Monday 30 November 2020

Hold on to your hats!

 



VACCINES: Let's get started.

Getting pretty tough out there. I never realized how important everything about the Christmas season gets you through November. I sat for a moment this weekend, trying to figure out why I was so down. Well, yeah, it could be a global pandemic but it's more than that. Between mid-November and January 1, y crew has eleven annual events including Bracelet of Hope's World AIDS Day Gala. Tomorrow is World AIDS Day. Eleven events with other people, with family, with friends, with staff. All of these events absorbed a lot of time and energy. They also brought consistency and predictability, something we humans need in order to feel comfortable in our own skin. Most of all, these events brought joy. I am missing the spontaneous joy that happens repeatedly at this time of year and I am dreading the idea of a very quiet Christmas Eve and Christmas Morning.
Dark, cold, quiet, unpredictable, and lonely. Yep. That's it. Plenty of reason to feel out of sorts and down. Please reach out if you are very low and it does not seem to be shifting. Talk to your doctor or nurse practitioner about using a SAD lamp. That's a seasonal affective disorder lamp. Sunlight hits the back of your eyes where it causes the clearance of dopamine. Dopamine is a brain chemical involved in establishing mood and many other things. Too much of it can lead to a significant depression. With so little sunlight at this time of year, dopamine is not metabolized the way it should be. We need sunlight for that. We all feel lower, slower and sleepier at this time of year as a result. Add COVID 19 and the lack of joyful events and much needed company and we are all at risk for major mood disorders. A SAD lamp emits light that is similar to the frequency of light we get from the sun. Sit in front of it for 30 min a day and the effect can be as significant as a low dose anti-depressant. Christine, my nurse practitioner and I, are putting a SAD lamp in our room tomorrow. Research shows that leaving it in a corner of a room you sit in for hours a day can improve mood, like a big window on a sunny day brightens our spirits. I have never used a SAD lamp before but, this year I am. My mood is definitely off.
Talk to a health care provider or pharmacist before using a SAD lamp. There are some folks who should not use one without medical supervision.
Thirty minutes of brisk activity everyday is also as powerful as a low dose antidepressant. Start slow and gradually increase. Walking is perfect. Daily exercise is a drug that reduces the risk of every chronic condition including cancer and it improves mood dramatically.
Focus on the good. Control negative thoughts if you can. Replace those worried and depressing thoughts with what we know to be true about COVID 19.
It will end. We will control it. We will go back to our normal lives. A vaccine will take us there.
Canada has ordered more vaccine than any other country. We are not in the back of the line when it comes to a COVID 19 vaccine. I wish the federal and provincial opposition politicians would stand down on their attack of our governments perceived lagging in getting vaccines to Canadians. It is fear mongering and we just don't need to be more fearful or more uncertain about our future.
The Moderna vaccine is now in the final stages of research. It is 94 % effective. Noubar Afeyan, co-founder and chairman of Moderna said in a statement yesterday that because Canada was among the first countries to make a pre-order with Moderna, the country is guaranteed to receive a certain portion of the company's initial batch of doses as long as the vaccine proves safe and effective and is given regulatory approval.
There will be plenty of vaccines, enough for every Canadian who wants one. It is very likely that the first 2 million most at risk Canadians will receive a COVID 19 vaccine by March. Two million may not seem like many but, once these at-risk populations are immune to COVID-19, the number of people who get seriously ill and die of COVID will drop dramatically keeping our ICU's below capacity. This is key. You will feel the winds of uncertainty and hopelessness change dramatically when these precious 2 million are immune. I can't wait!!!
The Moderna and Pfizer vaccines are mRNA vaccines. The scientific community has been developing these vaccines for 30 years. Their time has come. This technology is not new. There are several scientific facts about these vaccines that make them safe.
In order to understand these vaccines, we need to learn about cell biology and how a virus infects a cell causing disease.
Hold onto your hats because I am going to try to simplify some very complicated science into something we can all understand. Knowledge is power. Once you know how these vaccines work, you can make an intelligent decision about whether or not to be vaccinated; a decision based on science and not conspiracy.
I love the biology of cells. The next posts will be great fun....at least from my point of view.
Please share.
Some upcoming Canadian Mental Health Association webinars:
Men(tal) Health: A Movember Webinar
November 30, 2020 |7:00 pm to 8:30 pm
All about men's mental health. Sign up here:
Coping with Loneliness and Isolation during COVID-19
December 17, 2020 | 1:00 pm to 2:00 pm
Sign up here:
Check out a great place for mental health support here:
For local assistance with anxiety and depression:
CMHA WW Website: www.cmhaww.ca
Here 24/7 at 1-844-HERE-247 or www.here247.ca.
And for post-secondary students, Good2Talk
For non-Facebook users, you can find this post here:
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Thursday 26 November 2020

