The Renfrew County District Health Unit has confirmed a fourth staff member from Fellowes High School has tested positive for COVID-19.
RCDHU had deemed this person a probable case which factored into the decision to close the school on Sept. 16. This individual did not have any further exposures beyond the classes that have already been identified for testing and the staff member who became symptomatic last week has not been at school this week, according to a release issued Thursday evening.
The good news is that RCDHU has received negative test results for some staff and for all but two of the students in the original class that was exposed to the staff cases; these two tests have yet to be reported.
This afternoon RCDHU tested 98 individuals, 83 staff and 15 students. Almost all the staff from the school was tested along with most of the students considered to be at highest risk. There will be further testing tomorrow, for the remaining staff and students that could not attend today.
RCDHU will continue to update the school community and the public daily. In the meantime, RCDHU asks everyone to rigorously observe public health precautions as follows:
Limit your social activities and keep your bubble small.
Practice physical distancing (maintaining 2 metre distance).
Wear a mask when physical distancing cannot be maintained.
Clean your hands frequently with soap and water or an alcohol-based hand rub.
Cover your mouth and nose with a tissue when you cough or sneeze, then clean your hands.
If you don’t have a tissue, sneeze or cough into your sleeve and then clean your hands.
Avoid touching your eyes, nose or mouth, unless you have just cleaned your hands. • If you are ill, stay home.
Avoid contact with people who are sick.
Get your flu shot.
Use the COVID Alert App.
For all other information, visit RCDHU’s website at https://www.rcdhu.com/novelcoronavirus-covid-19-2/ or call 613-735-8654. For COVID-19 testing dates and times visit the Renfrew County Virtual Triage Assessment Centre (RCVTAC) website at www.rcvtac.ca for the testing schedule or call RCVTAC at 1- 844-727-6404 to book an appointment for testing.
Intensive care physicians and nurses share their concerns as they brace for an influx of patients that threatens to overwhelm hospitals due to the resurgence of the coronavirus and the flu.
When Canadians successfully flattened epidemic curves during the summer, the goal was to prevent hospitals and intensive care units from facing a crush of too many patients with COVID-19 all at once. Health officials wanted to avoid what happened in hospitals in New York City, where refrigerated trailers were used as temporary morgues.
But the recent surge of new coronavirus cases in all provinces beyond Atlantic Canada has already thwarted surgery plans and led to the cancellation of surgeries such as hip replacements at one hospital in Toronto and postponements in Edmonton.
Dr. Bram Rochwerg, an associate professor at McMaster University and critical care lead at the Juravinski Hospital in Hamilton, anticipates a surge of patients with COVID-19, and he worries they won’t be able to accommodate them all as more surgeries resume.
Unlike in the spring, beds and crucial staffing need to be reserved for medical and surgery patients, too. Traditionally, autumn in hospitals means scrambling for health-care workers such as nurses and respiratory therapists to backfill those sick with the cold and flu or who need to stay home to care for sick children.
“We’re all worried about it,” Rochwerg said. “You see the provincial [COVID-19] numbers creep up day by day. We see that critical care numbers [of ICU patients] creep up.”
The challenge, Rochwerg said, is to find a balance between adding restrictions to protect vulnerable populations such as residents in long-term care homes while preserving crucial aspects of society.
Rochwerg also pointed to several lessons physicians worldwide have learned to help take better care of patients critically ill with COVID-19 during the resurgence.
“We should treat them like we would any other patient,” he said. “Sometimes, you just need [to insert] a breathing tube.”
When patients are on a ventilator, it takes the skilled hands of four to six hospital staff, including a respiratory therapist who regularly checks the breathing set up and tubing to ensure the airway is protected, as well as nurses to safely turn or “prone” them onto the stomach to improve ventilation.
There is growing concern that Ontario hospitals and ICUs, especially in Ottawa and Toronto, may not have enough capacity for COVID-19 patients after weeks of rising infections. 1:55
The importance of getting patients up and out of bed, including those on ventilators when possible, as well as excellent nursing care and other day-to-day supportive care can’t be minimized.
“Supportive care is not the sexy part of it, but it’s so crucial,” Rochwerg said.
It gives patients’ bodies time to heal themselves, he said.
Fear of flood of sick patients
Patty Tamlin, registered nurse working in critical care at a hospital in Toronto’s east end, said she’s also concerned about the coming cold-and-flu season.
“One of the biggest concerns is you may be overrun by patients,” Tamlin said.
Her message to Canadians? “Tell everyone to get their flu shot.”
In the spring, the Ontario government created more beds for patients needing long-term ventilated care at a rehabilitation hospital. Even if administrators find more space for more beds, adding temp agency nurses can only go so far, she said.
“It’s going to be a long time,” Tamlin said. “It’s fatiguing … to have this constantly on our head all the time about COVID on top of our regular work.”
Experience, though, has helped ICU staff to prepare for a resurgence of COVID-19 patients.
“The more you do something, the more comfortable you are with going in and out of a room,” for example, to perform CPR during a “protected code blue” for cardiac arrest when wearing full personal protective equipment, which can be exhausting. The masks, gowns and gloves need to be donned and removed carefully to avoid health-care workers contaminating themselves.
