This week marks just over six months since China revealed that it had a ‘problem’ containing a virus and finally recognized that it was highly contagious and out of control in the following weeks. As we mark this grim milestone, I want to reflect with you on where we started and more importantly, where we are heading.
BEIJING (AP) — The head of a Chinese government expert team said Monday that human-to-human transmission has been confirmed in an outbreak of a new coronavirus, a development that raises the possibility that it could spread more quickly and widely. – Jan 19-2020
I guarantee you we are IN NO WAY OUT OF THIS PANDEMIC and the risk of YOU succumbing to COVID-19 remains present – but for now, it’s just hidden. In case you’re a non-believer, turn on your TV and watch what’s happening now in the USA. Wait another two weeks and you should be really scared for our American friends and their impact on our Canadian well-being, health-wise and economically too.
“100 days and 100,000 cases into the pandemic, we’ve moved from anxiety to complacency, without much reason to do so” – Andre Picard, Globe and Mail
What we know today that we didn’t know then
When I started Bulletin #1 on January 26, I was more than concerned. China never does things in public view with no reason. Building two hospitals from the ground up in 2 weeks was a sign there was something really wrong in proportions far bigger than SARS. We didn’t need W.H.O. to tell us that! But they finally did, 6 months ago today.
It was evident that anything Made in China was going to be short supply as I tried with Manny, my now famous National Post friend, to find masks for my cancer patient Marilyne and the country. The USA swept up all the PPE in the world and more.
We ran out of medications. I’m glad we got you to order six months supply in early February as we have only just returned to allowing 90 days supply again.
Some clinical trials showed that Vitamins C and D were very important and recently, Dexamethasone was shown to be effective in treating COVID-19. Why? Simply, these are antioxidants and anti-inflammatories, which are critical to preventing pneumonia. And yes, we correctly did not prescribe you hydroxychloroquine.
If you’ve taken the breaks off the antioxidant and anti-inflammatory supplements (AHCC, anti-oxidants, omega fatty acids), please get restarted and restocked.
3 new facts you need to know
People are most contagious during their asymptomatic phase of COVID-19 (day 0-3). Some people remain asymptomatic through COVID-19 – W.H.O. sets it to around 40%. In our cohort of people (clients, family and extended friends/staff of Executive Health Centre), about 8% tested positive for COVID-19 antibodies. Approximately 70% of this group could not recall specific symptoms which caused them to be concerned they were exposed to COVID-19.
Bottom line, temperature checks and questionnaires are inadequate and not useful for screening silent spreaders.
- Test for the COVID-19 virus using a nasal swab and for those who are positive, trace contacts and isolate them. This is the only way to keep this under control.
- Assess for the presence of antibodies with a blood test to determine a recent infection, especially if you didn’t get a virus detection test and are still concerned.
We are only at the beginning of seeing the curve begin to drop in Canada. Of the 5% who needed hospitalization, 96% had pre-existing chronic conditions of cardiovascular disease, diabetes, hypertension, etc. Obesity remains a predisposition for all these conditions. Although COVID-19 seems to impact the elderly with higher death rates, this disease is age blind. The younger folks who get the disease will suffer life-long impact on the lungs, heart and neurological system.
It’s time to get back into monitoring your basic health parameters. Your vitals – weight, blood pressure and blood biochemistry. Your annual health program needs to be completed. Now is the best time as COVID-19 cases are at a low level and it’s safer to get your testing completed.
My belief – a vaccine is not coming soon. An effective one is 1+ years away. If one becomes available, it could likely be less than 50% effective (flu shot, old shingles, etc.). Dr. Fauci says he’s going to settle at 75% and be happy. He warned however, if not enough people take the vaccine, then it would render the goal of herd immunity unachievable.
Historically, no vaccine was ever created for SARS because this virus mutated too much and too often. It finally mutated to a weaker strain, which made it unreasonable to mass produce a vaccine. The common cold (a coronavirus too) and other viruses like Influenza-A mutate frequently and antibodies often disappear over months.This results in our need to vaccinate often and annually.
We may be seeing more scientific evidence of those who tested positive for COVID-19 antibodies after being sick, may lose their antibodies (not detectable) levels in only a few months. This is especially true for those who had only mild symptoms for COVID-19. We are seeing this pattern in our clinic’s cohort as well. Hence, we cannot yet rest on our antibodies status because we are uncertain if the body will have memory and prevent a reinfection. To date, the hope we have is that those who have been ‘sick’ have not been ‘reinfected.’ True so long as the the virus does not mutate significantly enough to be a newer coronavirus strain.
Therefore, the only defense is a physical defense strategy with PPE and appropriate effective cleaning products.
Recommendation #3: Protection is key
A sneeze cloud is 12 feet and can linger in the air for 8-14 minutes. 6 feet or 2 metres of social distance space is not enough in a confined indoor space, including shared office spaces, elevators and hallways.
Based on a recent Lancet article, (see table below), the risk for infection is highly dependent on distance to the individual infected and the type of face mask and eye protection worn.
- Distances of 2 m are more effective than 1 m
- Both N95 and surgical masks (16-20 layers) have a stronger association with protection compared to single-layer masks.
2013 USA government study shows cloth masks are inferior both for fit and filtering.
WHO says that an effective cloth mask should have three layers of material (updated June 5-2020)
- Inner – Absorbent material like cotton
- Middle – Non-woven material, such as polypropylene as a filter
- Outer – Non-absorbent material, such as a polyester blend.
Recommendation #4: Wear a mask or Wear a ventilator
(Quote from a frontline healthcare worker)
I’m thankful that the city mayors around the GTA have the insights to mandate everyone to wear a mask indoors. Just make it a habit to wear a mask, regardless if you’re in the GTA or not. Wear at least a Level 1 Medical Mask and if you are at risk, wear an equivalent N95 to protect yourself.
The virus is not alive, it needs a host, and it can live on a hard surface for days as a RNA strand (New England Journal of Medicine April 2020). Read More>>>
- Cardboard (24 hrs)
- Steel (2-3 days)
- Plastics (3 days)
What we learned at home
All of us learned to sit and work from home. We learned so much more about our spouse, kids, and extended family. Many of you also expressed frustration in how your company’s team members responded. Some stepped up, while others stepped back. But hopefully, we all bonded closer.
I will treasure my son being home to finish out his third year of university online, hear him play video games past midnight, and watch my grocery bills balloon (with pleasure). I’ve even tried to bake (still with no success)!
In your home and at work, I hope you were able to engage in an important discussion with family, friends, and colleagues too. I’m certain you’re reflecting on your life and encourage you to hit a re-set button and change things for the better.
ELAINE CHIN, M.D., M.B.A. FOUNDER, CHIEF MEDICAL OFFICER North American trailblazer in Precision Medicine. Founder of Executive Health Centre, a Medical Wellness and Anti-Aging Clinic. Medical expert on CitylineTV and in Good Housekeeping Magazine’s GH Institute.