standards committee, Member of the Health Quality Ontario Asthma community management standards committee, Vice President Respiratory Effectiveness Group and Senate member of the International Primary Care Respiratory Group
Alan is also a Clinical Lecturer at the University of Toronto in the Department of Family and Community Medicine, while being a Member of the Physician Advisory Panel of the Medical Post, the Medical Advisory Committee of the Pulmonary Hypertension Association of Canada and a Member of Section of Allergy and Respiratory Therapeutics, Health Canada. Alan has authored 136 Peer Reviewed Articles and 104 Conference Abstracts.
Dr. Marla Shapiro C.M., CCFP, MHSc, FRCPC, FCFP, NCMP
Professor, DFCM, University of Toronto
Dr. Shapiro completed medical school at McGill University and trained at the University of Toronto for her Masters of Health Science. She concluded her specialty training in Community Medicine, receiving her Fellowship in Preventive Medicine and Public Health from the Royal College of Physicians and Surgeons of Canada. She also holds a Fellowship in Family Medicine and is currently a Professor in the Department of Family and Community Medicine at the University of Toronto. She is a credentialed expert in Menopause from the North American Menopause Society.
Dr. Shapiro is seen on CTV NewsChannel as the medical expert. She is the author of the bestselling book, Life in the Balance: My Journey with Breast Cancer.
Dr. Shapiro is a member of several advisory boards, having been a member of the Canadian Partnership Against Cancer, Research Canada and the Board of Trustees of the North American Menopause Society. She was the President of the North American Menopause Society in 2017 and the Scientific Chair of the 25th anniversary of NAMS.
Currently she sits on the Board of the Terry Fox Research Institute and the Board of Trustees of the International Menopause Society. She received an Award of Excellence from the College of Family Physicians of Canada, and was awarded the Excellence in Creative Professional Activity by the University of Toronto. Dr. Shapiro was also chosen in the top 10 of the 50 most powerful doctors in Canada by the Medical Post. In 2015 Dr. Shapiro was named a Member of the Order of Canada for her contributions as a family physician and trusted source of health information. One of this countryâs highest civilian honours, the Order of Canada recognizes outstanding achievement, dedication to the community, and service to the nation.
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ðïžðïžðïž ïž ðð¢ð ððð°ð¬ ðð«ðšðŠ ðð¡ð ð¡ððð«ð ðšð ððð§ððð'ð¬ ððð©ð¢ððð¥! ð
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ðð¡ð¢ð¬ ðð©ð¢ð¬ðšðð ð¢ð¬ ð²ðšð®ð« ðð¥ð¥-ððððð¬ð¬ ð©ðð¬ð¬ ððš ð ðð®ð«ðððð ð¬ðð¥ðððð¢ðšð§ ðšð ð ð¬ð¡ðšð«ð ððšð§ð¯ðð«ð¬ððð¢ðšð§ð¬ ð°ð¢ðð¡ ðð¥ð¢ð§ð¢ðð¢ðð§ ðð¡ðšð®ð ð¡ð ð¥ððððð«ð¬ ðð§ð ð ððŠð ðð¡ðð§ð ðð«ð¬ ð°ð¡ðš ðð«ð ð¬ð¡ðð©ð¢ð§ð ðð¡ð ðð®ðð®ð«ð ðšð ð©ð®ðð¥ð¢ð ð¡ððð¥ðð¡ ðð§ð ððð²ðšð§ð.
ððªð£ð ðð£, ð©ðªð§ð£ ðªð¥ ð©ðð ð«ð€ð¡ðªð¢ð, ðð£ð ð©ð§ðð£ðšðð€ð§ð¢ ð©ð€ððð©ððð§. ð§ #ðŸððŸ2023 #ðð€ððððšð© #ðð©ð©ðð¬ð
ðïžðïžðïž MINI EPISODE 1: A Conversation with Dr.Sonia Anand MD, PhD, FRCPC
ð¡ ð¡ ð¡Ensuring immunization of structurally disadvantaged populations: Black People and other people of colour
Podcast Learning objectives
⢠Describe how race-disaggregated data can allow for more targeted, community-specific interventions. ⢠Apply novel community-specific work to engage communities to support immunization. ⢠Illustrate how anti-Black racism presents a pervasive barrier to engaging with preventive health care initiatives.For this mini podcast, we delve into how historical and systemic racism creates hurdles not only in understanding vaccine coverage discrepancies in Canada, but also in crafting effective, nuanced responses. We spotlight the distinctive obstacles Black and Asian communities in Canada have faced in accessing vaccines, both amidst the pandemic and prior to it. In the absence of detailed race-specific data for monitoring diseases preventable by vaccines and tracking vaccination rates, it is difficult to adequately cater to marginalized communities who face systemic barriers to healthcare access, including vaccinations. Dr.Anand unpacks this complex issue.
About Dr.Sonia Anand MD, PhD, FRCPC
Professor of Medicine and Epidemiology, McMasterSenior Scientist Population Health Research InstituteTier 1 Canada Research Chair in Ethnic Diversity and Cardiovascular DiseaseHeart and Stroke Chair in Population HealthAssociate Chair of Equity and Diversity, Department of MedicineDirector of Chanchlani Research CentreDr. Sonia Anand is a professor in the Department of Medicine, and the Director of the Population Genomics Program, at McMaster. She is also a senior scientist at the Population Health Research Institute at Hamilton Health Sciences. Dr. Anand holds a Canada Research Chair in Ethnic Diversity and Cardiovascular Disease, and the Heart and Stroke Foundation of Ontario/Michael G. DeGroote Chair in Population Health Research. In 2010, Dr. Anand was named among the top 100 women by the Womenâs Executive Network for her accomplishments in research and medicine. Her current research focuses on environmental and genetic determinants of vascular disease in populations of varying ancestral origin, women and cardiovascular disease.
ðïžðïžðïž MINI EPISODE 2: A Conversation with Dr.Wayne Ghesquiere MD, FRCPC
ð¡ ð¡ ð¡Long-term protection against herpes zoster by the adjuvanted recombinant zoster vaccine: Interim efficacy, immunogenicity and safety results at approximately 10 years after initial vaccination
Podcast Learning objectives
⢠Discuss the interim efficacy of the adjuvanted recombinant zoster vaccine approximately 10 years post-vaccination.⢠Explain the immunogenicity of the adjuvanted recombinant zoster vaccine and how it contributes to its long-term protection against herpes zoster.⢠Evaluate the safety profile of the adjuvanted recombinant zoster vaccine based on data collected over approximately 10 years.⢠Analyze the significance of these interim results in the context of long-term vaccine strategies against herpes zoster.⢠Incorporate the provided insights into clinical practice and future research regarding herpes zoster vaccination strategies.⢠Communicate effectively to patients about the long-term benefits and safety of the adjuvanted recombinant zoster vaccineAbout Dr.Wayne Ghesquire MD, FRCPC
Dr Wayne Ghesquiere is a Clinical Infectious Diseases, Tropical Diseases and Internal Medicine consultant in Victoria BC as well as the former section chief for infectious diseases with the Vancouver Island Health Authority, VIHA.
Wayne is a Clinical Assistant Professor of Medicine with University of British Columbia. Teaches internal medicine residents and infectious diseases fellows. He is an attending physician at the Royal Jubilee and the Victoria General Hospitals in Victoria, BC. He has an inpatient and a private outpatient practice in infectious diseases.
Wayne is the chair and organizer of the annual Infectious Diseases Update in Victoria now in itâs 26th year. He is also the medical director of the Nova Travel Medicine and Immunization Clinic in Victoria.
Current areas of interests include clinical research in Hepatitis B and C antiviral therapies, new vaccines, and teaching. He is a principal investigator of many clinical trials. He has publications in peer-reviewed medical journals including the NEJM, Lancet, Clinical Infectious Diseases, CMAJ, Open Medicine and others.
ðïžðïžðïž MINI EPISODE 3: A Conversation with Dr. Juthaporn Cowan, MD, FRCPC
ð¡ ð¡ ð¡Management of COVID-19 in immunocompromised patients: Are you up to date?
This podcast episode is centered around COVID-19 protection strategies for immunocompromised patients. Additionally, listeners will gain up to date insight into the range of tools available for these patients' protection and treatment, including antivirals and both active and passive vaccination methods. We'll also tackle ongoing concerns regarding the management of COVID-19 amidst the persistent emergence of new variants, emphasizing the necessity of regular revisits and modifications to these management strategies.
