A new study offers a closer look at possible factors that may lead to some hospitalized COVID-19 patients being readmitted within a month of discharge.
At roughly nine per cent, researchers say the readmission rate is similar to that seen for other ailments, but socio-economic factors and sex seem to play a bigger role in predicting which patients are most likely to suffer a downturn when sent home.
Research published Monday in the Canadian Medical Association Journal looked at 46,412 adults hospitalized for COVID-19 in Alberta and Ontario during the first part of the pandemic. About 18 per cent — 8,496 patients — died in hospital between January 2020 and October 2021, which was higher than the norm for other respiratory tract infections.
Among those sent home, about nine per cent returned to hospital within 30 days of leaving, while two per cent died.
The combined rate of readmission or death was similar in each province, at 9.9 per cent or 783 patients in Alberta, and 10.6 per cent or 2,390 patients in Ontario.
For those wondering if the patients were discharged too soon, the report found most spent less than a month in hospital and patients who stayed longer were actually readmitted at a slightly higher rate.
“We initially wondered, ‘Were people being sent home too early?’ … and there was no association between length of stay in hospital and readmission rates, which is reassuring,” co-author Dr. Finlay McAlister, a professor of general internal medicine at the University of Alberta, said from Edmonton.
“So it looked like clinicians were identifying the right patients to send home.”
The report found readmitted patients tended to be male, older, and have multiple comorbidities and previous hospital visits and admissions. They were also more likely to be discharged with home care or to a long-term care facility.
McAlister also found socio-economic status was a factor, noting that hospitals traditionally use a scoring system called LACE to predict outcomes by looking at length of stay, age, comorbidities and past emergency room visits, but “that wasn’t as good a predictor for post-COVID patients.”
“Including things like socio-economic status, male sex and where they were actually being discharged to were also big influences. It comes back to the whole message that we’re seeing over and over with COVID: that socio-economic deprivation seems to be even more important for COVID than for other medical conditions.”
McAlister said knowing this could help transition co-ordinators and family doctors decide which patients need extra help when they leave the hospital.
On its own, LACE had only a modest ability to predict readmission or death but adding variables including the patient’s neighbourhood and sex improved accuracy by 12 per cent, adds supporting co-author Dr. Amol Verma, an internal medicine physician at St. Michael’s Hospital in Toronto.
The study did not tease out how much socio-economic status itself was a factor, but did look at postal codes associated with so-called “deprivation” indicators like lower education and income among residents.
Readmission was about the same regardless of neighbourhood, but patients from postal codes that scored high on the deprivation index were more likely to be admitted for COVID-19 to begin with, notes Verma.
Verma adds that relying on postal codes does have limitations in assessing socio-economic status since urban postal codes can have wide variation in their demographic. He also notes the study did not include patients without a postal code.
McAlister said about half of the patients returned because of breathing difficulties, which is the most common diagnosis for readmissions of any type.
He suspected many of those problems would have been difficult to prevent, suggesting “it may just be progression of the underlying disease.”
It’s clear, however, that many people who appear to survive COVID are not able to fully put the illness behind them, he added.
“Looking at readmissions is just the tip of the iceberg. There’s some data from the (World Health Organization) that maybe half to two-thirds of individuals who have had COVID severe enough to be hospitalized end up with lung problems or heart problems afterwards, if you do detailed enough testing,” he said.
“If you give patients quality of life scores and symptom questionnaires, they’re reporting much more levels of disability than we’re picking up in analyses of hospitalizations or emergency room visits.”
The research period pre-dates the Omicron surge that appeared in late 2021 but McAlister said there’s no reason to suspect much difference among today’s patients.
He said that while Omicron outcomes have been shown to be less severe than the Delta variant, they are comparable to the wild type of the novel coronavirus that started the pandemic.
“If you’re unvaccinated and you catch Omicron it’s still not a walk in the park,” he said.
This report by The Canadian Press was first published May 16, 2022.
Kingston, Ont., area health officials examining future of local vaccination efforts – Global News
More than 455,000 people in the Kingston region have been vaccinated against COVID-19.
Now health officials say they’re using the summer months, with low infection rates, to look ahead to what fall might bring, urging those who are still eligible to get vaccinated do so.
“Large, mass immunization clinics, mobile clinics, drive-thru clinics and small primary care clinics doing their own vaccine,” said Brian Larkin with KFL&A Public Health.
Infectious disease expert Dr. Gerald Evans says those who are still eligible for a third and fourth dose should take advantage and roll up their sleeves during the low-infection summer months.
