This story is part of CBC Health’s Second Opinion, a weekly analysis of health and medical science news emailed to subscribers on Saturday mornings. If you haven’t subscribed yet, you can do that by clicking here.
The rapid-fire spread of bird flu, an evolving toxic drug supply and the political response to it, plus the rise and expanding use of medications like Ozempic. These are some of the top medical stories we plan to cover in 2025.
We will also report on health-care topics, like how more than five million Canadian adults struggle to find a regular health-care provider and the challenges of vaccinating for preventable illnesses in children and adults alike.
Keeping tabs on H5N1 bird flu in North America
Flu watchers say they’ll continue to keep a close eye on the pandemic potential of the H5N1 strain of avian influenza in 2025. The virus continues to spread among U.S. dairy cattle and decimate Canadian poultry. It was found most recently in ringed seals in Nunavut and has infected dozens of people with mostly mild illness.
“If the virus adapts to a new host and mutates such that it’s able to spread person to person, it would be a big deal,” Dr. Lynora Saxinger, an infectious diseases specialist at the University of Alberta in Edmonton, said on CBC’s The Dose.
A respiratory virus that spreads easily between humans poses a major health risk, especially if it also causes severe disease.
Dr. Maria Van Kerkhove, the World Health Organization’s director of epidemic and pandemic preparedness, is calling for increased surveillance globally of animal populations that are known to be susceptible to H5N1, including wild birds, poultry, swine and cattle.
Following sporadic cases among humans and other mammals over the last decade, confirmed cases of H5N1 in animals started to explode in 2022, with the virus jumping from mink and seals to domestic dogs and cats.
The spillover to mammals is thought to be from eating infected birds, Dr. Samira Mubareka, an infectious diseases physician and microbiologist at Sunnybrook Research Institute in Toronto, said on CBC Radio’s Day 6.
In November, health officials in British Columbia confirmed that a teenager was in critical condition after getting infected with H5N1. It is still not clear how the teen caught the virus, and officials say that may never be known.
The Public Health Agency of Canada has said tests show the version of the virus collected from the teen is related to the type that’s circulating among poultry flocks in B.C., not the one spreading in dairy cattle in the United States.
As of Thursday, the U.S. Centers for Disease Control and Prevention reports 16 American states with outbreaks in dairy cows and 60 confirmed cases of infection in humans, mostly mild, but many infections are thought to go undetected.
Overall, pandemic scientists watch for what they call “reassortment events,” where different flu virus strains from different animal species mix together in a single animal, becoming a new version that humans have no immunity against.
— Amina Zafar
How will the toxic drug crisis evolve in 2025?
In the grim saga of Canada’s toxic drug crisis, a glimmer of hope started to emerge through 2024, when opioid death statistics showed a decline from the previous year. It still meant an average of 21 deaths per day nationwide. But it’s prompting questions about why the trend is happening and whether it will continue in 2025.
Government and political responses to the drug crisis will be a key theme to watch in the new year. In addition to a national-level debate during a likely federal election campaign about how to deal with drug addiction, look for how provincial measures play out — such as Ontario’s shutdown of supervised consumption sites, British Columbia’s move to recriminalize drug use in public spaces and Alberta’s push to force people with addiction into treatment.
In this political context, even the small pilot projects offering addicts a safer supply are under sharp scrutiny. An ongoing national evaluation of safer supply pilot programs is due to have a progress report in the early months of 2025.
Some preliminary results found a roughly 80 per cent reduction in overdoses among clients of the Toronto safer opioid supply program. The evaluation includes comparing the effectiveness of safer supply prescribing versus first-line opioid agonist treatment in improving health.
— Mike Crawley
Growth of Ozempic
The number of Canadians using GLP-1 receptor agonist drugs — like Ozempic — has continued to rise for both diabetes and weight loss. According to the latest numbers in Canada from GreenShield, an integrated health services organization that compiles insurance data, there was a 43 per cent increase in claimants using weight-loss medications between 2022 and 2023. GLP-1 agonists also made up 46 per cent of diabetes drug costs in the country.
