It’s becoming increasingly clear that what is happening in Italy is going to happen here in Canada. Sadly, our national, provincial and local efforts to stop the coronavirus have fallen short. Our system isn’t built to rapidly respond to this virus, which is proving to be far more dangerous and far more infectious than we all originally hoped. But the time for hoping is over.
Canada is about to be hit by a tidal wave of severe respiratory illness caused by COVID-19. This will overwhelm our traditional systems. Everyone in health care and government is singularly focused on preventing disaster, but our habits, our processes, and our institutions are not used to making the bold choices needed in this ambiguous and rapidly evolving emergency.
To date, the health care landscape has been plagued by indecision, wavering policies, and poor coordination. Now is not the time for consultations with stakeholders, circulating drafts and memos, or writing policies. Now is the time for clear, decisive leaders to bark orders. Urgent action is better than delayed action. Canada’s frontline healthcare workers are at war, and we need a General.
Justin Trudeau must step up and do these four things today, or Canadians will needlessly die. Tomorrow is not good enough.
1 – We need personal protective equipment (PPE) and mechanical ventilators.
At my hospital, we are running out of masks. We have already run out of face shields. We cannot fight a war without armour. In China alone, over 3,300 healthcare workers have fallen ill of COVID-19; doctors and nurses have died. Without the essential equipment to protect ourselves, we will not only become ill, but get wiped off the board, unable to man emergency rooms and intensive care units. The provision of adequate personal protective equipment must be the number one priority.
Based on the experiences of China and Italy, Canada is estimated to need 500,000 mechanical ventilators to help patients whose lungs have been disabled by the coronavirus. We currently have one per cent of that, at best. We must rapidly produce innovative machines that can keep oxygen flowing in and out of people while their lungs recover from the virus.
Justin Trudeau must implement the Emergencies Act and force companies with the capacity and ability to mass-produce PPE and ventilators to do so. Now.
2 – We need soldiers at every hospital.
Canada’s hospitals are not ready for this. We don’t have enough staff, we don’t have enough space, and we don’t have enough supplies. Militaries have the expertise and experience to rapidly deploy, set up shop, and build capacity. This skillset is needed now. We can’t leave it up to hospitals to be calling party shops and wedding planners to get tents, or third party security companies to supply undertrained and under-equipped guards. Our Italian colleagues have been loud and clear: it doesn’t ramp up, it hits you like a tonne of bricks. We are in the calm before the storm. This is our chance to act; there isn’t much time.
Justin Trudeau must deploy the Canadian Forces to every hospital. Now.
3 – We need regulatory flexibility.
Our current systems of governance aren’t brave enough to react to this pandemic. Doug Ford has led the way, using emergency powers to authorize hospitals to violate collective agreements to put staff where they are needed most. Others must follow his lead; federal regulators must assure engineers and companies working to innovate low-cost, easy-to-build ventilators that they will be allowed to provide them to hospitals. They won’t look pretty, but they are better than nothing.
Also, 2,000 specialist doctors scheduled to start as independent physicians on July 1 have had their exams cancelled by the 100-year-old Royal College, which is incapable of grappling with the seriousness of the moment. Their exams, a historical exercise of pride, not necessity, have astoundingly high pass rates. These 2,000 doctors are ready to practice. More than 2,000 current members of the Royal College have signed a petition to grant them certification in these exceptional times. Further, another 2,000 family medicine resident doctors are standing by to hit the front lines – they too must be certified by the College of Family Practitioners of Canada.
Trudeau must exercise his authority to override paralyzed regulators so that doctors, engineers, and manufacturers can get to work.
4 – We need every Canadian to stay indoors.
Asking nicely has worked to an extent, but on my drive to work, I still see children in parks and people chatting in coffee shops. The guidance of public health officials must become directives. Enforcement must be the norm, not the exception. This virus depends on our delinquency; if we all stay six feet apart, we can mitigate the damage. We can save lives.
Trudeau must clamp down on social distancing. It’s not a responsibility; it’s a requirement.
Healthcare workers are ready to fight the coronavirus. But in order to win, we need Justin Trudeau to step up and use his power to take unprecedented action; the lives of Canadians depends on him, and us, to act decisively. Now.
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the global health care workers doctors nurses dentist etc thats all we have …..with no one going to schools to learn cause their closed …..to become our new heath care workers….. how will we survive ……if most of them fall ill or die due to the coronavirus……..and if half the world dies cause of the pandemic,,,,,,who will govern the human race ,,the army the police,,people with guns,,,wow my imagination to what could happen goes on and on ,,,,MAD MAX…i dont think people realize how serious this virus is ,,,, stay home
Need some tax cut or bonus payment for these 4 months for them
my son is a 2nd year RT student in london ont he is going to the front lines to help test. I’m scared as hell for his safety but also proud as a father I hope the canadian government does just that govern the people to save lives
We need our government to provide incentives to companies such as 3M to start manufacturing in Ontario if they need to retool plants to enable the manufacturing then let’s do it. Our country has the resources to be able to do this.
