It must be confusing when you hear one thing from your local authorities and another from the World Health Organization (WHO) — especially when they seem to contradict each other.
We’ve been told to maintain a safe social distance of at least 6 feet (2 metres) from people; to wear a mask to reduce the risk of spreading the virus to others; and, to wash our hands regularly to reduce the risk that we infect ourselves by carrying the virus on our contaminated hands to our eyes, nose and mouth. But then we hear that asymptomatic spread doesn’t happen and that our nasal swab test to see if you are infected may be falsely reassuring at least 20 per cent of the time and maybe even more depending on when in the course of the infection you are tested.
What does this mean? Have all our efforts been in vain? Have we and our economy suffered for nothing? The answer is a conclusive no.
What we have done (with perhaps some tragic missteps) has saved us from the fate of Italy or New York City where people may have died unnecessarily because too many people got sick at the same time for the limited health care resources to cope. We have so far avoided that in our hospitals. People are still going to get sick with COVID-19 but our efforts are directed at slowing the spread of the disease to a level that no one need die for a lack of proper resources in our hospitals. Far too many may have died because of a lack of resources in our long-term care facilities which highlights tragically how that can happen.
Let’s look at the specific contradicting claims: More than one study has reaffirmed that asymptomatic spread can and does happen. The WHO rapidly (within a day) retracted their mis-statement. We have proven that people can spread the virus without realizing that they have it whether they fall sick later or, have recovered but are still spreading or, never show any symptoms. We do know that the sickest people are the ones most likely to spread the largest amount of virus but any spread needs to be contained.
In terms of the false reassurance from a falsely negative test when someone really does have the virus, that’s unfortunately true of any medical test. There are so many variables that can affect the test’s accuracy. Was the proper technique used? Did it sample the right area? How was the sample transported and handled? Etc. We know that all medical tests have a certain percentage of false negatives so we take that into account.
If we really think you may be at risk we will tell you to protect others by isolating yourself and repeat the test in a few days. Two negative tests within a few days of each other is highly likely to be real. Remember, too, that there are other illnesses out there. You could have a cold or strep throat and still need to stay at home.
Our collective sacrifices have not been in vain. It is still essential to maintain our vigilance as we open up. One day we will be able to hug and get together with our friends and loved ones. We will get there sooner and safer if we do it right.
Slow and steady wins this battle.
Dr Mitch Shulman is an Associate Professor in the Department of Emergency Medicine at McGill Medical School as well as an Attending Physician in the Emergency Department of the McGill University Health Centre. He’s also the CJAD AM 800 Medical Consultant.