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People with dementia among hardest hit by COVID-19 health restrictions –



Before COVID-19, Lyne Gauthier did her best to keep her husband’s mind from slipping away by organizing activities they had enjoyed together before he was diagnosed with early-onset Alzheimer’s disease.

She would visit the long term facility where Yves Dessureault, 66, has lived for three years and take him on simple outings.

“We’d go grocery shopping, go out for an ice cream cone,” said Gauthier. Sometimes they would just “listen to music and dance.”

But then the coronavirus hit, and there were no more outings.

There were also no more services like pet therapy or music therapy within the facility due to the pandemic. 

Gauthier says she has watched her husband deteriorate dramatically in the past six months. He’s now considered to be in the late stages of Alzheimer’s.

“I think COVID has really fast-tracked the progression of his symptoms,” she said.

Lyne Gauthier has watched her husband slip further and further away amid restrictions limiting family visits, outings, and therapeutic connections with the outside world. 3:26

Gauthier feels the health rules that curtailed their outings and deprived Dessureault of face-to-face contact robbed him of precious time as a husband, father and grandfather.

At his care home, there is little mingling these days and many residents eat their meals in their rooms.

The social isolation has left him more fragile, both physically and emotionally, said Gauthier.

Since the spring, she says, Dessureault appears more upset and anxious. His balance has gotten worse and even the simplest words have lost their meaning.

“If I want to show him where we’d like to sit, I need to tap the seat and do more gestures,” said Gauthier.

“There is a lot he can’t do anymore.”

Worsening symptoms linked to lockdowns

During the pandemic, many residents in long-term care experienced rapid cognitive decline, increased depression and more behavioural symptoms such as wandering and agitation, said Dr. Isabelle Vedel, a public health physician and associate professor in McGill University’s Department of Family Medicine.

McGill University’s Dr. Isabelle Vedel is leading a research project that will examine the impact of the pandemic on people living with dementia. (McGill University)

There is some preliminary research from the United States and the U.K. suggesting people with dementia were hit the hardest by the virus. 

Not only were they at an increased risk of being infected and of dying from COVID-19, but there were thousands of so-called excess deaths — meaning many more people died than the average for the same period in previous years.

Vedel fears the same will be true in Canada.

“People living in long-term care were extremely affected by the pandemic,” said Vedel. “Eighty per cent of the deaths happened in long-term care in Canada, and we know that approximately 80 per cent of people in long-term care have dementia.”

With funding from the Canadian Institutes for Health Research, Vedel is leading a research project in collaboration with Alzheimer’s societies across Canada that will measure the deaths of people with dementia during the pandemic.

It will also examine what impact the disruption of services and access to health care may have had on their lives.

For instance, during the first wave of the pandemic, Quebec feared hospitals would be overrun, so long-term care facilities were asked not to send people to the ER, said Vedel.

“It’s very probable that even though they had acute illnesses, they were not sent to the emergency department, so they didn’t receive the appropriate care they needed.”

Lessons for the 2nd wave

Maintaining services as much as possible during subsequent waves of the virus is paramount, Vedel said.

People with dementia rely on home care, community services, family physicians and caregivers. If there are obstacles to getting these services, people with dementia will decline and fall between the cracks, she said.

“We have to make an extra effort for them and make sure that they can be well cared for during the pandemic,” said Vedel.

She expects the research group will have statistics and recommendations in the spring.

Disruptions, reimposed restrictions

With parts of Canada now firmly in a second wave of the pandemic, all the changing health precautions and disruption can be especially distressing for people with dementia.

In Quebec, for instance, more and more regions are in red zones, where visits are once again limited in long-term care homes and private seniors’ residences. The partial lockdown also means many programs are suspended.

The goal is to limit contacts and keep the virus from sweeping through those facilities as it did in the first wave.

The directive to wear masks or face coverings to slow the spread poses a problem for these patients because it’s harder to read facial expressions, which they rely on to communicate and interact.

Many of the outings Gauthier and her husband enjoyed, like going out for an ice cream, were curtailed due to COVID-19 public health restrictions. (Submitted by Lyne Gauthier)

Overmedication is another problem: As patients get more agitated, more medication is being prescribed, including anti-psychotic drugs to calm them down, said Nouha Ben Gaied, the director of research and development for the Federation of Quebec Alzheimer Societies.

