​Region 5 Outbreak: let it play out

There has been a good deal of concern within the public, the media, and advocacy groups about the Covid-19 outbreak in Region 5.  For the provincial leadership team, it was akin to the opposing team hitting a game winning home run in the bottom of the ninth after a stellar pitching duel.  It was a big disappointment.  And the doctor who was thought to have been the carrier and whose life has been badly scarred will deal with the aftermath for years to come, no doubt.

People had a right to be frightened; it is a wicked virus made even more wicked by the fear that the warnings starting with the WHO and many others in regulatory and advisory roles play.  The fear of this awful virus has ensured that businesses closed, that commerce came to a halt, and that our lives have been put on hold as we “stay the blazes home”.  And just when we see light at the end of the tunnel and we think we can get back to the golf courses and Tim Hortons, we get broad-sided.

Somehow the virus found its way into a seniors care facility; this is one that otherwise has enjoyed a solid reputation and the fact that it has been, to this point, the only seniors care facility in New Brunswick with an outbreak could lead the uninformed to yet another level of fear and concern.

Concern is accentuated, of course, as a death is reported.  Any death is sad and any death with seniors creates distress for extended families including staff of care homes.  Yet this is what seniors care facilities deal with every year.  They care for persons who tend to be somewhat fragile with multiple underlying conditions that compromise the body’s ability to ward off attack by viruses and bacteria.  Each year, senior facilities are accustomed to the annual flu season that inevitably claims the lives of some seniors and, indeed, claimed 8 seniors in the current season.

During each of the several outbreaks in recent years, nursing homes have become accustomed to implementing controls and isolating residents, sometimes a section at a time.  That is part of the routine in operating a nursing home.

What seems different with Covid-19 is not so much that it is more deadly than the seasonal flu.  What seems different is that this virus, about which almost nothing was known six months ago, seems much more virulent than other viruses.  In watching the news, we recently learned that there was collaboration between a Canadian researcher and the research facility in Wuhan, China apparently focused on virulence.

At this point what is known in Region 5 is that there was an outbreak which has caused a number of persons to be infected and two to pass away.  It is also known that the Public Health Branch and the Extramural Program did what they are famous for:  they took control of the situation in a very professional manner.  We have every right to believe that with that competence in play, the outbreak will be well managed and the situation resolved in due course.

Is this the time to jump in with a high-level investigation or Public Inquiry?  Not at all.  As the old saying goes, “when you are up to your knees in alligators, the first order of business is to drain the swamp.”  Once the swamp is drained, then it is time to turn to detailed investigation and it needs to be far-reaching in order to ascertain the true source of infection and many other issues related to pandemic management.

For instance, did anyone actually know that a number of health care workers in Region 5 commute regularly from Quebec where there seems to be a higher incidence of Covid-19 than in New Brunswick.  And did anyone actually know that during the early weeks of the pandemic there was not only this one physician but several physicians who came to northern New Brunswick from Quebec?  On whose body did that virus enter northern New Brunswick?

I have no expertise in contact tracing but admire those who do.  It does seem reasonable that if there are people coming and going daily or weekly, the potential for there to be multiple carriers is significant and complicated, particularly if they are health care workers.

Should the border have been closed to physicians and all health care workers?  That is a tough call since several communities would be without essential health care service during this time.

What has become crystal clear to me in observing the evolution of this pandemic is that there is and has been so little known about this virus, how it spreads, what is its lifespan, has it actually been silently around for longer than we know?

Listening to the clinical and scientific leaders across the world it is clear that what was thought to be true in March has changed in much the same way that viruses mutate.  Original planning assumptions that informed international strategy were over-stated and based on false assumptions.  Effective potential therapies remain a matter of professional judgement and interpretation and the idea of how long the bug lives on surfaces has changed a few times.

In living with this pandemic, it is much like a living lab experiment with we humans as the objects of the research conducted by talented people who understand infectious disease but knew nothing of this virus until recently.  And still the level of real knowledge is far from perfect with many assumptions being made along the way.

We must not be jumping to ill-conceived initiatives that run the risk of diverting energy and attention from the mission of mitigation and control; what we need to do is support our leadership in managing through this pandemic and the re-opening of our society.  And if there is a second wave, we will have to take some serious measures but hopefully using some of the key lessons learned during the first wave.

But then, when we are seeing limited or no new cases consistently, a full review is essential at National level and at provincial level.  From all that I have read and viewed from leading world authorities; we should not have been surprised by this pandemic.  The fact that some media and the WHO were not taking it too seriously in January should be a concern because other international authorities have been saying, since 2016, that we will soon see a large pandemic.  Who was not paying attention?  That question needs to be answered in a comprehensive review.

Listening to world leaders, it seems like major outbreaks will be a way of life so Pandemic Planning really needs to get the high priority that Bill Gates discussed in his Ted Talk in 2016.  Like him or not, on this one he was correct.

Following any large event in my career, our team would always conduct a review within days while it was fresh in our minds.  Questions like:  what was right?  What went wrong?  What could we do better?  How do we make the next event better and more relevant for the public?  May we use the same discipline with the pandemic.

Ken McGeorge, BS,DHA,CHE 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 kenmc1@bellaliant.net. ​