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New Brunswick missed screening more than 1,800 possible tissue, ocular donors – CBC.ca

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New Brunswick has missed the opportunity to screen more than 1,800 potential tissue or ocular donors because no one was available to screen them, according to new figures obtained by CBC News through access to information.

The numbers, which capture the period April 2017 to September 2019, show the province has widespread gaps in its tissue and ocular donation program.

The figures don’t capture organ donation, which is separate and runs 24 hours a day, according to Horizon Health Network, which operates the New Brunswick Organ and Tissue Program.

Horizon estimates about four per cent of potential donor “referrals” will become tissue or ocular donors.

That would mean the 1,851 missed potential donors could have translated into about 74 actual donors, giving life-altering tissue or ocular donations such as corneas, tendons and bones. 

The numbers were “shocking” and “disappointing” for Michelle Astle, whose 16-year-old son, Avery, was one of the 1,851 missed potential donors.

“I think people in general have a trust that our system is not failing their citizens, their customers,” Astle said.

“However, with those stats, it’s proving that we are failing.”

Avery’s parents were hoping his blue eyes could help another person see the world. (Ed Hunter/CBC)

Avery and three of his friends — Emma Connick, Logan Matchett and Cassie Lloyd — died following a devastating car crash in Miramichi last Easter weekend.

The Astles remember their son as someone who always did the right thing and always wanted to help others. While they don’t believe Avery could have donated his organs, they were at least hoping he could provide a tissue or ocular donation that could help improve someone else’s quality of life. 

But when the Astles asked staff at the Moncton Hospital about donating Avery’s organs and tissues, they say they were told no one was available to facilitate the donation.

Earlier this year, provincial Health Minister Ted Flemming noted in the legislature that the crash happened “late at night on a Saturday between a Good Friday holiday and an Easter Sunday holiday.” 

“Sometimes, things like this unfortunately and regrettably happen,” Flemming said in the legislature on May 9, adding that he would “work hard to try to see that it is improved.”

But Astle said the statistics show it isn’t just a problem on holiday weekends.

“That obviously wasn’t the case, because you’re going month to month to month, and that many people not getting assessed,” she said.

‘Still work to be done’

In addition to Avery, 62 other potential donors weren’t screened in April because the program was closed or there was no technician on call, the figures show.

The month with the highest number of missed screenings was December 2018, with 112.

According to the data provided by Horizon, the program could be closed for a variety of reasons, including that the retrieval team is already working on a recovery for another donation. A technician might not be on call because of a “staff shortage and planned or unplanned absences.”

No one from the health authority was made available for an interview.

Human tissue is stored in the eye bank at St. Joseph’s Hospital in Saint John. (Graham Thompson/CBC)

Horizon sent along more recent statistics, which show “far fewer gaps in service” so far this fiscal year.

In August and September, the most recent months for which numbers are available, the program missed screening 31 and 27 potential donors, respectively.

“While Horizon acknowledges there is still work to be done in terms of addressing the gaps that continue to exist in our ocular and tissue programs, it is clear we are making progress,” Nadya Savoie, director of the New Brunswick Organ and Tissue Program, wrote in an emailed statement.

Savoie said the program has been able to hire and train new staff members, which has increased on-call service.

The picture elsewhere

In comparison, the Nova Scotia Health Authority’s Regional Tissue Bank is “always operating” with a full staff complement, according to an emailed statement from Harold Taylor, health services manager of the tissue bank.

Nova Scotia’s program has missed only five donations since April of this year.

A recovery suite at the Regional Tissue Bank at the Nova Scotia Medical Examiner Service building in Dartmouth, N.S. (Paul Palmeter/CBC)

“We have recently developed a service delivery model for tissue donation to be efficient and sustainable in the face of new legislation, and have developed a more effective referral process,” Taylor wrote.

In comparison, New Brunswick missed 204 potential donors between April and the end of September, Horizon’s figures show.

A spokesperson for Eastern Health in Newfoundland and Labrador said that province “does not have an ocular or tissue donation program.” Instead, the province imports tissue, including ocular tissue, for transplants.

Prince Edward Island doesn’t do tissue and ocular donation, according to a spokesperson for Health PEI. Potential donors are referred to the Nova Scotia Health Authority’s Regional Tissue Bank.

A new policy

In New Brunswick, in cases where a family wants to donate but no one is available to screen the potential donor, a new policy means there will always be a program member available to answer family members’ questions, Savoie wrote.

“We have already witnessed some successes as a direct result of this measure and are optimistic that will continue to be the case moving forward.”

But Astle said the new policy isn’t good enough because it still relies on family members to ask about donation.

