Sunday 29 March 2020

Do not give into the fear!






Do not give in to the fear. There is so much to be hopeful for. Get into a self-isolation routine. Exercise everyday. Practise mindfulness or prayer. Refuse, absolutely refuse to be afraid. This is such hard work. Instead of worrying, think about this:
Canada's COVID 19 caseload is much less than we expected. So far. More than 90 % have not required hospitalization and the death rate is only 1%. This pandemic hits some countries harder than others. The reason for Canada's hopeful numbers? We were given time. We were not the first country to be hit and our governments responded and continue to respond to the science.
There are experts called medical epidemiologists out there. Yes, they were probably nerds in high school but they are watching the numbers carefully. Canada's numbers are not climbing as quickly as did the outbreak in China. That is great news. We were given time and our leaders seized that time by pushing for social distancing, by closing schools, by recommending against travel during the March break and by telling us to stay home. By limiting the early spread of the disease, which I believe we have done, we had time to prepare our health care workers and hospitals. I believe we have flattened the curve.
Quebec has the highest numbers and there is a reason for that. This virus loves to travel and thousands of Quebecers travelled during a March break that was one week earlier than the break in Ontario. The travel bans were not put into effect until after their break. It is all about timing.
We love you Quebec and we are with you in this!!
This virus loves it when we congregate. We are the host it searches for, the host it needs to survive. The answer is that two pronged strategic plan: social distancing and testing on a massive scale. You will see our numbers increase over the next several weeks. There are now 70 testing centres in Ontario. By next week, we will be testing 20,000 people a day and those who test positive will be cared for and quarantined. Man, I am so proud of this country's leaders. This is brilliant!
I listened to this today and it filled me with hope. It was written by a teacher in China:
"Just finishing 7 weeks of lock down, we are happy, we are healthy, we are humble as we watch the rest of the world begin their time inside. My reflections on the last 7 weeks:
You have no control over the situation, let go of any thoughts of trying to plan too much for the next month or two. Things change fast, make the best of the situation whatever that might be for you. Accept that this is what it is and things will get easier. Try not to listen to, read or watch too much media. It will drive you crazy. There is such a thing as too much. The sense of community I have felt during this time is incredible. I could choose who I wanted to spend my energy with, who I wanted to call ,message and connect with and found the quality of my relationships improved. Appreciate this enforced down time. When do you ever have time like this? I will miss it when we go back to the fast paced speed of the real world. To those beginning this journey, you will get through it. Listen to what you are told, follow the rules and look out for each other. There is light at the end of the tunnel"
Wise, Wise words my friend!!
Share the good stuff!

The weariness is short term



Well, still a little weary but it is amazing what a good night's sleep and a long walk in the sun can do.  I noticed a few things as I walked.  Everything spring is just about to bolt out.  Little bits of evidence that nature carries on regardless of our human woes. 

It's kind of cool, this evidence of new life and renewal just under the surface, barely visible.  If you search, you'll see it:
B.C. health officials believe physical distancing restrictions are successfully beginning to slow the number of new cases of COVID-19 in the province by half. Read that again!
The Ontario Medical Association has been advocating daily on behalf of your doctors for PPEs ( Personal Protective Equipment). Today, we were informed that in the last 72 hours the supply chain has opened up and is moving quickly around N95 masks, rapid test kits, gloves, gowns and ventilators.
The government of Ontario is expecting delivery of an additional 1,000 ventilators and 6 million N95 masks by next week.
And in our community alone, I am getting a little choked up as I write this, the University of Guelph has donated 10,000 N95 masks to Public Health, sourced from labs across campus.
The Ontario Veterinary College is donating ventilator equipment and, get this, Guelph based Canadian Solar company imported 60,000 medical masks for health professionals in Ontario. The masks were donated from facilities in China. They came in numerous boxes that read ‘we shall overcome,’ in both English and Mandarin.
Thank You. Thank You. Thank You.
That N95 mask, it will save my life and the lives of all of your front-line healthcare workers. And those ventilators, they will save yours.....IF IT NEEDS SAVING.
That is so much good news. So much evidence that we shall overcome. BUT, the global coronavirus death toll passed 25,000 today with Italy and Spain announcing almost 2,000 fatalities in just 24 hours. And New York? God, please bless New York.
The weaponry we need to fight this war is arriving now. We will now stand on the front lines of that war, protected and confident. But this is an ugly disease. It kills both young and old. Please don't be lulled into anything close to complacency. Stop all socializing, even the teenagers and twenty somethings who seem to believe they are impenetrable. You are not.
Our weapons: ventilators and personal protective equipment.
Your weapons: social distancing. Stay home. Stay safe. Stay apart!
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Keep up your resolve!









