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Healthcare worker first case since virus crackdown – The London Free Press

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A primary healthcare worker in her 50s is the first confirmed case of COVID-19 in London and Middlesex since the beginning of radical containment measures to curb the global pandemic.

The woman, who was tested at the London Health Sciences Centre, has mild symptoms and is recovering at home. She had no history of recent travel to any areas affected by the novel coronavirus.

The London-Middlesex Health Unit said in a news release that its staff has met with the woman and is trying to find out the source of the illness. The agency is following up with her close contacts. They will be told to stay home in self-isolation for 14 days.

The woman is the second Middlesex-London person to test positive for the virus and the first since Jan. 25.  The first case in the province was a Western University student returning from China. She went into self-quarantine and her illness has resolved.

“What this shows is the measures we’ve taken so far have been appropriate and that we as a community have to remain diligent in taking steps to contain this virus and limit its spread,” said Dr. Chris Mackie, Middlesex-London health unit’s CEO and medical officer of health.

In its daily update, the provincial ministry of health said there are 96 active cases of the novel coronavirus in Ontario with 939 more awaiting test results.  Five cases have been resolved.

Along with cases in Toronto, Ottawa, Durham and Haliburton, there is also a reported case in Huron Perth, and the patient is self-isolating. No other details of the person’s age or method of transmission are available.

Since Thursday, in response to the virus being determined to be a global pandemic by the World Health Organization, schools, community events, sports and other activities where people come into close contact, have been cancelled or closed.

COVID-19 is usually spread from person to person. There is no vaccine.

Frequent hand washing, sneezing into your sleeve, avoiding to touch your eyes, nose and mouth, avoiding people who are sick and staying home when you’re sick is recommended to stop the community spread.

jsims@postmedia.com

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ICU beds main challenge in COVID-19 projections – The Telegram

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ST. JOHN’S, N.L. —

Peter Jackson

Local Journalism Initiative Reporter

The short-term outlook for COVID-19 spread in Newfoundland and Labrador looks promising under current health emergency measures.

But even the best-case long-term projections suggest a likely squeeze for intensive care unit (ICU) beds by the fall.

The projections were presented to reporters and to the public Wednesday by Dr. Proton Rahman, a clinical scientist with Eastern Health. The information was assembled through various local agencies with help from the University of Toronto and the Canadian Institute of Health Information (CIHI).

Even with current emergency health measures, long-term modelling showed the province needing about 200 ICU beds at peak coronavirus levels in November. That’s three times what is currently available, although there would still be enough ventilators.

Overall bed capacity would not be exceeded in this scenario, but Rahman said ICU care depends primarily on the number of nurses and specialists available.

“It’s not just about beds,” he said. “With each individual bed there’s human resources involved, such as respiratory technicians, which is going to be critical to this. We really have to rethink, to some extent, how to deliver these services.”

A more dire scenario presented Wednesday, in which half the population got sick, showed catastrophic results, with not nearly enough beds, staff or ventilators to go around.

“We will simply not be able to cope without drastic changes, and even then it is unlikely we would be successful,” Health Minister Dr. John Haggie said during a later video address.

Insufficient data

Rahman warned that the CIHI models are likely “off a fair bit.”

“We’re looking well beyond the time frame that we have any certainty about.”

He said Newfoundland and Labrador is at least three weeks behind other provinces in terms of usable date.

In particular, while tragic in themselves, the fact there has only been two deaths so far makes it impossible to offer accurate projections of mortality rates.

He said the higher rates of high blood pressure and diabetes in this province don’t bode well, since those underlying conditions increase the chance of severe symptoms or death.

But the virus can affect anyone.

“The experience that’s been reported in numerous states in America and also in Canada (is that) a lot of young, healthy people are actually ending up in the ICU. Most don’t, but it can happen to anyone,” Rahman said. “The people that we’re worried about the most are the old, the vulnerable, people with multiple medical conditions, but anyone can get in trouble and you really have to respect what this virus can do.”

