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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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Six people can be added to existing double bubbles, government announces – NTV News

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The provincial government announced Friday that residents can expand their bubbles effective immediately.

Up to six more people can be added to an existing double bubble. The new members do not have to be from the same household, but cannot change once added. The government still advises people to keep their bubbles as small as possible.

More guidance can be found online here: https://www.gov.nl.ca/covid-19/individuals-and-households/expansion-of-household-bubble/

Dr. Proton Rahman is scheduled to release new projections Friday on how the COVID-19 pandemic is unfolding.

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Dr. Fitzgerald announced no new cases of COVID-19 on Friday.

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Ontario ramps up COVID-19 testing – ThePeterboroughExaminer.com

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A new testing strategy for COVID-19 will see “targeted campaigns” to check workers in Ontario communities with hot spots and key sectors where the virus spreads easily, including auto manufacturing, food suppliers and major retailers.

Officials unveiled the new blueprint Friday, with elements echoing what Premier Doug Ford has been saying for more than a week — and what epidemiologists have been pushing for much longer — to get a better picture of the illness as the economy reopens.

“It’s really to be proactive and understand what’s happening,” said Dr. Vanessa Allen of Public Health Ontario, who was instrumental in cobbling together a network of provincial, hospital and private labs to expand testing capacity.

For example, workers at LCBO stores were offered testing in the last few days along with Toronto police, said Dr. Dirk Huyer, Ontario’s chief coroner, who was brought in to lead the testing strategy. Several liquor store workers have tested positive in the last few months.

If there are concerns about the virus in a particular business, mobile teams will be sent in to test, he added.

There are also plans to support “enhanced testing” for hospital workers and their families, residents and staff in retirement homes, and more testing in nursing homes, where a first testing blitz of all residents and staff was completed two weeks ago after the new coronavirus raced through hundreds of facilities. About 30 per cent of retirement home testing has been completed.

That testing will continue next week in addition to testing open to the public at Ontario’s 131 assessment centres, which changed their criteria two weeks ago to allow anyone with one symptom of COVID-19 to be swabbed, along with people with no symptoms but occupational risk of exposure, such as health-care workers, their families and grocery-store workers.

Previously, people with mild or moderate symptoms were turned away from testing centres and told to self-isolate at home. Confusion over eligibility prompted Ford to issue a plea for people to get checked under the new criteria.

The goal going forward is to “identify, contain and monitor” new cases and spread of COVID-19, officials said, releasing figures showing 55 per cent of test results are available the next day and 82 per cent within two days.

Aside from communities with a higher number of cases, officials will also focus on “high-risk” individuals, such as hospital patients and cross-border workers.

Officials are aiming to increase Ontario’s lab capacity to get ready for the fall, when more respiratory symptoms will pop up and create “a need for greater testing,” Allen said.

Ontario’s testing for COVID-19 has ramped up this week and is close to peaks rarely reached as the number of cases since the illness arrived four months ago approached 29,000 with almost 2,300 deaths.

Ministry of Health figures released Friday show 18,525 nasal swabs were processed at a network of provincial, hospital and commercial labs across the province the previous day.

The provincial daily lab capacity is just over 20,000.

Results were in progress on another 13,351 samples and there have now been 680,687 tests processed in the province of 14.5 million, or 4.7 per cent of the population.

There were another 391 confirmed and probable cases as of 11 a.m. Friday, according to a Star compilation of data from health units in the previous 24 hours.

That raised the total number of cases to 28,544 and 2,272 deaths.

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About 66 per cent of cases have been in the Greater Toronto Area.

To date, at least 1,625 nursing-home residents have died, and there are outbreaks in 123 homes, down six from the previous day. But 1,476 nursing-home residents and 1,113 staff members are still fighting active cases of the highly contagious virus that spreads easily in close quarters.

The Ministry of Health said there were 826 Ontarians in hospital for COVID-19, with 129 in intensive care and 100 on ventilators. While the first two numbers were down from the previous day, there were six more patients who had to be put on ventilators to breathe.

Just under 21,000 Ontarians have recovered from the virus.

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What's open Ottawa: H&M reopens Rideau Street store | CTV News – CTV News Ottawa

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OTTAWA —
Malls remain closed in the capital, under provincial orders, but stores with street entrances are allowed to reopen, and that means a popular fashion brand has reopened one of its stores in Ottawa.

H&M announced Thursday that its store at the Rideau Centre would reopen via its Rideau Street entrance.

Only 15 people will be allowed in the store at one time. The hours are to 11 a.m. – 7 p.m.

There are markers on the floor for physical distancing. Fitting rooms have been closed and there is no garment recycling program for now.

Hand sanitizer is being provided.

While the store accepts cash, they are encouraging card use. There is one line for cash users and one line for card users at the registers.

Employees will be wearing masks, and will be behind barriers at the register. The store will be cleaned more often.

H&M will still accept returns, but says it will hold all returned items for at least 24 hours before putting them back on the sales floor.

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