Stress and Anxiety and COVID During The Holidays

Foreword: The information in this article is what we know as of December 2, 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.

 

Hello friends!

I realize that some of you have been forwarded this newsletter from a friend and may not actually know who I am. Let’s start from there!

My name is Dr. Dina Kulik, most commonly referred to as Dr. Dina (or even just Dina or Dr. D by many of my patients!).

I am a pediatrician and pediatric emergency medicine doctor in Toronto.

I founded Kidcrew, a multidisciplinary kids health clinic dedicated to being the One-Stop for Kids’ Health™.

I am a mom of four young sons, and now three Portuguese Water Dogs. We have a busy house, and I thrive in organized chaos!

Thanks for joining me again for this week’s COVID-19 update.

I do hope one day soon I will be able to share with you a newsletter that isn’t just about COVID…

I continue to be overwhelmed by your kindness and words of encouragement as I produce these each week. It does take a fair bit of time, but I remain committed to providing you timely and evidence-based information.

There is too much nonsense out there, anti-science and rhetoric to weed through.

Here, we have facts.

Please remember you are welcome to share this with loved ones, or friends and family are welcome to subscribe here. The more the merrier from my perspective.

To subscribe go to drdina.ca/links/

As we do each week, I will present a lay of the land, in this case, the bad news. Then I will share some good news and my silver linings for this week.

The bad news

“Dr. Dina, how is Canada doing?”
(sorry, it’s the bad news)

Image Resource: CTVNews

Here is how Canada is doing right now.

You can see that Alberta, British Columbia, Manitoba, and Saskatchewan are not doing very well (considering where they were at a few weeks ago), but Ontario is starting to look a bit better, as is Quebec.

We are not looking good, mind you.

But not terrible.

Who is getting COVID-19?

Graph Resource: Statista.com

As you can see, over the last few weeks I have demonstrated that COVID-19 is NOT a disease of only elderly people.

Young people get COVID-19.

They don’t tend to get as sick and are less likely to die from COVID-19, but they do get infected. A lot.

How sick are people getting?

The brilliant Dr. Jennifer Kwan, a family doc in Ontario creates these incredible graphs for us over on Twitter at @jkwan_md

You can see that we don’t have as many people hospitalized now, but the wave is-a-rising.

Same with ICU non-ventilated patients and ventilated patients.

I hear people tell me daily that people are not really getting sick from COVID-19 anymore as they did in April and May.

Not true.

151 people in Ontario ICUs fighting for their lives is a lot.

These are people’s brothers and sisters and children and parents and friends.

How are we doing around the world?

Resource: New York Times

Pretty much the same story as last week.

The United States is a mess.

Much of Europe too.

Lots of South America and Canada are not looking great.

And check out Africa and South East Asia. Goodness friends, you are still doing so well. Bravo.

What’s the good news?

I have called out Australia for their ongoing success in preventing the devastation we are seeing in much of the Western world.

BTW, half my family lives in Aussie. My youngest son’s name is Austin, and we call him ‘Aussie’.

I love Australia and my family there dearly.

What did Australia do to prevent illness and death?

Australia quickly and tightly sealed its borders, which many countries, such as in Europe, did not do.

Australia’s states shut domestic borders or severely limited interstate and intrastate travel.

Contact tracing and testing to prevent outbreaks was done on mass.

Most importantly though, was that leaders across the country persuaded Australians to take COVID-19 seriously very early and prepared them for the likelihood of lockdown or restricted freedom.

The prime minister worked with all premiers to coordinate decisions.

This was done together.

With clear messaging.

The public was given the same information, unified.

They are one team on the same mission.

Australians saw their politicians working together to avert a health crisis.

The politicizing and polarizing that we have seen in other countries has most certainly led to more COVID-19 spread.

And for what?

Where has that gotten us?

I applaud Australia for their swift and decisive and collaborative action.

And guess what?

They will be having parties and events and group gatherings far sooner, with fewer deaths and significant illness because of that.

So, what’s the good news here? If you don’t live in Australia?

We know what to do!

We know how to beat this thing.

We just have to DO those things.

Are we seeing a lot of Influenza this year?

NO!

Here is the data from the WHO.

Resource: World Health Org.

The good news is that influenza activity is lower than expected for this time of the year.

This makes sense.

If we are doing what we need to do to prevent COVID – namely hand washing, keeping distance, wearing masks, and staying home if we are sick – we should see very little flu this year.

In the northern hemisphere, influenza activity is below typical levels, though some cases have been reported, as well as in some countries of Western Africa, Afghanistan, India, Lao People’s Democratic Republic (PDR), Thailand, and Vietnam.

Worldwide seasonal influenza A (H3N2) viruses accounted for the majority of influenza cases.

This, by the way, is not a nice flu strain, as it can cause severe influenza illness, and was responsible for the 1968 flu pandemic.

