Author: noorali

On Tuesday May 18, Canada reported 25,000 COVID-19 deaths. Unfortunately, this is not the end. There are many hot spots in the country.

Although we are making progress in terms of immunization and controlling the spread of the disease, the worst is not over yet. I feel we need to keep talking about this until we are in full control of the situation. Otherwise, nobody will be able to enjoy the summer or Christmas.

If you do get sick with severe COVID-19 then one or all of the four things will happen. You will be hospitalized, you may end up in intensive care unit, you may end up on a ventilator to help you breathe or you may even die. Nobody wants to be in this situation.

Who is at most risk?

We are learning more about the risk factors for severe COVID-19 outcomes.

Older adults are more likely to get severely ill from COVID-19. More than 80 per cent of COVID-19 deaths occur in people over age 65, and more than 95 per cent of COVID-19 deaths occur in people older than 45. Unfortunately, misinformation, isolation and fear are among the reasons why about 17 per cent of Albertans over 70 haven’t gotten first dose of COVID-19 vaccine.

Residents of long-term care facilities make up less than one per cent of the population but account for more than 35 per cent of all COVID-19 deaths.

Studies have shown COVID-19 does not affect all population groups equally. Your risk of getting sick and dying from COVID-19 goes up if you have long-standing disabilities and systemic health issues and/or belong to a racial and ethnic group. The risk increases as the number of underlying medical conditions increases in an individual.

A study published in Infectious Disease (December 10, 2020) titled Risk Factors Associated with In-hospital Mortality in a US National Sample of Patients with COVID-19 drew the following conclusions:

1. Thirty per cent of inpatients and 70 per cent of outpatients diagnosed with COVID-19 had no comorbidities. That means these were all healthy individuals.
2. Most common comorbidities were hypertension 46.7 per cent, hyperlipidemia 28.9 per cent, diabetes 27.9 per cent, and chronic pulmonary disease 16.1 per cent.
3. Twenty per cent of inpatients with COVID-19 died in the hospital.
4. Very old age (80 years) was the risk factor most strongly associated with death.
5. Pre-existing medical conditions significantly are associated with increased odds of in-hospital deaths. Examples are: metastatic cancer, history of heart attack, heart failure, anemia, stroke, dementia, diabetes and COPD.

What can we do?

Take this pandemic seriously. For yourself, your family and the general public. Most people do take this seriously and follow the rules: get vaccinated, wear a mask, practice social distancing, and hand hygiene.

In general, older you are, more health conditions you have, and more severe the conditions, higher the risk of dying. It is very important to take preventive measures.

We are all in this together. One for all and all for one. Stay safe and stay healthy. Follow the rules.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Statistics show as of January 15, 2021, there were 695,704 COVID-19 cases in Canada. Of those, 65,920 (9.5 per cent) were healthcare workers. Twenty-four healthcare workers had died from COVID-19 by that date. Since then, more doctors and other healthcare workers have contracted the disease or have died.

In Alberta, there were 7,986 COVID-19 cases in healthcare workers, which made up 6.9 per cent of the total cases. There were four COVID-19 – related healthcare worker deaths.

That raises the question: How can healthcare workers practice the best possible medicine under extraordinary circumstances?

Every Alberta healthcare worker is exposed through work in in-patient units that are likely to admit Covid-19 patients together with healthcare workers working in family medicine, emergency medicine, ambulatory care or in walk-in clinics.

Besides being exposed to COVID-19 there is psychological burden. Overall wellness of healthcare workers has received increasing awareness, with research continuing to show high rates of burnout, psychological stress, and suicide.

With this kind of burden, health care workers experience emotional exhaustion, which may lead to medical errors, lack of empathy in treating patients, lower productivity, and higher turnover rates. This has been seen not only in Alberta or Canada but all over the world. How is this going to affect them down the road is not known.

What can we do to help healthcare workers?

We should make sure we provide uninterrupted, quality care to healthcare workers when they are sick. They should be encouraged to take care of themselves.

We should understand that when we take care of ourselves, we are helping the doctors and other healthcare workers to take care of people who are sick.

We should follow the principles laid down by our government and healthcare professionals to prevent the spread of the virus: maintain social distance, wear a mask, wash our hands frequently, avoid parties and social gatherings and take care of our family and friends.

We should mitigate the impacts of COVID-19 on mental health by protecting and promoting the psychological wellbeing of healthcare workers during and after the outbreak. We should not forget them after the pandemic is over.

Following are key points mentioned in an article published in the Canadian Medical Association Journal (CMAJ April 27, 2020) titled “Mitigating the psychological effects of COVID-19 on healthcare workers”:

1. Combating fears and uncertainties by strong leadership with clear, honest and open communication.
2. Bolster individual self-efficacy and confidence by providing adequate resources (e.g., medical supplies) and mental health support.
3. Provide psychosocial support while preserving physical distancing.
4. Healthcare workers should be complimented for serving for greater good in times of crisis.

Doctors, other healthcare workers and the general public is stressed for several reasons: uncertainty about the duration of the crisis, social misinformation, lack of proven therapies, and shortages of healthcare resources, including personal protective equipment. Add to that are the effects of social distancing balanced against the desire to be present for their families, and the possibility of personal and family illness.

We cannot overlook the impact of COVID-19 on healthcare workers. Since there are no easy solutions to the current problems, mitigation strategies for all scenarios are vital to ensure psychological wellness and in turn ensure a healthy and robust clinical workforce. We are all in this together.

One for all, all for one. Take care.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!