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Heart attack patients are avoiding emergency rooms due to COVID-19: report – Global News

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People experiencing cardiovascular emergencies seem to be avoiding hospital emergency rooms due to fears of COVID-19, putting their health at risk, according to a new report.

Data compiled by Heart and Stroke and the Canadian Cardiovascular Society found that visits to Ontario emergency departments for ST-Elevation Myocardial Infarctions (STEMI) — a very serious type of heart attack — fell by nearly 30 per cent in the period between March 16 and April 12, compared to the same period a year earlier.

Similar numbers from Vancouver Coastal Health show a 40 per cent drop in STEMI patients over the same time last year.


READ MORE:
People are dying of illnesses other than COVID-19 because they wait too long to seek help

“This last weekend was a good example,” said Dr. Andrew Krahn, a cardiologist and president of the Canadian Cardiovascular Society.

“In downtown Vancouver, there’s an on-call group that looks after acute heart attacks. And they for one weekend actually had none, which was the first time in 11 years.”

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According to data from the Canadian Institute for Health Information, there were 26,950 emergency department visits for heart attacks in the 2018-19 fiscal year, corresponding to an average of about 74 visits per day across Canada.

“This data is distressing because there is no reason to believe that fewer events are happening,” Krahn said.

“There’s no plausible reason why COVID-19 should make for less heart attacks or strokes, for example. So what’s happening is we’re seeing less and less of these because people stay home when they happen.”

Reports from Spain and the U.S. have also shown similar drops in hospital visits for cardiovascular trouble.






1:45
Busy ER doctor tells hospital patients in need not to stay away


Busy ER doctor tells hospital patients in need not to stay away

Delaying medical care can have huge implications for someone’s health, Krahn said.

If you have a stroke, for example, “You have two or three hours, after which you’re going to be disabled.”

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“Many of these things that involve in particular acute heart problems, they have treatments that need to be delivered within hours or a day, quickly, to try to prevent the damage that is going to happen.”


READ MORE:
How to know if your chest pain is something serious

Delaying treatment also means that when patients do arrive at the hospital, they’re often sicker and there’s less that doctors can do to help, he said.

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Because of this, he worries that there will be a “surge” in very sick patients down the line, which could overwhelm hospital resources — particularly when added to the growing backlog of elective and non-emergent surgeries that were postponed due to COVID-19.

“It’ll create a burden on our ability to diagnose and see and manage those people who are sicker.”

Dr. Jeff Shaw, a Calgary cardiologist and internal medicine specialist, tweeted earlier in April that he was unable to save a patient who didn’t come to the hospital until it was too late.

“I lost the battle to save a patient last night because they waited too long to come to the hospital,” he wrote.

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“I’m afraid that there could be patients who have treatable issues who come in too late or get complications from the issues that could have been prevented had they shown up earlier,” he told Global News.


READ MORE:
These are the 3 clear warning signs of stroke all Canadians should know

Krahn says he understands that people are nervous about going to a hospital at a time when health authorities are urging people to stay home to avoid getting sick. But going to hospital doesn’t mean that you will catch the novel coronavirus, he said.

“People might forget that 80 to 90 per cent of COVID-19 patients are in the community, most of them are isolated in their homes,” he said.

Hospitals have protection systems to “wall off” suspected COVID-19 patients from those who are coming in with other ailments, he said, “so hospitals and emergency rooms are safe.”

Emergency rooms have also planned for the pandemic, Shaw said, so patients shouldn’t fear being turned away.






3:45
Healthy Living: Precautions, signs and symptoms of a stroke


Healthy Living: Precautions, signs and symptoms of a stroke

If you suspect that you’re having a major cardiac problem, like a heart attack or a stroke, Krahn urges you to go to the emergency room or call 911 as you normally might.

“The reality is the risk of contracting COVID-19 and then being so sick that it has a terrible outcome and so on is extraordinarily small compared to having an acute medical emergency where the consequences are real and personal and warrant attention.”

