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How quarantines work in Canada

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When news of Canada’s first presumptive case of novel coronavirus emerged on Jan. 25, officials said that the man was placed in isolation in Toronto’s Sunnybrook Hospital.

He was in a “negative pressure room,” said a hospital official, and health care workers were using personal protective equipment as they cared for him.

Here’s what that means, and how quarantine and isolation work in Canada.

Quarantine vs. isolation

According to Dr. Michael Curry, an emergency physician in Delta, B.C. and a clinical professor at the University of British Columbia, “quarantine” usually technically refers to a legal order put in place by a medical officer or even a provincial minister.

Laws vary from province to province, but generally, a health official can legally command that someone comply with the order, for example, by forcing them to stay in their home and not allow visitors, he said.

“The powers can be quite far-reaching,” he explained.

“They can issue warrants to get people arrested if they’re not compliant with orders to isolate themselves. They can force people to be immunized. They can force people to take medication.

“And in rare cases, these are enforced by court orders.”

More frequently, though, patients with possibly communicable diseases are put in “isolation” at a hospital or choose to isolate themselves at home, he said.

It’s a precautionary measure, and most patients are happy to comply, but it doesn’t carry the weight of a legal requirement, Curry said.

Under the federal Quarantine Act, the federal government has the power to protect the population from threats to public health from travellers — including issuing travel bans against people coming from specific locations. They can also require that travellers undergo medical examination.

Staying away from others

In a hospital setting, isolation means a separate room away from others, where medical personnel take extra care before they enter, such as putting on a gown, a mask, gloves, and other such things, he said.

Family is often able to visit, but they have to take the same precautions as the medical staff, he said, such as putting on a mask or gown before they enter.

Isolation isn’t that unusual at hospitals, Curry said. At his hospital, they will routinely have three or four isolated patients per day. It’s a pain for the staff — just getting a patient a glass of water can require putting on all kinds of protective equipment — but it’s a precaution to prevent the spread of infection.

“It really does slow down staff,” he said.

Depending on their symptoms and what illnesses doctors think they have, some patients might be placed in a “negative pressure” room. This is simply a room where the air is sucked inwards and ventilated out through special filters, Curry said.

This means that if someone opens a door, they’re not blowing contaminated air into the hallway, explained Stephen Hoption Cann, an epidemiologist and clinical professor at UBC’s School of Population and Public Health.

“Sometimes you go into a store in the wintertime and the doors will open, you feel all this hot air rushing out,” he said. “That’s positive pressure.”

Negative pressure would be the opposite — a slight vacuum to make sure everything stays in, he said.

 

But if a person’s symptoms aren’t too bad, they might just be asked to stay home rather than going to a hospital, he said.

“If a person can be stable and can be quarantined at home, that might be the best option.”

Two of Canada’s three coronavirus cases so far are in voluntary isolation at home.

Health care workers could call several times a day, or visit occasionally to check up on them, Hoption Cann said.

“This way, they’re not being transported, which could possibly contaminate the ambulance or paramedics that are transporting them and then going into the hospital system.”

Getting in and out

The decision to put someone into quarantine or isolation is made by medical professionals, based upon the perceived danger to others, Hoption Cann said.

There is guidance from the province on how to make those decisions, but it’s the individual physicians who make the call, he said.

The decision to bring someone out of isolation is also made by the medical team.

They usually make the call when someone’s symptoms have died down, Curry said. “If you don’t have a runny nose, if you’re not coughing, if you’re not sneezing, you’re probably not spreading that virus terribly effectively.

“It’s reasonably safe to think that when symptoms go away, your ability to spread the virus also goes down markedly.”

 

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In the case of a new virus, like this coronavirus outbreak, it’s a trickier decision to make, simply because doctors don’t know everything about how the virus spreads or how long someone might remain contagious, he said.

“This virus, basically we’ve only known about it for a month,” he said. “And so it’s hard for me to give hard answers.”

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Hundreds more unmarked graves found at erstwhile Saskatchewan residential school

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An indigenous group in Saskatchewan on Thursday said it had found the unmarked graves of an estimated 751 people at a now-defunct Catholic residential school, just weeks after a similar, smaller discovery rocked the country.

