If there is a pandemic, makeshift hospitals and quarantine centers could be needed to shore up a health system that has virtually no give, experts say
Coronavirus can hit 35-70 percent of the population of Canada, to make “a large number of sick people,” many critically, and hospital and emergency quarantine centers could be needed to sustain the health system has almost no give, experts predict.
According to the model of disease transmission developed by the University of Toronto researchers, the overall attack rate of the virus’ in Canada, without public health interventions, can exceed 70 percent. The amount that drops sharply, by about half, “if we add a simple control,” said epidemiologist Dr. David Fisman, one of the creators of the model, but it will take “aggressive social distance and large-scale quarantine” to reduce further, he said.
“It was still a great number of sick and critically ill people are a large fraction of this disease,” said Fisman in an email. “I’m not going to share a certain number more because I thought they would scare people with no particular end.”
The first confirmed death in Canada from COVID-19 brought home the fact that while most people infected with rogue virus eventually fully recover, the infection can be fatal.
A man was in her 80s with underlying health problems, residents of nursing homes North Vancouver, died Sunday night.
On Monday, there were 78 known and suspected cases of the virus confirmed in Canada, including six cases related to the previous leg of the cruise ship Grand Princess, the same ship that had been floating off the coast of California to the day before berthing at the Port of Oakland on Monday. At least 21 people aboard, including 19 crew, had tested positive for the virus. Ottawa was preparing Monday to fly 237 Canada boarded a ship to Canadian Forces Base Trenton, where they will be assessed and undergo a 14-day quarantine. Every Canadian who is infected will not be allowed to board the plane and will instead be referred for treatment at the head of the US public health officials are now recommending Canada Canada avoid all travel cruises.
Repatriation both Canada aboard a ship that is infected with the virus come amid concerns about the country’s readiness for public health threats increase. “We have a scenario where there are more people who need a bed ICU of existing bed acute care (all hospital beds) in Ontario at the top,” says Fisman, a professor in the division of epidemiology at the Dalla Lana School of Public Health. “We see in Italy that the G7 may have a total collapse of the health system is under pressure from this, even at the beginning of the epidemic.”
Doctors in Alberta complained of a “lack of forward-thinking” and poor communication about emergency planning. BC nurses have warned they are already working short, and there are concerns about the dwindling supply of face masks, eye shields, and other protective gear. Federal Health Minister Patty Hajdu acknowledged Monday that Ottawa was “very alive to the fact that some provinces that show they have a deficit.
“We collect information, and we have said all along that we would be there as a federal government to support them with the resources they need, whether they are financial resources or practical resources.”
It will be a tall order. The hospital has been running beyond capacity. “You’re working at 120 percent capacity, and now you have this on top of your normal work,” said Paul-Émile Cloutier, president, and chief executive officer of HealthCareCan, which represents hospitals and other medical facilities across the country.
On the ground, there are concerns about the supply of gowns, gloves, masks, oxygen, medications, ventilator, and laboratory capacity for virus testing.
“We need to improve the testing of this virus,” said Cloutier. “It’s taking too long in some centers to get results.”
Chrystia Freeland Deputy Prime Minister and Prime Minister Justin Trudeau asked the prime minister to identify the “state of readiness” and the critical gaps in inventory or capacity ahead of Friday’s first ministers meeting in Ottawa. In a letter to the prime minister, said the government Freeland led the provision of most of the personal protective equipment.
However, front-liners worried, said, Cloutier. “They are worried because they only see the beginning and they think that if there is a pandemic it will be very difficult to manage the capacity needs of our patients come through the system.”
Fisman team has experience dealing with SARS, H1N1, and Ebola and recently reported that the outbreak in Iran is much larger than reported. Among other data, the model they estimate the basic reproductive number – how many others one infected person tends to infect – as well as the number of cases are mild and asymptomatic fly under the radar, is believed to be much higher than the number of cases reported.
“China Epidemic controlled via a large quarantine, enforced by the threat of the death penalty, and the lockdown of 750,000 people at its peak,” said Fisman.
In Canada, the public health control efforts simply mean finding and isolating the approximately 50 percent of mild cases through testing, but there is no social distancing or quarantine.
more aggressive measures will be a kind of domestic lockdowns now happening in Italy, which has left the streets of the capital Rome and other cities deserted, as well as closing schools and banning mass gatherings and sporting events.
A new study finding that the elderly, and people with underlying sepsis or clotting problems, the most likely to die from the virus. Published in The Lancet, the study, based on 191 patients from two hospitals in Wuhan, the center of the outbreak, also found that people shed the virus longer than expected, on average 20 days on Survivor, and as many as 37 days. Prolonged shedding suggests people may still be able to spread the pathogen.
“The prolonged viral shedding is recorded in our study have important implications for guiding decisions about isolation precautions and antiviral treatment in patients with confirmed COVID-19,” the researchers reported in China.
At the hospital, the rooms, the environment and potentially the entire floor should be set aside because it can be infected not stored in a regular room as other patients, said Cloutier. “I’m not saying you need to build a new hospital,” he said. In China, where the virus has infected more than 80,000, a 1,000-bed hospital was panic built in just 10 days.
But if the virus spreads widely in Canada, “what would you do with patients already in the hospital,” said Cloutier. “Are you going to ask them to leave? What happens if a patient (who needs) care at home, and no capacity there? “
With almost zero capacity of a spare bed, Fisman, from the U of Toronto, said planners must prepare now for the hospital emergency. There should be a designated hospital for patients coronavirus and registries of health care workers who already have the virus and recover that now can work safely with the patient.
Studies show 80 percent of cases in China are mild. Those who died took 25 days to die on a ventilator. Those who survive are off the ventilator after two weeks but then spent two weeks being treated in the hospital.
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