A return to school

An oldie but a goodie and a return to school

This is an old photograph. It was taken in 2009 by my good friend Phillip Maher. We were hanging out at a day orphanage in Eshowe, South Africa with Rob O'Flanagan who was working for the Guelph Mercury at the time and Brenda Halloran who was the mayor of Waterloo and off course, Andy McDougall. Man, I miss him. We were quite a team.

The orphanage was built by a formidable African woman named Aurelia who devoted her life to caring for children orphaned by AIDS in her community. At that time, so many parents had died of AIDS that older siblings were left to care for their younger siblings alone on the family property. By older I mean age 10 and above. Man, the world can be an utterly nasty place and remains so for so many. Imagine your 10 year old being left alone with your younger children in your house after you and your spouse have passed. I can't. The options for these kids were very limited. An orphanage means that siblings are separated and the family land is lost, taking away any hope for a viable future. Bracelet of Hope cares for kids like these if foster homes in Lesotho where siblings can stay together in one home under the careful guidance of a loving foster parent. They stay in their community and we support them into young adulthood, moving them onto a skilled trade as they leave the foster home community. It works.

In Aurelia's community there were too many orphans, 16 million in sub Saharan Africa at the time; sixteen million orphaned by AIDS. They were the reason I devoted my career to those affected by HIV and built a charitable organization that could respond is some way. Their plight would have crushed my soul had I not responded. Aurelia felt the same way. She had the brilliant idea of building a day orphanage. The older sibling of a 'sibling-led' family would drop the younger siblings off at the orphanage and then carry on to the school next door. After school the entire family was given a meal and help with homework until just before dark when the whole troop was sent off home to and empty house. What a world. What a world. Aurelia was a teacher. Teaching was her passion. In her heart and mind, not responding to the tremendous difficulties of her students was not an option. I loved Aurelia and everything she stood for.

God love the teachers. Where would we be without you? Where would our children be without you? What is being required from you this fall is no small thing. You will become members of the esteemed group of frontline workers who have tackled this pandemic head on for months now. I would like to offer you my reassurance about what happens next but I will not downplay how difficult this will be and how terrified many of you are. I remember that first few weeks of treating patients after the pandemic was declared. I was terrified. I am not sure how I coped but I do know that I was not alone and that the wellbeing of my patients was paramount.

Five months in and we are in much better shape with respect to COVID 19. The incidence of cases is extremely low now. The risk of community transmission is also very low. Eight-nine cases in Ontario today. Eighty-nine out of 14 and a half million people. It is time to return to school.

Rely on this:

Students in Grades 4 through 12 will be required to wear a non-medical mask or cloth face covering while at school. Younger children will be encouraged, but not required, to do so. I think they should all wear masks and I hope their parents will enforce this.

Medical masks will be provided for teachers and other staff. This is key. That medical mask is protective. It not only stops you from transmitting the virus to others but, unlike a cloth mask, it reduces the risk of the virus being transmitted to you. Doctors, nurses and nurse practitioners have been relying on these masks in clinic settings for months now, including in COVID clinics where at-risk patients line up every day. No healthcare worker in the province has picked up COVID 19 at a COVID clinic. The surgical mask works.

The low incidence of infection, combined with the surgical masks you wear and the cloth masks that most of the kids will be wearing makes a return to school safe. Add to that physical distancing where possible and hand sanitizing and the risk of transmission is even lower. I think we would all prefer smaller class sizes. Perhaps we can all advocate on your behalf around this.

It is time to return. Some of the best pediatric minds in the province have reviewed the science, the pros the cons, the risks of returning, the risks of not returning. I agree with them. It is time to return.

More details to follow I am sure. I am not an expert but I trust the experts. I will do my best to share what I continue to learn including the promising results of an established return to school in Scandinavian countries who returned when their pandemics were not as well controlled as ours is now.

I hope you sleep well this weekend despite the fear. I pray for that for you!

Anne-Marie

Please share.

