If there is one word that I would use to describe 2020 it is uncertainty. There are lots of others but uncertainty in so many ways has been at the forefront. When COVID-19 first emerged in the early part of the year we had no idea where it would lead. Just another flu? Contained in some far away countries? A plague that will wipe us all out?
In March, we understood little about the virus – it was “novel” after all – and so there were many fears around that unknown part. Could we get it from packages dropped off by the Amazon delivery man? Would we need to wash our groceries? Will COVID-19 overwhelm our Health Care System? Will the measures we put in place to isolate and reduce spread actually work?
Now, by mid-August we have settled into a new reality. Standing on those little circles, wearing a mask and dealing with a cashier who is behind a plastic barrier has become the norm. There is less fear about the risk of spread from inanimate objects. Being able to interact with people outdoors has been a great boon. Our Health Care System was not deluged and is back to functioning, albeit with some new COVID-19 modifications. It is prepared and well positioned to deal with any new increase in cases should a second wave happen in the fall. The virus, we now know, is primarily droplet spread so hand-washing, keeping a suitable distance from others and wearing a mask when closer approximation is inevitable should pretty much keep us and our community safe.
Kingston has done remarkably well apart from the nail salon outbreak that was quickly contained. From what we are able to determine our community was COVID-free for over three of weeks until two new cases, both in their 20’s, were found on August 19. Over 2500 tests have been done in our health unit in the last seven days with a 0.1% positivity rate. This has given us a chance to enjoy more social interactions outdoors with low chance of being infected.
Many European countries, often using strict social distancing regulations, were able to bring their epidemics under control. They subsequently re-opened their economies, schools and tourist industry. Many are recently seeing upsurges in new case rates. Even Austria (and Australia, too), for some time held as a great example of success at suppressing the virus has had an upswing in cases. Good news is that, despite this uptick, death rates have not seen the same shift – yet. This reflects that we now have a better understanding of how to manage serious cases, more knowledge about transmission, and more diligence around protecting long-term care facilities and vulnerable people. We are seeing a lower rate of infection in older people who are at more risk of serious outcomes. Maybe they are being more cautious than people in their 20’s appear to be. Canadian new case rates have kind of stalled at about 350-500 per day but our daily death rates for the whole country in the past couple of weeks have ranged from 4 to 10. This compares to 150-200 daily deaths in early May.
But, There is always a but, right?
The uncertainty is still there and will likely increase in the next few months as we attempt to get back to “normal”. Cooler weather is approaching which will take us indoors. School for elementary and high school students will resume in September. We can’t keep kids away from school forever and our social and business needs will resume. There has been an obvious increase in tourism in Kingston in the past two weeks. Downtown patios are full. People can be seen wandering in clusters many are not wearing masks even when they are in a group. Restaurants have opened for limited indoor dining. Students will be returning to Queens and St Lawrence College and we know that this age group have contributed heavily to the Canadian new case figures in the past few weeks and might be less diligent in adhering to Public Health recommendations.
We will all feel anxious as these new parameters enter the mix. How can we deal with that anxiety?
Unfortunately, this virus is going to be with us for a while. Maybe forever. We will have to figure out how we best deal with it until effective immunization is available to a large proportion of our population.Even then there will be some folks who refuse to be immunized, lowering the effectiveness for achieving herd immunity.
There will be new outbreaks. But if they can be contained they will not lead to another shut-down. We will, no doubt, be inconvenienced and restricted from time to time. Over the next year, you may be required to isolate for a couple of weeks or your school/classroom/business might have to temporarily close. The ongoing surveillance, testing and quick responses to new cases by our local Public Health authorities has been impressive and has contributed to keeping our community safe. Ongoing cooperation with our Public Health officers is the essential key to success. If we continue to identify new cases early and squash opportunities for transmission, however, we will, as a community, be able to keep functioning. Advances in management will also lead to a reduction in serious complications of the infection.
The highest risks remain groups of people gathering, particularly indoors, with no social distancing and no facial coverings – especially parties or bar gatherings with clients “speaking moistly” and bending the rules for social distancing. My recommendation is to stay away from these situations and avoid any activities where people are not following Public Health advice. If you think you are in a situation where you can not keep the recommended social distancing, indoors or out, wear a facial covering. It will help to protect both you and others. Continue to wash your hands and keep your cohort of close contacts small.
We have already adjusted to the many changes in the way we interact socially. Our long term success in coping with COVID-19 will depend on our ability to continue to adapt and to follow the guidelines that our medical experts advise.
John A Geddes MSc MD CCFP