Podcast Learning Objectives
Describe the medical challenges faced by immunocompromised patients and discuss the unmet need for additional protection against SARS â CoV-2. Address the most recent data for prevention and treatment of COVID-19 in immunocompromised patients including the use of monoclonal antibodies. Share best practices for the optimum clinical management of COVID-19 in immunocompromised patients in the current Canadian context.About Dr. Juthaporn Cowan, MD, FRCPC
Assistant Professor, Associate Scientist, The Ottawa Hospital Research Institute
Dr.Juthaporn Cowan is an Associate Scientist at The Ottawa Hospital Research Institute, Assistant Professor at The University of Ottawa, cross-appointed Assistant Professor at the Department of Biochemistry, Microbiology and Immunology and a Physician for the Division of Infectious Diseases at The Ottawa Hospital.
Dr. Cowan began her training at Mahidol University in Thailand for her MD. She also obtained a PhD in Microbiology and Immunology at Kyoto University in Kyoto, Japan. She completed a Postdoctoral Fellowship at The Ottawa Hospital Research Institute. Her research at the time focused on Tuberculosis and immunopathogenesis. She then started her Internal Medicine training at the University of Ottawa. During her postgraduate training her interest shifted from tuberculosis to infection in immunodeficiency patients. Subsequently, she completed a Clinical Fellowship in Infectious Diseases with the University of Ottawa. Drs.D.William Cameron and Cowan run an immunodeficiency/immunoglobulin treatment clinic in Ottawa
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ðððŒð¿ ðð®ð»ð®ð±ð¶ð®ð»ð, ð»ðŒð ðºðŒð¿ð² ððµð®ð» ð²ðð²ð¿, ð®ð°ð°ð²ðð ððŒ ðð¶ðºð²ð¹ð, ðŸðð®ð¹ð¶ðð ðµð²ð®ð¹ððµð°ð®ð¿ð² ð¶ð ððŒðœ ðŒð³ ðºð¶ð»ð±.
ðð§ðµð² ðð®ð»ð®ð±ð® ðð²ð®ð¹ððµ ðð°ð, ððµð¶ð°ðµ ðŒððð¹ð¶ð»ð²ð ððµð² ð»ð®ðð¶ðŒð»ð®ð¹ ðœð¿ð¶ð»ð°ð¶ðœð¹ð²ð ððµð®ð ðŽðŒðð²ð¿ð» ððµð² ðð®ð»ð®ð±ð¶ð®ð» ðµð²ð®ð¹ððµ ððððð²ðº, ðð®ð ð²ððð®ð¯ð¹ð¶ððµð²ð± ð¶ð» ððµðŽð°.
â¶ïžð ð¹ðŒð ðµð®ð ð°ðµð®ð»ðŽð²ð± ðð¶ð»ð°ð² ððµð²ð».
ð¡ð¡ ð¡ð¡ ð¿ð€ ð¬ð ð£ððð ð©ð€ ðšð©ðð¥ ðððð ðð£ð ððð«ð ð©ðð ðð€ðªð§ððð ð©ð€ ð§ðð©ððð£ð ððð§ð ððð¡ðð«ðð§ð® ðð£ ð©ðððš ðð€ðªð£ð©ð§ð® ð©ð€ ð§ððð¡ððð© ð©ðð ðððð£ððð£ð ðððð¡ð©ð ð£ððððš ð€ð ðŸðð£ððððð£ðš? ððš ð¢ð€ð§ð ð¢ð€ð£ðð® ðð€ðð£ð ð©ð€ ðšð€ð¡ð«ð ð©ðð ð¥ð§ð€ðð¡ðð¢?
ð§ðµð² ð¿ð¶ððžð¶ð²ðð ð°ðµðŒð¶ð°ð² ððŒðºð²ðð¶ðºð²ð ð¶ð ððŒ ððið°ðž ðð¶ððµ ððµð² ððð®ððð ðŸððŒ, ð²ððœð²ð°ð¶ð®ð¹ð¹ð ððµð²ð» ðð² ððœð²ð®ðž ðŒð³ ðµð²ð®ð¹ððµð°ð®ð¿ð².
ðð¬ The premiers and the prime minister reached a new 10 year healthcare funding deal totaling $196 billion, with $46 billion in new funding with a tailored approach to the unique healthcare needs of each province and territory via bilateral deals. Provinces and territories in return must commit to health-care reform and improve transparency around data collection.
ðâ¶ïž We sit down with Canadian Prime Minister, Justin Trudeau, to chat about his vision for healthcare, opportunities and challenges, and what building accountability and innovation into these new bilateral healthcare agreements with each province and territory will, and can look like.
ððïž ðšïž Whether you practice in BC or Newfoundland, ð¬ððð©ððð§ ð®ð€ðª'ð§ð ð pharmacist, physician, nurse, nurse practitioner, or allied health professional, tune in to hear the PMâs personal message for our listeners and how the next generation of leaders in healthcare can play a meaningful role in shaping future of our healthcare system.
The Right Honourable Justin Trudeau, Prime Minister of Canada
Justin Trudeau is Canadaâs 23rd Prime Minister.
Justinâs vision of Canada is a country where everyone has a real and fair chance to succeed. His experiences as a teacher, father, leader, and advocate for youth have shaped his dedication to Canadians â and his commitment to make Canada a place where everyone has the opportunities they need to thrive.
The oldest of three boys, Justin grew up with the profound influence of his father, Pierre Elliott Trudeau, and his mother, Margaret Trudeau. He was raised speaking both French and English and has family roots in both Eastern and Western Canada. This background helped spark his passion for public service and shaped his conviction that diversity is Canadaâs strength.
Justin studied literature at McGill University, graduating with a Bachelor of Arts (B.A.) in 1994. He went on to complete the University of British Columbiaâs education program, and spent several years teaching French, math, and other subjects in Vancouver. Teaching allowed him to make a positive impact in the lives of young people. He remains committed to hearing the voices of young Canadians, from the classroom to Parliament Hill.
Before entering politics, Justin served as the Chair of Katimavik, on the board for the Canadian Avalanche Foundation, and as an advocate for young people and the environment. As a speaker at events and conferences around the country, he encouraged young people to engage with the issues important to them and participate as active citizens. These experiences made it increasingly clear to him that the issues young Canadians care about â education, the environment, and their generation's economic prospects â needed a stronger voice.
Justin entered politics to make change that would better serve all Canadians. In 2007, he built a community-based, grassroots campaign to win the Liberal Party nomination in the Montréal riding of Papineau. He was elected in 2008, and re-elected in 2011, 2015, and 2019.
Justin was elected Leader of the Liberal Party in April 2013. His leadership campaign focused on building a new, truly national movement of progressive Canadians, bringing hundreds of thousands of Canadians into politics, most for the first time. He worked closely with his team to build a plan to create jobs, grow the economy, protect the environment, and strengthen the middle class. With Justinâs leadership, the Liberal plan emphasized fair economic opportunity for everyone, respect for and promotion of freedom and diversity, and a more democratic government that truly represents Canadians.
On October 19, 2015, Justin led his party to victory, winning a majority government with seats in every province and territory across the country. He was sworn in on November 4, 2015.
On October 21, 2019, Justin led the Liberal Party to re-election, earning a second mandate from Canadians.
As Prime Minister, Justin leads a government that works hard every day to continue moving Canada forward. His team is focused on creating good middle class jobs, making life more affordable, keeping Canadaâs communities safe, fighting climate change, and moving forward on reconciliation with Indigenous peoples. A proud feminist, Justin appointed Canadaâs first gender balanced Cabinet.
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ð¬NOTE: Episode recorded in early Fall (September) as leadership candidate prior to David officially becoming Premier. ******
âïž Today, David Eby was sworn in as British Columbiaâs 37th premier.
ðšïž We sit down with Premier Eby to discuss his plans for the Province's #ðµð²ð®ð¹ððµð°ð®ð¿ð² ððððð²ðº, ð¶ð»ð°ð¹ðð±ð¶ð»ðŽ everything from ð²ð»ðµð®ð»ð°ð¶ð»ðŽ #patient ð®ð°ð°ð²ðð by expanding ððµð² ððð¶ðð² ðŒð³ ðð²ð¿ðð¶ð°ð²ð #ðœðµð®ð¿ðºð®ð°ð¶ððð ð®ð»ð± ðŒððµð²ð¿ #ððð£ð ð°ðŒðð¹ð± ðœð¿ðŒðð¶ð±ð², reforming primary care, and if outdated legislation around patient rights is meeting the needs of today's patients.
