Today’s post about Social Distancing is pretty brief.
Look at the chart. Do it.
Sticking to the Social Distancing model is a no-brainer to me.
Maybe Grover can help us understand this concept.
Today’s post about Social Distancing is pretty brief.
Look at the chart. Do it.
Sticking to the Social Distancing model is a no-brainer to me.
Maybe Grover can help us understand this concept.
We are social beings. We all need connection. Some of us more than others. This Social Distancing thing is urgently important so we can minimize the anticipated surge in cases of COVID-19 in our communities in the next few weeks. Unfortunately, the need to socially distance ourselves is not going to go away soon.
Social distancing is not the same as quarantine or self isolation. Those measures apply to people who are returning to Canada from international destinations, people who are symptomatic and awaiting COVID-19 test results, those who have had a COVID-19 diagnosis confirmed and people who have had direct contact with COVID-19 positive cases. These folks should not mingle at all with others for 14 days or until they are deemed cured.
Of course, if you are sick you should stay home, even if it is not COVID but is another Acute Respiratory Infection. This will minimize spread but also not lead to so many others getting a cold and then worrying it is COVID-19
All the rest of us need to practice Social Distancing. This means we minimize as much as possible close contact with others as well as follow all the other the routine advice for hand washing, elbow-sneezing, avoiding hugging or handshaking and not collecting in clusters of people.
I will share with you some practical strategies that I am adopting so I can comply with the need for social distancing over the next several weeks.
First of all, I will, at this point, go for walks outside. I need to get outdoors and have some exercise. We are lucky that spring is around the corner so we can actually get some fresh air. BUT that comes with the caveat that we must keep our distance from others. The advised two metres is best. I have a couple of friends who are also following the rules with whom I will meet periodically so we can smile at each other, have a bit of a laugh together and share some conversation. But we will work to maintain the required physical distance as best we can.
When I am out I don’t touch anything that I don’t need to touch. I don’t sit on a public bench, for example. I carry a small microfibre cloth in my pocket so if I have to open doors or carry a basket in the grocery store, I can use the cloth to make the contact. When I get home I throw it in the wash. (I have a pack of 5 that I got at Dollarama). If I can open a door using my elbow or hip or a push button or Key fob I do that rather than touch the handle. I am also putting my clothes in the laundry basket if I have been out somewhere during the day so I can start with fresh clean clothes every morning. Although the virus has been shown to live on plastic and metal for up to 72 hours, it can also remain viable on clothing or cardboard for a day or so. Better safe than sorry.
When I pass someone on the street I am attempting to say Hello or Good Morning even if they are strangers. It is always pleasant to be greeted and a brief verbal hello might just make someone’s day.
I will try to go to stock up on groceries at off-peak hours. I live only 10 minutes from my usual grocery outlet so I will walk there early in the morning or go in the last hour before closing to avoid the busiest times. We are being assured that generally the food supply will not be affected. The empty shelves that you may have experienced last week are the result of exceptional panicked buying and hoarding. It will take a while for those folks to use all that toilet paper they have in their garage so that will leave some for the rest of us when we need to buy it. Same with meat and pasta and rice and flour and… There will be food. Don’t panic. And while I am at it, I will extend our thanks to the people who are working to keep us supplied – clerks, shelf stockers, truck drivers, all of you. We need you and appreciate this service.
I will still see my family who don’t live with me from time to time. We will avoid hugging or touching and we will be careful to wash our hands or anything that we might have touched. We will keep our distance as much as practical. If any of us are sick at all we will self-isolate and not expose the others.
For example, I spent a couple of hours this morning with my 8-year-old granddaughter. Kids are scared. They know what is going on and they also know that their family and friends are scared too. We were able to have a great visit, taking extra care to avoid close contact, washing our hands after handling anything and playing interactive games that we streamed to the TV. We talked about COVID, how to look after ourselves and our worries. When she went home, we both felt infinitely better. She was happy and so was I.
