Severe chills. Aches and pains. Full-body weakness.
Bruce England says those intense symptoms began one night in 2003 after he’d wrapped up a shift as a Toronto paramedic.
“I couldn’t get out of bed, I couldn’t lift my head. I couldn’t go to the washroom,” he recalled. “I just didn’t have the strength. It was like being hit by a two-by-four and not being able to move.”
England called his team to report his sudden illness. Soon after, he says two fellow paramedics arrived at his home in full protective suits to take him to a hospital — where he was whisked right into an isolation room.
His eventual diagnosis? SARS, or severe acute respiratory syndrome, the condition caused by a coronavirus that spread through much of the world in the early 2000s, killing hundreds of people and afflicting thousands more.
As concern grows over the recent outbreak of another newly discovered strain of coronavirus, with two cases now identified in Toronto — one officially confirmed, and one presumed due to the results of an early lab test — England says his experience offers lessons for protecting Canadian frontline workers from a new but familiar threat.
Transparency, communication, and access to personal protective equipment are all key to ensuring the safety of paramedics and hospital staff, he said, echoing the recent comments of Canadian health officials who have stressed that protections are indeed in place.
“To me, there’s no question, we’re going to have more patients,” England warned. “And I worry about the health-care workers. They are putting themselves in harm’s way.”
Lessons learned from SARS
Rising concern over the impact of a coronavirus in Canada follows news on Saturday of the country’s first presumptive case.
That since-confirmed case involves a man in his 50s who recently travelled back to Toronto from Wuhan, China — the city thought to be the origin point for the new virus — who is currently in stable condition at Sunnybrook Hospital.
Health officials now believe his wife is the country’s likely second case; she’s currently in self-isolation, with less severe symptoms that haven’t required hospital care, according to provincial health officials.
Another 19 people in the province are also under investigation for possible infection, said Dr. David Williams, Ontario’s chief medical officer, on Monday.
While Canada grapples with a number of infected patients that could potentially rise, Chinese health commission officials said the number of deaths from the virus in Hubei province — where Wuhan is located — has climbed to 76, with four deaths elsewhere in the country, including one in Beijing, and several thousand others infected.
Ontario’s chief medical officer says preparedness is ‘well ahead’ of 2003 and SARS 3:15
During the SARS outbreak, which also originated in China, England said there was a lack of details flowing from both Chinese officials and medical professionals in Canada.
“I think back then what we didn’t have was transparency,” he said. “We weren’t sharing information quickly.”
England stressed the need for ongoing communication between medical professionals and the public, along with ensuring there are adequate supplies of personal protective equipment for personnel who may transporting or treating patients with the new coronavirus.
Previous research also suggests the added importance of isolating patients and implementing hospital-based screening measures.
A nurse in protective gear talks on her phone near an ambulance in Wuhan in central China’s Hubei Province on Sunday. (Chinatopix via AP)
“Canada’s experience with SARS illustrates the importance of identifying and isolating every infected individual in stemming the spread of the disease,” reads a 2004 report on the lessons learned from the National Academy of Sciences.
Early on in the Toronto epidemic, undetected patients went on to infect “scores” of others in several different hospitals, even after increased infection control measures were taken. The province later halted between-hospital patient transfers, created separate SARS hospital units, minimized visitor access, and establishing a screening process.
“Because the spread of SARS in Toronto was largely restricted to the hospital setting, these precautions were effective in controlling the outbreak,” the report notes.
Protections, ‘screening measures’ in place
In recent days, health officials have stressed efforts are being made to ensure there isn’t a repeat of a SARS-level outbreak in Canada, which chiefly affected health care workers and patients.
For one thing, the province has implemented “enhanced screening measures” at all emergency medical services’ communication centres to identify potential cases of the cononavirus before dispatching paramedics, said Dr. Barbara Yaffe, associate chief medical officer of health in Ontario, during a Monday news conference.
In recent days, health officials have stressed efforts are being made to ensure there isn’t a repeat of a SARS-level outbreak in Canada, which chiefly affected health-care workers and patients at several Toronto hospitals. (Michael Wilson/CBC)
Speaking to reporters on Monday, Toronto Mayor John Tory strived to quell fears over the virus, saying front-line workers in the city are “well-protected.”
There are now “detailed protocols” in place at both the paramedic and hospital levels, thanks to sweeping changes made in the aftermath of SARS, he added.
During the emergency call from the man who has since been confirmed as infected with the new coronavirus, for instance, paramedics did use “full personal protective equipment,” according to Dr. Rita Shahin, Toronto’s associate medical officer of health.
Toronto Mayor John Tory is among the officials trying to quell fears over a new coronavirus, saying protections are in place for front-line workers. (Lauren Pelley/CBC News)
Looking back on his time during the SARS outbreak, England wishes a similar procedure had been in place then.
Protective equipment procedures weren’t typically in place during those early days, he noted, and he believes he caught his illness from a patient in a hospital about two weeks before his symptoms showed up.
Now 68 and retired, he said getting hit with the illness in his early ’50s took a toll on his health.
England spent two weeks recovering in hospital and another month at home, but still felt unwell after he returned to work, and eventually shifted out of his front-line duties to work in Toronto’s office of emergency management.
Close to two decades later, England said he still has trouble breathing and experiences numbness in his hands and feet — lingering reminders of his brush with a deadly illness.
His message now for policy makers?
“Communicate with the public and look after the health care workers,” he said. “Remember, they’re the front-line staff — if they get sick, look after them.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
