OTTAWA — COVID-19 is already causing a crisis as it spreads through nursing homes, but an Ontario researcher warns that the much larger population of elderly patients in home care also faces huge risk from the virus and could overwhelm hospitals if they aren’t protected.
John Hirdes, a University of Waterloo professor who specializes in geriatric health-care, said authorities are “quite appropriately” focused right now on quelling the outbreaks in nursing homes.
But he said home-care patients — which he estimates at about 560,000 nationally, compared to 200,000 nursing home patients — must also be made a priority. Though they are obviously more spread out than nursing home patients, an outbreak in a community could quickly prove devastating to them.
“Many people in home care are only there because they’ve got a family member supporting them,” Hirdes said. “Otherwise they would be in a nursing home because they have comparable health conditions, but the family are what’s keeping them in place.”
He said data on how home-care patients have been affected by COVID-19 likely won’t be clear until months after the fact, but he suspects it’s already strongly present in Canada’s numbers. Federal data shows 94 per cent of COVID-19 deaths in Canada so far are from people aged 60 or older, and 62 per cent are from people aged 80 or older. Half of the deaths are connected to nursing homes.
“I would expect a good number of deaths that have occurred have been among people that are probably home-care clients, because they’re a very similar population (to nursing homes),” Hirdes said.
On Friday, Hirdes and his research team released a “COVID-19 Vulnerability Screener” for Canada that will allow partner organizations (who already use other screening tools his team has developed) to assess patients for being high-risk to the virus.
“It could be used by primary care physicians, by geriatric services, by retirement homes to do some basic screening for vulnerable populations, and that can be fed back to physicians or nurse practitioners to help identify the cases most at-risk and manage them in the community,” he said.
Hirdes said eventually the tool will be available as a web-based application that can be used by anyone, but for now he wanted to get it out the door quickly.
We’re just trying to catch up to the COVID-19 pandemic like a lot of people are
“We got this together in about a three-week period,” he said, adding that his research team (10 PhD students and four staff) has shifted to entirely focus on the virus. “We’re just trying to catch up to the COVID-19 pandemic like a lot of people are.”
Using COVID-19 patient data published by the World Health Organization and combining it with his own data, Hirdes said about 40 per cent of home-care patients and 60 per cent of nursing home patients in Canada are in the top risk category for COVID-19 mortality due to age and underlying conditions such as renal failure, heart failure and liver disease.
“If the home-care folks alone got sick, if they were exposed on enough scale, they would by themselves overwhelm the hospital system,” Hirdes said. “So we’ve really got to protect those people.”
Prime Minister Justin Trudeau said Canada’s death rate has been rising much faster than federal modelling had predicted primarily because of outbreaks in nursing homes, and it was scheduled to be a main topic of discussion in a call with premiers on Thursday evening.
“One of the things we’ve seen over the past number of weeks is a far more severe impact on seniors’ residences and long-term care centres than we had certainly hoped for, or more than we feared,” Trudeau said. “Therefore we need to take more measures to protect our seniors.”
Theresa Tam, Canada’s chief medical officer of health, said governments need to “double down” to stamp out outbreaks in high-risk settings. “If the measure of a society is in how it cares for its most vulnerable, this pandemic has revealed the chink in our armour,” she said.
The situation is most dire in Ontario and Quebec, as more than 100 nursing homes in each province have seen COVID-19 infections, and multiple homes in each province have seen more than 20 deaths.
Quebec has been facing a staffing shortage due to more than 1,200 nursing home staff contracting the virus, and the government has been redeploying staff from hospitals and recruiting physicians to help. It has also asked the federal government for military assistance. Ontario announced an action plan on Wednesday that promised increased testing and the deployment of medical “SWAT teams” made up of hospital staff and other health-care workers.
Hirdes said this is good, but warned against taking away resources for home-care patients, especially at a time when they’re already likely under-supported.
“Three quarters of the care home-care clients get comes from family members,” he said. “Now with social distancing, what’s happening is that we’re down to one family member, probably, providing the care and there’s fewer home-care staff available to provide support.”
He urged governments to look elsewhere, such as staff who provide post-surgical care and staff at complex continuing care hospitals, if governments are redeploying people with experience in geriatric care to nursing homes.
“I would be quite concerned if what we did was to take away personal support workers from these at-risk home-care clients and sent those personal support workers into the nursing homes, and leave the home-care clients behind,” he said.
New Brunswick‘s Liberal and Green parties are set to make announcements about health care on the campaign trail today as the provincial election race enters its second half.
Liberal leader Susan Holt is scheduled to hold her announcement this morning in Saint John, N.B., followed by lunch at the city’s market.
A spokesperson with the Progressive Conservative party shared few details about the event scheduled for leader Blaine Higgs in Fredericton this morning.
Green Party Leader David Coon will hold a news conference this morning about “local health-care decision-making” alongside deputy leader Megan Mitton in her Sackville, N.B. riding.
On Saturday, Coon said he was proud to put forward a gender-balanced slate among the party’s 46 candidates.
While the Liberals and Progressive Conservatives are running with full slates, the Greens are three candidates short and will not have full representation when the province’s residents go to the polls on Oct. 21.
