Hats off to New Brunswick and its leadership. During this dreadful time of pandemic, with the cooperation of most of the population, but not all, the numbers seem to be favorable relative to the rest of North America. Thankfully, while frail elders and residents of long term care are prime targets, there have not yet been serious issues. The thanks for that can be given not only to provincial leadership but also to the rapid response of Nursing Homes and Special Care Homes. And the fact that 4 political parties are pulling together is a model for North America!
Have there been problems of execution of procedures? Yes indeed. Have employees and administrators responded with determination? You bet they have. Listening to operators share their experiences thus far shows the determination, dedication to residents, focus on safety that families would want to see and hear.
Well over a month into the journey ....
we start to approach the point, as with every outbreak, where sides line up within the population looking for someone to blame. Usually the blame-game is initiated in the absence of complete information and, if you listen to it, which many do, it will get you depressed. As a citizen I have no knowledge nor understanding of why officials in Washington or Ottawa make decisions the way they do. I can have an opinion, I can read, I can surf the internet, I can watch that mass of videos that are appearing on YouTube that span the entire spectrum of opinion and truth. And depending on my political or philosophical perspective I can find material that will destroy what people find who have a different perspective, and vice versa. That is simply because no one, even those we see on Television, have all the facts and perfect understanding. It is an evolving science.
And thus it goes with pandemics. You start with a virus that is unknown to the medical community, it spreads by some form of human interaction, initially not much concern expressed. Early cases may simply be referenced as “a bad bug”. Then the spread expands or even explodes. Soon you have a full blown pandemic long before those who make policy, medicines, and treat sick people know much about this infecting agent.
With Covid-19, for instance, it was January 29, 2020 that the prestigious New England Journal of Medicine, a key authority for the medical profession, carried a letter from some Chinese researchers that noted early cases in China were young children, median age of 3, and that the risk of contagion was not higher than other viruses and less than measles. Now this was early on, the earliest cases apparently being discovered in China November and December 2019. The world fatality rate was, at that point, only 200 yet some in the US were already sounding alarm bells.
That led some popular media to publish pieces with headlines such as “Get a Grippe, America” and “Beware of the Pandemic Plague”. These articles tended to down-play the risk of the virus.
February saw a steady growth of the virus spreading around the globe causing havoc and, by the end of the month, some sign of panic in Italy, Spain, then New York. By the end of the first week of March the world was in full blown panic mode although having been reassured by the media in late January not to worry.
Since that time there have been various cottage industries spring up promoting masks, hand sanitizer, Personal Protective Clothing and more. One of the interesting cottage industries to emerge is the plethora of video creations on YouTube and other social media platforms. These pieces range from highly unreliable to well documented and in the hands of the unsuspecting, they can cause the mind to vacillate from conspiracy to act of God to the war for supremacy to the international strategy to create one world economy and government. Some are poor quality while others appear to be done with great skill and research. Wherever one is on the political and philosophical spectrum, there are tons of resources there to be had to advance your perspective.
Some document the dangers of social isolation while others maintain that it has gotten New Brunswick to the relatively good position that it is at this time. For every authority advancing a perspective there are equally valid and prominent authorities to refute and advance a contrary position.
How is the average New Brunswick resident to know who and what to believe. It is a battle for the mind unless you ignore it altogether and simply follow the leaders.
The key for New Brunswickers is, I believe, to support our leadership in the good work they are doing and to keep pushing for the earliest possible safe date to begin to restore some order to our economy and social system. During this mess, the hopes and dreams of thousands of New Brunswickers have been dashed, not the fault of leadership but the fault of this microscopic virus! Weeks morph into months and at some point many will reach a point of despair and depression. While many of us have welcomed the adventure to spend more quality time with our spouses and children, many live in isolation and, as one prominent elder told me yesterday, “it is really lonely”. A young mother told me of the huge disappointment of not being able to see her son graduate from high school. Sounds small; to that family it is huge!
In the aftermath, when the crisis subsides and we are beginning to restore some order, a high-level group needs to be commissioned to analyze, assess, summarize lessons learned from this mess and make recommendations that will ensure that when the next pandemic appears, the early warning signs are heeded, the storeroom is full, the action plan is clear, the people are trained. While each bug is different, the approach to containment is similar, the approach to screening is similar; indeed there are more similarities in preparation than differences. We did get caught a bit flat-footed on this one but we can do better next time.
With this bug, for instance, there has been no outbreak in long term care in NB. Why is that? And why are we not seeing what is being seen in other provinces, particularly since Covid-19 loves frail elders!
For whatever imperfections our system may have, the long term care system generally is pretty tightly managed with employees who tend to regard residents not as “clients” or “patients” but I hear employees regularly using terms of endearment: “they are my family.” That is one of the reasons why, when a resident passes, one often sees long term care staff at visitation or the funeral. That set of relationships tends to create a level of caring that leaves little to chance.
The Department of Social Development, as well, has a program of inspection of Nursing Homes and Special Care Homes that is detailed, unannounced, with results published in public. None of the foregoing is an absolute guarantee but when you have those sets of relationships, it tends to minimize the challenges that can lead to loose ends in care.
Ken McGeorge is a retired CEO in major teaching hospitals and long-term-care facilities. He was co-chair of the New Brunswick Council on Aging and is a columnist with Brunswick News. His email address is firstname.lastname@example.org.
Ken McGeorge, BS,DHA,CHE is a career health care executive based in Fredericton, NB, Canada.