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Is it strep throat? Pharmacies say they could give you the answer and maybe save a trip to the doctor

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‘Tis the season for colds, flu and sore throats. And anguishing over whether you — or your child — need to go to the doctor. Maybe it’s better to stay in bed — but what if it’s strep throat and antibiotics are required?

In three Canadian provinces (B.C., Alberta and Nova Scotia), you can walk into some pharmacies and get a rapid “point-of-care” strep throat test.

The pharmacist takes a throat swab, and within a few minutes, tells you whether it tested positive or negative for group A streptococcus — the bacteria that cause strep throat.

Now pharmacy owners want that test to be available across the country.

It’s a quick and easy way, they say, to confirm whether a sore throat is caused by strep bacteria or by a virus.

That’s important because only about a third of sore throats in children between five and 15 years old are caused by strep. The rest of the time it’s usually a virus, in which case antibiotics won’t do any good and shouldn’t be prescribed. 

So if the test comes back positive for strep, the pharmacist will advise you to go to the doctor and get the appropriate prescription. In Alberta, you could get the antibiotic right away, as pharmacists have prescribing authority in that province.

If the test comes back negative, “you may just need fluid and rest, which a pharmacist could advise you on,” said Sandra Hanna, vice-president of pharmacy affairs for the Neighbourhood Pharmacy Association of Canada and a pharmacist in the Toronto area.

“In the majority of cases, an antibiotic … would not be required, because it’s a viral sore throat,” she said.

Since about two-thirds of sore throats are viral and antibiotics shouldn’t be prescribed, ruling out strep infections in a pharmacy setting can help save patients unnecessary trips to the doctor’s office, says Sandra Hanna, vice-president of pharmacy affairs for the Neighbourhood Pharmacy Association of Canada and a practising pharmacist. (Neighbourhood Pharmacy Association of Canada)

The test, which costs patients about $15, allows people “to determine whether they need to go to the doctor or not,” Hanna said.

That, in turn, could help prevent the unnecessary antibiotic prescriptions which contribute to antibiotic resistance, she said.

For all those reasons, the association, which represents pharmacies (including chains such as Shoppers Drug Mart and mass merchandisers with pharmacy services such as Costco and Walmart), says strep point-of-care testing should be available across the country, and is currently lobbying to start it in Ontario.

Sounds great, right?

Not so fast, say infectious disease specialists.

When it comes to kids, point-of-care tests (also called rapid antigen tests) shouldn’t be used on their own to rule out strep throat, said Dr. Jeffrey Pernica, head of the Division of Pediatric Infectious Disease at McMaster University in Hamilton, Ont.

“These tests that they’re talking about don’t work well enough to be reliable in children. And children are the ones who are the most at risk from complications of strep throat, like rheumatic fever. And they’re the ones who get strep throat the most,” he said.

(For adults, strep throat is less common.)

When doctors suspect a patient has strep throat, they usually do a throat swab and send it off to a lab for a “throat culture test,” where the sample is left for a day or two to see if it grows into strep bacteria.

Dr. Jeffrey Pernica, head of the division of pediatric infectious disease at McMaster University, says he understands the appeal of rapid strep tests, but they shouldn’t be used in isolation when it comes to ruling out strep throat in children. (McMaster University)

That’s the “gold standard diagnostic test” for strep throat, according to the U.S. Centers for Disease Control and Prevention.

It’s also the accepted medical guideline for treating strep throat in children, said Dr. Jonathan Gubbay, a Toronto pediatrician specializing in infectious disease, as well as a medical microbiologist for Public Health Ontario.

Gubbay actually uses a point-of-care test in his clinic when he suspects a child has strep throat because he can get the result back in five or 10 minutes. If it’s positive, he can start antibiotic treatment right away.

But if it’s negative, he sends a sample to the lab for the culture test to make sure the point-of-care test wasn’t a false reading.

It’s important to make sure a strep diagnosis isn’t missed in children, Gubbay said, because although rare, it can progress into an invasive form of the disease or heighten the risk of rheumatic fever, which can damage the heart and joints.

“The sensitivity [of rapid tests] isn’t as good as we’d like,” he said.

So how reliable are they? It depends on who you ask.

The Neighbourhood Pharmacy Association says the point-of-care tests are accurate more than 90 per cent of the time. But both Gubbay and Pernica say that’s unlikely.

Dr. Jonathan Gubbay, deputy chief of medical microbiology at Public Health Ontario and a pediatric infectious disease physician, says a comprehensive physical exam of a child with a sore throat can sometimes rule out strep throat without requiring a swab at all. (Public Health Ontario)

Although studies that show such high accuracy do exist (including those cited by test manufacturers themselves), the doctors say a broader look at the research puts the number closer to 70 per cent.

Dr. Lynora Saxinger, an infectious disease specialist at the University of Alberta, also questions whether point-of-care tests are as accurate as they claim to be.

