This is my 24th weekly COVID-19 update. Subscribe to Dr. Dina
I hope you and your loved ones are healthy and safe.
This is our 24th weekly update and the most sobering so far.
I can’t sugar coat it, I wish I could.
As we do each week, let’s review the bad news, followed by the good news, the most asked question of the week, and I’ll leave you with something nice to focus on, as I share my silver lining.
What’s the bad news?
I am an optimistic person. Generally speaking, I like to focus on the positive and feel little to be gained by dwelling on the negative.
We need to get real. We need to pay attention now.
We can’t skirt the issues anymore.
There have been more than 135 MILLION cases of COVID-19 reported worldwide, with almost 3 MILLION deaths.
A humanitarian crisis in Brazil rages on, with over 4,000 DAILY deaths attributed to COVID-19. There are overcrowded hospitals, a collapsing health care system, and – wait for it – a REOPENING of the economy. More than 340,000 people have died in Brazil. President Bolsonaro continues to minimize the threat of COVID-19, saying distancing and public health measures are bad for the economy, and he backs remedies such as hydroxychloroquine which do not work. There is much concern in the public health community that Brazil is a ‘factory of variants’ as the virus has more and more opportunities to mutate with so many human hosts. The P1 variant is wreaking havoc in many other countries worldwide, including (Western) Canada.
Canada has surpassed 1 million cases of COVID-19, with over 23,000 deaths. We now have well over 4,000 new cases a day. There are a lot of sick people. We have a rising number of patients being admitted to ICUs across Canada due to the dramatic uptick of COVID-19 variants of concern (VOC). VOCs are more contagious and are making more people sick. The early vaccine efforts have shifted who is ending up in the hospital or worse. We are now seeing many younger people getting sick —people in their 20s and 30s and 40s. COVID-19 is not just an illness affecting the elderly anymore, not even close.
Ontario has announced they are scaling back on ALL non-urgent procedures. We discussed last week how there is a growing backlog for non-emergency surgeries and procedures. As the healthcare system gets more overwhelmed, the longer these surgeries will be pushed back. Ramping down all elective surgeries and non-urgent activities will preserve critical care and human resource capacity and free up hospital beds for patients with COVID-19. With this mounting backlog, it will be a long time before we catch up. Surgeries being canceled include cancer surgeries and heart surgeries. Some people will experience progression of the disease until the crisis is over.
The B117 variant (first identified in the UK) has essentially replaced the ‘wild type’ (or original COVID-19 strain) as the predominant strain. We have seen a 25% increase in ICU need this week.
Things are getting serious.
The Ontario government’s health agency issued two emergency orders to help hospitals cope with the massive surge in hospitalizations and ICU admissions. The strain on the healthcare system is significant and threatens our critical care capacity.
Hospitals can transfer patients without their consent if those facilities are in danger of being overwhelmed. If you or your loved one are admitted to a hospital, you are at risk of being transferred to another hospital, against your will, if they need that bed for someone else. This is significant.
Greater Toronto Area hospitals are transferring over 100 patients to hospitals outside the GTA in the next few days to provide space for new admissions.
Health care professionals and other community care workers may be redeployed to other areas of work if needed.
For example. I am a pediatrician and pediatric emergency medicine physician. I could be called to work in an adult ICU if they need more bodies to care for critically ill patients.
I have many friends who were redeployed in the US in Wave 2. Pediatric gastroenterologists and hematologists, with no adult ICU training, were working in adult ICUs. Why? They needed more people to help care for dying adults.
We are nearing this point in Ontario. You may have heard the Hospital for Sick Kids will be taking care of young adults in the ICU. Not kids. Adults.
Some terrifying news?
There continues to be so much propagation of myths and pseudoscience—Anti-vax and anti-mask sentiment rage on. I am sent dozens of videos a day from well-meaning followers, with questions about these videos’ accuracy. I am shown convincing ‘evidence’ that COVID is a hoax. That the death rate is exceedingly low, that governments are hiding something, that leaders are just trying to control us. Endless nonsense rhetoric.
And it breaks my heart. Because MANY people are dying, and hospitals are actually full.
My ICU and emergency medicine, and hospitalist colleagues are overwhelmed. They are being pushed to the brink, with very little support from the community.
For malls to be open when our case rate and death rate was rising was a slap in the face to all of us who care for patients and provide essential care. ‘For the economy’ we keep hearing. Do you know what isn’t good for the economy? Death? You know what costs A LOT, ICU level care. It is VERY EXPENSIVE. In-person shopping in a busy indoor space to fuel the economy simply isn’t acceptable when people are dying. There are plenty of online shopping opportunities. Not to mention the tragedy of lost lives.
If one of these anti-COVID naysayers gets sick from COVID, they will surely accept healthcare providers’ help. They would surely accept an ICU bed, ventilation, medication, and life-saving support. But their preaching puts so many lives at risk. And puts those very healthcare provider’s lives and their families’ lives at risk.
We are all at risk. And we need to start looking to protect our whole COMMUNITY.
A small study came out last week in a prestigious journal, JAMA. The terrifying projections have literally left me with nightmares. These researchers predict that over 50,000 American children will lose at least one parent due to COVID. Over 40,000 kids have already lost a parent to COVID-19. 25% of those kids are under age 10. My heart aches for these families.
(It is tough to recover from that to focus on something positive.)
What’s the good news?
More Canadians have been vaccinated this week, though not by an exciting margin. 18% of Canadian’s have received at least one dose, but only 2% have been fully vaccinated. When you consider how many people are at high risk of severe COVID-19 infection (the elderly, Indigenous people, healthcare providers, teachers, essential workers, and many others), this is pretty disappointing. Trudeau says by the end of June, Canada should receive at least 44 million doses from Moderna, Pfizer, AstraZeneca.
We need to ramp this up and fast.
Question of the Week
What is the plan for Phase Two of COVID-19 vaccine distribution in Ontario?
Ontario is moving into Phase 2 of the COVID-19 vaccine distribution plan, focusing on reaching people in “hot spot” communities that have been disproportionately impacted. This phase will also prioritize individuals with the highest-risk health conditions in April 2021.
The first group of essential workers to get the vaccine includes (FINALLY!) elementary and secondary school staff, childcare workers, agriculture workers, and those that work in food manufacturing. The second batch includes high-risk retail and restaurant workers, social workers, the lowest risk retail workers, and those in transportation.
My silver lining
I have to admit I am tired. I am feeling the overwhelm of this lengthy pandemic like the rest of you. I am a mom. I am an entrepreneur, and I am a health care provider.
What encourages me each day (aside from my incredible kids, husband, family, and friends) is YOU. I receive hundreds of kind messages of thanks from you every day. And I am so grateful. I am so appreciative of the opportunity to educate and inspire you, and I humbly thank you for allowing me to be a part of your life. On a tough day, filled with disappointing stats and endless phone calls from parents with the pandemic’s weight on their shoulders, YOU lift me up and inspire ME.
I know it has been a long year. I know many of you have ‘COVID fatigue’. I know many people think it simply won’t happen to them. If there was a time to take this seriously, like really seriously, it is now.
Please follow public health guidance. Wear a mask. Only be indoors with people you live with. Keep your distance. Spend time outside. If you can get vaccinated, consider it.
But please, don’t let impatience or poor advice lead you. We know how to prevent infection. It may seem like an impossible effort to continue to protect yourself, your family, and those around you, but we know how, and you should continue to.
Till next week,
Stay healthy and safe,