RSV cases on the rise stretch children's hospitals

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RSV cases on the rise stretch children’s hospitals

Published

7 months ago

November 5, 2022

Harry Miller

Coming down from the height of the COVID-19 pandemic, children’s hospitals across Canada are struggling to handle a new surge of young patients with viral infections in what pediatric health-care workers are calling their version of 2020.

Pediatric health-care professionals warn most children’s hospitals are operating at or over 100 per cent occupancy, that emergency room wait times can be up to 24 hours and that some non-emergency surgeries are already being delayed.

One germ in particular, respiratory syncytial virus (RSV), has especially stretched hospitals’ limits. RSV is a common childhood respiratory infection that normally results in cold-like symptoms which clear up after a week or two, according to the U.S. Centers for Disease Control and Prevention (CDC).

However, the Public Health Agency of Canada (PHAC) warns severe cases of RSV may lead to hospitalization. RSV can also cause secondary bacterial infections, such as pneumonia. There is no vaccine for RSV nor any medication that clears up an infection, so care is normally centred on treating symptoms and secondary infections.

While RSV infections normally peak in December and January, PHAC’s Oct. 29 Respiratory Virus Report warns the number of both RSV and Influenza A cases is “above expected levels for this time of year.” So far, the agency has detected 1,045 cases of RSV, with a seven per cent positivity rate.

Some health-care professionals attribute the spike in RSV infections to the fact that physical distancing and public health restrictions during the pandemic kept children from being infected with the virus for two years, so their immune systems have less experience fighting it now that those restrictions have lifted.

Dr. Robert Barnes, associate director of professional services at the Montreal Children’s Hospital, said that while the viral surge is affecting all pediatric age groups, the youngest children seem to be bearing the brunt of it.

“We have a huge amount of our very young children in the community who did not get so much of a turn with these viruses last winter or even the winter before that,” Barnes told CTVNews.ca on Wednesday. “So the virus is spreading much more, and much faster among our young people.”

Meanwhile, hospitals across Canada have already surpassed their emergency room and in-patient capacity levels and are struggling with long wait times.

When her asthmatic three-year-old James Pinter fell ill on Oct. 17 with a fever, cough, congestion and lethargy, Calgary mother Michelle Maguire decided he needed to see a doctor. Her first choice, Alberta Children’s Hospital, listed a wait time of more than seven hours online, so she went with her second choice, Rockyview General Hospital.

“All hospital wait times are flooded right now,” she told CTVNews.ca in a phone interview on Wednesday. “But the doctor we saw at the hospital did let us know that basically every child they’re seeing is presenting with RSV symptoms.”

James was diagnosed with RSV and released that day to recover at home. Maguire said he’s feeling much better, but that it was the most severe illness her eldest child has had.

A NATIONAL PROBLEM

Emily Gruenwold, president and CEO of Children’s Healthcare Canada, said conversations like the one Maguire had with the doctor at Rockyview General Hospital are happening in hospitals throughout Canada right now.

“Across the country, almost without exception, our children’s hospitals are all running at 100 percent occupancy or more,” Gruenwold told CTVNews.ca in a phone interview on Thursday.

Part of what’s driving high occupancy rates, she said, is the ongoing shortage of children’s Advil and Tylenol throughout the country.

“Parents are seeing their little ones not feeling the best, maybe struggling with high fever, body aches and headaches and they’re trying to control those symptoms at home,” Gruenwold said.

When they can’t find what they need to treat those symptoms on pharmacy shelves, she said they often turn to hospital emergency departments.

Gruenwold said CHU Sainte-Justine, in Montreal, was running at 300 per cent occupancy this week and that, as of Thursday morning, the Children’s Hospital of Eastern Ontario’s (CHEO) pediatric ICU was running at 200 per cent.

HSC Children’s, in Winnipeg, Manitoba, reported on Oct. 27 that its emergency department saw an average of 139.5 patients per day in September, an increase of almost 11 per cent year-over-year.

In an interview with CTV News Channel on Wednesday, Bruce Squires, president of McMaster Children’s Hospital, said the hospital’s in-patient occupancy was approaching 135 per cent.

“As our teams work to respond to that level of demand, we’ve had to open a significant number of additional beds on a daily basis,” he said.

Squires attributed the situation at his hospital to the culmination of several factors, including the ongoing COVID-19 pandemic and a “significant spike” of viral infections, including RSV and influenza. Pandemic-related delays for specialized pediatric treatments, he said, have also led to an influx of young patients who are sicker than they should be.

“Unfortunately it seems to be coming together all at the same time and it’s resulted in, for us at McMaster Children’s, unprecedented numbers of kids presenting to our emergency department,” he said, as well as “unprecedented numbers who require either an inpatient ward admission or, in some cases, an admission to our critical care units.”

