Please remain on high alert!

Cases of COVID 19 are now at the same level as they were at the beginning of the outbreak in March and April.

Fifty eight percent of new cases in Canada are from an unknown source. This means that when public health officials try to identify where a newly diagnosed person has been, no obvious source of infection can be identified which also means, public health officials cannot trace any contacts that a person with COVID 19 had during the days that transmission of the virus occurred.

Unfortunately, there is likely more community spread than first predicted. None of us can take for granted that the public space we are in is free of COVID 19. Assume that it is everywhere and take reasonable, proven action.

Without the ability to know where a person picked up the virus and who they may have been in contact with since becoming infected, contact tracing is not possible. Without the ability to find contacts and quarantine them, we must assume that there are people out there who do not know they are infected. If they are not keeping their distance and wearing a mask, they will spread the virus.

One way to assist public health in the vital role of finding all the contacts an infected person has come close to is to download the Federal COVID Alert App. With the free COVIDcovid Alert app, you can:

1/ get a notification if you may have been exposed to COVID 19

2/get advice on what to do next

3/tell nearby app users if you test positive for COVID-19 thus alerting them to the possibility that they have been exposed

The COVID Alert app creates a random code, so that no one will know your name, or your location once you download it.

The app uses Bluetooth to exchange random codes with nearby phones. The code is a randomly generated string of digits and letters that changes every 5 minutes, so it cannot be used to identify you.

If someone you've encountered later tests positive for COVID-19 and uploads to the app a one-time key they received from public health, you'll be notified that you may have been exposed.

If you test positive for COVID-19, you can upload your one-time key that you will receive from public health. The app will then notify the people you've encountered, without revealing your identity.

I have downloaded this app. This is one of these most important tools we can add to our COVID 19 war chest.

Find out more at Canada.ca/coronavirus

There were no new cases of COVID 19 in Guelph or Wellington county today. That is good news but the percent positivity of COVID tests done in the region has climbed from a low 0.2% to a still very low 0.56%. The reproductive number in our region has recently climbed above 1.0. Both of these numbers indicate an increase in COVID 19 activity. We are still well below the national numbers but the virus is moving in our area. Be on alert. Do not fear as a matter of fact, be fearless and confident that when you are practising public health guidelines you will be safe.

I recommend against all indoor gathering unless it is with the people in your bubble and I also recommend that we decrease the size of our social bubbles if possible. These are also the recommendations of the Toronto Medical Officer of Health, Dr. Eileen de Villa. It just makes good sense to really batten down the hatches for the next three weeks. Stay close to home if you are at risk or elderly. Wear a mask when you are in any public space. Keep a 2 m distance from anyone who is not in your bubble and wash your hands frequently.

Back to the beginning folks but not for long and without a lockdown this time. This second wave will teach us how to live with this virus and keep it at a slow burn until a vaccine comes.

We've got this.

Anne-Marie

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160Christine McEwan, Millie Timbers and 158 others

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Step back. Let's get some perspective on the numbers and RESPOND.

 

First off, I'd like to thank one of my patients who expressed such gratitude for these posts today that he made my day. He also made me cry. Literally, he turned the day around. He reminded me how the smallest gestures of gratitude, kindness and compassion can not only get a person through a difficult day but collectively, when we are all making an effort to be kind and grateful and compassionate, we can re-direct a nation.

And that is exactly what we need to do.

Seven hundred confirmed cases today is a 42.6 % increase in the number of new cases of COVID 19 from the day before.

The numbers started to take off on September 11th when Ontario’s daily COVID-19 case count surpassed 200 for the first time since early July. In just 17 days, the number of new cases has sky-rocketed and it is the rate of the increase that is the most concerning.

Yes. It is time to call this a second wave and yes, we need to sound the alarm. I don't want to diminish this at all but perspective is important. If we become overwhelmed with fear, we cannot act.

What has also increased in the last three weeks is the number of people being tested in the province. From August 30th to September 10th the province tested just under 24,000 people each day. That number shot up and consistently surpassed 35,000 by September 18th and since September 25th we have been testing over 40,000 people everyday. God bless our front line workers in those COVID clinics!!!

