Tag Archives: severe

Severe COVID-19 linked to increased risk of stillbirth, preterm birth

A new data analysis links COVID-19 to increased risk of pregnancy complications including preterm birth and stillbirth, with the risks rising if infection is severe.

Montreal researchers conducted a meta-analysis of 42 studies involving 438,548 pregnant people around the world.

Authors including Dr. Nathalie Auger of the University of Montreal’s School of Public Health said the data “provides clear evidence that symptomatic or severe COVID-19 is associated with a considerable risk of preeclampsia, preterm birth and low birth weight.”

“Clinicians should be aware of these adverse outcomes when managing pregnancies affected by COVID-19 and adopt effective strategies to prevent or reduce risks to patients and fetuses,” concludes the study, published Friday in the Canadian Medical Association Journal.

The study says COVID-19 patients were more likely than those without the disease to experience preeclampsia, stillbirth and preterm birth.

Urgent questions for medical community

Compared to asymptomatic patients, symptomatic patients were at double the risk of preterm birth and a 50 per cent increased risk of cesarean delivery.

Meanwhile, those with severe COVID-19 had a four-fold higher risk than those with a mild case to experience high blood pressure and preterm birth.

The reason for increased risk was unclear, but researchers said it could be because the virus that causes COVID-19 stimulates an inflammatory response affecting blood vessels.

The team also called for more research to better understand disease pathways that explain these associations.

“Lack of knowledge about SARS-CoV-2 infection in pregnancy has raised urgent questions among obstetricians and neonatologists about the risk of maternal, fetal and neonatal morbidity and mortality,” the study says.

“There is an urgent need for evidence to guide clinical decisions.”

The Society of Obstetricians and Gynaecologists of Canada (SOGC), has said all governments should grant access to the COVID 19 vaccine to pregnant and lactating individuals.

“The benefits of getting vaccinated for individuals at higher risk during pregnancy or while breastfeeding outweighs the risks of not receiving the vaccine,” SOGC said. 

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2 killed, 24 missing in severe floods in Italy and France

Flooding from record rains in the mountainous region that spans France and Italy killed two people in Italy and left at least 24 people in the two countries missing Saturday.

A storm that moved overnight across southeastern France and then northern Italy caused major flooding on both sides of the border, destroying bridges, blocking roads and isolating communities.


In Italy, a firefighter was killed during a rescue operation in the mountainous northern region of Val d’Aosta. Another body was found in Vercelli province, near where a man had been swept away by flood waters late Friday.

A total of 16 people were reported missing in Italy, all but one travelers in cars on the Col de Tende high mountain pass between France and Italy, according to civil protection authorities.

They include two people from Germany driving with their 11-year-old and six-year-old grandchildren, and a pair of brothers returning from France.


A building collapses into the river Cervo in Limone Piemonte, Italy, on Saturday. (Vigili del Fuoco/Handout via Reuters)

The spokesperson for Italy’s firefighters said a search was ongoing for a missing shepherd who was pulled into flood waters on Col de Tende. His brother managed to grab onto a tree and was saved, while authorities were searching on the French side for the shepherd.

Firefighter spokesperson Luca Cari said he suspects the other people reported missing in Italy have lost phone contact, but at the moment they are not thought to be in imminent danger.

The situation at the tunnel on the high mountain pass is complicated by the fact that French emergency responders cannot access their side due to flood damage, Cari said. Italian firefighters were searching the French side for people who may have been blocked.

Unrelenting rainfall overnight hit levels not seen since 1958 in northern Italy’s Piedmont region, where as much as 630 millimetres of rain fell in a 24-hour period, according to the Italian civil protection agency.

Hundreds of rescue operations were underway. Eleven campers were saved in Vercelli province, where floodwaters hit 20-year highs. And Alpine rescue squads have evacuated by foot seven people who were in houses cut off by flooding at Terme di Valdieri; some had to be carried on stretchers due to the muddy conditions and accumulation of detritus.


People clean up mud caused by flooding in Ventimiglia, Italy, on Saturday. (Federico Scoppa/AFP via Getty Images)

On the other side of the border, in southeastern France, almost a year’s average rainfall fell in less than 12 hours in the mountainous area surrounding the city of Nice. Nice mayor Christian Estrosi said over 100 homes were destroyed or severely damaged in the area.

French Prime Minister Jean Castex, who flew over the area in an helicopter, confirmed that at least eight people were missing, including two firefighters whose vehicle was carried away by water when the road collapsed during a rescue operation.

“I cannot hide our grave concern on the definitive toll,” Castex said.


Floodwaters can be seen circling a home in Saint-Martin Vésubie. (Valery Hache/AFP via Getty Images)

Many worried families had not heard from their relatives due to cellphone services being cut off in the area.