We need help for the truckers. They have no place to have a shower, use a bathroom, get proper meals . Even places with drive through are not serving them. They need our help
Salute to the nannies, psw’s, security guards, truck drivers, , garbage truck drivers & assistants and all the need payed and minimum wage workers in different areas of essential businesses, these are the “other” and forgotten/ minimized front line workers
Trudeau is a jurk
people should only be out for groceries or medicines, i have seen people walking on sidewalks side by side, i have seen a man with his grandson in the park. is society naturally obtuse and have issues understanding simple orders. stay inside, sit in your yard. stay the proper distance away, i am bored of being in my house, just like everyone else, but the main thing is, stay home, stay home, stay home, stay home. there, do you understand that. its not just the kids, its adults too. makes me so angry. maybe they all have a deathwish and hope it gets them. i just dont understand
We need better infection control practices at the government run nursing homes. Admission of patients continues despite lock downs everywhere else. New admissions are not isolated from the general population. This vulnerable population has no resistance spreading the virus to the workers which will in turn spread it to the outside general population. This is our weakest link now.
Early learning educators are not trained to deal with pandemic situations and yet child care centers are not included in the social distancing protocol. You cannot make children ages infant to 5yrs not lick you or a toy or pick their nose. It’s a petri dish of germs. Workers and children are at risk. Trudeau needs to override provincial premiers!!!! Our salaries are not guaranteed as are teachers and education assistants…we need funding!!!
Action now is needed, you are right.
Thank you for all you are doung.
Huge mistake to not also include requiring the public to wear masks when they go out. Health people are most at risk and they need the best masks and enough of, but a point missed is that infected people spread the virus even when they talk and a mask will capture that and reduce the spread. Given people can test positive and not yet have symptoms, there is a significant period where people can unknowingly be spreading it. People need to stay at home except for essential reasons, and they should be wearing masks for that. What’s keeping grocery store workers safe? What’s keeping the public safe if one of the workers who served them comes down with the virus? These workers should be wearing masks as well. Masks for the public is a very important and overlooked measure.
Indeed, how much safer will hospital workers be if patients have masks to start…
https://www.sciencemag.org/news/2020/03/not-wearing-masks-protect-against-coronavirus-big-mistake-top-chinese-scientist-says
This article is interesting, if extreme.
If Dr Bigham is going to make the extreme case that we will experience what Italy is facing he should provide evidence for that, otherwise he is engaging in unethical fear mongering. Canada is very different from Italy in many ways and that will cause our experience of Covid 19 to be quite different. Please skip the hyperbole.
Secondly, as a proud member of the RCPSC I think Dr Bighams comments on the College’s postponement of exams are ill informed, and quite frankly ridiculous. The Royal College is a great institution that leads the way in certifying specialists and has maintained high standards while innovating in remarkable ways. I think it is important that anyone practicing a specialty in Canada meet the College’s standards and pass their certifying exams. They have shown that they will provide flexibility in this time of crisis, but once we are beyond this I hope the RCPSC will maintain the standards that make it such a world class organization
Warren Terry MD, MEd, FRCSC
Dear Dr. Bigham,
I read your write up on Healthy Debate titled “Four things Canada needs to do NOW to support frontline health care workers and save lives” on March 25th which was republished on Global News on March 27th with much interest.
Your thoughts resonate with what I have been establishing as mandatory requirements since December 2019 when I read about the uncontrollable outbreak in Wuhan province, China.
My name is Warna Hettiarachchi, a physicist who has been geometrically modeling cluster spreads and sprawls into community and household clusters from the time of importation to any country. As I have removed myself from all social media, I find it difficult to communicate my thoughts to lawmakers, however, have been frustrated on the lackadaisical, lethargic, complacent and incompetent ways Canada’s leadership, Chief Medical Officer and Politically-correct legislative system miserably failed to prevent the COVID-19 virus from importing to Canada, quarantine/isolate and contain any imported cases and protect Canadians from this devastating highly pathogenic virus before it was too late.
We must remember one important fact, which evaded the radars of our politicians and regulatory bodies in Canada and worldwide: This virus which was confined only to China was spread to every other country on the infected list today only through TRAVELING carriers, who didn’t know they were infected due to asymptomatic nature of the pathogen. The government and health officials claiming to be “EXPERTS” advised Canadians to go ahead and travel, take the cruise, carry on with overseas vacation plans, and that they cannot contract the disease through contact, that it was NOT airborne, and that it was SAFE and cannot spread from person to person sitting in an airport lounge, lining up at check-in counters, boarding rooms for flights, inside aircraft, trains, buses, taxis, elevators, and public buildings as recently as in late February.
I have heard a “Medical Health Expert” come on a Radio Channel three weeks ago and said that no one can get infected with COVID-19 even if you sat in an airplane next to an infected person, unless they coughed or sneezed on you.
Today that perception has made paradigm shifts in our actions, albeit far too late as we missed that narrow window we had, in order to prevent the virus from being imported to Canada, or to contain it at strict quarantine facility from the airport itself.
Amidst the early warnings reviewing on dangers of TRAVEL industry becoming the ONLY vector-supporter for propagating this virus, Canada did not properly screen airline passengers with IR Thermographic sensors at airports, did not check each passenger for temperature rise or fever to isolate, did not impose mandatory screenings at airports, did not check inbound passengers for symptoms nor did they carry out nasal swab test to isolate positive cases, by placing all test subjects under temporary quarantine until lab test results were available.
The very “experts” and lawmakers around the world got infected from COVID-19, including the wife of our Prime Minister, Mr. Justin Trudeau. She also likely got infected from her recent travels.
Rather than trying to REINVENT THE WHEEL, we could look at how several other countries had effectively dealt with this virus, Singapore, Dubai, Abu Dhabi (UAE), South Korea, Taiwan, China and Sri Lanka, containing it, reducing community spread and cluster and sub-cluster formations, and eventually reducing the rate of transmission. The transmissivity of COVID Virus was estimated to be between 2-4 in February 2020, however, this number is a misleading factor as well as it is a variable which is case-wise dependent.
