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Chirico confident province ‘trending in the right direction’ – The North Bay Nugget

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Face masks, physical distancing, vaccinations still key to defeating pandemic

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COVID-19 “indications are trending in the right direction,” and the medical officer of health with the North Bay Parry Sound District Health Unit is comfortable with the province’s move toward reducing restrictions further.

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Dr. Jim Chirico told local media Thursday that as the province “moves into the next step of its reopening plan, indicators are that we are moving in the right direction.

“It’s nice to have some good news,” he said.

But he also pointed out that these advances have come because people have worked together to slow the spread of COVID-19, through vaccinations and protocols such as wearing masks.

“It is still important that you be fully vaccinated and receive your third dose” of the vaccine, Chirico said.

He said the spread of the coronavirus has been slowed by public health measures, such as wearing a mask or other face covering, maintaining distancing and frequently washing hands.

With the indicators “in a downward trajectory,” he said, “we’re in a really good place right now.”

He also pointed out that, as the province eases the restrictions, people continue to exercise caution to protect the health-care system.

But, he said, “there is risk no matter what you do.

“People should continue to do what they need to do,” and the health unit, he said, will continue to monitor the local situation to ensure public safety.

Chirico said the aim is to “keep key indicators such as hospitalizations, ICU admissions and deaths on a downward trajectory” so the province or the region don’t have to go into further lockdowns or reimpose restrictions.

Five deaths have been attributed to COVID-19 in the last two weeks, and 10 of the 19 deaths in the region linked to COVID-19 have occurred since the start of the year.

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Dr. Carol Zimbalatti, public health physician with the health unit, said the deaths during the most recent omicron wave “does speak to the number of cases we’ve had.

“Proportionately, we are seeing a higher number of deaths, even though, overall, omicron causes less severe illness.

“If it infects enough people, especially vulnerable individuals, it will cause severe illness and death in some.”

She said the deaths generally have “been in the older age groups and with comorbidities.”

Chirico said the availability of the vaccine, as well as third and fourth doses, has lessened the number of deaths for high-risk individuals.

Chirico said that, with the numbers now being reported in the province, he does not expect further lockdowns or restrictions will be necessary.

Current restrictions are planned to be lifted by March 1, a move Chirico supports, saying it is important “that we find the balance between reopening the economy and still protecting individuals and the health-care system from being overwhelmed.”

The region and the province, he said, are “on a really good path right now,” but “if anything changes, we can adjust.”

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Some in B.C. cross U.S. border for their next COVID-19 vaccine – Global News

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Global News Hour at 6 BC

There is evidence of the lengths some British Columbians will go to get a second booster dose of the COVID-19 vaccine — crossing the border to Point Roberts, WA for a shot. The movement comes thanks to the different approach to the fourth shot south of the border. Catherine Urquhart reports.

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Unknown hepatitis in children: Will it become a pandemic too? – CGTN

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The number of cases of a mysterious acute hepatitis in children continues to increase worldwide, with most cases occurring in Europe. As of May 10, 348 suspected cases had been reported in at least 20 countries. Information and data have pointed to an adenovirus called adenovirus-41 (HAdV-41) as the possible culprit. Does it have anything to do with COVID? Will it become a pandemic? How do we protect ourselves from it?

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Study tracks hospital readmission risk for COVID-19 patients in Alberta, Ontario – CBC.ca

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A new study offers a closer look at possible factors that may lead to some hospitalized COVID-19 patients being readmitted within a month of discharge.

At roughly nine per cent, researchers say the readmission rate is similar to that seen for other ailments, but socio-economic factors and sex seem to play a bigger role in predicting which patients are most likely to suffer a downturn when sent home.

Research published Monday in the Canadian Medical Association Journal looked at 46,412 adults hospitalized for COVID-19 in Alberta and Ontario during the first part of the pandemic. About 18 per cent — 8,496 patients — died in hospital between January 2020 and October 2021, which was higher than the norm for other respiratory tract infections.

Among those sent home, about nine per cent — 2,759 patients — returned to hospital within 30 days of leaving, while two per cent — 712 patients — died. The deaths include patients who returned to hospital.

