Health

COVID-19 patient discharged into cold after 10 days on a ventilator with no instructions – West Lorne Chronicle

Published

4 years ago

April 22, 2020

Rachel Newman was delivered to the exit of a Toronto hospital on a cold April night in just a hospital gown, with virtually no instructions on what to do next

Rachel Newman had just spent 10 days on a mechanical ventilator in a medically induced coma, then four days alone, scared and disoriented in a hospital ward room.

Countless studies suggest the experience could set her up for prolonged emotional distress and a steep physical recovery.

But when the COVID-19 patient was finally discharged from a Toronto hospital this month, she was delivered to the exit on a cold April night in just a hospital gown, with virtually no instructions on what to do next.

It is distressing to hear when patients and families experience any kind of gap in care

Newman’s husband, Zale, struggled to look after a wife whose stomach had shrunk and psyche had taken a beating, with health-care professionals refusing to see her in person. He had tested positive for COVID-19, too, and the couple seemed “toxic” to the medical system, Zale says. An overseas relative who had been a nurse finally gave some much-needed guidance.

“After somebody goes through something like this, there should be someone who looks after your needs,” Rachel Newman, 61, said.

Her experiences underline both the harsh after-effects of long stays in the intensive-care unit, and the impact of a pandemic on getting the required follow-up help.

Rachel stresses that she received “magnificent” medical treatment at North York General Hospital, especially in the ICU, and is well aware those health-care workers have a tough, dangerous job.

But as increasing numbers of Canadians emerge from such ordeals, the system has to do better at looking after those who survive critical bouts of COVID-19, the Newmans argue.

Rachel and Zale Newman.

Peter J. Thompson/National Post

Zale, owner of a financial services company, is a volunteer rabbi and visits the ICU at another Toronto hospital every weekend. Rachel is a social worker in children’s mental health.

“Most people are not connected like we are,” she said. “I think a lot of people come home, maybe to nobody, maybe to an old aunt who is not resourceful, who doesn’t have this information and it’s the blind leading the blind.”

Nadia Daniell-Colarossi, a North York General spokeswoman, said she cannot comment on individual patients.

But “it is distressing to hear when patients and families experience any kind of gap in care and it is important for us to know when we have not met their needs,” she said. “We of course want to have open and direct conversation with our patients and their families so we can understand and address their concerns.”

Dr. Brian Cuthbertson, critical care head at Toronto’s Sunnybrook Health Sciences Centre, said he has no knowledge of the Newmans’ situation, but suggested lack of aid for patients after they leave the ICU is not unusual.

“There’s a bit of a gap here, and the systems are not yet in place to give the sort of support these patients need,” he said.

North York General Hospital in Toronto. Rachel Newman stresses that she received “magnificent” medical treatment there.

Dave Thomas/Postmedia/File

And the “harsh reality” is that that gap has widened with the system being under pandemic lockdown, Cuthbertson said.

The Newmans’ encounter with the coronavirus began March 19, when Zale felt chills one day, and more or less fine the next. Then Rachel developed a high fever and nausea. She also had a dry, hacking cough, but that had been around for most of the winter. Acutely aware of the unfolding pandemic, they got tested for the new coronavirus. A day later, the results for both came back positive.

Rachel did not improve and a week later, on March 29, Zale took her to the hospital. By 1 a.m. the next morning, he learned that his wife had consented to being put into an induced coma – given a combination of sedatives and paralytic drugs – so staff could insert a breathing tube down her throat and attach her to a ventilator.

“That was the last time I saw my wife for two weeks,” he said.

Rachel says she recalls being asked for her consent to go on the ventilator, then has “zero” recollection of the next several days.

A week and half after the intubation, she was able to breathe on her own again. As she woke up dazed from the sedatives, staff asked if she knew the date. “Late 2019,” Newman responded.

The systems are not yet in place to give the sort of support these patients need

Conscious now, and transferred to a regular ward that seemed to have few patients or staff, Rachel says the next three or four days were also difficult.

“It was a very, very strange, surreal hospital experience,” she said. “I didn’t know if it was day, I didn’t know if it was night … You could feel completely alone.”

No one explained, Newman says, that she could be contagious and had to stay put.

“Sometimes I would just walk out of my room and say ‘Is there a nurse here?’ … Then I’d hear someone yell ‘Get back into your room now, you’re not to leave your room,’ ” said Newman. “It felt incredibly punitive.”

