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Long COVID may trigger chilblains, scaly plaques and black crusts on toes, study suggests – Yahoo Canada Sports

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Close-up of young woman scratching her arm while sitting on the sofa at home.

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Some former coronavirus patients are enduring rashes and other skin issues after testing negative for the infection. (Posed by a model, Getty Images)

Long COVID patients may be enduring dermatological symptoms, research suggests.

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="It is increasingly coming to light that not everyone who overcomes&nbsp;the coronavirus&nbsp;returns to a clean bill of health, with some facing complications after they test negative for the infection.” data-reactid=”42″>It is increasingly coming to light that not everyone who overcomes the coronavirus returns to a clean bill of health, with some facing complications after they test negative for the infection.

Dubbed “long COVID”, these patients are enduring everything from fatigue and palpitations to breathlessness and even signs of organ damage.

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="Early in the outbreak, experts warned the coronavirus may trigger skin-related symptoms like rashes, hives and chilblains.” data-reactid=”44″>Early in the outbreak, experts warned the coronavirus may trigger skin-related symptoms like rashes, hives and chilblains.

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="Read more: Coronavirus patients over 65 in the UK can test experimental drugs at home” data-reactid=”45″>Read more: Coronavirus patients over 65 in the UK can test experimental drugs at home

After looking at nearly 1,000 patients with these skin issues, scientists from Massachusetts General Hospital have reported how one individual continued to endure scaly plaques 70 days after testing positive for the infection.

Six of the patients with chilblains were still suffering 60 days later, while two with “COVID toes” experienced the small spots of blood and “blackish crusts” for more than 130 days.

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="Watch: What is long COVID?” data-reactid=”48″>Watch: What is long COVID?

“Our findings reveal a previously unreported subset of patients with long-standing skin symptoms from COVID-19, in particular those with COVID toes,” said study author Dr Esther Freeman.

“This data adds to our knowledge about the long-term effects of COVID-19 in different organ systems.

“The skin is potentially a visible window into inflammation that could be going on in the body.”

With the coronavirus only identified at the end of 2019, long COVID is a relatively mysterious phenomenon.

A team from King’s College London has estimated up to half a million Britons may be affected, with medics somewhat in the dark about how best to treat the little-known condition.

To better understand long COVID’s symptoms, the Massachusetts scientists created an international registry for coronavirus skin manifestations in April.

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="Read more: Death rates halved among COVID patients in England in three months” data-reactid=”59″>Read more: Death rates halved among COVID patients in England in three months

Doctors were contacted in June and August to update their patients’ coronavirus test results and the duration of any skin symptoms.

The scientists defined a “long hauler” as anyone with coronavirus-related skin symptoms that persisted for at least 60 days.

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="According to the World Health Organization, most coronavirus patients recover from severe symptoms within&nbsp;two to six weeks.” data-reactid=”62″>According to the World Health Organization, most coronavirus patients recover from severe symptoms within two to six weeks.

Patients enduring complications beyond this time are therefore generally considered to have long COVID, however, this definition has varied.

The King’s team has reported one in 20 former coronavirus patients endure complications for at least eight weeks, while one in seven is ill for at least four weeks and one in 45 for at least 12 weeks.

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The cause of long COVID is unclear, however, the coronavirus may linger in pockets of the body after it has been cleared from the airways. (Stock, Getty Images)

After looking at almost 1,000 coronavirus patients with skin symptoms, the Massachusetts scientists found most endured the complications for around 12 days.

Results – presented at the 29th congress of the European Academy of Dermatology and Venereology –– also revealed any measles-like rashes and skin weals typically resolved within a week, with all cases clearing up after 28 days.

Scaly plaques stuck around for an average of 20 days, however, one patient endured the unpleasant symptom for 70 days.

Chilblains and hand and feet swelling typically both lasted for around two weeks, however, six patients were enduring the symptoms 60 days after testing positive.

