The media is all over the place. We are all scared and confused - and with everything going on, I've found it really difficult to really understand this virus. I thought it might be a good idea to put some questions together about the virus and have Bryon answer them. I tried to ask questions that I felt were frequently asked and to clear up some things I've read/heard in the media. Bryon took over an hour to carefully answer these questions.
A little bit about my boyfriend: Bryon (Dr. Bryon McKay - M.D., PhD) is a 4th year surgical resident in Ophthalmology. He is currently doing his rotation at SickKids. He is also Chief Resident for his program (shameless bragging...I'm very proud of him). He takes the weight of his patient's health issues on his shoulders (trust me...I know) and will often talk about how he is worried about them. He rarely gets time to use the washroom or drink water while he's working because he is so busy...but he honestly loves his job and he truly cares about his patients. He is also one of the smartest people I know and the best dad to our son, Huxley (and furbabies!)
You can follow him on Instagram @dr.bmckay (although, he hasn't posted anything yet lol, but is planning to)
(beat the self-isolation blues by learning something new! Sign up for 2 free months of Skillshare and check out one of MANY online classes CLICK HERE)
I hope his answers provide some relief/answers to your own personal thoughts about what is going on. I know they clarified a lot for me.
Let's get started!
1. How serious is Covid-19
Dr. Mckay: Good question – based on the rapid spread and the relatively high number of cases requiring hospitalization and even ventilatory support due to severe lung involvement, COVID-19 has become a very serious issue for healthcare and for governments alike.
2. What is the virus exactly - how is it different from the flu?
Dr. McKay: This is a great question – at the onset of symptoms they can be quite similar. Both will cause fever, cough, fatigue, loss of appetite, sore throat etc. The flu symptoms tend to progress rapidly (1-4days) and some data on COVID-19 suggests that the onset of symptoms can be anywhere from 1-14days with the average around 5 days.
Coronaviruses are a large family of viruses that can cause respiratory illnesses, ranging from mild (e.g the common cold) to severe (e.g. pneumonia, acute respiratory distress syndrome- ARDS). Coronaviruses are common in animals but can occasionally evolve and infect humans and potentially spread between humans. Previous examples are: Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV).
Both the Flu (influenza A and B) and Coronaviruses cause respiratory infections, but the flu has a very predictable course and follows a seasonal pattern. Although the Flu can cause significant illnesses and lead to pneumonia and death, the vast majority of patients with the flu (>95%) are not severe enough to need hospitalization. Currently data from the WHO, the CDC in the US, and Data from China suggest that around 15% of COVID-19 cases are severe and 5% have been critical - Leading to ARDS and/or organ failure and death. This has been observed in both young and old as well as immunocompromised and those who are otherwise healthy. Making COVID-19 much less predicable in its clinical course compared to the flu.
3. How are hospitals in Toronto prepared for the virus? What essential equipment do we have/not have?
Dr. McKay: In Toronto we have some experience with the procedures necessary to combat coronavirus. We were front-line for the SARS-CoV outbreak in 2003. The Infectious Disease Specialists in Toronto are world leaders on these types of infections. That being said any healthcare system, especially publicly funded ones, are often running at 90-95% capacity. In Toronto we have excellent physicians and nurses on the front lines ready to help but the stark fact is we do not have an endless supply of ventilators or ICU beds to accommodate for a massive influx of sick people. – this is the basis of “flatten the curve” the media is talking about. If we have a steady – but small number of patients presenting to hospital, we can cope, and the outcomes will be very positive. If we have a large and steady influx of sick people we will not be able to properly care for those who need it most and unfortunately people will get very sick and likely die – we are seeing this in Europe at the moment.
3. Why is it important that we practice social distancing?
Dr. McKay: The virus is thought to spread mainly from person-to-person and primarily between people who are in close contact with one another (within about 6 feet). The spread is mainly via respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. We also know the virus can remain infective on surfaces like railings, doorknobs, counters etc. It is likely not the main mode of transmission but the virus can be transferred to your hand after touching a contaminated surface, then touching your face/mouth/nose/eyes.
Social distancing limits the risk of droplet exposure and also limits interactions between people who might be shedding the virus – and this limits the spread very effectively. Because there is no way to prevent the infection once exposed, social distancing provides a very effective way to stop the person-to-person spread and can (if done by all of us) eradicate the virus from our population.
4. Does this mean we shouldn't leave our homes?
Dr. McKay: Yes and No. The ultimate goal would be to minimize outside contact completely. But we live in an integrated society where we rely on each other for food, medicine, entertainment etc. The use of social media and video chats is a great way to remove that isolated feeling. Going outside to get some activity is OK as well. However, taking extra precautions such as covering your mouth and nose if you sneeze, maintaining a 10 foot distance from all others you might pass by and limiting gatherings are acceptable. Remembering to always wash hands thoroughly and avoid shaking hands, or any contact if possible. Making an effort to not touch your face at all when you are out is tough if you actually pay attention to it, but will also help reduce your risk.
Obviously if you are all symptomatic with cough, runny nose, fever, or feel sick – you MUST self isolate!
