Canadian international forward Adriana Leon will miss the rest of the FA Women’s Super League season after undergoing surgery to repair a fractured foot.
The English league runs through May 9. There was no immediate word on whether her recovery will stretch into the Tokyo Olympics, whose soccer competition is scheduled for July 21 through Aug. 7.
In a release Tuesday, West Ham said the surgery happened last Friday.
In 18 appearances this season, Leon has picked up one goal and five assists.
She joined West Ham United in January 2019 following a five-year stretch in the National Women’s Soccer League where she was last with the Seattle Reign, who decided not to retain her rights following the 2018 season.
In between that time, she made the move to Swiss Nationalliga A team FC Zurich Frauen in 2016, where she spent four months before returning to the U.S. to play for the Boston Breakers of the NWSL.
The King City, Ont. native attended Notre Dame University for her first two years on the Divison 1 level before transferring to the University of Florida for one year.
The 28-year-old has won 66 caps for Canada with 19 goals and four assists.
The Montreal Impact’s inability to hold individual workouts at their training facility has proved to be costly.
The MLS club reported Wednesday that midfielder Steeven Saba will be sidelined eight to 12 weeks after breaking his left foot “on a routine jog” near his home in Montreal.
The Impact are one of six MLS clubs still waiting for the green light from local health authorities to start the individual voluntary sessions outdoor at their training facility. Toronto and Montreal have already started such workouts.
Saba, a 27-year-old Haitian international, joined Montreal after attending the 2020 training camp as a trialist. He did not see any regular-season action.
MLS suspended play March 12, two weeks into the season, due to the pandemic.
“Wash your hands” has been the usual advice during flu season but “hands off” may well be the new mantra to reduce the risk of spreading the novel coronavirus as social norms like shaking hands are shunned for nods, smiles and tapping of feet.
Some churches in Canada have replaced handshakes with other gestures as COVID-19 spreads around the world.
Melissa Godbout, spokeswoman for the Roman Catholic archdiocese of Vancouver, said the archbishop has sent a letter to priests saying parishioners could be advised to replace handshakes with other ways of acknowledging each other during the sign of peace portion at mass.
She said her parish priest in nearby Chilliwack has acknowledged the virus as the dioceses watches for recommendations from the provincial government.
“We are monitoring the situation closely and checking in with the Ministry of Health multiple times a day and we will be working on updating the policy should we deem it necessary,” Godbout said.
“At my parish …. this past weekend our priest said if we feel comfortable we should just bow or nod instead of shaking hands so that’s what we did.”
Canada had 33 cases of the virus — 20 in Ontario, 12 in British Columbia and one in Quebec.
WATCH: Doctor encourages alternatives to hand shaking
Dr. Colin Lee, a specialist in public health and infectious disease, answers questions about screening travellers for coronavirus and whether people should stop shaking hands. 2:03
Neil MacCarthy, who speaks for the archdiocese of Toronto, said some parishes began shunning handshakes in 2003 during the SARS outbreak and have never returned to that nicety as parishioners have used smiling, nodding, bowing or holding up the peace sign to greet each other.
“What we’re really trying to stress is that people who are distributing communion are washing their hands before and after,” he said. “Some parishes have hand sanitizer available when people come into the church.”
Health officials in Toronto have not advised any other changes, MacCarthy said, adding parishes recommend people stay home if they are sick and watch mass online.
Dr. Bonnie Henry, provincial health officer in British Columbia, said she has stopped shaking hands and advised people to use another form of acknowledgment, such as putting their hands in prayer, bowing or just smiling and looking someone in the eyes when saying hello.
“It is an extraordinary time and it’s challenging for all of us,” she said, adding the change away from handshaking is a gesture of solidarity during the global spread of the virus.
“It’s a small gesture but a gesture that shows that we are paying attention to what’s going on and it’s something that we can do in our community.”
Henry said she worked on the Ebola outbreak in Uganda in 1999, when people replaced hugs and handshakes with tapping of their feet.
Dr. David Williams, Ontario’s chief medical officer of health, said he wouldn’t generally encourage a lot of hand shaking during the regular flu season.
