Parbs Bains had a “sinking feeling” when she heard a single staff member tested positive for COVID-19 at her grandmother’s care home.
On Nov. 20, Little Mountain Place sent an email to families that said an employee had contracted the virus and was in isolation. A Vancouver Coastal Health medical health officer determined there was “minimal exposure risk” and was not declaring an outbreak, it said.
Instead, the health authority placed the home on “enhanced surveillance,” including heightened monitoring of residents, hypervigilance in screening visitors and stronger infection control practices. Visitors were still welcome and group activities were continuing, the email said.
Bains felt certain that this was the beginning of the end for her 89-year-old grandmother.
“I was like, ‘This is it.’ I was bawling because I just knew this was going to be it,” Bains recalled.
The facility declared an outbreak two days later.
It has become the deadliest care home outbreak in British Columbia. Ninety-nine out of 114 residents have been infected and 41 of those have died, including Bains’s grandmother. Seventy staff members also tested positive, but most have recovered.
Two families are questioning whether some deaths could have been avoided if the home had taken stronger measures immediately after the first case was identified. They also say that a hard-working but understaffed nursing team struggled to keep residents isolated and care for those who were sick as the virus spread through the facility.
During a Zoom call with her grandmother after she contracted COVID-19, Bains said another female resident entered the room and began hugging and kissing the elderly woman on the forehead. After several minutes, a nurse rushed in and ushered the other resident out, she recalled.
Bains said that while she didn’t know if the other woman had the virus, it alarmed her that residents were able to wander between rooms without staff immediately noticing.
On other occasions, Bains said her grandmother’s oxygen tubes were out of her nose and she would desperately yell for help over the Zoom call. Nurses told her that her grandmother was actually one of the fortunate ones because her room was close to their station, Bains said.
Bains said she is “so angry” at the way the outbreak was handled.
“Something had to have gone wrong at Little Mountain Place … for this to be so lethal,” she said.
Little Mountain Place referred questions to Vancouver Coastal Health, where Chief Medical Health Officer Dr. Patricia Daly said the provincewide standard is that outbreaks are not automatically declared when one staff member tests positive.
The health authority determines whether the employee was in the care home during their infectious period and whether they potentially exposed other staff or residents, for example by not properly using personal protective equipment, she said.
If there is no evidence of exposures, the authority places the home on “enhanced surveillance” and monitors for other cases, she said. Some testing may be done, and group activities continue but must always follow a COVID-19 safety plan, she said.
Declaring an outbreak every time a single staff member tests positive would be too hard on residents who suffer when they are isolated and their visitors are restricted, Daly said.
“We’re trying to find that right balance.”
Vancouver Coastal Health said there was no mass testing of all residents and staff after the first case was identified. It was only on Nov. 22, after a resident tested positive and the outbreak was declared, that full-facility testing was done, it said.
Daly said broad testing is not always necessary because it depends on the risk and timing of potential exposures.
At Little Mountain Place, it became clear transmission occurred before the initial case was identified, she said.
She said during an outbreak, residents are supposed to stay in their rooms, but it is very challenging for patients with dementia to follow those rules. Staff are advised to monitor residents who wander but not to lock anyone in or restrain them,
“Keeping residents with cognitive impairment in their rooms, that has been a common challenge across all facilities in all of our outbreaks,” Daly said.
Bains and another relative, Bernadette Cheung, have demanded an investigation of the care home’s response to the virus.
Daly said she received a letter from a family member last week and has ordered Vancouver Coastal Health’s licensing team to conduct a review once the outbreak is over.
The team will examine whether the home is following regulations under the Community Care and Assisted Living Act and, if not, will require it to develop a plan to address those gaps. In very rare cases, reviews by the team have led to a change in management, Daly said.
B.C. Seniors Advocate Isobel Mackenzie said she wants to see routine testing of all staff members at care homes. At Little Mountain Place, all staff and residents should have been tested immediately after the first employee tested positive, she said.
Screening for symptoms is inadequate because people can be asymptomatic and contagious, she noted.
“The fact that more people were infected two days later, if you had tested everybody before then, you’d have caught some people,” she said. “You would have been able to isolate them if they were residents or you would have been able to pull them from the roster if they were staff.”