Staff are facing a similar situation at Montreal Children’s Hospital, where Barnes works. The hospital saw an emergency room occupancy rate of 193 per cent Tuesday night, up from an average occupancy rate of 113 percent around the same time in 2019. The hospital’s ICU is at approximately 115 per cent occupancy while the medical unit is operating at about 106 per cent.

According to staff at the hospital, emergency room wait times for the hospital’s least critical visitors are between 18 and 24 hours.

Diane Piques took her eight-year-old daughter, Chloe Santangeli, to the hospital on Oct. 8. Chloe, who has asthma, seemed to have a viral infection and was struggling to breathe. She was diagnosed with RSV and pneumonia and admitted overnight so she could receive IV antibiotics and supplemental oxygen. Chloe is slowly recovering, but Piques is haunted by the experience, and by how many other children on her daughter’s floor of the hospital seemed to be struggling with the same illness.

“The whole floor she was on had either pneumonia or had the virus,” she told CTVNews.ca in a phone interview on Wednesday. “The doctor that saw her said she’s never seen a rise like this, ever.”

Barnes said the hospital doesn’t reserve floors for specific illnesses, but that he isn’t surprised it seemed that way to Piques.

“There is not a dedicated RSV or pneumonia floor,” he said. “However, we are so overwhelmed that it would not surprise me if just about every patient on a particular floor might have that problem.”

The hospital has added more beds for admissions than it would normally need for this time of year, and Barnes said those admissions have begun to displace resources for other areas, like surgery.

“It has had an impact on our ability to carry out our surgical schedule for those children who need an operation, or who need a hospital bed or ICU bed folowing a surgery,” Barnes said.

As a result, some patients who have waited weeks or months for surgery may need to wait a little longer. Fortunately, Barnes said, the hospital has not had to postpone emergency operations or surgical procedures related to cancer.

To manage the influx of admissions, Cindy McCartney, associate director of nursing, said the hospital has leaned heavily on staff to work voluntary overtime. She compared the experience of children’s hospitals right now to the experiences of general hospitals throughout the COVID-19 pandemic.

“I think everyone is tired,” she told CTVNews.ca on Wednesday. “I think that the adult health-care system had a really difficult time during COVID, and this is like our COVID, and the demand on our staff is very high.”

Gruenwold made the same comparison.

“It feels like this is our 2020 moment,” she said. “In 2020, when the pandemic emerged, we saw unacceptable levels of care and outcomes for our seniors populations. Now, we’re seeing the same for our children.”

HOW PARENTS CAN HELP

Gruenwold believes it falls to the provincial and federal governments to give Canada’s hospitals and health-care system the resources they need to be more resilient and better prepared to face public health crises.

However, she, Squires, Barnes and McCartney all agreed that for now, there are steps parents can take to make sure they’re using the appropriate health-care services in order to preserve hospital capacity for children who need it most.

“It is helpful to review your options when you have some concerns about your child’s health,” Squires said. “Certainly, in an emergency situation, make sure you do call 911 or proceed directly to an emergency department.”

However, in cases where an illness doesn’t seem as critical, Squires said parents can sometimes take advantage of their primary care provider’s emergency after-hours clinic, if that clinic offers pediatric treatment.

For families who don’t have a primary care provider, or whose primary care clinics are closed, provinces and hospitals offer online and telephone triage and consultation services. For example, people in Quebec can call 811 to describe their symptoms, receive advice about the most appropriate care options and book appointments over the phone. Ontario offers a similar service in Telehealth.

Some children’s hospitals, such as CHEO and McMaster Children’s Hospital, offer a telephone triage service that allows parents to speak with a nurse practitioner or physician in the emergency department who can help determine a child’s care needs before a family has left their home.

Finally, Gruenwold encouraged parents to make sure they and their children are up-to-date on all their routine immunizations and COVID-19 vaccines, to help reduce overall strain on the health-care system.

“Even before they get sick, we encourage parents to get their kids caught up on routine immunizations, and make sure they’ve got their flu vaccine and their COVID boosters to set them up for success,” she said.

With files from CTVNews.ca producer Jennifer Ferreira, CTVNews.ca writer, producer Olivia Bowden, CTV National News correspondent Heather Wright and CTVNews.ca writer Daniel Otis.

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Air Canada issues: Passengers to be compensated – CTV News

Published

4 hours ago

June 9, 2023

Harry Miller

MONTREAL –

Air Canada says it made a mistake in rejecting some compensation claims from the thousands of travellers affected by delayed flights due to computer malfunctions.