In the case of Patient# 31 in South Korea, her Transmissivity was much larger, if you factor in all subsequent spreads caused by herself at the restaurants, hospitals, and Churches that she had attended while being infected but ignored mild symptoms at the beginning. She herself drove the infected patient curve higher out of proportion.
What this implies is that the statistical numbers mean nothing other than establishing a bare minimum figure for each country, as depicted by World Health Organization’s daily Situation Report. This number of infected in each country depends on the following:
1. Reported numbers given by individual countries
2. Includes only those patients who are tested and proven positive
3. Excludes those who have been turned away by hospitals, healthcare centers, testing centers and medical facilities
4. Excludes those who are infected, but not suspected of infection due to asymptomatic nature, thus not getting tested
5. Excludes those who are infected, however afraid to declare or register, worrying of overcrowded scary scenes of hospitals
6. Excludes those religious groups that are not allowed to register, believing in faith-healing
Had out authorities carried out strict measures as did all above countries, we could have taken just 1-month recession on economy, and saved the people. As they failed to do so, now we are faced with a massive outbreak at every city and township, with our people are being infected and dying, with further spread and cluster formations just as in US, Italy, Spain etc., straining and exceeding capacities of our healthcare professionals, resources and medical facilities, while taking much larger hit on economy and employment, government revenue, causing Canada to encounter massive economic downturn for many months if not a year or more.
Some of our “experts” and “politicians” kept saying it was safe to take MARCH BREAK travels and vacations with kids as recent at early March, just to have their statements retracted later!!
As such, the ACTUAL, REAL TIME numbers need to be much larger than published data. I gather that WHO advised to multiply published data by a factor of 8 or 10 depending on which country is being studied.
As for further preventive measures, I agree with your suggestions, and might I add the following to the list, including some of yours:
1. Close all airports, cancel all flights and public transit systems
2. Impose Emergency and bring in curfew – deploy police and military on street patrol to ensure isolation compliance by people
3. Do what Abu Dhabi and Dubai do to every incoming passenger aircraft – Send healthcare officials clad in protective gear and IR thermometers and thermographs to the aircraft parked at special apron to screen each passenger while seated. Anyone with higher than normal temperature reading, along with all passengers in the three rows up and down should be taken into a special isolation vehicle into a temporary quarantine, while the passengers with fever taken to a separate isolation quarantine facility. All of them should be subjected to nasal swab testing, and each passenger should be kept in temporary quarantine until lab results are ready. Any positive cases should be sent to isolation quarantine and treated. All other passengers should be mandated to be self-quarantined with a signed declaration that any breach of self-quarantine will bring in fiscal penalty and imprisonment as done in Singapore.
4. Mandatory Lock-Downs for each city and mobilize essential supplies and services such as food and grocery delivery and distribution for online ordering.
5. Make available plenty of hand sanitizers, isopropyl alcohol (90%) and Ethanol (90% USP) for disinfecting purposes to public.
6. Make available latex/nitrile gloves for public usage
7. Face masks and Ventilators – These are not complex technology, but simple to manufacture. They can make these items in every capable facility under emergency regulations in massive scale and distribute for healthcare and public access of N95 masks. Supply chain of raw materials and other equipment can be sourced or made locally.
8. Canada’s relief package does not seem to benefit small businesses in direct way but another debt-trap on the long run in some cases. Even the large banks are benefitting from the package, not the customer.
9. Issue permits for those who need to get access to medical facilities in emergency or curfew.
10. Any flight or travel cancellations should refund the customers, as the virus outbreak is no fault of theirs. They wouldn’t have taken travels if authorities and experts had warned them of actual risks and dangers of getting infected earlier on.
11. Government must acquire hotels nearby hospitals to create make-shift quarantine facilities.
12. Intensify testing hydroxychloroquine + Azithromycin following positive results published by Pfizer in France – This drug combination is widely available, costs much less, easy to produce and have no patents to pay royalties for – formulations are freely available. Clinical trials may be carried out on qualified infected patients with their consent and likely less contra-indications, who may have infection extended to lungs.
13. All Generic pharmaceutical manufacturers should be mandated to make this drug in mass-production, for which government can offer financial support.
14. Canada should realize that international food and materials supply chain will eventually collapse or weaken soon enough with every nation on planet Earth facing the same crisis. This is worse than WW-2 or may be worse than would-be WW-3, as every citizen of our planet is at risk and no one can be spared unless they are isolated from this deadly COVID-19 or the virus is contained or treated immediately with potential drugs.
15. Canada should keep and steadily increase in stock of its food and medical supplies and call into mandatory work on essential goods and services.
There may be more action items that we can formulate.
My request for you: Could you possibly get content of this note to you and add to your writing, and then propose to CMA to be presented to our Government of Canada and its lawmakers without any delay, as every second is ticking off against us.
Thank you and yours truly,
Warna Hettiarachchi (B.Sc. Nuclear Physics)
Peterborough, Ontario
647-523-7870
warna@sympatico.ca
“Based on the experiences of China and Italy, Canada is estimated to need 500,000 mechanical ventilators“
Can you please explain how you arrived at this Figure… The total number of cases in the world currently is just 580,000. Italy sits at just over 86,000. Are you saying Canada is going to have almost the same amount of Critical ill cases of Covid 19 as the entire world number of confirmed cases?
