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.

Hi everyone,
I would like to provide you all with some further feedback and guidance regarding coronavirus. There will be an additional update later today or tomorrow. As you know, it has been declared as a pandemic. It has become quite serious. This isn’t the first pandemic the world has had, and thankfully, we have an immense amount of useful information already on how to deal with this one.

Before getting into that, let’s highlight one of THE most important aspects to dealing with a pandemic. That is, slowing it down. Pandemics can happen slow or fast, and this makes a *critical* difference in the consequences. Everything we
do now must focus on slowing it’s pace. 
 
Why?
When an infection spreads around we can get a surge of patients at doctor’s offices and the hospital.  Let’s focus on the hospital. If an ICU has 10 beds, and 20 people all have to go to an ICU today for 1 week that is a big problem. But if we can slow down how quickly people get sick and need the ICU, so there are 10 this week, and 10 next week, there are enough ICU beds for everyone. Same total number of people sick, just a different time frame. We need to enable that. This has become known as ‘flattening the curve’. It is proven to work, as far back as the Spanish Flu of 1918. We need to minimize the strain on doctor’s offices and the hospital so all the coronavirus patients AND all the other usual care can continue to be provided. We’ll tell you how you can help with this below.
 
What is a pandemic?
So now that this is a pandemic, what does that actually mean? A pandemic is when an infection is spreading all over the world in a sustained manner. As opposed to an epidemic where an infection is more localized (usually defined as
1 country). So basically there were a bunch of coronavirus epidemics (in China, South Korea, Italy and so on), but so many countries are now affected that it is reclassified as a pandemic. A pandemic may not cause a lot of trouble, it just depends on how dangerous the virus is. It remains the case that the vast majority of people recover from this coronavirus, but it is also dangerous enough that we need to take this seriously.
 
So what can you do to help?
You have no doubt heard that you should wash your hands. This cannot be emphasized enough. It is likely the single most effective action you can take. Critical times are before you eat, and if you were recently in a public place. Think about what you have been touching…Handrails? Doorknobs? The doors themselves? Countertops? Absolutely any surface on a bus or skytrain? Contact with any of these should prompt you to wash your hands. Nose itchy? Use a tissue. Eyes itchy? Use a tissue. But preferably only after you washed your hands.

Those of you with kids should be on the lookout for them to do the same. Insist they wash their hands when they get home. I know schools have been great about going over this them over the past couple of weeks.

Try not to touch your face. This is actually incredibly hard to do. Most people touch their face without even noticing it several times per hour. This is why it is so critical to keep your hands clean. It is the most likely way you can get infected.

You have probably heard of the term social distancing. What does that actually mean? It literally means keeping your distance. The virus most likely spreads up to about 6 feet around a person. As far as we know so far, it does not linger in the air, and so is mainly an issue when you are close to someone. It CAN however linger on surfaces, possibly for a long time. So avoiding touching affected surfaces, and avoiding crowds, or at the very least trying to stand apart from a crowd will help. Now is not the time for big gatherings and parties. No handshakes. No fistbumps. No elbow bumps.
  
So how do you greet people? It’s called “hello”, and it comes with a smile.
Do not. Do not. Do NOT go out in public if you are sick. If you absolutely must, then that IS the appropriate time to wear a mask. Wash your hands REPEATEDLY, and try not to touch anything. Life will eventually go back to how it was before, and other countries have proven this is possible, but for now staying home when you are sick may literally save a number of lives. If someone can bring something to you, ask them to do so. They can leave it the door for you. Perfectly safe.

Please take extra careful consideration of protecting the most vulnerable. If you have elderly parents, or perhaps family members with chronic health conditions such as diabetes, heart conditions, or asthma, then all the above becomes that much more important. The vast majority of serious and deadly cases remain in people aver the age of 60, and in particular with other health conditions. It is important to recognize however that this is potentially serious at any age, and even among young people the mortality is a few times higher than the flu. There is no known death worldwide in a child below the age of 10. 
 
Office Protocols, a review:
Anyone with any infection type illness MUST CALL the office. There will be specific instructions for you. We will be trying to minimize your time in the office. It may be that the entire story is collected from you remotely, and the only thing that happens at the office is that a swab is quickly done. Further discussion may follow by phone/video consult.
 
We have been taking many steps already to prepare for this, and we will continue to adapt as we go along. All of us however can make a difference, and it mostly takes changing our behaviour for a little while. Let’s encourage each other. Let’s look out for each other. As your physicians, we are there for you!