Welcome to my Ottawa Coronavirus information pages, at the moment I am not impressed. The Prime Minister’s wife is down, so as the supreme brain looks around for a freshly cooked meal we are racing ahead with a solution to the problem.
Last updated 24th March 2020:
Between my last post and today the number of CoV19 cases in the world has leaped by 100,000 cases, Canada’s incidence continues to increase daily. Even remote areas are reporting cases. The lucky people have isolated themselves with the help of their younger family members, those who have no family to support them run a desperate risk simply by going out of their homes to buy food. Our hospitals are bracing themselves in anticipation, ill equipped to manage a virus. I am writing this from my 2nd day in isolation because I have a viral infection contracted somewhere, keen to get out there and help, but more of a nuisance than a help. Virtual care is here but it remains untested as a substitute for normal clinic work.
20th March 2020:
The incidence is set at 1000 cases per day in Italy, not letting up at this time, but at least it’s no longer exponential. The UK appears to be struggling. South Africa have ordered 1 million testing kits I hope Canada has done the same. Still the problem with testing persists – testing centers are a viral trap and endanger medical staff. Drive through testing is the only solution, coupled with an internet based triage system. This takes 24 hours to set up but Ottawa has closed down their only one.
18th March 2020 : Canada today is closing the border with the USA except for essential traffic. The logic being, the slower we move, the slower the virus moves. This gives care centers time to control the flow of infected cases. ‘Runaway’ cases in Seoul are a deliberate effort by the government to increase the rate of immunization as there’s no point in stamping out the virus and allowing a second wave in the fall. That is good news, it means the virus is being controlled. In China, there is more good news, the number of daily cases has plateaued and is beginning to drop – I am not sure whether this is due to a limit on the number of cases they can test, or whether this is a true reflection of the incidence of new cases. India is not reporting the number of cases and allowing it to run riot. Lock down in Canada is already taking effect well done everyone – my guess is Canada will have this 90% under control by mid-June – Trump will be probably be re-elected if he gets this right meanwhile our democrats will be out unless they can find a new PM to lead the party.
17th March 2020
Received a letter today from the secretary of a Dr Brewer, the aptly named GP Chief co-ordinator, asking whether I want to work in the Brewer Arena Testing Center. I ask myself was he named after the Brewer Arena or was it the other way round? How do I feel, well, somewhere between the Boy Scouts and Dad’s Army there is a place for Brewer’s Boys and Girls, doctors lining up for the Ministry trenches. The young and the brave who stand between the people of Ottawa and the ravages of Coronavirus. So I added my name as Dr Frodo Baggins and sent it in.
16th March
Work not as bad as I expected, everyone was pretty sensible – apart from a small number of gifted families who had clearly taken more than their fair share of the thick mince on offer at the canteen of humanity – arrived with eyes and noses streaming with CoV19, no fear, I have a special bonus community care feature for them. The 20 foot wheelchair ramp leading up to the side of the building has turned into what I call “The Luge”. Desperate efforts to maintain this access point in a -25C Canadian winter invariably end up converting our wheelchair ramp into an impressive 20ft long ski ramp much to the delight of local kids dreaming of days of glory in the Canadian Olympic bobsleigh team. I do have a cohort of more courageous wheelchair riders who, against strong medical advice, insist on finishing up and washing down their weekly consultation with a “drift’ down the 20ft ramp into the back of the car park, to cheers from other patients. For the seasoned rider, The Luge is a breathtaking challenge. However, as I open the door for the CoV19 snot brigade, noodles weighed down by mince, The Luge offers an existential experience not dissimilar to a trip into Neiche’s chasm of eternal nothingness.
Updated 15th March 2020
The government of Ontario has stated that they will be limiting further who has access to DNA testing for CoV19 coronavirus. This is understandable as the demand is going to be overwhelming. I have devised a simple risk test for you to use – contact me if you have any concerns. Meanwhile I am going to convert most of my appointments next week to virtual care. I will be seeing some vulnerable patients, so if you are at risk of carrying the virus please contact me on Whatsapp 613-8547845 from your car and I will let you know what to do.
Updated 14th March 2020
Get onto our own helpline here and speak to us (if the portal fails you can WhatsApp on 613-854-7845 if you have a healthcard get it ready) and of course, you can always contact Telehealth at (1-866-797-0000) they are answering bless them.
14th March 2020
Trump cancelling flights from UK & Ireland, fine well at least he tried. He’s going to throw money at testing and make sure his pals get well paid for it fine, and apparently they will offer free testing to all Americans can hardly believe it.
