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Nearly 20 per cent of COVID-19 infections among health-care workers by late July

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VANCOUVER — Health care workers in Canada made up about 20 per cent of COVID-19 infections as of late July, a figure that was higher than the global average.

In a report released earlier this month, the Canadian Institute for Health Information said 19.4 per cent of those who tested positive for the virus as of July 23 were health-care workers. Twelve health care workers, nine from Ontario and three from Quebec, died from COVID-19, it said.

The World Health Organization said in July that health-care workers made up 10 per cent of global COVID-19 infections.

A national federation of nurses’ unions blames the infection rate on a slow response to the pandemic, a shortage of labour and a lack of personal protective equipment.

Mahi Etminan, a registered oncology nurse who was working at a hospital in Vancouver in mid-March, says she doesn’t know how she was infected by COVID-19.

“It could have been anywhere in the hospital,” she said.

“In March, we weren’t required to really wear any masks or anything.”

Etminan said she has tested negative for the virus twice but still feels the after-effects of her illness. She tires easily, has lost her sense of taste — even salt — and is losing chunks of her hair.

She agrees with the Canadian Federation of Nurses Unions that proper precautions weren’t put in place to deal with COVID-19.

“I think we were behind in putting a proper protocol in place,” Etminan said.

Linda Silas, president of the 200,000-member nurses’ federation, said Canadian hospitals approached COVID-19 based on the findings of a 2003 Ontario government commission into SARS.

“I thought we were ready,” Silas said in an interview.

“And then mid-March, early March, we realized how unready we were. And that’s one of the reasons that we have one of the highest levels of health-care workers getting infected.”

She said with the routes of transmission for the virus being uncertain — and later research showing it was possible the virus could be airborne — it was critical that health care workers get full protection.

The Ontario government convened the commission to investigate the origin, spread and response to SARS. One of the key recommendations of the report was improving the safety of health-care workers.

Ontario Health Ministry spokesman David Jensen said lessons learned from SARS have been implemented, including giving more powers to the chief medical officer of health to issue directives to workers and organizations.

The province recommends health-care workers use appropriate precautions when conducting clinical assessments, testing and caring for patients who are suspected or confirmed to have COVID-19, he said.

The approach to the novel coronavirus was taken on a precautionary basis because little information was available about its transmission and clinical severity, Jensen said in an email response to questions.

“The majority of cases are linked to person-to-person transmission through close direct contact with someone who has COVID-19. There is no evidence that COVID-19 is transmitted through the airborne route.”

The World Health Organization acknowledged in July the possibility that COVID-19 might be spread in the air under certain conditions.

It said those most at risk from airborne spread are doctors and nurses who perform specialized procedures, such as inserting a breathing tube or putting patients on a ventilator.

Michael Brauer, a professor at the University of British Columbia’s school of population and public health, said COVID-19 doesn’t fit the traditional airborne model where viruses remain infectious over long distances and time periods.

“There’s been a little bit of an evolution in our understanding of the transmission,” he said, adding there was evidence as early as March that showed the virus can be transmitted via air.

While early on more attention was paid to surface transmission, it now seems as though the airborne route is more prominent, he said.

Health Canada spokeswoman Tammy Jarbeau said long-term care facilities and retirement homes were among the hardest hit during the peak of COVID-19 in the spring, likely affecting health-care workers.

The federal government is working with the Canadian Institute for Health Information to better understand the virus, including expanding case data for health-care workers.

The Quebec government said the high rate of community contamination in the province coupled with a labour shortage at the beginning of the pandemic affected health-care workers who were working in several long-term care homes to maintain essential services.

“In recent months, Quebec has gone through an unprecedented health crisis,” said Robert Maranda, a spokesman for the ministry of health and social services.

The plan to deal with COVID-19 was based mainly on the experience gleaned from the 2009 swine flu pandemic, he said.

“However, H1N1 influenza is not the same virus that we are currently fighting against,” Maranda said.

“A person with COVID-19 can transmit the virus without having any symptoms, which is not the case with the flu.”

But as more is known about the new coronavirus, he said the province’s response has changed, including no longer allowing health-care workers to work in different places.

Silas said the nurses’ federation has started an investigation led by a former senior adviser to the SARS commission into why Canada didn’t better protect health-care workers from COVID-19. The report is expected later this year.

The Public Health Agency has done a poor job of gathering data about health-care workers infected with COVID-19, she said, adding that the federation has relied on data collected by Statistics Canada.

“There’s this lack of information flowing,” Silas said.

Natalie Mohamed, a spokeswoman for the Public Health Agency, said 25 per cent of all reported cases were among people who describe themselves as working in health care and it has been collecting data from the provinces and territories since March.

Those who identify themselves as health-care workers include physicians, nurses, dentists, physiotherapists, residential home workers, cleaners, janitorial staff and volunteers.