Cheap ventilators are not an answer to diseased lungs. The ventilators MUST BE capable of mimicing the body’s normal pattern PLUS ADD medicinal extras that the body can’t even perform when healthy. To use anythng that doesn’t meet the Canadian Standards would be criminal and endanger people that possibly could be saved. Ventilators will only prolong life in terminally ill patients. COVID 19 is a death sentence to a lot of people and prolonging their deteriorated life is senseless and cruel even if there are an abundance of ventilators.
Well said. I am a canadian nurse living abroad in the cayman islands. We are currently in a complete lockdown with closed boarders land and sea. Every resident must stay on their own property under penalty of law. When this complete lockdown concludes on Sat morning, we will remain confined to our homes except for essential trips for supplies. All businesses are closed unless working remotely from home. The countries leaders made these tough decisions a week ago and so far we have mitigated community spread from the few Cases that have tested positive. I see what is going on at home and around the world and realize I am lucky to be here. This does not stop the angst that i feel for my loved ones at home . Please Canada follow the distancing recommendations, stay at home. No one is “immune” from this disease. Canada’s leaders are doing a great job but It will mean nothing if people do not heed the warnings and do their part! STAY AT HOME.
Kc
I fully agree with all you have said. Now is the time for decisive action!
Neil Mark Vannatto 2 things jump out at me our mindset on DISPOSABLE is killing us ,1. face shields are easily cleaned and sterilized. in a hosp environment a face shield should last literally forever if cleaned carefully a job anyone can do , 2. masks can be cloth and laundered to kill the virus. should last for many wearings
” I still see children in parks” – of course there are, are you a parent? you can’t expect parents to hold there kids hostage inside for weeks without going outdoors, unless you’d like to have mental health issues start to emerge. kids need fresh air and a way to expel energy and not everyone has a backyard… obviously they should do this safely, by staying off the playground structures and keeping 2 meters apart from non-family members (in a park 5 meters is probably even manageable). another problem is there has been inconsistent messaging from the governments and i think people aren’t sure where the line is. if this is a lock down then they need to say it.
Well said. Even in war kids need to be kids
Blair, thank you for those sage words. We can’t let politicians (lawyers) decide our present and future. Kevin Hanrahan MD
Could not agree more.
Clear concise and decisive.
But I would call it a global TSUNAMI not a tidal wave, devastating everything in its path- unless we do more NOW.
We need a complexity science thinking in times of uncertainty to produce simple decisive actions NOW as you offer, with feedback adaptation change and emergence as we go along (FACE the reality).
We need to follow these extreme measures NOW for prevention.
For more on this can google Complexity Explained, or New England Complex Complex Systems Institute Stopping the Corona Virus Pandemic and Google Tsunami Chaos Global Heart for a free book on this approach, using a 21 st Century science approach on how to act in the midst of uncertainty and ambiguity, to stop or at least turn the tide on this tsunami.
V Rambihar cardiology Toronto
A very good clinical and practical analysis of how health care delivery in Canada has not focused on the frontline services. Our family doctors, physician specialists, nurses, and, paramedic responders require, need consistent support. Politicians, particularly at the federal level, and, the health care bureauocracy (managers, consultants) often respond slowly, decision-making is slow.
Hospitals, public health need to look at a different paradigm to deal with pandemic, serious health care crises.
Patient-centered care is crucial…but, community-centered health care has to be the focus to deal witha serious health care crisis.
Please stay home safe and healthy!!
We need to make sure that the frontline heroes get home to their families!
We owe them that much ❤️
Thank you for sharing your insight. I wish i could copy and paste this in an email to Prime Minister Trudeau. I sent my own email with some of your suggestions.
I hope that all of these recommendations are already in the works. I am so frustrated watching this unfold, when we had lots of warning!
Yes the emergencies Act must be enforced so we can manufacture more supplies to safe guard our medical staff
Make this into a petition to be signed and sent to Trudeau.
Just DO it. The FOUR STEPS are so important at this time.
Thank you Blair
Thank you Michelle.
Thank you to all the medical workers for giving and giving.
Government and anyone else, please help them do their job safely!
Everyone who can, help them by staying home.
I totally agree!
We who have to go to work should have our temperature taken at the door before we enter the buildings . This would provide information if your running a fever and should be sent home and not infect orhers. Some workplaces are doing this.
We do not need the military yet, they will have lots to do soon enough. We need to bring the right amount of measure with keeping people inside and away from each other. Go to your backyard if you want out instead of wondering the streets. Why? Because you give others the idea they can do it to and then we have critical mass of people who are creating their own cultural norms which will kill us if we are not careful and error on the side of caution. I agree with I, 3, 4 and know the Army/Military in Canada are in reserve so let’s give the PUBLIC a chance to show up as Canadians do and do the right thing and follow #4… #Leaderteacher #AllLivesMatter
Having them already set up would be better than having them come in in the middle of the fray. If they are never needed fantastic. If they are, and they can relieve some of the stress and burden as it happens, the frontline workers will be better for it. You have seen Italy and Spain, you know what is coming.
The people need to start acting for themselves if people wait on the government to help them save their own life we could be in a lot of trouble The Chinese government hid it for a while and didn’t want the world to see anything. the world health organization took too long to declare it a pandemic. the president of the United States to too long, thought it was a joke and didn’t declared as an emergency. nobody really declared it as emergency until recently until it was all over the world spreading like wildfire. Do not trust the government to act reach out to those people that you need support from and ask them to start helping in the ways that are needed. There is a saying a little too little too late.
well said katherine, i agree totally
Very well said – so now Justin Trudeau step up to the plate, no more hesitation, do the job you have the POWER to do! Quit hesitating!!!