This is exhausting but we've got it. Please keep up your resolve. I am posting this quote again tonight. We must pay attention to what is happening in the USA. We must take heed. My heart aches for that beautiful country. It is an utter lack of leadership that has left them exposed. You are being led well. I will say that again, you are being led well. Let's be smart and follow that lead.
Your job is so simple. Stay home. Essential trips only. I believe that a complete shut down will be necessary. The list of 'essential businesses' is long. When our leaders shorten that list to the bare minimum, be grateful, not afraid. That is what is coming next. China and South Korea beat the virus just weeks ago. The number of new cases each day in these countries is very low and well within the ability of their health care systems to manage. They have provided the rest of the world with a strategic plan that will end the pandemic.
WE CAN WEATHER THE SOCIAL AND ECONOMIC CONSEQUENCES OF THIS SELF ISOLATION BECAUSE WE ARE DOING THIS AS AN ENTIRE COUNTRY. ALL OF US. TOGETHER WE HAVE IMMENSE POWER, IMMEASURABLE POWER.
Tedros Adhanom Ghebreyesus, the World Health Organization's director general, said Wednesday that staying home buys time and reduces pressure on health systems.
That's step one in the strategic plan, the step you are responsible for:
Stay home, stay 6 feet away from others when in public, wash your hands for 20 seconds in warm, soapy water if you have touched any public surface. And remember that 80 % of people who become infected recover well without the need for a hospital admission. Be of good cheer even when it feels like that is impossible.
Step two of the plan:
"Aggressive measures to find, isolate, test, treat and trace the contacts of people who test positive." That is the job of your governments both provincial and federal and your front line healthcare workers. Help is on it's way in the form of more testing kits and more personal protective equipment, vital to those on the front lines.
Stay strong folks. Take care of your neighbours and those in need and thank you for taking care of your medical team. We feel your support and it keeps us strong!
Keep this in mind: "If you can envision a world where we all stay in the same place, six feet away from everybody else, then the virus would die itself out. The outbreak would end."
Please share this widely. Thank God we can be so connected!

Here comes the tough part!






OK. Here comes the tough part. We knew this was coming. A larger and larger number of people testing positive for COVID 19. This is when we double down with our resolve to Stay Home and practise social distancing. This is the moment.
This quote sums it up:
"If you can envision a world where we all stay in the same place, six feet away from everybody else for the next 14 days, then the virus would die itself out. The outbreak would end."
It is extremely important that we all do this now. I was cleaning my exam room today. I am acting like a germaphobe. I have never been concerned about germs before. Every surface gets sanitized after every patient interaction. The personal protective equipment shenanigans before and after each patient visit and then there is the hand washing. Twenty seconds, warm soapy water. It takes 20 seconds to sing, "Happy Birthday" so today, that's what I sang, each time I washed my hands. My nurse practitioner was splitting a gut listening to me sing.
The COVID 19 virus has fat in it's outer layer. Soap emulsifies the fat, destroys the outer layer and kills the virus. Today, I washed my hands, sang "Happy Birthday" and envisioned that layer melting away.
Stay inside. Wash your hands. Essential trips to public places only and when you are there, stay 6 feet away from those around you. Wash your hands. Sing "Happy Birthday". And remember, there is a magnificent team of health care professionals and first responders that circle this city. They are standing between you and COVID 19. You are so cared for. Stay strong. Insist that your fear melts away with that fatty outer layer of the virus. Sing. Find joy. We've got this.
Please share. We need to get this message out far and wide.

Monday 23 March 2020

COVID 19: WE WIN IF WE DON'T PASS IT ON







Me and my crazy staff. I love you guys. It was a two stethoscope kind of day! We are thinking about bringing in sleeping bags and just moving into the office until the COVID 19 Crisis is over. Tomorrow, I will work my first shift at the COVID 19 Clinic in Guelph. Wish me luck and safety!
COVID 19 simplified: 99 % of people with COVID 19 have a fever and dry cough, which means, if you don't have both, chances are, you don't have the virus and you don't need to attend the clinic or the emergency room.
80 % of us who get this virus will be at home with cold symptoms, sipping neocitron and downing tylenol.
The virus is spread by respiratory droplets. That's the goop that comes out of an infected person's lungs. They have to cough or sneeze around you in order for you to breath the virus into your lungs. It's a nasty bug that can live for up to three days on plastic surfaces and stainless steal, 12 hours on cardboard. That means that if an infected person has coughed or sneezed near a surface, they infect those surfaces. If you touch those surfaces and bring your hands to your face, the virus can be transmitted to you.
The virus can't survive without a human host in which it reproduces itself. Unfortunately, that host is you and me. It dies if our immune system kills it, in which case we recover from the disease or if we die with it in our lungs which happens in 3 % of those infected usually in the over 70 year old population. Or, it can live on if we pass it on to our neighbours ,friends and colleagues. That's why we must isolate ourselves: It won't survive if we don't pass it on. WE WIN IF WE DON'T PASS IT ON.
Keep at least 2 m away from other people. Wash your hands after being in contact with surfaces in public spaces. Keep your hands away from your face. That's hard. Look at my hair. I am always pushing it off my face which means, I touch my face! We all do. Sneeze into your elbow. Stop all gatherings large and small. Absolutely, unequivocally, all of them!! If we do this for two weeks, we get control and the virus loses. WE WIN! 


