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Little Mountain Place care home allowed group activities to continue after positive test, family says – CBC.ca

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Parbs Bains had a “sinking feeling” when she heard a single staff member tested positive for COVID-19 at her grandmother’s care home.

On Nov. 20, Little Mountain Place sent an email to families that said an employee had contracted the coronavirus and was in isolation. A Vancouver Coastal Health medical health officer determined there was “minimal exposure risk” and was not declaring an outbreak, it said.

Instead, the health authority placed the home on “enhanced surveillance,” including heightened monitoring of residents, hypervigilance in screening visitors and stronger infection control practices. Visitors were still welcome and group activities were continuing, the email said.

Bains felt certain this was the beginning of the end for her 89-year-old grandmother.

“I was like, ‘This is it.’ I was bawling because I just knew this was going to be it,” Bains recalled.

The facility declared an outbreak two days later.

It has since become the deadliest care home outbreak in British Columbia. Ninety-nine out of 114 residents have been infected and 41 of those have died, including Bains’s grandmother. Seventy staff members also tested positive, but most have recovered.

Two families are questioning whether some deaths could have been avoided if the home had taken stronger measures immediately after the first case was identified. They also say a hard-working but understaffed nursing team struggled to keep residents isolated and care for those who were sick as the virus spread through the facility.

During a Zoom call with her grandmother after she contracted COVID-19, Bains said another female resident entered the room and began hugging and kissing the elderly woman on the forehead. After several minutes, a nurse rushed in and ushered the other resident out, she recalled.

Bains said while she didn’t know if the other woman had the virus, it alarmed her that residents were able to wander between rooms without staff immediately noticing.

The Little Mountain Place care home in Vancouver has suffered the deadliest COVID-19 outbreak among care facilities in B.C. (Ben Nelms/CBC)

On other occasions, Bains said her grandmother’s oxygen tubes were out of her nose and she would desperately yell for help over the Zoom call. Nurses told her that her grandmother was actually one of the fortunate ones because her room was close to their station, Bains said.

Bains said she is “so angry” at the way the outbreak was handled.

“Something had to have gone wrong at Little Mountain Place … for this to be so lethal,” she said.

Outbreaks not always automatically declared, officials say

Little Mountain Place referred questions to Vancouver Coastal Health, where Chief Medical Health Officer Dr. Patricia Daly said the provincewide standard is that outbreaks are not automatically declared when one staff member tests positive.

The health authority determines whether the employee was in the care home during their infectious period and whether they potentially exposed other staff or residents — for example, by not properly using personal protective equipment — she said.

A worker is seen cleaning surfaces inside Little Mountain Place on Jan. 7. (Darryl Dyck/The Canadian Press)

If there is no evidence of exposures, the authority places the home on “enhanced surveillance” and monitors for other cases, she said. Some testing may be done and group activities continue but must always follow a COVID-19 safety plan, she said.

Declaring an outbreak every time a single staff member tests positive would be too hard on residents who suffer when they are isolated and their visitors are restricted, Daly said.

“We’re trying to find that right balance,” she said.

No mass testing at facility

Vancouver Coastal Health said there was no mass testing of all residents and staff after the first case was identified. It was only on Nov. 22, after a resident tested positive and the outbreak was declared, that full-facility testing was done, it said.

Daly said broad testing is not always necessary because it depends on the risk and timing of potential exposures.

At Little Mountain Place, it became clear transmission occurred before the initial case was identified, she said.

She said during an outbreak, residents are supposed to stay in their rooms, but it is very challenging for patients with dementia to follow those rules. Staff are advised to monitor residents who wander but not to lock anyone in or restrain them, she said.

“Keeping residents with cognitive impairment in their rooms, that has been a common challenge across all facilities in all of our outbreaks,” Daly said.

Families call for investigation

Bains and another relative, Bernadette Cheung, have demanded an investigation of the care home’s response to the virus.

Daly said she received a letter from a family member last week and has ordered Vancouver Coastal Health’s licensing team to conduct a review once the outbreak is over.

