Covid-19: lessons learned
At this point, we are all experiencing Pandemic Fatigue, tired of hearing it as the main news item as if nothing else is happening except the US election! Tired of being locked down! Tired of following arrows and being so anxious in the grocery store! Tired of not being able to see family without someone making you feel guilty. Is the upper limit 5 or 10 or 20 this week? The prospect of Christmas being so very different from the way it has been forever is depressing to many!
As some have suggested, much that once was wholesome and fun in normal living has been stolen. One hopes the departure is temporary, but some may suspect otherwise.
We have had many serious outbreaks in our history and several just within the last two decades, namely SARS, H1N1, Ebola, Influenza, Measles, Cholera and more. Each has been serious and each has been deadly. Remember just two years ago in New Brunswick we were a bit panic-stricken with the detection of a few Measles cases that somehow got into the schools.
In March 2020, when Covid-19 struck Canada and our country signed onto the international Pandemic Declaration, suddenly came new restrictions, “stay the blazes home”, social distancing, wear a mask, shut down every place where humans come together, self-isolate even if there is a remote possibility of exposure but no symptoms. This came after this virus had already been present in China for six months and North American political leaders and media were saying no big deal. Suddenly it was a big deal.
On the international stage, very little seemed to be known about the virus and its characteristics. It was believed to be easily spread by humans and with human contact of surfaces on which the virus might have become lodged. But the country of origin seemed not too keen to give information in any official manner.
The World Health Organization, in its announcement of International Pandemic, with only the early experience of China as a guide, created international directives and guidelines based on worst-case statistical models. Whether correct or not, the world was sent into a frenzy with panic in the streets literally. By March, economies were shut down, schools shut down, major institutions and workplaces were shut down, and everything that was pleasurable stopped. Immediately we had the new vocabulary of social distancing, isolation, self-isolation, and more. Call it what you will but it was widespread fear.
The fear seemed to be based on the deadly nature of the virus which was influenced by highly exaggerated death forecasts. When, in the minds of the public, the high rate of contagion is combined with an exaggerated estimate of deaths we then had a formula for public panic. It was only after we had endured this level of fear and panic for 6 months that the facts started to emerge. Yes, it is a highly contagious virus; yes, this virus makes many people very ill; but no, it is not nearly as lethal as was said at the outset. Over 99% of those who contract the virus will recover; over 96% of those of us over 65 will recover; and most who do not recover for the most part have significant other health problems that will claim our lives sooner than later. The high rate of concern was legitimate but the high rate of fear of death was, and is, unfounded based on evidence.
In that sense, we did ourselves a disservice by not challenging the basis of the regulations at the outset. But from the beginning the common mantra was: “follow the science” but science is never black and white. In the care of sick people, 10 physicians treating patients with the same difficulty often treat in different ways, using different therapies and medications……unless they all came from the same training program. In the engagement of physicians over many years, the standardization of practices within hospitals has always been compromised by the fact that facts are interpreted differently by scientists and physicians working in different centres.
Prior to Covid, for instance, a good friend, having been told that nothing could be done for her congenital hip that cause pain and serious issues of mobility, went to another highly reputable teaching centre only to be operated on promptly resulting in restoration of normal gait, lifestyle and return to bicycling! So, the assumption that the science is entirely without room for interpretation and different application is naïve and unfounded.
History has shown what happens when populations are gripped with fear. Seventy years ago it was fear of Nazi leadership that led to World War II. Now we have the common enemy of Covid that has instilled fear in hundreds of millions, rendering normal interpersonal interactions cold and stilted, rendering shopping to be a chore to be dreaded, not an activity to be anticipated, rendering television church something as impersonal as a Netflix movie rather than the rich source of human interaction and encouragement that it has been for millions.
University students now miss the challenge of listening to a live lecture by faculty who have the talent to inspire; instead, they connect by zoom, with or without picture, and listen to a lecture that compromises the value of higher education immeasurably.
And the backlog of essential medical interventions is staggering with wait times now for diagnostic and surgical procedures going well beyond what should normally be considered clinically appropriate.
The good news has been that the health care system in New Brunswick has finally gotten to engage with virtual consults, a practice that has been common in other parts of the country. It has forced the issue of whether one really needs eye contact with the physician in order to get prescriptions renewed or basic diagnostic procedures initiated.
The pandemic has been managed well in the Atlantic Provinces where Medical Officers of Health and Premiers have not jumped to extremes or drama but have dealt with the facts at hand calmly and with determination.
While we were staying home and curtailing normal life activity, many found entertainment in following the drama of the various political forces at work in other parts of the world in which elected officials use the pandemic to provide almost unlimited free media coverage. The inconsistencies in approach around the world and even on this continent have been profound from things as basic as masks to large gatherings and entertainment. Some have coined the term “weaponizing the pandemic” which is what it seems that some have done by exacting measures that often anger the public with their inconsistencies.
One major conclusion from the pandemic is that since the preponderance of deaths have occurred in the over 65 age group and mostly in long term care, the reform of long-term care that has been called for by informed people for so long now must happen. In New Brunswick, the report of the NB Council on Aging provided a framework for the collaboration and direction that only government can instigate but failed to do following the publishing of the report. So major lesson #1 from the pandemic in NB is: Let’s get serious about comprehensive long-term care reform.
Ken McGeorge,BS,DHA,CHE is a retired career health care CEO, part time consultant, and columnist with Brunswick News; he is the author of Health Care Reform in New Brunswick and may be reached at firstname.lastname@example.org or www.kenmcgeorge.com
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Ken McGeorge, BS,DHA,CHE is a career health care executive based in Fredericton, NB, Canada.