Hospital’s chief of staff answers your questions on COVID-19

Dr. Gareth Mannheimer answers common COVID-19 questions and encourages continued caution

By Dr. Gareth Mannheimer, chief of staff of Invermere & District Hospital and local family physician

I would like to thank the majority of the community for continuing to act responsibly. This new reality is clearly getting more frustrating, particularly with the weather getting better and most of you wanting to get on with your normal lives. The state of emergency in B.C. as per Premier John Horgan is still in effect. While we all want to get back to normal, this is going to be a phased and thoughtful process. Unfortunately, it’s going to take time. Dr. Bonnie Henry, Provincial health officer, has said people need to “think small” and plan for a future that allows for physical distancing, including virtually or with a reduced number of people. I suspect the only realistic way we will see any easing of current restrictions, is if we continue to keep the spread of this virus controlled. This will require continued vigilance by each and every one of us.

All the sacrifices made are paying off and will continue to pay off, if we stay vigilant. Please, let’s not squander our hard-won gains. Make the sacrifice now so that we can get to a “new normal” as fast as possible. Keep in mind, this virus has up to a two-week incubation period, so health care workers haven’t yet seen the effects of people coming together over the Easter long weekend, or those who traveled unnecessarily in or out of the valley over the last couple weeks. It is this incubation period that dictates why the decisions around restrictions are made in two-week increments.

I know everyone has lots of questions. I am going to do my best to answer some of them.

Did members of our community get COVID-19 and is it still in our valley?

Yes. We have had positive cases in the valley as recently as last week. The virus remains in our community. COVID-19 continues to be spread here. Remember, it is possible to be infected with the virus and not show any symptoms. There are two kinds silent spreaders: the “asymptomatic” (people who carry the virus in their body and never get sick) and the “pre-symptomatic” (people who have been infected and are incubating the virus, but don’t show symptoms yet.)

Another common form of transmission is via people with very mild symptoms. A COVID-19 infection is often generally mild. And that’s really the secret to its aggressive and worldwide spread. People with very mild symptoms feel a little unwell, but continue to come in close contact with others. Unfortunately, these people often continue to frequent public places with a light cough or fever, and may unwittingly spread the disease in the early days of symptom onset, perhaps at the time they are most infectious.

Will COVID-19 come back to the valley?

The virus is already here. As we increase our testing, we are seeing more evidence of its presence. This increased testing is slowly giving us more meaningful information on actual infection rates.

Won’t COVID-19 go away like the flu?

The reality is we don’t know. This virus is novel. Scientists have studied the seasonal flu for decades and, despite its danger, we know a lot about flu viruses and what to expect each season. Very little is known about COVID-19. It’s a bit of a wild card. We are learning details in terms of how it spreads, how far it spreads, under what conditions it spreads, and how many deaths it will cause as we try manage it.

What is likely the most important factor is that we do not yet have a cure or a vaccine for COVID-19. We are still unsure if the new coronavirus will react as the seasons change, or if summer will do anything to alter or slow the spread. Until this critical information is clearer, we will likely see recommendations to err on the side of caution, and will continue to push for social and physical distancing. Right now, all we can control is our behaviour. We know from our own data over the past month that following the Provincial guidelines work, if we all respect the rules. If guidelines are ignored, the risk will be a second wave of infection and prolongation of all rigid restrictions. I ask each, and every one of you, to do your best and be the model of responsible behaviour.

Are the local medical clinics open to address my medical needs other than COVID-19?

Yes. Both Invermere Medical Clinic and Chisel Peak Clinic are open and providing consultations. The majority of these will be telephonic or via video, but in circumstances where you need to be seen in person, these are also being arranged.

Regardless of whether or not you have a family physician, we are ready and able to help all of you. We are pleased to welcome Dr. Cooze to our clinic team for a few months. Dr. Cooze is available to assist all patients as well. We will do what we can to get you treated. We are in this together and we are here for you.

  • Invermere Medical Clinic (250) 342-9206
  • Chisel Peak Clinic (250) 341-6900
  • Invermere & District Hospital (250) 342-9201

What do you think getting back to normal will look like?

We don’t know. Any decision to lighten restrictions will be slow and phased. We need to build community immunity and prevent any rapid spread or transmission. We remain concerned about sudden outbreaks and clusters.

There will likely be criteria and timelines set out by Provincial leadership, informed by medical experts, before businesses and public spaces return to normal. States of emergency can only be issued two weeks at a time in B.C.. It is my expectation that data-driven information, involving the health risks posed, will inform any actions on how we gradually return to normal. We do know the way we interacted, shopped and ran our businesses in the past will change.

Rapid response antibody testing will be increasingly important in shedding light on the extent of COVID-19 infections in B.C.. To know you are immune would provide important information to help get people back to work, and feel safe moving around the community, while we wait for a vaccine to be developed and approved.

What will happen if we get a second wave?

Our focus is firmly on playing it smart and staying apart. We know from our own experience and the experience of countries such as South Korea that social distancing, hand hygiene, travel restrictions and the use of cloth face coverings are important in mitigating a second wave. We do feel that if we experience a second wave, it will come because we relaxed these measures prematurely.

Second waves often occur when new cases emerge after a period of time with no to very few infections. Past pandemics of infectious disease are characterized by waves that last several months. The Spanish flu epidemic in 1918 had three waves with the second wave being more deadly and severe than the first. Today, we are watching China, South Korea, Japan and Singapore carefully for important insights on what we can learn and put into practice.

When will we have an effective vaccine?

Best current estimates are 12-18 months. Vaccine development is time consuming and requires multiple phased testing to ensure safety. Be assured, researchers from around the world are working to develop a vaccine at an unprecedented pace to ease suffering, and to get us back to our lives.

Should I be afraid to visit the hospital if I get sick or injured?

No. People can and will get sick and injured during a pandemic. We encourage you to try call us first to best direct you. If you have an emergency, please go to the Invermere and District Hospital immediately. If you have questions, please call the clinic where you normally receive care.

Why do we not have clearer and stronger rules about what we can and can’t do?

The COVID-19 situation in B.C. continues to evolve. Realistically, it is impossible to provide rules for every situation. Instead, we rely on Provincial and medical guidelines. This means in the absence of clear-cut rules, we must use common sense to apply, develop, adhere and remain vigilant in adopting and living each day with best practices.

If I own or am responsible for an essential service what should I do?

Control the risk of exposure. Focus on maintaining healthy and safe workplaces while balancing the needs of customers and staff. Focus on best practices from Work Safe BC to limit exposure, maintain distance and ensure adequate hygiene to mitigate exposure. Build a solid plan, train your employees, talk about developments and talk about any concerns they have. Call us if you need any help or information. If you need personal protective equipment (PPE), please contact echandler@shaw.ca.

What can I do?

The best way for you to help is to remain diligent and vigilant. Help and support one another safely. Now is the time to be hopeful, but we are not out of the woods. We can say in a very guarded way we are doing our part to flatten the curve, but what this really means is we have, so far, avoided the surge. We aren’t done. It’s not time to host a neighbourhood party. It’s not time to have friends over to the house for dinner or children over for a playdate – we aren’t there yet. We are social. However, I would urge you to stay social, but try to do it in new and safe ways. This is hard, but we can’t give up now while we as a community are collectively winning this fight.

Let’s give thanks to those who are out there every day for you. If you want to thank your health care workers, our local heroes working in the grocery store and the pharmacy, those providing take-out and delivery, truckers, and essential services – do it by protecting them! Stay at home, stay apart. You aren’t doing it just for yourselves, you are doing it for everyone.

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