“As I speak, priority goes to searching for victims, providing supplies and accommodation for the people affected, and restoring communications,” the prime minister said.

Rescue efforts included 871 personnel working on the ground, as well as military helicopters and troops helping with emergency assistance, Castex said.


A car lies in mud after being moved by floods in Roquebilliere, southeastern France. (Nicolas Tucat/AFP via Getty Images)

French President Emmanuel Macron on Saturday expressed gratitude toward rescuers on Twitter. “Together we will get through this,” he said.

France’s national weather agency, Meteo France, said that up to 500 millimeters of rain (19.7 inches) were recorded in some areas, the equivalent of almost one year of average rainfall.

Meteo France issued a danger alert on Friday and all schools in the region had been closed. Local authorities urged people to stay at home.

In central Switzerland, flooding along the Reuss River caused the closure of a stretch of the A2 highway – a major trans-Alpine route. Further east, 13 residents were evacuated from their homes in the town of Diesbach because of flooding.

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Health Canada authorizes drug remdesivir for severe COVID-19 cases

Health Canada has authorized with conditions the drug remdesivir for patients with severe COVID-19, though Canada’s top doctor says the supply is limited.

The drug — which will go by the brand name Veklury — is manufactured by Gilead Sciences Canada.

On Tuesday, Health Canada announced the drug is now authorized for use in adults and adolescents aged 12 years and older with a body weight of at least 40 kilograms. 

The company did not seek permission to use the drug to treat pregnant women or children under 12.

In April, a study run by the U.S. National Institutes of Health tested remdesivir versus usual care in 1,063 hospitalized coronavirus patients around the world. It found that the drug reduced the time it takes patients to recover by 31 per cent  — 11 days on average versus 15 days for those just given usual care.

But Dr. Theresa Tam, chief public health officer of Canada, warned that “the supply with this company is very low globally.”

WATCH | U.S. buys global supply of remdesivir:

The U.S. has bought the global supply of remdesivir, an antiviral drug that has been found to help certain patients recover more quickly from COVID-19. 4:20

Remdesivir is administered intravenously and used only in health-care facilities where patients can be closely monitored.

“It’s not something people can go out and access by themselves,” Tam said Tuesday during a press conference.

Because the drug has been given an expedited review, the manufacturer will have to ensure the continued safety, efficacy and quality of the drug, a statement by Health Canada said

Some already treated with drug

Remdesivir has also been granted emergency or conditional authorization in the U.S., Europe, Australia, Singapore and Japan.

In Canada, a small number of patients have been or are being treated with the drug under the Special Access Program.

Asked about reports the drug will be expensive, Tam said that may be the case, but the price will be subject to “appropriate reviews.”

“I am aware some of these drugs are going to cost a fair amount of money,” Tam said. “We have to look at access, as well as what’s a reasonable price.”

Matthias Götte, professor and chair of the medical microbiology and immunology department at the University of Alberta, said the drug’s approval is “excellent news.”

“I guess there’s no doubt this is really the the only antiviral agent with with a clear-cut advantage shown in the large clinical trial,” he said. 

Götte explained that the drug targets what he calls “the engine of the virus.”

“This is an enzyme that is absolutely required for replication of the virus, for spread and so forth. So if you target that engine, the virus cannot spread, cannot replicate.” 

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U.K. grapples with severe floods as storm death toll rises to 3

Britain issued severe flood warnings Monday advising of life-threatening danger after Storm Dennis dumped weeks worth of rain in some places. A woman was found dead after being swept away by the floodwaters, the storm’s third confirmed victim.

To the east, Dennis’s gale-force winds also left nine people injured in Germany as their vehicles crashed into broken trees littering roads and train tracks. Flooding and power outages were reported elsewhere in northern Europe.

By Monday evening, Britain’s Environment Agency issued seven severe flood warnings in the central English counties of Herefordshire, Staffordshire and Worcestershire. Another 200 lower-level flood warnings were also in place, meaning that flooding was expected.

Some 480 flood warnings and alerts were issued across England on Monday, the highest number on record, the agency said.

The storm’s confirmed death toll rose to three as West Mercia Police said a body had been found in the search for a 55-year-old woman who had been missing near Tenbury in Worcestershire since Sunday.


An aerial view shows flooding from the River Wye following Storm Dennis on Monday in Hereford, England. (Christopher Furlong/Getty Images)

A man pulled from the water in the same incident was airlifted to hospital, where he remained in stable condition, police said.

The weather system brought winds of more than 145 km/h and up to 150 millimetres of rain to Britain over the weekend. And the tumult is not over.

