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COVID-19 cases in Canada remain on troubling course, Tam says

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Canada remains on a troubling path for new COVID-19 infections as case counts continue to mount, the country’s top doctor said Saturday.

The most recent infection rates indicate Canada is on track to hit as many as 10,000 new cases a day by next month, Dr. Theresa Tam said.

“If we continue on the current pace, our longer range models continue to forecast significant increases in daily case counts and estimate that there could be up to 10,000 cases reported daily by mid-December,” Tam said in a written statement.

“Right now, we have a window of opportunity to act collectively together with public health authorities to bring the infection rate down to a safer trajectory.”

Canada is currently recording caseloads at about half that level, with the most recent seven-day average standing at 5,335 between Nov. 20 and Nov. 26.

Tam said Canada is also averaging 76 deaths a day and more than 2,100 people in hospital.

People 80 years and older are experiencing Canada’s highest COVID-19 death rate, and there are now more and larger outbreaks in long-term care facilities, hospitals, group living settings, Indigenous communities and remote areas, she said.

“Those developments are deeply concerning as they put countless Canadians at risk of life-threatening illness, cause serious disruptions to health services and present significant challenges for areas not adequately equipped to manage complex medical emergencies,” Tam said.

Her assessment came as case counts continued to soar in numerous provinces.

Quebec set a new single-day record with 1,480 new infections Saturday as the provincial death toll crossed the 7,000 threshold.

Alberta also broke its own record, reporting 1,731 new cases of the virus on Saturday. It also counted five new deaths.

Ontario logged case numbers just shy of Friday’s one-day record as it reported 1,822 new diagnoses in the past 24 hours.

Case numbers also jumped sharply in Manitoba, where officials recorded 487 new infections and 10 new deaths.

Among those who died was a boy under the age of 10, officials said, though they offered no other details.

Saskatchewan reported 197 COVID-19 cases and one death Saturday.

The province ordered the suspension of team sports earlier this week until Dec. 17 after confirmed COVID-19 cases among several minor and recreational hockey teams.

The Saskatchewan suspension applies to hockey and curling leagues and dance studios.

The Saskatchewan Health Authority posted notices Saturday of COVID-19 exposure risks at curling and recreation centres at Christopher Lake and Shellbrook. Those curling or socializing at either of the two facilities last month must self-isolate for 14 days, the health authority said.

In British Columbia, Fraser Health announced the closure of an elementary school in Surrey after confirming 16 COVID-19 cases.

Newton Elementary School will close for two weeks, said Fraser Health.

B.C. reported a daily record of 911 COVID-19 cases Friday. The province will update its numbers Monday.

People must continue to practise physical distancing, frequent hand washing and staying home as much as possible, said a newly appointed member of B.C. Premier John Horgan’s cabinet.

“I just think it’s important for us to be thoughtful and caring, but at the same time it’s critical that people follow the rules because it’s vital to be able to keep our schools open and keep as many of our business open as possible,” said Ravi Kahlon, whose ministry includes economic recovery.

Figures from New Brunswick and Newfoundland and Labrador show more modest increases of four and two cases, respectively.

Prince Edward Island reported two new COVID-19 cases, but they involved young males aged 10 and 19.

There were 14 new cases in Nova Scotia and five COVID-19 cases in Nunavut.

Tam redoubled her calls for Canadians to heed public health advice, limit their social interactions and practice physical distancing in a bid to bring surging case counts under control.

This report by The Canadian Press was first published Nov. 28, 2020.

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Older patients, non-English speakers more likely to be harmed in hospital: report

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Patients who are older, don’t speak English, and don’t have a high school education are more likely to experience harm during a hospital stay in Canada, according to new research.

The Canadian Institute for Health Information measured preventableharmful events from 2023 to 2024, such as bed sores and medication errors,experienced by patients who received acute care in hospital.

The research published Thursday shows patients who don’t speak English or French are 30 per cent more likely to experience harm. Patients without a high school education are 20 per cent more likely to endure harm compared to those with higher education levels.

The report also found that patients 85 and older are five times more likely to experience harm during a hospital stay compared to those under 20.

“The goal of this report is to get folks thinking about equity as being a key dimension of the patient safety effort within a hospital,” says Dana Riley, an author of the report and a program lead on CIHI’s population health team.

When a health-care provider and a patient don’t speak the same language, that can result in the administration of a wrong test or procedure, research shows. Similarly, Riley says a lower level of education is associated with a lower level of health literacy, which can result in increased vulnerability to communication errors.

“It’s fairly costly to the patient and it’s costly to the system,” says Riley, noting the average hospital stay for a patient who experiences harm is four times more expensive than the cost of a hospital stay without a harmful event – $42,558 compared to $9,072.

“I think there are a variety of different reasons why we might start to think about patient safety, think about equity, as key interconnected dimensions of health-care quality,” says Riley.

The analysis doesn’t include data on racialized patients because Riley says pan-Canadian data was not available for their research. Data from Quebec and some mental health patients was also excluded due to differences in data collection.

Efforts to reduce patient injuries at one Ontario hospital network appears to have resulted in less harm. Patient falls at Mackenzie Health causing injury are down 40 per cent, pressure injuries have decreased 51 per cent, and central line-associated bloodstream infections, such as IV therapy, have been reduced 34 per cent.

The hospital created a “zero harm” plan in 2019 to reduce errors after a hospital survey revealed low safety scores. They integrated principles used in aviation and nuclear industries, which prioritize safety in complex high-risk environments.