These drugs, “are inappropriate to use for people with dementia and they can cause more harm than benefits” said Ben Gaied.

Ben Gaied hopes Quebec’s health ministry has learned lessons from the first wave.

Nouha Ben Gaied, director of research and development for the Federation of Quebec Alzheimer Societies, said people with dementia are being prescribed more medication to keep them calm during the pandemic. (Dave St-Amant/CBC)

A spokesperson for the ministry said it has introduced measures to better protect this population and reduce the number of excess deaths.

That includes better access to a family doctor and improving the transition between primary care and specialized services, said Marie-Louise Harvey.

The government has also recruited nearly 10,000 new patient attendants, about 7,000 of whom are already working in the system. The rest are still in training.

The province has asked long-term care homes to limit the movement of employees between long-term care homes as much as possible.

Infection control and prevention is also being closely watched. 

Even so, since September, some of the new outbreaks in long-term care homes or private seniors’ residences in Quebec have been in units for people with a cognitive impairment like Alzheimer’s or dementia. 

‘He deserves better’

Gauthier’s greatest fear is her husband getting COVID.

She’s concerned about the high number of cases in Quebec, and what will happen to her husband if the partial lockdown is extended beyond the end of the month.

She’s doing everything she can to help her husband connect, though now that his care home is in a red zone, all she can offer are video chats with family, walks on the grounds or jaunts in the car to listen to music.

One of the activities that still makes Dessureault light up, she says, is a visit with his grandchildren — even if it is through a window or on FaceTime. Dessureault loves children, she says, and seeing them brings out his goofy, playful side.

“I find my husband for a few more seconds, a minute. It’s as if my husband is back,” said Gauthier, fighting to hold back tears. “The emotions are there. They connect. It’s just simple.”

Dessureault gets a visit from his grandchildren through the window of his care home. (Submitted by Lyne Gauthier)

She says she knows he’s still there, underneath the disease, but his quality of life has spiralled downward during the pandemic.

“He deserves better,” said Gauthier, who sometimes finds it hard to keep her spirits up.

“As a society, we can do better.”

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Coronavirus deaths surpass 250 in Manitoba on Wednesday – CTV News Winnipeg



The number of Manitobans who have died of COVID-19 has now surpassed 250, after Manitoba’s top doctor reported nine more deaths on Wednesday.

Dr. Brent Roussin, the chief provincial public health officer, said Manitoba’s most recent deaths include two men, one in their 40s and one in their 60s, and a woman in her 80s from the Winnipeg health region.

A woman in her 50s and a man in his 80s from the Southern Health–Santé Sud health region were also among the reported deaths.

The province also reported several deaths on Wednesday linked to personal care homes.

The death of a woman in her 70s was linked to the outbreak at the St. Norbert Personal Care Home, and the death of a woman in her 90s was linked to the outbreak at Saul and Claribel Simkin Centre, both of which are in Winnipeg.

The death of a man in his 80s was linked to the outbreak at the Buhler Active Living Centre, and the death of a woman in her 90s was linked to the outbreak at the Rest Haven Nursing Home, both of which are in the Southern Health region.

Roussin said a previously reported death, a man in his 20s from Winnipeg, is incorrect. He said due to a data entry error, the man was mistakenly included in the number of reported COVID-19 deaths. Roussin said this man does have COVID-19 and is currently in isolation.

“These are dealing with a lot of data entry and an error was made in this case,” Roussin said, apologizing for any confusion. “We have a lot of safeguards on the data and reviewing of the data, so I remain confident in the numbers that we receive, and we have a process to review and correct when needed.”

This brings the total number of deaths in Manitoba to 256.

Along with the deaths, the province reported 349 new cases of COVID-19, which has pushed Manitoba’s total number of cases to 14,907. The current five-day test-positivity rate in Manitoba is now 14 per cent.

The majority of these cases were once again in the Winnipeg Health Region, which reported 213 cases of COVID-19 as of Wednesday, bringing the test positivity rate in the region to 14 per cent.

The other cases reported on Wednesday include:

  • 22 cases in the Interlake-Eastern Health Region;
  • 30 cases in the Northern Health Region;
  • 11 cases in the Prairie Mountain Health Region; and
  • 73 cases in the Southern Health–Santé Sud health region.

The province also reported 260 more recoveries, bringing the total number of Manitobans listed as recovered to 5,893.