“If you’re going to shake my hand you don’t know what I did just before,” he said. “We tend to say not usually unless you’re pretty sure [about whose hand you’re shaking] or you’re going to be washing your hands afterwards and not going to touch your face.”
Kei Esmaeilpour, spokesman for the Civic Association of Iranian Canadians of B.C., said members have begun holding out their hands to each other instead of shaking hands.
“Everybody knows why and this is not rude,” he said. “This is about caring for each other. If you’re not handshaking, your friend will not be unhappy. He or she will just understand that you are caring for them.”
Esmaeilpour said Iranian-Canadians in the Vancouver area and Toronto are also considering cancelling Persian New Year festivities slated for later this month to avoid large gatherings that could more easily spread a respiratory illness.
On Tuesday, officials in British Columbia asked travellers from China and Iran to isolate themselves for 14 days when they return home to Canada.
Esmaeilpour said many community members have already started voluntarily isolating themselves at home for that length of time after returning from Iran.
On Monday, some Iranian-Canadians in the Vancouver area joined forces to start a new campaign to try and help people who would be stuck at home in quarantine. A group of 147 people had signed up on an app with days and times they would be available to drop off groceries or assist in other ways, Esmaeilpour said.
The issue of employers requiring doctors’ notes for minor illnesses has been hotly debated for years. Medical associations are strongly opposed to the practice, and according to a recent Ipsos poll, 70 per cent of Canadians agree.
While doctors’ notes can be important when there is a major medical condition requiring workplace accommodation, a significant number of notes are written to excuse absences for minor illnesses. This is widely acknowledged to be an employee management strategy, a way to reduce absenteeism by forcing the worker to “prove” his or her illness.
As any physician who’s written a note for a minor illness can tell you, we don’t perform sophisticated medical tests to verify a cold.
Going to the doctor for a note is used as disincentive to calling in sick — but not because medical expertise is needed for colds or minor stomach bugs. Simply reporting a few of the typical symptoms of one of these infections will invariably result in a note as requested. Doctors are not applying clinical skills to benefit patients in these cases (our medical advice would be to simply stay home); rather, we are unwilling participants in the workforce management strategy of employers.
These types of sick notes are problematic for multiple reasons. The requirement to see a physician takes up an appointment spot that could otherwise be used for a real medical need, not something for which the best health advice is to spend a day or two in bed. In addition, the cost of the medical assessment is paid by our increasingly overstretched public health care system.
The cost for the paperwork itself is not covered by provincial medicare plans, so that is either billed to the patient or else absorbed by the doctor. But most importantly, acute infections like colds and stomach bugs are highly contagious, so it’s a significant public health risk to force employees to sit in clinic and hospital waiting rooms, places that contain some of the most medically fragile people in our society.
‘Sick leave abuse’
Employers and supporters of mandatory doctors’ note policies point to the problem of “sick leave abuse,” which is reported to cost billions per year in Ontario in productivity loss. Yet nowhere in our health care legislation is there a requirement for public health care resources to be used as cost-cutting tools for private employers. That’s why we should consider putting the financial onus back on the employer — in other words: billing employers when their employees go to the doctor for sick notes.
What typically happens when you go to the doctor for a sick note is that the physician will bill medicare for the visit, and the patient will get billed for the sick note itself (or the doctor waives the fee for the note). Really, what should happen is the doctor sends an invoice to the employer for both the visit and the note. We send invoices to insurance companies or lawyers all the time for non-medicare-covered services (usually to write a medical opinion or complete insurance forms), so this would follow the same idea.
Certainly there are situations in which communication between the workplace and the employee’s physician is important for the health of the employee. Those are truly the only times when public health care funding can justifiably be used for doctors’ notes.
And, if anything, we should see private employers as accountable for the societal costs of increasing the spread of infectious disease and taking up appointment and waiting room space in our already overburdened system.
Mandatory doctors’ notes are just one management tool available to reduce the cost of absenteeism. Other strategies include workplace changes that improve morale, providing paid sick leave and allowing work-from-home flexibility. Large employers could also hire private health care staff, like a company nurse.