“The premise is first driven by a cultural shift where people feel comfortable actually calling out these events,” says Mackenzie Health President and Chief Executive Officer Altaf Stationwala.

They introduced harm reduction training and daily meetings to discuss risks in the hospital. Mackenzie partnered with virtual interpreters that speak 240 languages and understand medical jargon. Geriatric care nurses serve the nearly 70 per cent of patients over the age of 75, and staff are encouraged to communicate as frequently as possible, and in plain language, says Stationwala.

“What we do in health care is we take control away from patients and families, and what we know is we need to empower patients and families and that ultimately results in better health care.”

This report by The Canadian Press was first published Oct. 17, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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Alberta to launch new primary care agency by next month in health overhaul

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CALGARY – Alberta’s health minister says a new agency responsible for primary health care should be up and running by next month.

Adriana LaGrange says Primary Care Alberta will work to improve Albertans’ access to primary care providers like family doctors or nurse practitioners, create new models of primary care and increase access to after-hours care through virtual means.

Her announcement comes as the provincial government continues to divide Alberta Health Services into four new agencies.

LaGrange says Alberta Health Services hasn’t been able to focus on primary health care, and has been missing system oversight.

The Alberta government’s dismantling of the health agency is expected to include two more organizations responsible for hospital care and continuing care.

Another new agency, Recovery Alberta, recently took over the mental health and addictions portfolio of Alberta Health Services.

This report by The Canadian Press was first published Oct. 15, 2024.

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Experts urge streamlined, more compassionate miscarriage care in Canada

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Rana Van Tuyl was about 12 weeks pregnant when she got devastating news at her ultrasound appointment in December 2020.

Her fetus’s heartbeat had stopped.

“We were both shattered,” says Van Tuyl, who lives in Nanaimo, B.C., with her partner. Her doctor said she could surgically or medically pass the pregnancy and she chose the medical option, a combination of two drugs taken at home.

“That was the last I heard from our maternity physician, with no further followup,” she says.

But complications followed. She bled for a month and required a surgical procedure to remove pregnancy tissue her body had retained.

Looking back, Van Tuyl says she wishes she had followup care and mental health support as the couple grieved.

Her story is not an anomaly. Miscarriages affect one in five pregnancies in Canada, yet there is often a disconnect between the medical view of early pregnancy loss as something that is easily managed and the reality of the patients’ own traumatizing experiences, according to a paper published Tuesday in the Canadian Medical Association Journal.

An accompanying editorial says it’s time to invest in early pregnancy assessment clinics that can provide proper care during and after a miscarriage, which can have devastating effects.

The editorial and a review of medical literature on early pregnancy loss say patients seeking help in emergency departments often receive “suboptimal” care. Non-critical miscarriage cases drop to the bottom of the triage list, resulting in longer wait times that make patients feel like they are “wasting” health-care providers’ time. Many of those patients are discharged without a followup plan, the editorial says.

But not all miscarriages need to be treated in the emergency room, says Dr. Modupe Tunde-Byass, one of the authors of the literature review and an obstetrician/gynecologist at Toronto’s North York General Hospital.

She says patients should be referred to early pregnancy assessment clinics, which provide compassionate care that accounts for the psychological impact of pregnancy loss – including grief, guilt, anxiety and post-traumatic stress.

But while North York General Hospital and a patchwork of other health-care providers in the country have clinics dedicated to miscarriage care, Tunde-Byass says that’s not widely adopted – and it should be.

She’s been thinking about this gap in the Canadian health-care system for a long time, ever since her medical training almost four decades ago in the United Kingdom, where she says early pregnancy assessment centres are common.

“One of the things that we did at North York was to have a clinic to provide care for our patients, and also to try to bridge that gap,” says Tunde-Byass.

Provincial agency Health Quality Ontario acknowledged in 2019 the need for these services in a list of ways to better manage early pregnancy complications and loss.

“Five years on, little if any progress has been made toward achieving this goal,” Dr. Catherine Varner, an emergency physician, wrote in the CMAJ editorial. “Early pregnancy assessment services remain a pipe dream for many, especially in rural Canada.”

The quality standard released in Ontario did, however, prompt a registered nurse to apply for funding to open an early pregnancy assessment clinic at St. Joseph’s Healthcare Hamilton in 2021.

Jessica Desjardins says that after taking patient referrals from the hospital’s emergency room, the team quickly realized that they would need a bigger space and more people to provide care. The clinic now operates five days a week.

“We’ve been often hearing from our patients that early pregnancy loss and experiencing early pregnancy complications is a really confusing, overwhelming, isolating time for them, and (it) often felt really difficult to know where to go for care and where to get comprehensive, well-rounded care,” she says.

At the Hamilton clinic, Desjardins says patients are brought into a quiet area to talk and make decisions with providers – “not only (from) a physical perspective, but also keeping in mind the psychosocial piece that comes along with loss and the grief that’s a piece of that.”

Ashley Hilliard says attending an early pregnancy assessment clinic at The Ottawa Hospital was the “best case scenario” after the worst case scenario.

In 2020, she was about eight weeks pregnant when her fetus died and she hemorrhaged after taking medication to pass the pregnancy at home.

Shortly after Hilliard was rushed to the emergency room, she was assigned an OB-GYN at an early pregnancy assessment clinic who directed and monitored her care, calling her with blood test results and sending her for ultrasounds when bleeding and cramping persisted.

“That was super helpful to have somebody to go through just that, somebody who does this all the time,” says Hilliard.

“It was really validating.”

This report by The Canadian Press was first published Oct. 15, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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