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Canada’s hospitals deploy artificial lungs, scramble for staff as COVID-19 hits younger patients

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artificial lungs

By Anna Mehler Paperny and Allison Martell

TORONTO (Reuters) -Younger Canadians are bearing the brunt of the nation’s latest COVID-19 surge, creating growing demand for artificial lungs and a struggle to maintain staffing in critical care units as hospitals make last-ditch efforts to save patients.

Treatment with artificial lungs, known as extracorporeal membrane oxygenation, or ECMO, is much more likely to be deployed for patients under age 65, explained Marcelo Cypel, surgical director for the extracorporeal life support program at Toronto’s University Health Network (UHN).

Last week, there were a record 19 ECMO patients at UHN, 17 of them with severe COVID-19. When the sickest COVID-19 patients’ lungs fill with fluid and mechanical ventilators can no longer do the job, artificial lungs can save lives.

By Monday, doctors had weaned some off the machines and were down to 14 ECMO patients, 12 of them with COVID-19.

The need for these artificial lungs reflects a change in Canada‘s epidemic, which has taken a turn for the worse, with new cases surging and outbreaks hitting workplaces and schools.

With many seniors vaccinated and new, far more contagious coronavirus variants circulating widely, younger patients are increasingly arriving in intensive care.

“It’s very different now than the first wave, when we saw older people with comorbidities,” Cypel said. “We’re seeing more … young essential workers.”

The ECMO situation is under control for now, but things can change very quickly, Cypel cautioned.

When hospital systems in other countries were overwhelmed, they had to stop using ECMO because it requires a lot of staff – seven or more people to start the treatment.

About 55% of people who receive the therapy survive, Cypel said. However, they are often left with “severe physical limitations” from their extended hospital stay, he added.

Many of Canada‘s provinces are in the grip of a worsening third COVID-19 wave, as they struggle to hasten vaccine rollouts. The country reported more than 6,200 new cases on Monday, with the percentage of people testing positive for the virus up to 3.8%.

‘SEEING BURNOUT’

In British Columbia, where hospitals are bracing for a surge in demand for intensive care unit (ICU) beds caused by the highly concerning P.1 virus variant first discovered in, and now ravaging, Brazil, critical care doctor Del Dorscheid from Vancouver’s St. Paul’s Hospital is more worried about staffing than artificial lung use.

On a given shift, he said, a third of the staff are working overtime.

“They’re working so hard to find bodies to fill those empty spots,” he said. “I wouldn’t say we’re seeing more mistakes. Not yet, anyways. But we are certainly seeing burnout.”

For ICUs, there is no end in sight. As of Tuesday, there were 497 COVID-19 patients in Ontario’s ICUs, a new high. Last week, experts advising the provincial government said that could rise to 800 by the end of April even with a new stay-at-home order – or approach 1,000 without it. The province stopped short of a new stay-at-home order.

New restrictions implemented in Ontario last week change little for hardest-hit areas. In Toronto, patios for outdoor bars and restaurants closed, and a plan to reopen salons was shelved. On Monday, hard-hit Peel, west of Toronto, moved on its own to suspend in-person classes at schools for two weeks.

Canada‘s vaccination rate has picked up after a slow start, with 15% of the population getting at least one shot. But data from the Institute for Clinical Evaluative Sciences shows that the Ontario communities at highest risk of COVID-19 transmission also have the lowest rates of vaccination.

These communities tend to have a high proportion of residents unable to work from home, many of them non-white immigrants holding down jobs at high risk of virus exposure.

Some lack cars to drive to vaccination sites or paid time off to get the vaccine, said Brampton doctor Amanpreet Brar. Some of the hardest-hit neighborhoods lack pharmacies that dispense COVID-19 vaccines.

“It really reflects systemic inequities we see in our society,” said Brar. “They’re considered non-essential, while their work is considered essential.”

(Editing by Denny Thomas and Bill Berkrot)

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Calgary firm advances new trial, manufacturing of mRNA vaccine for COVID-19 – pentictonherald.ca

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OTTAWA – Calgary-based Providence Therapeutics says it has signed two contracts to have its developmental mRNA vaccine for COVID-19 manufactured in Canada.

