{"id":14427,"date":"2020-09-06T16:52:29","date_gmt":"2020-09-06T20:52:29","guid":{"rendered":"https:\/\/www.ontariohealthcoalition.ca\/?p=14427"},"modified":"2020-11-17T13:57:02","modified_gmt":"2020-11-17T18:57:02","slug":"as-we-enter-the-great-unknown-the-second-wave-of-covid-19-is-canada-better-prepared-than-we-were-before","status":"publish","type":"post","link":"https:\/\/www.ontariohealthcoalition.ca\/index.php\/as-we-enter-the-great-unknown-the-second-wave-of-covid-19-is-canada-better-prepared-than-we-were-before\/","title":{"rendered":"As we enter The Great Unknown, the second wave of COVID-19, is Canada better prepared than we were before?"},"content":{"rendered":"

(September 5, 2020)<\/p>\n

By: Sharon Kirkey, Calgary Herald<\/p>\n

One evening in mid-March, as a weird and eerie illness was making itself frighteningly real in northern Italy and New York City, Ontario hospitals were instructed to commence shutting down \u201cnon-emergent\u201d\u00a0procedures, in anticipation of a COVID-19 surge.<\/p>\n

Dr. Jonathan Irish is a cancer surgeon. He had five cancer operations scheduled the next day at Toronto\u2019s Princess Margaret Cancer Centre. Two of his patients had travelled by plane to get there. All five operations were cancelled.<\/p>\n

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By end of May, the directive was lifted.\u00a0In a study published this week in Canada\u2019s top medical journal<\/span>,<\/a>\u00a0Irish and his co-authors estimate it will now take a staggering 84 weeks to clear that surgical backlog owing to COVID-19. Roughly three-and-a-half months to get through \u201ctime-sensitive\u201d cases like cancers and coronary artery bypass grafts, and over a year-and-a-half to clear all surgeries, including joint replacements and cataract and hernia repairs \u2014 an estimated 148,364 surgeries in total.<\/section>\n<\/div>\n<\/div>\n
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In addition to the sheer magnitude of the backlog, \u201cobviously, the impact on our patients has been a profound one,\u201d Irish says.<\/p>\n

As Canada prepares for the great unknown, a predicted resurgence of COVID-19 in the coming weeks and months, that is one lesson that can be taken from the first ripple. Flip the emergency switch, and suppress, suppress the virus, and other dominoes can topple.<\/p>\n

The surgical ramp-downs were probably appropriate, Irish says, given what little grasp anyone had of this strange new virus. Across Canada, thousands of hospital beds \u2014 nearly 10,000 in Ontario alone, including critical care beds with ventilators \u2014 were freed in preparation for a feared flash-flood of critically sick COVID-infected people. It was a mass casualty response, Irish says, \u201cas if 100 airplanes had crashed.\u201d<\/p>\n

That\u2019s a response now off the table. \u201cWe understand now that within 24 to 48 hours, we can be responsive \u2014 we proved that in March when we created capacity for a lot of patients. It can be reactive to local testing, and it can be regional.\u201d An uptick of cases in Ottawa shouldn\u2019t shutdown OR\u2019s in Thunder Bay or Windsor or across the entire system, says Irish, who is working with Ontario\u2019s health ministry on a plan to keep operating on people who don\u2019t have the virus, in the background of a COVID-19 pandemic.<\/p>\n

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\u201cLook, I have kids. I have colleagues. We are all anxious about the situation,\u201d Irish says. But where we are now is different from where we were in March. Doctors know better how to treat this once-in-a-century biological entity. \u201cWe know better how to identify the disease and contact trace. We can\u2019t continue to function as we did in March, if there were a second wave,\u201d Irish says.<\/section>\n<\/div>\n<\/div>\n
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No one can say with any certainty if, when, or how big a second wave will be. Canada\u2019s Chief Public Health Officer Dr. Theresa Tam says provinces and territories should prepare for a \u201cfall peak,\u201d a resurgence, a rebound that could be several-fold worse than their previous experience. There were no actual numbers on a graphic illustrating that peak in the slides released in the latest modelling. \u201cThe national epidemic curve could be highly variable,\u201d the Public Health Agency of Canada said in response to a query from the\u00a0National Post<\/em>, \u201cand while we are hoping for the \u2018slow burn\u2019 pattern, public health authorities are preparing for a potentially high fall peak\u201d followed by other waves \u201cthat may exceed their current capacity to respond optimally.\u201d<\/p>\n

If systems weren\u2019t overwhelmed in March, and we\u2019re better prepared than we were before, why would capacity be exceeded next time? Tam speculated that something could happen to the SARS-CoV-2 virus that causes COVID-19. It isn\u2019t behaving like influenza. It hasn\u2019t shown any seasonal pattern so far; it continued circulating throughout summer. It\u2019s possible the virus could demonstrate \u201ca certain type of acceleration under certain conditions,\u201d Tam said.<\/p>\n

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Other countries \u2014 Italy, Spain, France, Germany, India, Brazil, Argentina, Russia and South Korea \u2014 are grappling with resurgences. U.K.\u2019s Prime Minister Boris Johnson put areas of Northern England under stay-at-home instructions last month. French president Emmanuel Macron made masking mandatory in busy outdoor spaces of Paris in response to flare-ups. White House coronavirus adviser Dr. Anthony Fauci this week pleaded with Americans to behave \u2014 wear masks, distance, avoid crowds and other \u201csimple things\u201d \u2014 over the Labor Day holiday weekend. Take the pressure off the virus, the World Health Organization\u2019s Mike Ryan has said, and it will boomerang back.<\/section>\n<\/div>\n<\/div>\n
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Dial in colder weather, which means more time indoors, school reopenings and a collision with seasonal flu \u201cand we have the makings of a really difficult time ahead,\u201d says emergency physician Dr. Alan Drummond. So what can we learn from our first go around with COVID-19 to prepare for the next?<\/p>\n

In the beginning, there was mixed messaging, says Drummond, a lack of clarity, a \u201cdesultory, lethargic and reactive and plodding response.\u201d The messaging from federal health officials was a no-drama, \u201cCanada is at low risk\u201d mantra. Except \u201cwe could see what was potentially coming and nothing was happening,\u201d Drummond, of the Canadian Association of Emergency Physicians wrote in an email back in May.<\/p>\n

The onslaught never happened. ER visits across the country fell sharply. People feared either contracting or transmitting the virus in packed waiting rooms. \u201cWhat\u2019s happened to the heart attacks,\u201d Drummond and his colleagues wondered, the strokes? The people with appendicitis-like pains? People were delaying seeking care,\u00a0\u201cand we partly own that,\u201d Drummond said this week. \u201cWe should have done a better job letting the public know our departments are safe, we\u2019ve adapted, we\u2019re maintaining physical distancing and it\u2019s safe to come to the emergency department.\u201d<\/p>\n<\/div>\n

Click here for original article<\/a><\/span><\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

(September 5, 2020) By: Sharon Kirkey, Calgary Herald One evening in mid-March, as a weird and eerie illness was making itself frighteningly real in northern Italy and New York City, Ontario hospitals were instructed to commence shutting down \u201cnon-emergent\u201d\u00a0procedures, in anticipation of a COVID-19 surge. Dr. Jonathan Irish is a cancer surgeon. 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