It is possible, but rare, to be infected with flu and COVID-19 at the same time.
A lung transplant team at Vancouver General Hospital. Photo: Provincial Health Department
Last Christmas, the Vancouver Sun gave me the opportunity to share the heartfelt words of appreciation from patients and families for the outstanding specialized health services we have in British Columbia.
In the months since then, I’ve learned more about the role of hope to enable moments of appreciation. Indeed, progress has been made in healthcare as we hope that efforts and innovations will bring better treatments, service models, protocols and even healing methods within reach.
We hope that our research will bear fruit and that our continued use of time and resources will produce treatments that are faster, less painful or more invasive and make life longer and better.
And since hope has always been part of the holiday season, it is worth sharing some of the hopes this year, through the efforts of dedicated staff and doctors who work in the Provincial Health Services Authority (PHSA) programs and services through collaborative partnership with like-minded people at the five regional health agencies of BC and the First Nations Health Authority.
One in seven young people in B.C. experiences a mental illness at some point. Pupils are increasingly reporting anxiety and depression. So, B.C. The children’s hospital founded Compass, a telephone resource for communities in the north, inland and on Vancouver Island. Healthcare providers in rural communities can now access Compass teams of psychiatrists, psychologists, and nurses. Social workers remotely access expert information, advice, resources, and counseling services, including aftercare in more complex cases. Your collective hope for better treatment has been implemented for more than 1,000 children and adolescents across BC.
Hoping to change the prognosis of pancreatic cancer, B.C. Cancer researchers conducted a study on the genetic structure of pancreatic tumors. In several cases, they identified a unique trait that they had previously seen in other types of cancer. it was a property that was potentially treatable. Looking at the overall genetic makeup of the participants and their cancers, the researchers managed to find an effective treatment. This sequencing technology helps researchers identify new and personalized therapies for cancers that are difficult to treat. It is a breakthrough in the potential of precision medicine for pancreatic cancer. And although it is rooted in science, it started with the hope of a better result.
B.C. The Ex Vivo Lung Perfusion Program by Transplant and Vancouver Coastal Health is another result of what started out as hope. The program, which is a partnership with the talented care team at Vancouver General Hospital, uses technology to help donor lungs live outside the body for up to 12 hours. A ventilator inflates the lungs and ensures normal breathing during the examination. Lungs that were originally rejected for transplantation can be re-examined and even repaired. In 2018, 50 double lung transplants were performed in B.C. With the hope of saving more lives, and with Ex Vivo as a way to realize that hope, that number is expected to rise to 60.
From newborns to hearing-impaired adolescents aged 18 and over, Cochlear Implant Services at B.C. Children’s Hospital. The initial programming of a cochlear implant takes place about four weeks after the operation and essentially turns the implant on so that the child can hear sounds. For follow-up care, it is necessary to visit B.C. to travel. Children.
With 40 percent of patients and families living outside of the Lower Mainlands, frequent trips to Vancouver can be stressful. Hoping for a better method, driven by their technological innovation, B.C. Pediatric audiologists can now virtually program cochlear implants using a computer and video conference with patients in their communities.
The other notable thing about this hope is that it spreads and inspires care teams, patients, and families to work together to achieve unimaginable, life-changing results in unexpected places. There are now 19 virtual health centers across China. Connection of local hospitals and regional health authorities to B.C. Children’s Hospital. This enables parents to access more than 40 areas of sub-special care for their children without the stress, expense and time of a physical trip.
BC paramedics are present during some of the most vulnerable moments in the life and health spectrum, including those experienced by palliative care patients living at home. They also hoped for a better result when they had to be taken to the hospital by ambulance to cope with a medical emergency. Hope comes from the B.C. Emergency Health Services (BCEHS), which has developed new paramedic guidelines and training to help palliative care patients who call 9-1-1 for help. Now more patients with minor medical emergencies can be treated comfortably from home. For seniors, particularly in rural and remote communities, this change means that they are calm and fulfill their desire to be treated with dignity and comfort at home.