“Now in 2022, although you still might get COVID, you’re probably not going to be very sick. You are less likely to transmit and ultimately that’s one of the ways we’re going to control the pandemic,” added Evans.
He expects another wave of COVID-19 to hit in late October to early November and that a booster may be made available for those younger than 60 who still aren’t eligible for a fourth dose.
“The best case scenario is a few more years of watching rises in cases, getting boosters to control things and ultimately getting out of it with this being just another coronavirus that just tends to cause a respiratory infection and worst-case scenario is a new variant where all the potential possibilities exist to have a big surge in cases and hopefully not a lot more serious illness,” said Evans.
Public Health says they’re still waiting for direction from the province on what’s to come this fall.
“We’re expecting that we would see more age groups and younger age groups be eligible for more doses or boosters but about when those ages start, we have yet to have that confirmed,” said Larkin.
The last 18 months of vaccines paving the way for the new normal could mean a yearly COVID booster alongside the annual flu shot.
© 2022 Global News, a division of Corus Entertainment Inc.
Monkeypox detected in Norfolk County | TheSpec.com – Hamilton Spectator
The monkeypox virus has found its way to Norfolk County.
The health unit announced on Friday that a Norfolk resident has tested positive and is currently isolating at home.
Contacts of the infected resident have been notified, according to a media release from the health unit.
“There is no increased risk of monkeypox to the general public stemming from this case,” acting medical officer of health Dr. Matt Strauss said in the release.
“Outside of an emergency situation, if you have symptoms of monkeypox, it is important to stay home and call your doctor to be assessed. When seeking medical care, you should wear a high-quality medical mask and cover up all lesions and open sores.”
Monkeypox is spread by direct physical contact, most often by touching a rash on an infected person’s skin but sometimes through “respiratory secretions” if in close proximity for a prolonged period, the health unit said.
“Most people infected with monkeypox will have mild symptoms and recover on their own without treatment,” said the release.
Symptoms lasting between two and four weeks can include fever, headache, swollen lymph nodes, low energy, muscle aches, skin rash or lesions, sometimes starting on the face or genitals and spreading elsewhere.
The health unit says symptoms usually start between six and 13 days of exposure to the virus.
The Halton region recorded its first confirmed case of monkeypox earlier this month.
Close contacts of monkeypox patients are eligible to receive the smallpox vaccine, which also provides protection against monkeypox.
Mass vaccination campaign against Monkeypox needed, experts say – Global News
As the World Health Organization calculates whether to declare monkeypox a global health emergency, infectious disease experts are urging health officials to be more proactive and start ramping up vaccinations and surveillance — especially in African nations where the virus is most prevalent.
The WHO convened its emergency committee Thursday to consider whether the spiralling outbreak of monkeypox should be declared a “public health emergency of international concern,” the WHO’s highest level of alert.
But the United Nations agency is facing criticism over its treatment of monkeypox — jumping into action only after the disease started to spread in rich western nations.
The viral disease that causes flu-like symptoms and skin lesions is endemic in parts of Africa, which means it is consistently present in certain regions. The continent has registered just over 1,500 suspected cases since the start of 2022, of which 70 have been fatal, according to the WHO.
By comparison, Canada has confirmed over 200 cases, the majority of which are in Quebec, and has had no deaths.
“There are more cases that occur in Africa on a yearly basis than have already been reported outside of Africa right now. And there are more deaths that have occurred in Africa from monkeypox than have occurred in the rest of the world,” said Dr. Sameer Elsayed, an infectious disease physician and professor of epidemiology and biostatistics at Western University.
That’s why he believes Africa should be getting the lion’s share of resources to deal with monkeypox — and that should include mass vaccinations, he says.
“I think Africa needs to be looked at with high, high priority,” he said.
“It needs to be a mass vaccination campaign for monkeypox with the newer vaccines for people in the African continent, especially in the high endemic areas.”
He’s not alone.
Dr. Monica Gandhi, a physician and infectious disease expert at the University of California, San Francisco, says she also believes more people living in regions where monkeypox is more prevalent should be vaccinated.
“That will actually stop it in endemic regions in this non-endemic outbreak.”
That the WHO is only now taking monkeypox seriously is “profoundly problematic,” Gandhi says, given that the disease has been spreading and killing people in Central and West Africa for years.
