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Severe COVID leads to higher risk of pulmonary fibrosis: research – CBC.ca

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For Vancouver resident Farrell Eckman, having a long conversation or attending a workout class without breaking into coughs is a major accomplishment. 

The 50-year-old is one of many people who researchers say developed pulmonary fibrosis — a condition that thickens the tissue in lungs and can affect breathing — after experiencing a severe case of COVID-19.

In January 2022, Eckman was admitted to Vancouver General Hospital because she was having trouble breathing along with flu-like symptoms.

“I spent over a month in ICU. I was on a ventilator. Not once, but twice. [My family] thought they were gonna lose me,” she recalled. “It was the scariest time we’ve ever been through.”

Farrell Eckman, who has been diagnosed with pulmonary fibrosis after she was hospitalized with COVID, at home beside an air compressor. Eckman occasionally uses oxygen to help deal with shortness of breath brought on by pulmonary fibrosis. (CBC News)

Eckman’s time in hospital was caused by her second bout of COVID. She had received three vaccines for the coronavirus that causes the disease.

While she eventually recovered and was released to go home along with six litres of oxygen, which is the maximum amount a patient can be discharged with. Eckman was later diagnosed with pulmonary fibrosis, caused by the toll that COVID took on her lungs. 

“The damage that was sustained to my lungs from COVID pneumonia was severe. They’ve looked at my lungs numerous times. I don’t know if I’ll ever fully recover. I’m functioning, which is tremendous. But I could possibly be dealing with this for the rest of my life.”

A meta-analysis published in the Annals of Medicine & Surgery in April 2022 found almost 45 per cent of recovered COVID-19 patients developed pulmonary fibrosis, and those patients often suffered persistent symptoms such as coughing, chest pain and fatigue.

The research also drew a link between severity of COVID-19 symptoms and severity of consequent pulmonary fibrosis. 

It’s something Daniel Marinescu, a respirologist at Vancouver General Hospital, says he is seeing more often, adding that patients are more prone to developing pulmonary fibrosis depending on how severe scarring of their lung tissue is. 

Doctor Daniel Marinescu and patient Farrell Eckman meet in an office at Vancouver General Hospital.
Dr. Daniel Marinescu and Farrell Eckman meet at Vancouver General Hospital. (CBC News)

Marinescu says he’s seen “several dozen” of these cases. 

“Most of the time it is a fairly mild disease and most of the time people slowly get better over months and years,” he said. “But sometimes people take a big hit if they’re in the ICU for a long time or on the ventilator for a long time.” 

Janet Pope, a rheumatologist and professor of medicine at Western University in London, Ont., says while research is limited, factors like age and smoking could affect the likelihood of patients developing the condition.

“We know that COVID pneumonia can cause pulmonary fibrosis. Not in most people who get COVID pneumonia, but if it’s more severe, older age groups, more severe inflammation of the lungs from COVID,” she said. 

Pope adds patients may feel frustrated with their symptoms, but recommends sharing concerns with health-care professionals. 

“They would take a stethoscope and listen to the bottom of the lungs. It takes four seconds to do. If they hear what we call ‘crackles’ then they can do a chest X-ray,” she said.

“Have a listen to people if they say they’re short of breath, if they’re coughing, if they have a cold that’s not improving,” she advises.

For Eckman, recovery remains a constant in her life. She says she works daily on improving her breathing, and does pilates regularly. However, she still occasionally has to use oxygen at night to help with her breathing. 

“I just passed my two-year anniversary. I’m still dealing with it. It’s an ongoing process,” she said.

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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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.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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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.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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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.

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