The latest discovery, the biggest to date, is a grim reminder of the years of abuse and discrimination indigenous communities have suffered in Canada even as they continue to fight for justice and better living conditions.

Prime Minister Justin Trudeau said he was “terribly saddened” by the discovery at Marieval Indian Residential School about 87 miles (140 km) from the provincial capital Regina. He told indigenous people that “the hurt and the trauma that you feel is Canada’s responsibility to bear.”

It is not clear how many of the remains detected belong to children, Cowessess First Nation Chief Cadmus Delorme told reporters, adding that oral stories mentioned adults being buried at the site.

Delorme later told Reuters some of the graves belong to non-indigenous people who may have belonged to the church. He said the First Nation hopes to find the gravestones that once marked these graves, after which they may involve police.

Delorme said the church that ran the school removed the headstones.

“We didn’t remove the headstones. Removing headstones is a crime in this country. We are treating this like a crime scene,” he said.

The residential school system, which operated between 1831 and 1996, removed about 150,000 indigenous children from their families and brought them to Christian residential schools, mostly Catholic, run on behalf of the federal government.

“Canada will be known as a nation who tried to exterminate the First Nations,” said Bobby Cameron, Chief of the Federation of Sovereign Indigenous Nations, which represents 74 First Nations in Saskatchewan. “This is just the beginning.”

OLD WOUNDS

Canada’s Truth and Reconciliation Commission, which published a report that found the residential school system amounted to cultural genocide, has said a cemetery was left on the Marieval site after the school building was demolished.

The local Catholic archdiocese gave Cowessess First Nation C$70,000 ($56,813) in 2019 to help restore the site and identify unmarked graves, said spokesperson Eric Gurash. He said the archdiocese gave Cowessess all its death records for the period Catholic parties were running the school.

In a letter to Delorme on Thursday, Archbishop Don Bolen reiterated an earlier apology for the “failures and sins of Church leaders and staff” and pledged to help identify the remains.

Heather Bear, who went to Marieval as a day student in the 1970s and is also vice-chief of the Federation of Sovereign Indigenous Nations, recalled a small cemetery at the school but not of the size revealed on Thursday.

“You just didn’t want to be walking around alone in (the school),” she recalled. There was a “sadness that moves. And I think every residential school has that sadness looming.”

The Cowessess First Nation began a ground-penetrating radar search on June 2, after the discovery of 215 unmarked graves at the Kamloops Residential School in British Columbia outraged the country. Radar at Marieval found 751 “hits” as of Wednesday with a 10% margin of error, meaning at least 600 graves on the site.

The Kamloops discovery reopened old wounds in Canada about the lack of information and accountability around the residential school system, which forcibly separated indigenous children from their families and subjected them to malnutrition and physical and sexual abuse.

Pope Francis said in early June that he was pained by the Kamloops revelation and called for respect for the rights and cultures of native peoples. But he stopped short of the direct apology some Canadians had demanded.

Thursday was a difficult day, Delorme told Reuters. But he wants his young children to know “we will get the reconciliation one day with action like today.”

($1 = 1.2321 Canadian dollars)

(Reporting by Anna Mehler Paperny in Toronto and Moira Warburton in Vancouver; Editing by Chizu Nomiyama, Alistair Bell, Grant McCool and Daniel Wallis)

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Teamsters votes to fund and support Amazon workers

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The International Brotherhood of Teamsters, a labor union in the United States and Canada, said on Thursday it has voted to formalize a resolution to support and fund employees of Amazon.com Inc in their unionization efforts.

Amazon did not immediately respond to a request for comment.

(Reporting by Eva Mathews in Bengaluru; Editing by Arun Koyyur)

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Citigroup names new sales head for Treasury and Trade Solutions unit

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Citigroup Inc has named Steve Elms as the new sales head for the bank’s Treasury and Trade Solutions (TTS) unit effective immediately, according to an internal memo shared by a company spokesperson.

Elms, who will oversee the management of the global sales teams, has been involved with the bank’s TTS division for over 10 years, according to his LinkedIn profile.

TTS is a division of the bank’s Institutional Clients group. The segment offers cash management and trade services and finance to multinational corporations, financial institutions and public sector organizations around the world.

(Reporting by Niket Nishant in Bengaluru and David Henry in New York; Editing by Krishna Chandra Eluri)

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