There is hope in health care and with the special people who make it available. Hope for better results – supported by skills, science, research and compassion – leads to life-improving and life-saving advances that help us and those who are important to us. Especially at this time of year we can comfort ourselves in this hope and let everyone share in their promise and their often wonderful result.
Tim Manning is the chief executive officer of the Provincial Health Services Authority.
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Will there be a twindemic? Fighting COVID-19 means fighting the flu – Nipawin Journal
Getting a flu shot is always a good idea. But infectious diseases experts say it’s crucial this year as the northern hemisphere faces a “twindemic” — the perfect storm of the convergence of COVID-19 and the seasonal flu.
It’s a scenario that could endanger an already strained health care system.
“Having two circulating respiratory viruses is not a good thing. This is something we can do something about,” said Dr. Kumanan Wilson, a senior scientist in the clinical epidemiology program with The Ottawa Hospital Research Institute and a professor of medicine at the University of Ottawa.
If COVID-19 testing centres are already exhausted and people show up with respiratory symptoms, it will overwhelm testing capacity, he said.
“From a societal perspective, we have to reduce the pressure on our health-care system.”
The flu season also presents a potential drain on families and workplaces. People with any respiratory symptoms, whether they are flu or COVID-19, will have to remove themselves from school and work.
The flu presents its own dangers. According to the Public Health Agency of Canada, there are an average of about 12,200 hospitalizations and 3,500 deaths related to the flu every year. Based on laboratory testing, there were 42,541 cases of seasonal influenza in 2019-2020.
“Everyone should get the flu vaccine this year,” Wilson said. “It’s a no-brainer.”
Concern about a potential twindemic is not overblown, epidemiologist Dr. Jeff Kwong said.
“Most health care workers would say we’re barely managing in a normal flu season. We’re always on the verge of collapse. If you add COVID, we’re in big trouble,” said Kwong, a professor at the Dalla Lana School of Public Health at the University of Toronto.
“The biggest problem with how we view influenza is that there are other respiratory viruses circulating,” he said. “The flu is a whole bunch of viruses with a whole bunch of different presentations. They’re impossible to distinguish without lab tests.”
If people let down their guard on measures to prevent the transmission of COVID-19, such as wearing masks, physical distancing and hand hygiene, there will be a twindemic, Kwong said.
“If people keep having parties, we’ll have influenza. But, if you can control COVID, you can control influenza.”
It is also possible, but rare, to be infected with flu and COVID-19 at the same time. A study published in June in the Journal of Medical Virology found that, among 1,103 patients who had been diagnosed with COVID‐19 in three hospitals in Istanbul, Turkey, six were diagnosed as also being infected with influenza. Co-infected patients have been reported in China, Germany, Iran, Japan, Spain and the United States.
In Canada, provinces and territories have ordered nearly 13.8 million doses of flu vaccine, an increase of 2.6 million over estimated demand at this time in 2019, said Maryse Durette, a spokeswoman for the Public Health Agency of Canada. A small reserve has also been created and it will be available for provinces and territories if needed.
So far, so good. Last year at this time, there were concerns that the flu vaccine might not be available until early November for most people because of delays in recommendations and production.
This year, flu vaccine will be made available for delivery beginning in mid-September, with most deliveries completed by the end of October, Durette said. To meet the increased demand this year, a small portion of Canada’s requirement will also be supplied in November and December.
“At the present time, no supply issues are expected this year and the increased demand by provinces and territories that has occurred since orders were first placed with suppliers in February is expected to be met in full.”
But getting the flu vaccine rolled out this year may produce additional challenges.
Health Canada has flagged some concerns, including the availability of staff and access to PPE for those who will be administering flu shots.
There are also some unknowns, including the public’s fear of exposure to COVID-19 while being immunized for flu. At the same time, there is the potential of increased demand for flu shots early in the season, something that was seen in the southern hemisphere, where the flu season starts in March.