“There are lots of tests that are licensed and the packages always tell you that they’re fantastic. In the real world, they vary a lot,” she said.

Both Saxinger and Gubbay also point out that diagnosing strep goes beyond the throat swab — regardless of how the results are processed, because physicians and nurse practitioners do complete physical exams. In many cases, they’re able to rule out strep throat without even doing a swab — a level of diagnosis they’re not sure all pharmacists are equipped to provide.

But Hanna said in the provinces where point-of-care tests are in place, pharmacists do have comprehensive conversations with patients — and also guard against missed strep diagnoses.

“Tests that show a negative result in patients where the pharmacist strongly suspected them of having strep throat, based on their symptoms, were referred to a physician for further evaluation,” she said.

The manufacturers of point-of-care tests, including those for strep throat, ‘always tell you that they’re fantastic. In the real world, they vary a lot [in accuracy],’ says Dr. Lynora Saxinger, an infectious disease specialist at the University of Alberta. (University of Alberta)

The in-pharmacy tests could also save the health-care system money, the Neighbourhood Pharmacy Association says, citing a study published in the Canadian Pharmacists Journal in August. It concluded the pharmacy-based treatment saved an average of $12.47 to $24.36 per patient.

However, the study did not account for the fact that patients pay about $15 out-of-pocket for the strep test — and it was funded by Loblaw Companies Limited, which runs pharmacies and owns the Shoppers Drug Mart chain.

That raises questions for Pernica about how impartial the findings are.

“There’s a clear incentive for the drug stores to get people [in],” he said. “Because if they have strep throat, they’ve done them a service. If they don’t have strep throat, they’re still there. And I think that people will be walking out of those drug stores with cough and cold remedies.”

Regardless, Pernica said he understand the appeal of the pharmacy-based tests for patients.

“Pharmacists will make a good point in saying that sometimes it’s hard to get in to see your doctor or nurse and it’s sometimes easier for people to access pharmacies. I completely agree with that,” he said.

But he’s not convinced there’s enough independent research to back up the claims that false negatives aren’t happening — or even that there’s a cost-saving to the health-care system.

“I’m not sure of the data yet,” said Pernica. “Will people actually get treated more appropriately faster? Will the overall costs be lower? I think these are answers we don’t have yet.”


This is an excerpt from Second Opinion, a weekly roundup of eclectic and under-the-radar health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.

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Post-vaccine surge? Michigan’s spring coronavirus case spike close to previous year’s autumn high

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(Natural News) The spike in new Wuhan coronavirus infections recorded in Michigan over the spring is similar to a spike seen during the 2020 fall season. According to a Wall Street Journal analysis, the state’s daily coronavirus case count averaged more than 7,000 for almost two weeks – before taking a slight dip to 6,891 on April 20. This echoed similar figures back in November and December 2020, which saw sharp rises in infections for those two months before plunging.

Back in autumn of last year, Michigan averaged more than 7,000 cases per day for a span of 10 days. New infections dropped slightly, then briefly spiked as the December holidays approached. It then fell to the low 1,000s for the succeeding two months – until ascending again in March.

According to University of Michigan internal medicine professor Dr. Vikas Parekh, the sudden increase in new infections could be attributed to several factors. Among the factors he cited was re-openings, which increased people’s interactions and mobility. Parekh said the loosened restrictions contributed to the spread of the highly contagious U.K. B117 variant.

“As the B117 variant spreads nationally, we will likely see other stats [with] their own surges – although I hope none are as bad as Michigan,” the professor remarked. He continued: “The milestone just tells us we are not yet in the clear, especially as we still have large portions of our population who are not vaccinated yet.”

Parekh also expressed optimism over the lower daily caseloads the Great Lakes State reported. He said he believes both cases and hospitalizations have plateaued and will likely decline soon. The professor commented: “[COVID-19] positivity has been declining now for one week, which is usually a leading indicator of case decline.”

Meanwhile, the state cited younger populations and youth sports, such as basketball, wrestling and hockey, to increase new COVID-19 infections. Because of this, Gov. Gretchen Whitmer called to suspend youth sports and indoor dining in the state. She also exhorted high schools to conduct remote class sessions for two weeks to curb the spread of the pathogen.

Michigan still experienced the spike in cases despite having one of the highest vaccination rates in the country

During the opening stages of the U.S.’s immunization drive against COVID-19, Michigan boasted of having one of the highest vaccination rates nationwide. A report by Bridge Michigan even noted the initial “frenzy for vaccines” that “far exceeded the state’s limited supply.” But things have appeared to turn around for Michigan, as it now struggles to reach the 70 percent vaccination rate needed for herd immunity.

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Scottish mom’s legs turn into a pair of “giant blisters” after first dose of AstraZeneca’s coronavirus vaccine

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(Natural News) Sarah Beuckmann of Glasgow, Scotland, felt a tingling sensation in her legs and noticed a rash flaring up around her ankles a week after getting her first dose of AstraZeneca’s coronavirus (COVID-19) vaccine on March 18.

