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Canadian researchers to release recommendations for treating youth eating disorders online – CBC.ca

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Sarah White sets a timer to remind herself to eat. She sets it six times a day so that she eats three meals and three snacks.

White says she’s always been a “picky eater.” But when she started working from home, her routine was interrupted and her already difficult relationship with food became dangerous. It ultimately led to an eating disorder diagnosis during the pandemic. 

“I had all of the time in the world to eat, but I was finding I wasn’t eating nearly as much as I should have been,” White, 33, said during a physically distanced interview at her Halifax apartment. “It started to feel a lot more serious than it had in the past.”

There’s been an alarming spike in the number of people seeking help for eating disorders. The National Eating Disorder Information Centre says the volume of inquiries to its help line and online chat service has been up 100 per cent during the pandemic.

“There’s been literature coming out across the world really suggesting that the numbers are skyrocketing and we’re trying to understand why that is,” said Dr. Jennifer Couturier, principal investigator for the Canadian Consensus Panel for Eating Disorders. 

Pandemic research effort

In May, the panel, which consists of clinicians, policymakers, parents and youth, received a $50,000 federal grant to determine how best to treat eating disorders during a pandemic, particularly in children and young adults under 25. Couturier says she feels this age group hasn’t received a lot of attention when it comes to research generally. 

The operating grant from the Canadian Institute of Health Research is part of a larger government program to fund mental health research related to COVID-19. 

The panel’s recommendations, which are about to be published in the Journal of Eating Disorders, are intended to help doctors determine what kinds of treatments they should and should not be delivering virtually.

WATCH |  Sarah White explains on her eating disorder:

Sarah White, 33, was recently diagnosed with avoidant restrictive food intake disorder (ARFID). She discusses the role the COVID-19 pandemic played in her illness. 0:56

The guidelines say that while virtual care can be suitable in some circumstances when treating eating disorders, it cannot wholly replace in-person visits, and that special care must be taken to ensure patients have enough privacy to express themselves during online sessions. 

In the early days of the pandemic, Couturier’s clinic was closed. She was not able to see patients in person at all until services slowly opened up for more urgent cases. 

It’s part of what made her realize new guidelines for online treatment were necessary. 

In-person visits still necessary

Couturier, who is also the co-director of the eating disorders program at McMaster Children’s Hospital in Hamilton, Ont., says in-person visits are still necessary in some cases.

“It’s not just talking, therapy, that’s important with eating disorders,” she said. “There’s also checking weights and checking vital signs, which can’t be done virtually.”

But she says some established treatments — such as family-based treatment, which gives parents an active role, and cognitive behavioural therapy — can be conducted virtually with some adjustments.

“We often start off the session saying, ‘Are you in a private space? Are you feeling comfortable?’ Couturier said.

Dr. Jennifer Couturier, principal investigator for the Canadian Consensus Panel for Eating Disorders, says there are benefits to virtual care, but some care must still be provided in-person. (Submitted by Jennifer Couturier)

She noted it’s also important for doctors to ensure no one barges into the room on their end while they’re with patients, especially if they’re working from home.  

Couturier says virtual care can improve access because it eliminates geographic inequities, but it can also create barriers for those who don’t have access to a computer and the Internet. She says her team’s guidelines encourage physicians and hospitals to be mindful of both. 

They’ll also recommend hospitals don’t, “just broadly say, ‘OK, eating disorders can be treated totally virtually,'” as was the case in the early days of the pandemic. 

Benefits to virtual care

Shaleen Jones, executive director of Eating Disorders Nova Scotia, agrees virtual care can increase access for people, particularly patients who live in rural areas. 

Her organization, which provides support, not medical care, planned to help 250 people over the past year. It ended up helping about 1,000 people through online peer support programs. 

Eating disorders thrive in isolation and secrecy– Shaleen Jones, Eating Disorders Nova Scotia

Jones says 85 per cent of the people her organization has helped are from Nova Scotia, with the remainder joining virtual sessions via Zoom from other Canadian provinces, particularly, New Brunswick and Prince Edward Island.

“Across Canada, we’ve really seen a number of folks who are reaching out for support for an eating disorder, just really going through the roof,” she said. “Eating disorders really thrive in isolation and secrecy.” 

Liberating diagnosis

White attended a peer support group offered by Eating Disorders Nova Scotia in the early days of the pandemic. She now works for the organization, a role to which she brings valuable real-life experience.

