Submitted by Dr. Mannheimer
Chief of Staff of Inecrmere & District Hospital

Dr. Gareth Mannheimer, Chief of Staff of Invermere & District Hospital, and a family physician, provides an update on COVID-19 in our community, staying safe and 2021 developments in self-care and vaccination.

The holidays are a time for reflection, family traditions and social celebrations. Like you, I look forward to our family traditions. But let’s face it, this year will be challenging for all of us.

I’m originally from Namibia, a country located on the southwest coast of Africa. Christmas takes place during one of the hottest times of the year. Having a Christmas tree is popular, but usually, it’s a branch of a thorn tree we put up and decorate. The main Christmas meal is often a braai (barbecue) shared with family, friends and sometimes, the local community. People often travel back to their home towns from the city to spend Christmas with their families, and often they head to the coast, where it’s a bit cooler – and, you might even build a ‘sandman’ rather than a snowman! This year, like you, my celebrations will be different, but hopefully, no less joyous. When I’m not at work, I will be spending time with my family, adapting and creating new traditions in our tight little bubble.

Unfortunately, because COVID-19 is a socially spread virus, it’s also looking forward to this holiday season – just as much as we are. It’s a menace. And now, the second wave has hijacked our most treasured holiday traditions, when we are most fatigued by months of social distancing and profound changes to our daily life.

The best and worst of COVID-19

We have seen the best and worst of COVID-19 in 2020. So, let’s start with the best. Seeing the majority of our community doing your part to stop the unnecessary spread is by far the best of COVID-19. Wearing your mask, cleaning your hands and tapering down social contact have all contributed to keeping our confirmed COVID-19 case counts down. Local businesses have adhered to and even gone beyond the BCCDC guidelines in an effort to stop the spread. We need to applaud these frontline business owners and their employees for creativity with vigilance. They are superstars!

Our COVID-19 testing center at the hospital is busy. Those of you with symptoms, even mild symptoms, are getting tested. Individuals in our community who have symptoms are staying home and isolating until they have their test results. Those who are confirmed positive are being contacted by Public Health and contact tracing is minimizing spread. I want to thank everyone for following medical guidelines and best practices. We should be very proud of each other.

The COVID-19 pandemic has helped highlight the importance of self-care. Spending time outside in the fresh air, eating fresh (local) whole foods, exercising regularly and paying attention to our mental and physical health has paid off. Staying at home has provided us with constant reflection on just what a spectacular area we get to live and play in. So, continue to enjoy it – safely!

The worst of COVID-19 is unfortunately people are still getting very sick and, some are dying. In the three weeks since my last update, the total number of cases in the Interior Health Region has increased from 1538 to 3124. And sadly, the number of deaths has increased from three to eight.

As you can see in the following chart, daily case counts across the region are starting to decline from a peak of 105 new cases per day on Dec. 10. In some parts of B.C., we have outbreaks where intensive efforts are underway to contain the spread. Beyond our provincial border, the impact on our neighbours in Alberta has been very difficult to watch.

BCCDC

The good news is that we are getting detailed reporting for our community to help us see how we are doing. In the Windermere Local Health Area in the period between Nov. 29 to Dec. 5, we had zero confirmed cases and since then, we have seen three confirmed cases. Locally, we are doing great. But, we can’t let down our guard. Our success to date speaks so loudly to the collective effort we have all achieved by following medical guidelines and putting others first.

Vaccines Are Coming

Vaccines can and will contribute to getting our Valley back to normal. And, if all goes as planned, hopefully, we will be in a position to offer everyone a vaccine by the end of 2021. I know many of you have apprehensions about these new vaccines. I encourage critical thinking to seek out the facts from scientific and public health sources. And, I encourage those who are hesitant about vaccination to learn what you can about them.

I would also urge you to consider the profound impact this pandemic has had directly and indirectly on our lives. We need to recognize being able to build on the knowledge, experience, skills and tools of previous vaccine design has enabled these phenomenal accelerated vaccines to be developed without skipping any safety processes. Today, vaccine scientists have the ability to view and simulate how viruses infect cells, how the immune system responds and how vaccines will bolster this targeted reaction down to the molecular level. Compared to vaccines developed fifty years ago, it’s completely mindboggling to comprehend how far we have come in applying advances in science and technology to this global pandemic.

We are born with the most astonishing and sophisticated immune systems imaginable. On one hand, the adaptive part of the immune system is capable of learning and making the required changes quickly. Usually, the immune system gets it spot on, but sometimes the disease it’s fighting can be challenging or maybe so insufferable that we would rather not catch it at all (like COVID-19). One of the ways we can help is to prepare our immune system to fight an adversary, much like practicing a sport or studying for an exam. By allowing us to “prep” our immune system, we can ensure we are fit and healthy when we are exposed to this virus. This is why we need to keep healthy, continue to follow medical guidelines and focus on doing what we have been doing since March as we wait for the vaccines. Being prepped will allow us to protect our community, especially the more vulnerable, faster and more efficiently than if we were to all catch the infection.