ð¬ ðïž ðð'ð ð»ðŒð ð±ð¶ð³ð³ð¶ð°ðð¹ð ððŒ ð®ð¿ðŽðð² ððµð®ð ð® ðð¿ð®ð±ð¶ðð¶ðŒð»ð®ð¹ ðºð¶ð»ð±ðð²ð ð°ð®ð» ð¯ð² ð°ðµð®ð¹ð¹ð²ð»ðŽð¶ð»ðŽ ððŒ ðð®ð°ðžð¹ð² ððµð²ð» ðð² ððµð¶ð»ðž ð®ð¯ðŒðð #ðµð²ð®ð¹ððµð°ð®ð¿ð² ð±ð²ð¹ð¶ðð²ð¿ð ð®ð»ð± ðœð®ðð¶ð²ð»ð ð°ð²ð»ðð²ð¿ð²ð± ð°ð®ð¿ð² ð¶ð» ðð®ð»ð®ð±ð®. ðð» ð® ðð¶ðºð² ðŒð³ ð°ð¿ð¶ðð¶ð, ð±ðŒ ðð² ð»ð²ð²ð± ð® ð³ðð»ð±ð®ðºð²ð»ðð®ð¹ ððµð¶ð³ð ð®ð¯ðŒðð ðµðŒð ðð² ððµð¶ð»ðž ð®ð¯ðŒðð #ðœð¿ð¶ðºð®ð¿ð ð°ð®ð¿ð² ð®ð»ð± #ðœð®ðð¶ð²ð»ð ð®ððð®ð°ðµðºð²ð»ð?
Questions we ask:
ð¡ð¡ ð«ððð ððððð ðªðððð ððð ðððð ðððððð ðð ð ð®ð·, ðð ð ððð ððððð ðªðððð ððð ðððð ðððððð ðð ðððð-ððððððð #ððððððð ðððð ðððððððð-ðððððððð ððð ðððððð ððð ððð ðð ððððð #ððððððð ðððð service ðððð ðððð? ð¬ð«ððð ððððððððð ððððððð ðððð ððððð ðððð ððððððððð ððððððð ðððð?
â¶ïž ð°ð ð° ððð 50 ðððððððð ððð ððð ððð 20 ðððððððð ð ð ðð, ððð ðð ð ððððððððð ðððððð #ðððð? ð°ð ðððð ðððð ððð ððððð ðððððððð ðð ððð? ð¡ð¡ ðð¶ð»ðžð¶ð»ðŽ #ðµð²ð®ð¹ððµð°ð®ð¿ð² #ðœð¿ðŒðð¶ð±ð²ð¿ ð¿ð²ðºðð»ð²ð¿ð®ðð¶ðŒð» ðð¶ððµ ðŸðð®ð¹ð¶ðð ðŒð³ #ð°ð®ð¿ð², ðð²ð¿ðð¶ð°ð² ð±ð²ð¹ð¶ðð²ð¿ð ðºð²ðð¿ð¶ð°ð, ð®ð»ð± #ðŒððð°ðŒðºð²ð ðµð®ð ð¯ð²ð²ð» ð® ð°ðŒð»ðð²ð¿ðð®ðð¶ðŒð» ððµð®ð'ð ð¯ð²ð²ð» ðµð®ð± ð³ðŒð¿ ðð²ð®ð¿ð ð®ð°ð¿ðŒðð ðð®ð»ð®ð±ð®.ðšðŠ
ðïžðªðµð®ð ðð¶ð¹ð¹ ð¶ð ðð®ðžð² ððŒ ðºð®ðžð² ððµð² ððµð¶ð³ð broadly across our healthcare ð³ð¿ðŒðº #ððŒð¹ððºð² ððŒ #ðð®ð¹ðð² ð¯ð®ðð²ð± ð°ð®ð¿ð² and why are we not there yet?
ABOUT DAVID EBY, KC
David Eby, K.C.David Eby is the MLA for Vancouver-Point Grey, first elected in 2013.
Before he was elected, David was the Executive Director of the BC Civil Liberties Association, an adjunct professor of law at the University of British Columbia, president of the HIV/AIDS Legal Network, and served on the Vancouver Foundation's Health and Social Development Committee.
An award-winning human rights lawyer, he has been repeatedly recognized in local media as one of British Columbia's most effective advocates and has appeared at all levels of court in BC.
His years of legal advocacy at Pivot Legal Society to protect the human rights and dignity of homeless and under-housed residents of Vancouver's Downtown Eastside were recognized in 2011 by the UN Association in Canada and the B.C. Human Rights Coalition with their annual award.
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â¶ïž ðšïž We are excited to sit down with Canada's Chief Public Health Officer, Dr.Theresa Tam, to discuss her personal thoughts about how this pandemic has reshaped how we think about public health's role and new opportunities to synergize with frontline healthcare providers.
ð¬ðïž Often climate change is not a top of mind issue when it comes to healthcare planning and resource allocation. In anticipation of Dr.Tam's upcoming Annual report, we deep dive into how public health is building in plans to address climate change, extreme weather event, and the changing endemicity of transmissible diseases as a result.
ð¡ You also don't want to miss Dr.Tam's secret talent.
ð¬NOTE: Links added below to Dr.Theresa Tam's Annual Report: Mobilizing Public Health Action on Climate Change in Canada as episode was recorded prior to release******
https://www.canada.ca/en/public-health/corporate/publications/chief-public-health-officer-reports-state-public-health-canada/state-public-health-canada-2022/report.html
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ð¢ EPISODE TIME STAMPSð¢
02:08 Intro
04:21 Dr.Tam's journey from practitioner to public health leader
07:48 Dealing with being a very public face and the pressures that come with it
14:55 Planning for the future of public health in Canada and the next "x" factor
21:18 Addressing gaps and needs in healthcare communication
28:36 Mapping synergy betwen frontline healthcare providers and public health in Canada
31:03 At the intersection of climate change and public health planning
35:09 What does Dr. Tam have to say to the next generation of leaders on the front line and potentially leaders in public
health?
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ðïž ABOUT DR.THERESA TAM
Dr. Theresa Tam was named Canada's Chief Public Health Officer on June 26, 2017. She is a paediatric infectious disease specialist with expertise in immunization, emergency preparedness and global health security.
Dr. Tam obtained her medical degree from the University of Nottingham in the U.K. She completed her paediatric residency at the University of Alberta and her fellowship in paediatric infectious diseases at the University of British Columbia.
She is a Fellow of the Royal College of Physicians and Surgeons of Canada and has over 55 peer-reviewed journal publications in public health. She is also a graduate of the Canadian Field Epidemiology Program.
Dr. Tam has held several senior leadership positions at the Public Health Agency of Canada, including as the Deputy Chief Public Health Officer and the Assistant Deputy Minister for Infectious Disease Prevention and Control. During her 25 years in public health, she provided technical expertise and leadership on new initiatives to improve communicable disease surveillance, enhance immunization programs, strengthen health emergency management and laboratory biosafety and biosecurity. She has played a leadership role in Canada's response to public health emergencies including severe acute respiratory syndrome (SARS), pandemic influenza H1N1 and Ebola.
Dr. Tam has served as an international expert on a number of World Health Organization committees and has participated in multiple international missions related to SARS, pandemic influenza and polio eradication.
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Your COVID vaccine is getting a makeover (well kind of).
Freshly formulated updated Omicron-specific COVID-19 vaccines are now available.
These new bivalent booster shots rolling out across Canada are specifically tailored to match currently circulating COVID omicron variants and are thought to provide enhanced protection against newer versions of SARS-CoV-2 than our earlier shots. Uptake of booster vaccines has not been anywhere near as high as the initial vaccines.
â¶ïžð§ ðïž ðð ð¬ð¢ð ððšð°ð§ ð°ð¢ðð¡ ð¥ðððð¢ð§ð ðð±ð©ðð«t, ðð«.ððð¢ð§ ðð¡ðð ð¥ð who breaks down all you need to know about (in less than 36 minutes):
âïžâïžHow do you approach and recommend the updated bivalent COVID-19 booster to eligible patients
âïžâïžHow should you be framing the efficacy conversation in relation to this bivalent booster-antibody data vs clinical effectiveness
âïžâïžStrategies to increase booster uptake in clinical practice
âïžâïžKey practicalities of the vaccine and how this would fit into your daily practice?
âïžâïžAre breakthrough infections less likely with this updated bivalent booster?
âïžâïžWill this booster still work if the virus mutates again and thereâs a new variant?
âïžâïž What does the healthcare provider need to know from this discussion to communicate with a patient the next day?
Dr. Zain ChaglaDr.Zain Chagla, MD MSc MD, FRCPC is an associate professor at McMaster University, co-medical director of infection control at St. Josephâs Healthcare Hamilton and a consultant in infection control at Woodstock General Hospital. Dr. Chagla is also a teacher at McMaster University where he won a clinician teaching award in internal medicine and a young investigator grant for his work in supporting undergraduate medical education at the University of Namibia.
Dr. Chagla also has a Master of Science in infectious diseases and a diploma in tropical medicine and hygiene from the London School of Hygiene & Tropical Medicine.