Another option would be for employers to pay into a fund similar to the provincial workers’ compensation boards, which reimburse health care providers directly for services rendered to injured workers.
We don’t have a comprehensive picture of the public health costs stemming from mandatory doctors’ note policies and the resulting infectious disease spread. But we do know they are having an impact — an unnecessary one, especially considering much better options are available. As long as employers can get away with demanding sick notes without carrying any of the logistical or financial burdens, they will continue to do so. That’s why it’s time to change that.
This column is part of CBC’s Opinion section. For more information about this section, please read our FAQ.
A broken foot is a painful but not unusual injury. Losing your leg as a result is anything but.
According to St. John’s resident Samantha Rideout, 30, her right leg was amputated below the knee after it took two months for a proper diagnosis, and even longer for her concerns to be taken seriously by Eastern Health staff.
“It’s not like I went in and I just lost a toe or a finger. It’s a whole leg, and it took a big part of my life away,” said Rideout, a single mother of three young children living in St. John’s.
Rideout was born with spina bifida — a spinal birth defect that, for her, leaves little sensation in her feet. She injured her right foot and knee after she slipped and fell down the stairs of her home last fall.
She said she went to the Health Sciences Centre because she felt something was wrong.
“I told them … ‘I don’t feel anything on my feet ever. And now I do feel something — which is very, very strange for me,'” Rideout said.
But despite multiple trips to the emergency room, X-rays, and rounds upon rounds of antibiotics, Rideout said, it took two months for her broken foot to be diagnosed.
By the time an orthopedic surgeon intervened in her care, it was too late, she said — her right leg had to be amputated from the knee down.
Eastern Health told CBC News it cannot speak specifically to Rideout’s case, due to privacy legislation.
But, in an emailed statement, a spokesperson said “providing safe, quality care” is the health authority’s No. 1 priority.
“When a person presents at any health-care facility at Eastern Health, staff are trained to assess the patient’s health issue and to provide expert advice on the best options for meeting those needs,” the statement reads.
“Eastern Health takes every complaint seriously, and will make every effort to resolve an individual’s concerns.”
While Eastern Health said it couldn’t provide further information, Rideout requested her own medical records, and gave them to CBC News.
When Rideout fell down her stairs in September, she took quite a tumble.
“I took the first stair and just missed it completely. So when I did, my right leg was up behind my head,” she said.
Rideout said she told the emergency room staff that she was worried about her foot.
“They kind of just focused on my knee and nothing else. I kept mentioning my foot and [the doctor] kept saying, ‘We’ll get to that.'”
But the doctor only ordered X-rays for her knee.
Rideout said she was told she had torn cartilage and to keep weight off it as much as possible.
After the diagnosis, she didn’t have a ride, so she decided to walk — about a 20-minute journey.
Rideout said her foot bothered her every step of the way, but it wasn’t until she got home that she became concerned.
When she took off her shoe, Rideout discovered her right foot was badly swollen and covered in bruises.
She said she put on her slippers — her foot wouldn’t go back into her shoe — and walked back to the emergency room, where her foot was X-rayed.
“[The doctor] was like, ‘We didn’t see anything on the X-rays. Someone will send them off to a specialist and someone will call you later,'” Rideout said.
“I never did get a call. Ever.”
Rideout said that since she said she didn’t hear any news about her X-ray, she assumed her foot wasn’t broken.
In an attempt to make walking as painless as possible, she started placing all her weight on one area of her foot.
Over time, a blister developed and Rideout thought it could be infected, so she headed to the hospital for antibiotics.
“They did X-rays on it … and the doctor on call in the ER that night told me that I had multiple breaks in my foot and asked if there was an injury that happened,” Rideout said.
She said she told them about her slip and fall almost two months earlier.
Doctors started her on IV antibiotics, as they had in the past. But this time, instead of admitting her to the hospital, she said, she was sent home and told to come back for daily treatments.
The change in care confused her.
“Any other time I’ve had [an] infection, it was always a bone infection,” she said.
“They always admitted me right away and did surgery to clean out the infection, and kept me in the hospital for a month, then crutches for a long time, then a walking boot, until it was all healed.”