Percent Positivity and the Reproduction Rate are two very important numbers that give us an idea of what the virus is really doing. Percent positivity is the percentage of all of the tests done on a given day that come back positive. In Ontario, that number is now 1.2% and is actually down by 0.2 % from the day before. The reproductive rate ( the number of people a person with COVID 19 can transmit the virus to) is 1.16. Above 1 is not good. Below one means we have this thing under control. But Ontario's R value has been above 1 since the end of July and has not climbed significantly since the middle of August.

The death rate has not change significantly either. Why am I throwing all these numbers at you? To give you some perspective and lots of hope. Because, there is lots of hope.

The numbers we need to be trouble by are the hospital admissions and ICU admissions because, as these numbers increase, we threaten the integrity of our health care system. If we push it past it's capacity, the whole system backs up and the number of people who suffer and die because of the lack of easy access to health care starts to climb unacceptably high.

September 11- 49 in hospital and 18 in the ICU

Today- 128 in the hospital and 29 in the ICU

God bless the health care team manning our emergency rooms, our hospital wards and our ICU's. God bless a province that has such great healthcare capacity in the first place. We are so lucky. Now lets respect that system, the people who man it and the lives it can save over the next few weeks.

Please reflect on these numbers and be inspired to take action. It is not too late. It is not out of control and we have time to act. Most communities in the province still have very few new daily cases. You are safe. But we need everyone and I mean everyone to respond in order to prevent COVID 19 from becoming a destructive run-away train.

Simple public health measures.

I united effort.

Now.

Stay home. Avoid gathering inside and outside. Get that mask on and leave it on while outside of your home and in public spaces. Don't be fearful. Don't be afraid. Just act. We can beat this virus but only if we deprive it of it's hosts and that is you and me.

Stay strong and keep that resolve up folks. We are in this together and we will win this together.

Anne-Marie

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Have no fear: A very successful weekend for COVID 19, not so great for us.....BUT WE WILL WIN

!

I am kinda getting used to being in isolation on the weekends. It's just me, my husband, my bike and whatever needs to be harvested from the garden. I must admit, until COVID 19, I took for granted some pretty important things in life like the value of living in the moment, of being grateful for the smallest of miracles including a really, really big butternut squash. Like warm pyjamas every night and a safe place to sleep. Like the sound of crickets. I love the sound of crickets but this year, I have really appreciated their high pitched purring. It is really beautiful out there right now. Not much can stand against the magnificence of a maple tree in autumn. Don't lose sight of these beautiful things and do look for more. Our gratitude for the blessings that surround us can get us through some very tough times. No one wants to officially announce this but we are riding the beginning of a second wave. Except for the maritimes, most provinces are now experiencing a significant surge in new cases. The new cases are still occurring in people under 40, the majority of which remain relatively healthy during and after COVID 19 infection. But, there are some new signs of trouble ahead. These are the signs that worry the healthcare system the most. On September 19th there were 64 people with COVID 19 in hospital in Ontario. Today, there are 112. Since yesterday, there has been a 10 % increase in hospitalizations and a 2.2 % increase in people requiring life support ( up 16 ....since yesterday). The increase in new cases we have seen over the last couple of weeks is now causing our hospitals and ICU's to fill up. If we surge past our hospitals capacity, the ICU could be too full to save the life of your father, your brother, your wife who just had that heart attack. COVID testing centres no longer have the capacity to manage the huge increase in people requiring or wanting testing. There is a back log of tests, a shortage of lab technicians and a much to lengthy time for test results. But, lets step back for a second. We have the tools to turn this around. Whether the peak of this second wave is reached this week when things are still manageable or in three weeks when we might be overwhelmed is entirely up to us. Remember the basics. When an infected person coughs, they propel viral droplets into the are in front of and around them. These droplets fall useless to the ground within about 4 feet. Stay six feet away and the virus stays out of you. The more virus you are exposed to, the greater the chance that you will become significantly ill. An infected person wearing a mask is wearing a barrier that limits the amount of virus they can spread. Two barriers of protection: distance and masks. I remember the first month of this pandemic, singing the alphabet song in front of my exam room sink as I washed my hands. COVID 19 has a fatty outer layer. Dunk that fat in soap and poof, the virus can no longer infect. The third barrier of protection: Hand washing and sanitizing. It seems so simple. So why is there a second wave? Because we are social beings. Our brains are hard wired to seek out social connections. These close connections give us a surge of dopamine which makes us feel happy. Without them, we aren't. Millions of years of hard-wiring is very difficult, if not impossible to dismantle in a mere nine months. But, do you know what else we are hard wired for? Kindness, goodness, selflessness and altruism. These values are also hard wired into our brains and practising them makes us happy. Our brains thrive when we focus on a purpose that improves the lives of others, that makes the world a better place. For a short time, our ability to work together for a common goal and a common good needs to over-ride our desire and need for connection. So let's do this. Let's do this while very smart people hand us a test we can do at home ( it's coming), while freaky smart people come up with several vaccines and while our freaky, smart and exhausted leaders lead us out of this thing. Yes, I just referred to our politicians as freaky, but just a little. I am a little bit freaky too. We can do this. There is no question and when we do, we're all going to feel good about the role we played to end COVID 19. Please avoid large outdoor gatherings with no social distancing. If you are planning an event like this, please reconsider. If you are contemplating attending an event like this, please don't. Indoor gatherings with no distancing or masks is just as dangerous. More on this tomorrow, but every year at this time, I push the freakiest part of me to cycle 50 km as a fundraiser for Bracelet of Hope. It used to be 100 km but with age, I am a little wiser ( or less stupid). My goal is to raise $30,000 for our HIV/AIDS and COVID 19 education and relief efforts in Lesotho. I think that 17,000 followers could raise a lot more than that. To whom much is given, much is expected. Anne-Marie Please share. Click here to get this physically distanced, socially acceptable party started! https://www.facebook.com/donate/2707157766204565/1892121307596677/