A great place for mental health support here:
https://familyserviceguelph.on.ca/

For equal access to treatment in Lesotho!
https://www.braceletofhope.ca/ways-to-give/

For non-Facebook users, you can find this post here:
https://braceletofhope.blogspot.com/

YES!

Only 76 CASES IN ONTARIO TODAY!

ONLY 76 CASES IN ONTARIO TODAY!

ONLY 76 CASES IN ONTARIO TODAY!

The lowest number of new cases since the end of March. I am not sure if you remember, but March 

was hell.

Look at us now.

This is the result of our hard work.

There are 14.7 million of us in this province. The naysayers might be loud and they may upset us but, obviously, most of us are getting it right.

I am so proud of all of you. Keep up this great work and our teachers and kids will head back to school safely and we will sail our way to a vaccine!

YES!

Please share

A great place for mental health support here:
https://familyserviceguelph.on.ca/

For local assistance with anxiety and depression:
www.here4help.ca
CMHA WW Website: www.cmhaww.ca
Here 24/7 at 1-844-HERE-247 or www.here247.ca.
And for post-secondary students, Good2Talk
https://good2talk.ca/

For equal access to treatment in Lesotho!
https://www.braceletofhope.ca/ways-to-give/

Lets keep our local charities strong by donating here:
https://www.canadahelps.org/en/dn/47254

For non-Facebook users, you can find this post here:
https://braceletofhope.blogspot.com/

Anti-masking groups and anti-vaccination groups?

What do anti-masking groups have to do with anti-vaccination groups and why are they joining forces?

I should be well condemned in the comments tomorrow. Thankfully, between the caterpillars that are twice the size of my index finger that are munching on my tomato plants and an office that is now 30 % busier than before COVID 19, I won't have time to read comments this week. Caterpillar advice greatly appreciated.

This just plain disturbs me. From an article in the CBC today:

"As more regions across the country adopt mandatory masking policies in an effort to minimize the spread of COVID-19, some anti-masking groups are joining forces with anti-vaccination proponents and adopting their techniques to spread misinformation and amplify their message." You can find the article here: https://bit.ly/39wDI28

I did not write it, I am just quoting it but I have to ask, do these two groups have anything to do with one another other than the questionable purpose of disseminating mistrust in the scientific and medical communities? Just asking the question. I won't attempt to answer it except to say, if the reason you exist is to go against the established scientific evidence in order to create confusion and chaos, I question the motivation. I just don't get it. Creating distrust in medical guidance during a pandemic can have dire consequences. Like death. And by the way, no one on the planet has said the a COVID 19 vaccine will be mandatory. So why spread the rumour that it will be mandatory and because of that we had better fight for our rights if not our very existence? Just does not make sense. Thankfully, only 14 % of people in Canada are opposed to wearing a mask.

On the topic of masks, I have seen a lot of people wearing theirs hanging from one ear. Not a good idea. Here is a May 2020 youtube video that reviews the proper way to put a mask on and take a mask off:

https://www.youtube.com/watch?v=0PsMbDsAOi4

The number of cases of COVID 19 globally has doubled in the last 6 weeks to over 16 million. Many countries that had their virus under control are now struggling with a surge in numbers including Australia, Belgium and Spain. The pressure we put on the virus to keep it under control needs to be sustained. Once we turn our backs in complacency, even for just a moment, it takes off again.

Ontario reported 119 new cases which is not bad at all but the cases in BC are up along with cases in Quebec, Alberta and Saskatchewan. Nationally, the new case total was almost 700 which is higher than it has been in weeks.

Of the 119 in Ontario, 76 , or nearly 64 % were in people under age forty which seems to be the trend across the country. I have one intense plea to make concerning this; to all of you older young people, please, please follow the social distance, mask wearing, no gathering in large social group guidelines. Do it for the younger young people who would like to have a chance at getting an elementary and secondary school education. You know, the education you may already be taking for granted. Do it for the kids so that they can safely return to school in the fall. I think we need to sell T shirts that say, " Do it for the kids!"