Flood warnings across much of England

“We expect disruptive weather into the middle of this week bringing a significant flood risk for the West Midlands, and there are flood warnings in place across much of England,” said Toby Willison, executive director of operations at Britain’s Environment Agency.

Forecasters said river levels in parts of northern England had yet to reach their peak. In the northern England city of York, authorities were piling up more than 4,000 sandbags as the River Ouse continued to rise. It’s expected to peak on Tuesday.

Other residents in Wales and western England were cleaning up Monday after the storm flooded roads, railways, homes and businesses and disrupted travel across Britain. Some told stories of fleeing for their lives.


Emergency personnel rescue people in Hereford, England, on Monday. (Phil Noble/Reuters)

Jeanette Cox, 68 and her daughter Rachel woke up to the sound of water in their home in the Welsh village of Nantgarw, near Cardiff, around 4 a.m. Sunday. Cox said the only object that survived downstairs was her wedding day photograph that she had kept on a windowsill. Her husband Bill died from cancer in 2009.

“It was pitch black,” she said. “All you could hear was the water running. I’ve never seen anything like it. I was very frightened.”


A flooded street is seen in Tenbury Wells, in the central England county of Worcestershire, on Monday. (Phil Noble/Reuters)

Britain’s environment secretary said climate change was making extreme weather events more common. But Prime Minister Boris Johnson’s Conservative government denied it was unprepared for such storms.

“We’ll never be able to protect every single household, just because of the nature of climate change and the fact that these weather events are becoming more extreme, but we’ve done everything that we can do with a significant sum of money,” Environment Secretary George Eustice said.

9 injured in Germany

In Germany, at least nine people were injured in weather-related car accidents as high winds brought trees down onto roads and train tracks.

A commuter train with 67 passengers also crashed into a fallen tree in the western German city of Dortmund, but nobody was injured. And in the German city of Hamburg, the city’s famous fish market was flooded for the second time this month.


Storm Dennis roared across Britain with high winds and heavy rains. (Ben Birchall/PA via AP)

Further north, strong winds and heavy rains caused flooding, road closures and electricity outages across the Nordic and Baltic regions, and forced the cancellation of several ferries between Denmark and Norway.

In Denmark, the southwestern city of Kolding was flooded as gale-force winds and heavy rains battered the area. In nearby Horsens, police protectively evacuated residents near Bygholm Lake out of fear that a levee would collapse.

In southwestern Norway, more than half a dozen roads and several mountain passes were closed amid heavy snow and high winds.

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Surgical option to treat severe tremor is life-changing, says patient

A New Brunswick man is trying to raise awareness after discovering he could be treated for his debilitating condition just one province away.

René Girouard of Sainte-Marie-de-Kent has coped with essential tremor for 16 years. It’s a neurological condition that is often confused with Parkinsons Disease.

Essential tremor causes shakes in the body, most often in the hands, that are so severe patients can’t feed themselves.

Girouard, a retired teacher, was unable to do basic tasks. He once painted in his free time, but last year he couldn’t even write his name.

“More and more, I had problems with my balance,” he said. “Years ago I used to cook quite a bit, but I couldn’t measure anything.”

Girouard visited several specialists in New Brunswick and joined a support group. He had given up hope that his condition would change, when a family member saw a story on the news about a surgery offered in Halifax.

Last year, he investigated and found out he was a candidate for deep brain stimulation.


Dr. Lutz Weise says deep brain stimulation isn’t a cure for essential tremor, but patients can see a significant reduction in their shakes. (Brian MacKay/CBC)

The full-day surgery implants a device similar to a pacemaker that sends electrical pulses to the brain to block the tremors.

“What we usually tell our patients is that they have an 80 per cent chance of having at least a 50 per cent reduction of their tremor,” said Dr. Lutz Weise, the neurosurgeon who performs the procedure.

Weise said about four per cent of adults over 40 are diagnosed with the condition. Often, they start isolating themselves from society because they don’t want to be watched as they struggle to do things like drink from a glass.

Weise agrees with his patient that not enough people with essential tremor know about the surgical option.

“What is quite impressive in essential tremor especially, as compared to other diseases where we perform deep brain stimulation, is the instant effect,” said Weise.

“When you turn on the stimulator, the tremor ceases almost within seconds.”


Yvette and René Girouard were shocked by the results of the surgery. They say it took years before they discovered it was an option for his essential tremor. (Radio-Canada)

That was the case for Girouard, who said he instantly felt like a new man. His wife, Yvette, said the change was shocking.

“He was feeding the birds and I was like, ‘Oh my gosh, he’s straight!’ Because he was walking like an old man,” she said.

Girouard said he once thought his condition would only get worse, but for the first time, he has hope. And he’s thinking of picking up his paint brush once again.