Roussin said the daily caseloads continue to put a strain on the health care system. He said as of Wednesday, 303 people are in hospital, including 50 people in Intensive care.

Along with these hospitalizations, the province also reported COVID-19 outbreaks had been declared at the Woodhaven Manor in Steinbach and the Lions Manor in Winnipeg.

“Our health-care providers on those front lines are overwhelmed – these number of cases and number of deaths reported can’t become the norm,” Roussin said.

“The message is quite clear – it is to stay home and leave only for essential reasons. That is the best way that we can quickly reduce the amount of contacts we have and thus bring down the number of cases.”

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Delays, conflicts and confusion hampered Ontario's COVID-19 response: auditor general –



Ontario’s response to the COVID-19 pandemic was hampered by poor emergency preparedness, inadequate lab capacity and a disorganized public health system, according to a report issued Wednesday by the province’s auditor general. 

In a special report on COVID-19, Auditor General Bonnie Lysyk raises concerns that flaws in Ontario’s communication, decision-making and management of positive cases contributed to a wider spread of the virus during the eight months since the pandemic was declared.

The audit found “delays and conflicts and confusion in decision-making,” said the 231-page report, tabled in the legislature on Wednesday morning. 

The report also lays bare for the first time the structure and membership of the so-called “tables” advising Premier Doug Ford and his cabinet on their response to COVID-19.

Among the auditor’s key findings: 

  • The Ford government paid a consultant $1.6 million to develop an organizational command structure for its COVID-19 crisis response, a structure that the auditor criticizes as “overly cumbersome,” with no top leadership roles given to public health officials. 
  • Laboratory testing, case management and contact tracing were not being performed quickly enough to contain the virus.
  • Weaknesses in the public health lab and information systems that were repeatedly flagged following the 2003 SARS crisis were never fixed before the arrival of COVID-19.
  • The province hadn’t updated its pandemic-related emergency plans for years, nor run them through testing scenarios. 

“Ontario’s response to COVID-19 in the winter and spring of 2020 was slower and more reactive relative to most other provinces and many other international jurisdictions,” Lysyk said in the report. 

Bonnie Lysyk, Ontario’s auditor general, has issued a report saying Ontario’s pandemic response was hampered by poor emergency preparedness, inadequate lab capacity and a disorganized public health system. (Frank Gunn/The Canadian Press)

“As we continue into this second wave, it is still not too late to make positive changes to help further control and reduce the spread of COVID-19.”

At a news conference Wednesday morning, Health Minister Christine Elliott said the report is “a disappointment, and in many respects a mischaracterization of the province’s pandemic response.

“The reality is that over the course of the pandemic, there have been differing views. Differing views among public health officials, amongst the medical community, amongst policy makers, and of course the public,” Elliott said.

“We have different views on various aspects of her report.”

 WATCH | Health Minister responds to auditor general’s report:

Minister of Health Christine Elliott says the report as “a disappointment, and in many respects a mischaracterization of the province’s pandemic response.” 1:36

One chapter of the report focuses on the public health systems for COVID-19 testing, for managing the cases of people who test positive and tracing their contacts who may have been exposed to the virus.    

Across the province, fewer than half of lab tests have been completed within 24 hours of the patient’s specimen being collected, the auditor found.

As recently as September and October, public health units contacted only 75 per cent of people who tested positive within 24 hours of receiving the result, short of the province’s target of 90 per cent. 

The auditor said the largest urban public health units were particularly slow at case management — the process of contacting people who test positive, advising them to self-isolate and investigating how they likely contracted the virus. In September and October, the auditor found the average time it took to begin managing a positive case after the person got tested was: 

  • Ottawa – 4.5 days.
  • Toronto – Four days. 
  • Peel – 3.25 days.
  • York – 2.25 days.

The delays “may have led to further exposure and spreading of the virus,” Lysyk said in the report. 

Ontario Premier Doug Ford declared a state of emergency in response to the COVID-19 pandemic during this March 17 news conference, alongside Health Minister Christine Elliott and Dr. David Williams, the province’s chief medical officer of health. (Frank Gunn/The Canadian Press)

The report delves into the command structure set up by the government to advise on the COVID-19 response.

At the top is the Central Co-ordination Table, co-chaired by the province’s top bureaucrat, cabinet secretary Steven Davidson; and the premier’s top political adviser, chief of staff James Wallace.

