Connect with us

News

Canada failed to protect elderly in first wave of COVID-19 — will the same mistakes be made again? – CBC.ca

Published

 on


This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.


As COVID-19 cases surge across Canada and outbreaks in nursing homes flare up once again, experts say vulnerable elderly populations are at extreme risk in the second wave due to a lack of government action. 

Long-term care facilities bore the brunt of the first wave of the pandemic in Canada, with more than 70 per cent of deaths from COVID-19 occurring in those aged over 80, about twice the average of rates from other developed countries.

“That is one of the most damning failures that’s taken place through the pandemic,” said Dr. Andrew Boozary, executive director of health and social policy for Toronto’s University Health Network. 

“If we were going to be judged by how we protected our most susceptible and people who are structurally vulnerable — we failed them.” 

Dozens of COVID-19 outbreaks have recently been reported in nursing homes in Ontario, B.C., Alberta and Quebec as the second wave arrives in much of Canada.

WATCH | Trudeau discusses the federal government’s role in long-term care:

Prime Minister Justin Trudeau explains what prompted his government to begin a dialogue with the provinces around national standards for long term care facilities. 1:49

In his address to the nation Wednesday night, Prime Minister Justin Trudeau said the situations experienced by “too many elders” in long-term care homes is “unacceptable.”

“That has to change and it will change,” he said. “We will be working with the provinces and territories to set new national standards on long-term care.”

But Canada’s systemic failures in long-term care are nothing new, and neither are the calls for action. 

Long-term care deficiencies a longstanding issue

A July report from the Royal Society of Canadaan association that includes some of Canada’s top scientists and scholars, described COVID-19 as “a shock wave that cracked wide all the fractures in our nursing home system.” It called on the federal government to act “immediately” on creating national standards of care.

Months later, no concrete action has yet been taken, and the second wave of COVID-19 infections is well underway in previously hard-hit provinces, such as Ontario, B.C. and Quebec.

On Friday, Trudeau conceded during a press conference that problems in long-term care facilities “existed long before COVID-19.”

Canadian Armed Forces personnel, along with hospital staff and some education workers, were among those brought in to assist long-term care homes during the first wave of the pandemic. A military report subsequently detailed abuse, neglect and cruelty inside nursing homes. (Ryan Remiorz/The Canadian Press)

“The systems that we had were inadequate all across the country,” he said. “They were not up to the task of protecting our seniors appropriately.”

But experts question why the process of fixing those systemic issues has only now just begun.

“The writing is on the wall that this had to happen yesterday,” said Boozary. 

“To not ensure that every measure, every resource is in place to protect these families and their loved ones — to me is just damning, it’s egregious.” 

The prime minister was quick to point out that long-term care is “very clearly a provincial jurisdiction,” adding that the federal government was busy helping the provinces “get the situation under control” early in the pandemic. 

“Whether it was sending in the military or the Red Cross or sending extra financial support to vulnerable health care workers, the federal government was busy acting,” he said.  

But Trudeau also said the need for national standards of long-term care only became clear to his government after “conversations with Canadians and the provinces” following the devastation caused in the first wave of the pandemic. 

Long-term care facilities unprepared for second wave

A group of major stakeholders in Ontario’s long-term care system sent a 60-page letter to Ontario Premier Doug Ford and the ministers of both Health and Long-Term Care this week calling for “immediate action” to protect the health of residents, staff and family members.

“In the absence of these measures and support from government, Ontario’s long-term care homes are not currently ready to manage a second wave of COVID-19,” said the letter, which was first reported on by the Globe and Mail.

WATCH | Canada’s prime minister on the country’s second wave of COVID-19:

Prime Minister Justin Trudeau spoke to Canadians in a rare national address from his office on Parliament Hill. 1:47

“The recent surge in cases in Ontario and other provinces is a warning that we have little time to waste,” it stated. “We need decisive action now.”

Dr. Anna Banerji, an infectious disease expert and faculty lead for Indigenous and refugee health at the University of Toronto, said she’s not convinced Canadian long-term care homes have made the necessary changes to protect elderly residents in the second wave.  

“We don’t want to see the same kind of disasters that we were seeing in the spring where we had all these people dying and the people that were living were basically living in squalor,” she said. “If that occurs again, it’s a real failure.” 

