Prime Minister Stephen Harper took steps Monday to reassure the public the government has the isotope shortage under control even as an international body of nuclear medicine called the ongoing shortage of the radioactive material one of the "greatest threats" to patient care in modern times.
"We do believe we have enough isotopes available to manage the current situation and to enable other diagnostic tests to be used in cases where isotopes cannot be provided," Mr. Harper told the House of Commons Monday.
But Robert Atcher, the outgoing head of the Society of Nuclear Medicine, told a news conference in Toronto that the shortage is affecting hospitals worldwide and is forcing physicians to look to more invasive diagnostic tools.
"Tests have been delayed, treatment has been delayed and referring physicians are becoming increasingly frustrated," he said. "I think we're going to see much more invasive tests being substituted for the nuclear imaging tests, even including exploratory surgery."
The molybdenum-99 isotopes in such short supply are considered the premier tool for many heart and cancer tests.
The reactor in Chalk River, Ont., normally supplies about a third of these medical isotopes worldwide; it has been offline since it was found to be leaking heavy water in May, and will likely be offline for at least three months.
Meanwhile, isotope provider MDS Nordion, still embroiled in a legal dispute with Crown corporation Atomic Energy of Canada Ltd. over the government's decision last spring not to bring the two new Maple reactors online, announced Monday it's partnering with the Moscow-based Karpov Institute of Physical Chemistry. Toronto-based MDS hopes that over the next year, Karpov's research reactor can be refurbished and coaxed into producing between 10 and 20 per cent of global isotope demand - about half the output MDS used to getting from the Chalk River reactor.
Jill Chitra, vice-president of strategic technology, said MDS is holding out hope for isotope production in Canada, despite Mr. Harper's assertion last week that Canada's getting out of the business it helped pioneer.
"We continue to believe the Maple reactors are the solution to this problem - short-term and long-term."
Hospitals and clinics across Canada currently have about 70 per cent of their normal supply of isotopes, Natural Resources Minister Lisa Raitt told Parliament Monday. A week ago, those facilities were operating with 10 per cent of the isotopes they need - and many had none at all.
Although the amount of isotopes available for medical tests has increased this week, it is expected to drop again in July when another major reactor in the Netherlands goes down for four weeks of maintenance.
Health Minister Leona Aglukkaq told Parliament that Australia will step in to help fill the gap in supply.
"Canada has been given regulatory approval today for isotopes at the Australia facility. This means that an additional supply of isotopes will be coming to Canada in the very near future," Ms. Aglukkaq said.
The Australians are expected to begin exporting molybdenum within the next couple of weeks from their OPAL reactor, which was built to serve that country's domestic needs. But the reactor can presently only produce about 10 per cent of global demand; although that's expected to increase slowly, it's not clear by how much.
The Health Minister will also announce funding for medical isotope research Tuesday at the University of Ottawa Heart Institute, which produces its own isotopes with a particle accelerator.
Some medical and nuclear experts have urged the government to consider recommissioning the two Maples reactors that were built to replace the aging NRU at Chalk River. But the Maples did not perform as expected after many years of experimentation and more than half a billion dollars, and the government has demonstrated no appetite for revisiting them.
Dr. Atcher said it was the prospect of the Maples coming online that convinced American researchers not to pursue molybdenum production in the U.S. more than a decade ago.
"There were assurances about 10 or 12 years ago that with the Maples coming online and with two of them being built that we in the U.S. really didn't need to invest in that very much more. So that project ceased," he said. "We had, at least in the U.S., some assurances that we were going to have an assured supply of molybdenum…The decision a year ago not to proceed with the Maples came as a shock, as you can imagine."
Dr. Atcher's remarks, and a statement on the society's behalf calling on governments and industry members to act quickly to defuse the growing crisis, came a day after Ms. Aglukkaq appointed Sandy McEwan as Special Advisor on Medical Isotopes for the duration of the isotope shortage. Dr. McEwan, a former president of the Society of Nuclear Medicine and oncology chair at the University of Alberta, said he still hasn't been given his "walking orders" by the minister and doesn't feel comfortable discussing what the job will entail.
But he said the ad hoc group of experts on medical isotopes formed following the Chalk River shutdown in 2007 helped health-care providers prepare for shortages like this by maximizing limited isotope supplies.
"I think we were better prepared than many people around the world."
Liberal Leader Michael Ignatieff, meanwhile, declared the isotope crisis to be one of the Liberal party's conditions for supporting the Conservative government through a confidence vote later this week. He demanded that Mr. Harper provide quick answers to questions about the shortage.
"If the nuclear plant in Chalk River cannot provide isotopes any more, how is the government going to go about getting the isotopes needed so that Canadian patients can have the treatments they need?" Mr. Ignatieff said at a morning news conference.
"Where is the government going to find that alternative supply? What plan has the government put in place to manage this health-care crisis in the future? Canadian patients and doctors deserve an answer. And they deserve an answer before Parliament rises."
François Lamoureux, the President of the Quebec Association of Nuclear Medicine Specialists, said in a telephone interview Monday that he didn't think Mr. Harper "lives in the same country where our patients and our nuclear doctors live."
Dr. Lamoureux said he has nothing against Dr. McEwan, but the government appointed him without consulting associations representing nuclear medical specialists.
"We sent her a proposition of names," he said, "and the name of Sandy McEwan was not on this list."