As an infectious disease specialist, Dr.Zain Chagla has given media interviews on the COVID-19 pandemic and published several op-eds on testing, disease elimination, and public health interventions. He has contributed to local, provincial, and federal policy planning, and to several clinical trials on COVID-19 therapies. He has published works on COVID-19 research, epidemiology, testing, and infection control. He is involved with a prospective cohort study looking at respiratory physiology and radiologic features of patients post covid with persistent symptoms over time, including those with long covid and those who were critically ill.
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ðððð¢ðð§ðð¬ ð¥ð¢ð¯ð¢ð§ð ð°ð¢ðð¡ ð©ðšð¬ð-ððð®ðð ð¬ððªð®ðð¥ðð ðšð ðððð-ððšð-ð ð¢ð§ððððð¢ðšð§ (ðððð), ððð ð¥ðšð§ð ððððð, ð¥ð¢ð¯ð ð°ð¢ðð¡ ð ð°ð¢ðð ðð«ð«ðð² ðšð ð¬ð²ðŠð©ððšðŠð¬, ð«ðð§ð ð¢ð§ð ðð«ðšðŠ ðŠð¢ð¥ð ððš ð¬ðð¯ðð«ðð¥ð² ðððð¢ð¥ð¢ðððð¢ð§ð .
ðïžðïžðïž ðð ð¬ð¢ð ððšð°ð§ ð°ð¢ðð¡ ð ð¥ðððð¢ð§ð ðð±ð©ðð«ðð¬, ðð«.ðð§ð ðð¥ð ðð¡ðð®ð§ð ðð§ð ðð«.ððð¢ð§ ðð¡ðð ð¥ð, ððš ð¬ððð€ ð¬ðšðŠð ðð¥ðð«ð¢ðð² ðððšð®ð ð¥ðšð§ð ðððððâð¬ ððððððð¬, ð©ðšððð§ðð¢ðð¥ ðð«ððððŠðð§ðð¬, ð¬ðð«ððð§ð¢ð§ð , ðð§ð ð¡ðšð° ðð¡ð ðð¢ð¬ððð¬ð ðŠð¢ð ð¡ð ð¢ðŠð©ððð ððð§ðððâð¬ ð¡ððð¥ðð¡ ððð«ð ð¬ð²ð¬ðððŠ ð¢ð§ ðð¡ð ðð®ðð®ð«ð.â¶ïžð§ ðïž Dr.Angela M. Cheung and Dr.Zain Chagla breakdown what you need to know about:
âïžâïžâïž New ð§ððšððð§ðð exploring how recent you've had your last dose of #ðŸðððð¿-19 ð«ððððð£ðð©ðð€ð£ and the link ð¬ðð©ð ð¡ð€ð£ð #ðŸðððð¿ ðšð®ð¢ð¥ð©ð€ð¢ ð¢ðð©ðððð©ðð€ð£.
âïžâïžâïžCðªð§ð§ðð£ð© ðð«ðððð£ðð ðð£ð ðªð£ððð§ðšð©ðð£ððð£ð ð€ð ðŸðððð¿ ð§ððð£ðððð©ðð€ð£ ðð£ð ð©ðð ð§ððšð ð€ð ððð«ðð¡ð€ð¥ðð£ð ð¡ð€ð£ð-ðŸðððð¿
âïžâïžâïž ððð¡ð¥ðð£ð ð®ð€ðªð§ ð¥ðð©ððð£ð©ðš ðªð£ððð§ðšð©ðð£ð ð©ðð ð§ððšð ð€ð ððð«ðð¡ð€ð¥ðð£ð ð¡ð€ð£ð ðŸðððð¿ ðšð®ð¢ð¥ð©ð€ð¢ðš ðð£ ðððªð¡ð©ðš ð¬ðð©ð ððŒðð-ðŸð€ð-2 ðð£ðððð©ðð€ð£ ðððð€ð§ð ðð£ð ððð©ðð§ ð«ððððð£ðð©ðð€ð£.
Dr. Angela CheungDr. Angela Cheung is the KY and Betty Ho Chair of Integrative Medicine at the University of Toronto and is a professor of medicine and internal medicine specialist, as well as a senior scientist at the University Health Network in Toronto. Dr.Cheung holds a Tier 1 Canada Research Chair and She obtained her M.D. degree from Johns Hopkins University School of Medicine, and her Ph.D. degree from Harvard University.
Dr.Cheung is the co-lead of CANCOV (Canadian COVID-19 Prospective Cohort Study) as well as RECLAIM (REcovering from COVIDâ19 Lingering symptoms Adaptive Integrative Medicine) trial, a Canada-wide, open-label, pragmatic, adaptive randomized clinical trial platform to assess the effectiveness of various interventions in patients with lingering symptoms of COVIDâ19.
Dr. Zain ChaglaDr.Zain Chagla, MD MSc MD, FRCPC is an associate professor at McMaster University, co-medical director of infection control at St. Josephâs Healthcare Hamilton and a consultant in infection control at Woodstock General Hospital. Dr. Chagla is also a teacher at McMaster University where he won a clinician teaching award in internal medicine and a young investigator grant for his work in supporting undergraduate medical education at the University of Namibia.
Dr. Chagla also has a Master of Science in infectious diseases and a diploma in tropical medicine and hygiene from the London School of Hygiene & Tropical Medicine.
As an infectious disease specialist, Dr.Zain Chagla has given media interviews on the COVID-19 pandemic and published several op-eds on testing, disease elimination, and public health interventions. He has contributed to local, provincial, and federal policy planning, and to several clinical trials on COVID-19 therapies. He has published works on COVID-19 research, epidemiology, testing, and infection control. He is involved with a prospective cohort study looking at respiratory physiology and radiologic features of patients post covid with persistent symptoms over time, including those with long covid and those who were critically ill.
Resources to further explore:
The Canadian COVID-19 Prospective Cohort Study (CANCOV) RECLAIM (REcovering from COVIDâ19 Lingering symptoms Adaptive Integrative Medicine) trialLancet: Risk of long COVID associated with delta versus omicron variants of SARS-CoV-2 -
ðððð¢ðð§ðð¬ ð¥ð¢ð¯ð¢ð§ð ð°ð¢ðð¡ ð©ðšð¬ð-ððð®ðð ð¬ððªð®ðð¥ðð ðšð ðððð-ððšð-ð ð¢ð§ððððð¢ðšð§ (ðððð), ððð ð¥ðšð§ð ððððð, ð¥ð¢ð¯ð ð°ð¢ðð¡ ð ð°ð¢ðð ðð«ð«ðð² ðšð ð¬ð²ðŠð©ððšðŠð¬, ð«ðð§ð ð¢ð§ð ðð«ðšðŠ ðŠð¢ð¥ð ððš ð¬ðð¯ðð«ðð¥ð² ðððð¢ð¥ð¢ðððð¢ð§ð .
ðïžðïžðïž ðð ð¬ð¢ð ððšð°ð§ ð°ð¢ðð¡ ð ð¥ðððð¢ð§ð ðð±ð©ðð«ðð¬, ðð«.ðð§ð ðð¥ð ðð¡ðð®ð§ð ðð§ð ðð«.ððð¢ð§ ðð¡ðð ð¥ð, ððš ð¬ððð€ ð¬ðšðŠð ðð¥ðð«ð¢ðð² ðððšð®ð ð¥ðšð§ð ðððððâð¬ ððððððð¬, ð©ðšððð§ðð¢ðð¥ ðð«ððððŠðð§ðð¬, ð¬ðð«ððð§ð¢ð§ð , ðð§ð ð¡ðšð° ðð¡ð ðð¢ð¬ððð¬ð ðŠð¢ð ð¡ð ð¢ðŠð©ððð ððð§ðððâð¬ ð¡ððð¥ðð¡ ððð«ð ð¬ð²ð¬ðððŠ ð¢ð§ ðð¡ð ðð®ðð®ð«ð.ð¡ ð¡ ð¡ ðððð© ððð£ ðð ðð€ð£ð ð©ð€ ððð¡ð¥ ð®ð€ðªð§ ð¥ðð©ððð£ð©ðš ð¬ðð©ð ð¡ð€ð£ð ðŸðððð¿?
ð¡ ð¡ ð¿ð€ððš ðððð£ð ððªð¡ð¡ð® ð«ððððð£ðð©ðð ð€ð§ ðð€ð€ðšð©ðð ð¢ðð©ðððð©ð ð©ðð ð§ððšð ð€ð ðð€ð£ð©ð§ððð©ðð£ð ðððð ðŸðððð¿ ð€ð§ ð¢ðð©ðððð©ð ð©ðð ðšððŠðªðð¡ðð ð€ð ðð©? ð¿ð€ððš ð©ðð ð§ðððð£ðð® ð€ð ð®ð€ðªð§ ðŸðððð¿ ðð€ð€ðšð©ðð§ ð€ð§ ð«ððððð£ðð©ðð€ð£ ðð¡ðšð€ ð¥ð¡ðð® ð ð§ð€ð¡ð?