In September, she was diagnosed with avoidant restrictive food intake disorder (ARFID), an eating disorder that involves selective eating. It’s similar to anorexia in that it involves limiting the amount of food consumed, but different in that it does not involve distress about body shape. 

She says it was the diagnosis she didn’t know she needed because it helped explain what she had been experiencing most of her life.  

“It was kind of liberating,” she said. “It makes sense. It wasn’t just me trying to be difficult or me being a picky eater. It’s a legitimate mental illness.” 

White lives in Nova Scotia, where COVID-19 rates have remained relatively low. She was able to meet her physicians and get a diagnosis in person.

Couturier says she expects virtual care to remain a part of her practice going forward.

“There are so many benefits to it that I think these guidelines will still be quite relevant and applicable even when the pandemic has passed,” Couturier said. 

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Canada finance minister: Pandemic an opportunity to bring in national childcare

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OTTAWA (Reuters) – The COVID-19 pandemic and its damaging impact on women has underlined the need for a national childcare plan, which would also help the economic recovery, Finance Minister Chrystia Freeland said on Thursday.

Since taking up her job in August, Freeland has repeatedly spoken about a “feminist agenda,” and has said childcare will be part of a stimulus package worth up to C$100 billion ($79.6 billion) over three years. She will unveil details in her April 19 budget.

“I really believe COVID-19 has created a window of political opportunity and maybe an epiphany … on the importance of early learning and childcare,” Freeland told a online convention of Canada‘s ruling Liberal Party.

The budget is set to be a springboard for an election that Liberal insiders say is likely in the second half of the year.

Canadian governments of various stripes have mused about a national childcare program for decades but never acted, thanks in part to the cost and also the need to negotiate with the 10 provinces, which deliver many social programs.

Freeland said a childcare program would help counter “an incredibly dangerous drop” in female employment since the start of the pandemic.

“It is a surefire way to drive jobs and economic growth … you have higher participation of women in the labor force,” Freeland said. “My hope … is that being able to make that economic argument as well is going be to one of the ways that we get this done.”

Freeland, who is taking part this week in meetings of the Group of Seven leading industrialized nations and the International Monetary Fund, said U.S. Vice President Kamala Harris and Treasury Secretary Janet Yellen had told her they saw early learning and child care as a driver for economic recovery.

($1=1.2560 Canadian dollars)

 

(Reporting by David Ljunggren; Editing by Leslie Adler)

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COVID-19 in Ottawa: Fast Facts for April 10, 2021

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OTTAWA —
Good morning. Here is the latest news on COVID-19 and its impact on Ottawa.

Fast Facts:

  • Ottawa’s top doctor warns schools could remain closed after the April break next week
  • Ottawa sets new record for COVID-19 cases and hospitalizations on Friday
  • The city of Ottawa admits it doesn’t have enough supply to vaccinate residents 50 and older in high-priority neighbourhoods
  • Kingston closes popular waterfront park to prevent COVID-19 spread

COVID-19 by the numbers in Ottawa (Ottawa Public Health data):

  • New COVID-19 cases: 242 new cases on Friday
  • Total COVID-19 cases: 19,030
  • COVID-19 cases per 100,000 (previous seven days): 146.0
  • Positivity rate in Ottawa: 9.2 per cent (April 2 to April 8)
  • Reproduction Number: 1.05 (seven day average)

Testing:

Who should get a test?

Ottawa Public Health says you can get a COVID-19 test at an assessment centre, care clinic, or community testing site if any of the following apply to you:

  • You are showing COVID-19 symptoms;
  • You have been exposed to a confirmed case of the virus, as informed by Ottawa Public Health or exposure notification through the COVID Alert app;
  • You are a resident or work in a setting that has a COVID-19 outbreak, as identified and informed by Ottawa Public Health;
  • You are a resident, a worker or a visitor to long-term care, retirement homes, homeless shelters or other congregate settings (for example: group homes, community supported living, disability-specific communities or congregate settings, short-term rehab, hospices and other shelters);
  • You are a person who identifies as First Nations, Inuit or Métis;
  • You are a person travelling to work in a remote First Nations, Inuit or Métis community;
  • You received a preliminary positive result through rapid testing;
  • You require testing 72 hours before a scheduled (non-urgent or emergent) surgery (as recommended by your health care provider);
  • You are a patient and/or their 1 accompanying escort tra­velling out of country for medical treatment;
  • You are an international student that has passed their 14-day quarantine period;
  • You are a farm worker;
  • You are an educator who cannot access pharmacy-testing; or
  • You are in a targeted testing group as outlined in guidance from the Chief Medical Officer of Health.