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Questions about COVID-19? Here are some things you need to know:

Health officials caution against all international travel. Returning travellers are legally obligated to self-isolate for 14 days, beginning March 26, in case they develop symptoms and to prevent spreading the virus to others. Some provinces and territories have also implemented additional recommendations or enforcement measures to ensure those returning to the area self-isolate.

Symptoms can include fever, cough and difficulty breathing — very similar to a cold or flu. Some people can develop a more severe illness. People most at risk of this include older adults and people with severe chronic medical conditions like heart, lung or kidney disease. If you develop symptoms, contact public health authorities.

To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. They also recommend minimizing contact with others, staying home as much as possible and maintaining a distance of two metres from other people if you go out.

For full COVID-19 coverage from Global News, click here.

— with files from Brian Hill, Global News

© 2020 Global News, a division of Corus Entertainment Inc.

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Nova Scotia reports no new cases of COVID-19 for first time since March – Toronto Star

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HALIFAX—Nova Scotia increased its social gathering limit on Friday as the province reported no new cases of COVID-19 for the first time since its initial infections were identified in mid-March.

Dr. Robert Strang, the chief medical officer of health, called the development a “significant and encouraging milestone” in a province that has seen a continuing downward trend in new cases over recent weeks.

It kept the total number of confirmed cases at 1,055, including 978 people who have recovered from the virus. Eight people are currently in hospital and three of them are in intensive care.

“It hasn’t been easy but we are seeing positive results,” said Strang.

Nova Scotia announced more details of a reopening plan set for next Friday, even as neighbouring New Brunswick put the brakes on expanding the current phase of its plan. That province is dealing with a growing cluster of new cases in the Campbellton area, allegedly caused by a health-care worker who returned from Quebec and didn’t self-isolate.

Strang was asked about what lessons Nova Scotia could take from the Campbellton outbreak.

“The message in that is really about the importance of self-isolation when you cross borders,” he said. “What it shows us is the importance of very closely monitoring our borders. We need to be very thoughtful and careful about how we lift those border restrictions.”

Premier Stephen McNeil announced a new gathering limit of 10 people effective immediately — a doubling from a limit of five that was imposed when health restrictions were put in place in late March.

Physical distancing of two metres would still be required, except among members of the same household or family “bubble.” The limit is the same indoors and outdoors, with exceptions for outdoor weddings and funeral services which can have 15 people.

Strang clarified that when it comes to weddings, that limit of 15 would have to include photographers and caterers if that’s what couples wanted in their ceremonies.

He said the gathering limit also applies to arts and culture activities such as theatre performances and dance recitals, faith gatherings, and sports and physical activity. Businesses such as theatres, concerts, festivals and sporting activities would also have to adhere to the 10-person limit.

“We are watching our epidemiology and will consider expanding the way people can have close social interaction when we see how this first stage in the reopening is going,” said Strang. “It’s very important that we don’t introduce too much risk of COVID-19 at any one time and we have the capacity to monitor the effect of any steps.”

McNeil said that private campgrounds would also be allowed to open, but would only operate at 50 per cent capacity and must ensure public health protocols are followed, including adequate distancing between campsites.

Provincial campgrounds are scheduled to open June 15 at reduced capacity to ensure a minimum of six metres between individual sites.

The latest measures came two days after McNeil announced that most businesses required to close under a public health order in late March would be allowed to open next Friday, provided they are ready with a plan that follows physical distancing protocols.

The list of businesses includes bars and restaurant dining rooms, hair salons, barber shops, gyms and yoga studios, among others.

Some health providers would also be allowed to reopen, including dentistry, optometry, chiropractic and physiotherapy offices. Veterinary services can also operate along with some unregulated professions, such as massage therapy, podiatry and naturopathy.