Rahman said the Caul’s Funeral Home cluster — a mid-March exposure that accounts for 75 per cent of subsequent COVID-18 hospitalizations — also makes it difficult to interpret the province’s numbers with any accuracy.

Models are usually based on more evenly distributed infections.

Buying time

Rahman said emergency measures imposed by the province could buy time to accommodate demand ahead of the surge.

“The time is key in terms of the health care capacity to be able to manage large amounts of patients,” he said. “The other reason why time is important, if we’re looking at an 18-month to two-year time period, lots could happen in terms of maybe a potential therapy, something that’s been repurposed in terms of a drug coming into it, some antibodies that you can take or possibly a vaccine. You’re buying time for potentially a therapy and you’re also buying time in terms of our health care capacity to adapt to this.”

Rahman wouldn’t speculate on how long current health measures would be in place, especially if the peak doesn’t arrive until November.

But he cited a scenario posed by some experts in which individual measures could be lifted temporarily and re-imposed if the number of cases rises again.

Chief Medical Officer of Health Dr. Janice Fitzgerald was not available for questions during the Wednesday evening briefing.

For now, Rahman said, it’s important to stay put.

“It just takes one small indiscretion to create a large increase,” he said.

“So, please, please follow the health guidelines put in place by Dr. Fitzgerald.”

With files from David Maher

Peter Jackson is a Local Initiative Reporter covering health care for The Telegram

peter.jackson@thetelegram.com

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U.S. CDC reports 374,329 coronavirus cases, 12,064 deaths – Financial Post

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The U.S. Centers for Disease Control and Prevention (CDC) on Tuesday reported 374,329 cases of coronavirus, an increase of 43,438 cases from its previous count, and said that the number of deaths had risen by 3,154 to 12,064.

The CDC reported its tally of cases of the respiratory illness known as COVID-19, caused by a new coronavirus, as of 4 pm ET on April 6 compared to its count a day ago. (https://bit.ly/2IVY1JT)

The CDC figures do not necessarily reflect cases reported by individual states. (Reporting by Vishwadha Chander in Bengaluru; Editing by Aditya Soni)

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Many Children With COVID-19 Don't Have Cough or Fever – Medscape

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The characteristic COVID-19 symptoms of cough, fever, and shortness of breath are less common in children than adults, according to the Centers for Disease and Prevention Control.

Among pediatric patients younger than 18 years in the United States, 73% had at least one of the trio of symptoms, compared with 93% of adults aged 18-64, noted Lucy A. McNamara, PhD, and the CDC’s COVID-19 response team, based on a preliminary analysis of the 149,082 cases reported as of April 2.

By a small margin, fever ― present in 58% of pediatric patients ― was the most common sign or symptom of COVID-19, compared with cough at 54% and shortness of breath in 13%. In adults, cough (81%) was seen most often, followed by fever (71%) and shortness of breath (43%), the investigators reported in the MMWR.

In both children and adults, headache and myalgia were more common than shortness of breath, as was sore throat in children, the team added.

“These findings are largely consistent with a report on pediatric COVID-19 patients aged <16 years in China, which found that only 41.5% of pediatric patients had fever [and] 48.5% had cough,” they wrote.

The CDC analysis of pediatric patients was limited by its small sample size, with data on signs and symptoms available for only 11% (291) of the 2,572 children known to have COVID-19 as of April 2. The adult population included 10,944 individuals, who represented 9.6% of the 113,985 U.S. patients aged 18-65, the response team said.

“As the number of COVID-19 cases continues to increase in many parts of the United States, it will be important to adapt COVID-19 surveillance strategies to maintain collection of critical case information without overburdening jurisdiction health departments,” they said.

SOURCE: McNamara LA et al. MMWR 2020 Apr 6;69(early release):1-5.

This story originally appeared on MDedge.com.

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