New studies confirm that multiple types of steroids improve survival for severely ill COVID-19 patients, cementing the cheap drugs as a standard of care.
An analysis of pooled results from seven studies, led by the World Health Organization and published Wednesday by the Journal of the American Medical Association, found that steroids reduced the risk of death in the first month by about one-third compared to placebo treatment or usual care alone in these seriously ill patients who needed extra oxygen.
“This result opens up more choices” of steroids, said Dr. Martin Landray of the University of Oxford, who led one of the studies. “The more options there are in terms of availability, the better.”
Dr. Anthony Gordon of Imperial College London called the result “a huge step forward,” but added, “as impressive as these results are, it’s not a cure.”
Steroid drugs are inexpensive, widely available and have been used for decades. They reduce inflammation, which sometimes develops in coronavirus patients as the immune system overreacts to fight the infection. This overreaction damages the lungs and can prove fatal. These drugs are not the same type of steroids that are used or misused for athletic performance.
In June, a large study led by the University of Oxford found that a steroid called dexamethasone cut deaths by up to 35% in hospitalized COVID-19 patients who needed treatment with breathing machines and by 20% in those only needing extra oxygen. It did not help less sick patients and might even have even been harmful at that stage of illness.
The results changed care immediately and prompted many other studies that were testing steroids to stop, so more people could be given the drug. The new analysis looked at results from six of those studies that were stopped early plus severe patients in the Oxford study to see if all types of steroids were similarly effective, and concluded they are.
There were 222 deaths among the 678 patients given a steroid and 425 deaths among the 1,025 patients given placebos or just usual care.
“I’m delighted,” said Dr. Derek Angus, critical care chief at the University of Pittsburgh Medical Center, who helped lead one of the studies. “”It’s incredibly reassuring that the other trials all were lining up in the same direction. It’s the most solid news we’ve had yet on how to take care of patients with COVID-19.”
Mark Shannon, a 61-year-old retired bank teller from Pittsburgh who spent 11 days on a breathing machine, received the steroid hydrocortisone in the study and recovered. His doctor told him “that was pretty stupendous” to recover from so long on a ventilator, he said.
“I realize how close I came to losing my life,” he said.
The WHO issued treatment advice Wednesday recommending steroids for patients with severe COVID-19 and suggested not using them for less sick patients.
Treatment guidelines in the U.S. now recommend dexamethasone or others only when it’s not available for hospitalized COVID-19 patients needing extra oxygen, but that could change with the new information.
AP medical writer Maria Cheng in London contributed to this report.
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
Probable COVID-19 case involving Dalhousie student announced Monday – HalifaxToday.ca
As of today, Sept. 21, Nova Scotia has no active cases of COVID-19. No new cases were identified Sunday, Sept. 20.
The province is reporting one probable case of COVID-19 involving a Dalhousie University student who has received indeterminate test results. The student recently returned from travel outside the Atlantic Bubble, lives off-campus and has been self-isolating, as required.
Based on public health assessment, this case is being treated as though it is a lab-confirmed positive to ensure all precautions are taken.
Indeterminate test results do not provide a negative or positive. They may occur because someone previously had COVID-19 and the virus is still detectable in their system, or someone has been tested before the virus is fully detectable. In these situations, public health conducts further assessment, including whether someone had or has symptoms or was recently exposed to someone with COVID-19, to inform how the case is treated. Since probable cases are not confirmed to be positive, they are not included in the total number of positive cases of COVID-19 in Nova Scotia.
Nova Scotia Health Authority’s labs completed 587 Nova Scotia tests on Sept. 20.
To date, Nova Scotia has 87,928 negative test results, 1,086 positive COVID-19 cases and 65 deaths. No one is currently in hospital. Cases range in age from under 10 to over 90. One thousand and twenty-one cases are now resolved. Cases have been identified in all parts of the province. Cumulative cases by zone may change as data is updated in Panorama.
Visit https://811.novascotia.ca to determine if you should call 811 for further assessment if in the past 48 hours you have had, or you are currently experiencing:
— fever (i.e. chills/sweats) or cough (new or worsening)
Two or more of the following symptoms (new or worsening):
— sore throat
— runny nose/ nasal congestion
— shortness of breath
When a new case of COVID-19 is confirmed, public health works to identify and test people who may have come in close contact with that person. Those individuals who have been confirmed are being directed to self-isolate at home, away from the public, for 14 days.
Anyone who has travelled outside of Atlantic Canada must self-isolate for 14 days. As always, any Nova Scotian who develops symptoms of acute respiratory illness should limit their contact with others until they feel better.