Banerji said nursing homes need to ensure they have no more than one resident per room with individual access to their own bathroom, while staff should have adequate personal protective equipment and infection control training — something they lacked in the first wave. 

Dr. Aisha Lofters, a family physician and researcher at Women’s College Hospital in Toronto, said nursing homes also need to ensure staff aren’t putting residents at unnecessary risk. 

“In the early days, we saw a lot of people who were working in multiple long-term care homes, working part-time and casual, having to move from home to home to home,” she said.

“We saw the devastating effects of that.”

National standards of long-term care need enforcement

Dr. Naheed Dosani, a physician and health-justice advocate in Toronto, welcomes the creation of national standards for long-term care, but hopes those homes in violation of them will face serious consequences. 

“One of the things that we need to be aware of is that at least in Ontario, it was shown that for-profit homes especially had a higher proportion of deaths,” he said. 

Dosani said he wants the national standards to create a baseline for where care needs to be in nursing homes across Canada, so that seniors aren’t left to suffer the consequences. 

“They already suffered in the first wave. My hope is that they don’t have to suffer and less people have to die in the second wave,” he said. 

“Why would we allow this to happen in the second wave? The federal government has the ability to set that bar where it needs to be so that standard of care is met so that doesn’t have to happen again.” 


To read the entire Second Opinion newsletter every Saturday morning, subscribe by clicking here.

Let’s block ads! (Why?)



Source link

News

Once Canada gets a vaccine, what happens next? Doctor answers our COVID-19 questions – Global News

Published

 on


Canadians have been asking this question for months now — when will we get the vaccine?

Epidemiologist Dr. Isaac Bogoch recently joined The Morning Show to speak to that question and to share all the latest COVID-19 updates.

On Tuesday, Moderna gave the world good news when it announced that its vaccine is up to 94.5 per cent effective.

However, Dr. Bogoch says the promising results also call for optimistic caution. The data still needs to be peer-reviewed and made accessible to experts.

READ MORE: Britain approves Pfizer coronavirus vaccine for use, 1st in world to do so

Moderna applied for vaccine approval in the U.S. and the U.K. However, the company has been gradually releasing data to Health Canada for its approval.

Story continues below advertisement

The infectious diseases expert believes the approval process will be fair and transparent.

READ MORE: Canada in talks with coronavirus vaccine makers ‘every day’ as approvals near: Anand

While we still don’t know when will we receive the vaccine, Bogoch says prioritized groups like people in long-term care homes and front-line workers will be among the first to get the vaccine when it is available.

He says a significant number of deaths come from long-term care homes and giving them vaccines will reduce the stress on the health-care system.

As for concerns about side-effects of the vaccine, Bogoch says people receiving the two-shot vaccine may experience fatigue, fever and a sore arm. “It is important to inform people on what they can expect,” he says.

READ MORE: How to naturally boost your immune system during cold and flu season

While Canada, and indeed the world, waits for vaccines amid continued restrictions to curb the spread of COVID-19, lockdowns have been working elsewhere — in countries like France and the U.K. — to reduce infection.

Bogoch says “we can all acknowledge that they’re terrible for mental health, they bad for physical health, they take a tremendous economic toll,” and urges Canadians to stay patient in these lockdowns because they can get the cases under control despite the challenges.

Story continues below advertisement

“Unfortunately, when health-care systems are stretched beyond capacity, that’s really the last straw,” he added.

To find out more about Canada’s process of getting vaccines, watch the full video above. 

© 2020 Global News, a division of Corus Entertainment Inc.

Let’s block ads! (Why?)



Source link

Continue Reading

News

CDC shortens quarantine recommendation for U.S., raising questions in Canada – CBC.ca

Published

 on


The recommended quarantine time for close contacts of a positive COVID-19 case is being reduced by up to a week in the United States, but while some of Canada’s health experts say a similar approach could be useful here, others aren’t so sure.

The U.S.-based Centers for Disease Control and Prevention (CDC) announced Wednesday it had shortened the recommended length of quarantine after exposure from 14 days to 10 — or seven days with a negative test result.

Health Canada was still recommending a 14-day quarantine period as of Wednesday, but Dr. Zain Chagla, an infectious disease specialist at McMaster University in Hamilton, says cutting that time in half would be beneficial.