While the injury was making it troublesome to get back and forth to class at Academy Canada, it was the daily visits to the hospital that were more than she could handle.
“I had to take a leave [of absence]. It was just too much,” Rideout said.
‘I just knew something was wrong’
In mid-November, Rideout’s symptoms worsened.
“I felt extremely sick. I had a high fever. I hadn’t eaten in over a week. And I just knew something was wrong.”
She went back to the ER, and Rideout said the physician on duty sent her for more X-rays and blood work.
What happened next shocked her.
“The doctor came back and told me everything looked perfect,” she said.
“Now, if you looked at my foot, anyone would know it’s still infected. It was still red. It was still hot to the touch. … But he said the infection was gone and that I no longer needed to be on IV antibiotics anymore.”
The physician wrote her a prescription for one week of oral antibiotics.
Rideout would not make it to the end of that prescription before ending up back at the Health Sciences.
A doctor assessed her symptoms and immediately placed her back on the IV antibiotics she had been taken off of just days before.
‘He did do everything in his power to fix my foot’
Rideout later received a referral to a wound-care clinic on Major’s Path, and said her treatment improved drastically once she came under the care of an orthopedic surgeon.
“He listened to me more. I found he was more thoughtful about what I was saying and he understood that I have no feeling in my feet — [that] this is what can happen and how bad it can get,” she said.
The specialist changed her antibiotics and immediately got her on crutches — despite being consistently told they were unnecessary, she said.
In January, after almost two months on her new course of medication, Rideout underwent surgery to try to clean out the infection in her foot.
“I ended up getting extremely ill again: throwing up, high fever. I went to see [the specialist], and he admitted me right there on the spot.”
The doctor ordered an MRI of Rideout’s foot. The results convinced him drastic intervention was needed to stop the infection from spreading further.
“He did do everything in his power to fix my foot,” Rideout said.
“The day that he told me I was going to have to lose my foot … he was very upset that this was the outcome of everything.”
Rideout said the orthopedic surgeon explained her two options: She could have half her foot removed and risk the infection coming back, or have her leg removed from the knee down, which would remove the risk completely.
It was a difficult decision, but she decided it was better to be safe than sorry.
“My kids were a big factor. I knew that I needed to be here for them. I’m a single mom, so it’s pretty much only me they have,” she said.
“And I was just sick of being sick.”
‘Missing a part of me’
In March, Rideout’s leg was amputated at the knee.
She remained in hospital for two weeks, where physiotherapists prepared her for life as an amputee.
Now, Rideout said, she struggles with stairs, but hopes to get a prosthesis within a few months.
Rideout said her four- and five-year-old daughters are adjusting well. The eldest often asks her when she will get her “robot leg.”
She said her six-year-old son has been a bit more withdrawn, but is coping well.
“The other night, he told me, ‘You know, mommy, just because you have your foot gone … you’re still the same person,'” Rideout said.
“I said, ‘Yeah I am, there’s nothing different. I’m just missing a part of me.'”
Encourages others to speak out
Rideout said she knows it won’t bring back her leg, but she wants some sort of justice for an outcome she feels, with proper care, could have been avoided.
She said the orthopedic surgeon who tried to save her foot shares that opinion.
“He said… the day that he told me the news [about my amputation] that I probably had a bone infection this whole time, and it was just getting worse and worse and worse.”
Rideout said she’s considering legal action pending the outcome of Eastern Health’s response to her concerns.
She advises anyone who feels their health concerns are being dismissed or not taken seriously: “I would tell them to fight for their medical rights, and if you think that something’s wrong, say it.
“And if they don’t listen to you, find someone else who will.”
Neymar is expected to be sidelined for about 10 weeks with a right foot injury, ruling the Paris Saint-Germain striker out of the Champions League matchup against Manchester United.
PSG travels to play United in the last 16 of the Champions League on Feb. 12, with the return leg in Paris on March 6. The injury potentially also rules him out both legs of the quarter-finals in mid-April if PSG advances.
However, if PSG reaches the semifinals, the 26-year-old Brazilian may be back in time for the first leg at the end of April and the return leg in the second week of May.
