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Strange symptoms, flare-ups, weeks-long illnesses for some COVID-19 survivors – CBC.ca

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Chandra Pasma thought it was strange when she started feeling a burning sensation in her neck and ear canal.

It was March 16, just days after COVID-19 had been declared a pandemic, and the 40-year-old Ottawa resident knew people were being infected across the country. But since her symptoms weren’t among those listed for the virus, she didn’t think much of it.

Then every single member of Pasma’s household started falling ill.

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First it was her husband, 44-year-old Matt Helleman, who suddenly felt exhausted. Just days later, the couple’s three children — seven-year-old twins and a nine-year-old daughter — started experiencing fevers, sore throats, and fatigue. And around the same time, Pasma’s own symptoms ramped up into chest pain and a cough.

“I thought, oh crap,” she recalls. “This is COVID.”

Like many people with milder forms of the illness, the whole family hunkered down, hoping to get better over a couple weeks at home — not knowing it would mark the start of a months-long recovery, with none of the family members feeling back to normal even now, more than 10 weeks later.

So far, at least 90,000 Canadians have been infected with COVID-19. In some cases, the illness leads to a stay in intensive care or even causes death, with roughly 7,000 people dying to date. 

But in most other instances, those suffering from less-severe forms do recover outside the health-care system. What’s growing clear, both patients and clinicians agree, is that some of those people wind up facing a long, rocky road to recovery.

‘Constant cycle’ of new symptoms

A few months back, as the little-understood virus was first spreading around the world, health officials initially described it as a respiratory illness, even weaving that piece into its official name: SARS-CoV-2, referring to “severe acute respiratory syndrome.”

Since then, evidence and patient stories have emerged suggesting it actually impacts various parts of the body.

One recent study published in the Canadian Medical Association Journal, for instance, determined that changes to someone’s ability to taste and smell are likely a common feature of infection — a symptom first noticed anecdotally by doctors around the world.

Similarly, early notions of a roughly two-week recovery period for mild cases — outlined in a February review of preliminary Chinese data from the World Health Organization — have been questioned by people who say their less-severe illnesses are still taking weeks, if not months, to fully clear up.

Pasma first realized her family wasn’t alone after joining a COVID-19 support group called Body Politic on Slack, an online communication platform. The group now includes more than 4,000 people. 

There, she met other global COVID-19 sufferers who were also documenting weeks-long illnesses with a strange mix of symptoms.


In Pasma’s home, multiple family members wound up having gastrointestinal issues, such as nausea and diarrhea, while she experienced inflammation in between her lungs and chest wall. Then, weeks later, a chicken pox-like rash broke out on her stomach and upper thigh.

Business trips

“It just went on like that: A constant cycle of new symptoms developing,” Pasma said. “One symptom would get better, and I’d start to feel optimistic I was through it. Then something new would set in — something totally random and strange.”

She isn’t sure where she caught the illness, but said it may have been during one of two business trips to Toronto for her job as a researcher at the Canadian Union of Public Employees in the weeks before her symptoms started.

Like many Canadians early in the pandemic, she wasn’t told to get tested by her family physician, who instead encouraged her to just stay at home. 

It’s an experienced echoed by others, who’ve reported bouts of illness but no positive test result to record their experience as a confirmed case of COVID-19 — an issue more common when testing guidelines in many places like Ontario were initially tied to travel abroad, which now represents the transmission source for less than six per cent of all confirmed cases to date in the province.

Test came back negative

Some now question how many cases are flying under the radar, amid additional concerns over false negatives from COVID-19 tests, which detect the active virus circulating in someone’s body, and a lack of access to antibody testing to see if someone previously had the virus, which wasn’t approved for use in Canada until May and isn’t widely available.

For Pasma, it wasn’t until after her symptoms worsened, flaring up a previous bout of pneumonia, that she went to a local hospital and got tested.

The test came back negative. Pasma believes that’s because it came so late in her illness — not that she wasn’t infected.

