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How Are We Doing – Part V

Dr Dina News, Infectious Diseases

Foreword: The information in this article is what we know as of November 18, 2020 – the pandemic situation is quite fluid and information can change rapidly. I post daily updates on social media and publish a weekly newsletter – click here for all my links and to subscribe. Dr. Dina Kulik

 

Hello friends!

I am back for another COVID update.

Thank you to everyone who has sent positive feedback – it is most welcome.

I started these newsletters due to the overwhelming demand for concise and up to date COVID information.

Many of you are confused about what is going on in the world, and there are plenty of conspiracy theories and myths out there.

Hope you find this helpful.

You are welcome to pass on this newsletter to friends or family, and they can sign up as well by clicking here.

As I do each week, I will start with the bad news. Hang on to your seat, this week is not very cheery.

This week Ontario updated their COVID-19 projections, and they look scary.

Some key summary points.

  • The COVID-19 pandemic continues to worsen, but the impact varies widely across communities.
  • Many countries that were late in controlling spread are struggling.
  • Long term care homes have increasing rates of COVID-19 and mortality.
  • 10% of cases are associated with outbreaks.• Indoor environments are high risk.
  • Our 5% growth will likely exceed many European countries that are already in lockdown.
  • Within 2-4 weeks, we will overwhelm ICU bed occupancy.

In other words, we have to get this under control NOW, or we are in BIG TROUBLE.

Particularly high-risk areas are Peel, York, Toronto, Halton and Ottawa, but many are on the rise.

 

As we discussed last week, we don’t know where many people with COVID- 19 were infected.

If we cannot contract trace, we don’t have control.

This is scary.

Please consider downloading the COVID alert app.

 

Some places have 10% positivity rate.

That means of 100 people getting COVID testing in Peel, 10 are positive!

Holy Moly!

These are BAD STATS.

 

 

If we keep on this trajectory, we will surpass UK and other European countries in cases of COVID-19.

This is not a game I want to win.

 

As a response to growing case numbers, Ontario moved some regions (Hamilton, Halton, Peel, Toronto, York) from the orange Restrict phase, to the red Control phase.

We are very close to Lockdown.

Other regions (Brant, Durham, Eastern Ontario, Niagara, Ottawa, Waterloo, Wellington-Dufferin-Guelph) moved into Orange, and are at risk of moving into Red.

But restaurants, malls and other indoor spaces are still open.

MANY public health, infectious disease and epidemiology experts think we need to be more strict, due to the overwhelming evidence as above, so brace yourself.

At the moment, 10 people can be indoors in restaurants for example.

Please remain vigilant.

How are we doing around the world?

Canada is getting worse, that’s for sure.

Oceana and Africa and much of Asia is looking great (or we don’t have accurate data from some countries).

It is VERY CLEAR that tight control, and lockdown does prevent infections.

But no one wants to be locked down.

Not easy decisions for sure.

 

 

It is not just new cases we are worried about, but deaths as well.

I hear from parents all the time, ‘COVID isn’t causing much death, we should consider RELAXING restrictions’.

Sadly, you are incorrect.

If you look at cases and deaths per capita in Europe and North America, we see about 1 death for every 100 cases.

This is HUGE.

 

 

Who is getting COVID-19?

Every province in Canada, and some more than others.

Notable, as always, are Quebec and Ontario, though every province is on a steep upward climb.

EXCEPT the Maritime provinces.

High five to you Maritime Bubble.

 

 

As we discussed last week – it is young people, and old people – all people.

No one is immune.

We really are all at risk.

Please move away from the mentality that only elderly people with chronic health conditions are getting COVID-19.

It simply isn’t true.

 

How are kids doing?

Evidence from around the world supports that if we keep community transmission rates low, schools can remain open, as kids tend to remain relatively healthy.

However, in Canada, the US, and Europe, community transmission rates are HIGH.

In Quebec, for example, there have been over 8,000 confirmed COVID cases in staff and students, and around 1700 schools have at least 1 positive case of COVID-19 case.

We need to remain vigilant – continue to reduce class sizes, mask when possible, ensure sick kids and staff stay home and ensure adequate ventilation.

Some jurisdictions have discussed having a longer winter break.

This may help break COVID transmission cycles. It could provide students and staff a mask-break and teachers, administrators, and the many other people who work in schools a much-needed break. But kids benefit greatly from being in school.

The CDC recently published that the mental health of kids is also suffering, with an increase in mental health-related emergency room visits.

It is a tough decision for sure.

We have seen a dramatic increase of deaths associated with overdoses, from an average of 34 deaths per week in the 3.5 months before the pandemic to 46 deaths per week in the first 3.5 months of the pandemic (38% increase).