Bubbles Pop!

 



So, may I make a suggestion?

Step back from the pit. It will rob you of all hope.
That pit is the political strife and conflict that is filling the airwaves right now. Did this medical officer of health do their job? Did that premier act quickly enough? Should this whole pandemic thing have been led by scientists and medical specialists, not politicians? Does anyone, anywhere actually know what they are doing? Anyone?
That's the pit. It is human nature to look for someone to blame or point fingers when things seem to be falling apart. Dangerous game to play, that one. All this strife t is distracting, it's negative and it takes our eyes off the goal.
Will we have an effective vaccine that is safe and effective? You bet we will. Several of them. They've already been created which is a massive miracle in itself. Will Canadians have access to that vaccine in January, February.....March? And, the questions we all really want to ask are, "Will that country get it before we do? Will the 'other' people suffer less than we are and for a shorter period of time? Will this ever end?"
Step back from the pit. No need to go anywhere near it. The science is here. The technology is outstanding. Science and technology will prevail regardless of who points fingers at whom, regardless of who gets blamed for what we perceive to be failures and regardless of which country gets the vaccine first.
Frankly, it is much safer to wait for these vaccines to be approved by our ever cautious Health Canada. Give them the time they need to cross every 't' and dot every 'i' of every ongoing research trial for this new group of vaccines. Can we wait a few months longer? Of course we can.
Here is what we should focus on:
Our federal government has signed deals with five of the leading vaccine candidates. They have ordered enough vaccine to supply Canadians with 190 million doses. Far more than we will need.
Ottawa is building up the infrastructure and resources we need for an unprecedented, massive vaccination program. We are damn lucky to be living in a resource rich country that has this kind of capacity. Nope. We are not making any of the top vaccines in this country for various reasons some of them related to decisions made by governments long past. Yes, the United Kingdom and the USA will likely get a COVID vaccine first. But only by a few short months and in both of these countries, the virus has infected millions and decimated economies. We are damn lucky that for various reasons, we are still holding our own with early indicators that in some provinces, Ontario being one of them, the curve seems to be flattening again.
Well done. Let's take care of each other while we wait. Let's keep wearing masks, staying apart, limiting our contacts and reducing the size of or eliminating small gatherings. The numbers are proving, once again, that these tried and true guidelines work. They will keep most Canadian communities out of the red and away from lockdown.
And, excuse me while I focus on Guelph for just a second. Three cheers Guephites. You are doing a marvellous job. Our COVID clinic is running so well that it is attracting folks from other communities. Our hospital remains free of COVID 19. The city of Guelph is barely in the orange and Dufferin is in the green. Outside of some key, now isolated outbreaks, we are in great shape. Please, Please keep it up. Follow the guidelines and keep our restaurants and small business open.
I am calling this the 'Guelph Bubble'. Bubbles pop. This one will only stay intact if we keep up our efforts and for those of you who are in the red or in lockdown, you'll get there. Stay strong. Focus on the goal and be ready to watch science and technology make history.
Anne-Marie
Please share.
Some upcoming Canadian Mental Health Association webinars:
Men(tal) Health: A Movember Webinar
November 30, 2020 |7:00 pm to 8:30 pm
All about men's mental health. Sign up here:
Coping with Loneliness and Isolation during COVID-19
December 17, 2020 | 1:00 pm to 2:00 pm
Sign up here:
Love it. Love it. Love it. That's a community taking care of it's own.
For non-Facebook users, you can find this post here:
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Tuesday 24 November 2020