The company says it has signed a $90-million, five-year contract with Emergent Biosolutions to make part of the drug substance, and also to fill and finish the vaccine, at its Winnipeg manufacturing plant.

Another $15-million contract was signed with Calgary’s Northern RNA firm to make some of the raw materials needed to produce the messenger RNA in the vaccine.

Providence this week reported that a Phase 1 trial, involving 60 adults between 18 and 64, showed its mRNA vaccine is producing immunity levels comparable to those produced by authorized mRNA vaccines from Pfizer-BioNTech and Moderna.

A Phase 2 clinical trial in 525 people is now about to begin to further test the safety and effectiveness of the vaccine.

Canada has yet to authorize a made-in-Canada vaccine for COVID-19 and has relied mostly on importing mRNA vaccines from Pfizer and Moderna.

As of Tuesday, 26 million Canadians have been fully vaccinated against COVID-19, and another 2.4 million people have received their first dose.

Canada’s lacklustre manufacturing capacity for vaccines was a major issue heading into the COVID-19 vaccination procurement process and the federal government is working to expand the industry.

The vaccines from Moderna and Pfizer are the first mRNA products authorized for widespread use and have been critical to helping slow the COVID-19 pandemic in Canada and elsewhere.

The technology is being researched for use on a number of other conditions including cancers and influenza.

Moderna recently signed an agreement to build a manufacturing plant for its mRNA vaccine somewhere in Canada, but the location has yet to be chosen. Earlier this week Moderna announced it has also signed a contract with National Resilience for the latter to start producing the mRNA used in Moderna’s vaccine.

The federal government last spring invested almost $200 million to help Resilience expand its manufacturing facility in Mississauga, Ont., so it can make more vaccines, including mRNA vaccines.

Emergent BioSolutions is based in Maryland and has multiple facilities in the U.S., Canada and Europe. The company was heavily criticized earlier this year when a mistake in manufacturing at one site in Baltimore, Md., led to the destruction of at least 60 million doses of Johnson & Johnson’s COVID-19 vaccine.

This report by The Canadian Press was first published Sept. 14, 2021.

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COVID-19 cases at Central Okanagan seniors facilities plateau as Interior Health numbers decline – Global News

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The spread of COVID-19 at Central Okanagan care homes seems to have slowed significantly in the last week.

Since infections started to spike in the Kelowna area in August, there have been 142 cases related to COVID-19 outbreaks in seven seniors facilities and 20 related deaths. This is up from 139 cases and 19 deaths just a week ago, on Sept. 9.


Click to play video: 'Interior Health loosens COVID-19 restrictions for vaccinated people'



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Interior Health loosens COVID-19 restrictions for vaccinated people


Interior Health loosens COVID-19 restrictions for vaccinated people

Of the cases, 98 have been among residents and another 44 were among staff members. Now six care homes remain on outbreak status from the original seven.

Read more:
NACI backs 3rd dose of COVID-19 vaccine for immunocompromised

Most affected by the outbreaks has been David Lloyd Jones long-term care in Kelowna, which has reported 55 cases among 41 residents and 14 staff. There were seven deaths connected to the outbreak.

Cottonwoods long term care was similarly hard hit, with 30 cases among 20 residents and 10 staff, with six deaths connected to the outbreak.


Click to play video: 'B.C. health minister provides details on unvaccinated ICU patients with COVID-19'



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B.C. health minister provides details on unvaccinated ICU patients with COVID-19


B.C. health minister provides details on unvaccinated ICU patients with COVID-19

Brookhaven Care Centre in West Kelowna has 17 cases, with 10 residents and seven staff, and three deaths connected to the outbreak.

Village at Mill Creek assisted living/independent living in Kelowna has 12 cases among seven residents and five staff with two deaths connected to the outbreak.

Read more:
Interior Health loosens restrictions on gatherings with implementation of Vaccine Card

Spring Valley Care Centre long-term care in Kelowna had 15 cases among 11 residents and four staff, with two deaths connected to the outbreak.

Sun Pointe Village assisted living/independent living in Kelowna has eight resident cases, with one death connected to the outbreak.