Monkeypox has about half of Canadians worried, but most confident with health response: poll
“It’s been circulating since 1958. There are increasing outbreaks — a severe one in Nigeria, for example in 2017 — and it’s only really essentially when this has affected high-income countries that the WHO is jumping on it.”
Experts who have worked on monkeypox in places like the Democratic Republic of Congo have long taken note of rising cases while population immunity to pox viruses has been decreasing, due to lack of vaccination. This is why the world shouldn’t be surprised at the current outbreaks, said Anne Rimoin, an epidemiology professor at UCLA in California, who has studied monkeypox for two decades.
The COVID-19 pandemic has demonstrated how quickly a deadly virus can spread across the globe when the right conditions are present, so health officials ought to learn from this and start being more proactive, she said.
“When it comes to infectious diseases, in particular those viruses that have the potential for global spread, it’s much easier to stay out of trouble than it is to have to get out of trouble.”
In addition to providing vaccines, health officials should also be ramping up resources to study this disease and do more surveillance to get a better understanding of monkeypox and learn why it is spreading in new and unusual ways, Rimoin said.
“We’ve given this virus a lot of runway to be able to spread. We have not been looking for it as vigilantly as we should be,” she said.
“I think we have to learn the lessons that we’ve learned with COVID-19 and that it is much better to invest ahead of time to get in front of these viruses, to do the kind of surveillance it’s necessary to be regularly updating our knowledge about viruses.”
Good disease surveillance is just as important in poorer countries as it is in “high-resource settings,” she added.
Like many countries around the world, Canada and the United States stopped vaccinating the general population against smallpox by around 1972, which means many on this continent are highly susceptible to pox viruses like monkeypox.
Given that scientists expect to see more emerging infectious diseases due to factors such as climate change, deforestation and globalization, the world should start getting better prepared for new outbreaks, Elsayed said.
This is why, in addition to calling for vaccinations and more resources to fight monkeypox in Africa, Elsayed believes governments in developed nations should also consider more options to protect citizens from pox viruses, including possibly re-introducing mass smallpox vaccinations.
“I believe that these vaccines should come on board again for the general population … but not (just) for monkeypox, but also to protect the world against perhaps a smallpox pandemic that can happen in the future, or even another virus that’s closely related to monkeypox but hasn’t reached humans,” Elsayed said.
He stressed this should only be considered after addressing the more pressing needs in Africa first.
WHO looks into reports of traces of monkeypox found in semen
Rimoin noted that when the world stopped vaccinating against smallpox, it opened a “gap of immunity” for populations to once again be vulnerable to it. And with the emergence of a number of new pox viruses in different parts of the globe, including mousepox, cowpox and camelpox, the world is not immune to new outbreaks, she said.
“We now have to really think about, How important is it for us to be able to keep pox viruses out of the population?” she said. “What are the stakes of allowing this virus to spread? And then acting accordingly.”
-With files from Global News reporter Reggie Checcini and Reuters.
© 2022 Global News, a division of Corus Entertainment Inc.
Google warns of 'hermit spyware' infecting Android and iOS devices – Mashable
Indigenous conservation Canada’s way of the future, Guilbeault says
Abortion ruling pushes businesses to confront divisive politics – PBS NewsHour
Silver investment demand jumped 12% in 2019
Europe kicks off vaccination programs | All media content | DW | 27.12.2020 – Deutsche Welle
Global Media Markets, 2015-2020, 2020-2025F, 2030F – TV and Radio Broadcasting, Film and Music, Information Services, Web Content, Search Portals And Social Media, Print Media, & Cable – GlobeNewswire
Economy9 hours ago
Putin Is Pushing Germany's Economy to the Breaking Point – BNN
Economy22 hours ago
Northern Shootout's return provides a big boost to Orillia's economy – CTV News Barrie
Tech24 hours ago
Vergecast: M2 MacBook Pro review, Solana's crypto phone, and this week's tech news – The Verge
Tech23 hours ago
iQOO Neo 6 VS Poco F4: We compare the specs, both will SURPRISE – HT Tech
Science17 hours ago
June 25: The Quirks & Quarks listener question show – CBC.ca
Politics3 hours ago
Abortion ruling pushes businesses to confront divisive politics – PBS NewsHour
Politics15 hours ago
Opinion: The vacuum at the centre of Canadian politics: an incompetent, unethical government faces an intemperate, unhinged opposition – The Globe and Mail
Sports21 hours ago
Canada's Bianca Andreescu reaches Bad Homburg final after Simona Halep withdraws – CBC Sports