She also had flu-like symptoms right after the vaccination.

Beuckmann called her doctor to arrange an appointment the morning she noticed the rash, but by the afternoon her skin was already breaking out into blood-filled blisters. Blisters also appeared on her legs, hands, face, arms and bottom.

“I ended up asking my husband to take me to A&E,” said Beuckmann, referring to “accident and emergency,” the equivalent of an emergency room (ER). “When I got there, my heart rate was sitting at 160bpm, which they were very concerned about. I got put on an ECG machine.”

Doctors determine AstraZeneca’s COVID-19 vaccine triggers the rash

Medics carried out tests for HIV, herpes and other skin conditions to work out what triggered the rash, but all results came back negative. Doctors finally determined that the vaccine caused her rare reaction after carrying out two biopsies.

“Once they found that it was a reaction to the vaccine, they put me on steroids and that really seems to be helping my progress,” said Beuckmann. She had been advised by her doctor not to get the second dose of AstraZeneca’s COVID-19 vaccine because of her reaction.

Beuckmann spent 16 days at Queen Elizabeth University Hospital. She was discharged to recover at home. The 34-year-old mother of one is currently wheelchair-bound due to the bandages on her legs and blisters on the soles of her feet. She may need physiotherapy to help strengthen her leg muscles.

“They are starting to heal and they’re looking a lot better than they were but as the blisters started to get worse, they all sort of merged together,” she said. “I didn’t know what was going on.”

With the blisters merging, her legs have looked like a pair of “giant blisters.” Beuckmann admitted that at one point she feared her legs might have to be amputated.

Dermatologist agrees COVID-19 vaccine causes the blisters

Dr. Emma Wedgeworth, a consultant dermatologist and spokeswoman at the British Skin Foundation, agreed that Beuckmann had likely suffered a reaction to the vaccine.

“Vaccines are designed to activate the immune system. Occasionally people will have quite dramatic activation of their immune systems which, as happened in this case, can manifest in their skin” Wedgeworth told MailOnline. “This poor lady had a very severe reaction, which thankfully is extremely rare.”

It is not clear why Beuckmann, who works in retail, was invited for a vaccine. Scotland’s vaccine rollout was focused on people over the age of 50 when she got vaccinated, although vaccines are available to those who are considered at risk from the virus, or live with someone considered vulnerable.

At least 20 million Briton have had AstraZeneca’s COVID-19 vaccine, which drug regulators say causes a rash in one percent of cases. They say rashes caused by the jab tend to go away within a week.

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Trojan labs? Chinese biotech company offers to build COVID testing labs in six states

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In 2012, BGI acquired Complete Genomics, a DNA sequencing company and equipment maker. The funds for the $117.6 million purchase were raised from Chinese venture capitals. The company has expanded its footprint globally. According to its website, BGI conducts business in more than 100 countries and areas and has 11 offices and labs in the U.S.

People are concerned about China’s access to American DNA data

Some said that with Complete Genomics providing an American base, BGI would have access to more DNA samples from Americans, helping it compile a huge database of genetic information. Some also worried about the protection of the genetic information’s privacy.

According to a 2019 report from the U.S.–China Economic and Security Review Commission (USCC), BGI “has formed numerous partnerships with U.S. healthcare providers and research organizations to provide large-scale genetic sequencing to support medical research efforts,”

There are three main reasons why many people in the biotech community and government have expressed concerns about China’s access to American DNA data.

In the “60 Minutes” interview, Evanina discussed the very likely scenario in which Chinese companies would be able to micro-target American individuals and offer customized preventative solutions based on their DNA.

Evanina asked: “Do we want to have another nation systematically eliminate our healthcare services? Are we okay with that as a nation?”

The second concern is that China may use DNA to track and attack American individuals. As the USCC report states: “China could target vulnerabilities in specific individuals brought to light by genomic data or health records. Individuals targeted in such attacks would likely be strategically identified persons, such as diplomats, politicians, high-ranking federal officials or military leadership.”

The third concern is that China may devise bioweapons to target non-Asians. Steven Mosher, president of the Population Research Institute, discussed it in his article “What Will China Do With Your DNA?” published by The Epoch Times in March 2019.

He wrote: “We know that the Asian genome is genetically distinct from the Caucasian and African in many ways. … Would it be possible to bioengineer a very virulent version of, say, smallpox, that was easily transmitted, fatal to other races, but to which the Chinese enjoyed a natural immunity? … Given our present ability to manipulate genomes, if such a bio-weapon can be imagined, it can probably – given enough time and resources – be realized.”

An article from Technocracy said: “China’s aggressive collection of American DNA should be doubly alarming because it can only spell one ultimate outcome: biowarfare. That is, genetically engineering viruses or other diseases that will be selectively harmful to U.S. populations.”

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