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Fear of COVID didn't keep people having a heart attack from going to hospital – Halifax Examiner

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The Halifax Examiner is providing all COVID-19 coverage for free.

Nova Scotians didn’t let their fear of contracting COVID-19 keep them from going to the hospital when experiencing heart attacks and strokes.

That’s one of the preliminary findings from Dr. Ratika Parkash’s ongoing research. The cardiologist, researcher, and Dalhousie University professor is looking at how the province’s pandemic response has affected the health and impacted the mortality rates of heart and stroke patients throughout Nova Scotia. 

“The bottom line is it appears that Nova Scotians came to the hospital when they needed to come. There are certainly some patients that we hear about anecdotally that didn’t come because they were scared and got sick,” Parkash said in an interview. 

“But when you look at the overall picture, we’re not seeing a lot of signals that there was an overall detrimental effect to the health of Nova Scotians because they were afraid of coming to the hospital because of COVID.”

Dr. Ratika Parkash. Photo: Dalhousie University

The Halifax Examiner is providing all COVID-19 coverage for free.

Parkash and her team took their first crack at the data on Monday. She said the data collection process is challenging because there’s no “one-stop shop.” They’re using their own hospital-based administrative systems in addition to working with numerous organizations like Health Data Nova Scotia and Cardiovascular Health Nova Scotia to pull everything together.

Emergency department data around pre-COVID cardiovascular outcomes compared with outcomes after the pandemic started indicates a “slight increase” in the amount of time patients waited to go to hospital following the onset of heart attack symptoms.

But Parkash said it wasn’t deemed statistically significant. There was also no significant drop in the number of patients showing up at the emergency department because of a stroke or a mini stroke. 

“I focused on acute conditions. So this is acute cardiovascular conditions and stroke and so on, those are the things that can cause people to die at home,” she said. “Certainly from an acute care point of view, I think it’s a good news story.”

Parkash was a little surprised by the findings because of anecdotal reports suggesting Nova Scotia patients were staying home during the pandemic and becoming more sick rather than heading straight for the emergency department. She said those anecdotes weren’t enough to “move the needle” to a point where people were dying from not seeking care. 

“That’s quite reassuring, because we may get a second wave,” she said.

The Nova Scotia Health Authority’s Central Zone includes the Halifax region and accounts for half of Nova Scotia’s population. Parkash said 2,800 Central Zone patients presented to emergency with cardiovascular conditions between March 17 and May 21, their COVID research period. That was an 18% drop when compared with the 3,400 patients who went to the emergency department with those same conditions over the same time period last year.

Parkash’s next step involves stitching data together for a complete picture that includes all of the statistical analysis. They’re also working on gleaning data from hospitalizations and mortality rates for patients who were waiting for cardiovascular procedures during this period of the pandemic.

“If we look at patients waiting for procedures, we had over 200 on the waitlist during COVID. About 7% of those had to come to the hospital or got admitted, and 1.5% died on that waitlist, which may not be very different from before,” she said. 

“So we’re trying to get the before numbers sorted out. The patients that died were mostly patients waiting for a valve-related procedure, so they’re the sickest.”

Although her research thus far has focused on acute cardiovascular patients, she intends to look at chronic cardiovascular disease (heart failure) patients. They’ll examine COVID’s impact on those chronically ill patients by focusing on the QEII Health Sciences Centre heart failure clinic. 

If a second wave of COVID-19 does hit the province, Parkash said they now have “good confidence” in their ability to safely manage patients without COVID who become ill. 

“They’re not going to be stroking out at home or dying of heart attacks,” Parkash said. “We can also reassure them that they can come to the hospital safely, we can look after them, they’re not going to get COVID.”

Parkash said her research also provides reassurance to Nova Scotians that we managed to get through COVID-19 “without a huge detriment” to the health of our population. 

“From all of this work that we’ve done is a message that if you have a problem with your heart or you’re having a stroke, come to hospital, don’t stay home,” she said. 

Earlier this month, the European Society of Cardiology published an article suggesting COVID-19 fears were keeping “more than half” of heart attack patients worldwide away from hospitals. The ESC survey was conducted in mid-April and consisted of 3,101 health care professionals in 141 countries.

The Nova Scotia data so far appears to buck that trend. 

Parkash hopes to have a report ready within the next few weeks. She expects when their report is eventually published in a medical journal, it will attract a great deal of interest because the Nova Scotia data is attractive to researchers from other jurisdictions.

“We are a low COVID province, and so it kind of gives you a snapshot of what happens when you dial back all of the services. What happens in those types of scenarios,” she said.

“That’s the advantage of our data over some of the data that’s released from other cities or other jurisdictions that are high COVID areas. You’re couching all of the outcomes in the context of having to deal with this pandemic, whereas here we had a pandemic but it wasn’t as severe.”


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Manitoba COVID-19 numbers low since reopening, but experts warn against complacency – CBC.ca

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Two weeks into Phase 3 of Manitoba’s reopening, new cases of COVID-19 in the province are at a steady trickle — but epidemiologists warn it could still roar into a flood if Manitobans don’t stay cautious.

“Don’t get complacent yet,” said Dr. Cynthia Carr, a Winnipeg-based epidemiologist and founder of EPI Research Inc. “It just takes one [case] to become an outbreak.”

It’s been roughly nine weeks since Manitoba set out on the first stage of a multi-phased plan to roll back pandemic restrictions on May 4. 

Since then, Manitoba has identified 45 new cases of COVID-19. Twenty-seven of them have been in the Winnipeg health region, 10 in the Southern health region and eight in Prairie Mountain Health.

Manitoba’s other two health regions, Interlake-Eastern and Northern, haven’t announced any new cases since April.

