COVID-19 health care rationing, diagnosis & death policies – Part 3
Edited: September 16, 2020
Continued from Part 2 | Part 1
Ontario Ministry of Health document: “COVID-19 Provincial Testing Guidance Update” April 8, 2020: https://off-guardian.org/wp-content/medialibrary/2019_covid_testing_guidance-Apr-10-2020-expanded-testing-and-expanded-signs-and-symptoms.pdf?x19699.
- There is an inexplicable focus on testing instead of treatment: “Additional guidance is expected to be provided in the coming days to increase the testing of Ontarians. This will initially focus on vulnerable populations and congregate settings, and then include broader population groups to better understand disease spread in Ontario.”
- Contradiction about Testing of Asymptomatic The document recommends the testing of asymptomatic persons in some situations, but at the end, it says: “• Testing of asymptomatic patients, residents or staff is generally not recommended. • Clinicians should continue to use their discretion to make decisions on which individuals to test.”
- Kitchen Sink List of Symptoms: “Following active surveillance, any patient/resident with the following, should be tested: Symptomatic patients/residents . . . who are experiencing one of the following symptoms …: • Fever (Temperature of 37.8°C or greater); OR • Any new/worsening acute respiratory illness symptom (e.g. cough, shortness of breath (dyspnea), sore throat, runny nose or sneezing, nasal congestion, hoarse voice, difficulty swallowing, new olfactory or taste disorder(s), nausea/vomiting, diarrhea, abdominal pain); OR • Clinical or radiological evidence of pneumonia. Atypical presentations of COVID-19 should be considered, particularly in elderly persons …” (p. 2) “Atypical Symptoms/Signs of COVID-19 Seen in Older Adults: Symptoms: • Unexplained fatigue/malaise • Delirium (acutely altered mental status and inattention) • Falls • Acute functional decline • Exacerbation of chronic conditions • Chills • Headaches • Croup. Signs: • Unexplained tachycardia • Decrease in blood pressure • Unexplained hypoxia (even if mild i.e. O2 sat <90%) [reduced oxygen, ironically since eventually they mandated masks] • Lethargy, difficulty feeding in infants (if no other diagnosis)." (p. 5)
Ontario Ministry of Health: “COVID-19 Patient Screening Guidance Document” April 22, 2020 https://off-guardian.org/wp-content/medialibrary/2019_patient_screening_guidance-Apr-22-2020-update.pdf?x19699.
- Screening Stops if One Question is Answered: “• The screening result is not equivalent to a confirmed diagnosis of COVID-19. . . . • Once the person has been screened as positive (answered YES to a question), additional COVID-19 screening instrument questions may discontinue.” “If response to ANY of the screening questions is YES: COVID Screen Positive.”
- The screening symptom lists are still very broad but more than one symptom is required "Q2: Is the person presenting with fever, new onset of cough, worsening chronic cough, shortness of breath, or difficulty breathing? . . . " "Q5: Does the person have two (2) or more of the following symptoms: sore throat, runny nose/sneezing, nasal congestion, hoarse voice, difficulty swallowing, decrease or loss of sense of smell, chills, headaches, unexplained fatigue/malaise, diarrhea, abdominal pain, or nausea/vomiting?" 'Q6: If the person is over 65 years of age, are they experiencing any of the following: delirium, falls, acute functional decline, or worsening of chronic conditions?" How many conditions potentially linked to these symptoms were given lesser priority because of the obsessive focus on identifying COVID-19?
Ontario self-assessment page: https://covid-19.ontario.ca/self-assessment/. It includes a link to a “test results” page.
May 11 document: Case Definition – Novel Coronavirus (COVID-19) (http://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/2019_case_definition.pdf)
COVID-19 website updated daily for Canada (https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html). Just singling out a date from the summer, I observed on July 3, 2020 for all of Canada: “people tested” is 2,885,746, total cases is 105,091, total deaths is 8,663 (similar to flu deaths for 2019), cases recovered: 68,693. It seems like governments are mostly interested in getting the “people tested” number as high as they can. It is a lot of money to spend on tests. In a normal situation, it would be better spent on actual health care treatment and homelessness.
Ontario page on COVID-19 data surveillance: https://www.publichealthontario.ca/en/data-and-analysis/infectious-disease/covid-19-data-surveillance
Older page at the CDC regarding the original SARS (https://www.cdc.gov/sars/guidance/b-surveillance/casedef.html), I noticed this: “Surveillance case definitions are used primarily for identifying and classifying cases for national reporting purposes.” Another page on the same subject.
COVID-19 Summaries and Resources
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