Foreword: The information in this article is what we know as of November 25, 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
Well hello, friends!
Welcome back for round 6.
If you are feeling stressed, anxious, or overwhelmed, you have every right to!
I’m with you!
I’m a mom of four.
I’m a front-line health care worker. And
I’m an entrepreneur.
Every week that goes by we get more irritated, feel less in control, and more helpless.
It’s frustrating, draining, and exhausting.
I feel you.
I think it is important to find someone (like your friend, partner, parent, dog…) to chat with to express yourself.
Vent a little.
Go for a run.
Punch a pillow or scream into one.
Get it out!
But also: Try to think and talk about something that isn’t COVID related.
A lot of my friends literally only talk about COVID. Eat, sleep, and dream COVID.
And that isn’t healthy either.
And, as always, if you are feeling really down, really anxious, are having concerns about your safety or the safety of those around you, please, please, please, reach out for professional help.
The amount of significant mental health concerns is skyrocketing.
You deserve to feel well and happy and healthy.
So, before we go on, I want you to think about this for a second.
Promise me that if you are feeling emotionally unwell, or know someone who is, you will reach out to a mental health care provider, or the emergency room, and stay safe.
Ok, on with the show.
Let’s start with the bad news.
Toronto and Peel are in lock-down.
By now you know that the Ontario government is shuttering most non-essential businesses, including gyms and personal care services, and will prohibit sit-down service in restaurants in Toronto and Peel.
This will last until a least December 21, 2020. This is legit! Ontario now has over 100,000 confirmed COVID infections.
Other regions, such as Waterloo and Durham have moved to the ‘red zone’ (see last week’s newsletter for a breakdown of these zones).
The idea for lockdown is to ensure schools and daycares can remain open, by minimizing the risk of spread outside of these settings. There is a real risk of overwhelming hospitals and ICUs in particular.
Here is a summary of the new lockdown restrictions:
Public events and social gatherings:
All indoor organized public events and social gatherings are prohibited (other than with those you live with already).
Restricted to 10 people, with physical distancing maintained.
Places of worship:
Restricted to 10 people indoors and 10 people outdoors (including religious services, weddings, and funerals).
Publicly funded schools in Ontario and child-care centers will remain open.
Post-secondary institutions – virtual instruction only.
Some exemptions for clinical training and trades.
Restaurants, bars, and clubs:
Indoor and outdoor service is prohibited.
Takeout, drive-through service, and delivery are permitted.
Retail and other businesses:
Non-essential retail stores – restricted to curb-side pick-up or delivery.
Essential businesses such as grocery stores, convenience stores, hardware stores, supply stores, alcohol stores, pharmacies will remain open and be limited to 50% capacity.
Gardening centers and motor vehicle establishments will be open by appointment only.
Customers are required to stand two meters away from each other.
Personal care services, such as hair salons, are closed.
Casinos, gaming establishments, cinemas (except drive-ins), and performing arts facilities are closed.
Sports and fitness centers:
All indoor sports facilities and fitness centers are closed.
Outdoor fitness classes will be limited to 10 people.
How will the government decide when other regions go into lockdown?
It’s pretty vague, but regions will be moved into a lockdown if they see “adverse trends” after entering the “red” zone.
• Increasing weekly positive cases
• Increasing weekly positive cases among people over the age of 70.
• Increasing outbreaks among vulnerable populations or congregate settings
• Hospital and ICU capacity at risk of being overwhelmed
• Public health unit capacity for case and contact management at risk or overwhelmed
Why are we being so strict?
Cases are going up.
This is Canadian data.
In graphical form. That looks like a pretty big wave to me.
And it isn’t just older people getting COVID anymore. Not close.
In last week’s COVID cases: 54% were under 40 years of age, including 19% under 20, 19% between 20 to 29, and 16% between 30-39 years of age.
This is my age cohort and many of you.
It’s very real everyone.
And where are people getting COVID?
Still a lot in long term care facilities, but also a lot in school and childcare centers.
How is the world doing?
Much like last week really, with some increased case rates in Africa.
COVID-19 cases are increasing pretty much around the world, save for the incredible, strict and conservative, Oceana.
Do masks really prevent COVID-19?
You may have heard about a recent study out of Denmark DANMASK19, that wanted to see if surgical masks protect the wearer from CIVID-19 infection.
Half the subjects wore a surgical mask when going out, and half did not.
They found that 1.8% of those wearing a mask were infected after 30 days, and 2.1% of those not wearing a mask became infected.
