Influenza is ranked among the top 10 leading causes of death in Canada. Nevertheless, we feel comfortable with the disease. It has been been with us a very long time and many people do not bother with vaccination. COVID-19 is new. It scares us.
It is already clear that, for more than 80 per cent of people who get the infection, the symptoms are mild: a cough and a fever. In the elderly and those with chronic health problems or a weak immune system, the infection can be serious and sometimes fatal.
Representatives from nearly 60 agencies spanning education, acute and primary care, long-term care, paramedic, police and municipal/social services met on March 9 in Sudbury for an all-day workshop. They met at short notice at the call of Dr. Penny Sutcliffe, medical officer of health and CEO of the Public Health Sudbury & Districts. The intent: to link community partners from across our region to ensure co-ordinated, effective responses to COVID-19.
What did we learn at the workshop?
Minimize visits to your family doctor/nurse practitioner unless seriously ill. Phone instead to get advice. Right now, the Telehealth Ontario service advertises itself as providing fast, free, general medical advice. Nevertheless, it may take three hours to connect. This service must become easy, reliable and useful.
The region will be setting up local testing sites for the virus and even home visits for this purpose. Testing is the most important tool in understanding the spread of a disease outbreak. Difficult decisions like banning gatherings require data.
Avoid going to the emergency department at the hospital for testing once the new testing sites become available.
We will need more home care in the community. As the demand for hospital beds increases, less seriously ill patients will have to be discharged. This will prove problematic because the community is already short of personal support workers. Volunteers and family will need to fill the gap. Our communities in the region should begin to enlist volunteers.
We will also need volunteers to make home visits on the disadvantaged who have no one to care for them. We need to create the database to ensure they will not be forgotten.
Ensure that we have the supplies and equipment to keep our health care professionals safe from infection so they remain able to care for the sick.
And keep the public fully informed: every day, all the time. This is essential. We need a single government representative and website who/which will provide clear, factual, reliable and sensible information to the public on a regular basis, striking just the right balance that provides both knowledge and re-assurance.
Dr. Abdu Sharkawi is an infectious diseases specialist at the University Health Network in Toronto. His Facebook post on March 5 says it all. Some excerpts:
“I have worked in inner city hospitals and in the poorest slums of Africa. HIV-AIDS, Hepatitis, TB, SARS, Measles, Shingles, Whooping Cough, Diphtheria … I am concerned about the implications of a novel infectious agent that has spread the world over and continues to find new footholds in different soil. I am concerned for the welfare of those who are elderly, in frail health or disenfranchised who stand to suffer mostly, and disproportionately, at the hands of this new scourge. But I am not scared of COVID-19.
“What I am scared about is the loss of reason and wave of fear that has induced the masses of society into a spellbinding spiral of panic, stockpiling obscene quantities of anything that could fill a bomb shelter adequately in a post-apocalyptic world. I am scared of the N95 masks that are stolen from hospitals and urgent care clinics, where they are actually needed for front-line health-care providers and instead are being donned in airports, malls, and coffee lounges, perpetuating even more fear and suspicion of others. I am scared that our hospitals will be overwhelmed with anyone who thinks they probably don't have it but may as well get checked out no matter what because you just never know...
“I am scared that travel restrictions will become so far-reaching that weddings will be canceled, graduations missed and family reunions will not materialize. I'm scared those same epidemic fears will limit trade, harm partnerships in multiple sectors, business and otherwise and ultimately culminate in a global recession.
“COVID-19 is nowhere near over. It will be coming to a city, a hospital, a friend, even a family member near you at some point. Temper fear with reason, panic with patience and uncertainty with education. Facts not fear. Clean hands. Open hearts.”
In a CBC interview, he cautioned about the implications of social isolation on mental and emotional health. “Do not hole yourself up in the basement with a can of tuna and rolls of toilet paper.”
One cannot over-emphasize the importance of awareness and knowledge even as information about COVID-19 is replaced by new information almost daily.
Dr. Peter Zalan is past president of the medical staff at Health Sciences North. His column tackles issues in health care from a local perspective. If you have a question for Dr. Zalan, email it to email@example.com.