What if I have active TB? Should I drop my application? Please help me!

[canuck78]

Most people have latent TB(people pass the immigration screening easily). Only 25% of the latent cases turn active and that too in immuno-compromised individuals. Even diabetes can turn latent tb into active tb. Don't be surprised if someone drives a Merc and is being treated for TB. It's a popular misconception that TB only affects refugees, homeless and others.

It's sad that public health sucks in your city. Refugees, homeless and reserve populations are humans too, and are not in control of their situations completely. I know the sad state of affairs concerning universal healthcare here, UK is worst. People think universal healthcare is the best..No wonder that topic never wins in US elections.

There is a higher incidence of TB in Canada in certain populations (refugees, homeless and people living in reserves). It is just a fact. If you look at the number of TB cases per the amount of refugees admitted into Canada each year the incidence rate is high compared to other immigrants. That is because they are allowed to arrive and seek treatment in Canada for their communicable diseases. If you work with the homeless population you also know that based on their living conditions they are more prone to many diseases including TB. Canada tries very hard to prevent TB from being in the Canadian population because of the rise of drug resistance and the fact that it takes a long time to treat. Many patients abandon treatment because it is long and often hard and that’s why you have a public health nurse following up with anyone who has been identified as having TB. Most physicians will not be comfortable if they are examining a patient and then discover they have TB. It just isn’t a common condition people and physicians see in the general population. If people have passed their medical many get TB when they travel home or they are part of the medical surveillance lost at public health. In many countries getting TB isn’t considered unusual or a big deal. In Canada it is. Public health doesn’t have to be bad in my city for public health workers not to make house calls. Many don’t make house calls purely for safety reasons and in larger cities people may not have vehicles or getting to numerous patients would be too time consuming. There are often local clinics that are more accessible for people or labs where people can do tests all over the city with a requisition. A lot of the work can be done over the phone. If a patient is not following the protocol the public health team may have to try and go to their home.

Would look at the US system and how it isn’t dealing well with covid 19. Think the many countries that have universal healthcare have been reacting much better than the US. The US will likely have the most deaths, have families left with so much medical debt that they have to declare bankruptcy and many patients will only seek out help when they already very sick because of lack of insurance. Not seeking help earlier may impact their survival. On top of this many hospitals may also go bankrupt because many operate month to month and depend on relatively simple elective surgeries where patients never need an ICU as their bread and butter. Long ICU cases tend to cost more than they can bill for and most hospitals have shut down their elective surgeries and have expanded their ICU beds. Rural and public hospitals are especially at risk. Some of the large private hospitals have big endowments and have more of a cushion. Not saying the Canadian system is perfect but the US system doesn’t work.

https://www.cbc.ca/news/health/cbc-explains-tuberculosis-banerji-tb-1.5046336
https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2019-45/issue-2-february-7-2019/article-4-tuberculosis-in-canada.html

 

[coolgal]

There is a higher incidence of TB in Canada in certain populations (refugees, homeless and people living in reserves). It is just a fact. If you look at the number of TB cases per the amount of refugees admitted into Canada each year the incidence rate is high compared to other immigrants. That is because they are allowed to arrive and seek treatment in Canada for their communicable diseases. If you work with the homeless population you also know that based on their living conditions they are more prone to many diseases including TB. Canada tries very hard to prevent TB from being in the Canadian population because of the rise of drug resistance and the fact that it takes a long time to treat. Many patients abandon treatment because it is long and often hard and that’s why you have a public health nurse following up with anyone who has been identified as having TB. Most physicians will not be comfortable if they are examining a patient and then discover they have TB. It just isn’t a common condition people and physicians see in the general population. If people have passed their medical many get TB when they travel home or they are part of the medical surveillance lost at public health. In many countries getting TB isn’t considered unusual or a big deal. In Canada it is. Public health doesn’t have to be bad in my city for public health workers not to make house calls. Many don’t make house calls purely for safety reasons and in larger cities people may not have vehicles or getting to numerous patients would be too time consuming. There are often local clinics that are more accessible for people or labs where people can do tests all over the city with a requisition. A lot of the work can be done over the phone. If a patient is not following the protocol the public health team may have to try and go to their home.

Would look at the US system and how it isn’t dealing well with covid 19. Think the many countries that have universal healthcare have been reacting much better than the US. The US will likely have the most deaths, have families left with so much medical debt that they have to declare bankruptcy and many patients will only seek out help when they already very sick because of lack of insurance. Not seeking help earlier may impact their survival. On top of this many hospitals may also go bankrupt because many operate month to month and depend on relatively simple elective surgeries where patients never need an ICU as their bread and butter. Long ICU cases tend to cost more than they can bill for and most hospitals have shut down their elective surgeries and have expanded their ICU beds. Rural and public hospitals are especially at risk. Some of the large private hospitals have big endowments and have more of a cushion. Not saying the Canadian system is perfect but the US system doesn’t work.

https://www.cbc.ca/news/health/cbc-explains-tuberculosis-banerji-tb-1.5046336
https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2019-45/issue-2-february-7-2019/article-4-tuberculosis-in-canada.html

Did you look at the pie chart in that link you sent me ? 71% TB is from foreign-born immigrants-Are you saying these people turn out to be homeless, refugees and other reserve populations ? Your theory is not supported by your facts. I think you hoped I wouldn't read it. No one is allowed to come with active TB into Canada, even refugees are not--that's a medical inadmissibility case. They may be latent but not active. Also read the corrections section of the second link you sent me.