“There seems to be zero followup,” she said. “I don’t know if there would be more follow up if we were acknowledged cases.”

Pasma also worries both the media and medical community have painted COVID-19 as far too binary, either on or off.

“You get better in two weeks, or you die,” she said. “There’s no talk at all about what happens to the people who do not get better in two weeks.”

600+ people surveyed about symptoms

Hannah Wei, a Toronto-based design and qualitative researcher who helped launch the Slack channel where COVID-positive people are swapping recovery stories, said most people are lacking “clarity” about how COVID-19 plays out beyond the most critical cases.

Like Pasma, Wei also believes she got the illness back in March, likely after travelling abroad to Taiwan. But she didn’t get tested after she returned to Canada because she said hospital staff in Vancouver, where she was staying for a client meeting, told her they were short on nasal swabs.

Wei said she was sent back to her Airbnb room with just a sheet of paper featuring COVID-19 information from the hospital’s website. She wound up stuck there with no followup until she tested negative weeks later before finally flying back home to Toronto.

“There’s no centralized way to track and monitor how we’re all doing,” she said.

Hannah Wei, a Toronto-based design and qualitative researcher, helped launch the Slack channel Body Politic where COVID-positive people are swapping recovery stories. (Supplied by Hannah Wei)

To give sufferers more insight into the spectrum of symptoms and recovery time frames, Wei’s team surveyed around 640 people from both their online channel, which is primarily younger adult COVID-19 sufferers, and other social media platforms.

Many respondents shared similar experiences of weeks-long recoveries, with some stretching beyond a month, and featuring a range of symptoms — including respiratory issues, gastrointestinal problems, and sometimes neurological symptoms like dizziness, trouble concentrating, insomnia, or just a general feeling of “brain fog.”  

“When we ran the survey, people were on, on average, their 40th day,” Wei said. “A lot of these people, they’re getting to the point where they’re not quite recovering, but they’re not severely sick in the bed either. They just can’t get back to their normal life.”

Patients calling for more followup

Wei and Pasma both say the medical community needs to focus more on these under-the-radar patients.

Ontario family physicians who spoke to CBC News say thanks to the rise of telemedicine, it’s easier to keep in touch with COVID-19 patients who don’t need hospital care. Still, treating them remains a challenge given the wide range of symptoms and length of illness.

It’s a mixed bag, according to Markham-based family physician Allan Grill.

“You can have patients with mild symptoms that recover in a few days, like less than a week,” said Grill, who is chief of family medicine at Markham Stouffville Hospital and lead physician at the Markham family health team.

“You can have other people where the symptoms last two or three weeks.”

WATCH | Physical distancing advice for those who have recovered from COVID-19:

An infectious disease specialist answers viewer questions about the COVID-19 pandemic, including whether someone who has recovered from COVID-19 can stop physical distancing. 2:46

Pasma said the digital divide between patients and care providers can leave people feeling isolated as they recover at home.

As she and her family slowly get their lives back, she’s hoping more physicians grow aware of the challenging recovery process many COVID-19 sufferers are experiencing — so they can give newly diagnosed patients a heads up on what to expect, and help them manage the possible weeks ahead.

“Just because you’re well and don’t die from pneumonia doesn’t mean you won’t spend three or four months of your life trying to recover from this virus,” she said.

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Federal budget 2024 disliked by half of Canada: poll

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OTTAWA –

A new poll suggests the Liberals have not won over voters with their latest budget, though there is broad support for their plan to build millions of homes.

Just shy of half the respondents to Leger’s latest survey said they had a negative opinion of the federal budget, which was presented last Tuesday.

Only 21 per cent said they had a positive opinion, and one-third of respondents said they didn’t know or preferred not to answer.

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Still, 65 per cent of those surveyed said the plan to spend $8.5 billion on housing, aimed at building 3.9 million homes by 2031, is good for the country.

Leger’s poll of 1,522 Canadians last weekend can’t be assigned a margin of error because online surveys are not considered truly random samples.