5. Does this only affect people over 60 and those who have pre-existing health conditions?
Dr. McKay: No! The scary thing we are learning from the cases in hospitals across Canada is that it can affect young, healthy people too. Now, the elderly and people with known immunocompromised states (other diseases / illnesses / medications) are definitely at a higher risk of a very bad outcome compared to a young healthy person, but the scary thing that is worrying us all in Healthcare, is those who are young and healthy who are in the ICU on ventilatory support.
6. I'm a mom (and you are obviously a dad lol)...I've read that children are not really affected by this? Should we be worried about kids getting the virus? How can we protect them?
Dr. McKay: Great Question – The WHO, and recent reports in the New England Journal of Medicine report that children are less likely than adults to be infected and have severe illness; however, they are still vulnerable, and deaths in China as well as countries world-wide have been reported. Although it is comforting to know children tend to have a less chance of being significantly ill with COVID-19. However, children can catch it and are notorious for spreading viruses. They tend to touch everything, and the really young ones will not cover up coughs and sneezes. We all know how fast colds spread through day-cares, schools and recreational programs. Any parent can attest to being sick with a myriad of colds as their kid brings home another runny nose.
7. How long do you think the government will ask Canada to practice social distancing? Will it be enough?
Dr. McKay: Our preliminary info releases from the Canadian Medical Association, Ontario Medical Association and the Ministry of Health and Long Term Care suggest it may take 8 weeks to prove effective. Although, this information is quite fluid, and we are learning valuable information about the epidemiology of this from China and Europe. So short story long…we are not actually sure.
8. Is there honestly a light at the end of the tunnel - or do you think we will continue to see this virus?
Dr. McKay: As serious as this is at the moment, I am staying positive that this will have an end date. Canadians are doing an excellent job of social distancing. It will take a few more weeks before we can see the impact of this, but we are all very hopeful this will make a large impact and really shorten the impact of this virus.
9. What do you know about the vaccine researchers have been developing?
Dr. McKay: Yes, there are several strong Canadian efforts on the go now and there are vaccines in trials in the US at the moment. But right now, it looks like we are about 10-12 months away from an effective vaccine that will be able to be distributed to the population.
10. Should we be going to see our doctor for regular appointments? When do we go to emergency/what are some other alternatives we can do?
Dr. McKay: First off – DO NOT LIE ABOUT TRAVEL OR SYMPTOMS – DO NOT SHOW UP TO A DOCTOR'S APPOINTMENT IF YOU ARE SICK – please please please. We have seen this in our Ophthalmology clinics. Patients worried about not getting to see the doctor if they report their travel or symptoms to they deny symptoms or recent travel. First off, this puts the doctor at risk and the clinic staff at risk – this is not good. We are seeing MANY patients and if we inadvertently get exposed this can be devastating.
Regular follow-up and prescription refills can be handled over the phone. Many physicians are setting up tele-health consults. Call your doctors office – leave a message or follow the instructions on their voicemail.
If you think you need to go to the Emergency for another reason that is urgent but not life-threatening – call Telehealth Ontario first if you can. If you think it is very serious (i.e. left arm and chest pain or stroke symptoms etc.) call 911. If you have symptoms of a cold or flu but need an ambulance please advise 911 of your cough/fever as well to protect the EMS people – they need to know too!!
If you are symptomatic (Fever, cough, sore throat) and think you might have COVID-19
Look at the following links:
11. Will wearing masks and latex gloves protect us if we need to go out in public?
Dr. McKay: If you have access to a mask it will not hurt. It will not guarantee that you will not get COVID-19 but might help prevent you from inhaling droplets if in close contact with someone and decrease the risk somewhat. Gloves are not going to prevent you from getting sick. With a gloved hand you might still touch a surface or your clothes or your face etc. The best thing to do is wash your hands frequently and use 60+% alcohol based hand sanitizer.
FOR THE LOVE OF ALL THINGS SACRED – DO NOT TAKE MASKS OR GLOVES OR SANITIZER FROM THE HOSPITAL!!!! – We do not have enough supplies of personal protective equipment! The health care workers need these precious resources.
12. What are your personal thoughts on this virus/how are you feeling about things?
Dr. McKay: I am on-call today at a major downtown hospital. I am not particularly worried, but it is on my mind. When I am seeing patients I will be taking a higher level of personal protection than I would normally take. We have employed extra barriers on our microscopes and I will be wearing a mask for all of my interactions.
In Ophthalmology (eye medicine and surgery) we are at a high risk as all of our interactions are face to face, sometimes within a few centimetres of a patient. In fact, the first physician to die from COVID-19 was the Wuhan Ophthalmologist Dr. Li Wenliang, a young and healthy man who was the first to bring the severity of COVID-19 to the world – he was the ‘whistle blower’ that brought the virus to the world stage. Unfortunately, he developed ARDS and succumbed to the infection in early February of this year. So this is on the mind of all of my Ophthalmology colleagues as we venture into the hospitals this weekend and for the coming weeks.
I hope this is helpful for you if you read this and that you gained some clarity on everything that is going on!