The team will examine whether the home is following regulations under the Community Care and Assisted Living Act and, if not, will require it to develop a plan to address those gaps. In very rare cases, reviews by the team have led to a change in management, Daly said.

B.C. Seniors Advocate Isobel Mackenzie said she wants to see routine testing of all staff members at care homes. At Little Mountain Place, all staff and residents should have been tested immediately after the first employee tested positive, she said.

Screening for symptoms is inadequate because people can be asymptomatic and contagious, she noted.

People wait to be screened before entering Little Mountain Place on Jan. 3. (Darryl Dyck/The Canadian Press)

“The fact that more people were infected two days later, if you had tested everybody before then, you’d have caught some people,” she said. “You would have been able to isolate them if they were residents or you would have been able to pull them from the roster if they were staff.”

Provincial Health Officer Dr. Bonnie Henry said Monday the province is “looking at” regular rapid testing of staff in care homes. Ontario started doing rapid testing at long-term care facilities in November.

Cheung, whose grandmother died of COVID-19 at Little Mountain Place and has been outspoken about her concerns, said Health Minister Adrian Dix called her on Monday. She said he promised an “intense review” of the outbreak and to follow up again with her about his conversations with the care home and the health authority.

The ministry did not immediately respond to a request for comment.

Though the conversation was light on details, Cheung said she appreciated his empathy.

“That gives us hope, at least, that it is a priority for him,” she said.

She said she has also received confirmation from Vancouver Coastal Health that her formal complaint against the care home will proceed.

Cheung has criticized the care home for not being transparent with families. She wants to know more about why the health authority determined there was “minimal risk” of exposure from the first infected staff member and declined to declare an outbreak on Nov. 20, she said.

“Essentially, we’re being kept in the dark and it raises concerns and even suspicions,” she said.

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Two new COVID-19 cases reported Friday – HalifaxToday.ca

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NEWS RELEASE
COVID-19/HEALTH/WELLNESS
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As of today, Jan. 15, Nova Scotia has 32 active cases of COVID-19. Two new cases are being reported today.

One case is in Northern Zone and the other case is in Central Zone. Both cases are close contacts of previously reported cases.

Nova Scotia Health Authority’s labs completed 2,010 Nova Scotia tests on Jan. 14.

There were 808 tests administered between Jan. 8 and 14 at the rapid-testing pop-up sites in Halifax, Sackville and Yarmouth.

Since Oct. 1, Nova Scotia has completed 137,534 tests. There have been 461 positive COVID-19 cases and no deaths. No one is currently in hospital. Cases range in age from under 10 to over 70. Four hundred and twenty-nine cases are now resolved. Cumulative cases may change as data is updated in Panorama.

Post-secondary students returning to Nova Scotia from anywhere except Prince Edward Island or Newfoundland and Labrador are strongly encouraged to visit https://covid-self-assessment.novascotia.ca/ to book a COVID-19 test for day six, seven or eight of their 14-day self-isolation period. COVID-19 testing appointments can be booked up to three days in advance.

Visit https://covid-self-assessment.novascotia.ca/ to do a self-assessment if in the past 48 hours you have had or you are currently experiencing:
— fever (i.e. chills/sweats) or cough (new or worsening)

Or:
Two or more of the following symptoms (new or worsening):
— sore throat
— runny nose/nasal congestion
— headache
— shortness of breath/difficulty breathing

Call 811 if you cannot access the online self-assessment or wish to speak with a nurse about your symptoms.

When a new case of COVID-19 is confirmed, the person is directed to self-isolate at home, away from the public, for 14 days. Public health works to identify and test people who may have come in close contact with that person.

Anyone who has travelled from anywhere except Prince Edward Island or Newfoundland and Labrador must self-isolate for 14 days. As always, anyone 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 when and where required. Wearing a non-medical mask is mandatory in most indoor public places.

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 and operate 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, 2020 and extended to Jan. 24, 2021
— online booking for COVID-19 testing appointments is available at https://covid-self-assessment.novascotia.ca/

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

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

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)

If you need help with a non-crisis mental health or addiction concern call Community Mental Health and Addictions at 1-855-922-1122 (toll-free) weekdays 8:30 a.m. to 4:30 p.m.

