IDH Chief’s guidance on COVID-19 as we open up
By Dr. Gareth Mannheimer
Thank you to everyone for your efforts to minimize the impact of COVID-19.
We did our part to flatten the curve. Our community members who contracted the virus are thankfully doing well in their recovery.
It has been an incredible four months. As we move into recovery mode, we know the cost to you and your family has been high, both in terms of personal sacrifice and economic impact. We are in the next stage of this battle, fully committed to working to minimize the ongoing effect of COVID-19, both medically and economically.
Restrictions are being lifted. As a consequence, our priority is shifting to disease prevention, averting a second wave, improving virus detection and minimizing the impact of disease. These priorities will always be better than the most effective treatment.
You and COVID-19?
COVID-19 has proven unpredictable and inconsistent. It is still here and is not going away any time soon. While most patients recover quickly, others get very sick and can die and we still don’t fully understand why. There is no effective vaccine yet. Managing risk is foremost.
The coronavirus needs you to survive. It can last a number of hours in the air and often longer on surfaces. If it cannot infect you as its host, it dies. If it does infect you, your immune system will usually kill it and learn to identify it quicker in future. This is what we want! No one is invulnerable but we’ve seen that older adults and patients with underlying chronic conditions are at increased risk for severe illness or death.
The risk of contracting coronavirus appears to depend on the degree and length of exposure. This is why minimizing large groups particularly indoors and maintaining physical distancing is so important. For example, a five to 10-minute conversation with someone who has the virus, without physical distancing, is all it takes to get infected.
This virus can be very efficient if it gets a good start. As we start to move around our community more freely and are in contact with more people in more places more regularly, the risks to ourselves, those close to us and our community are higher.
- Develop a plan to stay healthy and do all you can to not get the virus. Develop health promoting behaviours. Eat a healthy balanced diet, exercise, stay in contact with friends, try and get a good night’s sleep. Being healthy will help to minimize the effect of COVID-19 should you catch it. If you do not feel well, for any reason, call us at the clinic for advice.
- Make physical distancing an integral part of your plan going forward particularly if your interactions are going to last more than a few minutes. Encourage the same physical distancing standards for your family and others close to you. Use the two-metre rule to guide your actions.
- Make planning part of your daily life. Use planning to outline how you are going to social and physically distance when you go out or have people over. Try and stay outdoors when you can.
- If you come across a situation where you cannot safely social and physical distance make conscious choices. Consider delaying going, not going or returning later and consider wearing a cloth face mask.
- To mask or not mask? A cloth face mask will not prevent you getting the virus but it can help. More importantly, it will help to protect others from you if you happen to be infected, with or without symptoms. Use cloth face masks properly. Put others first. Watch this video if you have questions. https://www.youtube.com/watch?v=yLuEwwGhBxI
- Remember to wash your hands often. Clean surfaces at home often. If you are going to stores or businesses, use hand sanitizer going in and out and try to not touch surfaces.
- Be patient with other members of our community. Not everybody feels the same way about how to approach this situation and many are still just trying to process it.
Our Valley and COVID-19
How many people in the Columbia Valley have had COVID-19?
Fact is we don’t really know. We do know that some who were tested did test positive for the virus. Estimates of the number of unreported cases vary widely. And, we won’t know until we have broad antibody testing across our population that will show us definitively who had COVID-19, who has immunity and the strength of their immunity.
Based on the history of pandemics and reports by various research and policy agencies we suspect we may see recurrent waves of COVID-19 in the coming months. These second waves will still prove challenging for us particularly in smaller and less resourced settings. Work is underway to plan strategies to minimize any future effects of COVID-19 on our community, while trying to find strategies that will balance our desire to live life and conduct business in the ever-present company of this new and still poorly understood health risk.
COVID-19 is a serious disease that can spread rapidly once it gets a small foothold. That is why your health professionals constantly ask you to do all you can to stop the spread.
One of our challenges is that this virus is novel and as a community we have insufficient personal or community immunity built up to prevent an outbreak. Some call this herd immunity.
Herd immunity is reached when 70-90% of the community become immune, either because we have been infected and recovered, or through a vaccine. When that happens, the virus is less likely to spread to people who aren’t immune because there just aren’t enough infectious carriers spreading it. It is extremely unlikely that the Columbia Valley is anywhere near 70-90%. BC has now approved an antibody test, which means we will be able to test to see who has had coronavirus, but there are no plans yet to test everyone. I suspect that our communities did such a good job of limiting the initial spread that our current immunity rates from infection will be low. A vaccine will get us to herd immunity faster, but we do not have one yet. At best, a safe, effective and approved vaccine is six to eight months away.
