The first year of the COVID-19 pandemic in Alberta saw fewer stroke patients, but a higher number of stroke-related deaths, according to new research.
The study, published Monday in the Canadian Medical Association Journal, was conducted by a team of eight doctors and other researchers across the province.
“One of the things that we began to realize within the first few months of the pandemic is that there seemed to be a decline in the number of people presenting with acute strokes,” lead author Dr. Aravind Ganesh, a neurologist at the University of Calgary, said in an interview.
Several countries, he said, had started noticing a trend of fewer people seeking emergency care for a variety of medical issues during the pandemic.
“The question that people started asking was whether the public health restrictions that we had implemented as a result of the pandemic might be having some unintended consequences of dissuading people from attending at the hospital for emergencies like stroke and heart disease,” said Ganesh.
“So, the premise for this study came from this very legitimate worry on our part.”
Researchers looked at data for 19,531 Alberta patients from January 2016 to February 2020 and another 4,900 patients during the first year of the COVID-19 pandemic.
“In the first wave of the pandemic in Alberta, we had quite a decline in the number of people who were presenting with acute ischemic stroke — that’s strokes because of blood clots in the brain,” explained Ganesh.
Hospital avoidance suspected
“Along with that, we also found the that the use of stroke therapies declined by about the same amount.”
Researchers also found that the number of patients with stroke symptoms did not return to pre-pandemic levels after the first wave in spring 2020.
“Especially during the second- and third-wave periods of our study, when COVID-19 cases surged, we expected to observe an increase in stroke presentations instead of declines,” they write in the study.
Ganesh said he and other researchers were able to look at what happened to those patients by studying how many people died due to strokes.
“We found those out-of-hospital deaths ended up rising four out of the five time periods in the pandemic,” he said. “We ended up being able to find some of these missing strokes that way.”
Similar results were found in hospitals.
“During the second wave of the pandemic and the third wave of the pandemic, more people ended up dying in hospital who had strokes,” he said.
The study looked at population-level data, so it’s not clear why people decided not to seek treatment.
“Is it that people were waiting to seek help until their strokes became more severe?” he asked.
Ganesh said researchers don’t know for sure, but they believe people were trying to avoid hospitals.
“We suspect it was hospital avoidance because of the out-of-hospital deaths that we found.”
He said the results of the research weren’t all bad.
“We actually did end up catching up later on in the pandemic,” said Ganesh.
He said public health officials and doctors also worked to remind people to go to the hospital for emergencies.
“What we’ve understood is that we really need to think critically about the kind of public health messaging we do during the pandemic.”
Rare Cases of Monkeypox Diagnosed in Britain | Health | thesuburban.com – The Suburban Newspaper
TUESDAY, May 17, 2022 (HealthDay News) — Four men in England have been infected with a “rare and unusual” monkeypox virus.
Investigators from the U.K. Health Security Agency are investigating the cases and whether there is any connection between the men, according to the Associated Press. None of the individuals had traveled to the African countries where the virus is endemic. Three of the men are in London, and one is in Northeast England.
Three earlier cases were announced last week. In those cases, two of the patients lived in the same household. The third person had previously traveled to Nigeria, one of the countries where the virus is endemic in animals. Most people who get monkeypox recover quickly, within several weeks. The virus has symptoms that include fever, muscle ache, chills, and fatigue. A rash similar to that found in chickenpox and smallpox can form on the face and genitals in more severe cases.
The latest four cases all happen to be in men who identify as gay, bisexual, or men who have sex with men. However, monkeypox does not easily spread between people, and it is not known to be transmitted sexually. In Western and Central Africa, the virus is typically spread by touching or being bitten by an infected wild animal. However, it could be spread among people with extremely close contact, the British health officials said.
“The evidence suggests that there may be transmission of the monkeypox virus in the community, spread by close contact,” said Susan Hopkins, M.D., chief medical advisor for the U.K. Health Security Agency, the AP reported. “We are particularly urging men who are gay or bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay.”
Public health officials consider the risk to the general population to be low. They are working with hospitals and international partners to determine if there is a similar rise in cases in other places. This includes tracing people who had contacts with the monkeypox cases, including airline passengers, the AP said. Doctors who see patients with unexplained rashes should seek advice from a specialist, public health officials said.
Long COVID: Half of patients hospitalised have at least one symptom two years on – Australian Hospital + Healthcare Bulletin
Two years on, half of a group of patients hospitalised with COVID-19 in Wuhan, China, still have at least one lingering symptom, according to a study published in The Lancet Respiratory Medicine. The study followed 1192 participants in Wuhan infected with SARS-CoV-2 during the first phase of the pandemic in 2020.
While physical and mental health generally improved over time, the study found that COVID-19 patients still tend to have poorer health and quality of life than the general population. This is especially the case for participants with long COVID, who typically still have at least one symptom including fatigue, shortness of breath and sleep difficulties two years after initially falling ill.1
The long-term health impacts of COVID-19 have remained largely unknown, as the longest follow-up studies to date have spanned around one year.2 The lack of pre-COVID-19 health status baselines and comparisons with the general population in most studies has also made it difficult to determine how well patients with COVID-19 have recovered.
