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Coronavirus symptoms: How the COVID-19 disease progresses day by day – Business Insider – Business Insider

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It starts with a fever. That’s the most common symptom among patients who get the new coronavirus that has swept across China.

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A recent study of nearly 140 patients at the Zhongnan Hospital of Wuhan University identified a typical pattern of symptoms associated with the virus, which causes a disease known as COVID-19. Around 99% of the patients developed a high temperature, while more than half experienced fatigue and a dry cough. About a third also experienced muscle pain and difficulty breathing.

Research from the Chinese Center for Disease Control suggests that around 80% of coronavirus cases are mild. Around 15% of patients have gotten severe cases, and 5% have become critically ill.

Here’s how symptoms progress among typical patients:

  • Day 1: Patients run a fever. They may also experience fatigue, muscle pain, and a dry cough. A small minority of them may have had diarrhea or nausea one to two days before.
  • Day 5: Patients may have difficulty breathing – especially if they are older or have a preexisting health condition.
  • Day 7: This is how long it takes, on average, before patients are admitted to a hospital, according to the Wuhan University study.
  • Day 8: At this point, patients with severe cases (15%, according to the Chinese CDC) develop acute respiratory distress syndrome (ARDS), an illness that occurs when fluid builds up the lungs. ARDS is often fatal.
  • Day 10: If patients have worsening symptoms, this is the time in the disease’s progression when they’re most likely to be admitted to the ICU. These patients probably have more abdominal pain and appetite loss than patients with milder cases. Only a small fraction die: The current fatality rate hovers around 2%.
  • Day 17: On average, people who recover from the virus are discharged from the hospital after two-and-a-half weeks.

However, the first symptoms might not come right after a person has been infected. Lauren Ancel Meyers, an epidemiologist at the University of Texas at Austin, told Business Insider that a typical patient may be infected without showing symptoms for five or more days.

Once symptoms do appear, they can be similar to pneumonia. But Paras Lakhani, a radiologist at Thomas Jefferson University, told Business Insider that the way COVID-19 can worsen over time distinguishes it from pneumonia.

„Pneumonia usually doesn’t rapidly progress,“ Lakhani said. „Typically, most hospitals will treat with antibiotics and patients will stabilize and then start to get better.“

Coronavirus patients, however, can get worse even after they receive treatment such as fluids or steroids. One case study found that three days after a 33-year-old woman started receiving treatment at a hospital in Lanzhou, her case was more pronounced than when she arrived.

In total, the new coronavirus has killed more than 2,200 people and infected more than 76,000. It originated in Wuhan, central China’s most populous city, and has since spread to 29 other countries. The majority of cases are still located on the Chinese mainland.

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B.C. promises weekly updates on flu deaths as 6 children confirmed dead this fall – CBC.ca

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B.C.’s provincial health officer is promising weekly updates on the number of children who’ve died after contracting influenza following confirmation that six deaths have already been reported so far this fall.

Dr. Bonnie Henry said the deaths this year include one child under the age of five, three between the ages of five and nine and two teenagers between the ages of 15 and 19.

“My thoughts are with families and communities impacted by the loss of a loved one,” Henry said in a statement.

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“Early findings indicate some of the children experienced secondary bacterial infections contributing to severe illness, which can be a complication of influenza.”

She added that deaths have been rare in “previously healthy children” and that infants and toddlers, children with chronic medical conditions, kids who need to take Aspirin or ASA for long periods of time and very obese children are most at risk.

“Parents of all children should seek care if your child experiences difficulty breathing or if your child’s fever goes away and comes back or persists longer than five days. This may indicate a possible bacterial infection,” Henry said.

She described the flu season so far as an “unusual season with unusual characteristics,” including an early and serious surge in cases. As a result, the B.C. Centre for Disease Control will be posting weekly updates on pediatric flu-related deaths on its website.

B.C. health officials have urged parents to have children vaccinated against the flu, citing a “dramatic increase” in cases of influenza A, a strain which can cause severe illness in children. 

Historical data provided by the B.C. Coroners Service showed the number of deaths this year to be well above previous flu seasons before the COVID-19 pandemic. 