So, masks don’t really help prevent infection, right?
Masking is just one strategy that helps keep COVID numbers low.
By itself, it is not the be-all and end-all, unfortunately.
Masks help prevent infection when we look at infection rates on huge population bases, not just a few thousand in one study.
They found a 0.3% difference between the two groups.
What if we were looking at the population of Ontario, about 15 million. 0.3% of 15 million people is 45,000 people.
To prevent 45,000 infections, I would certainly be game to wear a mask.
Those 45,000 people are people’s daughters and sons, and parents and friends.
These are valuable real human lives we are talking about.
And it is just a mask people!
I’ll add that the ethics of this trial is sketchy! We think masks help, and they actively told people not to wear them. Hmmm…
Even if the benefit of masks is less than we think, they certainly do help prevent other illnesses, and we want our community to remain healthy anyway.
I don’t know about you, but (knock on wood), I haven’t had even a runny nose in 10 months.
Dr. Dina, what’s the good news?
A great piece of news is that kids are staying pretty healthy, even when infected with COVID-19.
Though more kids are being diagnosed, not many are getting sick enough to need hospitalization.
It is gone up in recent weeks but remains pretty low (17 hospitalizations reported in kids < 19 years this past week in all of Canada!).
Where are we at with vaccines?
We spoke about the Pfizer vaccine and the Moderna vaccines this week on Instagram, and last week in the newsletter.
By the way, if you want daily COVID updates and tons of other helpful parenting/kids’ health advice, check me out on Instagram (and Facebook, YouTube, Tik Tok, LinkedIn, Pinterest…). I’m always @DrDinaKulik.
We spoke about how these vaccines are mRNA vaccines.
The vaccine is a genetic code to create the spike protein of COVID inside our body, which will lead to an immune response and antibody formation.
Then when our body is exposed to COVID-19, it starts to fight it, as the immune system is primed to attack it, with antibodies already present.
Moderna announced this week that their phase 3 trial mRNA vaccine is 94.5% effective.
Then Pfizer announced that their vaccine is 95% effective (but needs to be kept at -70 degrees!).
Finally, Astra Zeneca announced that their vaccine which uses chimpanzee adenovirus to deliver COVID-19 particles to again have the body make antibodies is also looking safe and effective.
This vaccine is more similar to existing vaccines we have for illnesses we currently vaccinate against.
It’s a race, my friends.
I hope some of these options turn out to be safe, long-lasting, cheap, and easily accessible.
As a reminder though – these companies announced their findings in press releases. NOT in published, peer-reviewed journals.
I am hopeful and cautiously optimistic but will not be throwing away my masks yet.
I will continue to keep distance, wash my hands, and stay in my bubble.
And you should too.
Public health and infectious disease experts suggest that vaccination efforts will be unlikely till Fall 2021.
We are in this a while friends.
Unless COVID-19 randomly mutates and… poof-disappears.
With so much chaos in the world right now, I do like to turn my attention each week to some silver linings.
It keeps me feeling mentally ok, to be honest.
1. It’s been pretty darn nice outside lately.
Perhaps I am just overly happy to continue to spend time outside, without a mask, but I do think this year is warmer, and I am savoring every last second of unseasonably warm weather. We are loving biking and playing soccer outside and will keep doing that till there is snow on the ground.
2. We are watching our kids grow and develop before our eyes.
Our older three were in programs once they were 2, and we didn’t see them except at breakfast and dinner on weekdays. Now, our four kids are home all day, including our three-year-old who would ordinarily be in programs. Even though I work at Kidcrew each day, I am in the house till 9:30 am and home by 5 pm. My husband is with them all day. We see them so much more, and we are watching them mature and learn and become little men right in front of us. That is an incredible blessing. Even on days when we wish we had more separation!
3. I’m motivated every day by our incredible Kidcrew family.
My awesome team comes to work every day, eager and dedicated, even though they are putting their own health at risk. And it is a high-stress job, dealing with stressed and overwhelmed parents. As a team we have bonded, our focus and commitment to our patients’ have never been stronger and we realize how blessed we are to have jobs and an amazing group of colleagues. Love you guys!
That’s it for this week.
Stay healthy and safe.
Hug your loved ones (that you live with!) and cherish them.
See you next week (and on social daily!)
Dr. Dina Kulik
PS. I’m hosting 2 free webinars this week, focusing on better sleep and better rest. Click here to register.