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)

For more information about COVID-19 testing and online booking, visit https://novascotia.ca/coronavirus/symptoms-and-testing/

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Pfizer assures affordable vaccines for PH – CNN Philippines

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Metro Manila (CNN Philippines, January 15) — US drugmaker Pfizer is aiming to provide developing countries like the Philippines doses of its COVID-19 vaccine at an affordable price.

“I’m also very happy to announce that it is Pfizer’s intention to make available its COVID-19 vaccine to low-income countries like the Philippines at a not-for-profit price during the pandemic,” said Andreas Quercia, Pfizer country manager during the Senate Committee on the Whole’s hearing on the national COVID-19 vaccination plan Friday.

Pfizer also said it is in “advance discussions” with the Philippine government on a supply agreement for its COVID-19 vaccine, adding it plans to make doses available to the country as soon as possible. Vaccine czar Carlito Galvez Jr., meanwhile, said there might already be a term sheet and supply agreement with the pharmaceutical firm within next week.

The official also said Pfizer vaccine doses may reach the Philippines as early as the first quarter of 2021 through the help of the COVAX facility, of which the country is part of. The facility purchases vaccines to be distributed for free to developing countries, covering a maximum of 20% of their respective populations.

Pfizer is the first to secure Emergency Use Authorization in the Philippines for a coronavirus vaccine. The Food and Drug Administration granted the approval Thursday, citing the vaccine’s high efficacy rate.

Pfizer earlier bagged EUAs across the globe, including from the United States and the United Kingdom.

Agreements with Sinovac, other firms not a ‘done deal’

When asked whether agreements the country has entered into in advance for vaccine supply with firms like China-based Sinovac are already a “done deal,” Galvez said that is not the case.

Ang sa atin pa lang po ngayon [For now,] we are [just] dealing with the term sheet. Posible rin [It could also be possible] we have to lock (the supply), so that they can already make production. So sa ngayon po, wala pa pong government funds tayong naibibigay,” clarified the official.

[Translation: As of now, we haven’t given out government funds yet.]

National policy against COVID-19 deputy chief implementer Vince Dizon also reiterated the country’s vaccine expert panel has recommended seven vaccine brands for possible purchase, which includes Sinovac. However, none of this is final yet, as the government awaits the panel’s final recommendation, along with an EUA from the FDA.

Sinovac has also applied for emergency use authorization, the regulatory agency revealed earlier this week.

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Expanded vaccine rollout in US spawns a new set of problems – Powell River Peak

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The rapid expansion of COVID-19 vaccinations to senior citizens across the U.S. has led to bottlenecks, system crashes and hard feelings in many states because of overwhelming demand for the shots.

Mississippi’s Health Department stopped taking new appointments the same day it began accepting them because of a “monumental surge” in requests. People had to wait hours to book vaccinations through a state website or a toll-free number Tuesday and Wednesday, and many were booted off the site because of technical problems and had to start over.

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In California, counties begged for more coronavirus vaccine to reach millions of their senior citizens. Hospitals in South Carolina ran out of appointment slots within hours. Phone lines were jammed in Georgia.

“It’s chaos,” said New York City resident Joan Jeffri, 76, who had to deal with broken hospital web links and unanswered phone calls before her daughter helped her secure an appointment. “If they want to vaccinate 80% of the population, good luck, if this is the system. We’ll be here in five years.”

Up until the past few days, health care workers and nursing home patients had been given priority in most places around the U.S. But amid frustration over the slow rollout, states have thrown open the line to many of the nation’s 54 million senior citizens with the blessing of President Donald Trump’s administration, though the minimum age varies from place to place, at 65, 70 or higher.

On Thursday, New Jersey expanded vaccinations to people between 16 and 65 with certain medical conditions — including up to 2 million smokers, who are more prone to health complications.

The U.S., meanwhile, recorded 3,848 deaths on Wednesday, down from an all-time high of 4,327 the day before, according to Johns Hopkins University. The nation’s overall death toll from COVID-19 has topped 385,000.