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Alberta confirms province’s 1st case of severe vaping-associated lung illness

Alberta has recorded its first case of severe vaping-associated lung illness, the province’s chief medical officer of health said Thursday.

“We are actively monitoring the situation in Alberta” and working with health officials across Canada “to share information and better understand this illness,” Dr. Deena Hinshaw said in a news release.

The patient has received treatment and is recovering at home, Alberta Health spokesperson Tom McMillan told CBC News.

Alberta Health is not releasing where the patient is from, or where he or she was treated, McMillan said.

The Alberta case marks the 15th vaping-associated lung illness reported in the country, according to the Public Health Agency of Canada.

In Canada, the definition of a vaping-related severe pulmonary illness case includes shortness of breath, cough, chest pain, with or without vomiting, diarrhea, abdominal pain and fever.

Public health officials continue to advise Albertans that vaping is not without risk and the long-term health impact remains unknown.

Last fall, the Alberta government launched a review of Alberta’s Tobacco and Smoking Reduction Act exploring ways to address “the alarming rise in teen vaping,” the release said.

Health Minister Tyler Shandro is aware of Alberta’s first case of severe vaping-related iillness, he said Thursday on Twitter. Shandro said he is expecting a final report from the review shortly.

“Based on its findings, we expect to table new vaping-related legislation this spring,” Shandro said in a tweet.

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Michael Flynn sentencing delayed after judge hints at more severe penalty

A U.S. judge abruptly postponed the sentencing of President Donald Trump's first national security adviser, Michael Flynn, on Tuesday, saying he could not hide his disgust for Flynn's crime of lying to the FBI and warning that he could send the retired army lieutenant-general to prison.

Lawyers for Flynn, who pleaded guilty last year to lying to the agency about his Russia contacts, requested the delay during a stunning hearing in which U.S. District Judge Emmet Sullivan gave Flynn a blistering rebuke.

"Arguably you sold your country out," Sullivan told Flynn, who was flanked by his attorneys.

The judge added: "I can't hide my disgust, my disdain."

Flynn may yet get prison time

Sullivan's harsh words raised the prospect that he could send Flynn to prison — an unexpected development since prosecutors have recommended against prison time, citing his co-operation in special counsel Robert Mueller's Russia probe.

The hearing came amid escalating legal peril for Trump, who was implicated by federal prosecutors in New York this month in hush-money payments to cover up extramarital affairs. Nearly a half-dozen former aides and advisers — including Flynn — have pleaded guilty or agreed to co-operate with prosecutors.

Flynn became known during the Trump presidential campaign for leading chants of "Lock her up" during rallies, referring to Trump's rival Hillary Clinton.

Trump signalled his continued close interest in the case by tweeting "good luck" to Flynn hours before the sentencing hearing. He added: "Will be interesting to see what he has to say, despite tremendous pressure being put on him, about Russian Collusion in our great and, obviously, highly successful political campaign. There was no Collusion!"

'Doesn't have anything to do' with Trump

At the White House afterward, press secretary Sarah Huckabee Sanders was asked if the administration had changed its stance on Flynn or the FBI in light of his admissions and guilty plea.

"Maybe he did do those things, but it doesn't have anything to do with the president," she said. "It's perfectly acceptable for the president to make a positive comment about somebody while we wait to see what the court's determination is."

U.S. Vice-President Mike Pence is seen during Flynn's short stint as national security adviser. Flynn's conversation with Pence about contacts with the Russian ambassador to the U.S. was given as a reason for his firing by Donald Trump. (Joshua Roberts/Reuters)

Sanders repeated her allegation that the FBI "ambushed" Flynn in an interview in which he denied contacts with Russian officials, and she said of Trump's earlier criticism, "We don't have any reason to want to walk that back."

The new delay in sentencing will allow Flynn to continue co-operating with the Russia investigation and get credit for it in his punishment. The change upset what had been a carefully crafted agreement, with Mueller's office saying Flynn had already provided "the vast majority" of information he could.

Flynn visibly shaken

Flynn, who served as national security adviser for only a few weeks, was to be the first White House official sentenced in Mueller's investigation. Prosecutors had praised his co-operation and recommended against prison, and Tuesday's sentencing was expected to be relatively straightforward. Flynn had expected to walk out of the courthouse a free man.

But the hearing turned on a dime. Sullivan lambasted Flynn for lying to the FBI in the West Wing of the White House and said he wouldn't allow Flynn to minimize the seriousness of his crime.

