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COVID-19 causes sudden strokes in young adults, doctors say – CNN Philippines



(CNN) — The new coronavirus appears to be causing sudden strokes in adults in their 30s and 40s who are not otherwise terribly ill, doctors reported Wednesday.

They said patients may be unwilling to call 911 because they have heard hospitals are overwhelmed by coronavirus cases.

There’s growing evidence that COVID-19 infection can cause the blood to clot in unusual ways, and stroke would be an expected consequence of that.

Dr. Thomas Oxley, a neurosurgeon at Mount Sinai Health System in New York, and colleagues gave details of five people they treated. All were under the age of 50, and all had either mild symptoms of Covid-19 infection or no symptoms at all.

“The virus seems to be causing increased clotting in the large arteries, leading to severe stroke,” Oxley told CNN.

“Our report shows a seven-fold increase in incidence of sudden stroke in young patients during the past two weeks. Most of these patients have no past medical history and were at home with either mild symptoms (or in two cases, no symptoms) of Covid,” he added.

“All tested positive. Two of them delayed calling an ambulance.”

Other doctors have also reported that people are reluctant to call 911 or go to emergency rooms because of the pandemic.

It is not common for people so young to have strokes, especially strokes in the large vessels in the brain.

“For comparison, our service, over the previous 12 months, has treated on average 0.73 patients every 2 weeks under the age of 50 years with large vessel stroke,” the team wrote in a letter to be published in the New England Journal of Medicine. That’s fewer than two people a month.

A stroke in a large blood vessel causes severe damage if it is not removed right away. At least one patient has died, and others are in rehabilitation facilities, intensive care or in the stroke unit. Only one went home but will require intense care, Oxley said.

“The average person who has a large vessel stroke is severely impaired,” Oxley said. “It means it a bigger clot. It includes one of the largest arteries in the brain.”

Brain cells die when blood flow is stopped, and the longer it’s blocked, the wider the damage in the brain. Quick treatment is vital. “The most effective treatment for large vessel stroke is clot retrieval, but this must be performed within 6 hours, and sometimes within 24 hours,” Oxley said.

Oxley said his team wanted to tell people to watch themselves for symptoms of coronavirus infection and to call 911 if they have any evidence of stroke.

“Up until now, people have been advised to only call for an ambulance with shortness of breath or high fever,” he wrote.

The easy memory device for stroke, he said, is “FAST”: F for face drooping, A for arm weakness, S for speech difficulty and T for time to call 911.

This story was first published on, “Covid-19 causes sudden strokes in young adults, doctors say.” 

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Opioid crisis not going away amid pandemic, and will 'kill more Canadians,' says Dr. Daniel Kalla –



As the country and the rest of the world grapple with the coronavirus pandemic, the opioid crisis threatens to deepen and “kill more Canadians,” says a Vancouver ER doctor.

“[COVID-19] knocked … opioids right off the front page,” Dr. Daniel Kalla told White Coat, Black Art.

“But this is a crisis that we both know isn’t going away.”

In British Columbia, a total of 113 people died of suspected illicit drug overdoses in March — the highest death toll in a year, according to the B.C. Coroners Service. Experts have warned fentanyl and other contaminants are still present in many illicit drugs.

Kalla says people were afraid to use safe injection sites or join other people because they feared contracting COVID-19.

“So there was an increase in users using alone which … can be suicidal for opiate users.”

In his latest novel The Last High, Kalla chronicles the search for a deadly form of fentanyl in Vancouver. He spoke to White Coat, Black Art host Dr. Brian Goldman about his experience working in the ER for more than 20 years, how it has shaped his books and the pandemic’s impact on the opioid crisis.

Here is part of their conversation.

Your latest book The Last High begins with seven teenagers partying. All of them [overdose]. Only two make it to the ICU alive. Eventually we learn that an ultra-powerful form of fentanyl and carfentanil are behind the deaths. It sounds ripped from the headlines. Has anything like that ever happened on your watch?

Not in that scale. I’ve seen a couple of kids come in — and overdose — who didn’t know they were taking fentanyl or opioids. I saw one tragic 21-year-old girl — who ended up brain dead — who is not a regular opioid user.

As much as anything, I meant this book to be a cautionary tale. I have a 19 and 22 -year-old [daughters], and it’s the message I wanted to get out there that this stuff is the ultimate Russian roulette that some people are playing with.