Dr. Eddy Fan, medical director of the Extracorporeal Life Support (ECLS) program at Toronto’s University Health Network, said the increase in COVID-19 cases so far is “manageable.”
Extracorporeal membrane oxygenation (ECMO) is like an artificial heart and lung machine to support the sickest patients. People with COVID-19 who were intubated at hospitals across Ontario and didn’t improve with conventional therapy were transported to Toronto General for ECMO.
Still, Fan said, “We’re going to need to brace ourselves for another potential flood of very sick patients.”
During the spring, patients were transferred to Toronto General, but family members could not visit. Fan said cutting off patients from their relatives harmed morale not only among loved ones, but it pained people working in the hospital, too.
But influenza season also typically brings patients with lung failure who may need ECMO.
“Their families ask questions like ‘they’re dying of the flu?'” Fan said. “COVID is no different as a viral infection. We see even young patients come with very severe lung failure requiring ECMO.”
During Toronto’s first wave of COVID-19, the team successfully treated a 22-year-old with ECMO.
While respiratory failure from COVID-19 can resemble that of the flu, doctors say the scale is much larger.
Dr. Gregory Haljan, head of Surrey Memorial Hospital’s critical care department in British Columbia, said influenza has vaccines and medical treatments to shorten symptoms and improve death rates. COVID-19 doesn’t, aside from corticosteroids for severe cases.
When Haljan and his co-authors across the Lower Mainland looked at 117 people with COVID-19 who were admitted to ICU between Feb. 20 and April 17, they found the mortality rateranged from one in six to one in 10.
In comparison, the first studies from China and Italy showed mortality rates as high as one in two or one in three.
Safety ‘our primary focus’
Haljan credited having time to prepare, Dr. Bonnie Henry’s “outstanding” leadership as the provincial health officer, the support of British Columbians, hard work and luck.
“We never got overwhelmed,” he said.
To prevent being overwhelmed, Haljan said the hospital and its health region focused on basics, including:
Engaging patients in the community and long-term care homes through a virtual hospital to keep patients safe at home.
Improving communication with centralized repositories of information to avoid mixed messages.
Adapting as the science changes.
“It can be a challenge in that things change very, very slowly because safety is our primary focus,” said Haljan, who works at one of the hospitals caring for among the highest volume of patients in the emergency department, according to the Canadian Institute for Health Information.
“Research is how we keep change safe.”
Haljan said that includes research not only on vaccines and drugs but also measuring patterns and assessing them in areas such as delivering health services.
It’s that time of the year again. Flu shot clinics are starting to be offered in the Bulkley Valley. Avoiding the flu is especially top of mind for most people as the ongoing coronavirus pandemic is still being passed around.
Northwest Medical Health Officer and Acting Northeast Medical Health Officer Dr. Raina Fumerton said this year it is more important than ever to get the flu shot, not only to protect yourself but others around you and healthcare workers.
“There is no COVID vaccine yet,” she said. “But we do have a safe and effective flu vaccine and that will help to take influenza out of the mix of the respiratory season. In the midst of a global pandemic, it is important to get vaccinated against the flu.”
She is expecting more people than normal to roll up their sleeves this fall.
“People are anxious about having multiple circulating viruses around and knowing that there isn’t a vaccine for COVID-19, at least knowing that they can do something to reduce their risk of influenza and help reduce the potential for a co-infection of influenza and Covid at the same time.”
Dr. Fumerton hasn’t heard any predictions about the upcoming flu season and if it will be a banner year or not but also has not been made aware to anticipate anything unusual.
She added there are some ways to stay healthy this season.
“Aside from getting the flu shot, which I recommended anyone who is six months or older do — unless there is some sort of medical contraindication, the best way to protect yourself is get that shot, stay home if you are sick, follow all the health precautions including washing your hands.”
Beginning the week of November 2, the seasonal influenza vaccine will be available through Northern Health during flu clinics to be held in the gymnasium of Smithers Christian Reformed Church on Walnut Street. There are different days depending on age and last name. For a full list of details visit immunizebc.ca
Some pharmacies in Smithers have already started giving out the vaccine.
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Chapman Mills Community Building, 424 Chapman Mills Drive, Barrhaven
Eva James Memorial Centre, 65 Stonehaven Drive, Kanata
All six flu shot clinic locations will be appointment only, and no walk-up appointments are available.
Last Thursday, the health unit launched the appointment system to book a slot at the six clinics for the first seven days of the flu shot clinics from Oct. 29 to Nov. 4. Nearly 10,000 people booked an appointment for the first seven days within 18 hours.
Approximately 1,500 spaces are available daily at the six flu shot clinic locations.
Medical Officer of Health Dr. Vera Etches told reporters this week that new appointments will become available to book online starting at 9 a.m. Thursday.
The flu shot clinics will continue until everyone gets the flu shot that wants to get a flu shot.
Ottawa Public Health’s goal is to have 70 per cent of the population receive the flu shot this fall and winter.
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