Lead author Professor Bin Cao, of the China-Japan Friendship Hospital, China, said, “Our findings indicate that for a certain proportion of hospitalised COVID-19 survivors, while they may have cleared the initial infection, more than two years is needed to recover fully from COVID-19. Ongoing follow-up of COVID-19 survivors, particularly those with symptoms of long COVID, is essential to understand the longer course of the illness, as is further exploration of the benefits of rehabilitation programs for recovery. There is a clear need to provide continued support to a significant proportion of people who’ve had COVID-19, and to understand how vaccines, emerging treatments and variants affect long-term health outcomes.”3
The authors of the new study sought to analyse the long-term health outcomes of hospitalised COVID-19 survivors, as well as specific health impacts of long COVID. They evaluated the health of 1192 participants with acute COVID-19 treated at Jin Yin-tan Hospital in Wuhan, China, between 7 January and 29 May 2020, at six months, 12 months and two years.
Assessments involved a six-minute walking test, laboratory tests and questionnaires on symptoms, mental health, health-related quality of life, if they had returned to work and healthcare use after discharge. The negative effects of long COVID on quality of life, exercise capacity, mental health and healthcare use were determined by comparing participants with and without long COVID symptoms. Health outcomes at two years were determined using an age-, sex- and comorbidities-matched control group of people in the general population with no history of COVID-19 infection.
Two years after initially falling ill, patients with COVID-19 are generally in poorer health than the general population, with 31% reporting fatigue or muscle weakness and 31% reporting sleep difficulties. The proportion of non-COVID-19 participants reporting these symptoms was 5% and 14%, respectively.
COVID-19 patients were also more likely to report a number of other symptoms including joint pain, palpitations, dizziness and headaches. In quality of life questionnaires, COVID-19 patients also more often reported pain or discomfort (23%) and anxiety or depression (12%) than non-COVID-19 participants (5% and 5%, respectively).
Around half of study participants had symptoms of long COVID at two years, and reported lower quality of life than those without long COVID. In mental health questionnaires, 35% reported pain or discomfort and 19% reported anxiety or depression. The proportion of COVID-19 patients without long COVID reporting these symptoms was 10% and 4% at two years, respectively. Long COVID participants also more often reported problems with their mobility (5%) or activity levels (4%) than those without long COVID (1% and 2%, respectively).
The authors acknowledged limitations to their study, such as moderate response rate; slightly increased proportion of participants who received oxygen; it was a single centre study from early in the pandemic.
1. – National Institute for Health and Care Excellence – Scottish Intercollegiate Guidelines Network – Royal College of General Practitioners. COVID-19 rapid guideline: managing the long-term effects of COVID-19. https://www.nice.org.uk/guidance/ng188
2. – Soriano – JB Murthy – S Marshall – JC Relan – P Diaz JV – on behalf of the WHO Clinical Case Definition Working Group on Post-COVID-19 Condition. A clinical case definition of post-COVID-19 condition by a Delphi consensus. Lancet Infect Dis. 2021; 22: e102-e107
3. – Huang L – Yao Q – Gu X – et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. Lancet. 2021; 398: 747-758
Image credit: ©stock.adobe.com/au/ink drop
2SLGBTQ+ lobby group head speaks on the trauma of conversion therapy
Although conversion therapy has now been outlawed in Canada, many are still victims causing them to go through a lot of trauma in the process.
According to Jordan Sullivan, Project Coordinator of Conversion Therapy Survivors Support and Survivors of Sexual Orientation and Gender Identity and Expression Change Efforts (SOGIECE), survivors of conversion therapy identify the need for a variety of supports including education and increased awareness about SOGIECE and conversion practices.
Also needed is access to affirming therapists experienced with SOGIECE, trauma (including religious trauma), safe spaces and networks, and access to affirming healthcare practitioners who are aware of conversion therapy or SOGIECE and equipped to support survivors.
“In January of 2021 when I was asked to be the project coordinator, I was hesitant because I wasn’t sure that my experience could be classified as SOGIECE or conversion therapy. I never attended a formalized conversion therapy program or camp run by a religious organization. Healthcare practitioners misdiagnosed me or refused me access to care.
In reality, I spent 27 years internalizing conversion therapy practices through prayer, the study of religious texts, disassociation from my body, and suppression or denial of my sexual and gender identities. I spent six years in counselling and change attempts using conversion therapy practices. I came out as a lesbian at age 33, and as a Trans man at age 51. I am now 61 and Queerly Heterosexual, but I spent decades of my life hiding in shame and fear and struggled with suicidal ideation until my mid-30s.
At times I wanted to crawl away and hide, be distracted by anything that silenced the emptiness, the pain, the wounds deep inside. I realized that in some ways, I am still more comfortable in shame, silence, and disassociation, than in any other way of being and living, but I was also filled with wonderment at the resiliency and courage of every single one of the participants.
However, many of us did not survive, choosing to end the pain and shame through suicide. Many of us are still victims in one way or another, still silenced by the shame, still afraid of being seen as we are. Still, many of us are survivors, and while it has not been an easy road, many of us are thrivers too,” said Jordan.
In addition, Jordan said conversion practices and programs are not easily defined or identified, and often capture only a fragment of pressures and messages that could be considered SOGIECE.
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