Pragmatic advice to minimize your COVID-19 risk

The latest episode of Eat Move Think helps listeners prepare for the months ahead

This week it became apparent that the novel coronavirus, COVID-19, will not be contained and likely represents something that North America and the world will be navigating for months to come. Here, in a special episode of Eat Move Think, I interviewed Medcan Chief Medical Officer Peter Nord to create an audio explainer of the evolving situation at its most important inflection point yet. Listening to the episode, I love how reassuring and sensible Peter’s advice is. Honestly, if you’re looking for something to ease your anxiety and reassure you about the road ahead, this is what you seek.    

The following transcript has been edited and synthesized for readability 

 Shaun Francis 
We’ve entered our third month now since having heard of the coronavirus. Can you provide a quick summary of how we’ve arrived at this point? 

Dr. Peter Nord 
The story really starts on December 31 in China, where the first virus was identifiedThe Chinese government recognized that this was going to be an issue and fairly rapidly, actually, despite what you’ve heard in the media, tried to get a handle on this and put some measures in place. In early January, it started to spread quite significantly and quickly. We’re now seeing a bit of levelling off in mainland China and the rest of the world is on a fairly exponential growth curve. 

Shaun 
What are we doing at Medcan to make sure we stay coronavirus free? 

Peter 
We established our Coronavirus Working Group early. We brought together the heads of all of our divisions and began planning back in January. Today we’re taking extraordinary steps to ensure that we remain a safe place to visit through the COVID-19 pandemic. We’ve stepped up infection control with antivirals and disinfectants at regular intervals throughout the day and after each patient visit. We’re executing a virtual triage protocolThat means, we’re interact with our clients prior to their arrivalsSo before anyone arrives we screen them by telephone or virtually to identify those who may be high-risk due to fever, cough, shortness of breath and travel history. If that screening identifies any concern, we recommend that they visit an emergency department specifically to get the COVID-19 testing. [Government policy prevents Medcan from testing our clients for COVID-19.] If someone is already on site and they begin to feel unwell, we’ve established on our 19th floor an isolation area staffed by trained personnel wearing protective equipment.  And we’re prepared to scale Year-Round Care both physically and virtually to handle any increased demand for service.  

Shaun 
It looks like the virus is mutating and that there might be different variants of the COVID-19 virus. Does that concern you? 

Peter 
We might want to draw parallelto influenza A and B, which we have a lot of experience with. Every year, the flu is different from the previous year, because it mutatesAnd I would have fully expected that the COVID-19 virus would also be mutating. Every year, we develop an influenza vaccine that’s really based on what’s happening six months previously around the world. And so we’re constantly playing catch up. So it’s concerning that it’s mutating, but it’s not a big red flag. As far as what that means for the vaccine—we have to start somewhere, so they’re looking at the initial version of COVID-19 to develop the vaccines. Unfortunately, that is going to be, best case, nine to 12 months before we have a vaccine that is going to be useful globally.  

Shaun 
Which in turn likely means that we may have to live with this for the next year and a half or so? Is that what you’re thinking? 

Peter 
Yeah, I think this is a new normal for the globe. And it’s affecting different populations in different ways. By far the majority of people will do well, and most of those who do contract the virus will recover, and will have antibodies against the virus. So we’ll move on, but to get there is going to be a bit of a bumpy road. 

Shaun   
You’ve seen entire countries shut down right now. For example, in Italy, all schools in the country have been closed. Seattle closed the school system. And major companies are sending workers home. Do you see this now happening everywhere that experiences these outbreaks, where everyone is being instructed to go home for two weeks? 

Peter 
That’s an interesting question. What we are doing now is what is recommended, but we’re seeing examples where people are taking this to extremes. For example, even in Canada, we have just a few dozen cases at this point. So it’s hypothetical risk as opposed to an actual risk, and we have individuals reacting in ways that would be not in keeping with where the science is leading us right now. And sometimes we just have to deal with the rational and sometimes the irrational responses to these things. What I’ve been recommending to our corporate clients is, it’s an opportunity to engage, to communicate, to supportIf people want to wear masks, even though they’re at a very, very low risk for contracting, make masks available, even if scientifically maybe wearing those masks won’t make too much difference. Iit makes them feel better, excellent. If parents are feeling better that their kids aren’t at school, and that provides reassurance—why not?  

Shaun  
So given all that, how does this play out then over the next several months, in your opinion? 

