To Mask or not to mask!

Lot's of questions about masks. Here is an extra post to help clarify.

THE MASK: Remember, wearing a non-medical mask can reduce the risk of transmitting the virus to others. It has be be worn properly and once it is on, do not touch your face, mouth or eyes.

The mask should be made of a least 2 layers of tightly woven material fabric ( such as cotton or linen). It should be large enough to completely cover the nose and mouth without gaping. It has to fit securely to the head with ties or ear loops. I prefer the ties. They can be adjusted to fit more easily. The Earloop mask can be made to fit more securely and reduce ear discomfort if you use an ear tie that pull the loops off the ears ( see photo).

Change it as soon as it becomes damp or dirty. Throw it into warm soapy water or the wash machine once you have taken it off. Once dry, it should maintain it's shape and size, if not, it may no longer fit. I hang mine to dry to avoid shrinkage in the drier. Remember, the virus hates warm soapy water and cannot withstand drying

Non-medical ( cloth ) masks should not be placed on children under 2 or be placed on anyone who is unable to remove them without assistance. They should not be made of plastic or materials that can easily fall apart. They should not be secured with tape or be shared with others.

HOW TO PUT ON A MASK

Make sure your face is clean and dry. Wash your hands with warm water and soap or hand for at least 20 seconds before touching the mask, or hand sanitizer with a minimum of 60 % alcohol base. Hair away from the fact, place the mask over your nose and mouth and secure to your head with or ears with ties or elastics.

Make sure the mask fits snuggly, with no gaps
Wash your hands again, avoid touching your face. If you do, wash your hands or hand sanitize.

HOW TO REMOVE THE MASK
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Wash your hands with warm water and soap for at least 20 seconds or use the hand sanitizer. Remove by un-tying it or removing the loops from your ears by hooking the loops with your pinky fingers. Avoid touching the mask while when removing it.

If you are not at home, place the mask in a zip lock bag and seal it. Wash before reusing.

These guidelines come from the Health Canada website: https://bit.ly/2ScrZOT

Anne-Marie
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Excellent, Excellent, Excellent..... Indeed

Lot's of good news tonight. First off, my last post reviewed the proper use of cloth masks. Can you share this widely if you have not already? The instructions come directly off of the Health Canada website. I reviewed them with a medical professional's eye and they are bang on. Wearing masks in public will save lives and reduce the spread of this virus which will be so important as we move slowly through the re-introduction to work phase. Wearing a mask improperly, taking it off improperly can increase your risk of infection. The instructions in the last post are so very important.

For the last two days, I have been searching for clarity on whether or not we can gather outside in groups of five or less. According to the city of Guelph bylaw office, there is no issue with a gathering of 5 or less on private property as long as the 6 foot rule is maintained. The folks at public health referred me to their website which has great advice as does the Ontario public health website. The information about this issue is not clear on these sites and could be misinterpreted. I finally landed via telephone in our well loved MPP's office, Mike Schreiner. Thanks Mike. He is taking the issue to the top and will discuss it with the Medical Officer of Health of Ontario. My hope is that the 'gathering of 5 or under' restriction becomes clear to all of us. It will make a big difference to our emotional and mental well-being if these gatherings can take place. The bottom-line is our safety. More info on this by Wednesday. A big thanks to this group. The debate we had in the comments section of this page, may lead to a better understanding. Knowledge is power.

Now to the good news which is actually quite remarkable. The number of new COVID infections was doubling every two days at the beginning of the pandemic in this country. Last week is was doubling every 11 days and this week, it is doubling every 18 days. That is a dramatic reduction in the rate of new infections. That is a flattened curve and every indication points to that curve falling to 0 new cases a day in short order. Five provinces and territories had NO NEW CASES today and three have had no new cases for a week. Ontario will not be far behind provided we adhere to our strict social isolation and distancing guidelines.

Today, Ontario reported that more people have recovered from COVID 19 than people who were newly diagnosed with COVID 19.