We hope the numbers of flu cases continue to be low, as many of us are worried about what it looks like if a person becomes infected with COVID-19 AND Influenza at the same time.

Both are respiratory viruses, and both can make you very sick.

Hope we don’t have to see what that looks like.

How are we going to get through the holidays?

Many of us are feeling stressed or sad about the upcoming holiday season.

We want to be with our loved ones.

We want to share meals.

We want to rejoice and be with one another.

Here’s the thing though.

The more we avoid contact with others, the faster this will be over.

It isn’t complicated or unknown.

It is true.

Even if you live somewhere that is not currently in lockdown, I strongly suggest you pretend you live like you are in lockdown.

There are cases of COVID everywhere, and numbers rising every day.

Every single new case of COVID-19 counts, and more cases mean more risk of a lockdown or even schools closing.

Please be cautious.

As I have said since March, I believe conservative is king here.

I worry about people who live alone.

I don’t want anyone to feel isolated at this time, or any time.

If you live alone, please try to find a family you can spend time with.

As a real bubble, like you, are part of their household.

If you don’t live alone, but know someone who does, consider bringing them into your bubble.

These acts of generosity will not go unnoticed.

If you want to be with other family or loved ones over the holidays, please, please, please isolate and quarantine for 14 days beforehand.

This means each individual sees only those individuals, and NO OTHER PEOPLE, x 14 days.

Unfortunately, daycare, school, and workplaces are exposures.

If you want to prevent spread within your holiday bubble, every single person in that group has to seriously minimize all other exposures.

Minimize close interaction, wear a mask, wash your hands often, don’t touch your face, don’t be in a crowd, don’t go into other people’s homes, or have people in your home, keep 2 meters of distance, and be outside when with others, and even then, ideally with a mask and distance.

Ideally for 14 days, but if you can’t do 14 days, more is better than less. 5 days isn’t enough. Do at least 10. Ideally 14.

Vaccine good news?

There has been tons of news recently about the Moderna and Pfizer vaccines.

We discussed these in the last few newsletters.

While they both seem to be strong contenders, they will require Health Canada approval.

Some important points though.

They are not coming tomorrow.

They may not even come in the next few months.

Hold your horses.

We know they confirm some protection.

We do not know for how long they prevent COVID-19 infection.

We don’t know how to store vaccines at -70 (Pfizer requires this). I certainly can’t at Kidcrew.

We don’t know much about the safety profile.

Are there short-term side effects?

Are their long-term side effects?

These vaccines are newly created and have been around only a few months.

Also, there is a risk that COVID-19 will mutate and be resistant to these vaccines, and anyway, vaccines don’t necessarily eradicate all diseases.

Who will get the vaccines first?

My infectious disease and public health colleagues think it’ll go something like this:

– health care workers and adults in long term, care facilities may receive a COVID-19 vaccine by Summer 2021,

– other older adults and vulnerable populations by Fall 2021

– and the rest of the population by Winter 2022.

NOT TOMORROW.

If they work.

If they provide (somewhat) lasting immunity.

If they are safe short, medium, and long term.

But guess what?

We know how to prevent COVID-19!

Resource: World Health Org

This isn’t new.

And I don’t want to be facetious, but it’s true.

Movements to remove masks and fill up restaurants because ‘our freedom is at stake’ threaten our entire world.

It isn’t politicians or health care providers taking away your freedom.

It’s this freaking virus.

It sucks!

We want to be with our friends and family and roll back the clock to 2019.

But, sorry, we can’t.

We simply don’t have a choice but to do what works for now, as much as it sucks.

“What are your silver linings this week, Dr. D?”

Why thank you for asking:

1. We are so gosh darn resilient!
Many of us are suffering in some way, whether it’s emotionally or financially or in health. But there is meaning and purpose in moving forward and looking towards a time when COVID-19 is a thing in the past (I wish I could fast forward too!)

2. Mindfulness and work-life balance:
I have a sharper focus on what I value most in life, professionally and personally. I am more aware of how I spend my time and who with, and how to be most efficient with my time, what venture to work on, and how to focus my tasks. I am more mindful to allow interruptions that provide me joy, like a cuddle with a kid or a brief belly rub for one of my dogs, even if they may make my task take longer. I am thankful for the opportunity to have that cuddle or moment to play and relish in that.

3. Compassion, courage, and selflessness
I am so proud to be a health care provider in this chaotic time. The compassion and courage I have seen in my colleagues during this pandemic is incredible. Especially when teams often are understaffed and overworked, and sometimes, under-protected. I have immense pride in being a physician in Ontario working with incredible team members.

That’s it for this week.

Thanks for tuning in.

Please remember to do what you know we need to do to keep you, your loved ones, and the entire community safe and healthy:

– practice physical distancing,
– avoid gatherings,
– ensuring mask use whenever possible,
– and practice consistent and diligent hand hygiene.

Thanks, friends!

Have a healthy and happy week!

Dr. Dina Kulik