Thank you, Sandy.
Thank you, Mr. Chair and committee members.
I'm from Prince Albert, Saskatchewan, and I've been a volunteer with Patients for Patient Safety Canada for the past nine years.
It's been said that antimicrobial resistance is an abstract concept, except for its victims and their physicians. In an effort to make this problem clear, I'd like to introduce you to two retired farm women who valued their health and rarely accessed the health care system for an illness. The following events changed all of that.
The first is a story about my mom. It started as a symptomatic bladder infection, but a culture was not collected in the emergency room. The dose for the prescribed antibiotic was strong, prolonged, and likely wrong. This contributed to a severe adverse reaction. I'll never forget her desperation that morning as her hemoglobin dropped to a level incompatible with life, yet that was just the beginning of what she had to endure. She lost her hearing and her immediate memory, developed atrial fibrillation, had heart failure, had pneumonia, had a heart attack, and spent months regaining her strength.
It was amazing to everyone that she survived, but the deleterious long-term effects remain with her and are pronounced today. Many providers were on the wrong track in the early days of her treatment. A second, remarkable team stepped in and saved her. If she were here today, she would express her heartfelt gratitude for that. She's the reason I do this work.
This past year my mother-in-law, an extraordinary mother of 12, faced similar circumstances. Her ordeal started innocently enough: a pustule showed up on her leg. However, below the surface was a raging infection from a previous surgery. After two rounds of antibiotics, a month later the surgical site was finally cultured during another surgery to remove the hardware and to clean the bone in her leg.
As a result of this test, different antibiotics were prescribed for another six weeks. All was still going amazingly well for her. Her strength and determination were remarkable, but no surprise to us, her family. Then C. difficile struck, and I knew it could be the beginning of the end. More antibiotics were used to treat it, and then were repeated. There it was again, the familiar downward spiral: atrial fibrillation, blood clots, cognition changes, and end-stage heart failure. Prior to her surgery, her heart and mind were considered to be her greatest assets. Sadness filled her eyes as she lost her independence, her sharp mind, her home, and in a few months, her life.
I live in a community where sexually transmitted disease, such as gonorrhea, is alarmingly high, and where hepatitis C and HIV are epidemic, especially in first nations communities. More prevention work is needed to keep communities safe.
It's clear that antimicrobial-resistant infections are a patient safety issue and a public safety issue.
Last year, after surveying patients across Canada, my colleagues from CPSI and I published a paper in the International Journal of Health Governance that described Canadians' thoughts on the best approaches to reach and engage the public. From that, I offer two simple messages: first, the best defence for us is a good offence; second, we, the public, can help draw local and global attention to this issue.
This is some of that we heard and what we published in our paper.
We, the public, must strive towards good health and strong immune systems through handwashing, hygiene, immunization uptake, and fulfilling our personal responsibility to prevent transmission.
Patients view conversations with their providers as the most effective means of understanding appropriate use of antibiotics. Together with our primary care providers, we can learn how to manage viral illnesses so that antibiotics aren't the automatic first default in our quest to feel better quickly. The public has been blamed for demanding antibiotics, but perhaps more accurately, we go to providers for help with symptom relief and for reassurance that we aren't missing something more serious.
Patients told us that the abstract concept of antimicrobial resistance is more easily understood by them when it is placed within the context of a story. Sharing statistics and the cost to health care was deemed to be the least relatable for them. Canadians stated they are more inclined to change their behaviour when the information provided is succinct and diverse, with multiple complementary messages delivered in their communities.
For example, information can be shared about recent studies that suggest a relationship between antibiotics, our gut, and chronic diseases such as obesity, or the relationship between chronic and serious infections and dementia.
As Canadians, we can be champions for change. This year, volunteers from Patients for Patient Safety Canada have made presentations to our local communities and contributed to the design of mass public awareness campaigns.
When we are ill, we are vulnerable. We may not pay attention to who washed their hands prior to a procedure or whether the equipment and the furniture have been cleaned between patients. In these moments, we don't ask if we are on the correct antibiotic. We trust that health professionals, health care organizations, and ministries have done everything to protect us. There's the rub: much of it is up to you. However, we see this as a shared responsibility and we are willing to help.
Thank you very much.