Seven Candidate vaccines have gone into human trials according to the World Health Organization. Canadian researchers are part of this global race against COVID 19. This is huge. It usually takes years for a potential vaccine to make it to the stage where it is being tried out on human beings. We have never witnessed this level of global collaboration in the scientific arena. Be proud of that folks. It is such a remarkable thing. Once a vaccine trial enters the human phase, a vaccine could be ready for widespread distribution in record time.

We cannot loosen any of the social isolation restrictions in the province of Ontario yet. For most of us that means staying home, limiting local travel and maintaining that 6 feet of distance. Ontario must see a "consistent two-to-four week decrease in the number of new daily COVID-19 cases before the government can start loosening restrictions and begin reopening the economy......but WE ARE WINNING.

Take a big breath and spend some time taking in this great stuff. There is a huge light shining in the darkness. This remarkable trial will be over and in the process we will have reconnected with our communities, with generosity and kindness and with all that is strong and good in each of us.

Much to be grateful for.

Anne-Marie

Next post- where to reach out if you are struggling emotionally. Half of Canadians say mental health has worsened during the COVID-19 pandemic. You are not alone.

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Where do we find hope?

There are some days that are just more difficult than others. Especially on the days when COVID 19 and all of it's disconcerting ripple effects trickle onto our laps. Each day seems to be further and further away from the day when this virus was not a part of our lives.

But is is now a part of our lives and it will be for quite some time. I am not fond of the idea of calling our new reality with COVID 19, the ' new normal'. This is not normal. We will not look back in years to come and call anything about this pandemic normal. In the grand scheme of a lifetime, a generation, this is a momentary trial. It too shall pass.

We will put this virus behind us and believe me, beyond a shadow of a doubt, we will find that bright future where the struggles of this time will no longer be the frightening obstacles in front of us but distant memories behind us. We will get back to normal. Back to big weddings and movie theatres, romantic dinners and beers a the Wooly, Christmas parades and fundraising galas. Bonfires and ball room dancing.

So. How do we survive in the meantime? Isolation, separation from our pack, is not healthy for any of us. We are social beings. We thrive in social environments. We find safety in our groups. We grow, thrive and heal in communion with one another.

This is going to seem trite. There was one point today when my tasks became overwhelming. I practise medicine but I also run a clinic, manage staff and make the final decisions around patient management and office policies. Add in a little COVID 19, virtual medicine, Personal Protective Equipment and a panic stricken community and... well, all hell can break lose in a matter of seconds. Big breath. Get it together. You can do this. And just as I repeat that mantra, another 'Knock and Run' hits my back door: gifts of food, flowers, PPE of all kinds, donations for those in greatest need. We are keeping track of all of you generous people, what you donate and where it goes. This week, two donations filled me with such hope. Masks and gloves from Guelph Community Christian School and a bag of beautiful homemade masks from Hides in Hands that three young siblings purchased with their birthday money. A child's generous response in times of crisis is a very powerful thing.

We survive by finding hope. We find hope by looking outside of ourselves to the needs of others and by finding that perspective that reminds us that there are so many others with much greater problems than our own.

I had a great introduction last week to the executive director of the Canadian Mental Health Association of Waterloo Wellington, Helen Fishburn. They have new programs available to assist folks who are struggling emotionally at this time.

Here4Help is a new online repository of useful tools and techniques to manage the stresses of dealing with COVID-19. Resources are categorized according to:

Children, Youth & Parents/Guardians, Adults, Seniors and Care givers, employees and employers and front line health care

You can visit Here4Help at its own website: www.here4help.ca, or though the CMHA WW Website: www.cmhaww.ca

If you know of anyone who is in crisis or who needs service, please direct them to Here 24/7 at 1-844-HERE-247 or www.here247.ca. Staffing for this essential crisis line has been increased to manage the increased needs of our community during COVID 19.

Reach out to your neighbour, extend a hand to those in need. Donate. Build the strength in our community as we travel this difficult yet manageable journey.