Michelle Astle has spent the last eight months advocating for a better tissue donation system in New Brunswick, in memory of her 16-year-old son, Avery. (Kirk Pennell/CBC)

“I can see why many wouldn’t [ask] because you’re in such grief and shock,” Astle said.

“It shouldn’t be up to the family to ask. They should be coming to the family and explaining it and saying, ‘Are you willing?'”

‘We need to do better’

In the eight months since she said goodbye to Avery, Astle has had many dark days. But she’s also seen some light.

The Astles have started a campaign called Let’s Act 4 Avery to spread the word about donation, and she believes his story has already had an impact.

On her Christmas tree, she’s hung several ornaments made in Avery’s memory.

“It is always the right time to do the right thing,” one says.

“There’s been a lot of really good things to come out of it,” Astle said.

Michelle Astle keeps this framed sign underneath her Christmas tree in memory of her 16-year-old son, Avery. (Kirk Pennell/CBC)

But she believes there’s more to be done to make things better.

Horizon’s statement doesn’t mention what prompted a new policy and changes in the tissue donation program. That doesn’t sit well with Astle.

“The only reason those changes have happened is because we stood up and we spoke up. It’s because of Avery,” she said.

“So to me, at least own that and say, ‘Thank you, and because of your son these changes have been made to help others.'”

Michelle Astle has a collection of pictures of 16-year-old Avery in her living room, including this one with his sister, Alexa. (Kirk Pennell/CBC)

Asked what Avery would think about the number of missed potential donations, Astle said her son always found a way to see the good in everything. She doesn’t think he would have wanted to dwell on the negative. 

“It would be, ‘Well there’s a chance there to help save others and they’re doing the best they can,’ would be what Avery would say,” Astle said. 

“But mother bear kicks in and says, we need to do better.”

An ornament made in memory of Avery to raise awareness for the Let’s Act 4 Avery campaign hangs on Michelle Astle’s tree. Beside it is a doughnut ornament, a reminder of the doughnut socks Avery loved to wear. (Kirk Pennell/CBC)

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COVID-19 cases will climb in Canada before effects of latest restrictions kick in, experts say – CBC.ca

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Cases of COVID-19 will likely continue to climb in Canada’s most populous provinces for a while even if people start to hunker down, experts say, because of the nature of the infection.

Epidemiologists look at the effective reproductive number of COVID-19, which describes how many other people an infected person will pass the coronavirus onto on average.

Public health experts like to see the value significantly below one so cases don’t snowball and spread out of control.

The effective reproductive number of COVID-19 in Canada continues to hover at 1.4, the Public Health Agency of Canada reported on Friday. That means for every 10 people who test positive for COVID-19, they’ll likely infect 14 others who then pass it on to 20 others and so on.

Christopher Labos, a physician in Montreal with an epidemiology degree, said the effective reproductive number also varies depending on the population in which a virus is spreading.

“If nothing changes, certainly it’ll keep rising and may even surpass a number of cases we had before,” Labos said. 

The doubling time depends on how contagious someone is, the likelihood they’ll contact and infect another susceptible person and the frequency of contact.

But Labos said there’s another important factor: individual changes in behaviour.

A woman wears a face mask as she walks by a sign instructing people to wear masks at a market in Montreal on Sept. 13. The city’s restaurants will face new restrictions this week. (Graham Hughes/The Canadian Press)

“We probably will see rising case numbers in the next few days, maybe in the next few weeks. But if we take action now and control stuff, we might see this virus plateau before the end of the year. And that’s really what we’re trying to hope for.”

To that end, Quebec’s premier announced on Monday partial shutdowns in areas with high case counts, namely Montreal, Quebec City and Chaudière-Appalaches, south of the provincial capital.

“We see that our hospitals are in a fragile situation,” Premier François Legault said.

As of Thursday for 28 days, visiting those in other households won’t be allowed (with exceptions), restaurants will be serving delivery and takeout only and other gathering places such as bars, concert halls, cinemas, museums and libraries in the affected regions will close, he said

To explain why, Legault said protecting people in school communities, hospitals and long-term care homes are a priority.

Sacrifices required to change course

“None of this is a given. We can change the outcome,” Labos said. “It simply requires us to sacrifice a little bit.”

Nicola Lacetera, a behavioural economist at the University of Toronto, first studied compliance with physical distancing during the start of the pandemic in Italy. He found that the more frequently governments extended lockdown dates, the more disappointed the public tended to get, which could lessen co-operation.

“People say, ‘Well, I don’t know anybody who has COVID,'” Lacetera said. “From a statistical point of view, it makes no sense. But people tend to over-weigh what’s closer to them, like having known someone who got COVID.”

When the public can’t see the health consequences of COVID-19 directly in their daily lives then Lacetera said making hygiene, distancing and wearing masks more of a habit, alongside consistent messaging from different levels of government and communicating the science, could help.