To make matters worse, Zale slipped and fell on some concrete steps at their house, opening a nasty cut. Back at the North York General emergency department, a doctor stitched up the laceration. The staff, knowing he had tested positive for COVID-19, gave him a pair of scissors and tweezers. He was told to remove the sutures himself so he didn’t have to return.

On April 11, Zale learned that his wife was ready to be picked up, immediately.

Research has shown that patients spending days in an ICU, especially if placed on a ventilator, often suffer from what’s called intensive-care syndrome, symptoms that can include muscle weakness, cognitive deficiencies and depression or post-traumatic stress. The Newmans say they were told none of that.

I definitely feel anxious, more anxious. It’s very lonely, isolating

Rachel was wearing a “flimsy gown” on a “freezing” night when delivered to a hospital entrance by wheelchair, Zale recalls. The hospital staff member handed over a discharge notice that listed her diagnosis, the doctors who had treated the woman, her most recent lab results and medications she’d been given.

There were also six lines of instructions on what to do next: isolate until at least 14 days after onset of symptoms and contact her family doctor to follow up on the hospital stay and her “mental health.” Because she had hypertension while in hospital, they should also monitor her blood pressure, the note said. It did not specify how they were to do that.

But there were more immediate problems. Rachel could hardly eat without feeling nauseated and could barely move. She was clearly suffering psychologically, too, at one point even expressing survivor’s guilt, says her husband.

“I definitely feel anxious, more anxious,” says Rachel. “It’s very lonely, isolating.”

As per provincial guidelines issued to physicians not involved directly in the COVID-19 campaign, neither her family physician nor any other doctor would see her in person. Nor would a physiotherapist. Worried about Rachel’s blood pressure, Zale had to call paramedics on Monday to measure her vital signs.

Finally, Zale’s sister, Judith Berger, a retired head nurse at an Israeli hospital, sent instructions noting that Rachel’s stomach would have constricted during the 10 days of feed tubing. She should eat small amounts several times a day, and exercise for only a few minutes at a time.

Rachel wonders why it took someone on another continent to provide some of the most practical advice she’s received since leaving hospital.

“I think it’s a simple thing that when you leave a hospital with an illness that’s really rampant today, there has to be some material you just hand the person,” she said. “ ‘Know that this is what to expect, and this is what you work with.’ I had none of that, none of that.”

• Email: tblackwell@postmedia.com | Twitter: tomblackwellNP

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Health

Health Canada approves updated Moderna COVID-19 vaccine

Published

2 days ago

September 17, 2024

Anne Joseph

TORONTO – Health Canada has authorized Moderna’s updated COVID-19 vaccine that protects against currently circulating variants of the virus.

The mRNA vaccine, called Spikevax, has been reformulated to target the KP.2 subvariant of Omicron.

It will replace the previous version of the vaccine that was released a year ago, which targeted the XBB.1.5 subvariant of Omicron.

Health Canada recently asked provinces and territories to get rid of their older COVID-19 vaccines to ensure the most current vaccine will be used during this fall’s respiratory virus season.

Health Canada is also reviewing two other updated COVID-19 vaccines but has not yet authorized them.

They are Pfizer’s Comirnaty, which is also an mRNA vaccine, as well as Novavax’s protein-based vaccine.

This report by The Canadian Press was first published Sept. 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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Health

These people say they got listeria after drinking recalled plant-based milks

Published

2 days ago

September 17, 2024

Anne Joseph

TORONTO – Sanniah Jabeen holds a sonogram of the unborn baby she lost after contracting listeria last December. Beneath, it says “love at first sight.”

Jabeen says she believes she and her baby were poisoned by a listeria outbreak linked to some plant-based milks and wants answers. An investigation continues into the recall declared July 8 of several Silk and Great Value plant-based beverages.

“I don’t even have the words. I’m still processing that,” Jabeen says of her loss. She was 18 weeks pregnant when she went into preterm labour.

The first infection linked to the recall was traced back to August 2023. One year later on Aug. 12, 2024, the Public Health Agency of Canada said three people had died and 20 were infected.

The number of cases is likely much higher, says Lawrence Goodridge, Canada Research Chair in foodborne pathogen dynamics at the University of Guelph: “For every person known, generally speaking, there’s typically 20 to 25 or maybe 30 people that are unknown.”