Daniel Kalla, shown here with his daughters, says The Last High is a cautionary tale about opioid use. (Submitted by Daniel Kalla)

I want to take you back to that to that 21-year-old. What was that experience like for you?

Most opioid overdoses either die in the field or they get Narcan [brand name], naloxone, an antidote.

And by the time we usually see them in the emergency, they’re generally wide awake.

And then there’s that slim proportion that’s in the middle — whose [hearts] stay alive long enough to get to hospital — but they’re effectively brain dead. And I described that in the novel a little bit.

With no sign Canada’s opioid crisis will improve in the near future, the federal government has announced dramatic steps to try and stop its spread 3:18

I had the sense immediately when I saw her that she probably was brain dead.

She was deeply comatose … but, you know, she had a blood pressure. Her parents were rushing in. 

It was very devastating because even though we were trying to resuscitate her, I [had] this sinking feeling at the pit of my stomach that she’s never going to wake up, and sure enough, the CT scan confirmed that the brain damage was already irreversible. 

And she died a couple days later.

Clearly as a fiction author you want to entertain, but I’m getting the sense just listening to you that there’s a serious message behind this book. What would you say that is? 

Opioids touch everyone whether you’re a direct user or you’re a friend or a loved one of a victim and … when you look at our hardest core street users, homeless addicts … no one would choose that lifestyle.

They have a genetic predisposition towards addiction.

They make some wrong choices, and they end up where they do. 

I have friends … non-medical friends [who say], “Well, you know, it’s sad about fentanyl, but that’s a ‘them’ kind of thing.”

And it’s not. It’s pervasive, it’s everywhere, it can touch you personally. 

Solving Canada’s opioid crisis is complex, and those on the frontlines of the epidemic say over-prescribing, tainted drugs and housing issues are creating the perfect storm. 11:30

Based on your experience as an emergency physician, but also having conversations with your undercover police officer [Kalla’s source of background for his novels], any ideas on how to solve this crisis?

I’m one of those people who … first and foremost, believes in harm reduction at the top of the list and treating substance usage as a disease and getting them help and therapy. 

Second of all, stop treating users as criminals and treat them … as patients. 

The war … against drugs has never worked in the history [of] any country that’s tried it.– Dr. Daniel Kalla

Third of all, I think you need to decriminalize the drug. If we had control over the source, and you weren’t bringing in this dynamite that they’re using, we could control the death rate for sure.

The war … against drugs has never worked in the history [of] any country that’s tried it, and I think we really need to change the attitude. 

We have to stop the criminal supply of fentanyl that’s being shipped into the country,

But as long as people don’t have an alternative, they’re going to turn to the illegal dangerous stuff.

What are the lessons from the COVID-19 pandemic that you think might inform us on how to meet the needs of the patients you see?

Kalla says the opioid crisis is going to kill more Canadians and be with us long after the pandemic. (Submitted by Daniel Kalla)

I’ve been so generally impressed in the level of our response … the effort that we’ve put in, the innovativeness. 

We basically rejigged our entire emergency department  … we had, not just money, but thought and effort and dedication, and, you know, we saw a result right away.

I think the same thing can be applied to [not] just the opioid crisis, but the mental health crisis and the homelessness crisis. 

Obviously the pandemic gave us a pretty strong stimulus, but at the end of the day … I think the opioid crisis is going to kill more Canadians, certainly more young Canadians for sure, and be with us long after the pandemic.

You write fiction and sometimes real life is stranger than fiction. So let’s end our conversation on this. How do you think COVID-19 ends?

I keep hearing mixed things about how long the vaccine will take and … if ever they will get one. 

I think until we have that vaccine, or at least a very good treatment, which personally I think will come first — I think it’ll be like a cocktail HIV drug kind of treatment that will manage the sickest, and we reduce the death rate. 

Until then, I think we’ll see a rolling series of small little waves … that will lead to all kinds of, you know, social distancing.

We’ll move forward in these phases that Canada’s proposing now, and then we’ll have an outbreak, and we’ll all be stuck indoors for a couple of weeks again.

I don’t see any way around that because I don’t imagine natural herd immunity developing [with] this virus unless it has a horrific death toll across the world.

Q&A edited for length and clarity. 

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N.S. reports no new COVID-19 cases, gathering limit increased to 10 –



With no new case of COVID-19 being reported for the first time since March 15 in Nova Scotia, the province is increasing the number of people allowed to gather from five to 10.