Dr. Eileen de Villa, Toronto’s medical officer of health, announced new restrictions for restaurants to help curb COVID-19 spread. (Michael Wilson/CBC)

‘Targeted’ measures

Ontario’s Chief Medical Officer of Health, Dr. David Williams, suggested “targeted” measures are under consideration. His Toronto counterpart, Dr. Eileen de Villa, called for new limits in restaurants on Monday, such as reducing the number of patrons from 100 to 75 and requiring establishments to collect contact information from those attending.

De Villa also said the extent of spread of the infection in the city means the concept of the bubble or a social circle “no longer reflects the circumstances in which we live.” 

Jacob Wharton-Shukster said his Toronto restaurant would stay open until 2 a.m. before the pandemic. He voluntarily chose to close at 11 p.m. after watching what can happen elsewhere in the world late at night when people have been drinking alcohol.

“The numbers are doubling from last week, and this is all reasonably foreseeable,” he said. ” We would have had to have taken a mitigation strategy a month ago to see any result now.”

Epidemiologists agree, saying the effects of measures only become apparent two weeks down the road because of the lag when someone is newly infected, develops symptoms, gets tested and receives the result.

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How Quebec went from COVID-19 success story to hot spot in 30 days – CBC.ca

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A little over a month ago, Health Minister Christian Dubé congratulated Quebecers for their hard work at containing the spread of the coronavirus.

It was a Tuesday, Aug. 25, and the province had registered just 94 new cases of COVID-19 in the previous 24 hours. 

“We have really succeeded at controlling the transmission of COVID,” Dubé said at a news conference in Montreal. 

It was a statement of fact, but the ground had already started to shift. In the intervening weeks, transmission increased. At first it grew slowly, then exponentially. 

On Monday, the government implicitly acknowledged it has again lost control of the virus. The province is reimposing lockdown measures on Quebec’s two biggest cities, starting Oct. 1. 

Until Oct. 28, Quebecers won’t be able to entertain friends or families at home. Bars, restaurant dining rooms, theatres and cinemas will also be closed.   

“The situation has become critical” Premier François Legault said Monday evening. “If we don’t want our hospitals to be submerged, if we want to limit the number of deaths, we must take strong action.”

The new measures will bring abrupt changes to the lives of millions of Quebecers. They will also prompt questions about how the public health situation could have deteriorated so quickly.

This story tries to trace how Quebec again lost control of the spread of COVID-19.

At first, a stern warning

As Dubé addressed reporters on that Tuesday in late August, public health officials in Quebec City were busy trying to track down patrons of Bar Kirouac, a watering hole in the working-class Saint-Sauveur neighbourhood.

A karaoke night at the bar ultimately led to 72 cases and the activity being banned in the province.

There were also numerous reports by then of young people holding massive house parties and flouting physical distancing recommendations. One of them, in Laval, led to a small outbreak.

WATCH | Legault explains why harsh measures are necessary:

Quebec Premier François Legault says the second wave came because Quebecers did not follow public health guidelines. 0:39

On Aug. 31, as Quebec’s daily average of new cases neared 152 cases, Legault delivered a stern warning. 

“There has been a general slackening in Quebec,” Legault said. “It’s important to exercise more discipline.”

Legault and his health minister threatened stiffer punishments for those who disobeyed public-health rules, but stopped short of imposing new restrictions.

Private gatherings identified as the culprit

In late August, public health officials were attributing the rise in infections to Quebecers returning home from vacations around the province, as opposed to the start of school. 

Though Quebec’s back-to-school plan wasn’t met with widespread criticism, some experts expressed concern about the large class sizes and the lack of physical distancing guidelines for students. 

The government also ignored advice that it should make masks mandatory inside the classroom.

A teacher wearing protective equipment greets her students in the school yard at the Philippe-Labarre Elementary School in Montreal on Aug. 27. (Paul Chiasson/The Canadian Press)

But the first weeks of the school year went relatively smoothly. By the start of Labour Day weekend, only 46 out of the province’s 3,100 schools had reported a case of COVID-19. Importantly, there were no major outbreaks.

The problem was elsewhere. Outside schools, in the community at large, cases continued to rise. On Sept. 8, the province was averaging 228 cases per day.

By now public health officials had identified private gatherings as the main culprit behind the increase.

Montreal’s regional director of public health, Dr. Mylène Drouin, was among those who urged more caution when hanging out with friends and family. 

“Yes, we can have social activities, but we have to reduce contacts to be able to reduce secondary transmission,” Drouin said on Sept. 9.

Warning signs

In an effort to spell out the consequences of the increase in cases, the Quebec government unveiled a series of colour-coded alert levels. 