A very tough day

 




I hate COVID 19. Have I written that before? I say it several times a day, to my staff, to my patients and repeatedly to myself. It is not very professional. Hate is a strong word but that emotion gives me the strength and determination that I need to push through this.
We also swear. Not in front of patients, of course but sometimes that release of stress that a firmly vocalized profanity is exactly what we need to get through the next minute. In order to control this tactic, keep it at a reasonable level, we have a swear jar. Pay up if you swear. On a particularly bad day last week, I walked into the office I share with my beloved nurse practitioner, Christine. She was slipping her credit card into the swear jar. "Just get it over with", she said. Hilarious. I have such a great team. We laugh, we joke, we try to take care of each other but I am worried about our ability to keep up this pace.
I saw a record number of patients in the last two days. We are all behind on paper work which adds to the stress. COVID 19 has shoved itself into a health care system that was already struggling with a mental health crisis among young people and an aging population with an unprecedented number of chronic illnesses. Every medical professional on the front lines of this thing have absorbed at least a 30 % increase in demand. And we need to do this for months to come.
I want to thank my community tonight. Guelph has continued to keep the number of new cases low with only four new cases today, none in the ICU. You are following public health guidelines and in so doing, you are not only saving lives but you are preserving your medical team, allowing them to focus on providing ongoing care to the ill and at risk populations.
Thanks for that. It's pretty simple. Wear a mask, avoid social gatherings, keep your distance and wash your hands with a focus on avoiding all social gatherings unless at that gathering, everyone who is not in your household bubble is wearing a three layer mask and staying six feet apart. Gather only if you must, be ever so careful if you do and remember the indoor limit is 10. Unless you have a massive house, it is unlikely that you can safely manage ten so just avoid it.
Alberta has just announced a strong social gathering limit: no indoor socializing at all. This is the most common place the virus is spreading; amongst your family and friends.
By following the public health guidelines and I mean everyone following them, you are keeping us away from lockdown. You are keeping our small businesses alive and our healthcare system accessible to all. Buy from local businesses this Christmas. Support them, not big box stores if you can. In a neighbourhood in locked-down Toronto, all the shop keepers put up 'For lease' signs in all their windows this morning. They are not actually all up for lease but the visual was striking. They were drawing attention to exactly what could happen to the community if even more of it's beloved small businesses don't survive the lockdown.
Small businesses are the life blood of our community. Amazon, Walmart, Costco are just not the soul of our cities and towns. Buy for Christmas locally. Support restaurants by purchasing gifts of meals and treats for your staff and friends. Eat out or order in once a week if you can. The money you might usually spend on Christmas gatherings and office parties, put that into donations to your food bank or Hope House or gifts to people in need. That is the true spirit of Christmas is it not?
Finding the heart of Christmas when we cannot gather? Maybe the focus should just be serving our fellow man in need. We may not feel lonely at all.
Please reach out and thank a healthcare team member this week. That kind of support keeps us going.
Three astonishingly effective vaccines are getting ready for widespread distribution: Pfizer and Moderna using mRNA technology and the AstraZenica/ Oxford vaccine using the recombinant viral vector approach. No further delay, tomorrow's post will focus on the biology of these vaccines, how they work, why they are so effective and why they are so safe.
We are starting with messenger RNA. I can't wait! The game changer people. The virus cannot win once these vaccines are widely available. We have won. Just need a bit more time....stay strong and stay focused.
Give, Give, Give.... To whom much is given, much is expected. It helps those in need and it helps heal your weary heart
Anne-Marie
Please share.
Find a good three layer mask here:
For non-Facebook users, you can find this post here:
Check out a great place for mental health support here:
For local assistance with anxiety and depression:
CMHA WW Website: www.cmhaww.ca
Here 24/7 at 1-844-HERE-247 or www.here247.ca.
And for post-secondary students, Good2Talk
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Sunday 22 November 2020