We have other challenges. Residents of the Columbia Valley often travel both to go to the bigger communities to shop and just generally in the summer. This poses the risk of being exposed to the virus and bringing it back home. The population of the valley also grows from about 10,000 to 30,000 in the summer. We value the support that these visitors and second homeowners give to our local economy. They could, unwillingly and unknowingly, transport this virus with them. Both these challenges could result in people being infected here. The recommendations from federal and provincial governments is to limit non-essential travel, this being one of the main reasons why.
So, what do we do as a community?
Protecting ourselves and others takes work and discipline.
Be vigilant. Observe what is happening around you. Make every effort not to get infected or infect others. Are the stores, beaches, events etc. crowded enough to make it difficult to maintain two metre distances? When physical distance is not possible are people wearing a non-medical cloth face covering? Is everyone going in and out of stores sanitizing hands? If not just consider your next actions and the impact they may have on you, your family and others.
Studies of COVID-19 outbreaks show that the most infectious events were indoors, with people doing lots of talking, singing or yelling. Sources for infection can be anywhere. As our community opens back up, and we start to venture out more and have more visitors, we need to review our environments and make considered judgments. For example, how many people are there, how much airflow is around me, and how long will I be in this environment? Remember it’s a “dose and time” equation that adds up for possible infection.
- Use common sense to apply, develop, adhere and remain vigilant in adopting and living each day as if COVID-19 is still active in our community – because it is! An outbreak anywhere can fast become an outbreak everywhere.
- Maintain social and physically distancing. It’s important.
- Wash/sanitize your hands whenever possible including when at work. Continuously sanitize surfaces that could harbour the virus. If staff require constant, prolonged and close contact with people consider recommending they wear masks and eye protection. Ask customers to limit what they touch and to consider wearing a cloth face covering.
- More people are out. Use the two-metre rules to guide your actions. If this is not possible in a public or business environment, then limit the number of people.
- Clean hands and surfaces. If you are responsible for a public space or business, ask all who enter to sanitize hands in and out each and every time they enter and exit regardless. Look at COVID-19 as an opportunity to provide better service and a better experience. From what I have seen in the community local businesses are doing a great job with their COVID19 safety plans. For example, make hand sanitizing at store entry easy and accessible, if you have a large store with more traffic consider having a greeter at the entrance, welcome people, direct them to what they need to get, consider one way aisles to encourage physical distancing if possible, have staff wear mask to show you care, consider use of a barrier to protect cashiers, sanitize checkout counters after each customer, clean cart handles and baskets. We can all find ways improve!
A COVID-19 Outbreak and Our Response
We aren’t out of the woods. People can and do get sick during a pandemic. If you are not feeling well contact us immediately. Even if you have very mild symptoms do not wait! Watch for the following symptoms.
Most Common Symptoms
Fever; dry cough; tiredness.
Less common symptoms
Aches and pains; sore throat; diarrhoea; conjunctivitis; headache; loss of taste or smell; a rash on skin, or discolouration of fingers or toes Serious symptoms; difficulty breathing or shortness of breath; chest pain or pressure; loss of speech or movement.
Once you contact us we will assess your symptoms, test you if we suspect you have COVID-19, make appropriate recommendations on care and treatment, confirm your test results with you, and follow-up to check your progress.
We will work with you to determine where you may have caught the virus and who you may have exposed to it. We will investigate to see if others may have been exposed to the virus at the same place(s) you were and will put measures in place to stop the spread. We will ask those you have been in contact with to monitor themselves for symptoms, to take all precautions to prevent spread and to contact us immediately should they have symptoms.
We have nine physicians in the community who are supported by a strong team of Interior Health region professionals. We have an eight-bed hospital and a well-equipped emergency room. We are linked to more advanced care professionals and facilities should you need it.
Call us immediately if you have any symptoms!
- Invermere Medical Clinic (250) 342-9206
- Chisel Peak Clinic (250) 341-6900
- Invermere & District Hospital (250) 342-9201.
The news about COVID-19 and its impact on our lives has been unrelenting and at times it has been hard to cope with the stress, anxiety and other feelings that have surfaced during this period of social distancing. As a community, we have risen to a unique challenge. Our doctors, nurses and all our health care workers and those supporting those on the front lines continue to deliver first class care and caring to this community. They truly deserve our thanks and support. They remain at the ready. Their dedication is a true inspiration and I’m proud to be part of this team.
Stay vigilant. Stay safe.
Dr. Mannheimer’s latest update was originally published in the Columbia Valley Community & Economic Support Team’s COVID-19 Update for May 26.
– Dr. Gareth Mannheimer is Chief of Staff of Invermere & District Hospital, and a family physician.