I have been making a point of connecting with others both locally and internationally by using FaceTime or Messenger or Skype for audio/video chats. We need to stay connected. Text messaging is fine when we are busy and have the opportunity to interact face to face easily but a smile or the sound of someone’s voice does a lot to sooth that need for connection.
The economy is also taking a hit right now and where that leads is uncertain for all of us. We have enough to worry about now without being fussed about things we can not control. None of us know what the next month or six months or year will bring. It is futile to try to plan that far ahead right now so I am refusing to spend my energy trying to plan that far in advance or think about what situation I or, for that matter, the world, might be in by then. It is best to set priorities about what we need to do now. Currently my priority is to be responsible to my community, my friends and family and to myself so as to dodge as much as possible the immediate effects of COVID-19. Catastrophizing (is that a word?) is counter-productive and I will try to avoid going that route in my head.
There have been an absolutely phenomenal number of individuals, entertainers and groups that have reached out online to help us stay upbeat and mentally busy in our distancing mode. I have looked for those and will definitely join in to pass the added alone time. I will also break out a jig-saw puzzle soon.
This will pass. Unfortunately, the need to socially distance ourselves and the drastic disruption to our normal routine is going to last for weeks or even months. It will definitely get tiresome and I am afraid that it will be too easy to put these thoughts aside and let our guard down when the sun is shining and the weather is encouraging. In order for it to work, however, we will need to stay the course. Remember that it will take some time before we reap the benefits of this challenging change in our social interactions.
Hang in. Help others. Support each other.
John A Geddes MSc MD CCFP
March 20, 2020
Addendum: Six hours after I loaded this post, Balzac’s closed (along with other coffee shops like Starbucks.
We all feel a sense of urgency to get control over this darned COVID-19. It has been encouraging to see just how seriously most of us have taken the advice of our Public Health authorities. Even those who thought this was making a mountain out of a mole hill at first are starting to realize that it is serious. It’s scary to watch what is happening in Europe.
Our schools, restaurants, theatres have been closed. We are staying home in droves and our numbers in Canada are still going up. I’ve been asked why that is so if we are trying so hard to comply with the Social Distancing advice. We are sacrificing and not (yet) seeing a benefit. What gives?
There are a few things we have to keep in mind. This virus has been in our community, hovering unseen for a few days or maybe even weeks. It has an incubation period of around 5-7 days and maybe even up to 14 days. It can remain viable and infectious on shared hard surfaces for a few days. This means that even before we started the Social Distancing in earnest, there were some of us who had been exposed, maybe thought it was a cold, and unwittingly spread it to others. So even if we all locked ourselves up 100% it would take a couple of weeks to know whether that strategy was working because some of us would come down with symptoms from being exposed prior to our isolation. We have to be patient and persistent in order to see the results of this effort.
Secondly, we have had an influx of patients who have come home from other countries. Initially this was Canda’s main source of new infections. Unfortunately, before they were aware they were sick, they were able to pass it on. So we are getting a bit of a surge from that source and their contacts. Hopefully this will not blossom again when we have an influx of people coming home from winter vacations, March break or international travel. IT IS IMPERATIVE THAT PEOPLE WHO ARE RETURNING TO CANADA FROM ANY OTHER COUNTRY SELF ISOLATE FOR 2 WEEKS. THIS MEANS STAYING AT HOME. DO NOT EVEN GO TO THE GROCERY STORE. HAVE SOMEONE DO GROCERY OR PHARMACY RUNS FOR YOU AND LEAVE YOUR ITEMS AT YOUR DOOR. Without this cooperation from our returning friends and relatives, we will expect another surge and wider spread.
Another thing we have to keep in mind is that we are trying to flatten the curve but we can’t elminate it. There will be infections. But can we keep a handle on them enough to adequately maintain our health care system so we can look after ALL our people, not just the COVID-19 patients.
The graph below shows how rigid restrictions have been effective in South Korea, Hong Kong and even China. Reported new cases in China in the last 24 hours have been less than in Canada (13 in China as opposed to over 50 in Canada.) Their restrictions have been dramatic and very rigidly enforced for a month or so. But they are winning. We want, a month from now to be winning as well.
