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Record high ICU admissions in Sask. has doctor suggesting a different vaccine strategy –



Intensive care (ICU) hospitalizations in Saskatchewan are at an all-time high, with 47 patients there now in total. Thirty-one of those patients are in Regina. 

Variants of concern are spreading in Regina right now. The Regina zone accounts for 803 — or 84 per cent — of the VOC cases with confirmed lineage reported in Saskatchewan.

Dr. Hassan Masri, an intensive care specialist in Saskatoon, said the numbers there are under control at the moment. 

“The situation in Regina is certainly out of control,” Masri said. 

“Unfortunately, we did allow those numbers to rise here in Saskatchewan and specifically in Regina and so now we have ICUs that are really full in Regina and potentially patients will have to be diverted to Saskatoon.”

Masri said that has not happened yet, but it is a possibility. 

CBC has reached out to the Saskatchewan Health Authority for comment on the ICU situation in Regina on Monday, but has not received a response.  

People in the health care system familiar with the situation have told CBC that the breakdown of hospitalizations in the city is as follows:

  • Pasqua Hospital ICU: seven total beds, three positive COVID-19 patients, one recovered COVID patient   
  • Pasqua medical surveillance unit (MSU): five overflow ICU patients, zero positive COVID patients
  • General Hospital medical ICU: ten total beds, ten positive COVID patients, one recovered COVID patient
  • General surgical ICU: 12 total beds, 11 positive COVID patients
  • Cardiology Care Unit at the General: 5 overflow positive COVID patients

Intensive care specialist Dr. Hassan Masri was one of the first people in the city of Saskatoon to get the COVID-19 vaccine. (Don Somers/CBC)

Recovered patients are marked as such only after they are no longer contagious, but they may still require hospital or ICU care.

“The other important story in all of this is the age group that are filling the ICUs,” Masri said. 

“We are seeing a lot of patients in their 20s, 30s and 40s … the variant, which is really rapidly spreading in Saskatchewan, seems to affect younger people much more profoundly than the original COVID virus.”

Masri suggested that the vaccine strategy be tweaked slightly to include essential workers sooner. 

“You know, there are people going to work every day at grocery stores or truck drivers or even people in health care who are being asked to go to work everyday and put themselves at a really high risk, but yet they may not be vaccinated for two months or three months or four months from now,” he said. 

Masri said to see young people fighting for their lives in the ICU is “very disturbing and extremely unusual.”

As for restrictions in the province, Masri said the government should revisit the opening of bubbles and the loosening of those types of restrictions. He also said rapid testing has been underutilized in the province and country. 

Masri emphasized that this is not just a Regina problem, and that the entire province should be preparing. 

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Average age of Quebec COVID-19 patients has dropped by 10 to 15 years, doctors say – National Post



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MONTREAL — Over the past two to three weeks, Dr. Francois Marquis, head of intensive care at Montreal’s Maisonneuve-Rosemont hospital, says he started noticing the average age of COVID-19 patients dropping.

People arriving at the hospital are on average, about 10 to 15 years younger than earlier patients in need of medical care after contracting COVID-19, he said in an interview Wednesday.

“We are starting to see what was very unlikely during the first wave: 30 or 40-year-olds without any previous medical history, people in good health,” Marquis said.

“They’re not seeing a doctor, they’re not taking any kind of medication, they don’t have diabetes, they don’t have high blood pressure — they just get sick.”

Marquis’s observations echo a warning earlier this week from Dr. Theresa Tam, Canada’s chief public health officer, who said health officials across the country are reporting rising numbers of younger patients in hospitals who soon need intensive care.

“Many of them deteriorate quite quickly and have to be admitted to the ICU,” she said.

Dr. Gaston De Serres, an epidemiologist with Quebec’s public health institute, said the proportion of Quebecers over 80 in hospital with COVID-19 has been declining since mid-March — largely due to vaccination.


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He said it’s not just the proportion of hospital patients who are younger that’s increasing, the overall number of younger patients is rising as well. De Serres said there were 40 people between 50 and 59 years old who were hospitalized the week of March 7. During the week of March 28, there were 54.

But hospitalizations are still not rising significantly among people under 30. “It’s younger,” he said of the average age of patients. “It’s not young.”

Ten people between 20 and 29 years old were hospitalized with COVID-19 in Quebec the week of March 28, up from five two weeks earlier, De Serres said.

“If you have more cases, you will clearly have more hospitalizations, but the proportion of all hospitalized cases will remain small because these younger age groups are very low risk of being hospitalized.”

De Serres said he thinks more younger people are getting sick because the coronavirus variants of concern are more transmissible and they lead to more severe illness more frequently.

