If there was an award for the most contagious virus, measles would be a frontrunner. It can hang in the air for hours, and one infected person will pass it on to almost every unvaccinated person they meet. One in five people infected require hospitalization, and nearly one in 300 infected children die. Surviving doesn’t mean you’re in the clear, either: this particular virus erases the immune system’s memory of every virus, vaccine and bacterium it’s ever encountered, leaving people more likely to acquire other illnesses once they’ve recovered.

Thanks to high childhood vaccination rates—92 per cent nationwide—Canada typically experiences only a few measles cases annually, usually in travellers. But in the first few months of 2024, there have been almost twice as many cases as in all of 2023, and community transmission may be beginning in Ontario and Quebec. In Montreal, where public health has confirmed 14 cases since early February, several thousand people have been exposed.

I spoke to McMaster University immunologist Dawn Bowdish, who says that Canada could be on the cusp of a serious problem. Between pandemic-related vaccine disruptions, antibiotic resistance and an overstretched health system, we’re facing a cascade of simultaneous crises that could leave us vulnerable. “If community transmission can be traced and stopped, we may not end up having massive outbreaks,” she says. “But if we don’t? It’s just so incredibly contagious.”

—Jadine Ngan, digital editor

More than six million Canadians are without a family doctor—around 900,000 of those people are in B.C, where Renee Fernandez practises. After seeing first-hand how this shortage causes  missed screenings and delayed diagnoses, she and a group of her peers sat down with the provincial government to design a new payment model for family physicians. The work of a primary care provider is complex and demanding, she writes, so financial incentive is key if we want to boost numbers. Since the new longitudinal model took effect, which rewards physicians for time spent and continuity of care, the province has attracted 700 new family doctors. For Fernandez, this change is just the first step toward ensuring that Canadians get the health care they deserve.

Antibiotics uphold all of modern medicine, but in 2019, about 1.3 million people died from drug-resistant bacterial infections. As bacteria continue to evolve, that number is expected to hit 10 million per year by 2050, in what some have called a “silent pandemic.” The problem, explains McMaster University’s Jon Stokes, is that our antibiotic pipeline has become alarmingly lean. One potential solution? Using AI to help us discover new antibiotics.

Canada’s emergency rooms are grappling with persistent staffing and bed shortages, and hospital admission wait times are getting longer, sometimes stretching out to nearly a full day. We spoke to Michael Howlett, president of the Canadian Association of Emergency Physicians, about how decades of underfunding fuelled systemic problems that are now piling up. He says this is the worst year he’s seen in his three-decade career as an emergency physician—and offers advice on how to break the cycle.

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