Click to play video: 'According to  Interior Health, there’s been an uptake in people getting their first dose of vaccine since vaccine card announcement was made'



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According to Interior Health, there’s been an uptake in people getting their first dose of vaccine since vaccine card announcement was made


According to Interior Health, there’s been an uptake in people getting their first dose of vaccine since vaccine card announcement was made

The current stagnation of cases within the Central Okanagan seems to be reflected in the larger population. While current Okanagan-specific COVID-19 numbers aren’t readily available, the provincial ministry of health’s daily case numbers for health regions and Interior Health, which covers much of the Southern Interior has, shown some progress.

Read more:
‘Deflated’ health-care workers thankful for free meal in Kelowna

Of the 677 new cases across the province reported on Tuesday, 153 were within Interior Health. There are still 1,583 active cases in the region.
That’s the lowest new case count in weeks.


Click to play video: 'Interior Health hosts vaccine clinics at schools'



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Interior Health hosts vaccine clinics at schools


Interior Health hosts vaccine clinics at schools – Sep 4, 2021

And, while Interior Health may be showing some progress, things aren’t necessarily as rosy everywhere else.

Read more:
COVID-19 case numbers inching down in the Okanagan, still high

Fraser Health is now leading the province for new cases, reporting 237 new cases in the area. There were 102 in the Vancouver Coastal health region, 99 in the Northern health region, and 86 on Vancouver Island.

Ten more people are in hospital with COVID-19, bringing the total to 288, an increase of 10 from Monday. Nearly half of those patients are in intensive care.

B.C.’s COVID-19 death toll is now 1,866.

© 2021 Global News, a division of Corus Entertainment Inc.

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Manitoba reports 49 new COVID-19 cases, mostly among people not fully vaccinated – CBC.ca

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Manitoba reported 49 new COVID-19 cases on Wednesday, more than 80 per cent of them among people not fully vaccinated against the illness.

Of those infections, 31 are among people not vaccinated at all while another nine are among people who are only partly immunized, the province’s online vaccine dashboard says.

Two more deaths linked to the illness were also posted on Wednesday. While details have not been released, the number of deaths connected to more contagious coronavirus variants also rose by two, the province’s online variant dashboard says.

That dashboard also shows 104 newly identified cases of more infectious coronavirus variants: 100 more in the unspecified category, three more linked to the alpha variant and one more connected to the delta strain.

The deaths bring Manitoba’s total to 1,203. More details, including the ages, sexes and health regions of those who died, are expected Thursday in the province’s next COVID-19 news release.

Most of the new cases reported Wednesday are split between the Winnipeg health region, which has 20, and the much more sparsely populated Southern Health region, which has 17, the province’s online coronavirus dashboard says.

The rest are spread among the Interlake-Eastern and Northern health regions, with five new cases each, and the Prairie Mountain Health region, with two new infections.

Manitoba’s five-day test positivity rate dropped to 2.9 per cent, the dashboard says, down from 3.2. There were 2,364 more COVID-19 tests done in the province on Tuesday.

No fully vaccinated active cases in ICU

There are now 69 people in Manitoba hospitals after getting COVID-19, including 15 in intensive care, the dashboard says. Both numbers are up one since Tuesday.

Among those in hospital, 29 are still considered to have active cases of the illness — 86 per cent of whom either only have protection from one dose or aren’t immunized at all, the vaccine dashboard says.

In intensive care units, seven patients are considered to have active COVID-19 cases. None of them have been fully vaccinated, the dashboard says.

The number of people in Manitoba ICUs remains well above the province’s pre-pandemic capacity of 72. As of midnight, there was a total of 91 people in intensive care, including those with COVID-19 and those there for other reasons, a Shared Health spokesperson said.

Most of Manitoba’s 584 active COVID-19 cases — 70 per cent — are also among people not fully vaccinated against the illness.

The proportion of vaccinated eligible Manitobans rose slightly on Wednesday. For those with at least one shot, the number now sits at 83.9 per cent, while for those fully immunized, it’s now 78.9 per cent.

In total, 57,679 people have been deemed recovered after testing positive for COVID-19.

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