And with another lockdown imminent, this is very concerning.

If you or someone you love is suffering from mental illness, isolation, or safety concerns, please DO NOT DELAY CARE.

 

May a vaccine be on the horizon?

You may be aware that a Pfizer vaccine was announced last week as providing immunity for 90% of individuals who have received it.

mRNA is messenger RNA. It is the genetic code that leads to the production of protein.

The idea with this Pfizer vaccine (and another one by Moderna), is that if you inject mRNA that leads the person to build some of the COVID-19 spike proteins (but not the whole COVID-19 virus), the person will start to create antibodies against COVID-19.

Researchers who are trying to create a vaccine against COVID-19 are trying to target a specific protein (such as the spike protein), versus the entire virus.

If we target an immune response against the entire virus, we risk increasing side effects from the vaccine, and also the risk of the virus mutating.

This Pfizer vaccine appears to be more effective that was expected, and relatively easy to produce in large quantities. It may also be safer than injecting the whole virus into people.

But we need lots of data.

It is possible that on further testing it is not as effective as we hoped, or there are safety concerns, or it doesn’t last as long as we want, or the spike protein itself mutates and the mRNA no longer codes for it.

Also, apparently this vaccine needs very, very low temperatures to survive, (like -80 degrees C!).

So, I am cautiously optimistic, but still wearing a mask, social distancing and washing my hands.

Make sense?

 

What do minks have to do with COVID?

COVID-19 can’t infect all living things, but apparently it can infect minks.

Mink farms in Denmark (yes this is still a huge business!) have found mutated strains of the virus.

These new strains have different spike proteins.

They have mutated already.

The ‘mink strains’ have led to outbreaks in Europe and the US as well.

This means that minks have passed on the virus to humans, and those people have passed it on to others in their communities.

If the Pfizer vaccine is targeted at the original (non-mink strain), the vaccine will not work on this new strain.

I hope you are following.

So a ‘one size fits all’ vaccine does not exist, at least not yet.

The most promising vaccine options are very specific to the current predominant strain of COVID-19, which may be replaced by another new strain, or several new strains.

Viruses are smart and mutate to make themselves last longer or become stronger.

Scary…

 

Is there any good news?

Well, yes, a bit.

The good news is the average length of hospital stay for COVID-19 has declined.

We have better treatments and fewer people are needing to be admitted to the ICU or need ventilation, though plenty of people are still getting sick and very sick.

 

 

I am sorry this newsletter is a bummer.

But I do think it is important to be honest and share the real data.

Not some hokey pseudoscience and myth nonsense.

There are countless anti-mask rallies even in our backyard, and this is dangerous.

Please continue to wear a mask, practice social distancing, and stay home if you’re sick.

Please get tested if you meet criteria in your region and consider your community and the public good when you make decisions.

We do not live in a vacuum and your hourly decisions actually have a huge impact to the global good here.

 

On to my silver linings for this week.

I admit I am an optimist.

For self-preservation, I think.

It is easy to get overwhelmed with the data and the isolation and the devastation of COVID.

But what’s the point?

I don’t suggest closing your eyes or denying the absolute crap that is COVID (clearly!), but I think it is valuable to also spend some time focusing on the greatness in my life, and the silver linings that are highlighted for me at this time.

1. Time is precious
I know, I know, people say this all the time. But for me COVID highlights that we are all at risk in some way. And I want to live each day to the fullest, within the ridiculous confines of the pandemic. I cherish every second with my kids and my husband, and my virtual calls with family and friends. We have NOW. But I still want tomorrow, so I am following all the steps to keep me and my family safe.

2. Outdoors is king
We are an active family. We love a nice hike or run or bike ride. And a lot of people are learning to love the outdoors again. It is freeing to be outside, sometimes without a mask. Fresh air. Space. Especially in the lovely, and unseasonably warm, Fall weather. I have never paid attention to the sunset. Now I try to look outside daily to catch it. It’s a simple pleasure. I can’t touch it. It isn’t tangible in that way. But it is special and makes me feel good.

3. Entrepreneurial growth
We have seen and will continue to see such remarkable innovation stemming from new entrepreneurial efforts. Many companies have been created or have sped towards new offerings in a short time period due to the various needs highlighted by the pandemic. I am excited to see what companies and products people create.

4. Global collaboration
The entire world is fighting against a common enemy. From vaccine creation to COVID treatments, researchers around the world are collaborating in unique ways, and this is something to celebrate.

That’s it folks.

I hope that was helpful and not too depressing.

Always open to feedback and love.

And do me a favor – please, please, please think outside of yourself when moving about the world. Your actions affect us all.

Stay healthy and safe.

Dr. Dina Kulik

 

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