“We don’t want people congregating as they usually do in gymnasium-type programs,” Wilson said. “We need to do it differently. And well.”
Among the possibilities according to Health Canada: drive-through and parking lot clinics in locations ranging from car washes, arenas, insurance inspection centres and drive-thu tents.
Ottawa Public Health is still working out its flu shot strategy and is to present more detail Monday at a board of health meeting.
Pharmacists, who already administer between 40 and 50 per cent of flu shots in Canada, will also be enlisted to do more.
“We’re expecting increased demand. People are already making reservations,” said Shelita Dattani, director of professional affairs at the Canadian Pharmacists Association, which has already posted a fact sheet about what to expect from pharmacies this year.
Pharmacists may be delivering flu shots by appointment, through dedicated hours for walk-in clients, special hours for vulnerable patients, off-site services such as home visits and clinics at community halls or temporary structures.
“If there is one thing you can control this year, it’s the flu shot,” Dattani said. “It’s going to be a busy year.”
For those who monitor the spread of influenza, the Australian experience of the flu season, which just ended, is a sign for hope.
According to an Australian department of health report released Sept. 6, influenza and influenza-like illness activity was lower than average across all systems for this time of year.
There were 21,119 cases of laboratory-confirmed influenza and 36 laboratory-confirmed deaths related to flu in Australia. The numbers dropped and remained low as the flu season went on.
Many who monitor the situation, including Wilson and Kwong, believe COVID-prevention measures such as physical distancing helped to reduce the spread of flu in Australia.
Meanwhile, a study published last month in the Journal of Pediatrics of almost 3,000 families found that more parents planned to vaccinate their children for flu season.
The researchers asked parents who visited 17 emergency departments in Canada, Israel, Japan, Spain, Switzerland and the U.S. between mid-March and the end of June about their willingness to vaccinate their children. About 54 per cent said they did, an increase of nearly 16 per cent from last year. Among those who did not vaccinate their children last year, almost 29 per cent planned to vaccinate this year.
Dr. Ran Goldman, a researcher and professor of pediatrics at the University of British Columbia and the study’s lead researcher, is hoping that a minimum of 70 per cent of the population will get the flu vaccine.
It’s a tall order. Having 40 per cent of the population immunized for flu in an ordinary year is considered very good, Kwong said. Only among vulnerable groups such as people over 65 and those with chronic illnesses do the numbers reach 70 per cent.
As a pediatrician, Goldman says he sees parents are more open to flu shots for their children, especially after he explains to them that children may be vectors of the flu for older people, such as grandparents. If you protect children, you are protecting everyone around them, he said.
“I’m hoping for a milder flu season, but you can’t trust luck,” he said. “We need to tell parents to roll up their sleeves … and the sleeves of their children.”
The flu shot is not 100 per cent effective, as public health authorities have to make an educated guess about what strain will be in circulation. Given the low number of cases in 2020, it has been difficult to assess vaccine match and effectiveness, Australian authorities said.
For Canada, it’s still too early to say what might happen. Another strain of flu may appear in the early spring. The flu strain in circulation in November is not necessarily the same strain in circulation in March, Wilson said.
“But, if you could reduce your risk, why wouldn’t you do it? Even in a worst-case scenario, it’s still worth it.”
Meanwhile, Wilson sees the roll-out of this year’s flu vaccine as practice for rolling out a COVID-19 vaccine — when one becomes available — under physical distancing constraints.
“It will help us figure out the logistics.”
COVID-19 case count increases in Manitoba; two more deaths reported – ThePeterboroughExaminer.com
WINNIPEG—Manitoba’s chief public health officer says he’s worried by an increase in COVID-19 cases in Winnipeg and that some people are going to many different locations while symptomatic.
“It’s concerning,” Dr. Brent Roussin said Monday.