“It would be super important for the sake of incentivizing people to actually quarantine after exposure,” he said.

“And there’s a lot of different things that could theoretically open up — getting health-care workers back to work, getting kids back to school — a lot of ways where this could ease the burden of potential exposure in society.”

The CDC had previously said the incubation period for the coronavirus that causes COVID-19 could extend to 14 days, but the organization now says most people become infectious and develop symptoms between four and five days after exposure.

Chagla says the 14-day window was likely inspired from SARS data, where the incubation period was longer.

While isolation and quarantine are sometimes used interchangeably, Chagla says there’s a difference in the terms. Isolation is for those who have tested positive, while quarantine is for people who may or may not actually have the virus, like close contacts of positive cases or those travelling into Canada. Isolation recommendations for positive cases vary, but are typically 10 days after symptom onset.

Typical course of infection

Ashleigh Tuite, an epidemiologist at the University of Toronto, says a change in quarantine guidance reflects our evolving understanding of COVID-19.

“If you’re exposed, it takes a couple days for you to become infectious, so [seven to 10 days] should be enough to tell whether you’ve got the virus,” Tuite said. “But of course, that’s assuming your experience is reflective of the typical course of infection.”

The key to the CDC’s new guidance for Tuite is having the option to end quarantine at seven days with a negative test result. She suspects that’s in place to stop people who have the virus but no symptoms from ending the quarantine period too early.

A positive test at Day 7 would mean that person should continue to isolate, Tuite said, while a negative result would mean they could safely end quarantine, knowing enough time has passed since exposure to confidently assume they won’t still get sick.

Testing capacity challenges

Dr. Don Sheppard, the founder and director of the McGill Interdisciplinary Initiative in Infection and Immunity (MI4), says the CDC’s plan makes sense scientifically, but there would be logistical issues in testing every COVID contact in Canada who wanted to end their quarantine at Day 7.

“It’s impossible to do that,” he said. “It’s either 14 days of proper isolation, or it’s seven days with a negative test, and right now our system cannot offer seven days plus testing to the public at large.”

WATCH | Could the 14-day isolation period be shorter? (At 01:18:45):

Canadians put their questions about the worsening COVID-19 pandemic to experts during an interactive two-hour special, hosted by Adrienne Arsenault and Andrew Chang. 1:39:27

Testing capacity does exist in certain situations, Sheppard said, like for health-care workers and other front-line staff that need a quicker quarantine to get back to work. He cautioned, however, that taking a test on Day 7 still means isolating for an extra day or two while awaiting results.

Quarantine also needs to be done solo in order to work, Sheppard added, warning that the CDC guidance isn’t meant as a loophole for holiday gatherings if your family isolates together for seven days before an event.

Supports for people to quarantine

He used an example of military recruits in the U.S. who were told to quarantine for 14 days before reporting to camp. A handful of positive tests (0.9 per cent) were caught upon arrival, suggesting true quarantine hadn’t been followed.

Those recruits were sent home while the rest underwent another group quarantine. When tested again two weeks later, the positivity rate had grown to 1.3 per cent.

“Why? Because there were people incubating and they turned positive. And those people infected others in their groups,” Sheppard said.

“So if you don’t do strict, single-person isolation, you don’t actually break the cycle of transmission, you just pass it around in your group.”

Tuite says that further illustrates the usefulness of a shortened quarantine period.

A mother with young children, or someone who shares a small apartment with another person will find it harder to properly quarantine for longer periods, she said, as will someone who can’t afford to take a full two weeks off work.

“It really comes down to having the means to do it,” she said. “Can you survive for two weeks if you’re not getting income? Can you isolate in a household with multiple people?

“We need to have support in place so that people can quarantine, and that doesn’t change whether it’s for a week or 14 days. But it becomes much more challenging when it’s for longer periods.”

Let’s block ads! (Why?)



Source link

Continue Reading

News

CDC shortens quarantine recommendation for U.S., raising questions in Canada – CBC.ca

Published

 on


The recommended quarantine time for close contacts of a positive COVID-19 case is being reduced by up to a week in the United States, but while some of Canada’s health experts say a similar approach could be useful here, others aren’t so sure.

