For months, the CDC has warned people against vaping until it could determine the cause of a mysterious vaping-related lung injury. Now, the CDC confirms speculation that vitamin E acetate is “closely associated” with EVALI, or e-cigarette, or vaping, product use-associated lung injury.
A new clinical study analyzed samples from 51 EVALI patients and a comparison group of 99 healthy individuals. The study identified vitamin E acetate in bronchoalveolar lavage (BAL) fluid from 48 of the 51 EVALI patients. It did not detect the chemical in BAL fluid from healthy individuals.
This isn’t entirely surprising. Last month, the CDC said it suspected vitamin E could play a role in EVALI. The chemical is used to dilute liquid in some THC-containing e-cigs and vaping products. It can also be found in some foods and cosmetic products. It doesn’t seem to cause an issue when it is ingested or applied topically, but past research suggests it could be more harmful when inhaled.
The number of reported cases of EVALI seems to be on the decline, but the CDC says new cases are being reported weekly. As of December 17th, EVALI has injured 2,506 in the US, and the CDC has confirmed 54 deaths. It warns that there may be more than one cause of EVALI and it has not ruled out other substances and product sources.
Simcoe-Muskoka top doc on UK COVID variant in area: 'All eyes are watching us right now' – Sudbury.com
BARRIE – As more details emerge about the presence of the United Kingdom variant of COVID-19, it could also mean more changes to protective measures in long-term care homes, the local community, and abroad.
On Saturday, public health officials confirmed the more virulent UK B.1.1.7 variant is present at Roberta Place in south-end Barrie, where the death toll has now reached 40***.
There are 127 residents — which represents all but two residents — who have tested positive for the virus, as well as 86 workers, which represents approximately half of the entire staff. Six residents and one staff member are currently hospitalized at Royal Victoria Regional Health Centre (RVH).
The outbreak at the 137-bed Roberta Place long-term care home was first declared on Jan. 8.
This week, it was reported that a worker may have brought the virus into the Essa Road facility after being in contact with an international traveller. Simcoe–Muskoka medical office of health Dre. Charles Gardner was asked if charges could be laid if someone wasn’t following quarantine rules.
“When we look at the situation, we actually don’t see violation of any of the recommendations from the province, nor was there a violation of the Quarantine Act with regards to the individual who was travelling,” he said Saturday during a Zoom call with reporters. “So the exposure in question did not take place out in the community.”
The staff member who contracted the virus did not show symptoms at the beginning when they went to work, the doctor noted.
“They were asymptomatic when they were tested routinely,” Gardner said.
Public health officials have been reluctant to release any information that could identify either the staff member or the traveller, but Gardner did confirm traveller is a resident of Simcoe–Muskoka.
“There’s no requirement to be in isolation and not go into work solely because one has been in contact with a traveller who’s asymptomatic,” Gardner said.
“We need to keep learning about this virus as we go,” he added. “I have no doubt that, with this variant, we’re going to continue to have to change and tighten up requirements.”
Questions have also been raised about staff at Roberta Place going between rooms of residents who were positive for the virus and others who were not.
“I would agree that the home never successfully put in place the kind of cohorting… where you maintain the restriction on the movement of staff, or the exposure of staff to cases and non-cases,” Gardner said. “That was something that certainly was not the optimum practice in an outbreak and that wasn’t established, in part because of how quickly this spread and in part because the number of staff that became ill, they had such a difficulty maintaining the adequate staffing in the first place.”
Cohorting is a strategy to reduce risk of transmission by assigning health-care workers to patients or groups of patients based on patient exposure or infection.
Gardner said it can be “challenging” to do that, however, during a fast-moving outbreak.
“This moved very quickly,” he said. “There were 40 cases that emerged over the course of a single weekend at the very beginning. The rapid pace made it difficult to put those measures in place.”
David Jarlette, president of Jarlette Health Services, which operates Roberta Place, said the virus came into the long-term care home so quickly they weren’t able to achieve cohorting “in a quick and timely fashion.”
With so many staff and team members infected at Roberta Place, Gardner said they have had to take a multi-faceted approach to ensure staffing levels are sufficient at the facility. Jarlette Health Services has reallocated staff and also brought in temporary workers from outside organizations, such as the Red Cross.
An occupational health and safety team has been formed involving the health unit and other health-care partners. They also want to make sure all employees are offered the vaccine, Gardner said.
“From what we have seen, the uptake for this has been very, very strong, but we need to continue that as new people come into the facility,” he added.
There will be ongoing monitoring at Roberta Place through rapid testing by Orillia Soldiers’ Memorial Hospital (OSMH), which has been granted temporary leadership of the long-term care home following an order under the Health Protection and Promotion Act (HPPA). Testing will be done on a twice-weekly basis. Anyone who shows symptoms or who has a positive result will be placed in isolation at home, or hospitalized if needed.
Gardner said they hope to contain the variant to the site and limit spread into the community. This includes “a more strict threshold” for people who are at higher risk and more intensive follow-up. In cases where the person cannot isolate at home, they could be put up in a hotel to reduce the risk of spread to household members, he added.