People in Alberta were most likely to say they had a very negative impression of the budget, with 42 per cent selecting that option compared to 25 per cent across the entire country.

More than half of the people who took the poll said they are in favour of the government’s plans to spend more on energy efficiency, national defence and student-loan forgiveness for health care and education workers.

And 56 per cent said they think the increase to the capital gains tax inclusion rate — a move that’s estimated to raise another $19.4 billion in revenue over the next four years — is a good thing.

The Liberals are billing the change as critical to their plan to improve generational fairness by taxing the ultra-rich.

It has drawn criticism, including from the Canadian Medical Association, which warned on Tuesday that it could affect the country’s ability to recruit and keep physicians.

The budget proposes to make two-thirds of capital gains — the profit made on the sale of assets — taxable, rather than half. For individuals, this would apply to profits above $250,000, but there is no lower threshold for corporations.

The medical association said many doctors will face higher taxes because they have incorporated their practices and used those companies to save for retirement.

While the Liberals are aiming changes to the capital gains tax at younger Canadians including millennials and gen-Zers, Leger’s poll found it had the support of 60 per cent of respondents over the age of 55 — the highest among any age group.

People between 18 and 35 were least likely to support the Liberal plan to spend another $73 billion on defence in the next two decades. Just 45 per cent of respondents in that age group said ramping up defence spending is good for the country, compared with 70 per cent of people over the age of 55.

Leger also asked questions about the country’s fiscal future.

Almost half the respondents, 47 per cent, said they want to see the government cut back on spending and programs to get the budget balanced as quickly as possible.

Just 16 per cent said spending more and running large deficits is the best plan for the next five years, and 14 per cent want to see the government increase taxes to bring the deficit down.

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Provincial audit turns up more than 40 medical clinics advertising membership fees

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Alberta’s health ministry says an audit has determined that more than 40 medical clinics in the province are advertising membership fees for services, nearly a year after one such plan landed a Calgary clinic in hot water.

The audit was launched last December. In July, CBC News reported that a medical clinic in Calgary’s Marda Loop district was moving to a membership system and planned to charge $4,800 a year for a two-parent family membership, covering two adults and their dependent children.

The next day, Health Canada said the arrangement at the Marda Loop Medical Clinic equated to patients purchasing “preferential access” and warned Alberta that it could face cuts to federal health transfers if the situation wasn’t handled.

Alberta Premier Danielle Smith and Alberta Health Minister Adriana LaGrange directed Alberta Health to investigate, and the clinic halted its plan for membership fees shortly after.

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In December, LaGrange told CBC News that “appropriate action” would be taken if audits determined that violations were found, adding the province would do whatever it took to ensure clinics were in compliance.

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Speaking at a news conference in July 2023, Alberta Premier Danielle Smith said the Marda Loop Medical Clinic would be fined, lose medicare funding or be shut down altogether if it proceeded with a plan to charge membership fees. (CBC)

The province promised the audits early in the new year. Now, the health ministry says it has conducted interviews to gather information on operations and business models of the clinics, adding this work is ongoing.

“Over 40 clinics in the province [advertise] a membership meant to pay for a defined set of uninsured services, while also providing insured services covered under the Alberta Health Care Insurance Plan at no cost to Albertans,” wrote spokesperson Andrea Smith in a statement.

“Once this review is completed, its findings will be used to inform next steps. Alberta’s government will also determine if additional audits of more membership clinics is required.”

In July, Health Canada said executive and primary health clinics charging patients enrolment and annual membership fees exist in a number of provinces. Generally, investigations have indicated that clinics provide members with an variety of uninsured services, such as life coaching and nutritional services.

“However, in some cases … these fees are also a prerequisite to accessing insured services at the clinic (i.e., medically necessary physician services). Mandatory fees to access or receive preferential access to insured services are contrary to the Canada Health Act,” the government department wrote in a statement.

A spokesperson for LaGrange told CBC News in July the ministry wasn’t aware of any other clinics offering services for membership fees that didn’t align with legislation.

