My COVID-19 Diary – Week 3

March 29 to April 4, 2020

I have been closely following the COVID-19 testing results in Canada over the past month. Provincial and national statistics are available from several sources, including the media and dedicated websites. It is possible to track the number of people who have been tested, and whether the tests were positive or negative. For those who have tested positive, many have mild symptoms, and can self-isolate at home for 14 days, while others are hospitalized. The outcomes may be either resolved (the large majority) or, for the unfortunate few, death. One of the key elements in managing this pandemic is the ability to conduct widespread testing. As Tedros Adhanom Ghebreyesus (WHO Director-General) has stated:

To suppress and control epidemics, countries must isolate, test, treat and trace.

Tedros Adhanom Ghebreyesus

Canadians have been encouraged to stay home and self-isolate, and all inbound travellers are now mandated to self-isolate for 14 days. Up to the beginning of March, all COVID-19 tests had to be confirmed at a Federal lab in Manitoba, but most provinces and territories have implemented their own procedures and are now testing with local labs and resources. This has been a slow ramping up process; for example, a couple of the first coronavirus victims were only found to be COVID-19 positive subsequent to their deaths.

There continue to be limitations on the number of daily tests that are run, and some provinces, such as Ontario, have experienced increasing delays between taking a test swab and determining the results. As a result, a testing protocol has evolved to prioritize who gets tested first. Front-line health care workers are the top priority for testing, and they will need to be retested frequently. Emergency departments and their associated assessment clinics will continue to be the COVID-19 testing “gatekeepers” while the system remains in a reactive state. I have used this protocol for a calligraphy exercise, using pen and watercolours, which is illustrated below.

Until more tests can be run on a broader population base, and the testing procedures are accelerated, the extent of transmission of this disease will remain unknown. There is a shortage of some of the testing ingredients, and there may also be a lack of personnel to perform contact tracing to discover hotspots in the community.

Hospitals are now preparing for a rapid influx in COVID-19 patients for treatment. No doubt, this will become a topic for further discussion in the coming weeks.

Meanwhile, we have been warned that our current self-isolation and physical distancing procedures may continue to be invoked for a further 12 weeks. The silver lining is that the longer we stay at home, the more successful we will be at flattening the curve.

Be careful out there, and keep your canoe out of the white water.

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