COVID-19 Update

 Please Note: Our knowledge about best practices for COVID19 is changing all the time as new information becomes available. Please refer to our most recent update for the most up to date information.

Dear Patients,
Not surprisingly we have had a number of questions regarding coronavirus (the official name for this is now COVID-19). It’s natural to be concerned, and there has been a lot of confusion, so this will hopefully clear some of that up. The objective here is to provide practical information on how to properly protect
yourself, and what is helpful for this, and what is not. There is a lot of worldwide alarm, and while rational attention to this is appropriate, panic is not. The information I am providing is largely based on a just completed study of the spread and impacts of the condition among ~45000 cases from China.

How dangerous is it?
While all age groups can be affected, the vast majority of serious cases are people over the age of 50. Among young (under age 50) healthy people, the mortality rate is similar to the flu. For age 50-60 the risk is somewhat higher. After this the risk rises a fair bit. However, the vast majority of people still recover, even in the highest risk groups, even among those who end up admitted to hospital.
In all age groups, severe cases are also much more common for those with other health conditions, in particular heart disease, diabetes, and chronic respiratory conditions (in that order). 

What are the symptoms?
Mild cases show no symptoms at all. When symptoms are present, they most commonly are a fever, dry cough, and shortness of breath. Other symptoms such as runny nose and sore throat can occur but are very rare, and their presence suggests a different illness. 

Will there be a lot of this in Canada?
There have been about 2 dozen cases so far in Canada. The vast majority of cases remain in China. In the past 2 weeks there have been significant outbreaks in South Korea, Italy, Thailand, Iran, and Israel. Numerous additional cases have now shown up in the USA, and isolated cases in many other countries. While the spread of the virus may yet be stopped, I will not be surprised if we start seeing more cases here in the coming weeks. While other countries are starting to be affected, lost in all the confusion is that the number of new cases in China has actually started to drop. 

What should I do?
Standard infection precautions are important, and recommended at this time of year anyways regarding influenza. The virus is mainly contagious within about 6 feet of an affected individual, mostly while they are coughing. It can also linger on surfaces such as doorhandles, armrests, tables, and counters. It is not yet clear for how long it remains on surfaces.
What are the infection precautions to follow? Washing hands, especially before you eat. This sounds so simple, but is in fact highly effective. We are talking about a good scrub here, which should take about 15-20 seconds of
scrubbing, being sure to get between fingers etc. Also, try to avoid touching your own face. We all do this, a lot. Try to cut down on it. 
Do not wear a mask all the time. Masks should be worn if you are sick to prevent spreading it to others. 

What is the office doing to deal with this?
Several behind-the-scenes changes have been made to prepare for an outbreak here, and seeing affected patients in our office.
For your part, it is important that anyone who is sick, especially if you have fever, cough, or shortness of breath, inform us on the phone. We may decide to do an initial video consult in some cases. We need to know ahead of time so we can minimize your exposure time to others. If we will be seeing you in the office for a respiratory illness, please try to call us 1-2 minutes before your arrival as we may have specific instructions for you.
There is hand sanitizer at the front door and everyone, and I mean everyone, should be using this on arrival, and departure.
 We do have the ability to test for the virus, but please allow us to make the medical decision about whether the test should be done. 

Will there be any treatment for it?
Right now treatment is ‘supportive’. This mainly means providing oxygen to those who need it, which can help a lot. Some people need more advanced respiratory support. Vaccines take months to make, but numerous groups are aggressively pursuing this. There is also extensive evaluation being done with anti-viral medications to assess effectiveness. An anti-malaria drug may have some benefit, but is not recommended for use yet. It will probably be 1-2 months before any medication recommendation becomes available. 

This isn’t the first scary bug the world has had to deal with. There has been far worse in the past. Just like every other time, the best way for us to overcome this is by using our heads.

Please contact the office if you have any questions!