Dr. Bonnie Henry, the provincial public health officer, said Monday the province is “looking at” regular rapid testing of staff in care homes. Ontario started doing rapid testing at long-term care facilities in November.
Cheung, whose grandmother died of COVID-19 at Little Mountain Place and has been outspoken about her concerns, said Health Minister Adrian Dix called her on Monday. She said he promised an “intense review” of the outbreak and to follow up again with her about his conversations with the care home and the health authority.
The ministry did not immediately respond to a request for comment.
Though the conversation was light on details, Cheung said she appreciated his empathy.
“That gives us hope, at least, that it is a priority for him.”
She said she has also received confirmation from Vancouver Coastal Health that her formal complaint against the care home will proceed.
Cheung has criticized the care home for not being transparent with families. She wants to know more about why the health authority determined there was “minimal risk” of exposure from the first infected staff member and declined to declare an outbreak on Nov. 20, she said.
“Essentially, we’re being kept in the dark and it raises concerns and even suspicions,” she said.
Laura Dhillon Kane, The Canadian Press
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Dinosaur Fossil From Argentina Could Belong To Largest Terrestrial Animal Known To Science – Forbes
Fossilized bone fragments found in Neuquén Province in northwest Patagonia could belong to a new species of Titanosaur, a sauropod family of dinosaurs including some of the largest terrestrial animals to ever walk on Earth.
Titanosaurian sauropods were the most diverse and abundant large-bodied terrestrial herbivores in the Southern Hemisphere landmasses during the Cretaceous, a geological period that lasted from about 145 to 66 million years ago. Their fossils have been discovered on all continents and titanosaur species comprise approximately one-third of known sauropods. Some taxa are regarded as the most massive terrestrial animals known to science, whereas others were apparently no heavier than modern cattle.
The recovered remains are not a complete skeleton, and consist mainly of pelvic bones and vertebrae, and could belong to a previously unknown species. There are some similarities to fossils belonging to Andesaurus, a type of “super-sized titanosaur” which existed during the middle of the Cretaceous Period in South America. These large sauropods grew to be 18 meters (or 60 feet) long. Based on the size of the new remains, the authors suggest that this species was far larger, easily exceeding Andesaurus in size, maybe even bigger than the largest known Titanosaurian sauropods, the Patagotitan and Argentinosaurus. Patagotitan, described in 2014, is believed to have weighed almost 60 tons, reached lengths of over 31 meters (102 feet). Argentinosaurus is one of the largest known land animals of all time, with length estimates ranging from 30 to 40 meters (100 to 130 feet) and weight estimates from 50 to 100 tons.
Body size and mass estimation of the sauropod dinosaurs is generally tricky, as many species are known only from fragmentary remains. Based on the recovered fossils, the new species likely far exceeded a mass of 40 tons, however, only with further fossil discoveries a more accurate size estimation may be possible. The research was published in the journal Cretaceous Research.
The largest animal ever to have existed on Earth remains the modern blue whale. Living in the sea and not limited by gravity as much as land-dwelling animals, it can reach a maximum length of 33.5 meters and weigh 173 tons.
Dinosaur fossils could belong to the world's largest ever creature – msnNOW
Experts have uncovered the remains of a gigantic dinosaur in Argentina, and believe it could be one of the largest creatures to have ever walked the Earth.
Paleontologists discovered the fossilized remains of a 98 million-year-old titanosaur in Neuquén Province in Argentina’s northwest Patagonia, in thick, sedimentary deposits known as the Candeleros Formation.
The 24 vertebrae of the tail and elements of the pelvic and pectoral girdle discovered are thought to belong to a titanosaur, a diverse group of sauropod dinosaurs, characterized by their large size, a long neck and tail, and four-legged stance.
In research published in the journal Cretaceous Research, experts say they believe the creature to be “one of the largest sauropods ever found” and could exceed the size of a Patagotitan, a species which lived 100 million to 95 million years ago and measured up to a staggering 37.2 meters (122 feet) long.
“It is a huge dinosaur, but we expect to find much more of the skeleton in future field trips, so we’ll have the possibility to address with confidence how really big it was,” Alejandro Otero, a paleontologist with Argentina’s Museo de La Plata, told CNN via email.