I have been watching the numbers on Worldometer that are updated daily. If you are anxious about COVID, maybe you would prefer not to look at these. They show daily numbers – total cases, number of new cases in the past 24 hours, number of new deaths, total number of deaths and number of people who have been diagnosed and recovered. The last column, the number of cases per million population, is the one that interests me most and will be the one that we want to see level off if our management is being effective. Currently Canada has 17 cases per million population. Compare that to Italy where that figure is a startling 591. Our cases per million number will rise quite a bit over the next two weeks but if we are successful it should start to become more stable. That’s what flattening the curve means.
Realistically, we should prepare ourselves that the restrictions are not just going to be a 2 week thing. We are in this for the long haul. It is going to take several weeks or even a few months to get this to a manageable level. I can’t imagine that schools will reopen before the end of this school year. We will have to adopt these principles of Social Distancing for the next foreseeable future. Eventually we will find a medical treatment for this, I think. Immunization will be developed eventually as well. With time, there will have been enough people who have had the virus and recovered with some natural immunity to lower the prevalence and thereby lower the potential of spread. We need a concerted effort from everyone to tackle this. It will sort out. But it will take time. Hang in. Stay the course.
For a bit more on Flattening the Curve and Social Distancing, check out my last blog article here.
John A Geddes MSc MD CCFP
March 18, 2020
I have had some excellent questions come to me as a result of my recent blog articles and am happy to respond with my opinions which are, I hope, knowledgable but I will reiterate that I don’t claim to be a world expert. I am giving you my opinions as a local family doctor and neighbour.
One question that I thought was a very good one went something like this. “If the number of cases under the curve on the graph are the same, the blue ones the same as the red ones, why don’t we just let this virus run it’s course and get it over with quickly since the curve shows that the illness will deplete faster with the red curve. Get it over with.”
If we quickly look at the graph, that seems like a very logical question and the idea that eventually at least half of us are going to get this virus, one way or another, would suggest that we might as well just bear it now and get on with it. More people will have immunity and the virus will run out of steam.
The problem with this view is that we are not looking at that dotted line that indicates what our Healthcare System capacity is. If we go for the red curve you can see that very quickly we will overwhelm what resources we have to manage it. Conceivably the number of people infected if it is totally out of control might not be 50% but 70%. As a consequence, many more people will die because they will not have access to life-saving ventilation or hospital care.
A younger demographic may argue that the severe illness and death rates are in the elderly and those with chronic illnesses mainly. That fact is true, but others do succumb from this virus. And if the hospitals and medical staff are depleted of resources and spaces, where will your kid go when they are hit by a car and have a head injury, or you have a heart attack and need bypass surgery, or your sister needs cancer surgery or your wife has a postpartum bleed? The argument is not entirely about suppressing the total number of cases, but about making the inevitable manageable so we can continue to provide adequate health care to all.
I think many senior folks (I don’t like being called elderly) will agree with me that we might have a bit of a fatalistic attitude to the prospect of death from this virus. We realize that we will all die sooner or later. For those of us over 70, there is a bit more sooner and a bit less later in that equation and we know it. Sure, we think about our increased risk, but I suspect most of us worry more about our families and friends than ourselves.
To put this in perspective, let’s say in the greater Kingston area we have about 200,000 people. If half of those gets COVID-19 in the next few weeks that means 100,000 infections. Of those, 80,000 will take acetaminophen, stay home from work, feel lousy but get better. That will mean 80,000 people off work for at least two weeks, by the way. Another 10,000 will need some sort of medical care and a further 10,000 would benefit from hospitalization. Do we have 10,000 hospital beds to offer them? Even more drastic is that 5,000 will need ventilation. We have 35 ICU beds currently at Kingston General Hospital and they are usually full with people who need immediate intensive care with things other than COVID-19. So where will these 5000 people get their needed intensive care? Maybe we could handle it if they came in slowly but in a glut, the system would be overwhelmed and unmanageable. Bear in mind that with a high peak that means more health care workers would also be ill and out of commission to serve as well.
