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How prepared is Canada for a possible Coronavirus outbreak? – OttawaMatters.com

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OTTAWA — Canadian medical experts say the country’s already overstretched emergency rooms would find it difficult to cope if a true outbreak of the novel coronavirus, or COVID-19, were to take hold in Canada.

So far, the virus has been relatively contained to mainland China, thanks in part to one of the largest quarantines in modern history.

“We must not look back and regret that we failed to take advantage of the window of opportunity that we have now,” Dr. Tedros Adhanom Ghebreyesus, director general of the World Health Organization, said in a message to all the world’s countries Friday.

The risk of contracting the virus in Canada right now is extremely low, and public health officials have been lauded for their efforts to detect and isolate the nine cases confirmed in the country so far.

The hundreds of patients across the country who have tested negative for the virus are also a sign that containment efforts are working as they should.

But Canada’s most recent case in British Columbia has raised fears about where and how the disease is being transmitted abroad. Unlike others who’ve imported the virus from China or from people who have recently been to China, the woman in her 30s contracted the illness while in Iran.

“Any imported cases linked to Iran could be an indicator that there is more widespread transmission than we know about,” said Canada’s chief medical officer Dr. Theresa Tam Friday.

Canada has taken major steps to prevent the kind of shock that befell Ontario during the outbreak of the coronavirus known as SARS in 2003 that led to 44 deaths. Creating the Public Health Agency of Canada, which Tam heads, is one of them.

The country is now better co-ordinated, has increased its lab-testing capabilities and is prepared to trace people’s contacts to find people who might have caught a contagious illness without knowing it.

But once the number of incoming cases reaches a critical mass, the approach must change, according to infectious-diseases physician Dr. Isaac Bogoch of Toronto’s University Health Network.

He likens the response to trying to catch fly balls in the outfield: as the number of balls in the air increases, they become harder and harder to snag.

“Every health care system has limits,” Bogoch says. “The question is, if we start getting inundated with cases, how stretched can we get?”

Many emergency-room doctors argue Canada’s ERs are already as stretched as they can get and are worried about what would happen if they suddenly had to start treating COVID-19 cases en masse.

From the public-health perspective, the greatest challenge may be as simple communicating across all parts of the health system across the country, said Dr. Jasmine Pawa, president of the Public Health Physicians of Canada.

“We cover a very wide geographic area,” she said, though she added that Canada has made great strides over the course of the SARS experience and the H1N1 flu outbreak in 2009.

Dr. Alan Drummond of the Canadian Association of Emergency Physicians, who works at the hospital in Perth, Ont., says he doesn’t want to fearmonger, especially considering all the lessons Canada has learned from past outbreaks, but the reality of life in the ER gives him pause.

“Our day-to-day experience in crowded hospitals, unable to get the right patient in the right bed on a day-to-day basis … makes us really question what the integrity of our health-care system would be like in a major severe pandemic,” Drummond says.

He envisions that a disease like COVID-19, if it spread widely, would have a major impact, including the possibility of cancelled surgeries and moving stable patients out of hospitals who would otherwise stay.

“I think there would have to be hard decisions made about who lives and who dies, given our limited availability by both speciality and (intensive-care) beds and we would probably see some degree of health-care rationing,” he says.

The problem may be even more pronounced because of Canada’s aging population, he said. The virus tends to hit older people harder, according to observations made in China and abroad, and is also particularly dangerous for people with other health problems.

Older people also tend to stay admitted in hospital beds even when they are in relatively stable condition because of a lack of long-term-care beds across the country.

That keeps emergency rooms from being able to move acute patients out of the ER and into those beds, limiting hospitals’ capacity to handle new cases.

Tam agreed Friday that hospital capacity is a “critical aspect” of Canada’s preparedness for a potential coronavirus outbreak, but said even very bad flu seasons can have a similar effect on emergency rooms.

“If we can delay the impact of the coronavirus until a certain period, when there’s less influenza for example, that would also be very helpful,” she said.

She also suggested people who are concerned about the possibility that they’re developing COVID-19 symptoms should call ahead to a hospital so they can make proper arrangements for containment and isolation.

Canada is doing its best, along with every other country in the world, to seize this time of relative containment and plan ahead, Tam said.

This report by The Canadian Press was first published Feb. 22, 2020.

Laura Osman, The Canadian Press

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Ontario nursing home sees 7 coronavirus deaths, 24 staff infected – 680 News

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An Ontario health unit says one nursing home has seen seven COVID-19 deaths and at least 24 staff members infected.

The Haliburton, Kawartha, Pine Ridge District Health Unit has said the outbreak at Pinecrest Nursing Home in Bobcaygeon is believed to be the largest in the province.

The health unit says 10 other staff members are awaiting test results, and another person in the community has died in a case linked to the nursing home.

Ontario reported 351 new COVID-19 cases Monday, the largest single-day increase by far, which health officials attribute at least in part to clearing a backlog of pending test results.

Ontario’s chief medical officer of health is recommending that everyone in the province _ especially people over 70 and with compromised immune systems _ stay home except for essential reasons.

Premier Doug Ford says medical supply lines will be “seriously challenged” if there is a massive surge of people into hospitals in the next two weeks, and all options — including further shut downs — are on the table.

The new total of cases in the province is 1,706 — including 431 resolved cases and 23 deaths.

The number of resolved cases had been stuck at eight for many days, but health officials had said to expect a large jump once the data caught up to a new definition for resolved.

The increase in the number of resolved cases also means there are actually fewer active COVID-19 cases in Ontario — 1,252 — than the 1,324 that Sunday’s data had indicated.

