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ICU continues to deal with cases during COVID-19 pandemic with operating changes – Sudbury.com

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VANCOUVER — As a senior physician at St. Paul’s hospital, Dr. Del Dorscheid has a special view of how COVID-19 is affecting patient care beyond the pandemic.

Unlike other parts of the hospital, the intensive care unit he oversees has not been emptied in anticipation of a surge of cases. Staff treat COVID-19 and non-virus patients alike, and continue to support families as they come to terms with critical illness.

Dorscheid also runs a provincial asthma clinic for about 1,200 patients virtually.

“Even if I’m here in the ICU, in the background I still have other patients who need to be cared for. It gives me an interesting out-patient and in-patient experience as to what COVID is doing to health care in this province,” Dorscheid said.

His asthma patients are terrified of entering a hospital and even if they did, most out-patient testing has been shut down. The novel coronavirus has limited huge portions of the non-COVID population from accessing timely and appropriate out-patient care they need, he said.

Death is ever present in the ICU. Normally, about 85 per cent of admitted patients survive, Dorscheid said.

The doctors and nurses who care for the critically ill already understand death is a reality. But COVID-19 has added an emotional burden to their work.

The grieving room is now empty, and the rooftop garden is no longer a place for goodbyes. Dorscheid said he’s struggled with how to provide the same compassionate care to families under limitations imposed during the pandemic.

“For me it’s very important to have the physical contact with those individuals. I see their body language, I see who the matriarch, the patriarch is, you see all of that,” he said.

There is also a spiritual purpose to their work, he said.

“We’re all going to die, and that’s not something to be scared of. What we want to protect is the understanding of that individual and what they meant to those persons’ lives, and that passing can be gracious and comfortable and actually a very beautiful thing.”

Dorscheid and his team recently made special arrangements for the children of a patient who didn’t have COVID-19 to say goodbye before he died.

Only two family members would be allowed per day for a maximum of two days, a formula rooted in disease modelling. A nurse would meet them at the hospital door. They would be screened, gloved and gowned, and informed not to touch anything — not even their father.

“I still struggled with that a bit. At least they get to see him. But I mean, the number of family members who will take their hand, kiss their forehead and say goodbye — they can’t do that anymore,” he said.

“People die alone now.”

Dying alone is something staff at St. Paul’s in the city’s downtown core have long resisted. The hospital treated HIV patients in the 1980s and 1990s when others shut their doors. Today, patients include Vancouver’s most marginalized. About one third of Dorscheid’s patients have no family.

“The nurses and doctors of this hospital understand that and we kind of become surrogate family and make sure that person has great care, whether it’s in life or in death.”

This report by The Canadian Press was first published April 30, 2020.

Amy Smart, The Canadian Press


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2 new cases of COVID-19, bringing total long-term care residents infected to 5 – CBC.ca

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There are two new cases of COVID-19 in the province, both related to a recent outbreak in the Campbellton region.

There are now 15 active cases of COVID-19, all in Zone 5, which has been returned to the orange phase of recovery while restrictions remain eased in the rest of the province.

The new cases are an individual between 40 and 49 years of age, and an individual between 60 and 69 years of age.

A provincial press release said one of the two new cases is linked to a close contact of a previously identified case, and the other one is linked to Manoir de la Vallée, a long-term care facility in Atholville.

Social Development Minister Dorothy Shephard said in total, the facility has three staff and five residents test positive.

There are five people in hospital and one in the intensive care unit, the release said.

Three of the hospitalized people are residents of the long-term care home, Shephard said, including the ICU patient.

“To the best of my knowledge I can tell you that [their condition] is stable,” Shephard said.

All of the cases are isolated in the memory care wing of the facility, Shephard said. 

“This memory care wing would have doors, like locked doors,” shes said. “We can’t say 100 per cent that a patient doesn’t wander in some fashion but it’s very much minimized.”

She said all the rooms are private, but residents do share a bathroom.

“A cleaning crew has been brought on to support staff in washing down washrooms three times a day at a minimum,” she said.

Two of the positive residents are still in the wing in Atholville she said, and the staff members are isolating in their homes. 

She said administrators are in contact with family members on a daily basis. She said she’s sure residents and families are worried.

“But I’m sure that staff is doing everything they can to give them assurances that every precaution is being taken to protect them.”