Anne-Marie

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The Back Door!

Well...That was a day!

This group of followers has created quite a stir. My nurse practitioner and I are literally winded as we race to usher patients in through the back door, donning and doffing our personal protective equipment in between patients and carefully cleaning the exam rooms once a patient is ushered out the back door. It is a much lengthier process than it was in the pre-COVID 19 days when we just moved from room to room with no PPE and with all cleaning left to the office cleaner at the end of the day. These are just the patients we see. We phone most of the scheduled patients on top of all this.

Now we are weaving in YOU and happily doing so. Seven thousand dollars in donations so far with most of that already distributed to people in great need and to equipment for the COVID 19 clinic. There was $3,000 on my office manager's desk today. We discussed where we thought it should go. The needs are great. We decided to use it to purchase more high quality cloth masks. There are elderly and vulnerable people out there with no access to the internet. They can't order masks online nor can they download instructions as to how to make a mask. They also cannot go out in public without one. Several of these folks knocked on the back door today to pick up masks. I stand in the parking lot with them, showing them how to put them on and take them off. Just as we made the decision to buy more, four separate back door drop offs happened, all of them with the exact masks we needed. More vulnerable people will start picking these up next week and one fellow who dropped off a box of masks that his company is now making, offered to deliver masks to anyone in need who cannot make it to my back door.

Just as we recognize a need, you fill it. Thank you.

I heard a radio personality state that we are now living in isolation in a world that has lost it's culture. I disagree. We may have lost what our culture used to be with it's rich social activities and networks but now we have a culture of compassion and kindness. It is far richer. I am so proud of all of you. My office can't keep up and we are so 'OK' with that.

Lot's of good stuff to report which I will dole out in posts over the next few days. Here are some tidbits:

More than 20,000 Canadians have recovered from COVID 19.

Six provinces and territories reported no deaths this week.

The rate of infections of COVID 19 is now doubling every 21 days. In a post I wrote earlier this week, that number was 16 and in the early days of the pandemic, that number was every 2 days. The curve is brilliantly flat!! Your work of social distancing has allowed us to win this first battle. We won!

I have been treating HIV positive patients for 30 years. I have watched the remarkable development of anti-viral medications. We are now using that technology in the fight against COVID 19. There is an anti-viral drug that is heading into the final research phase and it is showing promising results in the treatment of the most critically ill COVID 19 patients.

There is more evidence that wearing a cloth mask in public stops a significant number of infections from occurring. It must become our newest weapon.

We are smashing this folks but we must remember, the hardship is great. More and more people are suffering economically and emotionally. We have not experienced this kind of overwhelming and collective trauma in 101 years. None of us have experience with this. But there is no question that we are learning not only to survive but to thrive.

Be gentle and kind to yourself and to others because this is massive. We will win. There is so much to learn about our strength, resilience, creativity, and ingenuity in the process. Have not doubt about my capacity and your capacity to manage this.

Be of good cheer my friends. Stay tuned for more information about that all-important mask.

Anne-Marie

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Masks, Masks and more Masks

I love this mask. The rainbow mask holds such meaning for me. I will wear it with pride in July.

It was national physician's day today. I would like to once again honour my colleagues in Guelph and around the world who have gathered together to lead so many COVID 19 efforts. To those who showed my how to find the courage to fight HIV/AIDS in Lesotho, Africa and to those whom I have followed as they have set the course for the fight against the COVID pandemic here in my community. It is such an honour to be counted among you.

It is a new month and the dawn of our warm, green, sunny season. We so need that. It will make all the difference in the world. It is also our third month of lock down. We are getting tired and although we have adapted so well, this is a tough slog. I can see and hear the discouragement, I am listening to the stories of loss and fear. So many of you have lost so much and the future is still so uncertain.

Be strong and courageous. Stand firm. And when you fall and everything is lost and you seem to be totally defeated, stand again. It is not lost. You are not defeated. You can stand again.