“Our goal is to avoid transmission into the community,” the doctor said.
Gardner conceded community spread involving the UK variant is likely already happening.
“It’s certainly on the edge,” he said. “It would depend on their contacts beyond their household and whether or not we’re starting to see spread there. We haven’t seen that yet, but we’re on the very edge.”
Gardner said health officials also want to protect long-term care homes and retirement facilities from community spread.
If outbreaks are seen at other facilities, Gardner said he will have the genome sequencing done to determine whether the variant is showing up in those other facilities.
With the local emergence of the UK variant, BarrieToday asked Gardner if any modifications to protocols or protective measures will be put in place at other long-term care homes in Simcoe–Muskoka.
In regard to Roberta Place, case and contact management has already changed to identify people who are considered high-risk.
“If in fact there’s been an exposure that’s just momentary, rather than 15 minutes or more, we’re considering that a high-risk contact and those individuals go into isolation or quarantine,” Gardner said.
As well, people in full protective gear who have been in a confined space for more than 30 minutes with an infected person, they will also be considered a high-risk exposure. The isolation period for such instances is being extended from 10 days to 14.
“The experience that has been seen with the UK variant in other countries has been of a higher viral load and therefore possibly a longer period of viral shedding,” said Gardner, resulting in a longer period of isolation. “We certainly will have to learn from this with regard to what we do at other sites. The whole province will have to learn as we go.
“All eyes are watching us right now,” the doctor added.
Gardner said the situation at Roberta Place will have a “profound” effect on other long-term care homes.
“We all need to be on the alert,” he said.
The immunization of all residents retirement homes is another immediate change in protocol at long-term care homes, Gardner said. Last weekend, vaccinations were completed for all residents of long-term care homes in Simcoe–Muskoka. That focus has now shifted to retirement homes in the region. There are still 16 homes to go, which Gardner expected to be done by Wednesday.
***This information has been updated with the most recent numbers.
Teen working in long-term-care home identified as Yassin Dabeh, a Syrian refugee who fled to Canada for a better life – Toronto Star
Nearly five years ago, Yassin Dabeh’s family fled war-torn Syria for a better life in Canada.
Now the family has been confronted with the unspeakable horror of watching Dabeh become the youngest person in the Middlesex-London area to die after being diagnosed with COVID-19.
Dabeh, 19, worked as a contract cleaner at the Middlesex Terrace Long Term Care home in Delaware, Ont., just west of London, and died after contracting the virus, said Mohamad Fakih, a businessman and philanthropist, who spoke with the young man’s father.
“In 2016, they arrived as immigrants from Syria,” said Fakih, CEO of Paramount Fine Foods, who reached out to the grieving family to offer financial assistance for the funeral. “He said that the community came together and paid for the funeral.”
Fakih said the teenager, who had three brothers and one sister, died on Thursday and was buried on Friday.
To honour Dabeh’s life in his own way, Fakih asked the organizers of a biweekly community outreach event in which 500 meals are cooked for those in need in Regent Park, if Sunday’s event could be held in Dabeh’s memory. They agreed.
Fakih said Dabeh’s father cried when he told him the meals would be served in his son’s honour.
“People need to feel that they’re not alone, especially if they’re refugees,” said Fakih, an immigrant himself who came to Canada from Lebanon more than 20 years ago. “We want to show them that … Canadians, we’re all one big family and they’re not alone. He was very appreciative, the father.”
Details around Dabeh’s death, and its cause, are still emerging.
Dr. Alex Summers, Middlesex-London Health Unit’s associate medical officer of health, told the Star he couldn’t confirm Dabeh’s identity, but only that a male between the ages of 10 and 19 who worked at a long-term-care home had died after testing positive for the virus.
“Obviously a death amongst somebody recently diagnosed with COVID in this age group is a surprise to many and something that is tragic,” said Summers, adding that the deceased was the youngest individual in the health unit region to have died after being diagnosed with COVID-19.
“The public health unit investigation is primarily on understanding where individuals contracted an infectious disease such as COVID and where it might be spread and trying to intervene to limit transmission,” he noted.
He said that the case in question was considered “resolved,” meaning that the patient was no longer infectious.
“Certainly COVID as a virus can have implications for people well beyond whether or not somebody’s infectious,” Summers said. “Sometimes the repercussions can extend beyond the infectious period certainly. In this instance, all I can share is unfortunately a person of that age recently diagnosed with COVID has passed away.”
According to the Middlesex-London Health Unit, an outbreak was declared at the Middlesex Terrace Long Term Care Home on Dec. 23 and remains “active.” The number of infections at the home is not published.
In the health unit as a whole, there have been 601 COVID-19 cases, 292 of which have been among residents and 309 in staff members, as well as 79 deaths.
Mary Raithby, CEO of APANS Health Services, the company that owns the network of homes to which Middlesex Terrance belongs, said in an email to the Star that “we extend our deepest sympathies to the family and friends of Yassin.”
“Out of respect for their loss and grief, we are declining any interview or statement requests at this time,” she said.