Social Development Minister Dorothy Shephard says three of the six people in hospital are long-term care home residents. One is in ICU and in ‘stable’ condition. (Ed Hunter/CBC)

The release said a Quebec resident has also tested positive, and is also linked to the facility, but the case will be counted as part of Quebec’s statistics.

Public H​​​​​ealth has previously linked the outbreak to a doctor who travelled to Quebec and didn’t self-isolate for the mandatory 14 days when he returned.

The province has conducted 31,791 tests in total, including 1,125 in the last 24 hours.

What to do if you have symptoms?

The province says if you or a member of your family are showing two of the following symptoms, contact Tele-Care 811 or your primary health-care provider:

  • Fever above 38°C or signs of fever (such as chills).
  • A new cough or worsening chronic cough.
  • Sore throat.
  • Runny nose.
  • Headache.
  • A new onset of fatigue.
  • A new onset of muscle pain.
  • Diarrhea.
  • Loss of sense of taste or loss of sense of smell.
  • In children, purple markings on the fingers or toes. In this instance, testing will be done even if none of the other symptoms are present.

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Province announces one new case of COVID-19 Wednesday – HalifaxToday.ca

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NEWS RELEASE
COVID-19/HEALTH/WELLNESS
*************************

As of today, June 3, Nova Scotia has 1,058 confirmed cases of COVID-19. One new case was identified Tuesday, June 2.

The QEII Health Sciences Centre’s microbiology lab completed 639 Nova Scotia tests on June 2 and is operating 24-hours.

There is one licensed long-term care home in Nova Scotia with active cases of COVID-19. Northwood in Halifax currently has three residents and two staff active cases.

The list of symptoms being screened for has recently expanded. If you have any one of the following symptoms, visit https://811.novascotia.ca to determine if you should call 811 for further assessment:
— fever (i.e. chills, sweats)
— cough or worsening of a previous cough
— sore throat
— headache
— shortness of breath
— muscle aches
— sneezing
— nasal congestion/runny nose
— hoarse voice
— diarrhea
— unusual fatigue
— loss of sense of smell or taste
— red, purple or blueish lesions on the feet, toes or fingers without clear cause

To date, Nova Scotia has 43,340 negative test results, 1,058 positive COVID-19 test results and 60 deaths. Confirmed cases range in age from under 10 to over 90. Three individuals are currently in hospital, one of those in ICU. Nine-hundred and ninety-three individuals have now recovered and their cases of COVID-19 are considered resolved. Cases have been identified in all parts of the province. A map and graphic presentation of the case data is available at https://novascotia.ca/coronavirus/data .

Public health is working to identify and test people who may have come in close contact with the confirmed cases. Those individuals who have been confirmed are being directed to self-isolate at home, away from the public, for 14 days.

Anyone who has travelled outside Nova Scotia must self-isolate for 14 days. As always, any Nova Scotian who develops symptoms of acute respiratory illness should limit their contact with others until they feel better.

It remains important for Nova Scotians to strictly adhere to the public health order and directives – practise good hand washing and other hygiene steps, maintain a physical distance of two metres or six feet from those not in your household or family household bubble and limit planned gatherings of people outside your household or family household bubble to no more than 10.

Nova Scotians can find accurate, up-to-date information, handwashing posters and fact sheets at https://novascotia.ca/coronavirus .

Businesses and other organizations can find information to help them safely reopen at https://novascotia.ca/reopening-nova-scotia/ .

Quick Facts:
— testing numbers are updated daily at https://novascotia.ca/coronavirus
— a state of emergency was declared under the Emergency Management Act on March 22 and extended to June 14

Additional Resources:
Government of Canada: https://canada.ca/coronavirus

Government of Canada toll-free information line 1-833-784-4397

The Mental Health Provincial Crisis Line is available 24/7 to anyone experiencing a mental health or addictions crisis, or someone concerned about them, by calling 1-888-429-8167 (toll-free)

Kids Help Phone is available 24/7, by calling 1-800-668-6868 (toll-free)

For help or information about domestic violence 24/7, call 1-855-225-0220 (toll-free)
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A look at how provinces plan to emerge from COVID-19 shutdown – Preeceville Progress

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Provinces have been releasing plans for easing restrictions that were put in place to limit the spread of COVID-19.