Between 2015 and 2019, B.C. recorded two to three influenza-related deaths in people aged 18 or younger annually. In 2020, the province recorded one death, while none were recorded in 2021.

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At least five B.C. children died from influenza last month, as mortalities spike

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At least five children died last month in British Columbia from influenza as a rise of early season respiratory illnesses added strain to the beleaguered healthcare system.

The figure marks a departure from the average of two to three annual flu deaths among children in the province between 2015 and 2019, data from the BC Coroners Service shows.

“Public health is monitoring the situation closely and is reminding people of the steps they can take to protect themselves, their children and their loved ones against the flu,” the B.C. Centre for Disease Control said in a statement.

“It is important to know that death associated with influenza in previously healthy children continues to be rare.”

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The centre said it is aware of a sixth reported flu death among children and youth under 19, but it was not immediately clear why the sixth wasn’t included in the coroners’ figures.

Provincial Health Officer Dr. Bonnie Henry said the children who died included one who was younger than five years old, three who were between five and nine, and two adolescents who were between 15 and 19.

“Early findings indicate some of the children experienced secondary bacterial infections contributing to severe illness, which can be a complication of influenza,” Henry said in a statement Thursday.

The deaths in British Columbia suggest figures could tick up across the country given the common challenges facing health systems this respiratory season. Alberta has also recorded the deaths of two children with influenza so far this season.

Before the COVID-19 pandemic, an average of five to six kids died per flu season across Canada, data collected from 12 hospitals across the country shows.

The national data was collected between 2010 and 2019 by IMPACT, a national surveillance network administered by the Canadian Paediatric Association. It was included in a research paper published in March in “The Lancet Regional Health — Americas” journal that also found no deaths from the flu among children in either 2020 or 2021.

No one from either IMPACT or the B.C. Centre for Disease Control was immediately available for an interview.

On Monday, Henry said that after two years of low flu rates, mostly due to COVID-19 pandemic restrictions, the province is seeing a “dramatic increase” in illness and it arrived sooner than normal.

She urged parents to get their children vaccinated against the flu.

On Thursday, British Columbia’s Health Ministry announced a “blitz” of walk-in flu clinics that will open across the province Friday through Sunday. Flu vaccines are free to all kids aged six months and older in B.C.

The B.C. Centre for Disease Control said getting the shot is particularly important for those at risk of severe outcomes, including those with chronic medical conditions like heart, lung, kidney or liver disorders and diseases, those with conditions that cause difficulty breathing or swallowing, those who need to take Aspirin for long periods of time and those who are very obese.

The BC Coroners Service said its data is preliminary and subject to change while investigations are completed.

The cases include those where influenza was identified as an immediate, pre-existing or underlying cause of death, or as a significant condition.

Henry said updates on pediatric influenza-related deaths will be posted weekly as part of the respiratory surveillance summaries on the B.C. Centre for Disease Control website.

This report by The Canadian Press was first published Dec. 8, 2022.

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Cough and cold medication shortage to end next year, pharmacists association says – The Daily Press

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Children’s Tylenol returning slowly to retail outlets in town

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Parents with sick kids might be able to take a break from crushing adult Tylenol and mixing it with apple sauce if they hurry quickly to a local pharmacy.

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Children’s Tylenol (acetaminophen) in liquid form began arriving at retail outlets in late November, but in such limited quantities that pharmacists are keeping them behind the counter and limiting them to one bottle per customer.

A Shopper’s Drug Mart pharmacist The Daily Press spoke with on Tuesday wouldn’t say how much they’d received but advised to hurry while quantities last. A Rexall pharmacist is only selling children’s Tylenol to parents with sick kids, not to those just preparing for a rainy day.

Adam Chappell, owner and pharmacist at Parma Right in The 101 Mall, told The Daily Press he was expecting nine retail-sized bottles of children’s Tylenol last Wednesday, which he also planned to keep behind the counter and limit to one bottle per customer.

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He predicts that more will become available, but that there will be extended shortages in the short term. Pharmacies are being allocated small amounts by the manufacturers, to spread out supply.

