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Report offers insights into why early coronavirus cases may have been missed – NBC News

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A highly anticipated report published Friday offers insights into how the new coronavirus affects patients.

The report, published in the Journal of the American Medical Association or JAMA, details the cases of 138 patients with the virus in Wuhan, China, the epicenter of the outbreak. It’s data that clinicians and public health officials worldwide have waited for as they seek to understand how the virus works.

All of the patients were hospitalized at Zhongnan Hospital of Wuhan University during January as the outbreak was spreading rapidly. More than a quarter developed complications and needed intensive care. Six patients died.

The risk for severe complications of the new coronavirus increases with age and for those with underlying health conditions, according to the report.

Fever appears to be a key symptom in how the virus manifests itself in patients.

Of the 138 patients:

  • 99 percent had a fever
  • 70 percent had fatigue
  • 59 percent had a dry cough
  • 39 percent had appetite loss
  • 34 percent had body aches
  • 10 percent or fewer had diarrhea, nausea and dizziness.

Coronaviruses, which cause respiratory infections, usually spread through the droplets that spray out when an infected person sneezes or coughs. This particular virus appears to have spread easily despite an apparent absence of sneezing, and may be a reason it circulated apparently undetected for a period of time.

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“One reason for the rapid spread may be related to the atypical symptoms in the early state in some patients,” the study authors wrote. That is, people may not have realized they were sick, because they didn’t have the sneezing and congestion usually associated with colds.

Indeed, other reports show the disease is mild for most people. Chinese health authorities had provided data on 17,000 patients to the World Health Organization as of Friday.

Eighty-two percent of those cases were determined to be mild, the WHO said. Fifteen percent were more severe, and 3 percent were determined to be critical cases.

“That varies with age,” Maria Van Kerkhove, technical lead for the WHO’s Health Emergencies Program, said during a media briefing Friday. “The older you are, the higher the proportion of [severe] cases there are.”

Full coverage of the coronavirus outbreak

The average age of the 138 hospitalized patients detailed in the JAMA report was 56 years. Nearly half had underlying health problems, such as high blood pressure, diabetes, heart disease or cancer.

Just because you’re well on day one or two doesn’t mean you’ll necessarily be well on day four, five or six.

Patients who developed complications did so about five days after they first started having the symptoms.

“Just because you’re well on day one or two doesn’t mean you’ll necessarily be well on day four, five or six,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said during an interview with the editor of JAMA, which was published by the journal.

Many of the patients got the infection in the hospital: 40 of the 138 are health care workers, and 17 of the 138 were already hospitalized for other reasons when they became infected by other patients.

In one case, a single patient is believed to have infected more than 10 health care workers.

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York Region COVID-19 long-term care death toll continues to climb – NewmarketToday.ca

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York Region continues to grapple to control several “very challenging” outbreaks at long-term care homes, with 14 more deaths reported over the last several days bringing the number of COVID-19 related outbreak fatalities to 166 today.

While 47 of 62 institutional outbreaks have been resolved, York Region medical officer of health Dr. Karim Kurji acknowledges several outbreaks have been difficult to control.

York Region Public Health issued today the first order of its COVID-19 response to have 18 residents of Woodbridge Vista Care Community transported to local hospitals, according to York Region spokesperson Patrick Casey.

Seventeen residents have died as a result of the outbreak declared May 7 at the Vaughan long-term care home, where 85 of 216 residents and 28 health care workers have been exposed.

“York Region Public Health has directly supported Woodbridge Vista Care Community on a number of occasions since the outbreak was declared including five visits and follow-ups related to infection prevention and control, enhanced testing of staff and residents and constant communication with representatives of the home. Despite all efforts, COVID-19 cases continued to increase at this facility,” according to an online statement.

Another persistent long-term care outbreak is at River Glen Nursing Home in Sutton, where the death toll, at 32 residents, is the highest in the region. Another resident case has been confirmed, now totalling 87, as well as an additional health-care worker case, totalling 32, at the 115-bed facility. It was among the first of two long-term care homes that the Ministry of Long-term Care designated to be temporarily managed by a hospital.

York Region Public Health continues to collaborate with Southlake Regional Health Centre, which is managing the outbreak, Casey said.