President-elect Joe Biden unveiled a $1.9 trillion coronavirus plan Thursday that includes speeding up vaccinations. Called the “American Rescue Plan,” the legislative proposal would meet Biden’s goal of administering 100 million vaccines by the 100th day of his administration.

More than 11.1 million Americans, or over 3% of the U.S. population, have gotten their first shot of the vaccine, a gain of about 800,000 from the day before, the Centers for Disease Control and Prevention said Thursday. The goal of inoculating anywhere between 70% and 85% of the population to achieve herd immunity and conquer the outbreak is still many months away.

Hard-hit Los Angeles County, the nation’s most populous county with 10 million residents, said it couldn’t immediately provide shots to the elderly because it had inoculated only about a quarter of its 800,000 health care workers.

“We’re not done with our health care workers, and we actually don’t have enough vaccine right now to be able to get done more quickly,” Public Health Director Barbara Ferrer said. “We haven’t heard back from the state about vaccine availability and how it would be distributed.”

Santa Clara County health officials said the county of 2 million people had only enough vaccine to inoculate people 75 and older, not the 65-and-older crowd.

“It’s almost like a beauty contest. And this should not be a beauty contest,” County Supervisor Cindy Chavez said. “This is about life and death.”

In Mississippi, officials said new appointments will probably have to wait until a hoped-for shipment of vaccine in mid-February.

In South Carolina, Kershaw Health in Camden implored people not to call its hospitals or doctors to schedule vaccination appointments after receiving more than 1,000 requests in two days. State health authorities said their hot line got 5,000 calls on Wednesday.

Francis Clark said she tried repeatedly to schedule an appointment for her 81-year-old mother, who lives alone outside Florence, South Carolina, and doesn’t have internet access. But the local hospital had no openings on Wednesday, Clark said, and the other vaccination sites are too far away.

“My mom can’t drive to Charleston,” Clark said. “She’s too old.”

Allison Salerno, an audio producer from Athens, Georgia, said she spent the better part of a day calling her state’s health department to get a vaccine appointment for her 89-year-old mother.

“I started calling at 8:30 a.m. and on the 67th call I was finally put on hold,” Salerno said. “I had already pre-registered her two weeks before online, but I never received a confirmation.”

After Salerno had spent 65 minutes on hold, someone finally came on the line and gave her mother a Saturday appointment.

“My mother has not been out since the beginning of the pandemic,” Salerno said. “She’s a very healthy woman and she wants to go to the grocery store, she wants to get her hair done.”

Meanwhile, some states, like Minnesota, are waiting before throwing open the doors.

“As we learn more, we will work to make sure everyone who is eligible for a vaccine knows how, where, and when they can get their shots,” the state Health Department said in an email. “Everyone’s opportunity to get vaccinated will come; it will just take some time.”

Arizona, which had the nation’s highest COVID-19 diagnosis rate over the past week, will start signing up people 65 and older next week. It also plans to open a vaccination site at Phoenix Municipal Stadium in addition to the one dispensing thousands of shots daily at the home of the NFL’s Arizona Cardinals.

To step up the pace of vaccinations, South Carolina made a rule change allowing medical students, retired nurses and other certain professionals to administer the shots.

California lawmakers are increasing the pressure on Gov. Gavin Newsom to likewise expand authorization for who can give injections to include nursing students, retired medical workers, firefighters and National Guard members with medical training.

Newsom said the state’s priority is to deliver vaccines “as quickly as possible to those who face the gravest consequences.” He urged patience for those not yet eligible, saying: “Your turn is coming.”

Jeffri, the New Yorker, spent several days trying to book a vaccination and once actually received a slot, only to get a follow-up text saying they didn’t have the doses. Finally, with some online sleuthing from her daughter, the retired arts-administration professor got an appointment for her first shot — two weeks from now.

“It’s a relief,” said Jeffri, who wrote to Gov. Andrew Cuomo about her ordeal. “But I’m not sure I trust it until it’s done.”

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