Submitted by Dr. Gareth Mannheimer
Dr. Gareth Mannheimer, Chief of Staff of Invermere, District Hospital and local family physician, discusses the recent surge in COVID-19 cases, virus science, and reminds the community of current provincial restrictions.
Hello again. It’s been a while since I provided an update to everyone. Unfortunately, despite reassuring numbers over the summer, we have entered another challenging period with the second wave of COVID-19. I know this is putting a tremendous strain on our lives, our livelihoods and our peace of mind. Like all of you, I had sincerely hoped we would have been able to contain the spread by now. Instead, we find ourselves watching surging new daily cases, and deaths in B.C., and our beautiful Columbia Valley is, unfortunately, not unaffected. Consequently, I thought I might update you on where we are, what we can do to reduce the spread of this awful virus and protect ourselves through coordinated individual and community action to flatten the curve – again!
COVID-19 has proven to be relentless despite myths to the contrary
I’m not a politician nor a policymaker. I’m not a public health official nor a COVID-19 scientist. However, I am a front-line physician, who along with all my other medical and health care colleagues have been very actively involved in the battle against COVID-19 since early March. We have been learning and adapting to try and minimize spread and to improve the quality of care and outcomes. We care about our community, care about you and your health.
Science has shown us COVID-19 is relentless, and because it’s a novel virus, it makes everyone susceptible. It’s called a novel because we have never seen it before. The fact is that COVID-19 is in virtually every part of B.C. It is easily transmitted and is capable of causing severe illness. This isn’t a myth! The research suggests that up to 80% of those with COVID-19 have no to mild symptoms, and because they don’t know they are infected, they have no reason to get tested.
To put this into context, on average, an adult can have up to three colds a year and depending on the severity of the flu season, 5%-10% may get the flu. School-age children and teenagers may suffer from six or more colds a year, and 20% to 30% may get the flu. This means that every day there are people in our community, in our homes or social network that might be suffering from something that is not distinguishable from mild COVID-19 until tested. But, here is the kicker. Those who have it don’t know they are spreading it! This is why we are struggling so hard to control the spread of COVID-19. This creates a vicious circle, which in turn limits our ability to isolate them and to determine who they may have infected. For the more vulnerable in our community, like seniors and those with compromised immune systems – well, it becomes the dynamic that drives and places the risk on lives, overwhelms our health care resources, services, personnel and hospitals. The great irony is if we don’t control transmission through limiting community spread by implementing masking and distancing, we won’t see it coming until we test and pick up the new cases. In our Columbia Valley, we need to be focused on limiting the spread of COVID-19 by paying close attention to colds and flu as well, because they all spread the same way. Be sure to get your flu shot as a way to help minimize risk. If you aren’t feeling well, contact us and always get tested regardless of how mild your symptoms are just to be sure.
COVID-19 doesn’t care if your beliefs are right or left, whether you like to follow the rules or value freedom, or if your priorities are individual or community-centric. It’s a killer for some and debilitating for others. As I have said before, COVID-19 has the ability to overwhelm our healthcare centres and services. It also creates other significant impacts to health and well-being.
It has delayed essential treatment and services for those that need it most in surgery, cancer care and other specialty medical services. COVID-19’s ability to disrupt our lives and our health care system is unparalleled. Our focus as a community must be to minimize serious illness and deaths. We must try and do so with minimal disruption to our society while maintaining our day to day activities as much as possible. This is unfortunately easier said than done. We all have a part to play.
To save lives, we need to maintain trust and confidence in the science of COVID-19 as it is developed. Our learning curve has been steep and fast. Our learnings are from shared surveillance globally and communication with policymakers. The virus has gone through different phases over the past eight months, with slightly different behaviors along the way. This doesn’t mean the science was wrong, it means it’s evolving as the virus does. What I do believe is that we always strive to be accurate based on what we know, and recommendations are always made with everyone’s safety and well-being as a priority. But, we should know that the debate we have is based on solid scientific evidence, not political rhetoric or social media hysteria. Whether you like it or not, believe it or not, care about it or not, the current phase of COVID-19 is primarily spread by contact to a local case or cluster, and less generalized community spread. This is why our community is being told to wear masks, avoid crowded public places and keep social gatherings small. We know following medical guidelines as informed by science gives us our greatest chance to flatten the curve of this second wave.