November 22, 1963

 



November 22, 1963
Do you remember where you were 57 years ago today? You have to be well over 60 to know the answer. I was born the hour JFK was assassinated. It's my claim to fame. I hear it was just as snowy in Ontario that day as it was today. I don't remember a birthday in the last 20 years when I could pull out my cross country skis. Had a good fall coming down the tiniest of hills. It reminded me that I am not 25, 35, 45 or 55 anymore.
Thanks for all the birthday wishes.
It was a weird day. I have a twin brother and sharing this day has always made it a little more special but today was just weird; kind of grey and heavy despite the marvellous snow. Might be a sign of things to come this winter.
7 MILLION ONTARIANS HEAD INTO LOCKDOWN STARTING TOMORROW.
That's half the province. Maybe that's what has cast this grey, heavy pall on things today. I heard from every person I love and then some. I have nothing to complain about but this is tough and I am worried about the folks who will have difficulty weathering the winter. They are shop-keepers, retailers, gym owners, hair dressers and restaurant owners, just to name a few, whose livelihoods are at risk. Everyone has the right to be down right annoyed, even angry. Why should we do all this if there are only 1500 new cases today and 14th deaths? Why put all these livelihoods at risk?
It comes down to a balance between livelihoods and life support. It's the dramatic exponential increase in new cases of COVID 19 and the ridiculously steep trajectory we are heading in if nothing is done.
If we do nothing, it will take only 8 days to reach over 378,000 cases of COVID 19 in Canada ( up 40,000) with 480 more deaths......in eight days.
If we maintain our present level of social interactions, we will reach 20,000 new cases a day nationwide by the end of December with many, many more deaths.
At that point, folks, our health care system is overwhelmed. What does that really mean? Let's say all the Intensive Care Units in Ontario are full by the end of December with every single ventilator in use. These are just two endpoints. Behind those full ICU's and in-use ventilators are hospital wards full of COVID 19 patients who need oxygen without a ventilator. There's pediatric wards, neonatal units, labour and delivery wards and post surgical wards that are all at risk of being over-run by COVID 19. There is an emergency room full of sick people, at capacity with patients spilling out the doors or waiting in hallways.
Did you know that in most communities, your family doctors have signed up to head into those emergency rooms and hospital wards as the whole thing bursts beyond capacity? What does that mean? It means that your GP is not available to care for your sick child, to immunize patients against a whole host of infectious diseases that are presently controlled. It means that high blood pressure, heart disease and diabetes are left unchecked. Your cancer screening stops, cold turkey. The emergency rooms have no room to treat the heart attack or stroke, no operating room to treat an acute appendicitis and no one available to assist with that advanced cancer that wasn't picked up in time. And this breaks my heart. That other pandemic, the rapidly rising cases of people in mental health crises, their urgent needs can't be met either.
It's a health care catastrophe that we are trying to avoid. Believe me, I have imagined this scenario many times in the last couple of months. We simply cannot go there.
There is good news. We are just a few months from a vaccine. It's predicted that the entire population will have the chance to be vaccinated by the end of summer. But once you get to a 60 % vaccination rate, which will happen much earlier, the number of new COVID cases start to decline.
By this time next year, there may not be 6 inches of fresh snow to ski on but that weird sense of heaviness and weariness will be gone.
Amen to that
So, here we are. We've been here before. Choices.
These are the recommendations for those of us who are not locked down (yet). The look very familiar:
Stay home
DO NOT TRAVEL IF YOU DO NOT HAVE TO
Work from home
Reduce your contacts
Do not travel if you are from an area with a high incidence of COVID 19 ( red zones)
Sign up for the COVID Alert Ap- over 5 million Canadians already have
Wear a three layered mask. Wash your hands and stay six feet apart.
THAT'S HOW WE TAKE A RAPIDLY RISING TRAJECTORY AND...wait for it....BEND THAT CURVE!!
Let's support local businesses this year. Small business are depending on this. Eat out where it is safe or take out. Support our restaurants too.
Most of all, hang in there folks. This will end. Spring will be glorious and we will see Hope climbing over the horizon well before that.
Anne-Marie
Please share.
Our next webinar is on December 14th
Find a good three layer mask here:
For non-Facebook users, you can find this post here:
Check out a great place for mental health support here:
For local assistance with anxiety and depression:
CMHA WW Website: www.cmhaww.ca
Here 24/7 at 1-844-HERE-247 or www.here247.ca.
And for post-secondary students, Good2Talk
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Thursday 12 November 2020

We have done this before and we will do this again.



