It can be overwhelming as we are constantly inundated with news, updates and recommendations regarding the coronavirus pandemic. Which information is validated, and what is speculation? What I valued most about the conversation I had with Dr. Brian Goldman was his honesty in outlining what we do not know and acknowledging the large grey area that underscores much of our understanding of the current situation.
Dr. Brian Goldman is an emergency physician, author and award-winning radio show host for CBC’s White Coat, Black Art. He has long been a leading voice about all healthcare-related issues in Canada, and his journalism is a culmination of deep curiosity and in-depth research.
While there's a lot about the virus we don't know, here's what we do know.
People can show signs of symptoms or can be asymptomatic but still infectious. It’s confirmed that the virus spreads through close physical contact with other people.
Symptoms have included:
- difficulty breathing
- pneumonia in both lungs
The incubation period of the virus is 14 days. In severe cases, coronavirus can lead to death.
The virus must be confirmed through laboratory tests and currently, there is no vaccine for it.
In a time when facts and certainty are what people seek most, Dr. Goldman was clear that perhaps the thing we know most is that the future is uncertain. We can speculate based on scientific knowledge, mathematical models and our experience over the past several weeks, but given this is uncharted territory, it would be foolish to believe we have all the answers.
“I don’t know, and that’s a problem; that’s a huge problem”, is Dr. Goldman’s reaction when asked about what Ontario’s trajectory is compared to other provinces and countries. “Right now, we don’t have adequate testing. They are ramping up testing, and there’s no question about that, and it’s better than before”.
Our current models are largely based upon “lag indicators” such as ICU admissions and deaths. The problem with these lag indicators is that they reflect virus transmission from up to two to three weeks ago. To truly know where on the curve we are today, we would need more widespread testing of all vulnerable populations. Such testing would provide data on how many people are currently infected with the virus, not just those who were infected weeks ago and are now manifesting severe symptoms. Only as testing continues to improve and we have access to that information, will we truly know where we are on the curve and how effectively our measures have been in flattening it.
It is important to understand that our definition of “normal” will continue to change. When the first wave of the virus comes to an end, that does not mean that COVID-19 is gone. It is inevitable that many people will still contract the virus and that those in vulnerable populations will still be more susceptible to a more severe course of sickness. Flattening the curve prolongs the pandemic but allows the healthcare system to catch up and cope with those who get sick.
So what does a return to “normal” mean? It does not mean we will return to a society where we are free of the coronavirus and the fears of contracting it. Perhaps normalcy best refers to the time when the high incidence of cases that will be seen in the first wave comes to an end and the healthcare system can sufficiently cope with the new cases that continue to develop. At that point, perhaps social distancing practices can be loosened and there can be a gradual return to work outside of the home. Acknowledging the uncertain timeframe, Dr. Goldman wagers this version of normalcy will not return until the end of June or perhaps into July.
Regardless of the uncertainty that lies ahead, there is reason to stay positive. Testing in Canada is improving, and this will help project our future course. Our emergency rooms and ICUs are not yet overloaded, and this has given the government and hospitals time to better prepare for the peak of the first wave.
Health care professionals, policymakers and the general public are all working together to achieve the same end. We are bound by common intention, and the resultant unity will put us in the best position to come out of this pandemic as a closer and stronger society.