You make so many contradictions in one paragraph, and your source doesn’t support your theory.

Coming to public health, in Toronto, TPH nurses meet clients everyday and not just in exceptional cases. If Toronto can do it, any big city in Canada can unless there's funding issues. And since you said TB is a big deal in Canada, I don't see how funding can be an issue.

It's very important to meet with clients especially when they have 10 pills to take in one go and those TB meds have both hepatotoxic and other sideeffects on patients, so I think it's bad that public health is not doing enough in your city. It goes to show the lack of due diligence on their part.

The US isn't dealing well with Covid-19 due to a lot of exposure from its previous incoming travel. Canada didn't have that kind of exposure. By the time the symptoms kick in, there's 50% fibrosis in the lungs, it's hard to survive once that happens. In the early days, the patients are asymptomatic and in the process infecting others too. So the fear of costs is not the driving factor for seeking late treatment for Covid-19, it's the asymptomatic nature of the disease.

You're a good ambassador for your city. But based on what you said, it looks like public health is bad there.(or you’re just making it look bad for the sake of a difference in opinion)

I think the pressures of being a VIP member require you to have the last word..so you cherry-pick certain points and draw inferences from them. Except that your facts don't support your theory.

I'll be wary of your future views. Grade F here(poor Canuck)

(I know public health in every city in the country visits people. You just wanted to have an opposing argument)

Anyway it's a free forum, VIP is not
really a VIP.

 

[canuck78]

Did you look at the pie chart in that link you sent me ? 71% TB is from foreign-born immigrants-Are you saying these people turn out to be homeless, refugees and other reserve populations ? Your theory is not supported by your facts. I think you hoped I wouldn't read it. No one is allowed to come with active TB into Canada, even refugees are not--that's a medical inadmissibility case. They may be latent but not active. Also read the corrections section of the second link you sent me.

You make so many contradictions in one paragraph, and your source doesn’t support your theory.

Coming to public health, in Toronto, TPH nurses meet clients everyday and not just in exceptional cases. If Toronto can do it, any big city in Canada can unless there's funding issues. And since you said TB is a big deal in Canada, I don't see how funding can be an issue.

It's very important to meet with clients especially when they have 10 pills to take in one go and those TB meds have both hepatotoxic and other sideeffects on patients, so I think it's bad that public health is not doing enough in your city. It goes to show the lack of due diligence on their part.

The US isn't dealing well with Covid-19 due to a lot of exposure from its previous incoming travel. Canada didn't have that kind of exposure. By the time the symptoms kick in, there's 50% fibrosis in the lungs, it's hard to survive once that happens. In the early days, the patients are asymptomatic and in the process infecting others too. So the fear of costs is not the driving factor for seeking late treatment for Covid-19, it's the asymptomatic nature of the disease.

You're a good ambassador for your city. But based on what you said, it looks like public health is bad there.(or you’re just making it look bad for the sake of a difference in opinion)

I think the pressures of being a VIP member require you to have the last word..so you cherry-pick certain points and draw inferences from them. Except that your facts don't support your theory.

I'll be wary of your future views. Grade F here(poor Canuck)

(I know public health in every city in the country visits people. You just wanted to have an opposing argument)

Anyway it's a free forum, VIP is not
really a VIP.

Number is not the same as incidence so no I didn’t contradict myself. There are fewer refugees therefore the amount of total cases will be lower than the amount in the total population. Meeting with clients on a daily basis is only necessary when patients are not compliant. A phone call can be enough for many people versus having an in person visit at home, in a clinic or elsewhere. Once people are shown to be conpliant their reminders or in person meetings can be less frequent. Visits requires a lot of resources and may.not be practical for the patient. Clients can be given lab requisitions postdated so they can arrange to do blood testing at their local lab whenever is convenient during that day. Similar things are done in various diseases. Public health budgets have been cut throughout Canada.

Cost is certainly a factor when it comes to seeking treatment in the US especially if you don’t have insurance. Patients without insurance tend to wait longer to seek treatment in general. They also tend to seek treatment though an ER and not contact their doctor if they have one. Although most covid tests should be free now the office visit may not be if seeking help in an office. I saw someone saying they had a $40 co-pay on their testing visit so the appointment at the GP was likely a couple hundreds of dollars which is not affordable for many. Cost is also a factor when seeking treatment in Canada if you don’t have medical coverage. Unfortunately the people who are living without status often don’t seek treatment until it becomes so severe that they have to. If you look at cases of cancer in people living in Canada without access to healthcare they often get diagnosed at late stages because they have only sought out medical help when symptoms become unbearable. Most provinces have made covid treatment free so that people will seek treatment as soon as possible and not spread it to others.

Canada has similar exposure to international travel especially in our largest cities. The fact that the cost of seeing a doctor is free or lower does influence people seeking help earlier. If you seek out treatment earlier you have a better chance of getting better with covid. some may still die but early treatment will help. In Canada you rarely have to worry about going bankrupt if you seek medical treatment. That is not the case in the US. You can go bankrupt due to medical bills even with insurance. Many people try to wait it out and don’t want to place a financial burden on their families. Although our testing is far from perfect because hospitals are privately run as a single entity or in groups there is a severe lack of communication between hospitals in a stare where as our provinces have hospitals reporting to them all the time. It becomes easier to coordinate that way. It is easier to fight a disease as a whole when the province is fighting covid 19 versus individual hospitals.