Here is what some of the provinces have announced so far:

article continues below

Newfoundland and Labrador

Newfoundland and Labrador announced on May 29 that “bubbles” that had been limited to two households could invite six additional people into their circle.

Small gatherings for funerals, burials and weddings had already been allowed with a limit of 10 people following physical distancing rules. However, parties or other social gatherings are still banned.

Outdoor games of tennis have been allowed to resume, though players must bring their own equipment, and not share it.

Pet grooming services began operating May 25, with companies ordered to ensure their employees have personal protective equipment.

Municipal parks, golf courses and driving ranges can open and recreational hunting and fishing are permitted.

The province is in “alert level four” in its five-level reopening plan, allowing some businesses such as law firms and other professional services to reopen along with regulated child-care centres, with some restrictions.

At Level 3, private health clinics, such as optometrists and dentists, will be allowed to open, as well as medium-risk businesses such as clothing stores and hair salons. Overnight camping will also be permitted at level three, though there’s no word yet when that will happen.

At Level 2, some small gatherings will be allowed, and businesses with performance spaces and gyms are to reopen.

Level 1 would represent “the new normal.”

Nova Scotia

On May 29 Premier Stephen McNeil announced a new gathering limit of 10 people, doubling the limit of five that was imposed in late March.

Physical distancing of two metres is still 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.

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 also must adhere to the 10-person limit.

Private campgrounds can reopen, but only at 50 per cent capacity and they 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.

Most businesses ordered shut in late March will be allowed to reopen June 5, if they have 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 will also be able to reopen, including dentistry, optometry, chiropractic and physiotherapy offices. Veterinary services will be allowed to operate along with some unregulated professions, such as massage therapy, podiatry and naturopathy.

McNeil earlier announced there would be no return to school this year, and a decision on reopening daycares would be made by June 8.

Trails and provincial and municipal parks can now reopen along with garden centres, nurseries and similar businesses, but playground equipment is still off limits.

Public beaches have reopened along with outdoor activities like archery, horseback riding, golf, paddling, boating and tennis, with the proviso that social distancing and hygiene be maintained. Sportfishing is permitted and people can attend boating, yacht or sailing clubs for the purpose of preparing boats for use.

Drive-in religious services are now allowed, if people stay in their cars, park two metres apart and there are no interactions between people.

Prince Edward Island

Prince Edward Island has extended its public health emergency until June 14.

Premier Dennis King says people wanting to travel to seasonal residences must apply beginning June 1, and those will be put through a risk assessment before approval. Seasonal residents will also be tested for COVID-19 before completing the two weeks they must spend in self-isolation after arriving in the province.

The province moved into the third phase of its reopening plan June 1, which allows such things as in-house dining at restaurants, small groups to participate in recreational and some sporting activities and libraries to reopen. Phase three also allows gatherings of up to 15 people indoors and 20 people outdoors and the reopening of child-care centres.

As well, family and friends can visit residents at long-term care homes. The visits require an appointment and must take place outdoors.

Under phase 2, non-contact outdoor recreational activities were permitted, and retail businesses could reopen with physical distancing measures in place.

Priority non-urgent surgeries and select health-service providers, including physiotherapists, optometrists and chiropractors, resumed on May 1.

The P.E.I legislature resumed May 26.

New Brunswick

New Brunswick moved to the “yellow phase” of its COVID-19 recovery plan on May 22, allowing barbers and hair stylists to reopen as well as churches and fitness facilities. Dental care, massage, chiropractors and other “close contact” businesses and services could also reopen.

But the Campbellton region, which extends from Whites Brook to the Belledune, had to take a step backwards to the “orange” level on May 27. Residents were told to once again avoid contacts outside their two-household bubble. Non-regulated health professionals and personal service businesses that opened May 22 also had to close again. And people should only be travelling in and out of Zone 5 for essential reasons.

Restrictions in the yellow phase of the province’s recovery plan will be lifted beginning June 5. The activities include outdoor gatherings of up to 50 people, indoor religious services of up to 50 people, low-contact team sports and the opening of a long list of facilities including swimming pools, gyms, rinks, water parks, and yoga and dance studios.

Licensed daycares started reopening May 19. Children don’t have to wear masks or maintain physical distancing but are being kept in small groups.