From May 29 to 31, 14 COVID-19 related fatalities at long-term care homes were reported:

  • A  92-year-old Georgina man passed away Wednesday, May 27 at River Glen Haven, after a positive test May 14;
  • A 74-year-old Georgina woman passed away Thursday, May 28 at River Glen Haven, after a positive test May 14;
  • An 80-year-old Georgina woman, who was asymptomatic, passed away Monday, May 25 at River Glen Haven, after a positive test May 25;
  • A 91-year-old Georgina woman, who was asymptomatic, passed away Saturday, May 23 at River Glen Haven, after a positive test May 25;
  • An 84-year-old Vaughan man, who was asymptomatic, passed away Tuesday, May 26 at Etobicoke General Hospital due to exposure at Woodbridge Vista Care Community;
  • A 64-year-old Vaughan man passed away Tuesday, May 26 at Woodbridge Vista Care Community, after a positive test May 17;
  • A 76-year-old Vaughan woman, who was asymptomatic, passed away Wednesday, May 27 at Woodbridge Vista Care Community, after a positive test May 21;
  • An 80-year-old Vaughan woman, who was asymptomatic, passed away Wednesday, May 27 at Etobicoke General Hospital, after a positive test May 21, due to exposure at Woodbridge Vista Care Community;
  • A 90-year-old Vaughan woman, who was asymptomatic, passed away Tuesday, May 26 at Woodbridge Vista Care Community, after a positive test May 21;
  • An 88-year-old Georgina man passed away Friday, May 29 at River Glen Haven, after a positive test May 22;
  • A 94-year-old Vaughan woman passed away Thursday, May 28 at Woodbridge Vista Care Community, after a positive test May 13;
  • A 92-year-old Vaughan man, who was asymptomatic, passed away Friday, May 29 at Woodbridge Vista Care Community, after a positive test May 21;
  • An 87-year-old Georgina woman passed away Saturday, May 30 at River Glen Haven, after a positive test May 22;
  • A 71-year-old Georgina woman, who was asymptomatic, passed away Sunday, May 31 at River Glen Haven, after a positive test May 24.

Other institutional outbreaks that have not resolved after multiple weeks include:

  • Villa Leonardo Gambin, Vaughan, 11 deaths, 44 of 168 patients, 32 health-care workers, 60 days, declared April 1
  • Kristus Darzs Latvian Home, Vaughan, 10 deaths, 29 of 99 residents, 22 health-care workers, 52 days, April 9
  • Participation House, Markham, 6 deaths, 40 of 42 patients, 57 health-care workers, 52 days, April 9
  • Villa Colombo Vaughan Di Poce, 20 deaths, 46 of 158 residents, 24 health-care workers, 50 days, April 11

As well, Dr. Kurji noted group homes at which outbreaks had been resolved have returned for second rounds, including New Leaf The Pines in East Gwillimbury (one staff member), Participation House Farintosh in Markham (one staff member), and Reena Home Crestwood in Thornhill (one resident, two staff).

The medical officer is urging all health-care workers and staff to get tested every two weeks.

Other COVID-19 related fatalities this weekend include a 69-year-old Vaughan man who passed away Tuesday, May 26 at North York General Hospital with a close contact case confirmed April 29, bringing the region’s total deaths to 209.

York Region Public Health is also reporting the second fatality due to workplace exposure, a 63-year-old Vaughan man employed at Ability Fabricators in Vaughan. He passed away Wednesday, May 27 at Mackenzie Richmond Hill Hospital following symptom onset April 27 and positive test results May 6.

The first workplace outbreak COVID-19 death was a 57-year-old Newmarket man, who died at home May 5 after being infected at Saputo Dairy Products Canada in Vaughan.

Workplace outbreaks continue to rise in York Region, with 69 workers who live in York Region infected, and others who live outside the region.  

Dr. Kurji outlined the concerning spread of the virus among workers: “Workers tend to get it from the community and then one given worker may pass it to the next and then to the next. These workers then tend to take it into their families, and so you get household contacts. Some of the workers work in multiple locations, and if they happen to be infectious, they take it to those workplaces. Sometimes, workers tend to carpool and sometimes workers from different workplaces carpool in the same car. And so, if one of them is infectious, you get spread to the other workplaces.”

Public health is monitoring the outbreaks, and is urging employers and employees to follow guidelines that include screening, wearing masks, disinfection policies, staggered lunch breaks, providing “good sick time practices” and, most importantly, physical distancing, Kurji added. 

York Region Public Health provides a toolkit for workplaces here.