Hi Blair;
You sir are the General we need guiding the troops if we were luck enough to have BOOTS on the ground.
Unfortunately if the troops are deployed, I’m thinking it will only happen when it’s too late and their Leader might not be the best choice for this unprecedented crisis.
I am a paramedic in York Region.
I’m 62 and work ambulance on the front lines still.
My partner Greg ACP is awesome. We are on the same page.
Since December, Greg and I have been watching this thing approach.
Every shift we spend the first hour and a half cleaning the Rig and our station.
We don’t trust our co-workers because we see their response, as we share our concerns.
We’ve been fearful of the lack of urgency from above. (WHO, Federal, Provincial, Regional and most of all the MEDIA).
“Wash your hands, cough into your elbow, the risk remains low.”
The print materials coming from our Service, Base Hospital, The Ministry and the Region are endless.
I don’t blame them. They are also given their directions from regulatory bodies above them.
Like you say, ….so much wasted time when ACTION is what’s required.
3 days ago a medic shared your article. I’ve done so numerous times and will continue.
I really, really hope you keep barking louder and louder and continue to share what we can do to help YOU?
Finally…Greg and I have issues with the most recent circulating memo about not needing N95’s.
Apparently surgical masks are fine. OMG
Keep up the great work my friend.
Many of us are listening and waiting for more LOGICAL URGENT ACTION.
THIS VIRUS IS MORE DANGEROUS THAN A WAR.IT IS IN VISABLE BUT IT IS EVERYWHERE.ANYONE WHO DOES NOT ADHERE TO THESE REQUESTS WILL BE CONSIDERED THE ENEMY.STAY HOME AND AND DO’NT BECOME PART OF THE PROBLEM.
Well said! Thank you for posting this & for all you do. I will share and I already wrote to my representatives about the lack of action and war-like effort with these matters a couple days ago. I too had been thinking that we really need to get soldiers and people to the battlefield and to have people help with the menial tasks rather than letting it be all up to Healthcare workers, who have way more important things to worry about now, and who so very much deserve some rest before the storm. I want to help, but cannot even find a way or any system in place to do so, there’s no coordination anywhere even though the healthcare workers are all overwhelmed and working overtime before the worst is here and that is already so horrifying. Unfortunately, those that know this, like you, the doctor may need to step up and find outside help without relying on the government. I wish so much this wasn’t the case, but I don’t want you holding your breath the way that those unemployed and unable to buy food are right now.
I would encourage hospitals and their doctors to rise to the challenge of delegate tasks they need done with local people and community rather than only relying on themselves and external (government) support. Call in someone well-organized to lead an effort of mass organization to recruit volunteers or workers and delegate everything you need externally to the central system to get more manpower in your hands ASAP. Even things like people sewing masks, 3D printing face shields, making/washing reusable gowns as a last ditch effort can help. But you have to have someone responsible for advertising this where you live or no one will know! Everyone wants to help you but you need to tell us what to do. I’m sitting on a 3D printer unsure of what I can make to best help or whether anyone will take it with all the regulations in place.
Hospitals could also consider training those willing on specific emergency medical tasks that don’t really *require* a full nursing/doctorate degree to help with the load, which I haven’t yet seen any efforts for. In Italy, they waited until they *needed* more in-hospital hands to approve it- big mistake. From abroad ER volunteer experience (things they expected of me to do would horrify you considering my lack of credentials!), I am so sure there are so many things that people could help with given proper coordination considering the nature of it being similar treatments for the masses, even if it’s not perfect. There is an aspect of well-deserved pride in being a healer but please consider specific tasks that may be teachable in a matter of days to many well educated and amazing Canadians out there willing to help. It could prove better than the unthinkable alternatives that could occur if you dismiss this option: the equivalent of an amateur stitching up his friends wound vs. no one being there to help while he bleeds to death. It’s unthinkable in a developed country but it is a reality in many countries and it’s better to realize that reality sooner rather than later while the amateurs have time to learn at least a little. One thing that comes to my mind is medical researchers like me that work with mice and are used to handling needles in very tiny veins, very likely would be able to do any stand deliver of meds, etc. I am sure that with some creativity there are other things different non-healthcare workers can help with if it comes to it as a last resort.
Regardless of whether you agree, we need leadership and direction right now to make it through this that we are unfortunately lacking and I am so sorry for that. I will do what I can to make this point known. Flattening the curve is only half of the solution — we need to raise that bar too!
Just do it like India is doing
Totally agree.
My daughter is a RN in ER has to pay to stay in a hotel as she wants to Procter her 3 kids and husband should Mr Ford do something to help the health workers
Kathleen,
Some hospitals are trying to negotiate with local hotels to provide this as a service (for free to front line staff). May I ask how much she pays and if it’s a reduced rate at all? And where this is? Thanks!
Excellent article. I hope the powers that be sees this
We do need to act in your suggestions. For sure!.
Thank you Blair for your sound opinion!