The number of Canadians using these drugs is expected to climb. “We do expect continued growth, no question. It may not be as explosive as it’s been over the last couple of years,” said Ned Pojskic, vice-president of pharmacy benefits management at GreenShield Canada.
Next year, drug manufacturers will also be looking to expand the use of the drugs beyond weight loss and diabetes. American pharmaceutical giant Eli Lilly will start large clinical studies in the use of GLP-1 agonists for alcohol abuse, nicotine use, drug abuse and anti-inflammatory conditions in 2025. “These medicines, we think, and we aim to prove, can be useful for other things we don’t think about connected to weight,” CEO David A. Ricks said.
Another thing to keep an eye on as GLP-1 drugs continue to grow in popularity: side-effects. Experts have warned about unintended outcomes, such as muscle loss, nausea and — in serious cases — potentially life-threatening conditions like pancreatitis.
— Jennifer Yoon
Long COVID’s lingering effects
Long COVID, also known as post COVID-19 condition, is defined by the World Health Organization as symptoms that persist for three months or longer after infection and can’t be explained by anything else.
Since some people have been living with its symptoms for up to five years, long COVID will be a condition to watch next year from a health-care perspective.
About 2.1 million adults in Canada, or roughly seven per cent of the adult population, live with long COVID symptoms, a 2023 survey by Statistics Canada suggests. Common symptoms include persistent fatigue, difficulty concentrating, shortness of breath and worsening symptoms after exertion, which can be debilitating.
In January, about 24 members of a long COVID support group spoke to CBC News about their day-to-day experience living with the condition and the difficulty they have finding help to recover.
“There are impacts on people, their ability to work and care for their families, and their continued struggles with obtaining disability insurance,” Dr. Kieran Quinn, a clinician scientist in internal medicine at Sinai Health and an assistant professor of medicine at the University of Toronto, said in an email update.
“There are also likely large impacts on the health-care system, including use of health services, which are more difficult to measure.”
— Amina Zafar
Vaccine progress and challenges
For the first time since 2016, Canada is due to renew its National Immunization Strategy in 2025. Public health authorities will adjust vaccination targets, based on how much progress the country has made in getting people vaccinated against preventable diseases — and the rates of those diseases in Canada.
We know some challenges persist. A federal vaccine registry — or lack thereof — is one example. Because each province and territory has a different system, it’s challenging to get a comprehensive look into vaccination coverage in the country.
During the initial rollout of COVID-19 vaccines, data was standardized across the country, and the Public Health Agency of Canada is looking to build on that for other common vaccines — working with provinces and territories on a blueprint for a model that would connect different vaccine registries across Canada.
And then there’s the elephant south of the border. The U.S. Senate is poised to confirm vaccine skeptic Robert F. Kennedy Jr. as secretary of health and human services. If he takes on the role, he’s promised to investigate the discredited link between vaccines and autism — with the blessing of president-elect Donald Trump. As vaccine skeptics take positions of power in the U.S., Canada should brace for their actions and words to have an impact here, too.
— Jennifer Yoon
Will federal deals with provinces improve health care?
Billions of additional health-care dollars have started flowing from the federal government to the provinces in bilateral deals targeting four key priorities. Canadians will start to find out in 2025 whether the money is having an impact on the health care they’re receiving.
The four priorities are:
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Expanding access to primary health care.
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Boosting the health workforce and reducing surgical and diagnostic backlogs.
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Improving access to mental health and addiction services.
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Increasing patient and provider digital access to health records.
Knowing whether the money is actually having an impact in those areas requires good data. The Canadian Institute for Health Information is tracking the progress. Its 2024 report, coming only a few months into the deals, serves mainly as a baseline for this data. Among its findings, one Canadian adult in six (roughly 5.4 million people) does not have access to a regular health-care provider, such as a family doctor or nurse practitioner. And even those who do, the report said, often face challenges getting an appointment quickly, especially on evenings and weekends.
The 2025 version of the CIHI report will be an important test of whether any progress can be seen on those shared health priorities. Pay particular attention to the figures for access to mental health and addiction care. The 2024 report said that about 25 per cent of Canadians with a diagnosed mental disorder are not getting the care they need. CIHI is planning to report for the first time on wait times for substance use services across the country.
— Mike Crawley