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="Read more:&nbsp;14% of all UK coronavirus deaths linked to air pollution” data-reactid=”89″>Read more: 14% of all UK coronavirus deaths linked to air pollution

The scientists also looked at COVID toes, which occur when small spots of blood and “blackish crusts” appear in sores on the feet.

Two patients still had COVID toes 130 days after testing positive for the coronavirus.

“We encourage clinicians taking care of patients with COVID-19 to ask about and evaluate any skin symptoms,” said Dr Freeman.

“Healthcare providers can enter information into our registry to further our understanding of the dermatologic effects of COVID-19.”

Medics have complained a lack of understanding over long COVID’s prevalence and cause makes treating patients tricky.

It has been suggested the immune response triggered by the coronavirus may lead to lasting inflammation that can theoretically affect any part of the body.

The coronavirus may also linger in pockets of the body after it has been cleared from the airways.

To learn more, NHS England and NHS Improvement have commissioned the National Institute for Health and Clinical Care Excellence (Nice) – a health watchdog – to develop a treatment guideline for long COVID, due by the end of 2020.

The NHS also recently announced a £10m ($13m) package to run designated long COVID clinics in every area of England.

Patients awaiting treatment are advised to rest as much as they can and pace themselves throughout the day.

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="Watch: Can you catch coronavirus twice?” data-reactid=”106″>Watch: Can you catch coronavirus twice?

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Province reports 1,707 new COVID cases today – SooToday

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Public Health Ontario has confirmed 1,707 new cases of COVID-19 today, which is 39 fewer than yesterday. There were 1,746 cases reported on Monday.

Of today’s new cases, most are confined to the Greater Toronto Area. There are 373 new cases confirmed in Peel Region, 727 cases in Toronto and 168 in York Region; that represents 1,268 — or 74 per cent — of the new lab-confirmed cases reported over the past 24 hours.

The agency also reported seven more deaths related to the coronavirus over the past 24 hours. Yesterday, eight deaths were reported.

More than 1,373 cases have been resolved since yesterday. 

Over the past 24 hours, 34,600 tests were completed.

Since the start of the pandemic, public health labs in Ontario have processed more than 6.3 million COVID-19 tests.

Throughout Ontario, there are 645 people currently hospitalized with the coronavirus.

  • Algoma Public Health: 60 cases, rate of 52.4 per 100,000 people. There are three known active cases.
  • North Bay Parry Sound District Health Unit: 79 cases, rate of 54.7 per 100,000 people. There are 10 known active cases.
  • Porcupine Health Unit: 106, rate of 127 per 100,000 people. There are no known active cases. 
  • Public Health Sudbury and Districts: 230 cases, rate of 113.1 per 100,000 people. There are eight known active cases.
  • Timiskaming Health Unit: 18 cases, rate of 55.1 per 100,000 people. There is one known active case. 
  • Northwestern Health Unit: 121 cases, rate of 123.2 per 100,000 people. The health unit has also reported two probable cases that are under investigation. There are 17 known active cases.
  • Thunder Bay District Health Unit: 308 cases, rate of 168 per 100,000 people.There are 93 known active cases.

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Some Ottawa Public Health programs slowly returning – CBC.ca

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Ottawa Public Health (OPH) has begun ramping up some community programs that were suspended at the start of the pandemic, but the city’s medical officer of health said not all will return to their pre-COVID-19 selves.

The pandemic didn’t just throw OPH’s budget into disarray but also how it offered many of its services, including chronic disease prevention work.

“These kinds of teams are completely redeployed to the COVID-19 response,” said Dr. Vera Etches, the city’s medical officer of health, on Monday.

OPH also had to shutter its four dental clinics across the city that offered services to people who had difficulties paying for care elsewhere.

The St. Laurent Boulevard clinic reopened for emergency services last week, while the Wabano Centre clinic should reopen part time on Thursday, Etches said.

Ottawa’s medical officer of health Vera Etches during a school visit in early September. Etches says some of OPH’s programs have gone virtual, while others have been scaled back or cancelled altogether. (Francis Ferland/CBC)

Those clinics together saw 140 clients a day before the pandemic hit, said OPH’s director of health promotion and chief nursing officer Esther Moghadam, and the hope is to get the other two open so vulnerable populations have easier access to one nearby. 