Earlier Friday, the province announced it would add 23 new long-term care beds because of a need resulting from some facilities slowing or stopping admissions during the pandemic.

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It said it is entering into an agreement with Shannex RLC Ltd. to convert a floor at the Caritas Residence, a private assisted-living home in Bedford, N.S., into nursing home beds.

Residents would be able to move into the facility in early June and will be tested for the virus before being admitted.

According to the government, there are 132-long term care facilities in Nova Scotia.

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Condition in kids with possible COVID-19 link being studied in Canada – Terrace Standard – Terrace Standard

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B.C. and Alberta have become the latest provinces in Canada to investigate cases of an unusual syndrome in children, which doctors around the world are studying to see if there’s a definitive link to COVID-19.

The Hospital for Sick Children in Toronto and Montreal’s Sainte-Justine Hospital are each examining 20 possible cases of Multisystem Inflammatory Syndrome in Children, or MIS-C.

Earlier this week, Alberta’s chief medical officer of health announced doctors are looking into one suspected case in the province, while British Columbia said it is investigating half a dozen cases.

“Because there isn’t really a definitive, one specific test that says, ‘yes, you have multisystem inflammatory syndrome’ or ‘you don’t,’ I don’t think that the cases themselves are 100 per cent clearly defined from children who might have some other type of infection,” said Dr. Jeremy Friedman, the associate chief of pediatrics at SickKids.

“It might take a little bit of time to really be absolutely certain about how many cases that are being investigated are actually truly related to COVID.”

Friedman’s team at the Toronto hospital have also been in contact with the study at Sainte-Justine run by Marie-Paule Morin, a pediatric rheumatologist.

This month, the U.S. Centers for Disease Control and Prevention issued an alert to doctors about MIS-C. The agency’s case definition includes current or recent COVID-19 infection or exposure to the virus, a fever of at least 38 C for at least 24 hours, severe illness requiring hospitalization, inflammatory markers in blood tests, and evidence of problems affecting at least two organs that could include the heart, kidneys, lungs, skin or nervous system.

The CDC said some children may have symptoms resembling Kawasaki disease, a rare condition that can cause swelling and heart problems.

In other parts of the world, the illness is also called Pediatric Inflammatory Multisystem Syndrome (PIMS).

Dr. Deena Hinshaw, Alberta’s chief medical officer of health, said Wednesday that while little is known about MIS-C, ”it seems to be more something that happens as a result of (a child’s) immune system going into overdrive after an infection and causing this inflammatory response in multiple organs.”

Hinshaw gave little information about the province’s first suspected case, other to say that the child is stable in hospital.

In Toronto, Friedman said one of the 20 children had to be admitted to an intensive care unit. All have responded well to treatment and have gone home.

There have been no reported deaths linked to MIS-C in Canada, but some children have died from the illness in New York, France and the United Kingdom.

Friedman said it is “highly suspicious” that there seems to be an increase in children presenting MIS-C symptoms about a month after the peak in the number of COVID-19 infections in their communities.

“That seems to be a consistent time that people are seeing this uptick,” he said.

But Friedman noted that none of the children at SickKids tested positive for an active coronavirus infection. His team has blood samples from each child that will then be tested for COVID-19 antibodies.

Although Health Canada has recently approved two serological tests, Friedman said he is waiting to hear from provincial experts on which one is most accurate.

The Canadian Paediatric Society recently published MIS-C guidelines for clinicians and caregivers and is tracking and studying the illness nationwide.

“This syndrome is still very new, and scientists and doctors are learning about it in real time,” the society said in an email Friday.

“The CPSP study will provide essential, timely information about how children are being affected, which children are at highest risk, and will enable us to adjust best practices for prevention and care based on evidence.”

Friedman said parents should be vigilant about signs of MIS-C, but they shouldn’t be alarmed since the numbers are low and the condition is treatable.

“This is definitely going to add to what we know about COVID and hopefully some aspects of what we learn will inform the development of vaccines,” he said.