We have also learned a few other important things:
The major source of current spread is person-to-person via respiratory droplets usually through close prolonged contact. This is most efficient in crowded, indoor and uncontrolled settings. This includes family gatherings, getting together with friends and attending events with others and especially those you don’t know.
Contaminated surfaces appear to be a less common source of transmission.
Most children appear to acquire this virus within their households with an adult as the most common source. Children are not currently the drivers of infection in their families or communities.
Transmission in schools is uncommon and children do not tend to spread the infection widely.
Our social framework is extremely complex and variable. Because of this, measuring and communicating risk is difficult and making recommendations that are proportionate to these risks is even harder to do. We know there are secondary unintended consequences of any measures, including the current drug overdose rate, worsening mental health in children, adults and seniors, impaired learning and social repercussions for our children and financial difficulty, to name only a few. Health care leaders, politicians, government officials, and public health experts are doing their best to balance individual risk with greater population risk. Our leaders are acting based on extensively considered medical scientific research with current provincial data to implement interventions and regulations that are specific and time limited. At face value, these measures and regulations can appear harsh. I know this can be deeply frustrating, but I assure you the time taken to consider and balance these risks is exhaustive. It’s a tough job.
Overall, B.C. is doing relatively well, but we are seeing a troubling surge in infections. As you can see from the following chart, there has been a significant increase in active daily cases in our region. The increase started in mid-to-late October and has continued to ramp up through November. Many have attributed this increase to close social gatherings, COVID-related fatigue and a failure to apply best practices.
Speaking to our community members, it has become apparent that there is a perceived disconnect between what is being portrayed in the media versus what is happening locally. I suspect there are many reasons for this. Some of this disconnect is related to access to our local data and the situation here in our Columbia Valley. What is undeniable is that we have not escaped the impact of COVID-19. Our Columbia Valley is categorized for data collection as the East Kootenays, and we report up into the Interior Heath region for data collection. As of Nov. 30, 47 new cases are resulting in 399 active cases in the Interior Health region. In total, we have seen 1,538 cases and three confirmed deaths in the Interior Health region. As of Nov. 19, in the East Kootenay’s, we had 68 reported cases in total and in the two weeks ending Nov. 19, we added 22 cases. The reality is COVID-19 is in the Valley and spreading.
As you can see from this next chart, COVID-19 has touched the lives of those under the age of 10 and over the age of 90 and everyone in between. It affects males and females equally.
The Second Wave Is Here
The most obvious problem is simple: our confirmed infection numbers are headed in the wrong direction. We have to seriously address these growing new case rates because hospitalizations are increasing, as are deaths and as these rates increase, so do the restrictions to curb them. B.C. has adopted a very balanced approach in comparison to other provinces and countries, but many still feel this infringes on their personal liberties. Some good news is our ability and accessibility to testing has improved significantly and, our efforts to get those individuals who have been in contact with test positive cases into self-isolation immediately, has improved through contact tracing. These tools will help, but we need to immediately and assertively make some hard choices. I urge you all to garnish the energy to redouble your efforts and follow medical guidelines and provincial regulations – individually and collectively. If we don’t, we could be facing a series of hard choices about where to deploy resources to respond to an overwhelmed healthcare system and a hurting economy. It’s a choice none of us wants to make.
In conclusion, knowing what you need to do now is tough, and it’s complicated. But we need to really consider and think about risk and how best to manage it. Understanding risk in terms of different contexts can be helpful. It’s different if you consider our risk as a community vs your risk as an individual or family. It’s hard to feel like your personal freedoms are being infringed when to you there is no evidence of this “catastrophic virus” in the streets around you, but I assure you, COVID-19 is real, it’s here, and it’s dangerous. If we can be patient, thoughtful and kind, we will be fine. Vaccines are on the horizon, and we need to be vigilant until these are approved and made available. In the meantime, we need to spend just a little more time thinking about others. Please consider our elderly, frail and vulnerable neighbours who are scared, our healthcare and essential workers who are exhausted, and our children who need to be allowed to be schooled, protected and socialised for their health. I know we can do this if we stay calm and do it together… Valley Strong.