Titanosaur fossils have been found on all continents except Antarctica. But the biggest “multi-ton” varieties of the species — including those titanosaurs exceeding 40 tons — have mostly been discovered in Patagonia.
Without analyzing the dinosaur’s humerus or femur, experts say it is not yet possible to say how much the creature weighs. However, the partially recovered dinosaur “can be considered one of the largest titanosaurs,” experts said, with a probable body mass exceeding or comparable to that of a Patagotitan or Argentinosaurus.
Patagotitans may have been the world’s largest terrestrial animal of all time, and weighed up to 77 tons, while Argentinosaurus were similarly gargantuan, and measured up to 40 meters (131 feet) and weighed up to 110 tons — weighing more than 12 times more than an African elephant (up to 9 tons).
Experts believe that the specimen strongly suggests the co-existence of larger titanosaurs together with medium-sized titanosaurs and small-sized rebbachisaurids at the beginning of the Late Cretaceous period, which began 101 million years ago.
“These size differences could indeed explain the existence of such sauropod diversity in the Neuquén Basin during the Late Cretaceous in terms of niche partitioning,” they wrote.
Researchers said that, while they don’t believe the creature to belong to a new species, they have so far been unable to assign it to a known genus of dinosaur.
The research was conducted by Argentina’s The Zapala Museum, Museo de La Plata, Museo Egidio Feruglio and the universities of Río Negro and Zaragoza.
Home-based Heart Monitoring Now Available to All Canadians Through Icentia Canadian company drives at-home cardiac monitoring nationwide during pandemic – Financial Post
QUEBEC CITY, Jan. 19, 2021 (GLOBE NEWSWIRE) — Icentia Inc., a leading Canadian technology company—specialised in cardiac ambulatory monitoring—will be providing a new home-based service nationwide that will enable patients with heart rhythm disorders to have access to an ambulatory cardiac test from the safety of their homes while the pandemic surges on.
Icentia enables at-home tests through its CardioSTAT® device, a Canadian designed and manufactured, proven alternative to traditional Holter monitor tests. Since its introduction in 2015, the CardioSTAT test has become the tool of choice for hundreds of physicians across Canada and the United Kingdom for the detection of heart rhythm disorders. This inventive and life-saving solution is now being implemented nationally for at-home tests in much needed times.
As the pandemic rages on, wait times in the Canadian healthcare system are becoming a serious issue. Backlogs for all procedures, including ECG monitoring, continue to grow. Social distancing and contamination risk requirements have increased the burden on hospitals and clinics, bolstering the demand for home-based tests. “The pandemic is forcing our healthcare system to evolve and adapt. This smart and accurate cardiac monitoring technology is what Canadians need right now to stay safe and keep healthy,” explains Dr. Marko Mrkobrada, Internist, London Health Sciences Centre, London, ON.
This new home-based solution, where no visit to health care facility for hook up or device return is required, promises to lighten the load on medical staff while also increasing safety for all. “We are glad to relieve some of the pressure on our healthcare system and to contribute to more safety through our home-based, patient-initiated tests. CardioSTAT test, which has proven to be easy to use, reliable and safe over the past years, makes even more sense in today’s context,” says Icentia CEO Pierre Paquet.
The CardioSTAT test relies on a unique single-use electrocardiography monitoring device designed to be comfortably worn on the upper chest for up to 14 days. It has the potential to reduce lead times to diagnosis, while providing the patient with a greatly improved experience. Quick and easy to install, it avoids the inconvenience and discomfort caused by multiple skin adhesive electrodes wired to Holter monitors. The result is a highly efficient, yet comfortable and very discrete, wire-free cardiac monitor that does not restrict patients from showering or doing physical activity. Upon complete analysis of the recording by Icentia, results are reviewed by a certified cardiologist before being reported to the patient’s prescribing doctor. For more information, visit cardiostat.com.
Based in Canada, Icentia is a combined medical device and service company. Icentia pioneers innovative solutions for healthcare institutions in the field of medical testing. Icentia aims to help healthcare institutions in becoming more efficient while providing patients with the ease, comfort, peace of mind and safety of reliable at-home medical monitoring through technological advances. For more information, visit icentia.com.
Icentia Inc. 1 800 431 9148 firstname.lastname@example.org
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