What comes next for those 40 clinics is a murky grey area, said Fiona Clement, a professor at the University of Calgary in the department of community health sciences. Much of it has to do with the exact language being used when services are outlined as parts of packages.

“We’re on the razor’s edge of exact wording there that runs them afoul. Really, I think it will come down to what the government is willing to fight with these clinics about,” she said.

CBC News asked the provincial government for a list of the clinics identified, but did not receive it by publication time. A spokesperson with the province said if any clinics are found to be non-compliant with legislation, appropriate action would be taken.

Report had identified 14 clinics

Clement said the big issue that got the Marda Loop Medical Clinic in hot water was the concept of guaranteed access.

“That’s the problem that Marda Loop got into, because there you are charging access to medical care, which is the part that contravenes the Canada Health Act,” Clement said.

At the time the Marda Loop clinic fell under scrutiny, it was clear there were other such clinics providing membership programs, in Calgary and Canada.

In 2022, researchers from Dalhousie University and Simon Fraser University released a paper tracking the number of clinics taking private payment across the country. Between November 2019 and June 2020, the period of the analysis, there were 14 private clinics in Alberta with a range of membership fees and private payment.

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Fiona Clement, a professor at the University of Calgary in the department of community health sciences, says she hopes to see an ongoing review tied to Alberta clinics charging membership fees made publicly available. (Riley Brandt/University of Calgary)

“So, 40 is a larger number than I was expecting. And I think it speaks to growth in this area, the number of clinics that are charging fees for different parts of care,” Clement said.

“I think it underscores the lack of stability, and the need to really think about how we’re funding primary care, because more and more clinics are turning to this private charge as a revenue source to keep the doors open.”

Provinces that allow private health-care providers to charge patients for medically necessary services have dollars clawed back by the federal government under the Canada Health Act.

According to Health Canada, Alberta was subject to a $20,450,175 deduction to its Canada Health Transfer payment in March 2024 under the diagnostic services policy. That’s up from $13,781,152 last year.

But the province received $20,538,796 in partial reimbursements tied to its March 2023 and 2024 deductions, which represents actions that Alberta Health has taken to limit patient pay for publicly funded goods or services, according to Clement.

“I guess we’re making some progress. But it’s still a big number, which says there’s still a lot of patient billing going on,” she said.

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What is a halal mortgage? How interest-free home financing works in Canada

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The federal government is looking at making Islamic home financing increasingly accessible to help more Canadians break into the housing market.

As part of the 2024 federal budget that was released last week, Ottawa said it is “exploring new measures to expand access to alternative financing products, like halal mortgages.”

Last month, the federal government started consulting financial services providers and communities to understand how policies can better support the needs of all Canadians seeking home ownership, according to the budget.

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“Canada is home to a vibrant and growing market of alternative financing products, including halal mortgages, that enable Muslim Canadians, and other diverse communities, to further participate in the housing market,” the budget states.


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Currently, none of Canada’s big six banks offer halal mortgages, which are an interest-free payment structure that follows Islamic principles.

However, some lenders in Canada have been offering halal mortgages for several years now.

“Halal mortgages are already offered to all Canadians by financial institutions,” Caroline Thériault, a spokesperson for the Department of Finance, said in an emailed statement to Global News Tuesday.

Thériault said halal mortgages are not government of Canada products.

“The government is simply looking at ways to help more Canadians become homeowners, while ensuring adequate consumer protections are in place.”

 

What is a halal mortgage?

A halal mortgage is a real estate financing method that complies with Islamic principles and teachings.

Under Sharia law, it is forbidden for Muslims to receive and pay interest, so a halal mortgage essentially takes interest out of the equation.

Instead, the mortgage is based on the principle of profit, said Mohamad Sawwaf, founder and CEO of Manzil, a Canadian financial institution that offers Sharia-compliant services.

Manzil has been offering halal mortgages that are both partnership- and profit-based since 2020.