The proposal is that if we follow the advice we are receiving for Social Distancing (in addition to all the handwashing, sleeve-sneezing advice) we can spread these infections out over time. Flatten the curve. Perhaps, if we can slow the spread over the next few weeks or months, science will come up with an anti-viral medication that can blunt the curve even more. Eventually there will be immunization available. People will develop natural immunity. With time the infection rate will slow down. China has put very stringent social interaction controls in place. In the last 24 hours, China has reported 24 new cases. Canada has had 89.
I present this to you to emphasize that we need to be doing everything we can NOW to minimize the shape of this curve and keep the inevitable crisis to within manageable bounds. I saw a headline somewhere that said “This is not a snow day.” We will all be required to sacrifice in some way in order to keep our community as safe as possible from a situation that could overwhelm our Healthcare System and be detrimental to us all, not just our vulnerable elderly neighbours and relatives. We can not just think about “me” but rather aim to help “us”.
John A Geddes MSc MD CCFP
March 15, 2020.
Consider this. Three weeks ago, on February 22, 2020, there were 11 known cases of COVID-19 in Italy. Since then, there have been over 15,000 diagnosed cases and 1000 deaths in Italy alone that have resulted from this viral infection. Italy now has a COVID-19 case rate of 250 per million population. The country has an excellent health care system but it has been overwhelmed. One might expect that the death rate is going to go up more because many seriously ill people will not now be able to get the intensive care they need. There are just not enough resources to cope with the rapid spread of the virus. The country is shut down and suffering badly both medically and economically.
Today, in Canada, with a population half that of Italy we have 122 known cases, a rate of 3.2 per million. This changes by the hour. Where will that be three weeks from today? We need to do whatever we can, and do it now, in order to mitigate the effects of this infection in our communities.
In Canada, we have a couple of advantages. Italy has a slightly older proportion of people over 65, those who are at highest risk for serious consequences of COVID-19 (22%) compared to Canada (17%). Their population of 60 million, nearly twice that of Canada’s, lives in a much smaller geographic area and therefore are living closer together in general. Most importantly, North Americans have had some advance warning of what COVID-19 can do, how it is spread, and what measures can best be taken to control it. Hopefully we can take what we have been able to learn from this head start in China, other places in the Far East and Europe and quickly – very quickly – change our behaviour in order to lessen the eventual impact this virus will have on our communities in Canada.
We have heard the “wash your hands”, “cover your nose when you sneeze” and “stay home when you are ill” messages and I suspect most of us are complying with those suggestions.
Another significant factor that has reduced the rate of spread of this disease and has been proven to be effective, both in the past and in some countries that have instituted it seriously for COVID-19 is Social Distancing. The reason this works is because COVID-19 is spread by droplets, not by fine little viruses floating around in the air. When an infected person sneezes or coughs, the droplet spray from their mouth or nose can travel a few feet but not more. If we are in the way, we are vulnerable. It may also land around them and live for some time (there are varying estimates how long and I am not going to spread inaccurate information to you). If you pick up the virus with your hands touching the sprayed-upon item you might then transfer the virus to your face and nose and become infected. Hence the hand washing advice.
So, increasing our comfortable social distance and minimizing close contact of numbers of people in close approximation to us is imperative. This is why in the last 24 hours we have learned that all schools in Ontario will be closed for two of weeks after next week’s March break, that the NBA and NHL have suspended the rest of its season (Netflix night in Canada replacing Hockey Night?), and that the Kingston Canadian Film Festival made the difficult decision to cancel the remainder of the festival after only one day. We all need to be supportive of this strategy, both for our own benefit and that of our community.
