Let’s dispel some myths about theCOVID-19 disease. As the summer progresses and people get tired of the restrictions and the mask-wearing, the risk is that we will have more and more outbreaks like the recent one on the South Shore. Sixty people gathering at a party and then continuing their partying by going to a bar results not just in more people being exposed and falling sick but collateral damage of significant proportions.
First, let’s dispel a myth. “Mild” doesn’t mean “not sick”. Ask any of the people with a “mild” case who spent days or weeks at home with high fever, muscle pain, fatigue and rip roaring headaches or diarrhea and severe tummy pain. Ask the people who weeks or months after their “mild” case are still too fatigued or short of breath to work or carry on their normal activities.
A Dutch study surveyed 1,622 COVID-19 patients with an average age of 53. More than 90 per cent had not been hospitalized and so you’d have thought that their cases would be over and done with once they recovered within a week or two. Not so! Eighty-eight per cent reported persistent intense fatigue; 75 per cent shortness of breath; and 45 per cent chest pressure. While 85 per cent had seen themselves as healthy before coming down withCOVID-19; only 6 per cent did so a month or more after.
Yes, these cases were “mild” in the sense that they didn’t require hospital admission, intensive care or a respirator and they didn’t die, but if you were to ask these people if they viewed their cases as mild, I think they would disagree. So, even mild cases can be extremely disruptive to your life.
What about the ripple effects? Not only did the involved bar have to close down to clean up, some of their staff had to go off work and into quarantine. Local business had to shut down, clean up and test and/or quarantine their staff. How “mild” were these effects? We talk about our concern with respect to how the economy is being affected by the restrictions being put in place to avoid the spread of the COVID-19 illness, but have you stopped to consider the even more significant effects of not stopping the spread of this illness? If we stop or slow down the virus’ spread in the community, then businesses will be able to recover. If we don’t follow these necessary steps, the disruptions will be more severe and longer lasting.
Lastly, let’s also remember some of the other less obvious but no less important collateral effects of allowing the virus to continue to spread. In the emerg I am slowed down because I have to take into consideration the possibility that the patient I’m seeing might be infected with the virus causing COVID-19. It takes time to gown, glove, mask and put on a face-shield. There’s on-going community spread (as the South Shore situation just highlighted), so these precautions are still necessary.
What about that extra time that it now takes me to see and evaluate a patient? Were the waiting times not long enough that we need to let them get even longer? I have to isolate the patient. Do I have the space to continue to do that if the numbers go up? What about a bed to admit the patient into until I know their COVID-19 status? I can’t send a person back to their nursing home, residence or convalescent facility until I document whether they are infected. How many more limited beds are tied up unnecessarily for that reason? What about the heart attack patient or the stroke victim I can’t get to in time or whose bed is now occupied by a COVID-19 patient who need not have been there in the first place?
When people talk about “mild” cases or their right not to wear a mask, maybe it’s time for them to think about all of this.
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.