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HSC Children’s Hospital postponing surgeries due to increase in critically ill kids

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Reassigning staff and postponing surgeries are just some of the steps being taken at HSC Children’s Hospital to deal with a spike in critically ill pediatric patients.

Dr. Shawn Young, the chief operating officer of HSC Winnipeg, said in a 48-hour period that ended Monday, 10 infants and children were admitted to the pediatric intensive care unit (PICU) and the neonatal intensive care unit (NICU).

Each patient was dealing with severe respiratory symptoms linked to influenza A and RSV bronchiolitis.

Those admissions pushed the number of critically ill children to 21, which is far above the baseline of the PICU, which is nine. There are also 48 patients in the NICU, which has a pre-pandemic baseline of 50.

Young said more beds have been opened in the PICU and 10 to 15 staff have been reassigned in the last couple of months, but he said more help is needed.

“In the last day, and earlier today, we have put out a call for nurses with pediatric critical care experience, who may be working in other positions, to see if they can pick up shifts in the PICU,” said Young.

That call for help isn’t just at HSC but has been put out across the health-care system.

Young said there isn’t a specific number of nurses that they are looking for.

“The demands are shifting by the hour, if not, certainly by the day. So the absolute number is not going to be a fixed number, it’s going to change almost continuously.”

Another step being taken to provide additional support is reducing the pediatric surgical slate. Young said they will continue to focus on life-saving surgeries, but any non-urgent surgeries will be postponed starting Thursday.

“Clinical leadership will assess and review each surgical case with postponements focused on patients who are able to safely remain at home until their surgery and where a short stay will not result in negative medical outcomes.”

The postponements will mean 4.7 full-time equivalent surgical nurses will be assigned to the PICU, there will be less pressure on the unit with fewer surgical stays and it will prevent kids from having to travel or stay at the hospital before their surgery, therefore decreasing their chances of also getting sick, according to Young.

At the moment, Young noted there is no impact on adult surgeries, but it is always a possibility depending on what happens in the coming days and weeks.

The postponement of surgeries is scheduled to last into the new year.

Even though there is a current spike in PICU patients, there appears to be some slightly good news coming from the emergency department.

For the first 10 days of December, there have been 142.7 patients per day in the emergency department, compared to 170.3 patients per day in November.

Dr. Elisabete Doyle, the section head of pediatric emergency medicine at HSC Children’s, said despite lower numbers there are still high admission numbers – 18 on Tuesday.

“So normally, we see between 10 and 12 admissions a day and we’re up to 18 and the acuity of the patients that we’re seeing is much higher,” said Doyle.

She said the majority of cases being seen right now are RSV and influenza, but there are some cases of COVID-19 as well.

“In November of this year, we saw 196 cases of influenza in emergency. This is about four times the number that we were seeing in pre-pandemic times in 2019. And in December, we have already seen 87 cases of influenza. So currently at this pace, we’re set to see about 245 cases, which would be higher than any flu season in the past five years.”

She said nearly half of all patients are being treated for an influenza-like illness.

Doyle was asked why this year is such a strong virus season compared to pre-pandemic years.

She said there are multiple factors for this.

“Through the pandemic, because of isolation, the viruses were not replicating and spreading, we had a lot of restrictions during the pandemic,” she said. “We also have this young group of children who didn’t get exposed to the virus and now are getting affected by the virus and it’s coming with a vengeance. It’s also disrupted our seasonal variation in viruses. So instead of the viruses respecting their seasons, they’re all coming at the same time.”

These reasons are why Doyle said parents and households should be doing everything possible to prevent their young ones from getting sick, including getting the flu shot.

“Taking preventative steps is also going to help, making sure to wash your hands frequently, stay home when you’re sick, masking indoors and in large crowds. So judicious use of masking and cleaning high-touch areas like doorknobs and counter surfaces. Doing these things are going to help protect your health and most importantly, the newborns who are not able to get vaccinated.”

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

The Canadian Press. All rights reserved.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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