A group of medical experts met Tuesday at PSG's training ground to assess the damage to his fifth metatarsal and decided the best course of action was a "conservative treatment" and not an operation, PSG said Wednesday in a statement.
Neymar was in "total agreement" with the decision, PSG added.
Neymar was injured while playing against Strasbourg last Wednesday in the French Cup, rolling his ankle as he fell to the ground following a couple of challenges.
It is Neymar's third injury in the last 12 months.
In February, Neymar cracked the fifth metatarsal in his right foot, and he underwent surgery back home in Brazil. Although he recovered in time for the World Cup, he was not at his best in Russia.
Then, Neymar was substituted with a groin injury during the first half of Brazil's friendly against Cameroon on Nov. 20.
Neymar became the world's most expensive player when he joined PSG from Barcelona for 222 million euros ($ 254 million) in 2017. He has scored 20 goals in 23 games this season and 48 in 53 overall.
If his recovery goes well, Neymar should be able to play at the Copa America tournament, which opens on June 14 in Brazil. Neymar, who has made 96 international appearances, is third on Brazil's scoring list with 60 goals, behind only Ronaldo (62) and Pele (77).
Tired Central American migrants rested in a southern Mexico town while their representatives tried to negotiate bus transportation hundreds of kilometres ahead, but then came the bad news: They'd be walking again before dawn Thursday.
They planned to take advantage of cool overnight and morning temperatures by hitting the road at 3 a.m. local time in Juchitan for a trek to Santa Maria Jalapa del Marques, about 57 kilometres to the west.
The migrants have not said what route they intend to take northward or where on the U.S. border they planned to reach, and Juchitan, still about 1,450 kilometres from U.S. soil, was something of a crossroads.
Choosing Jalapa del Marques as the next stop appeared to indicate they are opting to travel via Oaxaca state's eponymous capital instead of turning north toward the Gulf coast state of Veracruz, which is a common transit route toward McAllen, Texas.
On Wednesday evening it became clear that Mexican authorities were not acceding to the caravan's demand that dozens of buses be provided to whisk the 4,000 or so people to Mexico City.
"The attempt to travel by bus failed," caravan co-ordinator Walter Cuello acknowledged.
'Worth the effort'
Taking a day off from days of walking in the heat, migrants wandered around Juchitan looking for something to eat as classic songs by Mexican singer Vicente Fernandez, known as "the king of ranchera music," played in the background.
Red Cross personnel bandaged the swollen feet of Honduran farmer Omar Lopez, who has been pounding the hot asphalt of highways every day for the last two weeks and spending nights on concrete sidewalks with just a thin sheet of plastic for cover. Lopez said playing soccer back home had given him stamina but the "exaggerated" walk has taken its toll.
"The sacrifice is worth the effort," Lopez said. "I promised to buy my son a real motorcycle and I'm going to make good. I promised him many other things … not only things, I also want to give them education. Everything good costs money."
Migrants received medical care in a makeshift camp in Juchitan, with one saying the 'sacrifice is worth the effort.' (Hannah McKay/Reuters)
White House press secretary Sarah Huckabee Sanders praised Mexico for stopping the migrants from getting rides. "Mexico has stepped up in an unprecedented way," Sanders told Fox News. "They have helped stop a lot of the transportation means of these individuals in these caravans, forcing them walking. They have helped us in new ways to slow this down, to break this up and keep it from moving as aggressively toward the United States."
The Mexican government has, in fact, taken a fairly contradictory stance on helping or hindering the caravan, reflecting the country's balancing act: Officials don't want to irk U.S. President Donald Trump, but Mexicans themselves have long suffered mistreatment as migrants.
For the first week of the caravan, Mexican federal police sometimes enforced obscure safety rules, forcing migrants off paid mini-buses, citing insurance regulations. They also stopped some overloaded pickup trucks carrying migrants and forced them to get off.
But in recent days, officials from Mexico's immigrant protection agency have organized rides for straggling women and children as a humanitarian effort. And police have routinely stood by as migrants piled aboard freight trucks.