I went to med school and did a year of Medical residency in Quebec. I am now a Full Professor and have been involved in Medical Education, first as a consumer and later as a provider, here in the US ever since. Unlike American medical students, Canadian medical students do real clinical work throughout their entire education. It is hard to imagine how the hospitals in Canada could run without them; not so in the US. Thus. Canadian 4th year students function like a first year American resident. Canadian students and residents will be on the front lines in the COVID-19 crisis. The 2000 specialists about to graduate should be allowed to do so as fully capable physicians. It is the least that can be done to recognize the sacrifices and dangers that are willingly exposing themselves to. Their actions are in the highest tradition of medical professionalism, The students and residents do not need to wait till May to become what we expect them to be and so obviously are are now, physicians. They deserve to be recognized as such. After all, it is entirely likely that some will not be around to take an exam. It is their performance in life that determines who and what they are. not performance on a test.
And a very big thank you to you Sir for your contribution.
These undergrads must be so grateful for the supportive positive words on their behalf.
Agreed!
Agreed!
I have a daughter who practices as a nurse at St. Mary’s hospital here in Kitchener…her greatest concern is for personal protection equipment. This would reduce her anxiety in protecting her family which she must leave at home every day and return after her shifts. Please, please, please provide her with proper protection!
Ken (and others), what are RNs and Drs doing with their children right now? Are they leaving them with elderly grandparents and putting their loved ones at risk? I think it’s time for the government to allow any childcare providers who want to help these families to open their childcare during this pandemic just for front line workers, not for their regular families. I am one provider who is willing to take that risk and open up, but am not allowed to under ON emergency closures.
Absolutely true. As a family physician I have tried so hard on the prevention side of things.
I keep saying this pandemic trumps all negotiations,unions, rules etc. We need the guns to fight this virus now !!!!
Everything you have said should have been done in January !!!
A group of scientists at Oxford University has now issued another basis for predicting the trajectory of COVID-19. They’re bringing in antibody tests to determine who has already developed immunity. They’re speaking the language of ‘natural immunity’ based on recovery from this virus.
https://www.dailywire.com/news/oxford-epidemiologist-heres-why-that-doomsday-model-is-likely-way-off
Professor Gupta’s modeling study suggests that the virus was spreading invisibly at least a month earlier than suspected. She estimates that up to half the population in the UK have already been infected by COVID-19 and that fewer than 1 in 1000 who are infected are so ill they need hospitalization, leaving the vast majority with mild cases or symptom-free. The Oxford report continues:
“The modelling brings back into focus ‘herd immunity’, the idea that the virus will stop spreading when enough people have become resistant to it because they have already been infected.”
The Oxford modeling results indicate that as the virus quietly spread through the population, people were acquiring, “substantial herd immunity through the unrecognized spread of COVID-19 over more than two months.”
Endorsing heavy-handed measures suggested by Dr. Bingham, fraught with concerning unintended consequences, is troubling in light that reliable figures from Italy and work by epidemiologists, published in the renowned science journal ‹Science› who examined the spread in China made it clear that around 85 percent of all infections have occurred without anyone noticing the infection. Perhaps antibody testing is a far more reasonable solution
Great Comments
Totally correct. I agree Canadian military needs to be used at home. Canada is known for helping everywhere help is needed. They’re needed here.
Way to say it Blair! P.S. I am finding that a few Genesis ventilators may be kicking around a few EMS Services. In a pinch!
Wait, soldiers in the hospital? Why?
Matt,
It’s to set up the triage units and ER tents that we will need when the tsunami of patients hits. Right now, it’s on the hospitalists and administration, is my understanding from the piece.
Extremely well written and I really hope our government at all level do floow some or all of these recommendations! Thank you Blair for doing this! Well appreciated by many of us.
What can we do yo get this into Trudeau’s hands so he will see the intellegence of these initiatives. I have dtrs who are RNs and am terrified for them. I am an RN but ill doing chemo. I am terrified for me bc I have to ho yo the regional cancer centre for treatments. Please, other than just passi g tjus along & pushing the share button HOW do we get this message across?
I share your concern with my family…all the best to you and yours
Well written Blair, I was shocked about the part about specialty docs ready to work primary care being held up by a process. Hope your words make impact.
Excellent article, 100% truth to Dr. Brigham’s words.
I have written an email to our LEADER, Trudeau just last night.
We need all of these Professionals to be allowed to help in the crisis.
Thanks Dr. Janet McMordie for posting.
I support our healthcare workers, we’re staying home for them!!!
Terrific Blair, we hope this message gets through to the powers that be. Thanks,
Art & Anne-Marie
Couldn’t agree more!!! Lock it down. People aren’t listening. Common sense is not common. Give them a fighting chance!!! Please!!!
Yes!
Even final year nursing and RRT students can be utilized. Better than trying to train people with no medical background. Maybe even Veterinarians can help……they understand ventilation too.
I have preceptured 3rd & 4th year Nursing students trust me they are very booksmart but have no skill level they are told don’t worry you will get the skills after you graduated. There is more much much more to Nursing than plucking a newbie who hasn’t finished & put them into a life & death situation. They need their6 week pre grad placement this is the start of getting their Nursing experience. And you do not want one of these newbies managing an ICU patient I had to take a 2 yr critical care course before I could work ICU/CCU and that was after working for 5 years . We are always short of RNs and before RPNs start dumping on me you are very valuable resource but because you are cheaper than an RN we RNs were driven out of hospitals to save money. Hos is that working for you now?
Any port in a storm
Excellent ideas, which likely will fall on deaf ears in Ottawa. Trudeau is more intent on passing unlawful legislation allowing his minority government sweeping powers to spend still more money than we have – for the next two years – to battle this catastrophic crisis. Lets hope someone gets him the message.