“We look at this product as an innovation within the Canadian mortgage marketplace to allow for a segment of the population and the broader ethical community that may want to participate,” Sawwaf said in an interview with Global News Monday.

The end result of homeownership is the same, but the process and documentation are different compared with a regular mortgage, he said.


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“Within the Islamic finance principles, you’re acquiring a real asset, it’s commodity-based, and then you are reselling it or partnering in that asset long-term, so that is the key difference here.”


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Victor Tran, a mortgage and real estate expert at Ratesdot.ca and broker with True North Mortgage, said a halal mortgage is almost like a traditional mortgage where the lender and the homeowner have shared ownership of the property, but there are extra steps involved.

He said the difference is that “instead of charging interest to the homeowner, the contract is structured in a way where there’s a fee charged.”

Even though halal mortgages are interest-free, it doesn’t mean the lending happens at a zero per cent charge, Sawwaf said.

“It just means that you’re not part of a transaction where money is being lent and you have to pay more money back,” Sawwaf said.

“That is the principle of usury within Islam and other Abrahamic faiths that we’re trying to avoid.”

Usury, which is the lending of money at exorbitant interest rates, is also prohibited in Judaism and Christianity.

 

Types of halal mortgages

Halal mortgages in Canada fall under three different types of agreements, called Ijara, Murabaha and Musharaka, according to Rates.ca.

Ijara is like a rent-to-own agreement in which the inhabitant of the home starts as a renter and becomes the owner upon final loan payment, Tran said.

Under this type of financing, the home is purchased by a trust, which then leases it to the customer.

The Murabaha is a cost-plus financing structure in which an Islamic financial company becomes the owner of a home and sells it to their client for a price that includes a profit rate, which is benchmarked against the Bank of Canada’s overnight lending rate, Tran explained.

The client enters into a purchase agreement that specifies fixed monthly payments for the duration of the contract, which is usually up to 15 years.


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Under the Musharaka arrangement, an Islamic financial company and its client become co-owners of a home, Tran said.

Throughout the mortgage term, which will follow the traditional mortgage term of up to 25 to 30 years, the financial company’s equity position decreases and the customer’s equity position increases proportionately as they pay out the owned balance.

At the end of the contract, the client will have 100 per cent home ownership and the company will have zero per cent, Sawwaf said.

 

Financial pros and cons of halal mortgages

From the financial standpoint, one of the main benefits of halal mortgages is that it introduces a long-term fixed mortgage rate, Sawwaf said.

For instance, under the Murabaha agreement, which follows the buy-and-sell structure, the mortgage can run up to 10 to 25 years.

Sawwaf said because the lender is sharing in the long-term risk, halal mortgages are “much more ethical and valuable at the end of the day” as opposed to having a debt-based system that is “not really good for society and its long-term social impact.”

However, the downside is that the costs of halal mortgages are higher because the lenders are not able to access low-cost capital, Sawwaf said.

“We’re hoping that the government signalling that they’re in support of halal mortgages with respect to potential legislation or policy changes, this could allow us to tap into institutional capital at the banks or other institutions,” he said.


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Tran said because the costs and fees are a little bit higher for a halal mortgage than a traditional mortgage, it may not be a financially feasible option for many.

Among the measures that Ottawa is exploring are changes in the tax treatment of halal mortgages or a new regulatory sandbox for financial service providers.

 

Who can apply for a halal mortgage?

Anyone in Canada, Muslim or non-Muslim, can apply for a halal mortgage, which is currently offered by a few financial institutions.

“Everyone is allowed to have a halal mortgage no different than you can go to any restaurant and eat a shawarma with halal chicken in it,” Sawwaf said.

“We don’t care what your background is, your religion, your creed, even if you’re non-religious or an atheist.”

As for the down payment, most lenders in Canada require clients of halal financing to pay a minimum of 20 per cent of the market value, or purchase price, of the house.

Customers should also have a good credit history and sufficient income to meet the monthly payment obligation, the Canadian Halal Financial Corporation says.

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