In messages to some customers, the airline initially said the information technology fumble was out of its hands, relieving it of obligations to pay them compensation.

“In this instance, the compensation you are requesting does not apply because the disruption was caused by an event outside of our control. This flight is delayed due to an unforeseen technology issue, impacting one of our suppliers, which is impacting our operations,” the airline said Thursday in an email to passenger Douglas Judson.

Judson said he arrived more than three hours late after his June 1 flight from Winnipeg to Toronto was delayed due to the IT defect.

“I find the dishonesty and disrespect of it the most galling,” he said in a phone interview. “Some really interesting logic puzzles at Air Canada as to when something is actually their fault.”

While denying his compensation request, Air Canada offered him a 15 per cent fare discount on any upcoming flight as a “goodwill gesture.”

When contacted by The Canadian Press on Friday, the Montreal-based airline said the response stemmed from an error.

“Air Canada is offering compensation in line with APPR (Air Passenger Protection Regulations) compensation levels for flights which were affected by the IT outage. Some passengers had received erroneous responses from us, and we are in the process of re-contacting them with the correct responses,” spokeswoman Angela Mah stated.

The country’s largest carrier has struggled with intermittent computer problems over the past few weeks.

On May 25 it delayed more than half its flights due to a “technical issue” with the system that the airline uses to communicate with aircraft and monitor their performance. On June 1 it delayed or cancelled more than 500 flights — over three-quarters of its trips that day, according to tracking service FlightAware — due to “IT issues.”

That same day, Transport Minister Omar Alghabra stressed the carrier’s compensation responsibilities to its guests.

“Air Canada has obligations to passengers who are impacted because it is caused by things that the airline has control over,” he told reporters June 1, hours after the IT issues resurfaced.

Alghabra spokeswoman Nadine Ramadan said in an email Friday the minister’s office had been in touch with the company, which assured them it will compensate the affected passengers.

Gabor Lukacs, president of the Air Passenger Rights advocacy group, said the airline’s response “rings hollow.”

“We are hearing about too many of these ‘errors’ to believe that it was a genuine error,” he said in an email.

Lukacs suggested Air Canada’s response — including the discounted fare offer — marked “an attempt to make passengers go away and not pursue their rights.”

It was not clear whether the thousands of passengers whose flights were delayed or cancelled the day after the June 1 computer problem — Judson’s included — due to what the airline deemed “rollover effects” would receive compensation.

“They said in their official communications to passengers that it was maintenance. I do not believe it was maintenance. I think it was a direct consequence of their IP issues,” Judson said, noting that his return flight to Winnipeg landed more than three hours behind schedule.

Air Canada’s Mah said the airline would “investigate to determine the root cause of the cancellation and handle accordingly.”

At least 144 of its flights, or 27 per cent of the airline’s scheduled load, had been delayed as of late afternoon on June 2, along with 33 cancellations, according FlightAware.

In April, Alghabra laid out measures to toughen penalties and tighten loopholes around traveller compensation as part of a proposed overhaul of Canada’s passenger rights charter.

If passed as part of the budget bill, the reforms will put the onus on airlines to show a flight disruption is caused by safety concerns or reasons outside their control, with specific examples to be drawn up by the Canadian Transportation Agency as a list of exceptions around compensation.

“It will no longer be the passenger who will have to prove that he or she is entitled to compensation. It will now be the airline that will need to prove that it does not have to pay for it,” Alghabra said on April 24.

Currently, a passenger is entitled to between $125 and $1,000 in compensation for a three-hour-plus delay or a cancellation made within 14 days of the scheduled departure — unless the disruption stems from events outside the airline’s control, such as weather or a safety issue including mechanical problems. The amount varies depending on the size of the carrier and length of the delay.

This report by The Canadian Press was first published June 8, 2023.

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What started Canada’s wildfires and are they under control?

Published

10 hours ago

June 9, 2023

Harry Miller

Canada is seeing its worst-ever start to wildfire season, with blazes ravaging much of the country and creating hazardous smoky conditions across the continent and beyond.

After reaching New York earlier this week, on Thursday it blanketed Washington, DC, in an unhealthy haze, prompting many residents to stay indoors.

Here is what we know about the wildfires, their trajectory and climate change.

What started the Canadian wildfires?

Atlantic Canada received low snowfall this winter, followed by an exceptionally dry spring.

Nova Scotia’s capital Halifax received just 120mm of rain between March and May, roughly a third of the average, according to The Weather Network meteorologist Michael Carter.

A scorching late May heatwave pushed temperatures in Halifax to 33C (91.4 F) on Thursday, about 10 degrees Celsius above normal for this time of year.

The wildfires are believed to have been caused either by lightning, as in the case of Quebec, or accidentally by human activity.