While the clinics were closed, Moghadam said dentists across the community stepped up to help and will likely have to continue to do so until the clinics are at full capacity.

“It’s still very early … There is going to be a need that we won’t be able to address fully,” she said.

Another program that fell by the wayside was the Healthy Growth and Development Program, which Etches said is currently running at 50 per cent capacity.

Its breastfeeding support work is moving online or having mothers come to OPH or other community partners instead of nurses visiting them in their homes.

Two mothers breastfeed their babies in Spain in a file photo. Ottawa Public Health’s Healthy Growth and Development Program, which offers breastfeeding support, is running at about 50 per cent capacity and has had to prioritize who gets an at-home visit from a public health nurse. (Jaime Reina/AFP/Getty Images)

Not all programs are set to return to the way they once were.

“We’re looking to learn from the new tools we have, the innovative approaches that can be built upon and the partnerships that we have grown to extend some of this work into the future,” said Etches.

That future shift includes those services tailored at chronic diseases, which she said will change because private companies have been stepping up to help protect and promote employee health.

COVID-19 in 2021

Ottawa’s Board of Health unanimously passed its largest budget ever at its meeting Monday night, with $24 million of its $98.1 million budget for 2021 expected to cover a number of one-time COVID-19 expenses

Even with positive vaccine updates, Etches said next year’s budget forecasts a similar amount of COVID-19 cases, outbreaks, follow-up and communication work in 2021 as exists now.

It is also expecting to help provide that COVID-19 vaccine to Ottawa residents “which we are hopeful, initially, will protect against hospitalizations and deaths in the people most at risk,” she said.

“That would be excellent.”

The budget will go to city council for final approval on Dec. 9.

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Parents welcome asymptomatic COVID-19 tests in schools, even if the news isn't always good – CBC.ca

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It’s been a bit of a roller-coaster weekend for Toronto father Yaser Nadaf, after Ontario’s new asymptomatic testing for schools in COVID-19 hot spots turned up 19 new positive cases at his children’s school.

While his daughter and her Grade 3 class were cleared to return to school on Monday, his son’s Grade 2 class must self-isolate for 14 days, even though the youngster himself was among those who tested negative.

The weekend’s testing blitz at Thorncliffe Park Public School — the first Toronto District School Board (TDSB) location selected for the voluntary testing pilot announced last week — saw 14 classes affected and sent home for two weeks. However, the rest of the school will remain open, according to direction from Toronto Public Health.

Nadaf is rolling with it, saying he believes teachers and staff have been trying their best to maintain health and safety precautions and protocols.

“What can we do? This is going on everywhere in the world,” he said. “They try their best, but at the same time they cannot prevent it completely.”

Testing asymptomatic students and staff is currently being offered at designated schools in Toronto, Peel and York regions and Ottawa — four Ontario regions with a high number of active COVID-19 cases.

Thorncliffe Park Public School was the first Toronto District School Board location selected to participate in a new voluntary asymptomatic testing program at schools in four COVID hot spots in Ontario. The testing found 19 positive cases, and 14 classes were sent home to self-isolate. (CBC)

The goal is to improve tracking of the coronavirus and prevent transmission within schools, as well as to inform future public health decisions. While parents and health experts seem to be applauding the pilot, some are also highlighting shortcomings in how it’s being rolled out.

Over the weekend, testing also began in Ottawa at Manordale Public School, part of the Ottawa-Carleton District School Board. Amber Mammoletti, an occasional teacher working at two schools this fall, dropped by on Sunday to be tested with her son, Flynn.

“I think there’s people walking around not realizing they have it — no symptoms — so it’s just better to keep everyone safe: Get tested if you can and see what happens,” she said.