Some of those cases came in clusters, including a 10-case cluster at Brandon-based trucking company Paul’s Hauling. Four others were temporary foreign workers who lived and worked together in the Southern health region.

At least 14 of the cases were connected to the trucking industry, either working as truck drivers or close contacts of truckers who tested positive. That doesn’t include the Paul’s Hauling outbreak, where the province has yet to publicly announce how the first person got sick.

The apparently low number of community spread cases over the past couple of months is encouraging, but Manitobans shouldn’t breathe a sigh of relief yet, Carr says.

Manitoba’s low numbers are good for public health but pose a problem for experts or observers trying to interpret them, she said. When the overall numbers are so low, perceived patterns might just be flukes.

“Proportionally we could say … a high rate of them are related to [travel and contact with known cases]. But the reality is, you can see in other areas across the country and around the world where there’s more cases, there’s still general spread,” she said. 

“We don’t want to get complacent and say, ‘OK, it’s the people travelling across country for their jobs that are at higher risk, and not the rest of us.'”

Through a peak, into a trough

Manitoba has identified 325 lab-confirmed positive and probable positive cases of COVID-19 since March 12, when the province announced its first three cases.

As of Friday, 16 of them were active. Seven Manitobans have died. A total of 302 have recovered.

It’s been more than a month since anyone was in hospital care for COVID-19, according to provincial data. The province’s weekly test positivity rate — the percentage of completed tests that came back as positive — has been below one per cent since early May.

As of July 3, the Public Health Agency of Canada reported Manitoba’s overall test positivity rate, since the start of the pandemic, at 0.2 per cent, compared to 0.8 per cent nationally.

The province has had a handful of promising streaks with no new cases. Twice, Manitoba went six days without announcing a single case — once in mid-May and once in mid-June — but still hasn’t hit a week-long streak of zeroes.

Dr. Jason Kindrachuk, an associate professor and Canada Research chair in emerging viruses at the University of Manitoba, says Manitoba’s success at controlling the virus shows how seriously Manitobans responded.

The province was also insulated by reduced international travel, he says, and less status as a tourism destination compared to some other Canadian provinces.

“We’ve kind of gone through that … first peak and we basically come back down into a bit of a trough,” he said.

“[But] we do still see cases popping up here and there. It gives us a bit of a red flag to say, ‘Yes, the virus is still out there.'”

Future unclear

Public health officials trying to urge caution face challenges, Carr says. The very nature of COVID-19, which has a relatively long incubation period — the interval between when someone is infected and when they show symptoms —  can create the impression that infection isn’t spreading, even when it is.

The public may also lose patience with following restrictive public health rules, she says, and low case numbers can build a false sense of safety.

“The World Health Organization has said this is one of the most dangerous times, because people get restless, they want to go outside,” Carr said. “They feel safer, because numbers seem to be dropping off and things are opening.” 

“But you can’t conflate that with the virus not circulating in the population. It is still circulating and outbreaks can happen very quickly.”

Kindrachuk says it’s difficult for experts to give the public an idea of what to expect in the future, even the next couple of months. The virus is too, and the variables between different jurisdictions too great, to say for sure.

Ultimately, much of the province’s success will come down to Manitobans continuing to behave cautiously.

“If somebody tells you right now that they know what’s going to happen, they don’t,” Kindrachuk said. 

“We have to assume that … we could potentially pass ourselves back in a situation like we saw before, and we want to do everything we can to try and control that.”

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Four straight days of no new COVID-19 cases in Manitoba – CTV News Winnipeg

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WINNIPEG —
For the fourth straight day, there are no new cases of COVID-19 in Manitoba.

Health officials announced on Saturday that as of 9:30 a.m., no new cases have been identified.

There have been 325 lab-confirmed and probable cases in the province since early March.

As of Friday, there are 16 active cases in Manitoba and 302 people have recovered from COVID-19. The death toll remains at seven.

Since early February, 64,968 tests have been performed.

The province will provide an update data on case numbers, active cases and recoveries on Monday. 

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Why airlines won't contact you if a passenger with COVID-19 was on your flight – CTV News Winnipeg

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WINNIPEG —
The Manitoba government has explained why health officials are notifying airline passengers about possible COVID-19 exposure, and not the airlines themselves.

In recent days, the province has advised passengers on three Air Canada flights to self-isolate and monitor for symptoms, as a recent positive case was a passenger on the flights.

The flights are listed below:

  • AC 295 from Winnipeg to Vancouver on June 19. Affected rows are 19-25.
  • AC 122 from Vancouver to Toronto on June 21. Affected rows are 31-37.
  • AC 259 from Toronto to Winnipeg on June 23. Affected rows are 24-30.

Health officials said those in the impacted rows are considered close contacts and are asked to self-isolate for 14 days and monitor for COVID-19 symptoms. Any other passengers on the flights are asked to monitor for symptoms.

Since the pandemic started, the provincial government has maintained a list of flights where passengers with confirmed cases of COVID-19 were on.

However, some have wondered why provincial health officials are providing the updates, instead of the airlines.

CTV News Winnipeg reached out to the Manitoba government for additional information on the process.

A provincial spokesperson said the plan to post information on flights publicly, instead of requesting flight manifests, was established early in the pandemic.

“There is no direct evidence at this time that contacting individual air travellers has made it possible to find cases earlier,” the spokesperson said in an email to CTV News. “All air travellers should be self-monitoring for symptoms post-travel.”

The spokesperson went on to add, “Flight manifests take time to retrieve and often do not have contact information for all travellers that allows public health to follow-up. Airlines do not contact air travellers about public health issues directly.”

The province said the process is consistent with national guidelines and said most jurisdictions in Canada will publicly post the flight information for COVID-19 cases.

There have been 325 cases of COVID-19 in Manitoba since March 12.

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