Coronavirus news updates, like the disease itself, seem to be increasing at an exponential rate. Press conferences where government leaders sit side by side with public health officials are now the norm. Hand washing reminders are frequent, cancellations and closures are coming fast and furious and terms like social distancing and self isolation are part of our daily vocabulary. The Suburban spoke with Dr. Marty Teltscher, an infectious diseases specialist and medical microbiologist at the Jewish General Hospital, for his opinion on the ongoing crisis. This is an edited transcript of that interview:
The Suburban: What do you have to say about how we are now handling this crisis?
Dr. Marty Teltscher: The social distancing and all of the different measures that are being put into place now, although they may seem to some [people] extreme, are probably timed at the right moment. They may have even been more efficacious if they were put in place a week or two earlier, but what we are seeing now is appropriate and we hope to be able to control the rate of new cases and manage the new cases appropriately and not overwhelm the system by having the number of new cases reduced over time.
These measures are actually put in place to protect everyone and everyone has to play their part. Make proper decisions, be respectful of others, be courteous and remember that, in this type of stressful period, everyone is on edge. So everyone should be extra considerate about everything they do in every aspect of their life, whether it’s a business dealing, whether it’s driving, whether it’s shopping, this is the mode we are in right now. We have to look out for each other and we have to think about each other.”
The Suburban: There are people out there who are still saying this is just another flu. That the regular flu affects more people and more people die of cancer and so on. What do you tell them?
Dr. Teltscher: It’s a difficult argument because, the fact of the matter is that they are right. The mortality rate, or case fatality rate of this virus, COVID-19 is higher. But on an annual basis, even within our country, more people die of flu-related illness and complications than have or, I hope, will die of COVID-19.
But that’s not the problem. The problem with this virus is not the end result, the problem with this virus is what it does to the healthcare system as more people become sick.
It’s the middle ground. It’s not the number of people that get infected and it’s not the number of people that die, it’s the number of people that get sick enough to require hospital care and intensive care which then overwhelms the system. And then what happens is people who aren’t even infected by COVID-19 end up passing away because they may need advanced medical care or critical care that is no longer available because there are no more critical care beds and critical care equipment because it’s all been consumed.
So it’s not easy to explain this to most people who are thinking about sheer numbers.
The Suburban: Is there more that governments should be doing?
Dr. Teltscher: Well, I don’t speak on behalf of the hospital or on behalf of my order. This is my own opinion. If it were up to me the airports would have been shut down — for anything other than domestic flights — a month ago. I think that we’ve been importing infectious cases for over a month now, if not longer, and all it’s been doing is seeding infectious cases in the community. We’ve been trying to detect them before they spread and to this point we have not seen sustained community transmission, but if we keep importing cases it won’t let us deal with what we already have within our borders.
We are doing the best to keep up with things. I think we’re probably ahead of the game a little bit by putting all of these social distancing protocols in place. The reference labs are doing their best to keep up with increasing demand on a daily basis and we’re hoping that the tests will soon become available in service centre hospitals so that will enable us to have an even greater number of tests being done on a daily basis and hopefully get the turnaround time on the results more rapidly. It’s also a matter of trying to find the equipment required for testing which is in a global shortened supply.
The Suburban: How long do you think this whole ordeal might last?
Dr. Teltscher: There is no way to predict how long it’s going to last or how long we will be in this situation. This is a totally new event for everybody. Even when we prepare for pandemic flu, at least with pandemic flu we have the option of vaccinating and we have medications like Tamiflu. But at the current time we don’t have a vaccine, which hopefully will come around soon enough. And we don’t have medications, so it’s hard to say how long this will drag out. But the point is, if we can keep this at a low level and drag it out longer, then we might be in a better situation than if this all just explodes in one shot, in which case there will be an overwhelming of the system.
Most people will get better, even with that situation. However, the price we will pay as a result will be that those who needed our help will not be able to get it and we will probably lose somewhere between 0.5 and 3.5 per cent of those infected, plus whoever else needed medical care that couldn’t receive it and who required critical care during that time.
The Suburban: Is there anything else you would like to add?
Everyone should know about the dedication, caring and bravery of our front line physicians that have to stand in front of patients with unknown syndromes and which may unwittingly be harbouring this contagious illness. This is further exemplified by the outstanding emergency room doctors and intensive care doctors that are working diligently and tirelessly to diagnose and care for as many people as possible in a very difficult time. Finally, and most importantly, the emergency room and intensive care nurses that continue to offer fearless unparalleled care.