Change won’t happen overnight. The trail getting us back to normal will have ups and downs, switchbacks and possibly a few closures. I stress patience. Vaccines are coming and this is what we know so far. The Government of Canada has entered into agreements to purchase as many as seven different vaccines. Any and all vaccines will require approval by Health Canada, which will also oversee distribution and vaccination. A review of the scientific data is extensive before any vaccine is approved. This review process results in different approval timelines for each vaccine, so theoretically, we could be offered any one of them, assuming each one gets approved. In total, Canada has placed orders for enough vaccine to vaccinate the total population of Canada about five times. Think of this as an insurance policy in case some vaccines aren’t approved.

On Dec. 14, B.C. received 4000 doses of the Pfizer-BioNTech vaccine, the first vaccine to be approved by Health Canada. The firsts to get the vaccine in our province were located in the Vancouver Coastal and Fraser Health Regions. Health care workers, people over 80 and vulnerable populations have been prioritized, followed by frontline workers. The Government of Canada has announced that an additional 249,000 doses will arrive by the end of December, 2020. Additional shipments will arrive throughout 2021. We expect Health Canada will approve a second vaccine made by Moderna any day now. The Government of Canada has an agreement with this manufacturer to receive 168,000 doses by the end of December, 2020 with another two million doses arriving in the first quarter of 2021. Our Provincial Health Officer, Dr. Bonnie Henry, has stated that the province is expecting to immunize 400,000 British Columbian by March of 2021. This represents eight per cent of our population. Scientific studies suggest we might need 60 per cent to 70 per cent percent of people to be vaccinated to reach “herd immunity” – the point at which COVID-19 stops spreading because there are so many people protected. This means we won’t be throwing the mask away any time soon.


Continued on page 11



Here are a few more of the trail switchbacks and closures we need to pay attention to as we move into 2021.

Make no mistake, your health care providers are eager to offer you the vaccine as soon and as efficiently as possible. Getting to 60 per cent to 70 per cent vaccinated, 3,250,000 people provincially and some 6,500 Valley residents, in a compressed timeline is a big undertaking. Keep in mind, at the same time as we roll out vaccination, we will be continuing to test, contact trace and treat. So, from a logistics and organization perspective, we will be challenged. We have plans. Be rest assured, we will proceed carefully and prudently. We will get it done. You have our commitment.

Public polls suggest up to 69 per cent of us are willing to take a COVID-19 vaccine. Unsurprisingly, of the 69 per cent of, only 22 per cent of us said we feel strongly about taking the vaccine right now. This hesitation is understandable. It’s a scary time and a scary thought. When I am confused and scared about something I may not entirely understand, I usually ask an expert. I have an expert fix my car, an expert plumb and wire my house, and an expert teaches my children. Our health experts are collectively recommending vaccination. I can assure you, scientists and Health Canada are working very hard to ensure vaccines are safe and effective. This provides me with solace and confidence. I will get vaccinated. I will happily update you on that experience and keep you updated on key developments as vaccination rolls out. Your health care team can’t wait to answer your questions and offer you the vaccine when you are ready.

  

In all likelihood, pregnant women and children will be the last to be offered the vaccine. The reason for this is based on science that vaccines must first be proven safe and effective in the general adult population. The good news is that children are mostly, spared the worst of COVID-19’s wrath, but their risk isn’t zero, and at some point, they will also be offered a safe vaccine. If you are pregnant or plan to be, please be extra vigilant in protecting yourself from the virus.

I know everyone has many questions. We are on a journey. It’s important to note there are many other things we won’t know about COVID-19 vaccines until they have been in use for years. And, science will inform our answers. For example,

How well will these new vaccines actually work? Scientists are working on these answers every day. Current efficacy estimates are based on two months of follow-up after vaccination. We will have to wait and see what science tells us.

What are the side effects and for who? Side effects in clinical trials so far have been minimal and short-lived. There is no guarantee some vaccines won’t have rare, and possibly serious side effects for some. We are watching closely and learning every day.

How long will the vaccine last? It will take time to see how long vaccine protection lasts. Nearly a year into the COVID-19, we still don’t know how long people who were infected are protected. Could re-infections carry the same risk of severe illness, or will our immune systems respond quicker and turn future infections into colds? It’s too soon to say.

Will vaccinated people need to have their immunity boosted down the road with another shot, will they be able to get the same product they got the first time, or would they get better protection by moving to a different type of vaccine? We don’t know yet but plan to find these answers over time.

What Should You Do?

COVID-19 has dramatically changed our lives in less than a year. I think new vaccine developments will also create profound changes. We are at a critical juncture with our feet firmly planted in two different realities. The best path forward is to continue the amazing work we have done to minimize infections in our community and to consider vaccination. The best advice I can give you is to follow the science. Looking back, those countries where COVID-19 had the least impact followed the science – namely, New Zealand and Taiwan. If we do this, we will beat this horrible virus. So far, we have done what is right for this Valley by holding ourselves accountable, supporting each other, following science, medical guidelines and being safe. I know we can do this if we stay calm and do it together. We are Valley Strong!

On behalf of myself and your health care providers in the Valley, from our bubbles to yours, have a Merry Christmas and a joyous holiday season.