In the next while we will all be significantly inconvenienced by school closures, lack of availability of some items at the stores from people hoarding, cancellation of entertainment events and sports competitions and we will all have our anxiety piqued by the general sense of panic around us. Younger people may realize that their risk of death from this is much less than older people but it is not zero. They must also adhere to our community restrictions for the benefit of their neighbours and friends and parents and to avoid over-taxing our health care system which is already running at near capacity. If we can “flatten the curve” of this illness we can deal with it If it comes in a surge we are going to be overwhelmed.
I am 72 and hate to be called “elderly” but, in this case definition, I qualify. People over 70 have a 10% or more chance of becoming seriously ill with this virus or dying from it. Seniors with health problems like heart or lung diseases are at even greater risk. They should pay even more heed to the social distancing message.
So, what is my advice?
If you are sick, stay home. Don’t go to the Emergency Department. You might call your Family Doctor’s office for advice and to know if you need to be seen. There is no treatment for this illness at present so resting, taking medication to lower fever and drinking fluids is all that you can do. If you are becoming increasingly ill, you need to talk to your family doctor’s office about where to present for assessment and treatment. There will be designated regional assessment centres and you should not show up at the wrong place where you might contaminate other vulnerable people.
Wash your hands whenever you come in from being out somewhere or use hand sanitizer if you can find it available.
Cover your nose and mouth when you cough or sneeze.
Be ready to be in isolation for 14 days if you become infected. Develop a circle of friends or relatives who can support each other by bringing groceries and leave them on your doorstep if you are in isolation. It is probably reasonable to have some extra pasta or soup or cereal in your larder but hoarding should not be necessary and even makes things worse for others. In Italy, where most of the country is currently shut down (including tourist sites, restaurants, cafes, churches) the grocery stores and pharmacies have remained open.
When you do go out, think about keeping a reasonable distance (at least a metre) from others. Don’t shake hands or hug when you meet a friend or colleague. The old elbow bump would be more appropriate (if you have not just sneezed on our sleeve, of course.)
If you are over 70, you might want to limit your exposure by staying away from group events, exercise classes, theatres, festivals and even church if you can not keep a metre between you and your neighbour. The more you are exposed in a group, the more chance you have of being infected. Even people who are in the incubation phase with no symptoms can shed virus and be infectious for a couple of days before they realize they are sick.
Help each other. We are all in this together. We need to be cooperative, to listen to our Public Health Leaders and to follow instruction. This is a time to think about our community, manage our health care resources and support our family and neighbours. The measures i have talked about have been proven effective. But only if we follow them.
Although i am a pretty fearless traveller, I have decided that, until this has all stabilized in some way, I will stay in Canada where I can access my health care, not have to worry about international travel restrictions or being quarantined in some other country. There will, no doubt, be good travel deals to be had while the tourist industry is struggling but I prefer the safety and security of home for the time being.
Our municipal, provincial and federal governments, led by public health experts, are evaluating the best course to be taken to reduce the stress of this outbreak on our communities in terms of health and economics. There is no right answer. This is unproven ground and you can see that the situation changes daily. I think we need to be patient and trust that our community leaders are assessing and making decisions that are in our best interest and I am glad that they will guide us through this turbulent time.
I was astounded when my previous blog article was shared and read by over 40,000 people in three days. I thought I was writing it for 50 of my Facebook friends who were asking me questions. https://johnageddes.com/2020/03/08/coronavirus-in-kingston-canada-my-take-on-what-we-might-expect/
I soon realized that there is a thirst out there for some common sense advice from a regular Family Doctor and so I hope that this is helpful as an update for a crisis that seems to change by the hour. I have had lots of questions in the comment section of my previous article and am willing to answer any that I feel qualified to answer if you post it in the comments. I am not claiming to be an “expert” but I try to be a rational, down-to-earth family physician who has tried to keep up on the medical writings about this serious and unique health crisis. I hope these suggestions are helpful to you in wading through this quagmire of information about COVID-19.
John A Geddes MSc MD CCFP
March 13, 2020
Check out this article about how social distancing (or lack of it) was shown to have an effect on spread of influenza in the 1918 epidemic in the US.