A demonstrator holds a sign prior to the arrival of former national security adviser Michael Flynn for his sentencing hearing at U.S. District Court in Washington, U.S., Tuesday. (Reuters)

After a prosecutor raised the prospect of Flynn's continued co-operation with other investigations in the future, Sullivan warned Flynn that he might not get the full credit for his assistance to the government if he were sentenced as scheduled.

The judge gave a visibly shaken Flynn a chance to discuss a delay of the hearing with his lawyers, and the court went into a brief recess.

Judge fires back

When they returned, Flynn lawyer Robert Kelner defended Flynn's co-operation but requested a postponement to allow for him to keep co-operating. Kelner said he expected Flynn would have to testify in a related trial in Virginia involving Flynn's former business associates, and the defence wanted to "eke out the last modicum of co-operation" so he could get credit in any sentence.

Kelner asked Sullivan not to penalize Flynn for arguments his lawyers made in sentencing memos that appeared to suggest the FBI had tricked Flynn into lying. He said they only included those to differentiate Flynn from other defendants in the case who had received short prison sentences for lying.

But Sullivan fired back.

"Neither of those individuals were a high-ranking official who committed a crime while in the West Wing and on the premises of the White House," the judge said.

At the hearing, Sullivan told Flynn that he would take into account his extensive co-operation with the government, which includes 19 meetings with investigators as well as his 33-year military career that included service in Iraq and Afghanistan. But he also said he was forced to weigh other factors, including Flynn's decision as national security adviser to lie to the FBI about contacts he had with the Russian ambassador to the United States.

The judge set a new hearing date for March. Flynn left the courthouse hand in hand with his wife, climbing into a large, black SUV as protesters heckled and supporters chanted "USA!"

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'An incredible window into the brain': New treatments target severe depression

At 35, Sharon Jakab knew something was wrong when she started hallucinating.

"I saw my grandmother on the wall in the room. She was talking to me. I wasn't sleeping, and I was a mess," she says from her home in Burlington, Ont.

About a year and a half later, Jakab was suffering from postpartum depression following the birth of her second child. It became so bad, she was suicidal. "There was a gun in the house and there were cartridges. I was all set to kill myself."  

She had to suicide-proof her home by taking away all dangerous objects, even skates, which have sharp blades.

Sharon Jakab, right, received magnetic seizure therapy this year to deal with her severe depression. She and her partner Karen Inkster suicide-proofed their home in Burlington. Ont. (Craig Chivers/CBC)

Now 61, Jakab has been in and out of hospitals, dealing with what she calls "waves of depression" that have lasted most of her adult life. She's tried about a dozen medications, including the antipsychotic drug clozapine.  "Clozapine really helped me a lot, but I still suffered from depression, psychosis and mania."

Because standard treatment like medication and therapy weren't effective, Jakab was diagnosed with treatment-resistant depression, a severe form of depression that close to a million Canadians experience.

'A huge public health problem'

Electroconvulsive therapy or ECT, better known as shock treatment, is still considered the go-to treatment but comes with the common side effect of memory loss. So doctors are now exploring less invasive experimental approaches like brain stimulation that rewires the brain's circuits. 

"Hard-to-treat depression is a huge public health problem" says Dr. Jeff Daskalakis of Toronto, at the Centre for Addiction and Mental Health's Temerty Centre for therapeutic brain intervention. "The idea that treatments that could potentially rectify or improve their illness can be very reassuring to patients."

Dr. Jeff Daskalakis is working on new ways to deal with treatment-resistant depression. One method uses magnets instead of electricity to induce a seizure in a patient. (Craig Chivers/CBC)

One of those treatments being tested at CAMH is magnetic seizure therapy or MST. A magnetic coil to the front part of the patient's head delivers a high-frequency pulse that induces a seizure. A big advantage is there are few or no adverse effects like memory loss.

"If we can limit those effects by delivering the stimulus at a much lower intensity with an alternative type of approach, in this case magnets as opposed to electricity, we can spare cognition and produce a seizure that gets people better," says Daskalakis.

Over 150 patients have received MST during clinical trials at CAMH.

Jakab  jumped at the chance of getting the treatment. "I didn't want to have ECT", she says. "I had One Flew Over the Cuckoo's Nest image in my mind," she adds, referring to the movie where Jack Nicholson gets a jolt of electricity through his head.

Over eight months last year, Jakab received 30 sessions of MST. "I felt what I call lighter, because I feel less sad, less depressed, and the suicidal thoughts diminished."

Dr. Daniel Blumberger is part of a research team at the Centre for Addiction and Mental Health in Toronto looking at non-invasive therapies for treatment-resistant depression. (Craig Chivers/CBC)

"I think what's challenging about treating depression is that everybody is different, and people come to it in a different way", says Dr. Daniel Blumberger, medical head of the Temerty Centre. "There are probably multiple different types of depression, and finding the right treatment for the right individual is probably the next phase of delivering treatment for the illness."

