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A local doctor perspective on COVID-19

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Submitted by Dr. Leah Koetting on behalf of the Swan River physician group.

“Well, doctor. Don't you think people are overreacting just a bit? Blowing things out of proportion?” That is a question I've been hearing a great deal lately. It appears that there are two types of responses to the spreading of Covid-19: downplaying, or buying all the toilet paper.

Perhaps the most appropriate response is somewhere in between.

First, what is the social isolation for? If nobody in our health region has the virus, why do we have to distance ourselves?

Covid-19 is spread by droplets. Whenever an infected person coughs, sneezes, or exhales, the virus travels on droplets of moisture. It's estimated that these droplets can travel about 2 metres (6 feet) before settling onto surfaces (although it's possible they may travel further). Once on a surface, they have been found to survive for up to nine days. It's beginning to appear as though some people may be able to spread Covid-19 without even showing symptoms themselves. This may be particularly true of children, who don't get very sick with Covid-19 infections, if at all.

The purpose of social isolation is to keep all of us far enough apart that the virus can run its course in the sick people without making anyone else sick. Those who must be close to other people who have or who are at risk of having Covid-19 need to wear protective gear, like masks and gloves, and wash surfaces carefully.

This is why we screen. Right now, all but one of the cases of Covid-19 in Manitoba are travel-related. That is why you are asked about symptoms and travel. We are only testing people who answer yes to the screening questions. (If you are wondering if you should be tested, you can call HealthLinks, or you can use the online screening tool at manitoba.ca/covid19/.)

Some people have suggested to me that, since there are only seventeen sick people in Manitoba at this time, this social isolation might be an overreaction. Where's the crisis? Where's this so-called pandemic? In fact, the reason we do not (yet) have a crisis in Manitoba is because of all the precautions in place.

People and businesses have been doing everything they can to protect themselves and one another. Some stores have closed. Events have been cancelled. The clinic has moved to as many virtual or phone appointments as possible and is postponing non-urgent care, like physicals. Elective surgeries in the province have been postponed.

This is not an overreaction. The reason we are doing these things is to slow the spread of infection as much as possible. This is what is meant by “flattening the curve.” The curve refers to the graph of the number of cases infected over time. If we do nothing, the curve will be sharp, and tall, and the number of sick people will vastly outstrip our healthcare resources. But with precautions, with the social isolation we are practicing, we can slow the rate at which new people are infected. Even if, at the end, the same number of people get sick, the slower rate ensures we have enough healthcare resources to manage all the infections with the best possible care, which will reduce the overall deaths. This is why we are going to all this trouble, and why the precautionary measures continue to expand.

But the precautions only work before the infection arrives, not after. Countries around the world and even certain communities in Canada have discovered this: without a plan in place in time, the disease spreads from person to person in community and quickly overwhelms local resources. I am grateful that Manitoba has been so proactive.

The problem is that the novelty will soon wear off. People will get tired of this isolation business, or, more to the point, may no longer be able to afford it. People required to self-isolate may run out of paid sick time, if they're lucky enough to have it in the first place. Folks who live paycheck to paycheck (and that's many people), are looking at the months of unknown stretching away into the future with fear that they will not be able to make ends meet.

This is a scary time.

So how can we help one another to survive this, and continue to keep the virus from spreading?

Look around your neighbourhood. Many of the elderly have been encouraged to stay home and remain socially distant even without a history of illness or travel, simply to keep themselves safe. Are there elderly or shut-ins around you? Consider delivering groceries to their doorstep. Or packaging up a home-cooked meal to share.

Do you know any healthcare workers who are panicking because of the closure of schools and daycares? Perhaps you could consider watching their children a few times a week, so that our front-line care providers can continue to provide high quality medical care for non-Covid-19 patients, and make sure precautions don't slip because of understaffing. While it is true that watching a neighbour's child is slightly less socially isolated, that's still much less exposure than a classroom of thirty children. Perhaps healthcare families could take turns watching one another's children.

The personal care homes are no longer allowing visitors at all, and all the residents' activities have been cancelled. Perhaps you have some games or books or puzzles you could donate. Perhaps you and your children, enjoying this unexpected time at home together, could make encouragement notes and cards to send to residents in the care homes to brighten their day.

Continue to support local businesses as much as you can. Stay home, certainly, but consider ordering in from one of our fine restaurants. Or order a delivery meal to a sick or shut-in friend or neighbour.

If you are having financial difficulties related to self-isolation or business closure, reach out for help. Call Service Canada to find out what federal aids are available, or contact the financial facilitator at the clinic to help you explore your options. Consider contacting your bank, credit card, or utility companies to figure out creative repayment options for once you're able to get back to work.

We are living in a strange and difficult time. As in any difficult time, we have a choice. We can focus on the lack of certain supplies in the store, on the inconvenience of having to arrange alternate childcare, on the uncertainty of how we're going to get by financially. These are all real problems. But grumbling about them doesn't make these burdens any easier to bear. Throughout the hardest times of history, humanity has shone brightly through. Men and women have chosen to reach out and help others, focus on what joy there is to be had, and “keep calm and carry on.”

Every evening at 6pm in Italy, people open their windows, get out their instruments, and sing together. At the time of writing, over 3,400 people have died of Covid-19 in Italy, over 900 of them in the last two days. The medical system is so overwhelmed that they have protocols to determine who will get ventilators and who will not. They are no longer able to treat Covid-19 infected individuals over the age of 80. It is terrifying and tragic, and it's not over. And yet, the people sing.

I have written before about the amazing community of Swan River, and how very special it has become to me. You people are made of tough stuff. Caring stuff. Determined stuff. I believe in the power of “us.” If the people in Italy can sing through their sorrow, I challenge this community to find ways to shine light and comfort around us as we all go through this adventure together.

 

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