Unifor Local 302, which represents employees at Middlesex Terrace, told the Star that Dabeh was not one of its members, but that it sends its “deepest sympathies to this young man’s family and friends.”
Some politicians took to social media Sunday to express their thoughts on Dabeh’s death.
On Twitter, federal NDP leader Jagmeet Singh called Dabeh’s death “a tragedy.”
“Essential workers are at risk every day,” Singh wrote. “Paid sick days, faster vaccine rollout and access to PPE are needed urgently — to save lives.”
“My sincerest condolences to this young man’s family, friends, & loved ones — and all victims of COVID-19,” tweeted London mayor Ed Holder. “The virus doesn’t discriminate based on age, gender, race, religion, or creed. Everybody needs to take this seriously, otherwise anybody can find themselves at risk.”
Samir Sinha, director of geriatrics at the Sinai Health System and University Health Network, said the vast majority of young people who get COVID-19 experience mild, asymptomatic courses. But he said there is a very small segment of young people who get serious and hard-to-treat bouts of the virus that require hospitalization.
“One of the biggest reasons people die due to influenza is not actually due to influenza but because influenza can actually trigger other issues,” he said. “For a lot of older people, influenza can actually trigger a pneumonia or a co-infection with something like pneumonia. It can also, if you have something like heart disease, trigger you to actually have a heart attack or other things.”
Sinha noted that it is really hard to say at this stage what may have happened to Dabeh.
“It could have been something completely unrelated … or it might have been that COVID-19 triggered something else or caused something else to get worse.”
Dentists, teachers disappointed they won’t be prioritized for vaccine in B.C. – Global News
Dentists, bus drivers and teachers are among the essential workers who are disappointed they won’t be given priority to receive the COVID-19 vaccine in British Columbia.
B.C. rolled out its vaccination plan on Friday, revealing that after the most vulnerable groups have been immunized, shots will be given out according to age, with the oldest residents first in line.
That means many people who have not been able to work from home during the pandemic, including grocery store workers, police officers and mail carriers, will have to wait to get the vaccine along with others in their age group.
The British Columbia Dental Association has written a letter to Premier John Horgan strongly urging him to include dentists in Stage 2 of the vaccination plan, alongside family doctors and medical specialists.
“Dentistry is an essential service. More importantly, dental care, including aerosol-generating dental procedures, are provided to patients who cannot wear a mask during treatment,” said association president Dr. Anthony Nadolski in the letter.
B.C. teachers and grocery store workers won’t get COVID-19 shots early
“B.C. dentists continue to do everything they can to ensure dental offices are safe for patients and staff. Early access to vaccines will ensure continued access to urgent and emergency dental care.”
Other agencies such as the American Centers for Disease Control and Prevention have included dentists and dental workers in Stage 2 along with doctors and specialists not directly involved in providing care to COVID-19 patients, Nadolski added.
More recently, Ontario included dentistry in its second stage because dentists generally provide in-person care and many dental procedures are urgent and cannot be delayed, he said.
The B.C. Ministry of Health did not immediately respond to a request for comment on Sunday.
The province initially suggested that people delivering essential services such as teachers, grocery store workers and those in law enforcement could be prioritized to get the vaccine.
But when the finalized plan was released on Friday, Provincial Health Officer Dr. Bonnie Henry said scientific evidence supports an age-based approach because older populations are at much higher risk of infection and death from COVID-19.
The immense logistical challenge of B.C.’s mass vaccination program
Currently, hospital workers, Indigenous communities and long-term care home residents, staff and essential visitors are among those being vaccinated in Stage 1 of the plan.
Stage 2 will begin in February and include people 80 and over, Indigenous seniors over 65, general practitioners and medical specialists.
In April, the province will start vaccinating the general public according to five-year age groupings, starting with seniors aged 75 to 79 before moving on to those aged 70 to 74 and so on.
However, Henry added that the approval of more vaccines may mean the province’s plan could be revised to vaccinate essential workers between April and June.
Metro Vancouver bus drivers are “very disappointed” they will not be prioritized while they risk their lives to provide transportation to the public, said Balbir Mann, president of Unifor Local 111.
B.C.’s COVID-19 vaccine rollout plan
The union is calling on the provincial government to immediately change the plan and include transit operators in Stage 2.
“We’re basically frontline workers, taking people to work and grocery shopping. Our members are real heroes,” said Mann. “They’re putting their lives in front of this to help out the general public.”
Teachers are also disappointed there is no prioritization for front-line workers who have kept schools, public services and the economy open, said B.C. Teachers Federation President Teri Mooring.
“However, the vaccine supply limit is beyond our control and those among us who are most vulnerable of death and serious illness must be vaccinated first,” she said in a statement.
Hopefully more vaccines are approved and the immunization strategy will be appropriately adjusted and accelerated, she said.
Mooring added if teachers are not prioritized for vaccines, the government must take immediate action to improve safety measures in schools, including mandatory masks, better physical distancing and ventilation upgrades.
“There is no denying that teachers are stressed, anxious and even afraid. We do not have the layers of protection in our schools that exist in other environments.”
© 2021 The Canadian Press
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