Ellen Whitman, a research scientist with the Canadian Forest Service, said there is also speculation that trees felled during Hurricane Fiona, which hit Atlantic Canada in September 2022, or killed by an infestation of forest pests may be providing more fuel than usual for wildfires, but that theory requires further investigation.

While the focus has been on the smoke in eastern North America, fires continue to rage in western Canada.

This view from yesterday in British Columbia. pic.twitter.com/3jUXxYPpwu

— CIRA (@CIRA_CSU) June 8, 2023

Are the wildfires under control?

Not yet.

As of early Friday, there were 427 active wildfires, according to the C anadian Interagency Forest Fire Center; of those, 232 were out of control.

In the West Coast province of British Columbia, authorities reported 81 active wildfires – 28 out of control – while in the province of Alberta, authorities reported 72 active wildfires.

Quebec, on the country’s eastern side, has 128 active fires.

The fires have spread across about 4.3 million hectares (10.6 million acres), roughly 15 times the annual average of the past decade.

Where are the Canadian wildfires?

The forest fires started in late April in British Columbia and Alberta, displacing more than 30,000 people at their peak, and shutting down oil and gas production.

They have now opened new fronts, spreading to the eastern provinces of Nova Scotia, Quebec and Ontario.

Currently, Canada is receiving international help to battle the wildfires. Help has come from the United States, South Africa, Australia and New Zealand. In Europe, France, Portugal and Spain were also sending more than 280 firefighters to Canada.

How are the fires affecting air quality?

On Thursday, authorities in Washington, DC, issued a “Code Purple” air quality alert, warning of “very unhealthy air conditions for the entire public, not just those with respiratory illnesses”.

New York again had the worst air quality on Thursday morning, with an unhealthy Air Quality Index reading of 185, according to a website operated by IQAir.

Readings over 100 are classified as “unhealthy”, and those exceeding 300 are “hazardous”.

On Wednesday, authorities in Canada said Ottawa’s air quality was among the worst.

Experts have noted that acrid clouds of smoke and ash could continue to affect daily life for people in the US and Canada for the next several days.

Why is the smoke reaching so far away?

Strong winds high in the atmosphere can transport smoke long distances, and it is common for large, violent fires to create unhealthy conditions hundreds of kilometres away from where forests are burning.

In Canada, air is circulating counterclockwise around a low-pressure system near Nova Scotia. That sends air south over the fires in Quebec. There the air picks up smoke, and then turns east over New York state, carrying smoke to the eastern seaboard.

The smoke has now also been detected thousands of kilometres away in Norway, the Scandinavian country’s Climate and Environmental Research Institute NILU said on Friday.

“Very weak” concentrations of smoke particles have been detected since Monday, in particular at the Birkenes Observatory in southern Norway, researcher Nikolaos Evangeliou told AFP news agency.

Residents wear masks under an orange sky as New York City is enveloped in smoke — Residents of New York City wear protective masks as the city experienced its worst air quality on record due to a cloud of ash and smoke from the Canadian wildfires [Shannon Stapleton/Reuters]

What is the outlook?

Warm, dry conditions are forecast to persist for months across Canada though occasional rains and cooler temperatures are expected to bring short-term relief.

The Weather Network’s longer-term forecast expects Nova Scotia temperatures to be slightly warmer than normal for the rest of the summer.

What role is climate change playing?

Whitman of the Canadian Forest Service, said it is difficult to determine the effect of climate change on a single fire season. Atlantic Canada has been much hotter than usual and scientists expect temperatures in the region to continue to rise in the coming years.

For coastal regions, climate change is expected to bring more rain, which should reduce the risk of wildfires, but a warmer atmosphere is more efficient at pulling moisture out of soils, a factor that increases fire risk.

Widespread spring fires across the whole of Canada are also unusual, and research shows fire seasons across North America are getting longer.

A warming planet will produce hotter and longer heatwaves, making for bigger, smokier fires, according to Joel Thornton, professor and chair of the Department of Atmospheric Sciences at the University of Washington.

I have never seen a vertical wall of smoke like this one near Fox Creek, Alberta on Sunday.

And the strangest thing about this moment was I couldn’t smell any smoke. #ABfire #ABfires pic.twitter.com/I6vmJvUay4

— Kyle Brittain (@KyleBrittainWX) May 17, 2023

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1 arrested after stabbing at Olive Garden restaurant in Winnipeg

Published

11 hours ago

June 9, 2023

Harry Miller

Police officers went to the Olive Garden at the corner of Reenders Drive and Lagimodiere Boulevard in the Transcona neighbourhood to investigate a stabbing around 7 p.m. Thursday night.