I am hearing more and more infectious disease experts talk about a COVID 19 vaccine as if it is a sure thing, not just a dream and this is fabulous news. All bets are on that we will be watching the world roll out a COVID 19 vaccine in 2021. The largest vaccine trial in the world is taking place in the USA and will enrol 30,000 participants. YES. They will stand on their feet and lead the world again. After the election please. Kudos to you our beautiful neighbours. Takes a lot to keep you down!

Our present COVID 19 struggle will be over before you know it but not now. Don't take you eye off the ball, your hand off the wheel you ear off the track....you get what I mean. Stay solid in your resolve to adhere to the guidelines.

BE ever so amazed at the incredible scientific collaboration that will lead us to the end of this pandemic. I love scientists!

Anne-Marie

Please share.

A great place for mental health support here:

https://familyserviceguelph.on.ca/

For local assistance with anxiety and depression:

www.here4help.ca

CMHA WW Website: www.cmhaww.ca

Here 24/7 at 1-844-HERE-247 or www.here247.ca.

And for post-secondary students, Good2Talk

https://good2talk.ca/

Sneaking one in under the wire

Hoping it does not draw as much attention as my last post. Seven thousand shares and one thousand comments is over the top for me. Makes me feel uneasy. The world is not the brightest place at the moment. I have lived through some nasty consequences in the past as a result of this kind of exposure. There are folks out there who would do pretty much anything to harm someone they perceive as getting too much attention.

Not sure why I am telling to you this. Maybe if I name my fear and share it, I will rise above it. Consider it named.

I think we need to review bubbles. When we moved into phase three, new guidelines may have caused some confusion. I would like to clarify the guidelines as we head into another July weekend. We are doing pretty well nationally today. There were 359 new cases in Canada and 195 new cases in Ontario. We are no longer seeing that nice steady decline in cases but we are not seeing a surge yet either. There is much to be hopeful for. If we dig deep and stay the course we will continue to keep COVID 19 under control.

A lot of folks who follow this page are asking me to comment on a return to school in the fall. I have hesitated to answer and I think it is because whether or not returning to school will be safe really depends on what the rate of infection is in September and the percent positive cases. Yesterday there were 432 positive cases in Canada which works out to 2.9 % of the total that were tested ( percent positivity).

I follow the tables that quote these numbers. I am not well versed in the epidemiology behind these numbers. But the epidemiology experts would like to see a couple numbers stay under good control before we can even consider how and when kids will go back to school: The percent positivity needs to stay under 3 %, the R value under 1.0.

Here is the link to the national data that I follow:

https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html#a4

I have not been able to find a provincial site that quotes Ontario's percent positivity or R value on a daily basis. If any of you Statistician types have a link, please share. I would really like to keep track of these numbers.

If we do not stick to public health guidelines over the summer, we will not keep these numbers under control and my guess is, returning to school will be questioned. I am not an expert here but a return to school will be safe if the rate of infection in the province remains low. That's not really an answer for parents and teachers who rightfully need answers now. The awful thing about COVID 19 at the moment is that it is ruling our lives and our decision making, not the other way around.

Here is how we keep the numbers low:

Wear a mask in all public spaces.

Maintain a physical distance of six feet from anyone who is not in your social bubble.

Social bubbles can only contain 10 people. These ten can only be in your bubble and no other bubbles until and if the recommendations change. That does not mean that each person in your bubble can belong to another group of ten and move freely between the two. That also does not mean that the 10 person bubble you are in during the week can change on the weekend or expand to 30 or fifty on the weekend.

Ten people, one bubble, no movement in or out.

One hundred can gather outside but they must be physically distanced from one another or the social bubbles within that 100 must be six feet away from other bubbles. The one hundred rule is meant for things like weddings and funerals, not an outdoor party in your back yard where, I would imagine, there is not room for 100 people to stay physically distanced from one another.

Fifty can gather inside but the same thing, they must be physically distanced. This rule is also meant for formal events as I would imagine that most of us do not have space in our homes to host 50 people who can remain physically distanced. The 50 rule does not mean you can throw a party or gather your extended family and have a reunion inside your home.

