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.”
Patients who are older, don’t speak English, and don’t have a high school education are more likely to experience harm during a hospital stay in Canada, according to new research.
The Canadian Institute for Health Information measured preventableharmful events from 2023 to 2024, such as bed sores and medication errors,experienced by patients who received acute care in hospital.
The research published Thursday shows patients who don’t speak English or French are 30 per cent more likely to experience harm. Patients without a high school education are 20 per cent more likely to endure harm compared to those with higher education levels.
The report also found that patients 85 and older are five times more likely to experience harm during a hospital stay compared to those under 20.
“The goal of this report is to get folks thinking about equity as being a key dimension of the patient safety effort within a hospital,” says Dana Riley, an author of the report and a program lead on CIHI’s population health team.
When a health-care provider and a patient don’t speak the same language, that can result in the administration of a wrong test or procedure, research shows. Similarly, Riley says a lower level of education is associated with a lower level of health literacy, which can result in increased vulnerability to communication errors.
“It’s fairly costly to the patient and it’s costly to the system,” says Riley, noting the average hospital stay for a patient who experiences harm is four times more expensive than the cost of a hospital stay without a harmful event – $42,558 compared to $9,072.
“I think there are a variety of different reasons why we might start to think about patient safety, think about equity, as key interconnected dimensions of health-care quality,” says Riley.
The analysis doesn’t include data on racialized patients because Riley says pan-Canadian data was not available for their research. Data from Quebec and some mental health patients was also excluded due to differences in data collection.
Efforts to reduce patient injuries at one Ontario hospital network appears to have resulted in less harm. Patient falls at Mackenzie Health causing injury are down 40 per cent, pressure injuries have decreased 51 per cent, and central line-associated bloodstream infections, such as IV therapy, have been reduced 34 per cent.
The hospital created a “zero harm” plan in 2019 to reduce errors after a hospital survey revealed low safety scores. They integrated principles used in aviation and nuclear industries, which prioritize safety in complex high-risk environments.
“The premise is first driven by a cultural shift where people feel comfortable actually calling out these events,” says Mackenzie Health President and Chief Executive Officer Altaf Stationwala.
They introduced harm reduction training and daily meetings to discuss risks in the hospital. Mackenzie partnered with virtual interpreters that speak 240 languages and understand medical jargon. Geriatric care nurses serve the nearly 70 per cent of patients over the age of 75, and staff are encouraged to communicate as frequently as possible, and in plain language, says Stationwala.
“What we do in health care is we take control away from patients and families, and what we know is we need to empower patients and families and that ultimately results in better health care.”
This report by The Canadian Press was first published Oct. 17, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
CALGARY – Alberta’s health minister says a new agency responsible for primary health care should be up and running by next month.
Adriana LaGrange says Primary Care Alberta will work to improve Albertans’ access to primary care providers like family doctors or nurse practitioners, create new models of primary care and increase access to after-hours care through virtual means.
Her announcement comes as the provincial government continues to divide Alberta Health Services into four new agencies.
LaGrange says Alberta Health Services hasn’t been able to focus on primary health care, and has been missing system oversight.
The Alberta government’s dismantling of the health agency is expected to include two more organizations responsible for hospital care and continuing care.
Another new agency, Recovery Alberta, recently took over the mental health and addictions portfolio of Alberta Health Services.
This report by The Canadian Press was first published Oct. 15, 2024.
Rana Van Tuyl was about 12 weeks pregnant when she got devastating news at her ultrasound appointment in December 2020.
Her fetus’s heartbeat had stopped.
“We were both shattered,” says Van Tuyl, who lives in Nanaimo, B.C., with her partner. Her doctor said she could surgically or medically pass the pregnancy and she chose the medical option, a combination of two drugs taken at home.
“That was the last I heard from our maternity physician, with no further followup,” she says.
But complications followed. She bled for a month and required a surgical procedure to remove pregnancy tissue her body had retained.
Looking back, Van Tuyl says she wishes she had followup care and mental health support as the couple grieved.
Her story is not an anomaly. Miscarriages affect one in five pregnancies in Canada, yet there is often a disconnect between the medical view of early pregnancy loss as something that is easily managed and the reality of the patients’ own traumatizing experiences, according to a paper published Tuesday in the Canadian Medical Association Journal.
An accompanying editorial says it’s time to invest in early pregnancy assessment clinics that can provide proper care during and after a miscarriage, which can have devastating effects.
The editorial and a review of medical literature on early pregnancy loss say patients seeking help in emergency departments often receive “suboptimal” care. Non-critical miscarriage cases drop to the bottom of the triage list, resulting in longer wait times that make patients feel like they are “wasting” health-care providers’ time. Many of those patients are discharged without a followup plan, the editorial says.
But not all miscarriages need to be treated in the emergency room, says Dr. Modupe Tunde-Byass, one of the authors of the literature review and an obstetrician/gynecologist at Toronto’s North York General Hospital.
She says patients should be referred to early pregnancy assessment clinics, which provide compassionate care that accounts for the psychological impact of pregnancy loss – including grief, guilt, anxiety and post-traumatic stress.
But while North York General Hospital and a patchwork of other health-care providers in the country have clinics dedicated to miscarriage care, Tunde-Byass says that’s not widely adopted – and it should be.
She’s been thinking about this gap in the Canadian health-care system for a long time, ever since her medical training almost four decades ago in the United Kingdom, where she says early pregnancy assessment centres are common.
“One of the things that we did at North York was to have a clinic to provide care for our patients, and also to try to bridge that gap,” says Tunde-Byass.
Provincial agency Health Quality Ontario acknowledged in 2019 the need for these services in a list of ways to better manage early pregnancy complications and loss.
“Five years on, little if any progress has been made toward achieving this goal,” Dr. Catherine Varner, an emergency physician, wrote in the CMAJ editorial. “Early pregnancy assessment services remain a pipe dream for many, especially in rural Canada.”
The quality standard released in Ontario did, however, prompt a registered nurse to apply for funding to open an early pregnancy assessment clinic at St. Joseph’s Healthcare Hamilton in 2021.
Jessica Desjardins says that after taking patient referrals from the hospital’s emergency room, the team quickly realized that they would need a bigger space and more people to provide care. The clinic now operates five days a week.
“We’ve been often hearing from our patients that early pregnancy loss and experiencing early pregnancy complications is a really confusing, overwhelming, isolating time for them, and (it) often felt really difficult to know where to go for care and where to get comprehensive, well-rounded care,” she says.
At the Hamilton clinic, Desjardins says patients are brought into a quiet area to talk and make decisions with providers – “not only (from) a physical perspective, but also keeping in mind the psychosocial piece that comes along with loss and the grief that’s a piece of that.”
Ashley Hilliard says attending an early pregnancy assessment clinic at The Ottawa Hospital was the “best case scenario” after the worst case scenario.
In 2020, she was about eight weeks pregnant when her fetus died and she hemorrhaged after taking medication to pass the pregnancy at home.
Shortly after Hilliard was rushed to the emergency room, she was assigned an OB-GYN at an early pregnancy assessment clinic who directed and monitored her care, calling her with blood test results and sending her for ultrasounds when bleeding and cramping persisted.
“That was super helpful to have somebody to go through just that, somebody who does this all the time,” says Hilliard.
“It was really validating.”
This report by The Canadian Press was first published Oct. 15, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
