Good morning. I will be delving into sepsis today, a life-threatening medical condition, especially if not diagnosed promptly. We’ll have more about the families fighting for better treatment in Canada below. Plus, small businesses prepare for the end of de minimis, and throwing tomatoes, but in a good way. But first:

• Russia’s overnight drone and missile attack on Kyiv has killed over a dozen people including three children and injured nearly 50, with the death toll expected to rise
• The FBI announced a domestic terrorism investigation into the Minneapolis school shooting that killed two and injured 17.
• Ottawa is encouraging Canada’s financial sector to lend to defence companies, according to Industry Minister Mélanie Joly
• In closing arguments, Jimmy Lai’s lawyers say the case against the Hong Kong publisher has no legal or logical basis

I’m Kristy Kirkup, a health reporter for The Globe.

Sepsis moves quickly and treating it is considered a race against time. It occurs when the body’s immune system reacts in an extreme way to an infection and can cause organs to shut down. A report published in the Lancet journal estimated that 75,000 cases of sepsis occur every year in Canada and it likely causes 18,000 deaths.

Today, a growing number of families are speaking out about how their loved ones died and how they didn’t receive urgent medical care fast enough to treat it. They believe their deaths could have been prevented and are speaking out in hopes of spurring change.

Last week, I wrote a story for The Globe about the death of Finlay van der Werken in February of last year.

When I spoke to his mother, Hazel, I was struck by how she is finding the strength to speak out about her son’s death while navigating profound grief. She is doing this because she wants urgent reforms to emergency room care. She doesn’t want her son’s death to be “for nothing.”

Finlay’s mom replays in her mind what happened before her son died over and over. She also feels strongly that her son’s death, which occurred after he developed sepsis and pneumonia, was preventable.

When Finlay was visibly in distress on the evening of Feb. 7, 2024, van der Werken rushed her 16-year-old to a hospital in Oakville, Ont., about 20 minutes from their home. But even though he was triaged as a “Level 2,” which means a patient requires urgent medical intervention, he waited more than eight hours to see a doctor.

Finlay went on to suffer a cardiac arrest and that afternoon was transported to the Hospital for Sick Children in Toronto where he would later be taken off life support.

Finlay’s family wants to see legislative change for emergency rooms, including an enforceable standard to ensure pediatric patients are seen within certain time frames. They also want an inquest held.

Ontario’s Health Minister Sylvia Jones told reporters yesterday the government is committed to ensuring there is sufficient staff at hospitals. In a statement, the provincial health ministry called Finlay’s death “deeply tragic and unacceptable.”

Septic shock is considered to be the final and most severe form of sepsis. Sepsis also moves incredibly fast. Every hour of delayed treatment increases mortality risk by almost 8 per cent.

Sepsis affects millions of people all over the world and can lead to serious health complications, long-term effects and deaths. In 2017, the World Health Organization declared sepsis to be a global health threat. Symptoms include chills and sweating, fever and low blood temperature and a high heart rate, among others.

In 2022, Rheanna Laderoute walked into the emergency department at Newmarket’s Southlake Regional Health Centre and died 10 days later with signs of septic shock. In the week leading up to her death, Laderoute visited Southlake’s emergency department three times.

Her sister Kassandra Costabile says the health system failed her.

“It failed to look deeper into what was causing her pain, failed to act urgently, failed to listen to the nurses who were sounding the alarms,” she said.

Sepsis Canada says despite how serious the condition is, it remains difficult to identify and treat effectively. The organization says this challenge highlights the need for action and research.

Unlike Australia and Britain, Canada does not have a national sepsis strategy.

A national research network in Canada was established through funding from the Canadian Institutes of Health Research to better understand causes, as well as look at improved prevention, detection and management, along with recovery supports.

Researchers are hopeful that innovation could play a key role in reducing the number of deaths from sepsis in Canada. For example, a team from across Canada developed a new molecular-based blood test to predict sepsis with high accuracy. It can be used with a “lab on a chip” device that delivers results within just three hours.

Last year, Nova Scotia introduced a new program to give front-line health workers in emergency rooms new tools and training to help determine when patients are at risk for sepsis.