Blumberger has been working on a less invasive technique than MST, called repetitive transcranial magnetic stimulation, or rTMS. It delivers a repetitive burst of magnetic pulses to the part of the brain affected by depression.

Over 1,000 patients have used the treatment which lasts three minutes. A study published in The Lancet this year showed how effective the treatment is, compared to the standard length of about 37 minutes.

"The outcome can be dramatic", says Blumberger. "We will see a clinically significant response in about 50 per cent of patients, and 30 per cent of people have remission of their depressive symptoms."

'Ninety per cent of what we've learned about the brain, we've learned in the last 10 to 15 years,' says Toronto psychiatrist Dr. Anthony Levitt. (Craig Chivers/CBC News)

At Sunnybrook Health Sciences Centre in Toronto, researchers have been using a technique called MRI-guided focused ultrasound to help patients overcome hard-to-treat depression. With pinpoint accuracy, ultrasound beams heat and disrupt specific areas of the brain associated with depression.  

"The ultrasound goes directly to that circuit, makes a cut, and stops it from firing when it shouldn't be firing," says Dr. Anthony Levitt, chief of the Hurvitz Brain Sciences Program at the hospital. "This is an incredible window into the brain. We no longer have to open the skull to cause damage to the brain."

He adds, "Ninety per cent of what we've learned about the brain, we've learned in the last 10 to 15 years."

Sky Zazlov of Toronto was one of the first patients to try the ultrasound treatment in May. She was diagnosed with treatment-resistant depression in 2011.

"It seems unrelenting," she says. "I don't even know how to explain it because it's not angering, it's frustrating."

Sky Zazlov, right, with her son Isaak, was diagnosed with treatment-resistant depression in 2011. Close to one million Canadians suffer from this condition. (Craig Chivers/CBC)

Before she was placed inside the MRI scanner, technicians shaved her head and fitted her with a round metallic helmet that transmits the ultrasound waves. The procedure lasts several hours, and as the patient is wheeled out, it's too soon to know if the treatment worked.

A few months later, Zazlov is disappointed. There have been no changes in her mood. But she says she's not giving up. Neither are her doctors, who've told her it could be up to a year before the treatment provides some relief.

"I'm not looking for a magic bullet," says the 40-year-old mother. "I'm willing to put the work in, but I hope this will take away some of the despair."

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Severe shortages plunge Puerto Ricans into struggle for survival

Brian Jimenez had burned through dwindling supplies of scarce gasoline on a 45-minute drive in search of somewhere to fill his grandmother’s blood thinner prescription. He ended up in Fajardo, a scruffy town of strip malls on Puerto Rico’s northeastern tip, where a line of 400 waited outside a Walmart.

The store had drawn desperate crowds of storm victims who had heard it took credit or debit cards and offered customers $ 20 US cash back — a lifeline in an increasingly cashless society. Store employees allowed customers in, one by one, for rationed shopping trips of 15 minutes each.

Then, at noon, the store closed after its generator croaked and before Jimenez could get inside to buy his grandmother’s medicine.

“Every day we say, ‘What’s the thing that we need the most today?’ and then we wait in a line for that,” said Jimenez, a 24-year-old medical student from Ponce, on the island’s southern coast.

Hurricane Maria Reporters Notebook

People affected by Hurricane Maria wait in line at Barrio Obrero to receive supplies from the National Guard, in San Juan, Puerto Rico, on Sept. 24. (Carlos Giusti/Associated Press)

By Saturday, 11 days after Hurricane Maria crippled this impoverished U.S. territory, residents scrambled for all the staples of modern society — food, water, fuel, medicine, currency — in a grinding survival struggle that has gripped Puerto Ricans across social classes.

For days now, residents have awoken each morning to decide which lifeline they should pursue: gasoline at the few open stations, food and bottled water at the few grocery stores with fuel for generators, or scarce cash at the few operating banks or ATMs. The pursuit of just one of these essentials can consume an entire day — if the mission succeeds at all — as hordes of increasingly desperate residents wait in 12-hour lines.

U.S. lawmakers urged President Donald Trump on Sunday to stop sniping at Puerto Ricans and get to work helping them recover, two days before he was to visit the island.

As criticism mounts about a slow disaster response by Trump’s administration, residents here in Fajardo said they had seen little if any presence from the federal government. Across the island, the sporadic presence of the Federal Emergency Management Agency or the U.S. military stood in sharp contrast to their comparatively ubiquitous presence after hurricanes Harvey and Irma recently hit Texas and Florida.