The number of active cases in the capital city has almost tripled to more than 280 since the start of September. Sixteen of 22 new provincial cases reported Monday were in Winnipeg.
The province identified several Winnipeg restaurants, bars and gyms as sites of possible exposures over the last week. There have also been cases in schools and from gatherings in homes.
Roussin said the number of contacts for each person who tests positive has increased, which is putting pressure on staff tasked with tracking them. One person who tested positive in Winnipeg had 50 contacts, according to recently released data in the province’s public health report for the week of Sept. 6 to 12.
Roussin said mandating masks and bringing back other restrictions are on the table. But for now, the province is monitoring the situation.
Roussin is encouraging people to wear masks even if not officially required.
“If the vast majority of Manitobans want to wear a mask in indoor public places, we don’t really need a mask mandate.”
Roussin also announced that two more Manitobans have died after testing positive for COVID-19. That brings the total in the province to 18. The recent deaths were of a man in his 80s in the southern health region and a woman in her 80s in the Prairie Mountain region.
Those areas saw a resurgence in positive cases in July and August. As a result, specific regulations around masks and group sizes were put in place in Prairie Mountain, which includes Brandon. Infection numbers in those regions have since dropped, while cases in Winnipeg have surged.
The surge prompted the captain of the National Hockey League’s Winnipeg Jets to make a request on social media for mandatory masks.
“Time for universal mask mandate. Why not? Let’s take care of each other,” read a post on Blake Wheeler’s Twitter account, directed to Premier Brian Pallister.
When asked about the request, the premier said he would defer to health experts.
“I personally have a ton of affection for Blake Wheeler and the way he plays hockey,” Pallister said.
“To make sure that we get through this together, we have to demonstrate that we can respect those who we’ve put in a position of trusted leadership. And Brent Roussin’s been put in that position and it’s really important we respect that.
“It doesn’t mean we have to agree with everything Brent says or does — that’s not what I’m saying. But I am saying that I am going to respect … what our experienced public health officials decide.”
Also Monday, the government revealed details of how it will spend its $85.4-million share of recently announced federal funding to help schools during the pandemic.
Education Minister Kelvin Goertzen said the money is to help enhance remote learning for students who can’t attend classes, such as those with chronic health conditions who are advised by doctors to not attend.
Remote learning is also available for some high school students in more-crowded schools and for students whose classes have been temporarily cancelled due to a COVID-19 outbreak.
Goertzen said the province is not expanding remote learning to make it an option for any student who wants it.
Two more Alberta schools with in-school transmission; 1,459 active cases province-wide – Calgary Herald
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There are two schools in the province with outbreaks of five or more cases, including St. Wilfrid Elementary in Calgary and Vimy Ridge School. And the list of Calgary schools with outbreaks of two to four cases now includes Notre Dame High School, Lester B. Pearson High School, Henry Wise Wood High School, Auburn Bay School, Crescent Heights High School, Chris Akkerman School, Saddle Ridge School and Apostles of Jesus.
“Every single Albertan can make school reopening successful by working to limit and minimize community transmission. And again, that’s the message I want to make sure everyone understands,” said Hinshaw.
Meanwhile in British Columbia, the Ministry of Health has removed 10 symptoms from the student health checklist — including sore throat, runny nose, headache and fatigue — because they are common in children and there’s a low probability these symptoms by themselves are indications of COVID-19.
When asked if this is something being considered in Alberta, Hinshaw said it has been discussed at length because of the pressures the current checklist puts on families that have to adjust their daily schedules when they need to keep their child home from school because of a runny nose.
“In Alberta, we are not far enough along yet to know whether or not we could take some of those symptoms off of our list, without increasing the risk that COVID-19 could be introduced into the school,” she explained.
“We try to reach the right balance between keeping our kids in school, and making sure that their learning is as smooth as possible while at the same time, minimizing the risk of the COVID-19 introduction and spread. Right now, we are keeping our symptom list as is.”
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