“Today we come before you with good news. No new cases to report. Zero. That’s exciting,” Premier Stephen McNeil said at a press briefing on Friday.

Dr. Robert Strang, Nova Scotia’s chief medical officer of health said zero cases is a “significant and encouraging milestone.”

The new gathering limit is effective immediately, but physical distancing — except among members of a household or family bubbles — is still required.

The limit is the same indoors and outdoors, with an exception for outdoor weddings and funeral services, which can have 15 people.

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“I hate to be a damper on these joyous events, but at this time we need to make sure that the numbers are limited so the officiant is the only extra person and if you want a photographer or a DJ or something like that, they would be included in your number of 10 indoors and 15 outdoors,” Strang said.

The 10-person limit applies to:

  • Social gatherings.
  • Arts and culture activities like theatre performances and dance recitals.
  • Faith gatherings.
  • Sports and physical activities.

Strang said for faith gatherings, safety precautions are required. He said passing around a collection plate is not allowed. Strang said singing is highly discouraged because “people singing can significantly increase the spreading of respiratory droplets, [which] increases the risk of transmitting the virus that causes COVID-19.”

It also applies to businesses that are too small to ensure physical distancing.

Reopening timelines announced for campgrounds

The province also announced timelines for the reopening of more businesses:

  • Starting June 5, private campgrounds can open for all types of campers. But they can only operate at 50 per cent capacity and must ensure public health protocols are followed.
  • Provincial campgrounds will open to all Nova Scotians June 15, with the reservation line opening June 8. Those campgrounds will operate at a reduced capacity.
  • Pools can begin maintenance work to prepare for reopening, likely in time for summer.
  • Sleepover camps are not permitted this year.

Two things not changing are the requirement of self-isolating for 14 days when people visit Nova Scotia, and the household bubble is not expanding.

Nova Scotia Chief Medical Officer of Health Dr. Robert Strang called the announcement of zero new COVID-19 cases a ‘significant and encouraging milestone.’ (CBC)

“I know some of this is confusing. People say, ‘I can go to a restaurant and there will be 10, 20, 30 people in that restaurant as long as the tables are kept apart.’ That seems to be OK, but they can’t go hug their grandparents or they can’t go practise with their soccer team,” Strang said.

“It’s important that people understand we recognize those, but this is about taking measured steps so we can reopen the economy, loosen restrictions in a carefully, measured way.”

In a news release Friday, the province said the microbiology lab at the QEII Health Sciences Centre completed 1,034 tests on Thursday.

Why daycares are reopening later

McNeil addressed why daycares aren’t reopening at the same time as many other businesses on June 5.

He said he wanted daycares to reopen at the same time as everything else, but public health made a recommendation against it, so the date was moved from June 8 to 15.

“When public health comes to me and says the plan is not ready and they need another week, why would I go against that? That is about the safety of our children,” McNeil said.

Nova Scotia Premier Stephen McNeil said the decision to push back the reopening of daycares from June 8 to June 15 was made based on a recommendation from public health. (CBC)

He said “too many provinces” reopened daycares too soon and “look what’s happened in those provinces.”

“Some of you are saying, ‘Why didn’t you change the date of the economy?’ Because people have to get back to work to pay the bills and take care of their families,” he said.

McNeil acknowledged the 10-day difference “will be long for people going back to work right away and [who] need child care.”

Respect employees having child-care issues

McNeil asked businesses to “please respect” employees who have “issues with child care” over that 10-day period.

“We need to take care of each other, we need to be kind to each other, we need to support each other as our province tries to come back from COVID-19,” he said.

McNeil closed the briefing by addressing people who are asking about expanding their household bubble and “get the long-awaited hug.”

Provincial campgrounds, such as Rissers Beach Provincial Park in Lunenburg County, will open to all Nova Scotians June 15. (Submitted by the Department of Natural Resources)

“A hug is a beautiful and dangerous thing,” McNeil said. “Close contact means so much to us, but it is the very thing that could set our province back.”

McNeil said people can “hang out” now and grandparents can “watch your grandchildren play.” But to protect everybody, he said hugs, kisses and handshakes are off limits.

“Stay six feet apart a little longer,” he said. “If we continue to flatten the curve, we’ll be able to lift up your spirits by taking down more restrictions.”

Outdoor weddings are an exception to the gathering limit and are allowed to have 15 people, rather than 10. (Christian Petersen/Getty Images)

There remain 18 active cases of COVID-19 in the province, 14 of which are residents and staff at the Northwood long-term care home in Halifax. There are eight people in hospital, including three people who are in the intensive care unit.