The virus is dictating these rules, not some draconian government. It is most easily transmitted when people are in close proximity inside and when too many people are in close proximity outside. These are not difficult rules to follow but they do introduce a level of hardship we have not suffered as a community before. Suffer the hardship with strength and selflessness. Fewer people will die. We will avoid the risk of another lock down and our kids might just be able to safely return to school in the fall.

If nothing else, do it for the kids

Anne-Marie

Please share

In my family practise, the number of people suffering from serious mental health issues is up by at least 30 %. Please reach out.

Check out a great place for mental health support here:

https://familyserviceguelph.on.ca/

For local assistance with anxiety and depression:

www.here4help.ca

CMHA WW Website: www.cmhaww.ca

Here 24/7 at 1-844-HERE-247 or www.here247.ca.

And for post-secondary students, Good2Talk

https://good2talk.ca/

For equal access to treatment in Lesotho!

https://www.braceletofhope.ca/ways-to-give/

Lets keep our local charities strong by donating here:

https://www.canadahelps.org/en/dn/47254

For non-Facebook users, you can find this post here:

https://braceletofhope.blogspot.com/

Furious

Warning. There are harsh words in this post that may not refer to you. If they don't, thank you.

I was furious but I went for a walk and calmed down a bit. You have not seen the side of me when I rage. Yes, I rage. I have Sicilian roots. Passion flows easily and comes in many forms.

Two reasons for my rage:

1/ I have had it up to here with the myths about masks. Here is the absolute final word according to experts who practise good science. The same folks that don't really care if you don't follow the science. They will forge ahead and find a vaccine whether you spread myths or not. I use the word 'myths' kindly. Lies and hate are stronger words that I would not use in a Facebook post but, there you have it. My rage has obviously overruled my calm, levelheadedness.

A good quality cloth mask stops 85% of the respiratory droplets filled with COVID 19 viruses from exiting or entering your mask.

Masks do not cause your blood oxygen levels to drop.

They do not increase your risk of being infected with bacteria from your mouth.
They do not cause brain damage.

Done. Period. Over. Post as many nasty comments as you'd like. If you don't believe in masks and if you shame others who wear them, you are wrong. Some folks may have a good reason not to wear a mask. Leave them alone too. But if you are spreading myths about masks and people believe you, you are putting lives at risk and that is just not acceptable.

ONE OF THE KEY WAYS TO PREVENT A NEW PANDEMIC SURGE IS TO WEAR A MASK. It is our best weapon in the absence of a vaccine

2/ You won't like me for this one. If you are not following public health guidelines because you don't believe that COVID 19 will infect you or you don't believe that COVID 19 is real, look south and give your head a shake.

Cases are up across the country and in four provinces including Ontario. And most of these cases are being traced to young people who have frequented bars, private parties and large, unauthorized outdoor gatherings. God love Dr. Bonnie Henry, the chief medical officer of BC. I bet she doesn't walk around in her back yard spewing out profanities. She has taken action. Seventy new cases have now been linked to events and parties in BC over the past several weeks.

"There are close to 1,000 British Columbians self-isolating at home;. This means people are unable to work, see friends, enjoy the summer.”

Dr. Henry has just introduced new measures. She is brilliant. Under the new measures, all patrons in restaurants, bars and nightclubs will be required to be seated, alcohol self-service will not be available (that means no ordering from the bar), and dance floors will be closed.

British Columbia did not open too early and neither did we. Our kids need to get back to school...safely. People need to get back to work. We must re-open or the education of our youth will be irreparably interrupted. Food insecurity will increase. People will lose their homes and their livelihoods, if they have not already.

If you think it is OK to have that party, or increase your social bubble to 20 or thirty, or keep it at 10 during the week but change it or expand it when you head to your cottage on the weekend, you are part of that group who have caused the virus to spread and you will be responsible if a surge stops our children from heading back to school. You will be responsible if the death rate increases. You will be responsible if we lose some of our hard earned freedoms. You will be responsible when families can no longer cope financially. It is on you!!