More good news and more advice:

I heard back form our honourable MPP, Mike Schreiner. There is a provincial order about gatherings. It states:

Prohibition
1. (1) Subject to subsection (3), no person shall attend,

(a) an organized public event of more than five people, including a parade;

(b) a social gathering of more than five people; or

(c) a gathering of more than five people for the purposes of conducting religious services, rites or ceremonies.

At all levels, the interpretation of this order is vague and varied. The chief medical officer of the province, Dr. Williams suggests we reach out to our local medical officer of health for clarification or ask the city to issue a clear guideline like Ottawa has done. In the end, it is the decision of Guelph By-Law and according to them it is OK to gather in groups of 5 or less as long as the physical distance rules are maintained.

I will pursue this a little more but it sounds like the Premier is about to loosen some of the restrictions in parks and the gathering issue may become clearer at that time.

How's that for a political answer. If you do gather in groups of 5 or less on private property, please wear a mask. And here is why. The U.S. National Institutes of Health, which I follow closely to stay up to date with respect to my HIV patients, published a research letter in the New England Journal of Medicine this week which showed visual evidence that "speech- generated droplets" can become suspended in the air and inhaled by other people.

That dear friend who is sitting 6 feet away from you on your patio could be spreading virus just by speaking. If you inadvertently reach over to refresh his beer, you could be exposed. This may be how the virus is still spreading. Wear a mask.

A growing chorus of experts is calling for the widespread use of masks to slow the spread of COVID-19 and suggesting it may be a key factor in why some countries seemingly have their outbreaks under control while others are completely overwhelmed.

The guidelines for the proper use of a cloth mask come from the Health Canada website: https://bit.ly/2ScrZOT

And did you hear that Guelph is bucking the provincial average and no one at St. Joe's Health, a longterm care and rehabilitation facility of over 900 people, tested positive for COVID 19. Well done St. Joe's!

Of the 3 million people who are infected with COVID 19 world wide, 1 million have recovered. Of the 55,000 infected in Canada, 22,000 have recovered.

Good news is getting harder and harder to hide in the dark chaos of the media. And now we begin the slow and careful process of re- opening our economies. Be patient, stay the course. Be courageous. This next part will not be easy.

Anne-Marie

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Vaccines on Fast-track and A DOWNWARD SLOPING CURVE:

Don't get me started on vaccines. I will write 500 posts about them and believe me, you do not want 500 posts about vaccines. But, they are miraculous inventions that have saved millions of lives and reduced the suffering of billions. Viruses are interesting. Creating a vaccine is difficult. It usually takes four years before a vaccine is ready for general use among humans. But never, in human history, have so many countries and so many research facilities been put to the task of making a vaccine against COVID 19 AND given the financial resources to do it.

Scientists in the UK began trials of a potential Covid-19 vaccine on humans last week. Sarah Gilbert, professor of viroloy at Oxford University, told The Times of London she was "80% confident" that the vaccine being developed by her team would work. It is hoped about a million doses could be ready by September. This early vaccine will be used to protect our front line workers first with expansion there after into the general public.

It may not be until this time next year that a vaccine will be available for widespread use. Until then, we will need to continue our social distancing measures

Be strong and courageous and when you fall, stand up and BE strong and courageous. We have the strength to do this and to do it well.

And tomorrow, it begins. We start the slow and careful process of re-opening the economy. The goal of your leaders is to limit the number of new infections as much as possible and to keep our health care systems prepared for the effective treatment of the most ill. Remember that an intact and well preserved health care system reduces the death rate of this virus to < 2 %. We can handle that. We will lose some. Bless them. But the vast majority will do well.

Here is what you have already accomplished:

Canada's top public health official struck an optimistic tone about the COVID-19 pandemic on Saturday, saying that efforts to flatten the curve are working as provinces across the country reported more positive figures.