I agree with you. Thank goodness we have Doug Ford to lead the way in Ontario. Trudeau doesn’t care about Canadians, therefore, he won’t step up to the plate and do his duty to protect us.
Shame on YOU!! Would you rather have Trump as your Country’s leader? He is doing the best he can in a situation that is changing by the hour…and you are obviously a Conservative and I worked in health care during SARS which some have forgotten was in 2003… the Harper years. WHY DIDN’T THE GOVERNMENT PUT IN A SPECIFIC PLAN TO BE BETTER PREPARED IF THAT HAPPENED AGAIN? And that was nothing like today. 17 years ago the government had thre chance to implement a plan so we would have been better prepared. And I hope that you are not working at an essential job and are able to protect yourself while I want to vomit every morning getting ready for work. Just do you part and STAY HOME and keep your political views to yourself….because you sound UNCANADIAN and quite frankly a whiner. But I am a proud CANADIAN HEALTH CARE WORKER who hopes you are pne of the lucky ones. #staysafe #stayhome
Hey Trish,
It looks like the author is a physician, maybe you missed that part. His bio at the bottom, “ Blair Bigham is an emergency physician and science writer in Hamilton, Ontario. He trained at the London School of Hygiene and Tropical Medicine and has a background in emergency management. @BlairBigham”
I believe Trish is referring to two people who commented, not to the author. I agree with Trish in a sense that this is NOT the time for politics. Let’s all stay focused on what’s important right now…LIVES. Typically I would be scrutinizing and criticizing the Liberal government for their unchecked spending and liberal morals, but I am putting all political judgment aside at this time and praying for our leaders to make wise decisions. Let’s shift our focus to that which is beneficial and hopefully life-saving.
The man who wrote this is a Doctor so i believe he speaks what he knows.
I commend you for your comment. Basically, let’s NOT make this political, and let’s MAKE this about people’s lives! My son, who didn’t graduate from high school, said that if people live, economies can grow back, but if people die, there will be no economies to go back to. If he can figure that out, why can’t these highly educated people see that? I can’t imagine how sick you must feel, going to work as a health care worker; I’m terrified being in the high-risk category, but non-essential and thankfully staying home. I thank God for people like you, and my heart is with you as you go to battle every day. God bless you and I will keep you in my prayers.
Foolish, foolish woman. Your TDS prevents you from seeing the truth. Open your eyes and read what Conrad Black and other intelligent people have to say. Oh, that’s right, he leans right so what would he know?
You really are a special kind of stupid Trish…Harper wasn’t elected until 2005 and Dalton “the dolt” McGuinty was Ontario Premiere….I wonder how things went so horribly wrong??? Do you think Stephen Harper would have sent the Chinese 16 Tons of medical equipment leaving Canada with a massive shortage? Who is it that admires China’s COMMUNIST Party again???
Are you out of your mind. Doug Ford is a bumbling idiot. He’s a druggie like brother Rob. They ran around starring on every American late night show making Canada the laughing stock of the world. He can’t even get his own body in shape. He is a mess.
Thank you Blair!
It is time for more action. I feel so much safer now that I am back in Canada. Our governments, both provincial and Federal have done so much more to make sure we are safe, and that others around us are safe. I believe the idea of the military assisting at hospitals is critical to our safety. Let’s get all those members of the Royals college to work, whether they have written that exam or not, saving lives is more important T this point. Great article.
I agree get them started it will be the best trading they will ever have and we need them NOW
There was a time when the men went to war, the ladies were but in the factories to make shells. The factories I believe where forced to change there production line to accommodate the worlds crisis. Everyone got on board to help.
Is there factories that can adapt to help out with PPE (personnel protective equipment). Our front line heroes needed our help so they can help us. The PPE’s not only helps them, but with them more protected, it protects everyone around them as well.
Our front line heroes have to do so much to fight this battle with little ammunition.
We can help them by staying home so they do not have to watch our backs. We are out of the scenario. Less need to do battle and to use so much supplies.
If everyone at the same moment stayed in, the two weeks would have been over by now.
Hey
as a kind and caring dr
You ever consider the consequences of locking people up and removing their civil liberties ?
Particularly when countries around the world have taken no such Draconian action and are coping well ?
I suggest the long term consequences of economic and social instability will far outweigh those of Covid.
https://blogs.scientificamerican.com/observations/covid-19-policy-must-take-all-impacts-into-account/
There is too much political correctness, people need to comply or be enforced in a manner that will work
please share this vital information
Each province is different. I’m in BC and we’ve done a fairly good job of physical distancing, in metro Vancouver at least where I am. Every business is informed and in compliance with regulations. We’re (public) getting updates hourly every day from the premier and his immediate staff. Communications are direct.
I agree with you 100% Daniel Re! Enough dithering. Mr. Trudeau, please take a firm stand and ensure enforcement of social distancing. If some citizens want to behave like defiant children then let there be huge consequences. Our lives are at stake!
How can health care workers be expected to fight the war without the proper armour? It will be a losing battle.
The UK has downgraded COVID-19 stating it is no longer a high consequence of infectious disease (2). A new study suggests that half of the UK Population may have already been infected, meaning we are pretty much at the thickest point of the curve.
“According to hypothetical modeling from Oxford’s Evolutionary Ecology of Infectious Disease lab, half of the population of the United Kingdom may have already been infected with the coronavirus. If this modeling is confirmed in follow-up studies, that a minuscule number of those infected require hospital treatment, with a majority showing very minor symptoms, or none at all.”(3).