Pretty harsh eh.

Rant over. Please do the right thing. Behave as if the world is at war because at this point in time, WE ARE.

Dr. Anne-Marie Zajdlik MD CCFP O.Ont MSM

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For non-Facebook users, you can find this post here:
https://braceletofhope.blogspot.com/

Just putting a smile on your face.

Thanks to Ricki and the Guelph Kit Mask Squad for making me a personalized mask. These ladies have made over 11,000 cloth masks. Not sure which smile I like better. Silly.

A beautiful young 21 year old patient of mine needed her diphtheria/pertussis/ tetanus vaccine updated today. Left deltoid, 0.5 ml, intramuscular injection...done in a couple of seconds. I have never payed such close attention to a vaccine injection before and I have given hundreds. But it dawned on me how little fluid ( just 1/2 a millilitre, a tsp is five millilitres) that is required to prevent diseases that cause severe illness or death. I have never seen a case of diphtheria or tetanus. Thirty years of practising medicine in the developed world and I have not seen a case. I have seen pertussis. It's nasty. We had an outbreak in unvaccinated and under-vaccinated kids years ago in Ontario. It is called the 100 day cough. I remembered kids being completely exhausted from coughing day and night for weeks and weeks. Just 1/2 ml of this golden liquid has prevented so much illness and saved so many lives.

The COVID 19 vaccine will be like this. Such a small amount of fluid will end a global pandemic that has erased many of the things we remember as normal.

The leading vaccine candidate in the world is Oxford University's AZD1222 vaccine ( yes, it already has a title). Developed by Oxford University, the vaccine has been given to half of the 1,000 participants. This is fascinating. They used a chimpanzee cold virus, which cannot cause illness in humans as a vector for a piece of the COVID 19 virus. Essentially, they attached one of those spiky things that cover the COVID 19 virus to a chimpanzee cold virus and injected that into humans. Why do that? Because the human immune system is a complicated, wonderful, intricate system that will see the spike, and mount an immune response to it. The spike can trigger your body to respond but because it is not a whole COVID 19 virus, it cannot cause COVID 19.

The hope is, that our immune system will be tricked, in a way, into making antibodies, structures that kill viruses, that will kill COVID 19 without needing to be exposed to the whole virus. Love this stuff. Many effective vaccines have been developed using this technique.

And guess what? In the early phases of this scientific trial, people who received the vaccine have developed antibodies to COVID 19. This particular vaccine appears to trigger the two major arms of our immune system which is a big deal. It may not only block COVID 19 from causing infection but it seems to trigger the immune system to fight the virus by making antibodies.

Next step: onto a phase three trial ( not to be confused with the phase three re-opening plan) which will involve many more study participants. You need thousands of them in order to prove that the vaccine is effective and safe. It is a huge and expensive undertaking. It is the expense that has made vaccine development in the past very slow, not the science. We have the technology to make effective and very safe vaccines in under 18 months. Now we have the financial resources to make it happen.

The world must wait for the results of this phase three trial and others that are being developed. If everything goes perfectly, a vaccine may be available in the first third of 2021.

There is a global vaccine working group that is watching all of this very closely.

This is the link to the Lancet Medical Journal article that describes this trial for the geeky nerds that would like to know the details: https://bit.ly/2E44eEt

Suffice it to say, that a vaccine will come but not for months. Our greatest threat now is not COVID 19. Canada has it under good control. It is the threat that complacency and carelessness will erase the progress we have made by not following public health guidelines. New daily cases are increasing nationwide. Dr. Bonnie Henry used the words, "explosive growth" as a real possibility if we let our guard down.

Stay six feet apart. Avoid all gatherings where social distancing is not possible. Wear a mask in all public spaces. Keep your social bubble to under 10 people only. Blending bubbles to include 15 or 20 close social contacts will have catastrophic consequences. Lets avoid another lock down.

Stay the course. Stay strong and resolute. We are winning but the battle is far from over.

Anne-Marie

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For non-Facebook users, you can find this post here:

https://braceletofhope.blogspot.com/