The combined rate of readmission or death was similar in each province, at 9.9 per cent or 783 patients in Alberta, and 10.6 per cent or 2,390 patients in Ontario.

For those wondering if the patients were discharged too soon, the report found most spent less than a month in hospital and patients who stayed longer were actually readmitted at a slightly higher rate.

“We initially wondered, ‘Were people being sent home too early?’ … and there was no association between length of stay in hospital and readmission rates, which is reassuring,” co-author Dr. Finlay McAlister, a professor of general internal medicine at the University of Alberta, said from Edmonton.

“So it looked like clinicians were identifying the right patients to send home.”

Examining the peaks

Craig Jenne, an associate professor of microbiology, immunology and infectious diseases at the University of Calgary who was not involved in the research, said the study suggests that the health-care system was able to withstand the pressures of the pandemic. 

“We’ve heard a lot about how severe this disease can be and there was always a little bit of fear that, because of health-care capacity, that people were perhaps rushed out of the system,” Jenne said. “There was a significant increase in loss of life but this wasn’t due to system processing of patients.

“Care was not sacrificed despite the really unprecedented pressure put on staff and systems during the peaks of those early waves.” 

The study also provides important insight on the power of vaccines in preventing severe outcomes, Jenne said.

Of all the patients admitted with COVID-19 in both provinces, 91 per cent in Alberta and 95 per cent in Ontario were unvaccinated, the study found.

The report found readmitted patients tended to be male, older, and have multiple comorbidities and previous hospital visits and admissions. They were also more likely to be discharged with home care or to a long-term care facility.

McAlister also found socio-economic status was a factor, noting that hospitals traditionally use a scoring system called LACE to predict outcomes by looking at length of stay, age, comorbidities and past emergency room visits, but “that wasn’t as good a predictor for post-COVID patients.”

“Including things like socio-economic status, male sex and where they were actually being discharged to were also big influences. It comes back to the whole message that we’re seeing over and over with COVID: that socio-economic deprivation seems to be even more important for COVID than for other medical conditions.”

McAlister said knowing this could help transition co-ordinators and family doctors decide which patients need extra help when they leave the hospital.

‘Deprivation’ indicators

On its own, LACE had only a modest ability to predict readmission or death but adding variables including the patient’s neighbourhood and sex improved accuracy by 12 per cent, adds supporting co-author Dr. Amol Verma, an internal medicine physician at St. Michael’s Hospital in Toronto.

The study did not tease out how much socio-economic status itself was a factor, but did look at postal codes associated with so-called “deprivation” indicators like lower education and income among residents.

Readmission was about the same regardless of neighbourhood, but patients from postal codes that scored high on the deprivation index were more likely to be admitted for COVID-19 to begin with, notes Verma.

Verma adds that relying on postal codes does have limitations in assessing socio-economic status since urban postal codes can have wide variation in their demographic. He also notes the study did not include patients without a postal code.

McAlister said about half of the patients returned because of breathing difficulties, which is the most common diagnosis for readmissions of any type.

He suspected many of those problems would have been difficult to prevent, suggesting “it may just be progression of the underlying disease.”

Looking at readmissions is just the tip of the iceberg.-Dr. Finlay McAlister-Dr. Finlay McAlister

It’s clear, however, that many people who appear to survive COVID are not able to fully put the illness behind them, he added.

“Looking at readmissions is just the tip of the iceberg. There’s some data from the [World Health Organization] that maybe half to two-thirds of individuals who have had COVID severe enough to be hospitalized end up with lung problems or heart problems afterwards, if you do detailed enough testing,” he said.

“If you give patients quality of life scores and symptom questionnaires, they’re reporting much more levels of disability than we’re picking up in analyses of hospitalizations or emergency room visits.”

The research period pre-dates the Omicron surge that appeared in late 2021 but McAlister said there’s no reason to suspect much difference among today’s patients.

He said that while Omicron outcomes have been shown to be less severe than the Delta variant, they are comparable to the wild type of the novel coronavirus that started the pandemic.

“If you’re unvaccinated and you catch Omicron it’s still not a walk in the park,” he said.

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