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COVID 19 Second Wave simplified

Let's keep this simple. We are 6 months into a global pandemic. Because of good, collaborative and effective leadership across the country and the united response of Canadians, we tackled the first wave of COVID 19 very effectively.

We smashed it.

We kept the level of new daily COVID cases at low levels throughout the summer surpassing the expectations of the best case scenario presented to us at the beginning of April. Again, we smashed it. Working together we saved thousands of lives, protected the integrity and capacity of our health care system and slowly re-opened our economies at a very reasonable pace.

We suffered but we succeeded.

Now, the number of new daily cases is on the rise. This time we are prepared and we know what works to deprive this virus of the human hosts it needs to replicate and spread. This time, most of the new cases are in people under the age of 40. These folks handle the virus fairly well. They generally do not get sick enough to require hospitalization and they rarely die. As a result, even though the rate of new cases is on a steep climb, the rate of hospitalizations and death are not increasing dramatically. This will change in short order unless we coordinate our stellar efforts again.

There are three potential outcomes. The first is a continued very steep curve that is climbing faster than it did in March. The second is a not so steep curve and the third.....IS A FLAT CURVE.

We already know how to flatten the curve and there is no doubt in my mind that we can do it again. To flatten the curve of this second wave will require three weeks of diligent work. For three weeks we need to be obsessive about wearing a mask. We need to keep six feet between you and each person who is not in your social bubble and we need to get back to washing our hands. For the next three weeks, minimize all social gatherings. We are back in the trenches but the trenches are safe if we follow the guidelines.

All of my social plans for the next three weekends are cancelled. Please think about cancelling yours too. Even those gatherings that are permitted, avoid them unless they are absolutely necessary. Hibernate for three weeks and we get this thing back to a slow burn.

Thanksgiving celebrations are off the table so that, potentially, Christmas celebrations are on the table... so to speak. Grab a book, go for walks, sit on the porch, ride a bike, Zoom like mad, sit in the park but do not gather. Small gatherings and bubble breaches caused this second wave. Wipe out the gatherings, reduce the size of your bubbles, stay six feet apart, wear a mask and voila, we will be back in the game in short order.

End of pep talk.

Saw a lovely hashtag on a poster today.

#doitliketerrywould

That's what we need. A Terry Fox attitude. Hard work, selflessness, perseverance and determination for the good of all.

Anne-Marie

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