Humanitarian crisis

The severe shortages have thrown even relatively affluent Puerto Ricans into the same plight as the hundreds of thousands of poor residents here. The broad humanitarian crisis highlights the extreme difficulty of getting local or federal disaster relief to a remote U.S. island territory with an already fragile infrastructure and deeply indebted government.

Even those here with money to spend now cannot often access it or find places open and supplied to spend it as stores are shuttered for lack of electric power, diesel for generators, supplies or employees.

PUERTO RICO food shortage

Residents look for food in an empty area of a supermarket following Hurricane Maria in San Juan, Puerto Rico, on Thursday. (Alvin Baez/Reuters)

Jimenez’s failed trip to Walmart came after chasing groceries at a store near Yabucoa, near where his grandmother lived. He planned to spend the next day in one of the miles-long gas lines that snake from stations onto highways and up exit ramps.

‘The gas lines are ridiculous. Fifty cars is wonderful. Most are 100-plus cars.’
– Brian Jimenez, Puerto Rico resident

At the beginning of many lines were stations already out of gas — but motorists still waited, hoping a fuel supply truck would eventually arrive.

“We wasted gas getting here and going back,” Jimenez said as he watched police usher dejected customers away from Walmart entrance. “The gas lines are ridiculous. Fifty cars is wonderful. Most are 100-plus cars.”

Another customer turned away from Walmart, Daniel Santiago, 51, said he had waited in a gas line for 12 hours one day and 14 hours the next. Neither attempt had been successful, so he, his wife and three daughters had walked 4.5 kilometres to the Fajardo shopping complex, where they waited in line for the Econo grocery.

“We have to do this every day,” Santiago said. “Yesterday, we came down walking. The day before that, we walked up a really big hill to try to get a signal to contact our family.”

That had not worked either.

Unfortunate reality

Even before the storm hit and knocked out the island’s dilapidated power grid — an outage expected to persist for months — Puerto Rico was suffering through a growing economic crisis that dates back to 2006. The island has an unemployment rate more than twice the U.S. national average and a 45 per cent poverty rate.

PUERTO RICO power outage

A woman uses a flashlight as she reads a book in darkness at her home, which is without electricity following Hurricane Maria, in Carolina, Puerto Rico, on Thursday. (Alvin Baez/Reuters)

The island had earlier this year filed the biggest bankruptcy in U.S. municipal history in the face of a $ 72 billion debt load and near-insolvent public health and pension systems.

In an interview with Reuters on Saturday, Puerto Rico Gov. Ricardo Rossello said relief efforts were still focused almost solely on saving lives; restoring basic necessities to the masses would come later.

“We’re not at the phase where we are focusing on comfort,” Rossello said. “Unfortunately, that’s the current reality that we’re dealing with.”

His team was still scrambling to open roads to communities blocked by landslides, and to deliver food, water, medicines and generators to remote homes and hospitals.

‘I have no idea how I’m going to get through the next few days. We have money, but we just can’t get to it.’– Jose Melero, Salinas resident

The island’s battered infrastructure left Manny De La Rosa, 31, to crisscross the island with his pregnant wife, Mayra Melendez, also 31. They were trying to find places to spend the $ 40 in coins they had extracted from the family piggybank.

“All of our money is held up in the bank,” De La Rosa said.

They live in Luquillo in the northeast, but found an ATM in Humacao on the southeastern coast. Their cellphones vibrated to life for the first time alongside a stretch of highway in Isla Verde, nearly an hour west of their home.

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People stop on a highway near a mobile phone antenna tower to check for mobile phone signal, after the area was hit by Hurricane Maria, in Dorado, Puerto Rico, on Sept. 22. (Alvin Baez/Reuters)

Now, they were in line in Fajardo, hoping to buy supplies with a credit card to conserve their cash.

“We see these lines, and we think, ‘We’re not even going to make it before the money runs out,'” Melendez said, standing in front of the Walmart.

Down to $ 14

In the economically depressed agricultural town of Salinas, an hour-and-a-half drive from Fajardo on the island’s southern coast, 93-year-old Lucia Santiago sat outside in a lawn chair and rested her swollen legs.

Her son, Jose Melero, 67, brought her food that had been delivered by the town’s mayor on a golf cart.

“We have to be out here, because we’d die from the heat in there,” he said, gesturing toward the house.

The two had started eating less every day to conserve provisions. That day, they had split a can of ravioli and a piece of bread.

Melero was down to $ 14 of cash without the means to withdraw more.

“I have no idea how I’m going to get through the next few days,” he said. “We have money, but we just can’t get to it.”