Boris BJ Johnson meanwhile has gone viral stating the obvious fact that once we are immune to the virus, people will eventually stop dying. Given the penchant this virus has for the wealthy elite I’m cautiously optimistic that BJ himself over 60, obese and shockingly negligent may be self isolating soon.
The situation is moving quickly. Word is out that it was the Ministry who last week initiated the strategy of centralized testing centers in the community, obviously this was to get the virus out of hospitals. I get that, but the risk has been shunted into the community without having any community care strategy! I understand the situation is moving fast, I have offered my assistance to the Testing Facility and I think they are taking my suggestions on board.
I’m continuing to offer my patients drive-through testing which has been tried and tested in South Korea with success. If the city doesn’t provide it – we certainly will try it ourselves.
Appletree Medical clinics are the major community care provider in Ottawa, continue to refuse patients into their walk-in centers and are ordering them across to the hospital ER just more foot-dragging in my opinion, a disaster in the making. No response from their side either, is Tom Tyson back from Granada?
Would have liked to have been involved earlier as a community of physicians we get this – the College of Family Physicians blissfully ignorant at this stage however – if their website is anything to go by.
13th March got an insight into the Brewer Arena facility on its first day today. Let’s ignore the fact that it’s Friday 13th okay, but I am particularly concerned at the level of protection afforded to their front-line staff – inadequate particularly since repeated viral exposure in a closed facility such as this has been associated with deaths among highly dedicated Italian healthcare workers earlier this week. Looks like a decoy facility!
Mask pores on facility staff N95 face masks 0.3 microns vs Coronavirus 0.05 microns – go figure how a modern democratically elected government protects its health care workers.
12th March: I cannot speak for the whole country, I am pleased to announce that Ottawa has set up its first testing center at Brewer Arena – they have drained the ice-rink and have set up the arena for testing suspect cases opens tomorrow at 12:00am. I have not advised many patients to go for testing for a variety of reasons, not least of all the arena represents a viral trap which should be avoided unless one fulfills certain criteria, and I have some testing kits of my own. I am visiting the center in the early morning getting under the feet and up the noses of everyone there, the arena represents an outstanding effort by Ottawa City to protect its citizens, but only once it is conducted outdoors as a drive-through service will it be safe enough for me to advise my patients to use it. The fact is, I feel the programmers simply do not want you to go for testing because there simply isn’t the capacity to test everyone, so most people attending are queuing up before being turned away – after having unnecessarily exposed themselves and therefore others to the virus. I will check tomorrow if there is any change and post it here.
Looking and Learning from others…
Having said that this is Canada’s first modern attempt at pandemic control. Nobody knows how this is going to work and only time will tell. Our response is nowhere near as efficient as we see in Hong Kong and Singapore but it’s our first time since SARS – while Canada has stood still in this field, advanced Asian countries have developed a sophisticated response to viral epidemics and have expansive testing and tracking capabilities. South Korea has already managed to curb spread of infection just 1 week after the WHO announced a global pandemic – see how they did it here.
Primary Care Centers and our efforts to protect our patients:
After many late nights trying to figure out the best way stimulate a flow of care to our patients and caution and awareness between ourselves we are beginning to build a system that could curb the spread of nCoV19 in our sector of Ottawa, but there are a number of key components missing, and it is not all about funding. The take-away message here is that while in North America we are very good at fast food, we are not very good at fast infection control, even though the systems involved are pretty much analogous. I wish the planning genius that created our Appletree Walk-in Clinics had been engaged in this effort from the outset but let’s not cry over lost time – nevertheless their advice today to their patients worried about CoV19 infection to go directly to hospital is precisely what needs to be avoided. With a web-based menu of symptoms and a logical check-in process similar to that used by Appletree Clinics and other integrative care clinics in Ottawa we should have been able to manage drive-through testing facilities which would not assist the virus and would not endanger medical staff – which the current system is set up to do beautifully. Then there has to be online patient follow up – my patients generally prefer Whatsapp and I have given up on using a secure platform because the key here is ease of use and speed of setup – I would be thrilled if Government and software companies would work this out, because Whatsapp are fundamentally disinterested in adapting their platform to assist a small urban GP but they will work with government. All I ask is virtual contact with my tested and non-tested patients as they progress without losing them to follow up while the results feed back (this takes days and is a major bottleneck in the flow of care). Specifically I want to broadcast updates on available options and news to all my unwell patients, and I want to pin as many critical cases to the top of my contact list. But, anyway, in the meantime everyone should be considered positive carrying virus. I also wish we knew who has recovered from the virus because the vast majority of these individuals will be able to return to a normal life without fear of re-infection, another long term benefit of testing which we often forget is we can test our knowledge and beliefs of how this virus behaves, it’s modes of spread, how it mutates and finally how to annul the harm it can cause.