ð¡ ðð€ð¬ ðšðð€ðªð¡ð ð¬ð ðð ð©ððð£ð ðð£ð ððð€ðªð© ðð€ð¢ð¢ðªð£ðððð©ðð£ð ð©ðð ðð€ð£ððð¥ð© ð€ð ð§ððšð , ðð£ð ðð§ðð¢ðð£ð ð§ððšð ð©ð€ ð€ðªð§ ð¥ðð©ððð£ð©ðš ðð£ ð©ðð ðð€ð£ð©ððð© ð€ð ð¡ð€ð£ð ðŸðððð¿?
Dr. Angela CheungDr. Angela Cheung is the KY and Betty Ho Chair of Integrative Medicine at the University of Toronto and is a professor of medicine and internal medicine specialist, as well as a senior scientist at the University Health Network in Toronto. Dr.Cheung holds a Tier 1 Canada Research Chair and She obtained her M.D. degree from Johns Hopkins University School of Medicine, and her Ph.D. degree from Harvard University.
Dr.Cheung is the co-lead of CANCOV (Canadian COVID-19 Prospective Cohort Study) as well as RECLAIM (REcovering from COVIDâ19 Lingering symptoms Adaptive Integrative Medicine) trial, a Canada-wide, open-label, pragmatic, adaptive randomized clinical trial platform to assess the effectiveness of various interventions in patients with lingering symptoms of COVIDâ19.
Dr. Zain ChaglaDr.Zain Chagla, MD MSc MD, FRCPC is an associate professor at McMaster University, co-medical director of infection control at St. Josephâs Healthcare Hamilton and a consultant in infection control at Woodstock General Hospital. Dr. Chagla is also a teacher at McMaster University where he won a clinician teaching award in internal medicine and a young investigator grant for his work in supporting undergraduate medical education at the University of Namibia.
Dr. Chagla also has a Master of Science in infectious diseases and a diploma in tropical medicine and hygiene from the London School of Hygiene & Tropical Medicine.
As an infectious disease specialist, Dr.Zain Chagla has given media interviews on the COVID-19 pandemic and published several op-eds on testing, disease elimination, and public health interventions. He has contributed to local, provincial, and federal policy planning, and to several clinical trials on COVID-19 therapies. He has published works on COVID-19 research, epidemiology, testing, and infection control. He is involved with a prospective cohort study looking at respiratory physiology and radiologic features of patients post covid with persistent symptoms over time, including those with long covid and those who were critically ill.
Resources to further explore:
The Canadian COVID-19 Prospective Cohort Study (CANCOV) RECLAIM (REcovering from COVIDâ19 Lingering symptoms Adaptive Integrative Medicine) trialLancet: Risk of long COVID associated with delta versus omicron variants of SARS-CoV-2 -
â¶ïžâ¶ïž Les patients à haut risque voient aujourd'hui une combinaison de variantes COVID plus transmissibles et de vaccins dont l'efficacité peut diminuer.
Mais lorsque nous pensons aux patients à haut risque et aux patients cliniquement vulnérables, nous pensons souvent à la population de patients IC. Que diriez-vous si vous êtes obÚse ou souffrez de diabÚte, d'insuffisance cardiaque, d'hypercholestérolémie, d'hypertension ? Qu'en est-il de ceux qui ont des handicaps cognitifs ou physiques spécifiques ? Qu'est-ce qu'un risque élevé au-delà de la population de patients immunodéprimés ?
Nous sommes rejoints par deux experts en maladies infectieuses qui dispensent une masterclass en temps réel sur l'évaluation du risque de COVID chez vos patients et connectent les données émergentes autour des 1er et 2e rappels du vaccin COVID-19.
ð° ðº Les fameuses questions "Demandez à l'expert" de cet épisode explorent des facteurs de risque spécifiques au-delà de l'âge et comment traduire et encadrer efficacement la conversation de rappel en premiÚre ligne avec votre patient. Comment dépister et communiquer en premiÚre ligne ? Et comment regardons-nous les conseils du NACI sur les rappels par rapport aux recommandations du JCVI pour l'automne ?OBJECTIFS D'APPRENTISSAGE DE L'ÃPISODE :
o Explorer la compréhension et la définition actuelles des populations de patients à haut risque et comment stratifier le risque dans le contexte de la progression vers une maladie COVID-19 sévÚre en fonction des comorbidités
o Démontrer comment les prestataires de soins de santé de premiÚre ligne peuvent dépister efficacement les patients présentant des comorbidités pour des doses de rappel COVID-19
o Décrire comment encadrer efficacement la communication des vaccins de rappel COVID-19 dans le contexte des questions cliniques réelles des patients
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Dr. Zain Chagla
Dr.Zain Chagla, MD MSc MD, FRCPC is an associate professor at McMaster University, co-medical director of infection control at St. Josephâs Healthcare Hamilton and a consultant in infection control at Woodstock General Hospital. Dr. Chagla is also a teacher at McMaster University where he won a clinician teaching award in internal medicine and a young investigator grant for his work in supporting undergraduate medical education at the University of Namibia.
Dr. Chagla also has a Master of Science in infectious diseases and a diploma in tropical medicine and hygiene from the London School of Hygiene & Tropical Medicine.
As an infectious disease specialist, Dr.Zain Chagla has given media interviews on the COVID-19 pandemic and published several op-eds on testing, disease elimination, and public health interventions. He has contributed to local, provincial, and federal policy planning, and to several clinical trials on COVID-19 therapies. He has published works on COVID-19 research, epidemiology, testing, and infection control.
Dr. Srinivas MurthyDr. Srinivas Murthy MD MASc FRCPC is the Health Research Foundation of Innovative Medicines Canada Chair in Pandemic Preparedness Research, and co-chair of the World Health Organizationâs (WHO) clinical research committee on COVID-19. He is an associate professor in the Faculty of Medicine at University of British Columbia, as well as a critical care and infectious diseases physician at B.C. Childrenâs Hospital in Vancouver. Murthyâs research focuses on infectious disease, clinical practice and clinical trials, and global health. He has also worked on the frontlines for a number of infectious disease outbreaks, including work on Ebola in Liberia, West Africa.
NEJM: Protection by a Fourth Dose of BNT162b2 against Omicron in Israel
https://www.nejm.org/doi/full/10.1056/NEJMoa2201570?query=recirc_mostViewed_railB_articleJCVI interim statement on COVID-19 autumn 2022 vaccination programme
https://www.gov.uk/government/publications/jcvi-interim-statement-on-covid-19-autumn-2022-vaccination-programme
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âïž ð¶ ððšð® ð ðð ð ð©ð¡ðšð§ð ððð¥ð¥ ððš ðšð«ð ðð§ð¢ð³ð ðð§ ðð§ðð¢ð«ð ðð«ðšð¯ð¢ð§ðð'ð¬ ð¯ðððð¢ð§ð ðððŠð©ðð¢ð ð§ ðð«ðšðŠ ð¡ð¢ð«ð¢ð§ð ð¬ðððð, ððš ð¬ððð®ð«ð¢ð§ð ðð¥ð¢ð§ð¢ðð¬, ððš ðð¯ðð¥ð®ððð¢ð§ð ðððð¡ð§ðšð¥ðšð ð² ðð¡ðð ð¡ðð¬ ððš ð°ðšð«ð€ ð¢ð§ ð«ððð¥ ðð¢ðŠð-ð°ð¢ðð¡ ð ððð° ð°ððð€ð¬ ððš ð¬ð©ðð«ð ðð§ð ð§ðš ð«ððð¥ ð©ð¥ðð²ððšðšð€-ð°ðšð®ð¥ð ð²ðšð® ððððð©ð?
ð¬ðð ð ðš ððð¡ð¢ð§ð ðð¡ð ð¬ððð§ðð¬ ðšð ðð'ð¬ ð¥ðð«ð ðð¬ð ð©ð®ðð¥ð¢ð #ð¡ððð¥ðð¡ ðððŠð©ðð¢ð ð§ ð¢ð§ ðð§ ðð±ðð¥ð®ð¬ð¢ð¯ð ððšð§ð¯ðð«ð¬ððð¢ðšð§ ð°ð¢ðð¡ ðð«.ððð§ð§ð² ððð¥ð¥ððŠ, ð°ð¡ðš ð«ððð¥ðððð¬ ðšð§ ð¡ðšð° ð¬ðð«ð¯ð¢ð§ð ð¢ð§ ð©ð«ðð¯ð¢ðšð®ð¬ ð¥ððððð«ð¬ð¡ð¢ð© ð«ðšð¥ðð¬ ð©ð«ðð©ðð«ðð ð¡ðð« ððšð« ð¥ðððð¢ð§ð ðð'ð¬ #ððððð-ðð #ð¯ðððð¢ð§ð ð«ðšð¥ð¥ðšð®ð.
