As Canada comes to grips with its first death from COVID-19, experts say it’s important not to give in to undue fear around the outbreak but instead to put the tragedy into context.
B.C. health officials confirmed Monday the patient, a man in his 80s with underlying health conditions, died Sunday night after becoming infected with the illness at the Lynn Valley Care Centre in North Vancouver.
While tragic for those close to the victim, the man’s death should not be used as a way to justify panic for the majority of Canadians who are not at risk of severe complications from COVID-19, experts say.
The percentage of people who die from the illness is currently estimated at upwards of 3.4 per cent, according to the World Health Organization, which is significantly higher than the seasonal flu at less than one per cent.
In patients aged 70 and up, that fatality rate increases to eight per cent, and for those above 80 years old, it rises to almost 15 per cent.
A man wearing a protective suit and mask is pictured at the Lynn Valley Care Centre in North Vancouver, B.C., on Monday. A man in his 80s who lived in the nursing home is the first fatality of the COVID-19 outbreak in Canada. (Ben Nelms/CBC)
“The majority of people who get this infection have mild disease and recover,” said Dr. Jocelyn Srigley, a physician and clinical assistant professor with the department of pathology and lab medicine at the University of British Columbia.
“It’s not unexpected that we would see patients in those age groups dying of this disease and it’s similar with many other infections that with age your chance of dying from it goes up.”
Canadians need to understand that the vast majority of us are going to manage well if infected with the illness, with most not even requiring hospitalization, says infectious disease physician Dr. Isaac Bogoch at Toronto General Hospital.
“We know this COVID-19 infection can disproportionately make individuals who are elderly and individuals with chronic medical conditions more sick, but we also know that almost any infection or condition can make that population more ill as well,” he said.
“It’s not surprising, but it’s still sad, and I think people should be mindful that we can expect to see more cases like this — this is not going to be a unique case.”
First death still a wake-up call for Canadians
While many Canadians may feel uneasy about the first reported death from COVID-19 in the country, it unfortunately comes as no surprise to experts following the situation closely.
“I think that this was very, very expected,” said Dr. Michael Gardam, an infectious disease specialist and chief of staff at Humber River Hospital in Toronto.
“I think it just reinforces the fact that this virus is now very much on Canadian soil.”
Gardom, a veteran of SARS and H1N1 who is watching this outbreak closely, says while that panic is ill-advised, Canadians do need to be aware of what’s happening with COVID-19 worldwide.
“I think Canada has been living in a bubble the last two months thinking that this is something that’s happening elsewhere,” he said.
“We’re just at the beginning of now, this starting to really happen here. This isn’t the last death we’re going to hear about from this virus.”
Provincial health officer Dr. Bonnie Henry says people should remain home if they’re sick in order to protect those more vulnerable in the community, “even if you have the sniffles.” (Darryl Dyck/The Canadian Press)
Canada’s first COVID-19 death does not mean, however, that the illness is significantly widespread across the country, said Dr. Jerome Leis, medical director of infection prevention and control at Toronto’s Sunnybrook Hospital, who treated Canada’s first case of the illness.
“It’s not accurate to say that the virus is everywhere. Certainly, we’ve begun to see some communities spread in British Columbia. We still don’t have evidence of that here in Ontario and we’ve been looking and a number of other provinces are looking for community spread,” he said.
“But we do know that when community spread begins to increase, one of the consequences is that it can affect the most vulnerable people in our society and from that standpoint it was a matter of time until we would have the first deaths reported from this virus in Canada.”
Leis said when outbreaks of any respiratory viruses hit long-term care homes, there can be a disproportionately high risk of death, which is why health officials advocate so strongly for flu vaccines to spread immunity to the whole population.
“Unfortunately, this is a very vulnerable population,” he said. “The problem in this situation is we have no vaccine against COVID-19 — our whole population is susceptible. And so as it spreads in the community, it is certainly the most vulnerable patients that are at risk.”
Bogoch said it’s time to start considering implementing policies and behaviours that will mitigate the spread of the infection in the community. Visiting policies at long-term care homes should be examined closely, he added, especially given the outbreak in Washington state.
“Stay home if you’re sick. Even if you have the sniffles, a bit of a cold, your children are feeling a little bit under the weather — keep them home from school. Keep yourself home from work if you’re not feeling well,” B.C. chief medical officer of health Bonnie Henry said Monday.
“Even if you have no relationship to COVID-19, we want you to do that. We want you to clean your hands regularly, we want you to cough in your sleeve. Those are important issues all of us need to take right now.”
Henry referenced the concept of “social distancing” as a way of mitigating the effects on the most vulnerable populations in society. Social distancing will likely be rolled out in other provinces more formally if increased community transmission is seen outside of B.C.
A patient is shielded as they are put into an ambulance outside the Life Care Center of Kirkland, Wash. Several residents have died from COVID-19 and others have tested positive for the novel coronavirus. (Karen Ducey/Getty Images)
“If people do limit their interaction and exposure with others, it does somewhat reduce the risk not just at an individual level, but at a population level as well,” Bogoch said, adding they were effective in limiting transmission in China and South Korea.
“So I think it’s time. I’m not sure to what extent these should be employed, but they certainly should be considered now.”
The next few months will be especially critical for preventing the spread of COVID-19 in long-term care facilities to protect the elderly, said Dr. Allison McGeer, an infectious diseases specialist at Toronto’s Mount Sinai Hospital who worked on the front lines of the SARS epidemic in 2003.
“So for any of us visiting those facilities, it’s a message about the critical importance of hand hygiene, of not visiting when you’re sick no matter what the circumstances are, of following the guidance from public health or from the nursing home,” she said.
“Because it’s really clear that as we have to deal with this outbreak, that long-term care facility residents are going to be one of the most vulnerable populations and it’s really important that we work together to try to protect them.
“They are a very different group of people then most of us in Canada and they badly need our protection during this outbreak.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