Some health-care workers may also be getting infected outside work, Mohamed said, although exposure data is incomplete.

The associate executive director of the Canadian Medical Protective Association, which provides advice and assistance in medical-legal matters to doctors, said it began fielding concerns from members about a lack of protective equipment when the virus started spreading.

Dr. Todd Watkins said the questions have shifted to how things will be handled in the future.

“Will there be a second wave and how am I going to respond to that? Is my clinic prepared for that? Will there be appropriate protective gear?”

Christine Nielsen, chief executive officer of the Canadian Society for Medical Laboratory Science, said the flow of information is affected by the fact the provinces and territories deliver health care and they could collect data differently.

“There’s room for improvement with how public health has responded,” she said. “Just the scale of the pandemic has really caught everyone off guard.”

This report by The Canadian Press was first published on Sept. 19, 2020.

 

 

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At least 49 cases of COVID-19 linked to wedding in Calgary: Alberta Health – Peace Arch News

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Alberta Health says 49 active COVID-19 cases have been linked to a wedding in Calgary earlier this month.

The health agency says the wedding had a large number of Albertans from different households.

Alberta Health spokesman Tom McMillan says aggressive contact tracing is underway to identify anyone who may have been exposed to make sure they are isolating and getting tested.

He did not say how many people attended the wedding and says specifics about individual cases cannot be disclosed because of patient confidentiality.

COVID-19 restrictions implemented by the province say a maximum of 100 people can attend outdoor and indoor seated events, such as wedding ceremonies, funeral services, movie theatres, indoor arts and culture performances.

McMillan says the city of Calgary has recently seen several outbreaks linked to social gatherings.

“This is a reminder to all Albertans that this virus is still here and any social gathering carries a risk of exposure,” he said in an email Tuesday.

“It is important that nobody attend if they are feeling ill with even mild symptoms, or if they are awaiting test results.”

He says it is also important that organizers do everything possible to comply with the public health guidance in place, including having enough space for physical distancing between cohorts, following gathering size restrictions and avoiding sharing food and utensils.

The Canadian Press

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Asymptomatic testing no longer available to Albertans without known exposure to COVID-19 – Edmonton Journal

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Article content continued

With 3,203 active cases, Hinshaw said right now the province is at a critical point.

“We’re in a danger zone where the coming weeks will really tell that story about whether we are able collectively to bend that curve downwards by following all of that guidance that’s already out there, that’s up online,” Hinshaw said.

“Or if we start to tip the wrong way, and start to see our hospitals fill up, and impair our ability to do elective surgeries, impair our ability to offer services that our health-care system needs to be able to offer to others that are not COVID related. So we’re not yet again at that point where our system is not able to cope. But we are getting closer.”

Hinshaw continues to be concerned by the high number of cases of COVID-19 in the Edmonton Zone where additional voluntary measures to prevent spread of the virus were implemented almost two weeks ago. There are currently 1,607 active cases in the zone that includes the City of Edmonton and surrounding municipalities, or about 50 per cent of the province’s active cases. Over the last 24 hours, 147 new cases were identified in the region.

The City of Edmonton has 1,318 active cases or 129 per 100,000 people.

“There is some good news in Edmonton,” Hinshaw said. “The rate of growth has started to slow somewhat and the R-value (reproductive rate) in Edmonton has come down from 1.35 to 1.17.

“This is a good start but the bad news is anytime the R-value remains above one, the number of cases is still growing. We need to bring this value below one to reduce the burden on our health system.”

COVID-19 in schools

About eight per cent of schools across the province have one case of COVID-19 or have an outbreak of two or more cases, Hinshaw said, with 512 confirmed cases currently in these schools.

Ninety-six schools have an outbreak with 26 of those on the province’s watch list after five or more cases have been identified.

In Edmonton, J. J. Bowlen School declared an outbreak after a second case was confirmed on Monday.

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Alberta pauses asymptomatic testing for COVID-19 – rdnewsnow.com

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By Chris Brown

results taking too long, Hinshaw says

Oct 20, 2020 5:47 PM

Saying that test results are not getting back to Albertans quick enough, the province’s top doctor has announced a “significant” change to testing that she called a critical step to improving COVID-19 control in the province.

“Effectively immediately we will be pressing pause on all asymptomatic testing in those who have no known exposure,” Dr. Deena Hinshaw said Tuesday. “This is an important and necessary step that will help us reduce testing wait times, get results to Albertans and limit the spread.”

With cold and flu symptoms mirroring COVID-19 symptoms, labs became overwhelmed in the past few weeks by the increase in tests.

Hinshaw said even with a September shift to only doing asymptomatic testing among priority groups, wait times for results have not decreased as much as they need to in order to use lab test information to prevent spread in an optimal way.

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