Where to get tested for COVID-19 in Ottawa:

There are several sites for COVID-19 testing in Ottawa. To book an appointment, visit https://www.ottawapublichealth.ca/en/shared-content/assessment-centres.aspx

  • The Brewer Ottawa Hospital/CHEO Assessment Centre: Open Monday to Sunday, 8:30 a.m. to 7:30 p.m.
  • The Moodie Care and Testing Centre: Open Monday to Friday from 8 a.m. to 3:30 p.m. Open Saturday and Sunday, 8 a.m. to 11:30 a.m. (testing only)
  • The Heron Care and Testing Centre: Open Monday to Friday from 8 a.m. to 4 p.m.
  • The Ray Friel Care and Testing Centre: Open Monday to Friday from 8 a.m. to 4 p.m.  Saturday and Sunday, 8 a.m. to 4 p.m. (testing only)
  • COVID-19 Assessment Centre at Howard Darwin Centennial Arena: Open daily 8:30 a.m. – 3:30 p.m.
  • Centretown Community Health Centre: Open Monday, Tuesday, Wednesday, Friday from 9 a.m. to 4 p.m.
  • Sandy Hill Community Health Centre: Open Monday to Friday from 9 a.m. to 3 pm.
  • Somerset West Community Health Centre: Open from 9 a.m. to 4 p.m. Monday to Wednesday.
  • COVID-19 Drive-Thru Assessment Centre at 300 Coventry Road: Open seven days a week from 10 a.m. to 6 p.m.

Vaccine eligibility screening tool:

To check and see if you are eligible to receive a COVID-19 vaccine in Ottawa, click here.

COVID-19 screening tool:

The COVID-19 screening tool for students heading back to in-person classes can be found here.

Symptoms:

Classic Symptoms: fever, new or worsening cough, shortness of breath

Other symptoms: sore throat, difficulty swallowing, new loss of taste or smell, nausea, vomiting, diarrhea, abdominal pain, pneumonia, new or unexplained runny nose or nasal congestion

Less common symptoms: unexplained fatigue, muscle aches, headache, delirium, chills, red/inflamed eyes, croup

Ottawa’s top doctor warns it’s “more likely than not” that all elementary and secondary schools in Ottawa will be closed for in-person learning after the April break.

“I am now thinking the probability that schools will close to in-person learning after the spring break is higher than the probability the COVID-19 situation will improve in time to keep schools open,” said Dr. Vera Etches, Ottawa’s medical officer of health.

“My heart is heavy because I know how important schools are to the health of our community.”

Etches says Ottawa Public Health will make a decision by next Wednesday on whether schools will reopen or close after the April Break.

Ottawa Public Health reported 242 new cases of COVID-19 in Ottawa on Friday, the highest one-day case count in the capital during the COVID-19 pandemic.

The surging numbers prompted the city’s medical officer of health to issue a rallying cry to Ottawa residents, saying the city has reached a key point in the COVID-19 “marathon.”

“We are tired. We’re fatigued. We want this to be over. And this is the point in our COVID marathon where we’re hitting the wall,” Dr. Vera Etches told reporters Friday. “This is our defining moment. It’s a moment where we’ve got to break through that wall.”

Ottawa’s positivity rate increased to 9.2 per cent for the period of April 2 to 8 from 8.8 per cent. Ottawa’s weekly incidence rate is now 146 cases per 100,000 people.

Residents aged 50 and over in three hot spot postal code areas in Ottawa can now book an appointment to receive a COVID-19 vaccine, but the city warns it doesn’t have enough vaccine supply to vaccinate everyone.

On Friday, Ontario opened vaccine appointments at community clinics to residents born in 1971 or earlier who live in certain “hot spots.” In Ottawa, the hot spots have been identified as postal codes K1T, K1V, K2V.

A memo from Dr. Vera Etches and Ottawa’s general manager of emergency and protective services Anthony Di Monte said residents 50 years of age and older living in the provincially identified “hot spots” of K1T, K1V and K2V are eligible for vaccine appointments at community clinics.

Residents living in the high-priority neighbourhoods of Emerald Woods – Sawmill Creek and Greenboro East and Ledbury – Heron Gate and Ridgemont will have the option to book at either a community clinic or at a pop-up clinic.

COVID-19 vaccine Ottawa immunization clinic

One day after a COVID-19 outbreak was declared in Kingston’s University District, the city is closing the popular Breakwater Park until the end of the university school year to prevent large gatherings.