"By following public health recommendations, we have collectively brought down the rate of infection. We are flattening the curve," said Dr. Theresa Tam. And premier Ford, ""We're seeing a gradual downward slope (in infections) in the public domain, and the lower we get the more we can open up and get back to the new normal."

That is not just a flattened curve it is a curve that is on it's way down. We have reached this goal much, much sooner than was predicted just 2 months ago. Well done. Well done and well done. WE DID THAT!

See what you have done? See what we have done as a nation? Do you know how remarkable this is? I am so proud of our leadership, so proud of my country and so proud of you. But you cannot stop yet. Stay home and keep up the physical distancing measures until they are lifted

Have faith and be courageous. You will not be forsaken. You will overcome. We will overcome.

Let’s reach out to those in need. I need 2,000 masks for a remote community. They will protect 2,000 of our beloved indigenous Canadians. Donate freely if you have the capacity. We need to meet the needs of those who will struggle the most over the coming months.

Anne-Marie

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PS. These are the local websites and number to call if you are having difficulty coping emotionally. Please reach out.

www.here4help.ca,
CMHA WW Website: www.cmhaww.ca
Here 24/7 at 1-844-HERE-247 or www.here247.ca.

Donations eagerly received at Hope Health Centre ( 21 Yarmouth St,)....back door.

Vaccine's hit a sensitive spot!

Wow. That was tough. This is my sixtieth post. The first was on March 14th. I have posted faithfully every day since. On two occasions, I posted twice. Last night's post generated such hostile commentary with ample use of insults and profanity that I honestly considered quitting. I was going to delete the offensive comments but I decided to leave them. I did delete one. I could barely stomach reading it.

So, instead of posting about the positive things we need to be aware of during this pandemic, AND THERE CONTINUE TO BE MANY, I am going to indulge in providing you with a little information about who I am in the hopes that such scathing commentary will not don the pages of these posts again.

I was born and raised in small town Ontario by two, very hard working parents. My father immigrated from Holland as a teenager and my maternal grand-parents immigrated from Italy in the 1920's. I was raised in a home with 4 siblings that I love dearly, crammed into under 1400 square feet of house much like many of my neighbours in the 1960's. My mother was a devout Roman Catholic who went to church every day. She was a woman of prayer. Both my parents were heavily involved in their communities. They were incredible volunteers. They encouraged me to work hard and to set no limits on my goals. Their actions taught me to love others and give back, constantly.

I was lucky enough to get into medical school. I married a very strong and brilliant man when we were both 22. I had three children whom I love more than life itself, and I focused my career on treating and caring for the most vulnerable and marginalized people on earth. I was blessed to be in the room when the first dose of the first medication available to treat HIV was given to the first patient in the country which set me on a life-long path of fighting to end HIV. I am not a hero. I am hard wired to serve. This desire does not come from a place of ambition or a desire to achieve. It comes from the pure example of love and generosity passed on to me by my parents and by my own faith which has taught me that nothing is in possible, that faith and love conquer all and the loving God first and then my neighbour is the most pure and the most difficult of all callings. To whom much is given, much is expected.

I have put into intense practise what I believe for decades and I will continue to do so. My community, my country is suffering. We are walking though a very dark valley. We need each other more than we ever have. But, we need to be the best of ourselves and to give the best of ourselves to those around us. I can promise you this. Every post that I write is based on my own intense research and my faith in humanity's ability to overcome when we work together for the good of all.

I will honour and respect who you are. I will serve you to the best of my ability because, you, my own fellow citizens are now the vulnerable ones. To you, I will give my utmost to help us all overcome our present hardship and suffering.

But in the future, I will follow the comments carefully and delete everyone one that diminishes, defeats, discourages or defames. We are better than this. We are stronger than this. We are smarter than this.

On a bright note, I have to share one piece of news that proves many of my points. I put a call out last night for 2,000 cloth masks for a First Nations community. As of tomorrow, we have 700. That's a beautiful community in action. Well done. Well done.

Sleep well. We've got this.

Anne-Marie