More caravans en route
A second, smaller group of 1,000 or so migrants is more than 320 kilometres behind the first caravan. A third band of about 500 from El Salvador made it to Guatemala, and a fourth group of about 700 set out from the Salvadoran capital Wednesday.
Altogether, the four caravans represent just a few days' worth of the average flow of migrants to the United States in recent years.
Migrants from El Salvador board a truck as they start on their way to the U.S. from San Salvador. (Diana Ulloa/Associated Press)
Similar caravans have occurred regularly over the years and passed largely unnoticed, but Trump has focused on the latest marchers seeking to make border security a hot-button issue in next week's midterm elections.
The Pentagon has announced it is sending 5,200 troops to the southwest border, with their role largely limited to such activities as providing helicopter support, installing concrete barriers and maintaining vehicles. Trump said Wednesday that number could go as high as 15,000.
Worn down by days of long walks, many migrants have dropped out and returned home or applied for protected status in Mexico.
The initial caravan has shrunk significantly from its estimated peak of more than 7,000 migrants. A caravan last the spring ultimately fizzled to just about 200 people who reached the U.S. border at San Diego.
Mexican Interior Secretary Alfonso Navarrete Prida said about 2,300 migrants have applied to stay in Mexico under a government plan, and hundreds more have accepted assisted repatriation.
Also Wednesday, a Guatemalan woman gave birth to the first known caravan baby at a hospital in Juchitan. Mexico's governmental National Human Rights Commission said it had arranged for medical attention for the woman, who was 28 weeks pregnant, and the girl was healthy.
A caravan of more than 1,000 Hondurans is winding its way toward their country's border with Guatemala, with the goal of reaching a better life in the United States.
Dunia Montoya, a volunteer helping the migrants, said the group planned to sleep Saturday inside an auditorium in Santa Rosa de Copan, a town several hours east by car from Guatemala.
The migration began swelling spontaneously Friday after local media reported on approximately 160 migrants who had agreed to depart together for greater safety from San Pedro Sula. The aspiring migrants organized via WhatsApp chats.
A large group of Hondurans fleeing poverty and violence, move toward their country's border with Guatemala on Saturday. Many say they plan to request refugee status in Mexico or seek visas to pass into the U.S. (Jorge Cabrera/Reuters)
"People leave Honduras every day, but this is the first time (they do it) in a public way and in a group," Montoya said in a telephone interview from Santa Rosa de Copan.
Other Hondurans who had been thinking of leaving the country saw an opportunity to go with a support network. They stuffed backpacks with essentials and rushed to join the caravan.
People lent vans and trucks to help the group, whose initial members had started out on foot. Hondurans offered bottles of water or food along the way.
Montoya, who plans to stay in Honduras, said many in the caravan have tried multiple times to reach the U.S.
Some did not enrol their children in school this year, planning to take off any day, she said. Others joined the group with months-old babies.
If separated 'they don't come'
News of the growing caravan came as U.S. President Donald Trump appeared to defend family separations for such groups.
"If they feel there will be separation, they don't come," he told reporters at the White House on Saturday.
The Trump administration abandoned its policy of separating immigrant children from their parents on the U.S.-Mexico border in June.
Poor economic prospects are the main reason Hondurans want to leave the Central American country of 9.4 million people, according to a recent survey by the Center for Immigration Studies. Violence was the second most-cited reason.
Fleeing 'misery and violence'
The United Nations Economic Commission for Latin America and the Caribbean projects 3.9 per cent economic growth for Honduras this year. The Honduran labour ministry pegs unemployment at 6.7 per cent, although nearly half of working age Hondurans are underemployed, meaning they can't make ends meet with the amount of paid work they can secure.
"There's a misery and a violence that is overwhelming people. People no longer have faith in this country, and they are fleeing," said Montoya.
Maria Dolores Moreno, 31, said she stuffed a bag with a few personal belongings and grabbed her 10-year-old son to join the caravan Friday. She didn't bring any money with her. She has been unemployed for more than a year, she said. Previously she sold Avon products.
Moreno said by phone that she hopes to find a job — any job — anywhere in the United States.