A lovely patient brought me a coffee this afternoon. I was in PPE all day; flu shots, pneumonia vaccines, skin cancer treatments, ear infections, lumps and bumps, migraine headaches. This stuff just has to be seen in the office. We received a huge shipment of surgical masks months ago but unfortunately, they are all too big. They practically fall off of our ears. Remember that barrel of monkeys from decades ago? One of those monkeys works very well as an ear saver that holds the loops of the mask at the back of your head, making the mask tighter with a safer fit. I guess I was pretty desperate. In between patients, flipping one of the loops off to take a drink is quick and easy but not when a monkey has a grip on both loops.
In frustration, I yanked the mask above my nose. This is not the proper way to wear a mask but the coffee was delicious.
I remember doing a similar thing in March when the pandemic was new and we were all locked in an terrified. I brought a Tim Horton's coffee to my lips only to realize that an N 95 mask was in the way.
Do you remember March? Think back for a second. That was dark and very, very difficult.
We are not in that place now. Cases are surging but this time our future is not unknown. We know about this virus. We know there will be a vaccine very, very soon. We know that vaccine will be very effective and safe and that it will be the next tool we need to conquer COVID 19 and we will conquer COVID 19. Don't forget that as we listen to the grim projections forecasting 6500 cases a day in Ontario in just a few weeks.
We need to return to staying at home, staying in very tight bubbles and religiously wearing a mask and social distancing when we are out of our bubbles and our homes.
Yep. I am going to pull out some good news in all this mess.
1/ We have successfully opened our schools. Kids are back where they need to be and it is highly unlikely that schools will be closed again leaving parents with the ability to work and kids with the ability to learn. We have not seen the transmission we worried so much about. Kids with masks on who spend the day looking toward the front of the class, are not spreading the virus even if they are not 6 feet apart. In our region, COVID 19 in schools is coming from people outside the school who have gathered in social settings, picked up the virus and passed it on to their kids.
2/ No cases of the flu yet and evidence from the Southern Hemisphere where the cold and flu season has just ended shows us that the incidence of the flu is dramatically reduced because mask wearing reduces the spread of the flu as well as COVID 19. There is early evidence that people who have received a flu vaccine in the past are less likely to get COVID 19.
3/ The spike in COVID 19 cases across the province are, for the most part, linked to small indoor gatherings where people were not wearing masks. The flip side of this is that public health now has the ability to track cases so that we know how transmissions are happening. And, we know that masks work.
4/ We have more cases because people are not adhering to guidelines. The flip side of that is that when we get back to adhering to guidelines the cases will come down again
5/ There have been no staff to patron transmissions in restaurants in our public health region. Masks and distancing work.
6/ O yeah, it's worth repeating. A vaccine is close at hand. It will require a herculean effort to distribute it to all Canadians but we have time to plan that.
Take home message: we expected a second wave and it is here. Whether it feels like it or not, we have developed a new strength and resilience over the last 8 months, individually, as a community and as a country. That may be hard to recognize but it is there.
Courage my friends: to collectively follow the next steps recommended to us, to keep adhering to public health guidelines and to keep our faith in a bright future.
Please share.
Our next webinar may be next week. We are working on it. The planning committee believes we need it sooner than later.
Find a good three layer mask here:
For non-Facebook users, you can find this post here:
Check out a great place for mental health support here:
For local assistance with anxiety and depression:
CMHA WW Website: www.cmhaww.ca
Here 24/7 at 1-844-HERE-247 or www.here247.ca.
And for post-secondary students, Good2Talk
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