16 days after the beginning of the outbreak, the Italian government took decree today to take exceptional measures to contain about 16 million Italians living in 14 provinces in the north of the country, as well as restrictive measures covering the whole country. [source]
– Lombardy region (entire region, all provinces)
– Piedmont (provinces of Alessandria, Asti, Novara, Verbano Cusio Ossola, and Vercelli)
– Veneto(provinces of Padua, Treviso, and Venice)
– Emilia Romagna (provinces of Modena, Parma, Piacenza, Reggio Emilia, and Rimini)
– Marche (province of Pesaro Urbino) In the above areas:
There has been a lot written and published about COVID-19 and I don’t want to add to the barrage of information out there. But I thought I could give my friends some indication of what I have learned and what to expect with regard to current status about COVID-19 as it pertains to our Kingston, Canada community.
In some ways, we are lucky that we are farther down the chain. Our Public Health authorities have had the advantage of seeing how this is playing out in other parts of the world and how the virus is behaving so appropriate measures can be taken to limit its effect here.
The numbers around the world change by the hour. For up to date numbers you can see how many people have been diagnosed worldwide and in every country (and their outcome) on this website. https://www.worldometers.info/coronavirus/
This novel coronavirus was unknown only a few weeks ago and currently there are over 100,000 cases and there have been 3600 deaths. Using these figures, gives a death rate of over 3%. The death rate from influenza which causes thousands of deaths a year is 0.1%. In other words, according to current worldwide figures, COVID-19 has about 30 times the death rate of influenza. This figure may be a bit high as there are likely undetected cases in the community which would skew the denominator but even conservative estimates indicate that COVID-19 is at least 10 times as deadly as influenza which causes about 3,500 deaths in Canada and over 50,000 deaths in the USA annually.
Of those who contract the virus, 80% will have relatively mild symptoms – cough, fever and shortness of breath – that will resolve in a few days with symptomatic treatment. Another 10% may develop pneumonia (viral or a superimposed bacterial pneumonia) and require additional support. Another 10% may require hospitalization and 3% will die of complications of the infection.
Currently the highest death rate occurs in people over the age of 70 and particularly those with other chronic diseases like diabetes, COPD, cardiovascular disease and high blood pressure. If you are under 50 and in good health your risk of dying from this virus is minimal but you might have a couple of weeks when you are sick. You will, no doubt, know people who become seriously ill and who die from this virus.
As for your kids and grandkids, for some reason, not yet understood, children either tend not to get this virus or are not significantly affected by it. It may be, however, that children can present a minimally ill or asymptomatic reservoir that can spread the virus to others who are more vulnerable.
The virus attacks and replicates in the lungs primarily and as lung cells are compromised, breathing becomes more difficult. Any illness associated with significant fever also causes malaise, muscle aches, headaches and fatigue.
The virus spreads by droplets from sneeze or cough. Droplets containing virus can also be on hands, phones, desks, coins or any other surface. If you are within a metre or so of people who sneeze or cough without covering their face, or if you handle some object that has been contaminated by infected hands or droplets from sneezes and then touch your face, you may become infected,
The incubation period from exposure until when symptoms appear is about 5-7 days. Most people who have been exposed and will get ill, should show signs of the illness by 14 days.
The test for the virus is a Nasopharyngeal swab. This is done by advancing a swab through your nostril to the back of your throat for a sample. It is uncomfortable but not painful. Currently there there are an adequate number of swabs to test and identify patients who are most likely to be infected and the turnaround time for a test, done in Kingston, is 24 hours. If you require a test, you will be asked to self-isolate until the results are back.
The 95% of people who acquire this virus and recover from it will likely develop immunity, at least for a few years. Only time will determine with certainty how we respond with acquired immunity to this virus but one hopes that it will be like how we react to similar viruses.
There is no immunization yet for this virus and it will take at least a year to get one. longer to have it widely distributed. Having an influenza shot is a good idea if you have not yet done it BUT the FLU shot does not protect from COVID-19 (just as it is not effective for the common cold).
