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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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COVID-19 takes toll on physical health of young Canadians, scientists, school board find – CBC.ca

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Just five per cent of Canadian children met basic physical activity guidelines early on in the pandemic, which is why school phys-ed programs are now looking for alternatives to get students to work up a sweat in a safe fashion.

As a result of physical distancing measures and increased remote learning, children have had more sedentary time during the pandemic, and that has had implications for schools planning physical education.

The Toronto District School Board, for instance, has asked gym teachers to cancel fall fitness training after phys-ed instructors reported that students’ physical activity levels have been alarming so far.

“They’ve noticed that kids are out of breath immediately, so the lack of physical activity that’s taken place over the last seven months is showing,” said George Kourtis, who heads the TDSB’s phys-ed program.

Even so, educators say it’s imperative that kids get a workout of some sort. But that comes with challenges in a remote learning environment.

WATCH | Schools adjust as kids lacked exercise during lockdown:

At one point in the pandemic, only five per cent of Canadian children were meeting the minimum requirements for physical activity. Now, school phys-ed programs face new challenges in keeping kids moving without most team sports because of distancing requirements. 4:10

Jennifer Bell, a Grade 11 phys-ed teacher with TDSB’s virtual school, recently demonstrated lunges to a class by doing the movements toward her laptop screen. But the students had their cameras turned off, which makes the learning more difficult.

“How do we teach sports skills while you’re standing in your living room?” Bell said. “You don’t necessarily have another opponent or a partner to play a sport with. That’s where we’re trying to get creative.”

Physically distanced football

Getting creative includes activities like juggling to practise movement skills and having students regularly type in their 15-second heart rate measurements to show that their heart rate is increasing from the participation, Bell said.

Maryam Sabir, 14, is taking Grade 9 phys-ed in person in Toronto. Maryam said physical distancing rules put a new twist on learning to play football.

Sagier Abdul takes part in a football lesson at her Toronto high school earlier this month. (Craig Chivers/CBC)

“You had to stay six feet apart,” both horizontally and vertically, Maryam said. “You can’t really communicate with other people. It becomes harder to play in the game.”

Maryam said she enjoys being physically active. When the phys-ed class ends next month, she plans to continue to get a workout by playing basketball or soccer with friends.

Importance of movement

National health guidelines recommend that children and youth (aged 5-17 years) have high levels of physical activity, low levels of sedentary behaviour and sufficient sleep each day, including: 

  • An accumulation of at least 60 minutes per day of moderate to vigorous physical activity (such as walking quickly enough to still be able to talk but not sing).
  • Nine to 11 hours of uninterrupted sleep per night for those aged five to 13 and eight to 10 hours per night for those aged 14 to 17, with consistent bed and wake-up times.
  • No more than two hours per day of recreational screen time.

Mark Tremblay, a senior scientist in obesity at the CHEO Research Institute in Ottawa, was part of a team that surveyed more than 1,400 parents of children and youth online nationally in April, about a month after the COVID-19 pandemic was declared in Canada.

Prior to the pandemic, about 15 per cent of kids met Canada’s 24-hour guidelines for physical activity, sedentary time and sleep, said Tremblay.

Kids do a workout in the park in Coronado, Calif., in March. Public health messaging about staying home is important, but it doesn’t mean you have to stay inside, said one obesity researcher. (Gregory Bull/Associated Press)

He found that movement levels had plunged as low as three per cent during the early days of the restrictions.

“Almost no Canadian kids were practising the healthy living behaviours that are associated with health, and that puts them at increased risk, of course, of physical and mental health issues going forward,” Tremblay said, which “is not what public health officials want.”

The study, published this summer in the International Journal of Behavioral Nutrition and Physical Activity, suggested that the pandemic wasn’t entirely to blame. But certain factors could increase the likelihood of healthy movement behaviours outside of school, including:

  • Parental encouragement and support.
  • Parents playing actively with their children.
  • Dog ownership.

The lack of physical activity was also influenced by children’s living arrangements. Kids who spent more time active outdoors were more likely to live in a house as opposed to a 40-story apartment building downtown where families may not feel safe playing outside, Tremblay said.

Tremblay said the public health messaging about staying home is important, “but it doesn’t mean stay inside.”

The scientists plan to repeat their survey on kids’ physical activity levels in early November.

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Calgary 'superspreader' wedding responsible for at least 49 cases of COVID-19 – CBC.ca

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At least 49 active cases of COVID-19 have been linked to a wedding held earlier this month in Calgary. 

