A little background first.

The Federal Framework on Lyme Disease Act was Assented to on December 16, 2014 – https://laws-lois.justice.gc.ca/eng/acts/F-7.35/FullText.html

In 2016, a conference was held in Ottawa to discuss Lyme and develop a federal framework on Lyme disease – https://www.canada.ca/en/public-health/news/2016/05/minister-philpott-launches-conference-to-develop-federal-framework-on-lyme-disease.html. It was an opportunity for doctors, patients, researchers, and caregivers to be at the same table to discuss issues regarding Lyme and tick-borne diseases in Canada. Within one year of the conference, a Federal Framework on Lyme Disease was to be completed.

The Federal Framework on Lyme Disease was made public in May of 2017 – https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/diseases-conditions/lyme-disease-canada-federal-framework/lyme-disease-canada-federal-framework-eng.pdf.

In May of 2022 a five year report on the effectiveness of the Federal Framework on Lyme disease was provided – https://www.canada.ca/en/public-health/services/publications/diseases-conditions/federal-framework-lyme-disease-report-parliament-may-2022.html

Although undertaking a cost analysis was included in the Federal Framework on Lyme Disease, as far as I know only Manitoba has undertaken one and, based upon the results, opened the Tick Collaborative Care Service TiCCS – https://healthproviders.sharedhealthmb.ca/services/ticcs/.

The cost for undiagnosed, misdiagnosed, under-treated, etc., Lyme and tick-borne diseases is significant. How significant is unknown.

When I speak to most people who have been dealing with tick-borne diseases, you hear about all the specialists that they gone to; the myriad number of tests that they have had; the number of surgeries that they have had due to damage that has occurred because of the bacteria and other things that the ticks have transmitted; the number of work or school days that they have missed; and so much more. You hopefully get the drift.

It’s not a stretch to suggest that the cost associated with having a comprehensive and dedicated Lyme & Tick-Borne Diseases Care Clinic developed in Nova Scotia (and every province), that included well-trained health care professionals in all aspects of Lyme & tick-borne diseases, would save the province, and country, a significant amount of money.

How can we make this happen?

As a reminder, a petition was tabled by the Nova Scotia government last year that included the following ASKS:

1. Complete the three ASKS of the NS Lyme Disease Advocacy Group as presented to the PC Caucus in February of 2022. The three ASKS were:

• Adequate education for all health care providers and residents;
• Development of a dedicated Tick-Borne Diseases Care Clinic;
• Formation of a Non-Partisan Task Force, including those with lived experience.

2. Undertake a year round awareness campaign, such that ALL Nova Scotians, and visitors to the province, are informed about ticks, what diseases/infections they can carry, how to prevent being bitten, how to properly remove, how to landscape to prevent, how to get diagnosed/treated, that a negative ELISA does not mean that you do not have Lyme disease or another tick-borne disease, etc.

3. Include in the “Guidance for Primary Care and Emergency Medicine Providers in the Management of Lyme Disease, Human Granulocytic Anaplasmosis, Babesiosis and Powassan virus infection in Nova Scotia” the following disclaimer contained in the Infectious Diseases Society of America (IDSA) Lyme Guidelines, which the NS Infectious Diseases Expert Group recommends for treatment: “It is important to realize that guidelines cannot always account for individual variation among patients. They are assessments of current scientific and clinical information provided as an educational service; are not continually updated and may not reflect the most recent evidence (new evidence may emerge between the time information is developed and when it is published or read); should not be considered inclusive of all proper treatments methods of care, or as a statement of the standard of care; do not mandate any particular course of medical care; and are not intended to supplant physician judgment with respect to particular patients or special clinical situations. Whether and the extent to which to follow guidelines is voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient’s individual circumstances.”

If our ASKS had been completed, the province would have significantly reduced ongoing costs associated with the increasing number of ticks, tick-borne diseases, the number of annual cases, and improved the overall health of those presently suffering.

What has been done in NS since the first presentation in 2022 (which was given to all three main parties) is minimal and in some cases has gone backward – Some signage has been installed at the entrance of provincial parks, the province came up with the hash tag “BeTickAware”, they stopped updating and printing Lyme disease pamphlets, they placed ads on games for one season, and I’m having a hard time thinking of what else has occurred, that we know about that is, as who knows what might be happening behind closed doors. Maybe they are investigating how to improve the situation. We don’t know!

Undertaking a cost analysis will finally make everyone understand the actual impact that ticks are having in this province. It should have been the first thing undertaken in Canada in 2017 when the Federal Framework on Lyme Disease was completed. However, it wasn’t. Now it’s up to Nova Scotia to do the same as Manitoba.

If you want to help get this moving, please contact your local MLA and consider also reaching out to your MP and Municipal Councillor. All three levels of government have a part to play.