Its membership includes nine deputy ministers, as well as five political advisers from the offices of the premier and the health minister. However, the auditor notes, neither Chief Medical Officer of Health Dr. David Williams nor anyone from Public Health Ontario sits on this table.   

Below the Central Co-ordination Table are four others, including the Health Command Table, which the auditor found had as many as 90 participants. Its meetings were held by teleconference instead of videoconference until July, a format the auditor said was not effective for clear discussions.     

The auditor said Williams did not chair any of the Health Command Table’s meetings. She calls Ontario’s decision not to give its chief medical officer of health the lead role in its COVID-19 response “unusual.”  

Fewer than half of the COVID-19 lab tests conducted in Ontario have been completed within 24 hours of the patient’s specimen being collected, the auditor general found. (Craig Chivers/CBC)

At the same time, the auditor criticizes Williams for failing to use his full powers to issue directives quickly, notably for a provincewide masking order or for protecting temporary foreign workers on farms. Williams told the auditor he only issued directives after consulting with the Health Command Table.

The auditor’s report said Williams and the Ministry of Health were slow to react in the early weeks of the pandemic. The report questions why provincial officials: 

  • Waited until March 13, the Friday before the scheduled start of Ontario’s March Break, to warn against non-essential travel.
  • Refused to acknowledge community transmission of the virus until March 26.
  • Did not order all long-term care workers to wear masks throughout their shifts until April 8.    

The auditor finds instances where the government’s decisions did not follow the advice of public health experts, including allowing anyone who wanted to get tested to do so from late May until early October.

The auditor also details how the government ignored the advice of Public Health Ontario on setting infection thresholds for the restrictions in its colour-coded COVID-19 response framework. 

A report from Ontario’s auditor general lists the membership of the Ford government’s top advisory table on COVID-19, made up almost entirely of deputy ministers and political staff. (Ontario Auditor General)

She said Public Health Ontario has played a “diminished” role in responding to the pandemic and posed that this “may have been impacted by its funding.”  

The Health Ministry did not fully use the key lesson from SARS — the precautionary principle of acting as soon as there is reasonable evidence of a threat to public health — to guide its initial response to COVID-19, the auditor said.

The ministry categorized the risk to Ontarians as low even as the virus spread to more than 20 countries and the auditor said this meant Ontario developed its strategy for responding more slowly than other provinces. 

She points to repeated reports by her office since 2003 — a time period in which the Liberals were in power for nearly 15 years — warning of the need to strengthen the public health system and improve Ontario’s emergency preparedness.        

The auditor is working on a second special report on COVID-19, which will focus on health-related pandemic expenditures, personal protective equipment and long-term care, and said it will be issued soon. 

WATCH | How Ontario got to this point in the coronavirus pandemic:

With Premier Doug Ford poised to implement tighter restrictions in Toronto, Peel and possibly York, here’s a look back at how the novel coronavirus has surged this fall. 6:24

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‘Majority’ of U.K.’s vulnerable population could get coronavirus vaccine by April: PM – Global News



With major COVID-19 vaccines showing high levels of protection, British officials are cautiously — and they stress cautiously — optimistic that life may start returning to normal by early April.

Even before regulators have approved a single vaccine, the U.K. and countries across Europe are moving quickly to organize the distribution and delivery systems needed to inoculate millions of citizens.

Read more:
Boris Johnson to end England’s coronavirus lockdown on Dec. 2, implement tiered system

“If we can roll it out at a good lick … then with a favorable wind, this is entirely hypothetical, but we should be able to inoculate, I believe on the evidence I’m seeing, the vast majority of the people who need the most protection by Easter,” Prime Minister Boris Johnson said Monday after vaccine makers in recent weeks have announced encouraging results. “That will make a very substantial change to where we are at the moment.”

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The U.K. has recorded more than 55,000 deaths linked to COVID-19, the deadliest outbreak in Europe. The pandemic has prevented families from meeting, put 750,000 people out of work and devastated businesses that were forced to shut as authorities tried to control the spread. England’s second national lockdown will end Dec. 2, but many restrictions will remain in place.

The British government has agreed to purchase up to 355 million doses of vaccine from seven different producers, as it prepares to vaccinate as many of the country’s 67 million people as possible. Governments around the world are making agreements with multiple developers to ensure they lock in delivery of the products that are ultimately approved by regulators.