It comes as Alberta hits its highest case numbers ever — 3,138 active cases, 998 of which are in Calgary. 

The wedding featured a large number of Albertans from different households, Alberta Health spokesperson Tom McMillan said.

Aggressive contact tracing is underway to identify anyone who may have been exposed and ensure they are isolating and getting tested, and anyone at risk is being contacted directly by Alberta Health Services. 

McMillan said Alberta Health can’t comment on specifics about individual cases due to patient confidentiality, but he did say it’s not yet clear what led to the level of exposure and that an investigation is underway.

Reminder that ‘this virus is still here’ 

Several recent outbreaks in Calgary have been linked to social gatherings, he said, adding that no one should attend a gathering if they have even mild symptoms or are awaiting test results. 

“This is a reminder to all Albertans that this virus is still here and any social gathering carries a risk of exposure. This is true for both planned events, like wedding receptions, or informal get-togethers in a house or community space,” McMillan said. 

“It is also important that organizers of social gatherings do everything possible to comply with the public health guidance in place, including ensuring that there is enough space for physical distancing between cohorts, following gathering size restrictions and avoiding sharing food and utensils.”

We also have to keep in mind that many of these gatherings … probably have a significant number of people that are in at-risk groups.– Craig Jenne, infectious disease expert

Dr. Craig Jenne, an infectious disease expert with the University of Calgary, said based on the high transmission numbers, he would consider this event a “superspreader.”

“Although 49 cases may not seem like a huge number, we have to keep in mind that these people have perhaps had continual contact with others after the wedding … if each person passes [COVID-19] on to two, three, four other people, we may be looking at an event that has now led to 200, 300 or more cases in the community. And again, each of those cases has the potential to spread it further,” he said.

“We also have to keep in mind that many of these gatherings … probably have a significant number of people that are in at-risk groups — older parents, grandparents.”

Jenne said while it’s worth looking at whether guidelines like physical distancing, mask-wearing and attendance numbers were followed, ultimately, having large indoor gatherings right now simply isn’t safe. 

“The virus doesn’t really care that you wore a mask until you sat down at the table … you have 100 people eating in the same room and multiple people at tables, this really creates an opportunity for the virus to move around,” he said.

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Manitoba's COVID-19 numbers trend downward as bars and restaurants face restrictions – OttawaMatters.com

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WINNIPEG — Manitoba’s COVID-19 numbers have started to drop somewhat following a surge last week and after restrictions were imposed on restaurants and bars.

Health officials reported 80 new cases and the deaths of two residents at a Winnipeg personal care home Monday.

It was the fourth consecutive day that the new case number was in the double-digits after peaking last week at 173.

Chief Public Health Officer Dr. Brent Roussin said there is no definitive way to link the drop to earlier closing times that were imposed on licensed restaurants and bars in the Winnipeg region two weeks ago.

But he said that was the aim of the rules — to cut the case count by reducing the amount of time people spend gathered in groups in close quarters.

“We just know with this virus that it’s prolonged indoor contact, and so businesses that have that as a major part of their business operation are unfortunately quite affected by this pandemic.

“And so when we see the cases going up, we have to do whatever we can to try to keep the numbers manageable.”

Further restrictions in greater Winnipeg took effect Monday. Casinos and live-entertainment nightclubs must close. Bars, lounges and restaurants must operate at half capacity.

The measures are to be in place for two weeks and may be extended if COVID-19 numbers don’t drop.

Bars that are attached to hotels — licensed with the province under the category of “beverage rooms” — were originally supposed to be closed for two weeks as well. But the government changed its mind at the last minute and allowed them to stay open under the same half-capacity limit as bars, lounges and restaurants.

“We’re happy that they’re having a different thought on that,” Scott Jocelyn, president of the Manitoba Hotel Association, said of the government move.

“So many areas of our industry have been impacted (by the pandemic) and it (would have been) just another body blow.”

Business groups in Winnipeg have said bars and restaurants were already hurting and the increased restrictions are likely to force some to close unless the Manitoba government offers financial help.

The province has already offered general wage subsidies to businesses, but has been noncommittal on further aid geared toward the hospitality sector.

The province is also trying to tackle long wait times for testing by using doctors’ offices after normal business hours.

The first office is scheduled to open Tuesday evening at a walk-in clinic in the city’s south end. Appointments will be available online.

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

Steve Lambert, The Canadian Press

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