The scientist who guided UK prevention measures based upon his calculation that Covid would kill over 500,000 has now retracted that statement and adjusted it by 480,000 to that of 20000 or less (4)He now adds that the British medical system is equipped to manage these numbers
A reasonable solution would be to stringently cocoon the vulnerable (who, according to Italian government data, comprise 99% of mortality risk), while those of us who have not already unknowingly contracted Covid-19, acquire natural immunity, ultimately protecting the vulnerable and our economy. Yet, such suggestions are held in contempt and rather we opt for unsustainable safety nets with numerous serious unitended consequences potentially formulated upon flawed data
I am inclined to agree. The response that is needed is a level headed, effective response that avoids the twin pitfalls of panic and laxity, a response that is based on solid data, one that puts in place effective measures where needed while avoiding as much as possible the hazard of unintended and highly problematic side effects. Those in positions of political leadership have a very challenging task; they have to effectively manage the response to COVID-19 and the follow-on effects of the measures taken in response to it.
Obviously you have no clue. The only thing you are considering is mortality rate. More importantly is hospitalization rate, time in hospital, etc. This will, and has in numerous jurisdictions worldwide put a massive drain on hospitals. Further you are only considering the direct impact of virus. What about all the deaths and issues caused due to an inability to get regular medical care for other medical issues. You need to get past you simplied view on a complex problem.
I suggest you refrain from such disrespectful comments as “ you have no clue” simply because I don’t fan fires of hysteria. In fact, examining mortality rate plays a major role in determining the severity of an infection and how to prepare for it. BTW, My busy hospitals’ ER looks downright calm, admissions are not high, and indeed the army need not be called in. Certainly things could change but we have had equal demands in severe flu seasons that did not necessitate shut down of our economy nor armed guards. Perhaps you may benefit from hearing a balanced narrative ? ( since I’m so dumb in your mind) https://www.spectator.co.uk/article/The-evidence-on-Covid-19-is-not-as-clear-as-we-think
Ps Does your ‘simplified view ‘ consider the consequences upon equally vulnerable populations subjected to lockdowns that will result in economic and social instability?
https://blogs.scientificamerican.com/observations/covid-19-policy-must-take-all-impacts-into-account/
Hi Vanessa, thank you so much!
So wonderful beyond words to know someone out there is still thinking rationally, instead of just reacting emotionally to an over exaggerated situation. Yes people- over exaggerated!
Check the numbers and data and compare it to past history and the truth/biology of viruses and real epidemics.
Thanks Beth! I think what concerns me most is that this author is a physician and commenters largely health care workers . They respond with hysterical, Lynch mob like fervor that endorse rail roading human rights.
Never do they consider the benefit of distancing measures are based on limited evidence nor the tremendous social and economic consequences upon those they seek to lock in their homes.
It speaks from a place of elitism
I’d like to see how the working poor, those who live in rooming houses, those subject to domestic abuse, those with mental health issues feel about this apparent empathetic Docs viewpoint
Really ?! let us consider the one situation where an entire, closed population was tested was the Diamond Princess cruise ship and its quarantine passengers. The case fatality rate there was 1.0%, but this was a largely elderly population, in which the death rate from Covid-19 is much higher.
Accumulating evidence shows that the vast majority of cases are mild or asymptomatic. A reanalysis of data from China by Japanese researchers estimated that the fatality rate there is not 4% but 0.04% — orders of magnitude lower.
even some so-called mild or common-cold-type coronaviruses that have been known for decades can have case fatality rates as high as 8% when they infect elderly people in nursing homes yet the army is not called in. I suggest we militantly protect the vulnerable yes, but resorting to the use of force to do so is unbecoming of the country of Canada.
Source?
https://off-guardian.org/2020/03/24/12-experts-questioning-the-coronavirus-panic/?
John Ioannidis… beyond highly credible source
I could not agree more.
I am worried about home care and going to house to house going out to getting groc and meds for the seniors that I meant give them the virus or my family I wash my hands alot I hardly sleep because I so worried
Well said Blair, Canada is not ready to tackle this monster at the rate it is going, if above actions you pointed out are not carried out.
I am a frontline caregiver and these indecisions and wait and see games, really makes me want to stay at home and protect my family.
I feel like the martyr sent out without adequate gears to fight for people who dont give a damn about us frontline workers. Wake up leaders and lead or risk frontline workers like myself refusing to be in unsafe environment…. I love the job I do, and even more when I am protected……
EVERYONE MUST WEAR A COVERING/MASK/BANDANA, ETC to protect points of entry(mouth, nose, and eye shields) in public or at home is sick. In addition, to washing hands, sanitizing environment.
Please, standing six feet apart alone wont help if we sneeze and cough in our hands, then those hands touch surfaces handled by others. Also, if we sneeze or cough in open air, transmitting droplet particles aided by wind, further then the usual 3 to 5 metres, in someones mouth, nose, eyes.
EVERYONE MUST COVER HIS/HER POINTS OF ENTRY……
Or perhaps wrap all citizens in Saran Wrap
Put down your pitch fork
You do know even dr Fauci now states Covid is looking like it is the same threat at the flu right ?!
You gonna lock people up and put nonsense masks on healthy people each season …. second thought don’t answer that
https://www.nejm.org/doi/full/10.1056/NEJMe2002387
OMG Dr Fauci is not the person to trust when he stands next to the Orange one on this matter.
I act with you 100%