Areas coded green would see few restrictions; yellow zones would see more enforcement of existing rules; orange zones would be the target of added restrictions; and red zones would see more widespread closures of non-essential activities.

When the scheme was announced on Sept. 8, Quebec City was classified yellow. Montreal was classified green.

At this point, though, health experts were already concerned that more needed to curb the spread of the virus.

“It is important to intensify these measures,” Dr. Cécile Tremblay, an infectious disease specialist with the Université de Montréal hospital network, said after the alert levels were announced.

The warning signs were starting to multiply.

Officials in Montreal were investigating 20 outbreaks at workplaces on Sept. 9; a week later that number had risen to 30. Long lines were also forming outside testing centres, filled with anxious parents and their children.

And more stories were circulating of private gatherings where the 10-person limit was ignored, angering the health minister.

He told reporters about a dinner with 17 people at a restaurant in Montérégie, which led to 31 cases. A corn roast in the Lower St. Lawrence, he said, resulted in 30 cases.

“To me, that’s unacceptable,” Dubé said on Sept. 15  “If people won’t understand from these examples then, I’m sorry, but they’ll never understand.”

He moved Montreal, and four other regions, into the yellow zones and banned bars from serving food after midnight. The province was averaging 338 new cases per day.

Quebec Health Minister Christian Dubé said the province is at a fragile state in its fight against COVID-19. He encouraged Quebecers to act responsibly. (Sylvain Roy Roussel/Radio-Canada)

Second wave arrives

The warnings from the government did not curb the spread of the virus. By mid-September, authorities were reporting more cases in closed settings.

On Sept. 17, Herzliah High School in Montreal became the first school in the province to say it was shutting down for two weeks to deal with an outbreak. At least 400 other schools were also dealing with active cases of COVID-19. 

Cases accumulated too in private seniors homes (known as RPAs), a major source of concern for public officials given the vulnerability of the residents to COVID-19. 

There were only 39 cases in RPAs at the start of the month, and 157 by Sept. 20.

On that day the government announced it was moving Montreal, Quebec City and the Chaudière-Appalaches region into the orange zone, the second-highest alert level. Private gatherings were capped at six people.

The province was by then averaging 501 new cases per day. The second wave had begun, according Quebec’s public health director, Horacio Arruda. 

Red zone

Over the last week, Quebec’s health system has shown signs of strain as authorities race to contain the spread of the virus. 

Drouin, the Montreal public health director, admitted on Sept. 21 that her contact-tracing teams were swamped by the demand.

Until now, the increase in cases had not been accompanied by a corresponding surge in hospitalizations. Most of the new cases were concentrated in younger people.

But the number of hospitalized COVID-19 patients in Quebec has increased by 45 per cent in the last seven days. Hospital staff are starting to get stretched. Several thousand health-care workers are in preventive isolation. 

“We’re feeling the second wave,” Dr François Marquis, the head of intensive care at Montreal’s Maisonneuve-Rosemont hospital. “We were apprehensive about it, but now it’s a reality.”

On Monday, Quebec reported 750 new cases of COVID-19. Montreal and Quebec City were classified as red zones later that evening.

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Nova Scotia awards contract for wood heat projects to N.S., P.E.I. companies – Cape Breton Post

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Fossil fuel heating systems at six sites in Nova Scotia are to be converted to locally sourced wood chip boilers over the next several months.

An announcement from the province on Monday said the contracts to design, build and operate boilers include agreements to source wood chips from private woodlots and sawmills.

The contracts were awarded to Mira Forestry Development of Albert Bridge to convert Memorial High School in Sydney Mines and Riverview High School in Sydney. Wood4heating Canada of Charlottetown will convert Perennia Park Atlantic Centre for Agri-Innovation in Bible Hill and Hants East Rural High School in Milford.  Spec Resources in Church Point was awarded the contract for NSCC Centre of Geographic Sciences in Lawrencetown, and ACFOR Energy of Cocagne, N.B. will convert Bridgewater Provincial Court.

Additional sites for expansion of the program are being assessed. 

At Perennia Park, a district heating network will be formed and three buildings will be heated by the new boiler. Bridgewater provincial court will be converted to a two-building district heating network that will also include the NSCC Lunenburg campus.

“These projects help us progress towards a greener economy and reduce the carbon footprint of government buildings by replacing fossil fuels with a renewable resource,” Lands and Forestry Minister Iain Rankin said in a release. “Using lower grade wood for heat will create new and stable markets for Nova Scotia’s wood chips and opportunities for private woodlot owners and sawmills to sell lower grade wood locally.”

Each wood heat system will be in an exterior structure built so that it can be expanded.  The six sites are forecast to use between 2,000-2,500 tonnes of wood chips.

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