A new reporting format from the province also shows that more than 61 per cent of all cases are in the Greater Toronto Area.

Information on how people became infected is still pending for nearly half of all cases in Ontario. About 16 per cent are attributed to community spread, 26 per cent to recent travel, and nearly 10 per cent to close contact with another confirmed case.

About 10 per cent of people in the province who have tested positive for COVID-19 have been hospitalized.

The median age of people infected is 50, with cases ranging in age from under one year old to 100 years old.

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'Nobody went out and intentionally spread this': No order broken in Caul's cluster – CBC.ca

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The first person who had COVID-19 at a St. John’s funeral home— also known as the index case — did not spread the virus knowingly and did not violate any government orders by being there, says the province’s chief medical officer of health.

As of Monday, 111 people infected with coronavirus in Newfoundland and Labrador contracted it either directly or indirectly from Caul’s Funeral Home in St. John’s, between March 15 and 17. One man, 78, died Sunday as a result of the virus, linked to the funeral home.

Social media has been awash with vitriol, shaming and misinformation on the incident, with some calls for the individual to be charged, but Dr. Janice Fitzgerald called for calm.

“Nobody went out and intentionally spread this,” Fitzgerald said Sunday. “This happened at a time when we didn’t have the same measures in place that we do now.

“Taking our experience from now and trying to apply that to something that happened nearly two weeks ago is fraught with problems because where we are now is very different.”

Dr. Janice Fitzgerald, N.L.’s chief medical officer of health, says the person who spread coronavirus at Caul’s was not violating any government rules in place at the time when they attended a wake. (Malone Mullin/CBC)

Fitzgerald, who is Newfoundland and Labrador’s chief medical officer of health, said it does not appear anyone violated government rules at the time, and shaming individuals is not conducive in the fight against the ever-spreading virus.

Caul’s Funeral Home disclosed March 22 that people who had attended its LeMarchant Road business for visitation for two people between March 15 and March 17 were being contacted by public health, as a suspected infected person had visited the building. 

The provincial government had only ordered public sector employees who returned from travel outside the country to self-isolate on March 16. Also on that date, the federal government advised all Canadians returning from outside the country to voluntarily self-isolate for 14 days. 

It is unclear if the individual was showing symptoms at the time, and where they were prior to the funeral service.

“That is our balance we always have to achieve,” Fitzgerald said Sunday. “We want people to come forward, we want people to feel safe to come forward.”

The self-isolation period for anyone who did attend the funeral home and has not yet been sick ends Wednesday.

Read more from CBC Newfoundland and Labrador

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‘It’s a war zone’: Coronavirus deaths at Bobcaygeon, Ont., nursing home climb to 9 – Global News

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Nine residents of a long-term care home in Bobcaygeon, Ont., have died of COVID-19 complications since March 25, according to the facility’s medical director.

Dr. Michelle Snarr has called the Pinecrest Nursing Home a “war zone” since an outbreak of the novel coronavirus disease was declared on March 18. The nine deaths are presumed cases of COVID-19, she said, noting that seven of the deaths occurred over the weekend.

“It’s a war zone — more than one nurse has said that,” Snarr said Monday morning. “I feel like a field commander in a war.”


READ MORE:
2 long-term care home residents in Bobcaygeon, Ont. die after COVID-19 outbreak

“We started off with 65. We’ve had nine die so far,” said Snarr.

“There are patients dying right now; more are going to die.”

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Snarr said she emailed families on March 21, warning them they may have to decide on sending a loved one to the hospital or placing them on a ventilator — the latter of which Snarr said would likely cause a patient to “suffer a great deal,” adding that they “may not survive.”

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“I cannot begin to imagine what the abysmal quality of life would be for a person in a nursing home — that frail — and if they survived a ventilator, the quality of life would just be abysmal,” she said.

Snarr thanked the public for the outpouring of support and said a “plea for compassion is needed” for the situation, which she describes as “beyond horrifying … heart-wrenching, gut-wrenching.”

“I can’t put it into words. It’s just devastatingly horrible. So, so, so sad,” she said.

The health unit has called the outbreak the largest in the province.

Global News has reached out to Health Minister Christine Elliott’s office numerous times for comment on this story, however the minister’s office has declined to comment, saying it would have more details Monday afternoon.

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On Monday afternoon, the Haliburton, Kawartha, Pine Ridge District Health Unit confirmed the seven COVID-19-related deaths. As of Monday, 24 staff at the nursing home have been confirmed positive for COVID. Test results are pending for 10 other staff, the health unit stated

There have also been two additional deaths at the home since March 18 that were not related to COVID-19, the health unit issued in a release.

Mary Carr, Pinecrest administrator, says residents have been isolated in the home and staff with symptoms have been sent home for self-isolation to help limit the spread of the virus.

“Our team members are dedicated professionals, trained in infection, prevention and control strategies and they will continue to focus on keeping our residents, families and team members safe,” said Carr in an email to Global News. “We actively monitor and screen our residents to determine if they are showing any of the related symptoms and take necessary precautions if they do. We also actively screen all our team members every time they enter our building, and they are encouraged to self-monitor at home and are not permitted to come to work if they are feeling unwell.”

Carr said limited visitation is only for essential visitors.

“Our residents and staff have shown incredible resilience during this difficult time and we truly appreciate the support we have received from the community,” she said.

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COVID-19: Positive case confirmed at Peterborough long-term care facility


COVID-19: Positive case confirmed at Peterborough long-term care facility

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

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