Dr. Anne-Marie Zajdlik MD CCFP

A day at a COVID 19 Screening Clinic



Well. Today was an interesting day. Let me walk you through a day at a COVID 19 Screening Clinic. The day started at 7:30 for training. A team of incredible health care professionals met in a common area to gear up, share stories, encourage each other and make efforts to settle the inevitable anxiety we all feel about testing and treating people who may be infected with one of the most terrifying viruses this planet has ever seen. Not a small task at all but the morning gathering reminded me of the days when I was delivering babies at the Guelph General Hospital: the atmosphere of camaraderie, team work, purpose and compassion. Mostly women, all nurse practitioners and nurses, administrative folks, these are your COVID 19 warriors. These are the folks that will risk their lives for their communities, the people that will win this battle against this pandemic. People with husbands and partners and kids and mortgages and aging parents just like the rest of us. These are your COVID 19 heroes and I am humbled and honoured to be on their team on this day.
The clinic has been well planned and coordinated. It is designed to move you through with your safety and care in mind at all times. Carefully designed areas where staff are gowned and gloved and masked before seeing each patient. Each patient interaction is in a private cubicle that is pristine: questions asked, vitals taken, stories told, anxieties quelled, comfort given. Most are just reassured and sent home to self isolate like the rest of us. A few are sicker with concerning vitals signs that compel us to test and make very clear follow up plans. One or two are sent to the emergency room. A well oiled machine of a team that 5 days ago did not even exist. Did we see COVID 19 today? Maybe. Time will tell when the test results are in. Did we witness the fine execution of a health care system that is one of the best in the world? Yes, we did. Are you in good hands? Their is no doubt that you are. No doubt at all.
This team is here for you and they are ready. We were made to do this. We signed up for this. We are at our best when your lives are put in our hands and we can take the incredible skills, knowledge and training we were given and use it to take care of you under any circumstances regardless of the risk or the consequences.
A shout out to all the nurses, nurse practitioners, doctors and administrative folks across this country who have lined up to take this on. For them, please take care and do your part. Self isolation / social distancing is our social vaccine and it is the only vaccine we've got. We will suffer for a time but no enemy can beat an army like this. Sleep well tonight. We will be OK. We will triumph over this and be better people because of it. Please reach out to the vulnerable and to those who are in isolation alone. They need you.


Dr. Anne-Marie Zajdlik MD CCFP

Sadness and Sacrifice in the COVID 19 Era


Sadness and Sacrifice.....for a world saving cause.
Another day at the office. Wearing a mask has it's setbacks. You cannot sip your Tim Horton's coffee if you are wearing a mask. These masks are precious. I won't take it off until I have seen the handful of patients who have presented today for face to face visits. Patients with symptoms that might suggest COVID 19 are screened over the phone and if they have a new cough, fever, travel history, difficulty catching their breath, they are sent to the COVID 19 clinic for screening and possible testing. Everyone else is receiving consultations using various telecommunication methods. But, that 3 year old with ear pain and that mother who is 17 weeks pregnant, that 65 year old who just had a brain tumour removed...they all need in office appointments. They wear a mask and I wear a mask. Note to self, sip that coffee before the mask is put on.
Today, I felt this huge rush of hope and a surge of renewed energy. It made me realize how troubled I have been, how deeply worried. That hope came from firm and unequivocal government orders telling us to stay home. This is your job while the front line healthcare workers manage the sick and test as many people as we can. This is your job while the scientific community works towards creating an effective vaccine and this is your job while governments figure out how to protect the citizens of this country both from the virus and from the economic toll of shutting down an entire work force and education system.
Several Asian countries who were hit very hard are now recovering and loosening their social distancing rules. They are recovering because they fought hard at the beginning. They put draconian measures in place to keep people apart and they enforced them. This bought them time to test as many people as they could. Now, they are in a phase of sending people back to work and school because they can focus on isolating only those that test positive. While you stay home, preventing further spread of the disease, we will test as many people as possible. It's a two pronged approach: social distancing and massive testing. Give us time to get those test kits and the resources we need to test as many people as we can. Give us time by staying home and halting further spread of the virus. Your government, your healthcare workers and your scientist have a job to do and we can't do it without your help.
If you do this, we will be locked in for weeks, not months and we will get more and more of our freedoms back. Our governments ( provincial and federal) are following the science. Have faith in them and follow them.
In the last 10 days this country has tested 10,000 people/ day. You will see the number of infections go up as these results come in. Don't be alarmed. This is the beginning of a brilliant strategic plan.
The role you play in this plan?
In the words of our brilliant Chief Public Health Officer, Dr. Theresa Tam, we must practise, "unrelenting social distance".
STAY HOME!

DR. Anne-Marie Zajdlik

Friday 13 March 2020

Collaboration for Global Health and the End of AIDS




Mobile Health Unit Launch, Lesotho, Africa
March 11, 2020



Bracelet of Hope's first mobile health unit on the ground in Lesotho.  Built in collaboration with our Swiss partner, SolidarMed and the Ministry of Health in Lesotho.  Proof that there is nothing that human kind cannot accomplish when we use our skills, expertise and financial resources in collaboration with other like-minded, compassionate and motivated people.  Thank you Bracelet of Hope, SolidarMed and the Ministry of Health in Lesotho.