Northwood remains the only long-term care facility in the province with active cases.

In an interview Friday, Northwood CEO Janet Simm said it was the first day “in a number of weeks” the facility had no new cases to report.

The Nova Scotia Health Authority’s COVID-19 map for Friday, May 29. (Nova Scotia Health Authority)

“So we’re celebrating that within the facility,” she said.

Fifty-nine people in Nova Scotia have died from the virus, 52 of those at Northwood.

Simm said 179 residents in Northwood had recovered as of Friday.

The state of emergency declared under the Emergency Management Act on March 22 has been extended to June 14.

Updated symptoms list

The list of COVID-19 symptoms recently expanded. People with one or more of the following updated list of symptoms are asked to visit 811’s website:

  • Fever (chills, sweats).
  • Cough or worsening of a previous cough.
  • Sore throat.
  • Headache.
  • Shortness of breath.
  • Muscle aches.
  • Sneezing.
  • Nasal congestion/runny nose.
  • Hoarse voice.
  • Diarrhea.
  • Unusual fatigue.
  • Loss of sense of smell or taste.
  • Red, purple or bluish lesions on the feet, toes or fingers that do not have a clear cause.

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Testing underway after 8 migrant workers at Elgin County farm test positive for coronavirus – Global News



Officials with the Middlesex-London Health Unit (MLHU) and Southwestern Public Health (SWPH) say coronavirus testing is underway at a St. Thomas-area farm after at least eight temporary foreign workers tested positive for the virus this week.

An outbreak was declared on Thursday at Ontario Plants Propagation, a greenhouse operation along John Wise Line, days after the MLHU said it first became aware of a case Monday night involving a worker at the farm, health officials said on Friday.

New Brunswick reverses ban on temporary foreign workers

That initial case led to 16 of the worker’s close contacts being tested on Tuesday, with seven of the tests coming back positive. As those workers live in London, the seven are included in the tally of new cases that was reported on Friday by MLHU.

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According to the health unit, another 40 workers living at the same complex as the first case were tested on Wednesday at London’s Carling Heights Assessment Centre.

The remaining workers in the group, meanwhile, were to be tested on Friday at Ontario Plants Propagation. Test results for all were expected over the coming days.

“The operator of this farm has been tremendously co-operative with us, and we believe that this outbreak is now contained,” said Dr. Alex Summers, associate medical officer of health with the MLHU, during Friday’s coronavirus media briefing.

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“Of course, we will be monitoring that very closely over the next couple of weeks.”

Coronavirus outbreak: How the pandemic has exposed the vulnerabilities in the food supply chain

Coronavirus outbreak: How the pandemic has exposed the vulnerabilities in the food supply chain

Summers said the workers had arrived primarily from Guatemala and Jamaica, and that as far as the health unit was aware, all had quarantined for 14 days upon arriving in Ontario.

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The workers are currently in self-isolation, and none have been admitted to hospital.

Health officials are still working to find the source of the outbreak, but Summers said it was believed they had been in Canada long enough that they either contracted it here, or “one of the other workers may have had mild symptoms that weren’t identified and transmitted it subsequently to their colleagues.”

“We believe that we have readily identified all close contacts and any additional cases,” Summers said. “Of course, we continue to watch for further results. But those tests have been done.”

Health officials stressed there was no risk to the public from the products grown on the farm, and that they didn’t believe there had been any close exposure or close contact outside of the migrant farmworker community.

“The living conditions for these migrant farmworkers were certainly a congregate living setting, but not exceptionally crowded, nor of specific concern for us,” Summers said.

“They were people living together and that would have resulted in the transmission.”

B.C.’s agricultural sector short 6,000 to 8,000 jobs due to lack of foreign workers

COVID-19 cases have also been reported at other southwestern Ontario farms during the pandemic.

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Fifty-one workers, local and foreign, at Greenhill Produce in Kent Bridge, Ont., tested positive for the coronavirus last month.

In Windsor-Essex, at least 16 workers from three farms in the region had tested positive for the virus as of early this month, the region’s health unit said.

In March, four workers tested positive at Highline Mushrooms in Kingsville, Ont.

Approximately 20,000 migrant workers come to the Ontario each year to work on farms and in greenhouses.

— With files from Shawn Jeffords of The Canadian Press

© 2020 Global News, a division of Corus Entertainment Inc.

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