The number of hospitalized patients in York Region has dropped to 46, with 17 cases critically ill in ICU. One Newmarket resident is hospitalized, none in ICU.

As of 4:30 p.m. May 28, Southlake Regional Health Centre is reporting three COVID-19 patients in ICU, and 16 COVID-19 positive patients being cared for in an inpatient unit. The number of inpatients under investigation for COVID-19 is 31. Deaths total 20.

Of 2,434 cases in York Region:

  • 1,047 (+12) are confirmed in Vaughan, 84 deaths, 756 (72%) resolved;
  • 525 (+6) in Markham, 45 deaths, 380 (72%) resolved;
  • 256 (+8) in Richmond Hill, 8 deaths, 193 (75%) resolved;
  • 210 (+1) in Newmarket, 22 deaths, 158 (75%) resolved; 
  • 134 (+2) in Georgina, 25 deaths, 85 (68%) resolved;
  • 102 in Aurora, 13 deaths, 78 (76%) resolved;
  • 65 in Whitchurch-Stouffville, 1 death, 46 (71%) resolved;
  • 54 in East Gwillimbury; 1 death; 42 (78%) resolved;
  • 31 (+1) in King, 3 deaths, 23 (74%) resolved.

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Owner of infected long-term care facility says COVID-19 outbreak was unavoidable – CBC.ca

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The owner of the Manoir de la Vallée in Atholville, N.B., said his facility an outbreak of COVID-19 at his facility was unavoidable.

An employee in their 30s at the long-term care facility near Campbellton, N.B., tested positive for the virus last week. Since then, four residents at the facility have also tested positive. Three of the residents are in their 80s and one resident is in their 70s. 

“We knew COVID would start somewhere in our facilities, but we didn’t know exactly when it would start,” said Guy Tremblay, president and general director of Groupe Lokia, which owns the special care home for seniors.

About 100 people, including 57 residents, may have been exposed to the worker, who was contagious during three night shifts at the facility. 

All of the staff and residents at the facility have been tested, Dr. Jennifer Russell, New Brunswick’s chief medical officer of health said at a news conference on Sunday.   

Tremblay feels he did as much as he could to prevent the virus from entering his facility.

‘”All our staff have been prepared to prevent the spreading of COVID since the first week or second week of March,” he said. 

‘All the prevention, all the techniques we demonstrated to our employees was pretty much well-learned over the last two months.”

More than a third of staff at the long-term care facility are no longer working there. 

Ten of the 28 staff choose to leave the Manoir de la Vallée long-term care facility because of the COVID-19 outbreak. 

“As soon as the staff learn that COVID is around, many of them are just scared about that.” 

Ambulance New Brunswick and Extra-Mural, the province’s home health-care program, are on site to provide additional help caring for residents at the facility.

Tremblay said he is happy the government chose to bring in help. 

“It’s not bad news for me really. It should be like that. We should work all together to face that situation.” 

Cecile Cassista, executive director for the Coalition for Seniors and Nursing Home Residents Rights, is also pleased the government chose to ask for additional help.

Cecile Cassista of the Coalition for Seniors and Nursing Home Residents’ Rights is worried about the senior population in Campbellton after the COVID-19 outbreak at a long-term health care facility in the region. (Wayne Chase Photography)

Cassista is “very upset” about the outbreak at the home, however. 

“This is about our aging population and our seniors,” she said. “I had the greatest fear when I heard of one person being infected and now we have it spreading throughout the home.”

There are 132 confirmed cases of COVID-19 in the province. Of that, 120 have recovered since the pandemic beegan in March. 

The 12 active cases are all in the Campbellton region, or Zone 5. 

Three of the long-term care cases are in the hospital, including one patient in ICU.

A cluster of COVID-19 cases sprung up there after doctor who travelled to Quebec contracted the coronavirus and didn’t self-isolate when he returned to New Brunswick.

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SHA warns of possible COVID-19 transmission at North Battleford Walmart – News Talk 650 CKOM

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A person who tested positive for COVID-19 visited the North Battleford Walmart on May 21.

In a release Sunday, the Saskatchewan Health Authority and Indigenous Services Canada said the individual was likely infectious at that time.

Public Health Officials are advising customers who were at the North Battleford Walmart on May 21 between noon and 2 p.m. to immediately self-isolate if you’ve had any symptoms of COVID-19, and call HealthLine 811.

All other customers who were at the business during the time period should self-monitor daily for symptoms of COVID-19 until June 5.

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