ð ððšð® ððšð§'ð ð°ðð§ð ððš ðŠð¢ð¬ð¬ ð¡ðð« ðŠðð¬ð¬ðð ð ððšð« ð²ðšð®ð§ð ð¥ððððð«ð¬ ð¢ð§ #ð©ð¡ðð«ðŠððð² ðð§ð #ð¡ððð¥ðð¡ððð«ð.
DR.PENNY BALLEM
Dr.Ballem is the executive lead for British Columbia's COVID-19 vaccine rollout and immunization efforts and is Chair of the board of Vancouver Coastal Health.She's served in the past as BC's Deputy Minister of Health and City Manager for the City of Vancouver. She's a former board director of the Canadian Institute for Health Information (CIHI) and advises governments across Canada on health policy, health systems, and health human resources.
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â¶ïž ð¬ ð¬ ðªð² ðð¶ð ð±ðŒðð» ðð¶ððµ ððâð ððµð¶ð²ð³ ð ð²ð±ð¶ð°ð®ð¹ ðð²ð®ð¹ððµ ð¢ð³ð³ð¶ð°ð²ð¿ and findmyvaccine podcast Faculty, ðð¿.ððŒð»ð»ð¶ð² ðð²ð»ð¿ð, ðŒð» ð® ð¿ð®ð»ðŽð² of issues in PART 2 of our conversation.
ð¡ð¡ðïž Dr.Henry ð¬ð¡ðð«ðð¬ her ð©ðð«ð¬ðšð§ðð¥ ðð±ð©ðð«ð¢ðð§ðð ð§ðð¯ð¢ð ððð¢ð§ð an ðð¯ðð«ðð¡ðð§ð ð¢ð§ð ð©ð®ðð¥ð¢ð ð¡ððð¥ðð¡ ð¥ðð§ðð¬ððð©ð ðð§ð battling a duelling pandemics- COVID19 and the opioid crisis.
ð¡âïž She also walks ðð ððµð¿ðŒððŽðµ her thoughts for what the future may look like with the COVID-19 pandemic.ð
ð¡ ðªðµð®ð ð±ðŒð²ð ðŽðŒðŒð± ðœðð¯ð¹ð¶ð° ðµð²ð®ð¹ððµ ð±ð²ð°ð¶ðð¶ðŒð» ðºð®ðžð¶ð»ðŽ ð¹ðŒðŒðž ð¹ð¶ðžð² in a pandemic?
PART 1 of the episode: https://findmyvaccine.simplecast.com/episodes/kind-calm-and-safe-leading-in-a-time-of-covid-19
Dr. Bonnie Henry, MD MPH FRCPC, BC Provincial Health OfficerAs BCâs most senior public health official, Dr. Henry is responsible for monitoring the health of all British Columbians and undertaking measures for disease prevention and control and health protection. Most recently, Dr. Henry has led the provinceâs response on the COVID-19 pandemic and drug overdose emergency.
Dr. Henryâs experience in public health, preventative medicine and global pandemics has extended throughout her career. Prior to her current role, Dr. Henry was the deputy provincial health officer for three years. She also served as the interim provincial executive medical director of the BC Centre for Disease Control (BCCDC) from December 2013 until August 2014.
She was the medical director of Communicable Disease Prevention and Control and Public Health Emergency Management with the BCCDC and medical director for the provincial emerging and vector-borne diseases program, as well as a provincial program for surveillance and control of healthcare associated infections from 2005 to 2014.
Dr. Henry joined Toronto Public Health in 2001 as Associate Medical Officer of Health, where she was responsible for the Emergency Services Unit and the Communicable Disease Liaison Unit. In 2003, she was the operational lead in the response to the SARS outbreak in Toronto. She was a member of the executive team of the Ontario SARS Scientific Advisory Committee.
Dr. Henry is a specialist in public health and preventive medicine and is board certified in preventive medicine in the U.S. She graduated from Dalhousie Medical School and completed a Masters in Public Health in San Diego, residency training in preventive medicine at University of California, San Diego and in community medicine at University of Toronto.
She has worked internationally including with the WHO/UNICEF polio eradication program in Pakistan and with the World Health Organization to control the Ebola outbreak in Uganda.
Dr. Henry is an associate professor at the University of British Columbia, Faculty of Medicine. She is the past chair of Immunize Canada and a member of the Canadian National Advisory Committee on Immunization and the National Infection Control Guidelines Steering Committee. She chaired the Canadian Public Health Measures Task Group and was a member of the Infection Control Expert Group and the Canadian Pandemic Coordinating Committee responding to the 2009 H1N1 influenza pandemic.
She has been involved with planning, surveillance and response to mass gatherings in Canada and internationally, including with the Vancouver 2010 Olympic and Paralympic Winter Games. She is also the author of âSoap and Water and Common Senseâ a guide to staying healthy in a microbe filled world.
New York Times: The Top Doctor Who Aced the Coronavirus Test -
â¶ïž ð¬ ð¬ ðªð² ðð¶ð ð±ðŒðð» ðð¶ððµ ððâð ððµð¶ð²ð³ ð ð²ð±ð¶ð°ð®ð¹ ðð²ð®ð¹ððµ ð¢ð³ð³ð¶ð°ð²ð¿ and findmyvaccine podcast Faculty, ðð¿.ððŒð»ð»ð¶ð² ðð²ð»ð¿ð, ðŒð» ð® ð¿ð®ð»ðŽð² of issues.
ð¡ð¡ðïž Dr.Henry ð¬ð¡ðð«ðð¬ her ð©ðð«ð¬ðšð§ðð¥ ðð±ð©ðð«ð¢ðð§ðð ð§ðð¯ð¢ð ððð¢ð§ð an ðð¯ðð«ðð¡ðð§ð ð¢ð§ð ð©ð®ðð¥ð¢ð ð¡ððð¥ðð¡ ð¥ðð§ðð¬ððð©ð ðð§ð ð¥ðð¬ð¬ðšð§ð¬ ðšð§ ð¥ðððð¢ð§ð ð¢ð§ ðð®ðŠð®ð¥ðð®ðšð®ð¬ ðð¢ðŠðð¬.
She also walks ðð ððµð¿ðŒððŽðµ ðµðŒð ððµð² ðºð®ðžð²ð ððŒðºð² ðŒð³ ðµð²ð¿ ðžð²ð ð±ð²ð°ð¶ðð¶ðŒð»ð.ð
âïž Dð²ð°ð¶ðð¶ðŒð»ð ðð¶ð¹ð¹ ð®ð¹ðð®ðð ðµð®ðð² ð® ð°ðŒðºðœðŒð»ð²ð»ð ðŒð³ ð®ðððŒð°ð¶ð®ðð²ð± ðð»ð°ð²ð¿ðð®ð¶ð»ðð.
ð¡ ðªðµð®ð ð±ðŒð²ð ðŽðŒðŒð± ðœðð¯ð¹ð¶ð° ðµð²ð®ð¹ððµ ð±ð²ð°ð¶ðð¶ðŒð» ðºð®ðžð¶ð»ðŽ ð¹ðŒðŒðž ð¹ð¶ðžð² in a pandemic?
âïž ððŒð ð±ðŒ ððŒð ð°ð¿ð²ð®ðð² ð® ðð²ð»ðð² ðŒð³ ð°ð²ð¿ðð®ð¶ð»ðð ð®ðºð¶ð±ðð ð® ðœð®ð»ð±ð²ðºð¶ð° ð°ðµð®ð¿ð®ð°ðð²ð¿ð¶ðð²ð± ðŒð»ð¹ð ð¯ð ðð»ð°ð²ð¿ðð®ð¶ð»ðð?
Dr. Bonnie Henry, MD MPH FRCPC, BC Provincial Health Officer
As BCâs most senior public health official, Dr. Henry is responsible for monitoring the health of all British Columbians and undertaking measures for disease prevention and control and health protection. Most recently, Dr. Henry has led the provinceâs response on the COVID-19 pandemic and drug overdose emergency.
Dr. Henryâs experience in public health, preventative medicine and global pandemics has extended throughout her career. Prior to her current role, Dr. Henry was the deputy provincial health officer for three years. She also served as the interim provincial executive medical director of the BC Centre for Disease Control (BCCDC) from December 2013 until August 2014.
She was the medical director of Communicable Disease Prevention and Control and Public Health Emergency Management with the BCCDC and medical director for the provincial emerging and vector-borne diseases program, as well as a provincial program for surveillance and control of healthcare associated infections from 2005 to 2014.