Anyone who has travelled outside of New Brunswick will not be allowed to visit early learning and child-care facilities for 14 days.

Retail businesses, offices, restaurants, libraries, museums and seasonal campgrounds were earlier allowed to reopen providing they have clear plans for meeting public health guidelines. The resumption of elective surgeries was also part phase two of the province’s reopening plan.

Phase one, which started on April 24, allowed limited play on golf courses as well as fishing and hunting. Post-secondary students could return if it was deemed safe by the school, and outdoor church services were again permitted, providing people remain in their vehicles and are two metres apart.

The final phase, which will probably come only after a vaccine is available, will include large gatherings.

Quebec

Quebec began allowing outdoor gatherings with a maximum of 10 people from three families with social distancing in place on May 22.

On May 25 some retail businesses reopened in the greater Montreal area. Quebec reopened retail stores outside Montreal on May 11.

Parks and pools can reopen across the province but are still be subject to physical distancing and other health measures

Day camps across the province will be allowed to open as of June 22, with physical distancing and other COVID-19 health measures in effect. That means smaller groups of children and frequent handwashing. Sleep-away summer camps won’t be allowed to reopen until next year.

Lottery terminals are also reopening after being shut down on March 20 with sales moving to online only.

Quebec’s construction and manufacturing industries have resumed operations with limits on the number of employees who can work per shift. Elementary schools and daycares outside Montreal reopened on May 11, but high schools, junior colleges and universities will stay closed until September.

Elementary schools in the greater Montreal area will remain closed until late August.

Courthouses across the province were permitted to reopen starting June 1, with limited seating capacity and Plexiglas barriers protecting clerks and judges.

Camping is now allowed outside the Montreal and Joliette regions, as are cottage rentals.

Shopping malls, nail salons and other personal care centres are also reopening, but only outside Montreal.

Hairdressers, nail salons and other personal care businesses will be able to open in the Montreal area on June 15.

Meanwhile, checkpoints set up to slow the spread of COVID-19 came down on May 18 in various parts of Quebec, including between Gatineau and Ottawa.

Ontario

Ontario began its first stage of reopening May 19 including lifting restrictions on retail stores and surgeries.

The province says workplaces can begin to reopen but working from home should continue as much as possible.

The Royal College of Dental Surgeons of Ontario says the profession is currently in Stage 2 of its three-phase reopening plan. Dentists had previously only been allowed to practice emergency or urgent care on patients in-person but can now offer other essential services with enhanced precautions.

All construction can resume, with limits also lifted on maintenance, repair and property management services, such as cleaning, painting and pool maintenance.

Most retail stores with a street entrance can reopen with physical distancing restrictions, and curbside pickup and delivery.

Golf courses can reopen though clubhouses can only open for washrooms and take-out food. Marinas, boat clubs and public boat launches can also open, as can private parks and campgrounds for trailers and RVs whose owners have a full season contract, and businesses that board animals.

Other businesses and services included in the stage one reopening include regular veterinary appointments, pet grooming, pet sitting and pet training; libraries for pickup or deliveries; and housekeepers and babysitters.

Drive-in movie theatres and batting cages reopened May 31 with physical distancing measures in effect.

Backcountry campers returned to provincial parks June 1 with certain stipulations. No more than five people can occupy a single campsite, unless they live in the same household. Provincial parks will also expand permission for picnics and off-leash pet areas.

Premier Doug Ford earlier announced that Ontario schools would remain closed for the rest of the school year.

Meanwhile, this summer’s Honda Indy Toronto has been cancelled.

Manitoba

The Manitoba government has lifted its one-month limit on people’s prescription drug supplies, allowing people to again get prescriptions filled or refilled for 90 days.

Its health offices, including dentists, chiropractors and physiotherapists can also reopen. Retail businesses can reopen at half occupancy providing they ensure physical spacing.

Museums and libraries can reopen, but with occupancy limited to 50 per cent.

Playgrounds, golf courses and tennis courts have reopened as well, along with parks and campgrounds.

On May 22 the province began allowing groups of up to 25 people indoors and 50 people outdoors.

On June 1, the province eased a ban on people visiting loved ones in personal care homes.

Homes can now offer outdoor visits with a maximum of two guests per resident. Visitors will be screened upon arrival and must practice physical distancing.

