COVID -19 will be a threat we have to deal with for the next several months and possibly years. So we need to find a way to reduce its impact on our physical and mental health and our society as a whole.
Part of that transition involves cautiously opening up the economy and getting kids back to school. This makes us all anxious because our generation has not been in this precarious position before. We find ourselves faced with a threatening new virus – a global pandemic. The whole world is wading through a quagmire where there is no sure footing.
I have children who are teachers, grandchildren who are pupils, family who are health care providers and I have been back to working as a physician and teacher of Medical Residents for the past three months both in a clinic and in a small group at Queens. I get it. I understand the angst about going back to work and school. Where I am working we are not doing things the way they were done before but we have been able to find a balance between providing service and taking care not to spark COVID-19 transmission. It has meant several adjustments, wearing a mask for several hours at a time, keeping a reasonable distance between people where possible and respecting others. It has not proved to be that hard to do. Schools will have a similar transition period filled with uncertainty and change and angst but I hope that, with time and inevitable adjustments, teachers and students will find a safe balance point.
There will be pockets of COVID-19 that spring up menacingly in localized schools, neighbourhoods and cities. We are in a much better place now to deal with those clusters than we were this spring. What we have learned about transmission and mitigation strategies may be able to help contain outbreaks and avoid a generalized surge that would require a more widespread shutdown.
Our Public Health authorities are preparing for these inevitable challenges, armed with better testing, improved availability of health care resources and ever increasing knowledge about the virus itself. We now know how to more effectively contain it and have improved management for patients who become severely ill. I have pointed out before that our Canadian numbers seem to be hovering for the past several weeks at a daily new case level of around 500 people per day. Despite this, our reported death rates are staying very low, averaging 4 per day over the past week. In May we were averaging around 150 COVID-19 related deaths per day in Canada! Let’s not lose sight of this good news. Are you aware that, by comparison, on average every day in Canada 11 women die as a consequence of breast cancer and around 12 people die of opioid overdoses? The Canadian Government reports that “Every hour, about 12 Canadian adults age 20 and over with diagnosed heart disease die.”
Now, this is not to downplay the consequences of the current COVID-19 pandemic in any way and other long-term consequences of having had a COVID-19 infection have not yet been determined with any certainty. We are being bombarded, however, with daily statistics about COVID-19 but we are not updated every day on how many Canadians (228 on average) have died in the previous 24 hours of cancer. COVID-19 is scary, but we have been made more frightened by the daily global focus on its statistics. Can we govern our behaviour based on responsible common sense rather than fear?
What do I think should happen now?
Cautious reopening of schools and offices is important to reestablish whatever normalcy we can find in this new pandemic situation. Children need to play and learn with and from each other. Following whatever public health guidelines are advised is important. Masks and social distancing as much as practical and minimizing opportunity for spread within a school cohort will be challenging but we won’t know until we work with it and make the necessary adjustments as time goes on and as we learn more.
What will I personally do In the next few months?
I will continue to work. I will follow the restrictions and Public Health guidelines that will, no doubt, change from time to time, particularly if there is some increase in COVID-19 in our community. I trust the judgement and advice of our local Public Health Unit and know that whatever recommendations they put in place are based on the best epidemiological and medical information available and done with the safety of our community in mind.
I was glad to see that the beach at the Gord Downie Pier was closed off entirely this weekend after a couple of days when young adults swarmed to the beach area and appeared not to be taking the required precautions. I hope that our city officials and public health can keep an eye on any elements in our community that are not respecting the current recommendations and move to enforce these with authority. If we don’t follow the rules, we will lose privileges. This applies to restaurants and businesses and movie theatre and schools and churches. And beaches
I will avoid crowded indoor environments. If I find myself somewhere that I think the required precautions are not being respected I will leave, and if I feel it is a significant infraction, I will report it to Public Health.
I will wear my face covering in any situation where I am exposed to people outside my close social circle where I am not able to adequately distance myself. This includes all indoor spots like cafés or stores or offices but I will also put my mask on outdoors if I find myself in the midst of a number of people. And, by the way, the mask doesn’t work if you wear it below your nose.
I have installed the COVID app on my phone and hope that you do too. This will ensure that if I have been in close enough contact to establish Bluetooth connection with another phone and that person, who may have been standing in line behind me waiting for the bank machine for 10 minutes tests positive and subsequently enters a confidential code, I will be notified that I should watch for symptoms and maybe get tested as it appears that I have been close to a person who has COVID-19. This will only work if lots of people do it. It will help in Public Health tracing for community transmission. Do it, please.
I will stick to myself if I am sick in any way. If my symptoms include cough, shortness of breath or fever, I will get a COVID-19 test. This will become simpler over the next months when rapid tests that only require a saliva sample are approved and become widely available.
I will keep a small circle of social contacts who I trust are also being cautious. We have been enjoying outdoor summer patios and walks but as the weather closes in, this will become more difficult. Indoor dining at restaurants poses a higher risk of transmission and if there is any increase in community cases of COVID-19, I will stick to meals at home. I will try to help the food hospitality industry by ordering take out or home delivery. It is not the food that is a risk, but groups of people sitting around indoors for a period of time, all without masks as they eat and chat.
I will not go to bars or indoor parties.
I will not travel outside my community for a while, apart from occasional visits to kids and grandkids in Whitby.
I will be eager to get my annual flu shot and whenever safe COVID-19 immunization is available I will take it.
I will be respectful of people who have views who are not the same as mine (like anti-vaxxers and people who balk at wearing masks ) but that doesn’t mean I have to mingle with them. I have clear boundaries about what I will tolerate or how I will protect myself and others and will adhere to them.
I remain guardedly optimistic that we will pull through this unprecedented disruptive time with lots of inconveniences but hopefully with minimal serious illness or loss of life and manageable strain on our Health Care System. It requires cooperation and diligence from all ages and segments of our community. We are certainly in a much better position in September to manage the challenge than we were when this was all brand new in March. Stay the course. We will get there.
John A Geddes MSc MD CCFP. Kingston, Canada.
This is an op-ed. It is my opinion. Yours may differ. What we know about COVID 19 is changing every day and depends on the current situation in your district. We need to be flexible and adjust to new reliable scientific data.