The case count has remained unchanged over the last month, but the Public Health Agency of Canada says it won’t declare the outbreak over until early October because of listeria’s 70-day incubation period and the reporting delays that accompany it.

Danone Canada’s head of communications said in an email Wednesday that the company is still investigating the “root cause” of the outbreak, which has been linked to a production line at a Pickering, Ont., packaging facility.

Pregnant people, adults over 60, and those with weakened immune systems are most at risk of becoming sick with severe listeriosis. If the infection spreads to an unborn baby, Health Canada says it can cause miscarriage, stillbirth, premature birth or life-threatening illness in a newborn.

The Canadian Press spoke to 10 people, from the parents of a toddler to an 89-year-old senior, who say they became sick with listeria after drinking from cartons of plant-based milk stamped with the recalled product code. Here’s a look at some of their experiences.

Sanniah Jabeen, 32, Toronto

Jabeen says she regularly drank Silk oat and almond milk in smoothies while pregnant, and began vomiting seven times a day and shivering at night in December 2023. She had “the worst headache of (her) life” when she went to the emergency room on Dec. 15.

“I just wasn’t functioning like a normal human being,” Jabeen says.

Told she was dehydrated, Jabeen was given fluids and a blood test and sent home. Four days later, she returned to hospital.

“They told me that since you’re 18 weeks, there’s nothing you can do to save your baby,” says Jabeen, who moved to Toronto from Pakistan five years ago.

Jabeen later learned she had listeriosis and an autopsy revealed her baby was infected, too.

“It broke my heart to read that report because I was just imagining my baby drinking poisoned amniotic fluid inside of me. The womb is a place where your baby is supposed to be the safest,” Jabeen said.

Jabeen’s case is likely not included in PHAC’s count. Jabeen says she was called by Health Canada and asked what dairy and fresh produce she ate – foods more commonly associated with listeria – but not asked about plant-based beverages.

She’s pregnant again, and is due in several months. At first, she was scared to eat, not knowing what caused the infection during her last pregnancy.

“Ever since I learned about the almond, oat milk situation, I’ve been feeling a bit better knowing that it wasn’t something that I did. It was something else that caused it. It wasn’t my fault,” Jabeen said.

She’s since joined a proposed class action lawsuit launched by LPC Avocates against the manufacturers and sellers of Silk and Great Value plant-based beverages. The lawsuit has not yet been certified by a judge.

Natalie Grant and her seven year-old daughter, Bowmanville, Ont.

Natalie Grant says she was in a hospital waiting room when she saw a television news report about the recall. She wondered if the dark chocolate almond milk her daughter drank daily was contaminated.

She had brought the girl to hospital because she was vomiting every half hour, constantly on the toilet with diarrhea, and had severe pain in her abdomen.

“I’m definitely thinking that this is a pretty solid chance that she’s got listeria at this point because I knew she had all the symptoms,” Grant says of seeing the news report.

Once her daughter could hold fluids, they went home and Grant cross-checked the recalled product code – 7825 – with the one on her carton. They matched.

“I called the emerg and I said I’m pretty confident she’s been exposed,” Grant said. She was told to return to the hospital if her daughter’s symptoms worsened. An hour and a half later, her fever spiked, the vomiting returned, her face flushed and her energy plummeted.

Grant says they were sent to a hospital in Ajax, Ont. and stayed two weeks while her daughter received antibiotics four times a day until she was discharged July 23.

“Knowing that my little one was just so affected and how it affected us as a family alone, there’s a bitterness left behind,” Grant said. She’s also joined the proposed class action.

Thelma Feldman, 89, Toronto

Thelma Feldman says she regularly taught yoga to friends in her condo building before getting sickened by listeria on July 2. Now, she has a walker and her body aches. She has headaches and digestive problems.

“I’m kind of depressed,” she says.

“It’s caused me a lot of physical and emotional pain.”

Much of the early days of her illness are a blur. She knows she boarded an ambulance with profuse diarrhea on July 2 and spent five days at North York General Hospital. Afterwards, she remembers Health Canada officials entering her apartment and removing Silk almond milk from her fridge, and volunteers from a community organization giving her sponge baths.

“At my age, 89, I’m not a kid anymore and healing takes longer,” Feldman says.

“I don’t even feel like being with people. I just sit at home.”

Jasmine Jiles and three-year-old Max, Kahnawake Mohawk Territory, Que.