Puerto Rico Hurricane Maria

Ricardo Gonzalez sits on a gas container with his uncle Miguel Colon as hundreds of people wait in line to buy gasoline, days after the impact of Hurricane Maria in Carolina, Puerto Rico. (Carlos Giusti/Associated Press)

Others in isolated areas struggled to find medicine. U.S. army veteran Sandalio DeJesus Maldonado, 87, took a 7 a.m. ferry from his home on Culebra, an island off Puerto Rico’s eastern coast, to Fajardo, to refill blood pressure and prostate medications.

The hurricane had shuttered Culebra’s only pharmacy, DeJesus said.

In Fajardo, DeJesus waited at an overcrowded Walgreens because he did not have enough gas to drive to the Veterans Affairs hospital where he normally filled his prescriptions.

As he waited in line late Saturday morning, DeJesus fretted that he would not be able to return to Culebra until after 5 p.m., when the only scheduled ferry was slated to depart.

“All I need is a few pills,” he said.

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Eyeball tattoos could lead to blindness and severe infections, doctors warn

Medical professionals and body artists say the practice of tattooing the eyeball, which recently left an Ottawa woman facing the prospect of vision loss, is on the rise despite its many risks.

Ophthalmologists and tattoo studios decry the practice, saying it’s very difficult to engage in it safely.

Nonetheless, they say they hear of increasing demand for the extreme form of body modification which involves injecting ink into the whites of the eyes.

A 24-year-old woman says she has learned the hard way about the risks of the procedure.

Catt Gallinger says she recently allowed someone to dye the white of her right eye purple, but has since developed major complications.

Gallinger does alternative modelling, a branch of modelling that features models who do not conform to mainstream beauty ideals and who often have body modifications.

She has currently lost part of the vision in her swollen, misshapen eye and is facing the prospect of living with irreversible damage.

“This is a very big toll on the mental health,” she said in a telephone interview. “At this point, every day is different. Some days I feel a bit better, other days I kind of want to give up.”

​Gallinger said she has long had an interest in body modification, and especially in tattooing the white of her eye, technically known as the sclera. But she said she took the plunge without doing adequate research on the procedure.

Had she done so, medical and tattoo professionals say she could have found a plethora of evidence discouraging the practice, which has gained traction among body modification enthusiasts in recent years.

Eyeball Tattoos 20170929

Medical professionals and body artists say the practice of tattooing the eyeball, which recently left an Ottawa woman facing the prospect of vision loss, is on the rise despite its many risks. (Justin Tang/Canadian Press)

Ottawa-based ophthalmologist Dr. Setareh Ziai said she first heard of sclera tattoos as a rare phenomenon about a decade ago, but said she now learns of cases across Canada on a monthly basis.

Although ophthalmologists do occasionally use tattoo ink for medical purposes, such as to reduce glare or corneal scarring, she said the type of process Gallinger underwent bears little resemblance to those approved by the medical profession.

‘We have no idea’ of long-term impacts 

Ophthalmologists using ink inject it into the cornea in operating rooms using sterile equipment, Ziai said, adding most scleral tattoos are administered using an everyday syringe injecting the ink under the conjunctiva, the mucous membrane that covers the eye.

The area under the conjunctiva contains blood vessels, she said, meaning the ink can be carried throughout the eye and pose a greater risk to the organ. Immediate consequences of the injection can include blindness, while longer-term effects may include cataracts and severe infection, she said.

‘I would never recommend anyone get it done until it becomes something that is a cosmetic procedure done by surgeons.’
– Catt Gallinger

Most alarming of all, Ziai said, is the fact that researchers do not yet have a handle on the long-term impact of such a procedure.

“What’s going to happen when these dyes migrate to different parts of the eyeball or different parts of the body?” she asked. “Are there risks related to cancer? Persistent inflammation? We have no idea. So even if you really like what you look like and the procedure went perfectly well, we don’t know what’s going to happen three, five, 10 years down the road.”

Many tattoo artists are similarly leery of the practice, according to one Toronto studio owner.

David Glantz of Archive Tattoo Studio said he knows of very few that offer scleral tattoos despite the growing fascination with the procedure he’s observed online.

He said insurance companies will not cover studios that provide scleral tattoos, adding that no licensed training is currently offered for the procedure.

“No tattooer I know would offer it. Most of us have a conscience, would like to keep our jobs and keep making cool tattoos in whatever style we choose to work in,” Glantz said in an email. “There’d be no point to any of us jeopardizing our careers for a ‘wow, one or both of you are really daring or stupid,’ kind of story. It’s not the kind of bragging most of us are in this trade for.”

Gallinger said she hopes to see the practice become regulated and performed by highly qualified professionals.

“I would never recommend anyone get it done until it becomes something that is a cosmetic procedure done by surgeons,” she said.

“I’m hoping that that will happen, because people are going to do this either way.”

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