“It’s quite reassuring to know that we can all learn from each other and that is happens in a pretty rapid sequence.”

Daniela Germano, The Canadian Press

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Condition in kids with possible COVID-19 link being studied in Canada – Lacombe Express

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British Columbia and Alberta have become the latest provinces in Canada to investigate cases of an unusual syndrome in children, which doctors around the world are studying to see if there’s a definitive link to COVID-19.

The Hospital for Sick Children in Toronto and Montreal’s Sainte-Justine Hospital are each examining 20 possible cases of Multisystem Inflammatory Syndrome in Children, or MIS-C.

Earlier this week, Alberta’s chief medical officer of health announced doctors are looking into one suspected case in the province, while British Columbia said it is investigating half a dozen cases.

“Because there isn’t really a definitive, one specific test that says, ‘yes, you have multisystem inflammatory syndrome’ or ‘you don’t,’ I don’t think that the cases themselves are 100 per cent clearly defined from children who might have some other type of infection,” said Dr. Jeremy Friedman, the associate chief of pediatrics at SickKids.

“It might take a little bit of time to really be absolutely certain about how many cases that are being investigated are actually truly related to COVID.”

Friedman’s team at the Toronto hospital have also been in contact with the study at Sainte-Justine run by Marie-Paule Morin, a pediatric rheumatologist.

This month, the U.S. Centers for Disease Control and Prevention issued an alert to doctors about MIS-C. The agency’s case definition includes current or recent COVID-19 infection or exposure to the virus, a fever of at least 38 C for at least 24 hours, severe illness requiring hospitalization, inflammatory markers in blood tests, and evidence of problems affecting at least two organs that could include the heart, kidneys, lungs, skin or nervous system.

The CDC said some children may have symptoms resembling Kawasaki disease, a rare condition that can cause swelling and heart problems.

In other parts of the world, the illness is also called Pediatric Inflammatory Multisystem Syndrome (PIMS).

Dr. Deena Hinshaw, Alberta’s chief medical officer of health, said Wednesday that while little is known about MIS-C, ”it seems to be more something that happens as a result of (a child’s) immune system going into overdrive after an infection and causing this inflammatory response in multiple organs.”

Hinshaw gave little information about the province’s first suspected case, other to say that the child is stable in hospital.

In Toronto, Friedman said one of the 20 children had to be admitted to an intensive care unit. All have responded well to treatment and have gone home.

There have been no reported deaths linked to MIS-C in Canada, but some children have died from the illness in New York, France and the United Kingdom.

Friedman said it is “highly suspicious” that there seems to be an increase in children presenting MIS-C symptoms about a month after the peak in the number of COVID-19 infections in their communities.

“That seems to be a consistent time that people are seeing this uptick,” he said.

But Friedman noted that none of the children at SickKids tested positive for an active coronavirus infection. His team has blood samples from each child that will then be tested for COVID-19 antibodies.

Although Health Canada has recently approved two serological tests, Friedman said he is waiting to hear from provincial experts on which one is most accurate.

The Canadian Paediatric Society recently published MIS-C guidelines for clinicians and caregivers and is tracking and studying the illness nationwide.

“This syndrome is still very new, and scientists and doctors are learning about it in real time,” the society said in an email Friday.

“The CPSP study will provide essential, timely information about how children are being affected, which children are at highest risk, and will enable us to adjust best practices for prevention and care based on evidence.”

Friedman said parents should be vigilant about signs of MIS-C, but they shouldn’t be alarmed since the numbers are low and the condition is treatable.

“This is definitely going to add to what we know about COVID and hopefully some aspects of what we learn will inform the development of vaccines,” he said.

“It’s quite reassuring to know that we can all learn from each other and that is happens in a pretty rapid sequence.”

This report by The Canadian Press was first published May 29, 2020

— With files from The Associated Press

Daniela Germano, The Canadian Press

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