COVID-19 is terrifying, but let's not let fear defeat public health
It was a video that chilled me to the bone. It was from northern Italy, where COVID-19 has caused stunning damage. This video showed the obituary section in a newspaper from the city of Bergamo, from two issues published a month apart.
The first one shows what would presumably be a normal day. The second one, featuring a newspaper published March 13, shows page after page of obituaries, with photos of those killed by a virus that is now worldwide.
Terrifying.
And what struck me most is when I decided to learn more about Bergamo, a city about which I knew hardly anything. Its population is just over 120,000. In other words, it's comparable in size to St. John's.
Bergamo daily newspaper <a href="https://t.co/N3ECABz8dr">pic.twitter.com/N3ECABz8dr</a>
—@davcarrettaThat second newspaper in the video, which you can see above, was published just two days after the World Health Organization declared that COVID-19 was now a global pandemic.
In the days that followed, Italy's death toll continued to escalate on a curve that is exponential. Italy has overtaken China as the country with the highest death toll in the world.
The WHO declaration of March 11 changed daily life almost everywhere, including here in Newfoundland and Labrador.
Our first presumptive case was announced one week ago today, with two further cases — connected to the first — announced Tuesday and a fourth on Friday. At least the first three cases involved patients with mild symptoms.
Amid it all, we saw unprecedented actions, from employers sending workers home, schools closing and ultimately a public health emergency declared Wednesday. Bars were subsequently closed, as well as gyms, arenas and other businesses. The Liquor Corp. has gone to a new business model of phone or electronic orders.
A system that is often ignored
We are not yet in a state of emergency, which provinces like Ontario, Alberta and British Columbia have declared.
There's a paradox in public health: the better it is, the less likely people know it even exists.
Newfoundland and Labrador is trying to manage, ahead of a pending storm.
So too is the public health system — a vital part of our social infrastructure, and one which is almost always ignored, except during times of crisis.
There's a paradox that is very well known to those whose work involves public health: the better it is, the less likely people know it even exists. We've seen this apply in so many cases, and nothing is better than immunization against diseases that have practically disappeared, like polio. I'm not old enough to remember what it was like for children to contract polio, but you hear older people talk about how the illness would come around some summers, and would strike someone they knew.
In our day and age, the public health system chugs away in the background. We see the diligence and talents of the people who run it only occasionally. My memory is drawn to the flu shot clinics that public health nurses run; at the last one I attended, it appeared to be a huge crowd, and I sighed and expected a long wait.
But the wheels of this machine were in top gear. We were all registered and immunized with no real disruption to our schedule. These nurses are total pros.
Panic is in the air
COVID-19 is very different indeed from regular flu season, and panic is in the air.
For instance, I've lost count over how many people have called for universal testing of every single person in the province for this particular coronavirus.
This is of course not remotely feasible — there aren't enough swabs in the province, let alone staff who can do this at once — but more importantly, it would not stop the virus's path.
Let me explain. If we were all tested this afternoon, say, it would only tell us the relevant results for right now. A test is not immunization, and it does not offer protection. In fact, it could give a very false sense of security to many individuals.
The virus is still in our midst, and any of us could become infected in the days, weeks and, yes, months (and, yes, years) to come. While testing needs to ramp up, it's certain that testing is going to need to be an ongoing process.
That's why Dr. Janice Fitzgerald, Newfoundland and Labrador's chief medical officer of health, is emphasizing why there is a logical system for testing. If someone has symptoms, they should contact public health or call 811 and follow instructions, and not go straight to a doctor's office or an emergency room. Self-isolation is the best, safest option.
Even now, the system — even more in jurisdictions where deaths are being reported — is struggling to keep up with demand for people who feel they may be infected, and want to be tested.
Much more lethal than flu
As Fitzgerald has told briefings, this virus is very different from seasonal flu. There is no vaccine for it. There is no treatment for it, either.
Much more critically, it is a much more lethal virus than influenza, which is dangerous enough. It's true that many people who get the new virus experience mild symptoms, but a great danger of COVID-19 is that people assume that is the universal and expected result of infection.
It's not. Carrying the virus to someone in a risk group — the elderly, or someone with compromised immunity — could have fatal consequences. (This is, sadly, comparable to influenza, and why it can be so deadly to elderly people.)
As I write this, the mortality rate in Italy for COVID-19 cases is just above eight per cent. In Canada, the rate (again, as I write this on Friday) is substantially less, at 1.3 per cent.
In Newfoundland and Labrador, there are no deaths. I've been wondering how that may involve our geographic isolation, our low population density, and the fact that Newfoundland is an island. As the late great Tom Cahill wrote in a song for Joan Morrissey, "Thank God we're surrounded by water."
These factors, though, are not shields. The virus will find its way here in numbers. It's just a question of when.
We cannot be complacent about this.
We also need to be calm and rational, and guided by science and best practices in public health. I spoke the other night with a friend who is an epidemiologist. One of the topics we discussed are the fiery calls on social media for people to publicly identify neighbours— that is, on those same social media platforms — who may or may not be sick.
This is not contact tracing, she said. "That's vigilantism."
Still, the system needs to protect itself. On Friday, Health Minister John Haggie said the government is figuring out how to enforce new rules requiring self-quaranting, including those coming from other provinces. Haggie said government will have an online form where the public can report those flouting the new rules.
"It's likened to retuning and rebuilding a car engine while the vehicle is actually moving. We are in uncharted waters here. We're making some sensible, or what we believe to be sensible first steps," he told reporters.
The virus is not the only thing that's spreading quickly.
Our collective safety, and sanity, depends on keeping things in perspective, and working together to ensure that our public health system can work properly to protect us, especially those who need the help the most.
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