Navigating the Crisis of COVID-19

I wasn’t going to do this. I thought it was better to let the authorities do the teaching without any interference. And don’t get me wrong, you should definitely listen to the authorities. But, the way things have been going, I would feel stupid not to share the knowledge I have; even if no one reads this post, at least I tried, right? I’m not aiming to scare you, but only to educate, because not everyone is taking this as seriously as they should.

As many of you know, I live in Canada. The situation here changes by the day, but currently Canada has 846 cases. 146 of these are in my province. Out of that, 101 cases are in the city I live in. All schools are closed until further notice, with online education resuming after spring break. All elective surgeries are cancelled, except oncology and cesarean sections. All dental practices are closed except for emergencies. Many businesses have closed temporarily. There is a ban of gatherings of no more than 50 people. These are some of many restrictions our government has put into place. Many of these measures were introduced when we (Alberta) had only about 20 cases, which was about a week ago, and is less cases than what New Zealand have now. Canada is basically on lockdown. For my family and friends in New Zealand, I am shocked to see that the New Zealand government isn’t doing more…I recognize New Zealand has yet to see community transmission, but honestly, with the way things are going and the number of cases continuing to rise, I would have hoped to see greater restrictions put into place.

Even if you think it’s not going to affect you, even if you feel absolutely fine, you should be putting steps into place of social distancing, because some people are more vulnerable and any steps you can take to help stop the spread does make a difference. This is a personal plea; my husband is in the small bracket of oncology surgeries going ahead (he has a benign tumor that they’ve decided to take out as it was what caused his bowel perforation over Christmas). So he is having major open bowel surgery, and over the next few weeks he will not only be more vulnerable, but also in a place that has high exposure to the virus.

So what can you do to help people in similar situations as ours? (and with the bonus effect of hopefully not contracting it yourself)

• Everyone’s saying it. Wash your hands. I have additional advice around this. With a background in the operating rooms I have a greater knowledge around infection control than the usual lay person. So here’s the extra advice:
  • Treat the community as both: a) already infected and b) vulnerable to being infected by you (even if you are showing no symptoms). Whenever you go out, wash your hands before leaving so you don’t accidentally spread pathogens. When out, hand sanitize regularly and do not touch your face. When you get back, wash your hands immediately upon entering your home.
  • When you wash your hands pay particular attention to the cracks. We’ve all seen those pictures of how to wash your hands, but pay attention to why you’re washing them, too. Steps numbered 2-4 are because pathogens build up between your fingers. Step 6 is to help get pathogens out from the cracks in your palms, and to help rid of some of the pathogens from under your nails.
  • Drying your hands. We’ve all seen those people who give their hands a brief run under the tap and then scoot out the washroom with a couple of quick shakes. Warm, wet hands are the perfect growing medium. It totally defeats washing them in the first place. Get sparkly, get clean, and get dry.
  • Clean under your nails regularly, and keep them short. You don’t need to be too crazy about it, but this is another hot spot for pathogens to hide.
  • Nail Polish and fake nails – if you want to go hardcore (which you should) in preventing infection, take off the nail polish, remove the fakes. These harbor pathogens. Wear those bare hands with pride, knowing you’re doing your bit in preventing spread.
  • Lastly, rings. Although it’s hard to take them off when you’re out in the community, move them up your finger and wash underneath, making sure that you don’t miss this particular area, and make sure to thoroughly dry the area too, as this is often where residual dampness can cause proliferation.

• Practice Social Distancing. People think they know what this is, but for it to be effective, really think about your spatial awareness. If you’re unsure about what this actually means, visit guidelines by John Hopkins Medicine. And OK, you might say, after looking at this resource, but what else does this mean for you?
  • It means, when you go to the grocery store, go at non-peak times if possible. If there is someone reaching for the same item that you want, don’t march right up and grab it. Wait a few moments for them to move on, and keep a distance of 1.8 meters whenever possible. It means if you have a community mailbox, standing back until another person moves away.
  • It means not going to large events (e.g. WOMAD. I still can’t believe this went ahead?! 52,000 people over 3 days, I mean, come on NZ, wake up! This is not the time to say ‘she’ll be right’.)

• Don’t bulk buy. I know, I know. If everyone else is bulk buying, then what choice do I have? I know I asked that question myself. The answer is this:
  • Do buy enough to get you through a little extra time to account for delays in shipping and supply. I have developed a rule when shopping that says, if an item is in demand, sure. Buy one extra. But only one extra. Hopefully, in a month or so we’ll start seeing the spread lessen, and things begin to resemble normalcy. If not, well at the rate some people are shopping I’m guessing their houses will explode with toilet paper, hand sanitizer and tinned food, so eventually they’ll stop buying it and it will come back in stock again.

• A note on masks. They do work, but only sort of. Take this from someone who has worn a mask as daily workplace PPE.
  • The reason they only sort of work is in part due to user compliance. Even in the operating rooms I have seen masks worn wrong more times than I care to admit. Some people don’t pinch the nose (“because then I can’t breathe”). Some people don’t extend it around the curve of their chin for the same reason. In both these cases, your breath shoots out the top and the bottom and you’re not really protecting anyone. Also, for people who are unused to wearing them, you will constantly be wanting to readjust them. The more fiddling you do, the more you’re touching your face and making your own exposure worse. And don’t forget, if you’re not also wearing eye protection, you’re still vulnerable to getting sneezed or coughed on. And no, normal eyewear does not count as eye protection (unless you regularly wear ski goggles, which would be weird).
  • As to the actual effectiveness, if users are compliant? N95 masks are definitely the best grade, but the average mask (and anything else you use, like neck gators and bandanas) don’t stop small droplet particles. It stops the large ones, sure, and may help reduce the spread. But because of the low user compliance, for most people (if you’re not sick), you’re probably going to find you’re better off without it and just practicing social distancing. If you are sick, wearing it does not give you a free pass to go out into the community. Stay home and get others to bring you food and supplies you need.

• Lastly, be kind to each other! Be understanding! It gets scarier by the day, this thing. Some of you might think I’m over-reacting, or under-reacting. But honestly, everyone’s situations are different. Every country is at a different threat level based on how many cases and whether or not they’ve seen community transmission, and I know some people may respond angrily to my reference to the WOMAD festival for that very reason. But, it’s heartbreaking for me, watching my friends and family at the same spot we were in a week ago, right before shit hit the fan. If NZ gets on top of this, great! I am so happy for you. But be prepared, just in case.

My love to you all, every one of you. ~ Sarah