Dr. Henry joined Toronto Public Health in 2001 as Associate Medical Officer of Health, where she was responsible for the Emergency Services Unit and the Communicable Disease Liaison Unit. In 2003, she was the operational lead in the response to the SARS outbreak in Toronto. She was a member of the executive team of the Ontario SARS Scientific Advisory Committee.
Dr. Henry is a specialist in public health and preventive medicine and is board certified in preventive medicine in the U.S. She graduated from Dalhousie Medical School and completed a Masters in Public Health in San Diego, residency training in preventive medicine at University of California, San Diego and in community medicine at University of Toronto.
She has worked internationally including with the WHO/UNICEF polio eradication program in Pakistan and with the World Health Organization to control the Ebola outbreak in Uganda.
Dr. Henry is an associate professor at the University of British Columbia, Faculty of Medicine. She is the past chair of Immunize Canada and a member of the Canadian National Advisory Committee on Immunization and the National Infection Control Guidelines Steering Committee. She chaired the Canadian Public Health Measures Task Group and was a member of the Infection Control Expert Group and the Canadian Pandemic Coordinating Committee responding to the 2009 H1N1 influenza pandemic.
She has been involved with planning, surveillance and response to mass gatherings in Canada and internationally, including with the Vancouver 2010 Olympic and Paralympic Winter Games. She is also the author of âSoap and Water and Common Senseâ a guide to staying healthy in a microbe filled world.
New York Times: The Top Doctor Who Aced the Coronavirus Test -
Dr. Karl Weiss, M.D., M. Sc., FRCPC
Le Dr Karl Weiss est microbiologiste et spécialiste en maladies infectieuses à lâHÃŽpital général juif de Montréal ainsi que professeur à la Faculté de médecine de lâUniversité McGill. Il est chef de la Division des maladies infectieuses de lâHÃŽpital général juif de Montréal, qui est lâhÃŽpital ayant le plus important volume clinique en maladies infectieuses au Canada.Il a Åuvré comme microbiologiste-infectiologue à lâHÃŽpital Maisonneuve-Rosemont de 1994 à 2016, et y a occupé de trÚs nombreuses fonctions, dont celle de chef de département durant plusieurs années. Il est également professeur titulaire de clinique à la Faculté de médecine de lâUniversité de Montréal et a été directeur de la recherche pharmacologique à lâHÃŽpital Maisonneuve-Rosemont de 2001 à 2013. Il a également été coprésident de la Table en prévention et contrÃŽle des infections de lâÃle de Montréal.
AprÚs avoir reçu son doctorat en médecine de lâUniversité de Montréal en 1989, le Dr Weiss a poursuivi ses études en médecine interne à lâUniversité de Montréal et à lâUniversité McGill, puis a terminé sa formation en maladies infectieuses et en microbiologie à lâUniversité de Montréal. Il a également effectué des études postdoctorales et obtenu une maîtrise en épidémiologie clinique. Il a étudié de nouvelles méthodes de détection et de nouveaux antibiotiques dans le traitement des infections à Helicobacter pylori.
Au cours de sa carriÚre, le Dr Weiss a participé comme invité à plus de 500 conférences au Canada et à lâinternational. Il a présenté ou publié plus de 400 résumés et articles dans des journaux prestigieux comme The New England Journal of Medicine, The Journal of Antimicrobial Chemotherapy, Antimicrobial Agents and Chemotherapy, Canadian Journal of Infectious Diseases, American Journal of Epidemiology, Clinical Infectious Diseases and Infection Control and Hospital Epidemiology. Ses recherches se concentrent principalement sur les infections des voies respiratoires, les antibiotiques et la résistance antimicrobienne. Lâéquipe de recherche du Dr Weiss a souvent été lâune des premiÚres au Canada à travailler avec les nouveaux antibiotiques en développement.
Le Dr Weiss est aussi le président de lâAssociation des médecins microbiologistes-infectiologues du Québec (AMMIQ) et il a présidé de nombreux comités québécois et canadiens dans le domaine des maladies infectieuses. En 2005, il a été le président du CongrÚs mondial sur la pneumonie, qui sâest tenu à Montréal. Par ailleurs, il a présidé le jury dâexamen en microbiologie médicale du CollÚge royal des médecins et chirurgiens du Canada entre 2002 et 2005. Il a longtemps siégé à lâexécutif de lâAssociation canadienne de microbiologie médicale et dâinfectiologie (AMMI Canada) et a représenté cet organisme à plusieurs comités.
Il a reçu le prix Distinction de la Société canadienne des maladies infectieuses en 2005 et le prix Médecin de cÅur et dâaction de lâAssociation des médecins de langue française du Canada en 2008. Le Dr Weiss est trÚs souvent sollicité par les médias pour discuter de problÚmes liés aux maladies infectieuses.
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"ðâðð² ðµð®ð± ðððŒ ðð¢ð©ðð-ððµ ð±ðŒðð²ð ð®ð»ð± ð±ðŒð»âð ð³ð²ð²ð¹ ð®ð»ð ðð¿ðŽð²ð»ð°ð ððŒ ðŽð²ð ð® ððµð¶ð¿ð±."
ðªð² ðð¶ð ð±ðŒðð» ðð¶ððµ ð® ð¶ð»ð³ð²ð°ðð¶ðŒðð ð±ð¶ðð²ð®ðð² ð²ð ðœð²ð¿ðð ð®ð»ð± ð°ðµð®ð ð®ð¯ðŒðð ðð¢ð©ðð-ððµ ðð®ð°ð°ð¶ð»ð² ð¯ðŒðŒððð²ð¿ð. ðð¿.ðŠð¿ð¶ð»ð¶ðð®ð ð ðð¿ððµð ð®ð»ð± ðð¿.ðð¹ðŒð» ð©ð®ð¶ððºð®ð» ð²ð ðœð¹ðŒð¿ð² ðµðŒð ððŒ ð²ð³ð³ð²ð°ðð¶ðð²ð¹ð ð³ð¿ð®ðºð² ððµð² ð¯ðŒðŒððð²ð¿ ð°ðŒð»ðð²ð¿ðð®ðð¶ðŒð» ðð¶ððµ ðœð®ðð¶ð²ð»ðð. ðªð¶ððµ ðð®ð»ð¶ð»ðŽ ð±ð²ðºð®ð»ð± ððµðŒðð¹ð± ðð² ð¯ð² ððµð¶ð»ðžð¶ð»ðŽ ðŒð³ ð®ð±ð±ð¶ð»ðŽ ð® ð¯ðŒðŒððð²ð¿ ð¿ð²ðŸðð¶ð¿ð²ðºð²ð»ð ððŒ ðð®ð°ð°ð¶ð»ð² ð°ð²ð¿ðð¶ð³ð¶ð°ð®ðð²ð?
ðð®ð ðºð²ððð®ðŽð¶ð»ðŽ ð³ð¿ðŒðº ðœðð¯ð¹ð¶ð° ðµð²ð®ð¹ððµ ð¹ð²ð®ð±ð²ð¿ð ð®ð»ð± ð³ð¿ðŒð»ðð¹ð¶ð»ð² ððð£ð ð®ð¿ðŒðð»ð± ððµð² ð¶ðºðœðŒð¿ðð®ð»ð°ð² ðŒð³ ððµð² ð¯ðŒðŒððð²ð¿ ð±ðŒðð² ð¯ð²ð²ð» ð°ð¹ð²ð®ð¿ ð²ð»ðŒððŽðµ?
ðŠðµðŒðð¹ð± ðð² ð²ðð²ð» ð°ð®ð¹ð¹ ð¶ð ð® ð¯ðŒðŒððð²ð¿ ð±ðŒðð²? ðð ð¶ð ð¯ð²ððð²ð¿ ð±ð²ðð°ð¿ð¶ð¯ð²ð± ð®ð ð¯ð²ð¶ð»ðŽ ð³ðð¹ð¹ð ðð®ð°ð°ð¶ð»ð®ðð²ð±? ððð¹ð¹ð ðð®ð°ð°ð¶ð»ð®ðð²ð± ðð¶ððµ ð®ð» ð®ð±ð±ð¶ðð¶ðŒð»ð®ð¹ ð±ðŒðð²? ð§ð¿ð¶ðœð¹ð² ðð®ð°ð°ð¶ð»ð®ðð²ð±?
ð§ðµð² ðœð®ð»ð²ð¹ ð®ð¹ððŒ ð®ð»ððð²ð¿ð ð®ð¹ð¹ ððŒðð¿ ð¯ðð¿ð»ð¶ð»ðŽ ðð¢ð©ðð ð¯ðŒðŒððð²ð¿ ðŸðð²ððð¶ðŒð»ð ð³ð¿ðŒðº ððµð² ð³ð¿ðŒð»ðð¹ð¶ð»ð²ð.