The U.S.-based Centers for Disease Control and Prevention (CDC) announced Wednesday it had shortened the recommended length of quarantine after exposure from 14 days to 10 — or seven days with a negative test result.

Health Canada was still recommending a 14-day quarantine period as of Wednesday, but Dr. Zain Chagla, an infectious disease specialist at McMaster University in Hamilton, says cutting that time in half would be beneficial.

“It would be super important for the sake of incentivizing people to actually quarantine after exposure,” he said.

“And there’s a lot of different things that could theoretically open up — getting health-care workers back to work, getting kids back to school — a lot of ways where this could ease the burden of potential exposure in society.”

The CDC had previously said the incubation period for the coronavirus that causes COVID-19 could extend to 14 days, but the organization now says most people become infectious and develop symptoms between four and five days after exposure.

Chagla says the 14-day window was likely inspired from SARS data, where the incubation period was longer.

While isolation and quarantine are sometimes used interchangeably, Chagla says there’s a difference in the terms. Isolation is for those who have tested positive, while quarantine is for people who may or may not actually have the virus, like close contacts of positive cases or those travelling into Canada. Isolation recommendations for positive cases vary, but are typically 10 days after symptom onset.

Typical course of infection

Ashleigh Tuite, an epidemiologist at the University of Toronto, says a change in quarantine guidance reflects our evolving understanding of COVID-19.

“If you’re exposed, it takes a couple days for you to become infectious, so [seven to 10 days] should be enough to tell whether you’ve got the virus,” Tuite said. “But of course, that’s assuming your experience is reflective of the typical course of infection.”

The key to the CDC’s new guidance for Tuite is having the option to end quarantine at seven days with a negative test result. She suspects that’s in place to stop people who have the virus but no symptoms from ending the quarantine period too early.

A positive test at Day 7 would mean that person should continue to isolate, Tuite said, while a negative result would mean they could safely end quarantine, knowing enough time has passed since exposure to confidently assume they won’t still get sick.

Testing capacity challenges

Dr. Don Sheppard, the founder and director of the McGill Interdisciplinary Initiative in Infection and Immunity (MI4), says the CDC’s plan makes sense scientifically, but there would be logistical issues in testing every COVID contact in Canada who wanted to end their quarantine at Day 7.

“It’s impossible to do that,” he said. “It’s either 14 days of proper isolation, or it’s seven days with a negative test, and right now our system cannot offer seven days plus testing to the public at large.”

WATCH | Could the 14-day isolation period be shorter? (At 01:18:45):

Canadians put their questions about the worsening COVID-19 pandemic to experts during an interactive two-hour special, hosted by Adrienne Arsenault and Andrew Chang. 1:39:27

Testing capacity does exist in certain situations, Sheppard said, like for health-care workers and other front-line staff that need a quicker quarantine to get back to work. He cautioned, however, that taking a test on Day 7 still means isolating for an extra day or two while awaiting results.

Quarantine also needs to be done solo in order to work, Sheppard added, warning that the CDC guidance isn’t meant as a loophole for holiday gatherings if your family isolates together for seven days before an event.

Supports for people to quarantine

He used an example of military recruits in the U.S. who were told to quarantine for 14 days before reporting to camp. A handful of positive tests (0.9 per cent) were caught upon arrival, suggesting true quarantine hadn’t been followed.

Those recruits were sent home while the rest underwent another group quarantine. When tested again two weeks later, the positivity rate had grown to 1.3 per cent.

“Why? Because there were people incubating and they turned positive. And those people infected others in their groups,” Sheppard said.

“So if you don’t do strict, single-person isolation, you don’t actually break the cycle of transmission, you just pass it around in your group.”

Tuite says that further illustrates the usefulness of a shortened quarantine period.

A mother with young children, or someone who shares a small apartment with another person will find it harder to properly quarantine for longer periods, she said, as will someone who can’t afford to take a full two weeks off work.

“It really comes down to having the means to do it,” she said. “Can you survive for two weeks if you’re not getting income? Can you isolate in a household with multiple people?

“We need to have support in place so that people can quarantine, and that doesn’t change whether it’s for a week or 14 days. But it becomes much more challenging when it’s for longer periods.”

Let’s block ads! (Why?)



Source link

Continue Reading

Trending