Temas de Capa

A doctor has to face the danger

How much can we ask from a doctor? They are humans and they also have family and love ones, but the recent pandemic is testing them every single day. They fight an invisible virus with a lack of masks, gloves and other essential personal protective equipment (PPE) to protected them from COVID-19. But even so, they will keep fighting because is their duty, they were trained to save lives even if that jeopardize their own lives.

BlueDot, founded by St. Michael’s Dr. Kamran Khan, is using human and artificial intelligence to help the Canadian government track and make decisions on COVID-19

The 1922 version of the Canadian Medical Association’s code of ethics is very clear about these pandemic times. “When pestilence prevails, it is their (physicians’) duty to face the danger, and to continue their labours for the alleviation of suffering, even at the jeopardy of their own lives.”

During the last weeks, all levels of government in Canada keep saying that essential workers are our heroes and that they are doing everything that they can to make sure that they are protected at work. Unfortunately, we are running against time and the high demand for PPE in all the world is not helping. PM Justin Trudeau said that we have to make an effort to think about “Canadian solutions”, and Premier Doug Ford underlines that “there is nothing that we can’t do in Ontario”. This week Ontario produced the N96 masks, the first ones to be made in Ontario. Last Wednesday (1) Ford said that there is no excuse to not increase the capacity of COVID-19 tests in Ontario. 

The question is: if we are unable to create a vaccine in less of a year, for how long can we fight this new virus? Although Federal government created the biggest financial assistance program in our country’s history, we know that there is no public health service in the world prepared for an epidemic of this proportion.

Dr. Ramzi Fattouh, Clinical Microbiologist and the Director of Molecular Biology at St. Michael’s Hospital, is pictured with a new machine that detects the virus that causes COVID-19

The Canadian Medical Association (CMA) was created in 1867 and represents more than 70,000 physicians and physicians in training. They are the voice of those who are on the frontline now, scared and exhausted, but resilient.

Milénio Stadium: Health care workers make up one in 10 known cases of COVID-19 in Ontario, this includes physicians, nurses and other health-care workers. Can you please comment?

Canadian Medical Association: It is hard to know the true extent of the numbers. Health care workers are a priority group for COVID-19 testing, so we expect a higher rate. But health workers are also very much at risk, given they are caring for people who come to health services with symptoms of COVID-19. It is critical that they have the equipment they need to protect their own health, and by extent, that of their families. Having protective equipment is imperative. It’s like asking firefighters to combat a fire without equipment – which would be unheard of. For people at home, they can help too – by staying home, following the measures we’re all taking to protect our communities.

MS: Health Canada approved N96 masks – they will be produced in Mississauga, Ontario, by Woodbridge Group. Could this be the relief that health care professionals were expecting?

CMA: It is heartening to see everyone raising their hands to help – and this is an all-hands on deck situation. This is one of many initiatives that will hopefully provide sufficient supplies for the health system. The goal is to get this equipment in the hands of health workers – from the hospital cleaners to the nurses and physicians – as quickly as possible.

MS: Ontario ordered 10,000 ventilators but the population of the province is 14.57 million. How many doctors do we have in the province and how will doctors decide who gets a ventilator?

CMA: In Canada, it is well accepted that everyone should have an equal opportunity to access and receive medical treatment. This is possible when there are sufficient resources. But, as we’ve seen in other countries, the pandemic may outgrow our health care capacity and difficult decisions may have to be made about who receives critical care. We’re hoping that we don’t get there, but we must prepare for the worse. It’s one of the reasons why the CMA – as well as other organizations and provincial government – have developed clinical triage protocols to support physicians and health workers in their decision-making.

MS: The Premier of Ontario said that PPE shipping from US to Ontario was stopped by the president of the US and they only released 500,000 masks, which means that Ontario could run out of medical supplies in two weeks.

CMA: This is a serious issue indeed. Thankfully, 3M was able to reverse this US decision a few days later. But it does highlight the need for producing equipment here in Canada.  We know that the Federal government – along with its provincial counterpart – is working hard to make this a priority. Asking health care workers to be on the frontlines of this pandemic without the proper equipment unacceptable and shortages must be addressed immediately. People’s lives are on the line here.

MS: Will you consider that recycling masks and hand sanitizer, like Quebec is already doing, it is only a matter of time in Ontario?

CMA: We’ve heard of instances of it happening in Ontario already. Unfortunately, if the PPE supply is low, we will do what they feel is best to stay protected in order to do their job.

MS: Should physicians, nurses and health-care professionals be living in an hotel room to protect their families? How do they know that they are completely disinfected before they get home with their families?

CMA: Protecting health care workers and their families is of utmost importance.  By following infection prevention and control guidelines set forth by their health authority, they will significantly reduce the risk of transmission of the virus to their families and communities.

MS: In Ontario some health care and frontline workers can send their children to emergency childcare while they are at work and mental health will be available every day. In BC, the government temporarily suspended pay parking at hospitals and other health facilities. What else can we do to help the professionals that are essential in handling this pandemic?

CMA: We’ve seen tremendous support by so many in our communities – it is heartwarming to see. We know that communities are running errands, providing meals or looking after pets and members of the family. Health professionals have really appreciated these gestures and the recognition of their valuable work in addressing this pandemic.

MS: Canada’s chief public health officer, Dr. Theresa Tam said on Monday (6) that transmission has been happening more often than previously thought right before development of symptoms, as well as evidence of asymptomatic transmission. As a result, she said the special advisory committee for COVID-19 has determined wearing a non-medical mask can help people prevent transmission and protect others. The Canadian Medical Association is afraid that this new advice will increase demand for masks?

CMA: We are hopeful that people at home will understand the difference between medical and non-medical equipment. The single most important thing people can do is stay home. This is how we will flatten the curve. But if you must go out, take all precautionary measures to protect yourself – and most of all others – of potential contamination. And a home-made mask can be a solution for that – save the medical masks for health care workers. But don’t forget to wash your hands and don’t touch your face!

Joana Leal/MS

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