Mike Benigeri, director of the data bureau at the Institut national d’excellence en sante et services sociaux, a Quebec government health-care research institute, said that over the past two weeks, there has been a 40 per cent increase in the number of people aged 40 to 69 who have been infected with COVID-19. He said the percentage is even higher among people aged 18 to 30.


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Marquis said older people and those with other medical conditions may notice a COVID-19 infection sooner. People who are healthier may not seek medical attention until they’re very ill, he added.

“They will push the limits of endurance up to the point when they say, OK, it’s enough, I really need to go to the hospital,” he said.

Despite the odds of dying being low among younger people, that doesn’t mean the consequences among the small group who do get severely ill are any smaller, he said.

“If you’re that unlucky guy, well, you’re going to die — and you’re not going die 1.5 per cent, you’re going be fully dead.”

Quebec Premier Francois Legault has repeatedly said that with vaccination protecting older people, the province will be able to tolerate more COVID-19 cases.

Dr. Quoc Nguyen, a gerontologist at the Universite de Montreal hospital centre, said while that may be true when it comes to deaths, it may not be the case for ICU capacity.

“When we look at one case in December versus one case in March, it seems that for a single case we have more intensive care than we used to before, but we don’t necessarily have more hospitalization,” he said.

It’s ICU capacity that worries Marquis. His ICU is supposed to have 24 beds, but because staff members have left the health-care system — particularly nurses — it now has a capacity of 14: seven beds dedicated to COVID-19 patients and seven for everyone else.

“I am really afraid that in two weeks we’re going to be in the same place as Ontario is right now and I don’t think that we can deal with that many patients,” he said.

Ontario Premier Doug Ford has imposed a four-week stay-at-home order after a third wave of COVID-19 started to overwhelm the health system.

“They’re going to saturate the ICU availability very, very quickly for a very long time,” Marquis said.

This report by The Canadian Press was first published April 8, 2021.


This story was produced with the financial assistance of the Facebook and Canadian Press News Fellowship.


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Canada’s hospitals deploy artificial lungs, scramble for staff as COVID-19 hits younger patients



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By Anna Mehler Paperny and Allison Martell

TORONTO (Reuters) -Younger Canadians are bearing the brunt of the nation’s latest COVID-19 surge, creating growing demand for artificial lungs and a struggle to maintain staffing in critical care units as hospitals make last-ditch efforts to save patients.

Treatment with artificial lungs, known as extracorporeal membrane oxygenation, or ECMO, is much more likely to be deployed for patients under age 65, explained Marcelo Cypel, surgical director for the extracorporeal life support program at Toronto’s University Health Network (UHN).

Last week, there were a record 19 ECMO patients at UHN, 17 of them with severe COVID-19. When the sickest COVID-19 patients’ lungs fill with fluid and mechanical ventilators can no longer do the job, artificial lungs can save lives.

By Monday, doctors had weaned some off the machines and were down to 14 ECMO patients, 12 of them with COVID-19.

The need for these artificial lungs reflects a change in Canada‘s epidemic, which has taken a turn for the worse, with new cases surging and outbreaks hitting workplaces and schools.

With many seniors vaccinated and new, far more contagious coronavirus variants circulating widely, younger patients are increasingly arriving in intensive care.

“It’s very different now than the first wave, when we saw older people with comorbidities,” Cypel said. “We’re seeing more … young essential workers.”

The ECMO situation is under control for now, but things can change very quickly, Cypel cautioned.

When hospital systems in other countries were overwhelmed, they had to stop using ECMO because it requires a lot of staff – seven or more people to start the treatment.

About 55% of people who receive the therapy survive, Cypel said. However, they are often left with “severe physical limitations” from their extended hospital stay, he added.

Many of Canada‘s provinces are in the grip of a worsening third COVID-19 wave, as they struggle to hasten vaccine rollouts. The country reported more than 6,200 new cases on Monday, with the percentage of people testing positive for the virus up to 3.8%.


In British Columbia, where hospitals are bracing for a surge in demand for intensive care unit (ICU) beds caused by the highly concerning P.1 virus variant first discovered in, and now ravaging, Brazil, critical care doctor Del Dorscheid from Vancouver’s St. Paul’s Hospital is more worried about staffing than artificial lung use.

On a given shift, he said, a third of the staff are working overtime.

“They’re working so hard to find bodies to fill those empty spots,” he said. “I wouldn’t say we’re seeing more mistakes. Not yet, anyways. But we are certainly seeing burnout.”

For ICUs, there is no end in sight. As of Tuesday, there were 497 COVID-19 patients in Ontario’s ICUs, a new high. Last week, experts advising the provincial government said that could rise to 800 by the end of April even with a new stay-at-home order – or approach 1,000 without it. The province stopped short of a new stay-at-home order.