Community centres and seniors’ clubs are also getting the go-ahead with limits on customer capacity and rules for physical distancing.

Bars, tattoo parlours, dine-in restaurants, fitness clubs and pools could reopen June 1 under limited capacity.

Elementary and high schools stopped in-class instruction in March and will not reopen this school year. But they were allowed, as of June 1, to offer tutoring or student assessments in small groups. Some extracurricular sports and other activities can restart.

At universities and colleges, some specific instruction such as labs and arts studios will be able to resume for up to 25 students and staff at a time.

Amateur sports and recreation programs, as well as bowling alleys, are on the list to resume operations.

A ban on non-essential travel to the province’s north was also eased starting June 1. Southern residents can now travel directly to cottages, campgrounds and parks, but are being told to avoid visiting northern communities.

Film productions can also resume, as well outdoor religious services with no crowd limits providing people stay in their vehicles.

Movie theatres and casinos must remain closed. Concerts, professional sporting events and other large public gatherings won’t be considered until at least September.

Manitoba has extended a province-wide state of emergency until mid-June, to help prevent the spread of COVID-19.

Saskatchewan

The Saskatchewan government’s five-phase plan to reopen its economy started May 11 with dentists, optometrists and other health professionals allowed to resume services. Phase 1 also includes reopened golf courses and campgrounds.

Under phases 2 and 3 the province says restaurants, gyms and nail salons can start reopening on June 8. Restaurants will be allowed to operate at half capacity and restrictions will also lift on some personal care services, childcare centres and places of worship. The government also plans to increase its 10-person gathering limit to 15 people indoors and to 30 for those outdoors.

Phase 4 could see arenas, swimming pools and playgrounds opening, while in Phase 5, the province would consider lifting restrictions on the size of public gatherings.

Alberta

Alberta has completed the first phase of its economic relaunch. Retail shops, restaurants, day cares, barber shops, hair salons, farmers markets and places of worship have reopened with some conditions.

Outdoor gatherings are currently limited to 50 people, and indoor gatherings to 15.

The next phase is scheduled to begin June 19 with the reopening of stage and movie theatres, spas and services like manicures, pedicures and massages.

Alberta allowed some scheduled, non-urgent surgeries to start on May 11.

Service provided by dentists, physiotherapists and other medical professionals are also permitted. Golf courses reopened May 2, though pro shops and clubhouses remain shuttered.

British Columbia

The provincial government allowed a partial reopening of the B.C. economy starting May 19.

The reopening plans are contingent on organizations and businesses having plans that follow provincial guidelines to control the spread of COVID-19. Hotels, resorts and parks will follow in June.

Parents in B.C. were given the choice of allowing their children to return to class on a part-time basis starting June 1. The government says its goal is for the return of full-time classes in September, if it’s safe.

Under the part-time plan, for kindergarten to Grade 5, most students will go to school half time, while grades 6 to 12 will go about one day a week. A mix of online and classroom post-secondary education is planned for September.

Conventions, large concerts, international tourism and professional sports with a live audience will not be allowed to resume until either a vaccine is widely available, community immunity has been reached, or effective treatment can be provided for the disease.

Northwest Territories

The Northwest Territories announced on May 12 a three-phase reopening plan, but the government didn’t say when it would be implemented.

The plan includes more gatherings and the possible reopening of some schools and businesses. However, the territory’s borders remain closed indefinitely to non-residents and non-essential workers.

There are several requirements that must be met before any measures are relaxed: there must be no evidence of community spread; travel entry points in the territory are strong and secure; risks are reduced from workers coming into the territory; and expanded community testing is available.

Yukon

Travel restrictions will be lifted between Yukon and B.C. after July 1 under the second phase of the territory’s pandemic restart plan.

After that date, travellers between the province and territory will no longer be required to self-isolate for 14 days.

The territory says monitoring the status of neighbouring jurisdictions will determine if it’s safe to further lift restrictions.

Yukon has been gradually easing pandemic restrictions since May 15 with dine-in restaurants, day cares and recreational centres reopening.

Territorial parks and campgrounds will open for the summer next week.

Two households of up to 10 people in total are currently able to interact with each other as part of a “household bubble.”

The territory’s reopening plan outlines five phases including a period after a vaccine is available.

This report by The Canadian Press was first published June 3, 2020

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