Peter  
China will continue to level off, and then for the rest of the world we’re going to see the kind of growth rates that we initially saw only in China. And the first couple of weeks that we were watching itthe first week, it actually went up by 15 times from one week to the next, and then it went up eight times. And that went up three times, and then twice, and now it’s flattened out. So that’s probably what we’re going to see in different clusters around the world over the next number of months. It’ll be scary, for sure. But again, good containment measures will really help to modify that. 

Shaun  
With the proliferation in Italy, should we avoid contact with people who have been to Italy for the next couple of weeks?  

Peter 
That’s fair. We have many of our corporate clients that have employees that are coming back from Italy and we’re recommending, to be on the safe side, that they are self isolating at home and working remotely for 14 days just to make sure they don’t have any symptomsThe challenge is, as we see an increasing number of countries make it onto the watch listtravelling anywhere outside of your home country will become problematicAt that point, the country list eventually will be moot. So that’s going to affect how people travel, and it’s going to affect how business is done. Fortunately, we can leverage technology and do things as remotely as we possibly can.  

Shaun 
But again, as you say, once every country has its cases, maybe it will just become the new normaland all of us will just have to get on with things. 

Peter 
It will become the new norm. It’ll become part of our annual flu season. It‘ll bounce between the northern hemisphere in the winter, and the southern hemisphere in their winter, and it’ll mutate and we will have systems in place to develop vaccines that’ll do a pretty good job. And ultimately, again, it’s that same older, sicker, more vulnerable population that will be affected by all of it. And in terms of protecting ourselves, obviously, you can talk about protection at the borders, at points of entry. And then the next area, the next circle of protection, would be within two metresbecause we’re saying we need to stay two metres away. That’s where the coughing droplets can impact somebody else. Within that two metres, it comes back to what our mother told us. Frequent hand washing and cough into your elbow. Don’t sneeze in people’s faces. Use hand sanitizer. All those normal sort of things 

Shaun 
I’ve heard that 15 per cent of people who get the virus may get sick enough to require hospitalization. So how does one minimize the risk to not become one of that 15 per cent?  

Peter 
The last frame of protection is keeping ourselves healthy. So if the virus happens to get within two metres of us and we happen to have it enter our nose or mouth, and it enters our lungs, then we want to make sure that we’re healthy, to be able to fight it off. Sit’s critically important that people, for example, don’t smoke, because smoking impairs the lungs ability to fight off infection. Take care of yourself. Make sure your immune status is good. Exercise. Eat well. Manage your stress levels, all of those things, ultimately, are things that we can control that will minimize how seriously it affects us. If the other levels of protection have broken down, our final level of protection is keeping ourselves healthy. 

Shaun 
You hear things about taking Cold FX, vitamin C, vitamin supplements—will these things help boost our immunity? 

Peter 
There hasn’t been any decent research that shows thatFor surevitamins are required to keep our immune system healthy and we often hear about vitamin C being excellent, vitamin B being excellent. But with both vitamin B and vitamin C, if we take more than we need, we just actually pee it out. The body says I’ve got that much and I’m just going to excrete the rest. So triple dosing, quadruple dosing on vitamin B and C really won’t make too much difference.  

Shaun   
Let me ask one question I haven’t got to yet, Peter. Are the coronavirus symptoms more severe than what you’re seeing in severe cases of flu?  

Peter 
Great question. It is very similar to the symptoms as they present with regular influenza. Again, I go back to that mortality rate that we’re seeing in Canada on an annual basis. With COVID-19as we said, our mortality rates likely are going to be lower than 2%. So there might be a very slight, more virulent picture having to do with COVID compared to influenza. But I think what we’re going to find eventually is, that it’s just going to settle down, and itjust going to become part of our new normal. 

Shaun   
Terrific, thanks very much, Peter. That’s super informative. And given the daily news feed on this, I think it’s calming for my nerves, at least, to have your input, to put this into perspective and to have a longerterm outlook. And to know that the road ahead might be bumpy, but we should not panic 

 

As part of our 30 years of experience assisting companies to care for their workforces, Medcan provides Medical Advisory Services to address and provide counsel to our clients on pandemic risk management.  

 

Subscribe to Eat Move Think with Shaun Francis on Apple Podcasts or your favourite podcast listening platform. Follow Shaun on Twitter @shauncfrancis.  

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