Dr. Srinivas Murthy MD MASc FRCPC is the Health Research Foundation of Innovative Medicines Canada Chair in Pandemic Preparedness Research, and co-chair of the World Health Organizationâs (WHO) clinical research committee on COVID-19. He is an associate professor in the Faculty of Medicine at University of British Columbia, as well as a critical care and infectious diseases physician at B.C. Childrenâs Hospital in Vancouver. Murthyâs research focuses on infectious disease, clinical practice and clinical trials, and global health. He has also worked on the frontlines for a number of infectious disease outbreaks, including work on Ebola in Liberia, West Africa.
Dr.Alon Vaisman MD MAS FRCPC is an Infectious Diseases and Infection Control Physician at the University Health Network and the University of Toronto.
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âðâðº ð±ðŒð»ð² ðð¶ððµ ðð¢ð©ððâ ð¶ð ð²ð®ðð¶ð²ð¿ ðð®ð¶ð± ððµð®ð» ð±ðŒð»ð²-ðšðð ðð ð·ððððð , ð®ðððð ððð ðŽððð ð±ðð.24ðð 2022
ðïžðïžðïž ðð¿ðŒðº ðð¢ð©ðð ð¿ð²ððð¿ð¶ð°ðð¶ðŒð»ð ð®ð»ð± ð¶ðºðœð¹ð¶ð°ð®ðð¶ðŒð»ð ð³ðŒð¿ ððµð² âð»ð²ð ð ð»ðŒð¿ðºð®ð¹â, ððŒ ððµð² ð³ðð»ð±ð®ðºð²ð»ðð®ð¹ ððµð¶ð³ðð ð¶ð» ðœðð¯ð¹ð¶ð° ð®ððð¶ððð±ð²ð ððŒðð®ð¿ð±ð ðµðŒð ðð®ð»ð®ð±ð¶ð®ð» ðµð²ð®ð¹ððµð°ð®ð¿ð² ð¶ð ð±ð²ð¹ð¶ðð²ð¿ð²ð±, ðŒð»ð² ðŒð³ ðð®ð»ð®ð±ð®'ð ðšðŠ ððŒðœ ðµð²ð®ð¹ððµ ð®ð»ð± ðœðð¯ð¹ð¶ð° ðœðŒð¹ð¶ð°ð ðŒð¯ðð²ð¿ðð²ð¿ð ð®ð»ð± ð°ðŒðºðºð²ð»ðð®ððŒð¿ð, ðð»ð±ð¿Ã© ð£ð¶ð°ð®ð¿ð± ð·ðŒð¶ð»ð ðð ð¶ð» ðððð±ð¶ðŒ.
ð° ðªð² ð²ð ðœð¹ðŒð¿ð² ððµð¶ð³ðð ð¶ð» ð·ðŒðð¿ð»ð®ð¹ð¶ððº ð®ð»ð± ððµð² ð¿ðŒð¹ð² ðŒð³ ððµð² ðºð²ð±ð¶ð® ð±ðð¿ð¶ð»ðŽ ð® ðœð®ð»ð±ð²ðºð¶ð°, ð®ð ðð²ð¹ð¹ ð®ð ðœðŒðžð² ððµð² ðœð²ð¿ð²ð»ð»ð¶ð®ð¹ ðœðð¯ð¹ð¶ð° ðð.(ðŒð¿ ð®ð»ð±) ðœð¿ð¶ðð®ðð² ð±ð²ð¯ð®ðð² ð¶ð» ðµð²ð®ð¹ððµð°ð®ð¿ð².
ððð¡ððŒð ð±ðŒð²ð ðð»ð±ð¿Ã© ð®ðœðœð¿ðŒð®ð°ðµ ðµð¶ð ðœð¶ð²ð°ð²ð ð¶ð» ððµð² ðð¹ðŒð¯ð² ð®ð»ð± ð±ðŒð²ð ðµð² ð²ðð²ð¿ ðµð®ðð² ðð¿ð¶ðð²ð¿âð ð¯ð¹ðŒð°ðž?
ððð¢ðšð§ ðð»ð±ð¿Ã© ð£ð¶ð°ð®ð¿ð±
André Picard is one of Canada's top health and public policy observers and commentators. Currently the health columnist at The Globe and Mail, he has been a staff writer for over 30 years. Picard is also the author of five books and has received acclaim for his writing and for his dedication to improving health care. In 2010, he was awarded a National Newspaper Award as Canada's top newspaper columnist.
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Dr.Brian Conway, MD, FRCPC Infectious Disease Physician
Medical Director - Vancouver Infectious Diseases Centre (VIDC)
Dr. Brian Conway is the Medical Director of the Vancouver Infectious Diseases Centre (VIDC), specializing in the diagnosis and treatment of chronic infectious diseases and related conditions, with a focus on HIV and HCV infections. At VIDC, he is the Principal Investigator for over 25 HIV and HCV clinical research trials, and is credited with the conceptualization and implementation of the ENTENTE (Engage, Test, Engage, Treat, Engage) program that led to the development of VIDCâs Community Pop-Up Clinics (CPCs).
The VIDCâs CPCs provide point-of-care testing for HIV and HCV in Vancouverâs Downtown East Side (DTES). Over 500 patients have been diagnosed with HCV and engaged in care through this program, and over 150 have already received HCV treatment. His leadership with the CPCs has led to the development of novel strategies for the delivery of care emphasizing the simplification of therapeutic options and integration of medical, addiction, social, and psychological aspects of care.
Recent Media:
Molnupiravir for Oral Treatment of Covid-19 in Nonhospitalized PatientsCOVID-19: B.C. should be prepared to abandon six-month wait for booster, Dr. Brian ConwayMedical experts weigh in on new COVID measures brought in by B.C. government.Canucks and COVID: Omicron virus variant vigilance vital for NHL, says diseases centre doc -
Dr.Santa Ono
President and Vice-Chancellor - University of British ColumbiaSanta J. Ono PhD FRSC FCAHS is the 15th President & Vice-Chancellor of the University of British Columbia.
Installed as President and Vice-Chancellor in 2016, he also serves as Chair of the U15 Group of Universities, on the Board of Directors of Universities Canada, and as Past Chair of Research Universities of British Columbia. He is also a member of the Boards of Fulbright and MITACS. He has also served on the Boards of the American Council on Education and the Council on Competitiveness and as Chief Innovation Advisor to the Province of British Columbia.
Prior to his appointment as President and Vice-Chancellor of UBC, Dr. Ono served as the 28th President of the University of Cincinnati and Senior Vice-Provost and Deputy to the Provost at Emory University.
He was appointed by Governor John Kasich to lead Ohioâs Biopharmaceutical Task Force and to the Board of the Ohio Third Frontier â Ohioâs technology-based economic development program, when he served as President of the University of Cincinnati.
A molecular immunologist educated at the University of Chicago and McGill, Dr. Ono has taught at Johns Hopkins, Harvard University and University College London. He has advised national and regional governments on higher education and mental health. He has also advised companies such as GSK, Johnson & Johnson, Merck and Novartis on R&D.
He has served on a number of editorial boards, including Immunology, The Journal of Biological Chemistry, The Journal of Immunology and The Journal of Allergy & Clinical Immunology.
Dr. Ono has been inducted as a Fellow of the American Association for the Advancement of Science, the Canadian Academy of Health Sciences, the National Academy of Inventors, USA and the Johns Hopkins Society of Scholars.
He holds Honorary Doctorates from Chiba University and the Vancouver School of Theology and is a recipient of the Reginald Wilson Diversity Leadership Award from the American Council on Education, the Professional Achievement Award from University of Chicago, a Grand Challenges Hero Award from UCLA and the NAAAP 100 Award from the National Association of Asian American Professionals.
Listen to the Blue and Gold Podcast with Professor OnoThe National Forum on Anti-Asian Racism Final Report: https://events.ubc.ca/wp-content/uploads/2021/10/UBC-National-Forum-Anti-Asian-Racism-Report_18-Oct-2021_web.pdf -
Dr. Katharine Smart, CMA President
Dr. Katharine Smart is a pediatrician in Whitehorse, Yukon. Her work is centered on developing collaborative partnerships with community and government services to serve marginalized children using a model of social pediatrics. She works primarily with children who have experienced trauma and adverse childhood events, and she witnesses the broad and lasting impact these events have on children and their development daily. She is passionate about improving services for marginalized children in an effort to change their life trajectory.
In addition to her community-based work, Dr. Smart enjoys acute care and provides on-call services to the hospital. Before moving to the Yukon, she was a pediatric emergency medicine physician at the Alberta Childrenâs Hospital in Calgary. Dr. Smart is the past president of the Yukon Medical Association.
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