This report by The Canadian Press was first published Oct. 7, 2024.
EDMONTON – The Health Quality Council of Alberta is investigating how some medical referrals weren’t properly processed, potentially affecting 14,000 patients over the last five years across the province.
The referrals were made to specialists outside of Alberta Health Services, such as physiotherapists and dietitians.
The health authority’s CEO, Athana Mentzelopoulos, says it does an average 100,000 referrals per year, but in some cases it can’t confirm if patients received referral services.
She says the problem was flagged in late September, and a preliminary estimate suggests 31 patients may have experienced a potential negative outcome due to the delays.
The provincial government requested the investigation, and the quality council is to find out how the snag occurred and how it can be prevented in the future.
The health authority says it has begun notifying patients who may have been affected by the disruption, and the cases could date back to 2019.
This report by The Canadian Press was first published Oct. 4, 2024.
WASHINGTON (AP) — If you have stained or chipped teeth, you might be considering veneers, customized teeth coverings that can restore a photogenic smile without more extensive dental work.
But dentists warn that these pricey cosmetic enhancements are at the center of a worrisome online trend: unlicensed practitioners without proper training or supervision offering low-cost veneers.
These self-described “veneer techs” often promote themselves on Instagram and TikTok, promising a full set of veneers for less than half of what dentists typically charge. Some also market their own training courses and certifications for people looking to get into the business.
It’s misleading, health professionals warn — and illegal. All states require dental work, including veneers, to be performed under the supervision of a licensed dentist.
On Thursday, Georgia law enforcement officials arrested Brandon Diller, who promoted himself to 158,000 Instagram followers as “Atlanta’s top veneer specialist and trainer.” Diller practiced dentistry without a license and sold “training and certificates, which were worthless” and “provided no legitimate or legal credentials,” according to an arrest warrant from Fulton County’s District Attorney’s office.
Here’s what to know about veneers and how to avoid bogus providers and services:
What are dental veneers?
Veneers are thin, custom-made dental coverings used to hide minor imperfections or to fill in gaps between teeth. Unlike crowns or more invasive dental implants, veneers are almost always considered cosmetic dentistry and generally aren’t covered by insurance.
Dentists usually charge between $1,000 and $2,000 per tooth for veneers, with higher prices for those made from porcelain compared with lower-grade materials.
Placing veneers involves stripping some of the natural enamel from the tooth and bonding the new covering into place. Because of that process, getting veneers is considered an irreversible procedure, according to the American Dental Association. They are not permanent, and can be expected to last between 5 to 15 years before they degrade and need to be replaced.
In recent months the ADA has been stepping up warnings about the risks of veneer procedures done by unlicensed individuals.
“Quality control is lost without the involvement of a licensed dentist,” said Dr. Ada Cooper, a New York-based dentist and ADA spokesperson. “We undergo years of education and training and need to be licensed by various regulatory bodies before we can practice.”
What are the risks of getting veneers from someone who isn’t licensed?
Improper veneer procedures can cause a range of health problems, including severe pain, nerve damage and tooth loss.
Patients need to be anesthetized before the enamel is removed from their teeth.
“It could be incredibly painful if they’re not anesthetized correctly,” said Dr. Zach Truman, who runs an orthodontics practice in Las Vegas. “You can also go too deep into the tooth and penetrate what’s called the pulp chamber, which contains blood vessels and nerves.”
One of the biggest problems Truman sees with unregulated veneer work is that customers aren’t getting screened for existing dental problems, such as gum disease and cavities.
“If you put a veneer on a tooth that has an active cavity, you’re just going to seal it in there and eventually it’s going to progress to tooth loss,” Truman said.
Dental veneers aren’t the only option for improving the appearance of teeth. Over-the-counter whitening kits can help with minor stains and discoloration. And dentists can sometimes use composite materials to reshape chipped or uneven teeth. But Truman says those fillings are prone to crack and won’t last as long as veneers.
How can I spot bogus veneer providers online?
One clue: Many individuals performing unlicensed dental work promote themselves on social media as “veneer technicians.”
Instead of working out of a dental office they often perform treatments at beauty salons, hotel rooms or private homes. Some advertise multi-city tours and encourage clients to message them to book an appointment in advance.
Much of the appeal of the services is in their pricing, with some offering a full set of veneers for a flat fee of $4,000 or $5,000. That’s less than half of what patients can generally expect to pay at a dental office.
Performing dental work without an appropriate license is illegal, the ADA notes.
Dentists and hygienists are licensed by state governments, who also define the work dental assistants can perform. But in all cases, veneers and other dental procedures must be supervised by a licensed dentist.
Earlier this year, Illinois law enforcement officials arrested a woman running a business called the Veneer Experts after she posted videos of herself fitting braces, veneers and other dental products without a license. She was previously arrested in Nevada on similar allegations of practicing dentistry without a license.
What are the best ways to find legitimate dental providers?
The ADA maintains a website detailing the training and licensing requirements for dentists across the U.S. Most states also maintain websites where you can lookup and verify licensure information and find any past disciplinary actions for dentists and other health professionals.
“It’s really critical to understand that dentistry is a regulated health care profession that requires formal educations and licensure,” Cooper said.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