New restrictions implemented in Ontario last week change little for hardest-hit areas. In Toronto, patios for outdoor bars and restaurants closed, and a plan to reopen salons was shelved. On Monday, hard-hit Peel, west of Toronto, moved on its own to suspend in-person classes at schools for two weeks.

Canada‘s vaccination rate has picked up after a slow start, with 15% of the population getting at least one shot. But data from the Institute for Clinical Evaluative Sciences shows that the Ontario communities at highest risk of COVID-19 transmission also have the lowest rates of vaccination.

These communities tend to have a high proportion of residents unable to work from home, many of them non-white immigrants holding down jobs at high risk of virus exposure.

Some lack cars to drive to vaccination sites or paid time off to get the vaccine, said Brampton doctor Amanpreet Brar. Some of the hardest-hit neighborhoods lack pharmacies that dispense COVID-19 vaccines.

“It really reflects systemic inequities we see in our society,” said Brar. “They’re considered non-essential, while their work is considered essential.”

(Editing by Denny Thomas and Bill Berkrot)

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Western Canada: B.C. faces vaccine shortfall amid rising cases of COVID-19 variants – The Globe and Mail



Good morning. Wendy Cox in Vancouver this morning.

As the number of vaccines ramps up across the country, provinces are scrambling to boost their own efforts to get doses into arms. The increased availability of doses is still falling far short of the demand.

British Columbia finally opened its online registration portal on Tuesday, allowing people born in 1950 or earlier to register to get a confirmation code. The code allows them to book an appointment for a shot when they are contacted by e-mail, text or phone.

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But the continued scarcity of the resource was underlined even as British Columbia received more vaccines over the weekend and into this week. About 700,000 British Columbians between the ages of 55 and 65 can expect a chance to book a COVID-19 vaccine at their local pharmacy by the end of the week, but only about 200,000 doses of AstraZeneca are expected to be available.

Meantime, the 300,000 front-line workers who were promised priority access to that stream of vaccine supply in mid-March still have no answers about when they will be back in line as Canadian health officials reconsider the safety of the vaccine for younger populations.

“We do not have enough vaccine to provide it to everybody, but it’s a way of jump-starting that part of the age group,” Bonnie Henry, B.C.’s Provincial Health Officer, said Tuesday.

Meantime, case counts across the country continue to surge, driven by highly contagious variants.

“On present course, the pandemic will blight the spring and shorten the summer for millions of Canadians,” said David Naylor, the co-chair of the federal COVID-19 Immunity Task Force.

The surge “cannot be contained without tough public health measures and a substantial acceleration of the current vaccine rollout.”

Alberta brought in new measures Tuesday, announcing it would reimpose restrictions on restaurants, gyms and other activities as more transmissible and lethal variants spread without restraint.

Premier Jason Kenney said the province will return to the first phase of its reopening plan as Alberta forecast 1,000 people with COVID-19 will be in hospital by the end of the month. Restaurants will be closed for indoor dining as of Friday and gyms must stop group activities Wednesday. Retailers and shopping malls must reduce capacity to 15 per cent of fire code, down from 25 per cent.

Alberta’s retreat comes less than a month after Mr. Kenney bowed to pressure from inside his own caucus to loosen the rules. But the variants of concern, which now make up about 43 per cent of Alberta’s 10,809 active cases, are undoing progress to contain infections and threaten to overwhelm the health care system. Alberta projected 2,000 new daily cases of COVID-19 by the end of the month.

“We must defeat these variants,” Mr. Kenney said. “This wave is here.”

Cases are also climbing in British Columbia, but new restrictions weren’t imposed here.

B.C. posted another 1,068 new cases of COVID-19 on Tuesday, and the province identified more than 200 new cases involving the variants of concern. Health officials blame the rise in cases on social interactions and non-essential travel in defiance of health orders, and expressed alarm at the rising number of younger residents who are now in hospital. Restaurants and bars have been closed for in-dining service since March 30.

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Health Minister Adrian Dix urged British Columbians to follow the existing rules while the mass vaccination program continues to roll out.

On Monday, federal Health Minister Patty Hajdu highlighted the discrepancies between the available shots and the number administered, but on Tuesday she and Prime Minister Justin Trudeau were careful not to directly criticize the premiers.

“We all need to speed up the vaccination process,” Mr. Trudeau said in French.

Ms. Hajdu was not able on Tuesday to say how quickly the federal government expects provinces to administer vaccines once they receive them. The federal public health agency wasn’t able to provide data on how fast shots are being given, and neither were provinces such as Ontario and B.C.

That information is crucial to ensuring an effective vaccination campaign, Dr. Naylor said.

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“You absolutely have to have a sense of your inventory and how fast it’s moving so that you can determine how sites are performing relative to the demand they’re facing,” he said.

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