In the short time since early February the world has been brought to a virtual standstill due to one miserable little bug, Covid-19. Universities shut down, graduations cancelled, meetings postponed, vacations cancelled, much normal social and economic activity grinding to a halt. Millions of people worldwide will receive no paycheque until the dust settles!
The stock market went crazy requiring the Fed and Bank of Canada to restore confidence, a rare intervention significant of the seriousness of this bug and its potential impact on human health and the economy.
Dreams are being dashed for millions of people due to this one, little bug whose impact on humans can, albeit rarely, be lethal. As one physician pointed out, 99.9% of people less than 50 years of age who contract the virus will recover. But for those in my age group who have compromised immune systems and other co-morbidities, the prospect is serious and often lethal.
Such has always been the case with communicable diseases. Many, many years ago the annual stories of the impact of the Plague in Europe were legendary with thousands of people dying annually. And since that time, and prior to that, each generation has had its major public health catastrophes to deal with. Then along came modern drugs and medicine and the science of prevention and cure has grown exponentially in the last century.
Corona Viruses are not new! They represent a family of bugs that have been with us in the world for many decades, according to Google. They are referred to as “zoonotic” in that they are transferred from animals to humans. The impact on humans is fairly predictable with fever, weakness, cough, fatigue, achiness.
Covid-19 was discovered in 2019 in Wuhan, China and its distinguishing characteristic is the speed and virility of its transmission to other humans.
In this century thus far we have seen several major viral episodes, each of which caused major societal upheaval. First was SARS in 2004 which, again, had its roots in China and spread worldwide. It was introduced to Canada fairly innocently when a patient returning from China was treated at a Toronto hospital .
Then Avian in 2008, Swine in 2010, MERS, 2012, Ebola 2014, ZIKA in 2016, EBOLA 2018, and Corona 2020. In each year, the populations of the world were engrossed in other concerns ranging from just normal living to large political events evolving. And in each case, the imposition of these nasty bugs served to distract the population, the medical community, the elected and non-elected government officials, financial institutions. It is safe to say, however, that none yet have had the same initial, early societal and economic impact that is currently being experienced with Covid-19. Watching the retail shelves go bare and stock markets reeling, one is caused to wonder why all the fuss because of what statistically are a small number of cases and a smaller still number of cases that prove fatal.
Each year during “flu season”, thousands of New Brunswick residents have their lives put on hold for anywhere from a few days to 4-6 weeks while they battle with the flu bug and this after flu vaccines have been on the market for years. Indeed, in the fall of 2019 there was a serious, “nasty virus” circulating in New Brunswick that had a really serious impact on people and businesses; but it was not the Covid-19 apparently.
In the period from August 25, 2019-March 7, 2020, New Brunswick had over 2000 cases of influenza A and B with 223 persons hospitalized, 31 in ICU, and 6 deaths attributable to flu. Thus far the province has 1 confirmed case of Covid-19, 5 probable cases, with 40 testing negative. But it will get worse! And that is the reason that physicians, nurses, and public health officials need to be very attentive in the efforts to provide timely, accurate direction to those of us who need to know.
But after all these years of dealing with these highly contagious virulent situations, we will have to ask ourselves: what have we learned from previous “crises” and have we, as a health system and society, diligently applied what we learned?
Lessons from SARS were abundant; it was a huge “wake up call” for our society and for the health system. While hospitals had been, for decades, notorious for cross infection issues, SARS brought a new, overdue focus on hand-washing and hygiene for staff and the public alike. I remember well, in the years prior to SARS, having to remind staff to wash hands between patient visits, to wear gloves in doing examinations and treatments.
Public communication was, with SARS, a huge issue and so, it seems again, with Covid-19. Why would toilet paper fly off the shelves when diarrhea is not even one of the common symptoms? Public reaction at the hoarding level is driven by panic which is borne from lack of complete, timely information. At a meeting of the heads of North America’s leading retailers on Sunday, they observed the irrational behavior of the public, noting that people are buying more than they would even at Christmas which is the peak season.
This is the most important element of the COVID-19 issue: the disease can and will be managed but it will take much longer when the public is in panic mode unnecessarily. The communication from policy makers and health officials needs to be accurate and clear enough that a grade 5 graduate can readily understand.
With SARS, it was determined early that the transfer of relevant information to and from Public Health with transmission to organizations needing timely information was a large problem. Some provinces invested huge sums of money in modernizing IT systems that would provide key information from public health to long term care and hundreds of other service centres very quickly.
The issue of personal hygiene and human behavior was also cited in SARS. Since all of these viruses are transferred from one human to another by touch, close proximity, or contact of contaminated surfaces, a focus was placed on cleaning, intensity and frequency of cleaning was cited and highlighted during the height of the battle with the disease.
Then about two years following the SARS battle, a national television network filmed a documentary on hospital cleaning. In the documentary, they used the blue light that exposes microscopic organisms that were very prevalent, if not frightening, on “freshly cleaned surfaces”. Even today it is not uncommon for members of the public to express concern about cleaning in various public institutions.
A major source of spread of disease is in public washrooms and, in light of SARS, you would expect that such facilities would be maintained to the highest of standards and tightly monitored and regulated. But there are many inconsistencies in this area.
Another element of strange reaction is with the concept of Social Distancing in which we promote huge gatherings of people for events from sport to music to education and religion, but again with Port-A-Potties galore! We have turned universities, sports world, and churches on their ear and by summer there will be huge gatherings of people again.
Our diligent medical officers of health will guide our province through this mess; our elected and other public officials need to ensure a sense of calm at a time when citizens are showing signs of panic. Get the facts out there in a way that grade 5 kids can clearly understand. And when it is all over, let’s learn from this so that we are better able to cope without panic with the next virus!
Ken McGeorge,BS,DHA,CHE is a retired career health executive, part time consultant and columnist with Brunswick News.
Ken McGeorge, BS,DHA,CHE is a career health care executive based in Fredericton, NB, Canada.