Mayor Bryan Paterson has issued an emergency order to close Breakwater Park for the next 10 days.

“This timeline coincides with students move-out, but can be extended if needed. As one of our most popular community parks, closing it is a last resort,” said Paterson in a statement

“Yesterday, however, we saw troubling instances of overcrowding, which is especially concerning given the current outbreak in the nearby University District.”

Pictures on social media showed dozens of people in the popular park along the waterfront on Thursday.  During the provincewide shutdown, outdoor gatherings are limited to a maximum of five people.

Kingston's Breakwater Park

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Average age of Quebec COVID-19 patients has dropped by 10 to 15 years, doctors say

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MONTREAL — Over the past two to three weeks, Dr. Francois Marquis, head of intensive care at Montreal’s Maisonneuve-Rosemont hospital, says he started noticing the average age of COVID-19 patients dropping.People arriving at the hospital are on average, about 10 to 15 years younger than earlier patients in need of medical care after contracting COVID-19, he said in an interview Wednesday.

“We are starting to see what was very unlikely during the first wave: 30 or 40-year-olds without any previous medical history, people in good health,” Marquis said.

“They’re not seeing a doctor, they’re not taking any kind of medication, they don’t have diabetes, they don’t have high blood pressure — they just get sick.”

Marquis’s observations echo a warning earlier this week from Dr. Theresa Tam, Canada’s chief public health officer, who said health officials across the country are reporting rising numbers of younger patients in hospitals who soon need intensive care.

“Many of them deteriorate quite quickly and have to be admitted to the ICU,” she said.

Dr. Gaston De Serres, an epidemiologist with Quebec’s public health institute, said the proportion of Quebecers over 80 in hospital with COVID-19 has been declining since mid-March — largely due to vaccination.

He said it’s not just the proportion of hospital patients who are younger that’s increasing, the overall number of younger patients is rising as well. De Serres said there were 40 people between 50 and 59 years old who were hospitalized the week of March 7. During the week of March 28, there were 54.But hospitalizations are still not rising significantly among people under 30. “It’s younger,” he said of the average age of patients. “It’s not young.”

Ten people between 20 and 29 years old were hospitalized with COVID-19 in Quebec the week of March 28, up from five two weeks earlier, De Serres said.

“If you have more cases, you will clearly have more hospitalizations, but the proportion of all hospitalized cases will remain small because these younger age groups are very low risk of being hospitalized.”

De Serres said he thinks more younger people are getting sick because the coronavirus variants of concern are more transmissible and they lead to more severe illness more frequently.

Mike Benigeri, director of the data bureau at the Institut national d’excellence en sante et services sociaux, a Quebec government health-care research institute, said that over the past two weeks, there has been a 40 per cent increase in the number of people aged 40 to 69 who have been infected with COVID-19. He said the percentage is even higher among people aged 18 to 30.

Marquis said older people and those with other medical conditions may notice a COVID-19 infection sooner. People who are healthier may not seek medical attention until they’re very ill, he added.

“They will push the limits of endurance up to the point when they say, OK, it’s enough, I really need to go to the hospital,” he said.

Despite the odds of dying being low among younger people, that doesn’t mean the consequences among the small group who do get severely ill are any smaller, he said.

“If you’re that unlucky guy, well, you’re going to die — and you’re not going die 1.5 per cent, you’re going be fully dead.”

Quebec Premier Francois Legault has repeatedly said that with vaccination protecting older people, the province will be able to tolerate more COVID-19 cases.

Dr. Quoc Nguyen, a gerontologist at the Universite de Montreal hospital centre, said while that may be true when it comes to deaths, it may not be the case for ICU capacity.

“When we look at one case in December versus one case in March, it seems that for a single case we have more intensive care than we used to before, but we don’t necessarily have more hospitalization,” he said.

It’s ICU capacity that worries Marquis. His ICU is supposed to have 24 beds, but because staff members have left the health-care system — particularly nurses — it now has a capacity of 14: seven beds dedicated to COVID-19 patients and seven for everyone else.

“I am really afraid that in two weeks we’re going to be in the same place as Ontario is right now and I don’t think that we can deal with that many patients,” he said.

Ontario Premier Doug Ford has imposed a four-week stay-at-home order after a third wave of COVID-19 started to overwhelm the health system.

“They’re going to saturate the ICU availability very, very quickly for a very long time,” Marquis said.

This report by The Canadian Press was first published April 8, 2021.

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