WATCH | How testing helped Cornell University become a model of COVID-19 prevention:

At the start of the school year, Cornell University implemented a strategy of regular testing and robust contact tracing on campus. The plan was expensive, but it’s prevented any major COVID-19 outbreaks at the New York institution. 8:19

School boards are working with local public health authorities to determine which schools to target over the next four weeks, but the expectation is that new positives will undoubtedly emerge, TDSB spokesperson Ryan Bird said.

“The 19 cases we’ve learned about over the weekend [at Thorncliffe Park PS] as a result of the testing is a concern, but it’s not unexpected,” he said Monday.

“While this information is concerning, it really is the information that our public health officials need to know, because it gives them a better snapshot of how many of those asymptomatic people are positive cases of COVID.”

Despite the batch of positive cases arising from this first weekend, Ontario Education Minister Stephen Lecce reiterated his assertion that “99.9 per cent of Ontario students are COVID-free” during a press briefing on Monday afternoon.

Acknowledging that “we still have work to do” in tracking COVID-19 cases in communities, he characterized the new testing initiative as an extension of the existing safety measures his ministry had announced.

“The fact that hundreds of children, students and staff have gotten tested [at Thorncliffe Park PS] in conjunction with the local public health unit I think underscores that the plan in place is … working hard to mitigate any further spread: identifying COVID cases, isolating them or moving them from the school, so we don’t have spreaders within the school.” 

‘Canaries in the coal mine’

A targeted campaign of testing in schools — which in most neighbourhoods are considered trusted, known places — is a welcome tool that adds to the barometer of what’s happening in the communities they’re located in, said Dr. Zain Chagla, an infectious diseases physician and assistant professor at McMaster University in Hamilton.

“Parents who may not be encouraged to go get tested in their local communities will readily take their kids to the school, which is a place they know,” he said.

“Things like this are going to be canaries in the coal mine. You kind of get a better sense of what’s happening in the community by doing these local testing strategies.”

Manordale Public School in Ottawa was also among the schools selected for the pilot project. Students and staff lined up on Sunday for testing. (CBC)

He added the caveat, however, that the type of test being used will likely cause more chaos for families and schools.

For the pilot, Ontario is using PCR testing, which detects the genetic material of a virus. Although considered the gold standard, it’s also so sensitive it would “pick up kids who are infectious, as well as kids who were infectious two, four, six weeks ago,” Chagla said.

He suggested that they could have chosen rapid antigen tests, which flag active infections by identifying proteins on the surface of infectious virus particles.

The rapid antigen tests may offer a more precise picture “of who is really a threat to the community versus who had COVID six weeks ago, where they’re not really a threat,” Chagla said.

WATCH | Nova Scotia offers rapid COVID-19 tests in Halifax for asymptomatic cases:

Health officials in Nova Scotia offered rapid COVID-19 testing in Halifax to reduce the virus’s spread in the province by catching asymptomatic cases. 2:01

Though Toronto parent Jessica Lyons welcomes the introduction of asymptomatic testing, she said it comes months late and should be offered more widely.

“This is desperately needed,” said the mother of two school-aged children and an organizer with the Ontario Parent Action Network.

“Much more testing in schools — to make it accessible, to make it easy for parents and families and students to do — is really essential. So we support this pilot, obviously, but we think that it should have come … weeks and weeks ago, and it needs to be expanded.”

PCR testing being used in the pilot project is considered the gold standard, but it’s also so sensitive it would ‘pick up kids who are infectious, as well as kids who were infectious two, four, six weeks ago,’ said Dr. Zain Chagla. (Craig Chivers/CBC)

Back in Thorncliffe Park, among the Toronto communities hardest hit by COVID-19 this year, parents in the neighbourhood expressed concern about the new positive cases found through the testing initiative. But they’re also adamant about one thing: their schools staying open.

Remote learning last spring was “really hard for kids. We’ve seen the mental stress on our child and other kids,” said Osamah Aldhad, father of a second grader who he said really missed being at school.

“When we were kids, you know, we used to run away from school,” Aldhad noted.

“Now they’re actually really wanting to go to school, which is really important for them.”

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