It remains important for Nova Scotians to strictly adhere to the public health order and directives – practise good hand washing and other hygiene steps, maintain a physical distance when and where required. Wearing a non-medical mask is mandatory in most indoor public places.
As of July 3, interprovincial travel within Nova Scotia, New Brunswick, Prince Edward Island and Newfoundland and Labrador, without the requirement to self-isolate for permanent Atlantic Canadian residents, is permitted. All public health directives of each province must be followed. Under Nova Scotia’s Health Protection Act order, visitors from other Canadian provinces and territories must self-isolate for 14 days. Other visitors from outside the Atlantic provinces who have self-isolated for 14 days in another Atlantic province may travel to Nova Scotia without self-isolating again.
Nova Scotians can find accurate, up-to-date information, handwashing posters and fact sheets at https://novascotia.ca/coronavirus .
Businesses and other organizations can find information to help them safely reopen at https://novascotia.ca/reopening-nova-scotia .
— testing numbers are updated daily at https://novascotia.ca/coronavirus
— a state of emergency was declared under the Emergency Management Act on March 22 and extended to Oct. 4
Government of Canada: https://canada.ca/coronavirus
Government of Canada information line 1-833-784-4397 (toll-free)
The Mental Health Provincial Crisis Line is available 24/7 to anyone experiencing a mental health or addictions crisis, or someone concerned about them, by calling 1-888-429-8167 (toll-free)
Kids Help Phone is available 24/7 by calling 1-800-668-6868 (toll-free)
For help or information about domestic violence 24/7, call 1-855-225-0220 (toll-free)
Toronto Public Health preparing for second wave of COVID-19 – 680 News
New daily COVID-19 cases are looking very similar to when the virus brought our daily lives to full-on standstill.
The bulk of Sunday’s new cases came in Toronto and the Peel Region, but data suggests the York region now could also be an emerging hotspot with 38 infections that day alone.
Toronto Public Health is preparing for a resurgence of COVID-19, and on Monday will present the board of health with three possible scenarios of what a second wave could look like.
Scenario one would see peaks and valleys, which public health describes as a series of small waves, and could require a reinstitution of public health measures.
The second scenario warns of a large wave in the fall or winter and one or more smaller subsequent waves in 2021, which would require the reinstitution of lockdown measures in an attempt to reduce the spread of infection and prevent the healthcare system from being overwhelmed.
Scenario 3 predicts a slow burn, with no clear wave pattern. Public health says this would not require further lockdowns.
Monday’s meeting is scheduled for 9:30 a.m.
Sore throat, runny nose among symptoms removed from student health checklist, province confirms – CBC.ca
The list of symptoms parents are urged to screen their kids for each morning before they send them to school has gotten shorter.
Since the reopening of schools across the province, parents have been asked to monitor their children for symptoms of COVID-19, with districts releasing a daily health checklist. Fever, chills, and shortness of breath are among the 17 symptoms parents were told to screen for.
Kids that exhibited any of the symptoms were urged to stay home.
But that list of symptoms has been reduced, B.C.’s Ministry of Health has confirmed. Ten symptoms have been removed, including sore throat, runny nose, headache, and fatigue. Districts have since released updated daily health checklists.
“This was a recommendation from public health to remove some of the symptoms, given the very low probability of these symptoms by themselves indicating COVID,” the ministry said in an e-mailed statement.
“They are also very common in children so there are concerns that it would unnecessarily exclude children,” said the ministry.
The bulk of the symptoms removed from the daily health check for students are still included in both B.C.’s self-assessment tool and the B.C. Centre for Disease Control’s list of COVID-19 symptoms.
Some parents concerned
Parents like North Vancouver’s Amitis Khorsandi say the sudden change has reignited health concerns she had before sending her five-year-old to kindergarten. She fears some COVID-19-positive students could slip through the cracks.
“A lot of people made tough decisions to go back to school, and we’re all taking a risk to send our kids … and then within a week, or less than a week, the rules have already changed,” she said.
Parents are asked to screen children for the following symptoms daily:
- Cough or worsening of chronic cough
- Shortness of breath
- Loss of sense of smell or taste
- Nausea and vomiting
The following symptoms have been removed from the daily checklist:
- Sore throat
- Runny/stuffy nose
- Loss of appetite
- Muscle aches
- Conjunctivitis (pink eye)
- Dizziness, confusion
- Abdominal pain
- Skin rash or discolouration of fingers and toes
The ministry says it’s still important to seek medical assessment if children are exhibiting a combination of symptoms.
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