The National Health Service is making plans to administer 88.5 million vaccine doses throughout England, according to a planning document dated Nov. 13. Scotland, Wales and Northern Ireland are developing their own plans under the U.K.’s system of devolved administration.

Coronavirus: U.K. PM Boris Johnson announces end to nationwide lockdown

Coronavirus: U.K. PM Boris Johnson announces end to nationwide lockdown

The first to be vaccinated would be health care workers and nursing home residents, followed by older people, starting with those over 80, according to the document, first reported by the London-based Health Service Journal. People under 65 with underlying medical conditions would be next, then healthy people 50 to 65 and finally everyone else 18 and over.

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While most of the injections would be delivered at around 1,000 community vaccination centers, about a third would go to 40 to 50 “large-scale mass vaccination centers,” including stadiums, conference centers and similar venues, the document indicates.

The NHS confirmed the document was genuine but said details and target dates are always changing because the vaccination program is a work in progress.

Professor Mark Jit, an expert in vaccine epidemiology at the London School of Hygiene & Tropical Medicine, said Britain has the advantage of having a well-developed medical infrastructure that can be used to deliver the vaccine.

But this effort will be unlike standard vaccination programs that target individuals one at a time.

Read more:
Boris Johnson claims he’s ‘bursting with antibodies’ while in coronavirus self-isolation

“The challenge now is to deliver the biggest vaccine program in living memory in the U.K. and other countries around the world,” Jit said. “We’re not vaccinating just children or pregnant women like many other vaccination programs…. We’re trying to vaccinate the entire U.K. population. And we’re trying to do it very quickly.’’

Other European countries are also getting ready, as are the companies that will be crucial to the rollout.

For example Germany’s Binder, which makes specialized cooling equipment for laboratories, has ramped up production of refrigerated containers needed to transport some of the vaccines under development. Binder is producing a unit that will reach the ultra-cold temperatures needed to ship the Pfizer vaccine.

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The German government has asked regional authorities to get special vaccination centers ready by mid-December. France, meanwhile, has reserved 90 million vaccine doses, but has not yet laid out its plan for mass vaccination. A government spokesman said last week that authorities were working to identify locations for vaccination centers, choose companies to transport vaccines and set the rules for shipping and storage.

In Spain, health workers will get priority, as will residents of elder care homes. Spain hopes to vaccinate some 2.5 million people in the first stage between January and March and have most of the vulnerable population covered by mid-year. The vaccinations will be administered in 13,000 public health centers.

Click to play video 'Coronavirus: UK says it has secured 5 million doses of Moderna COVID-19 vaccine'

Coronavirus: UK says it has secured 5 million doses of Moderna COVID-19 vaccine

Coronavirus: UK says it has secured 5 million doses of Moderna COVID-19 vaccine – Nov 16, 2020

But sticking syringes in people’s arms is just the last part of the enormous logistical challenge the worldwide mass vaccination campaign will pose.

First, drugmakers must ramp up production, so there is enough supply to vaccinate billions of people in a matter of months. Then they have to overcome distribution hurdles such as storing some of the products at minus-70 degrees Celsius (minus-94 Fahrenheit). Finally, they will need to manage complex supply chains reminiscent of the just-in-time delivery systems carmakers use to keep their factories humming.

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“It will be the challenge of the century, basically, because of the volumes and everything else which are going to be involved … ,″ said Richard Wilding, a professor of supply chain strategy at Cranfield School of Management. “It’s just the absolute scale.″

Vaccines from three drugmakers are considered leading candidates. Pfizer and Moderna have released preliminary data showing their vaccines were about 95% effective. AstraZeneca on Monday reported interim results of its vaccine developed with Oxford researchers that were also encouraging. Dozens of other vaccines are under development, including projects in China and Russia.

Read more:
People of colour disproportionately affected by coronavirus in U.S., U.K.: study

Britain and other Northern Hemisphere countries may also get a boost from the weather, said Chris Whitty, England’s chief medical officer. Transmission of respiratory viruses generally slows during the warmer months.

“The virus will not disappear, but it will become less and less risky for society.”

But Johnson, who credited NHS nurses with saving his life after he was hospitalized with COVID-19 earlier this year, warned restrictions will continue for months and Christmas celebrations will be curtailed this year.

“We can hear the drumming hooves of the cavalry coming over the brow of the hill, but they are not here yet,” Johnson said.


© 2020 The Canadian Press

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