There is no current treatment, other than symptomatic management for the disease in the 80% who are mildly affected. These folks should NOT go to the Emergency Department or even to their doctor’s office. They should self-isolate at home for 14 days, use fluids, and acetaminophen or ibuprofen. Cover their mouth when sneezing or coughing. Avoid close contact with others in the household. Do not go to the store or out to places where you are in contact with others. You might wear a mask to avoid droplet spread to others but masks are now in short supply so you may not be able to get them. Masks in public to prevent getting the disease are not effective and not necessary.
People who are more significantly ill with an Acute Respiratory Illness (ARI) of cough, fever and shortness of breath should call their doctor’s office for information as to where to be evaluated. In all likelihood, there will be Regional Assessment Centres set up in our community where all people with ARI will be evaluated and tested if deemed necessary. This will avoid anyone with COVID-19 passing the virus on to other people who are seeing their doctor for other reasons and may be more at risk for serious complications. Currently the testing in Kingston will likely be for anyone presenting with an ARI and who have been outside Canada in the previous 14 days since person to person spread in our community has not been happening – yet. Yes, this means if you were in Florida for Spring Break and within 14 days develop a cough or fever, you will be sent to the Regional Assessment Centre and be tested. Drive-through testing might also occur. You wind down the window of your car and are swabbed through the open window, thus avoiding contamination of others in an office or waiting room.
Even those who are not ill or are minimally affected should be prepared to be significantly inconvenienced by an outbreak which will inevitably arrive in our community. There may be school closures and cancellations of sporting events or conferences or meetings. Certain travel might be curtailed. Theatres or any place where people may be congregating within a metre of each other may be closed. You may be required to self isolate (stay home) if you have been in close contact with a known COVID-19 case or if you have returned from traveling to a high risk area – and these are increasing all the time.
So, if most people have mild illness, what’s the big deal?
This is a totally new virus and none of the 7.7 billion people in the world will have acquired immunity to it. (Except the 60,000 who have had it in the past month and have recovered.) We are all susceptible.
This virus is readily transmitted by droplet spread.
We have no treatment to cure it.
It will be at least a year before immunization is available.
It has a high death rate for vulnerable people.
It will put a huge strain our health care resources if it comes in a big wave.
We can not prevent this virus from hitting our community but we can dampen the spread by diagnosing and isolating positive cases, avoiding close contact with others in group events, avoiding shaking hands or hugging friends or co-workers, washing hands regularly with soap and water or using a 60% alcohol hand sanitizer (currently not available as it has been sold out), and avoiding touching your face.
If you have symptoms or if you have been diagnosed by swab, you MUST self isolate. This may seem like a bother if you are only mildly ill but you need to avoid spreading this into the community and to others who may be at much higher risk.
If we can flatten the curve of infection in the community using the above measures, we will be able to deal with those who are more seriously ill with the virus. If there is a huge spike in cases all at once, the health care system will be overwhelmed, there will not be enough beds to support those who are seriously ill and health care workers will also be affected and need to self isolate which will cut the number of health care providers who can look after the acutely ill.
If you want to see the restrictions ITALY has put in place today, March 8, 2020, to try to curb spread of this virus for the above reasons, check here : https://johnageddes.com/2020/03/08/restrictions-applied-in-italy-on-march-8-to-curb-spread-of-covid-19/
All this is changing day to day. I have tried to give a current status of how we are or might be affected in Kingston. We have to hope that there will be a slow infection rate so our system is not overwhelmed. If we are lucky, there may be some abatement over the summer (we don’t know if that will happen yet but it does with influenza) but, even if that happens, it will definitely be back with a vengeance next fall as immunization will still not be available at that time and there may be more asymptomatic or mild cases throughout the community.
I hope this information is helpful to you. We will be OK in the long run but there may be some bumps along the way. Be glad that you live in Canada where we have a capable, publicly-funded health care system.
John A Geddes MSc MD CCFP
March 8, 2020