Jasmine Jiles says her three-year-old son Max came down with flu-like symptoms and cradled his ears in what she interpreted as a sign of pain, like the one pounding in her own head, around early July.

When Jiles heard about the recall soon after, she called Danone Canada, the plant-based milk manufacturer, to find out if their Silk coconut milk was in the contaminated batch. It was, she says.

“My son is very small, he’s very young, so I asked what we do in terms of overall monitoring and she said someone from the company would get in touch within 24 to 48 hours,” Jiles says from a First Nations reserve near Montreal.

“I never got a call back. I never got an email”

At home, her son’s fever broke after three days, but gas pains stuck with him, she says. It took a couple weeks for him to get back to normal.

“In hindsight, I should have taken him (to the hospital) but we just tried to see if we could nurse him at home because wait times are pretty extreme,” Jiles says, “and I don’t have child care at the moment.”

Joseph Desmond, 50, Sydney, N.S.

Joseph Desmond says he suffered a seizure and fell off his sofa on July 9. He went to the emergency room, where they ran an electroencephalogram (EEG) test, and then returned home. Within hours, he had a second seizure and went back to hospital.

His third seizure happened the next morning while walking to the nurse’s station.

In severe cases of listeriosis, bacteria can spread to the central nervous system and cause seizures, according to Health Canada.

“The last two months have really been a nightmare,” says Desmond, who has joined the proposed lawsuit.

When he returned home from the hospital, his daughter took a carton of Silk dark chocolate almond milk out of the fridge and asked if he had heard about the recall. By that point, Desmond says he was on his second two-litre carton after finishing the first in June.

“It was pretty scary. Terrifying. I honestly thought I was going to die.”

Cheryl McCombe, 63, Haliburton, Ont.

The morning after suffering a second episode of vomiting, feverish sweats and diarrhea in the middle of the night in early July, Cheryl McCombe scrolled through the news on her phone and came across the recall.

A few years earlier, McCombe says she started drinking plant-based milks because it seemed like a healthier choice to splash in her morning coffee. On June 30, she bought two cartons of Silk cashew almond milk.

“It was on the (recall) list. I thought, ‘Oh my God, I got listeria,’” McCombe says. She called her doctor’s office and visited an urgent care clinic hoping to get tested and confirm her suspicion, but she says, “I was basically shut down at the door.”

Public Health Ontario does not recommend listeria testing for infected individuals with mild symptoms unless they are at risk of developing severe illness, such as people who are immunocompromised, elderly, pregnant or newborn.

“No wonder they couldn’t connect the dots,” she adds, referencing that it took close to a year for public health officials to find the source of the outbreak.

“I am a woman in my 60s and sometimes these signs are of, you know, when you’re vomiting and things like that, it can be a sign in women of a bigger issue,” McCombe says. She was seeking confirmation that wasn’t the case.

Disappointed, with her stomach still feeling off, she says she decided to boost her gut health with probiotics. After a couple weeks she started to feel like herself.

But since then, McCombe says, “I’m back on Kawartha Dairy cream in my coffee.”

This report by The Canadian Press was first published Sept. 16, 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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Health

B.C. mayors seek ‘immediate action’ from federal government on mental health crisis

Published

3 days ago

September 16, 2024

Anne Joseph

VANCOUVER – Mayors and other leaders from several British Columbia communities say the provincial and federal governments need to take “immediate action” to tackle mental health and public safety issues that have reached crisis levels.

Vancouver Mayor Ken Sim says it’s become “abundantly clear” that mental health and addiction issues and public safety have caused crises that are “gripping” Vancouver, and he and other politicians, First Nations leaders and law enforcement officials are pleading for federal and provincial help.

In a letter to Prime Minister Justin Trudeau and Premier David Eby, mayors say there are “three critical fronts” that require action including “mandatory care” for people with severe mental health and addiction issues.

The letter says senior governments also need to bring in “meaningful bail reform” for repeat offenders, and the federal government must improve policing at Metro Vancouver ports to stop illicit drugs from coming in and stolen vehicles from being exported.

Sim says the “current system” has failed British Columbians, and the number of people dealing with severe mental health and addiction issues due to lack of proper care has “reached a critical point.”

Vancouver Police Chief Adam Palmer says repeat violent offenders are too often released on bail due to a “revolving door of justice,” and a new approach is needed to deal with mentally ill people who “pose a serious and immediate danger to themselves and others.”

This report by The Canadian Press was first published Sept. 16, 2024

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