The shortage makes it difficult for parents to control fevers in their children, leading to more doctor visits, he said.

“We had more public health measures in place with COVID, so we had 1½ to two years where we really didn’t see much influenza or common cold,” said Chappell, whose independent pharmacy opened in November.

“So now we’re seeing everything all at once because we’re now socializing more. It’s that time of year, so we’re starting to see more influenza, cough and colds and COVID is still circulating. I think it’s a combination of higher use and some lingering logistical issues.”

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Shelves sit half empty in the adult cough and cold section at the Shopper’s Drug Mart at 227 Algonquin Blvd. E. on Tuesday. The shortage is expected to end between January and March of 2023, said Jen Belcher with the Pharmacists Association of Ontario. The timing would coincide with the end of the cold and flu season.NICOLE STOFFMAN/The Daily Press
Shelves sit half empty in the adult cough and cold section at the Shopper’s Drug Mart at 227 Algonquin Blvd. E. on Tuesday. The shortage is expected to end between January and March of 2023, said Jen Belcher with the Pharmacists Association of Ontario. The timing would coincide with the end of the cold and flu season.NICOLE STOFFMAN/The Daily Press jpg, TD

A children’s drug shortage began in the spring and worsened in the summer when an early onset of flu and respiratory syncytial virus was made worse by COVID-19, which presents as a cold. Parents began stocking up.

When local manufacturers could not keep up with demand, Health Canada arranged to import supply from the United States and Australia, whose first shipment in early November went straight to hospitals, in part because the labels were not bilingual, Postmedia reported.

Health Canada has authorized 500,000 bottles of imported children’s acetaminophen for retail to arrive in December, and domestic supply is starting to recover, Jen Belcher with the Ontario Pharmacists Association told The Daily Press in a telephone interview.

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“The demand really hasn’t abated, and manufacturing really hasn’t been able to keep up from a straight capacity standpoint, rather than a supply interruption with a lack of ingredients,” she said, when asked to respond to a claim by the German pharmacist’s association.

That organization asserts pandemic lockdowns in China are blocking exports of the raw ingredients used for medications, Postmedia reported Nov. 16.

If lockdowns in China continue, however, she conceded it could interrupt the ingredient supply in the long-term.  There is also a global reliance on India for the raw ingredients used in over-the-counter medication.

Canadian manufacturers can tap various international suppliers if approved by Health Canada, Belcher said.

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Children’s Advil (ibuprofen), an anti-inflammatory, continues to be in short supply in pharmacies, but available in hospital. Neither Belcher nor Chappell has heard reports of Health Canada planning to import it for retail outlets.

Adult Tylenol and Advil remain plentiful.

Chappell recommends that parents speak to their pharmacist to determine a dosage of adult pills based on the child’s weight and symptoms. They can be crushed and added to yogurt, apple sauce or chocolate syrup.

If parents can wait a few days for the package to arrive, they can order a supply for their child from a compounding pharmacist, who is qualified to make custom medications including liquid formulations. There are several compounding pharmacists in Sudbury, but none in Timmins.

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Adults in Timmins who have come down with a cold or flu lately may also have been surprised to see empty shelves in the adult cough and cold section of their local pharmacy.

“When it comes to cough and cold medication for both adults and children, we’re not seeing an imported supply of those. Those are short and have been for quite some time due to this high level of demand, small amounts have been trickling through the supply chain but it hasn’t been enough to keep up with demand,” said Belcher.

She expects the adult cough and cold medication shortage to end sometime between January and March, 2023, just in time for the end of flu season.

A quick check of the adult cough and cold section of four downtown pharmacies on Tuesday showed partially empty shelves, but there was still a variety of medication to choose from.

Belcher said pharmacists have lots of experience finding alternatives for patients, if necessary.

“While the over-the-counter medications in short supply are the most visible representation of the challenges to our supply chain, pharmacy teams have been managing very high levels of drug shortages, some critical, where there are really few or no alternative options,” she said, adding that up to 20 per cent of the team’s day is spent managing shortages.

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