COVID-19 Update (01/13/2021): It’s A Marathon

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When we’re really old, people in the future will interview us, because we lived through one of the biggest events in human history. Like the Spanish flu of 1918 that killed over 50 million people. Or the great depression. Or Pompeii. Or the Titanic. Oliver Markus Malloy (German/American author and artist)

It’s been some time since I wrote an update with respect to COVID-19. In the midst of a second lockdown, in the midst of the second wave, it’s time again to talk about what’s happening.

In the quote above, Oliver Malloy is not wrong when refers to the COVID-19 pandemic. We are living through a momentous time, an era-defining event and we’re in the thick of it now. A second wave is always expected in a pandemic and it’s always much worse than the first. It may have seemed worse back in the spring of 2020 when our lives were so suddenly upended and the lockdown was so all-encompassing. But the reality is that the second wave was always projected to be more significant.

Our lock-down at present is not the all-encompassing lockdown like last spring even despite the renewed state of emergency announced January 12 and the stay at home orders. But it likely needs to be. Covid-19 is spreading in our community at an unprecedented pace. The projections are not good. And people are tired. Tired of restrictions, tired of isolation, tired of working through screens or while wearing PPE. A third of the province is shirking the rules. But exhaustion is normal in a pandemic. Like a marathon, we have to pace ourselves as the going gets tough. Pandemics typically have 3 waves and last for 2 years. Knowing this we have a responsibility to plan to endure for the full 26.2 miles of the marathon.

When Ontario published its new “COVID Response Framework – Keeping Ontario Safe and Open” back in November 2020, the government outlined 4 levels: Prevent (green), Protect (Yellow), Restrict (Orange) and Control (Red). Each level provided instructions on how Ontarians could interact within each level depending on the area of society (eg. businesses, schools, restaurants, social situations etc.). The aim of the framework was to:

  1. Limit transmission of COVID-19
  2. Avoid closures
  3. Keep Schools and childcare open
  4. Maintain healthcare and public health system capacity
  5. Protect vulnerable populations
  6. Provide additional supports where possible

The framework, however, also hinted at something else. Ominously, there was a fifth level which was grey called ‘lockdown’. In the initial document, published November 20th, there were no specifics about lockdown, it was effectively blank. Was this left blank because the government was overly optimistic? Were they overly invested in #2 above? Who knows. But as November progressed into December it became increasingly clear that the second wave was upon us and a lockdown was coming.

The government of Ontario has tried to walk a very fine line. The order of their priorities above is interesting. I might have done 1,5,4,3,2,6. This current lockdown is not as severe as the spring 2020 lockdown and yet the second wave is worse. It is not at all clear whether that is a viable strategy. Quebec has already adopted curfews to deepen its lockdown. Ontario has extended online learning in Southern Ontario hotspots for 4 more weeks. Decisions are week to week. The government has talked of a ‘darker grey’ level of lockdown. We always seem to be a step or two behind the COVID-19 wave.

Meanwhile, what I think we have to worry most about is Number 4 above. Our healthcare system is becoming overwhelmed. Hospital beds, ICU and ventilator capacity is becoming strained if not overwhelmed. Modelling over the next few weeks paints a worsening picture. On top of COVID related concerns, other acutely ill patients are presenting to hospitals much sicker than usual as they try to avoid coming to hospital during COVID – heart patients, cancer patients etc. Nurses and doctors and long-term care workers are burning out. Vaccine roll-out is coming but slowly.

Things are not good and yet the public is restless, straining under the restrictions. A recent poll suggested that 50% of Canadians interacted with others outside their household during the Christmas holidays. People are travelling to sunny destinations despite stern warning from the federal government to avoid travel outside the country. Returning to my marathon analogy, I think there’s a lot to be learned there. Thomas Watson, an American marathon running coach with many publications to his name, states that there are 15 emotional stages of running a marathon.

  1. Anticipation
  2. Sudden euphoria
  3. Adrenaline
  4. Fortitude
  5. Boredom
  6. Doubt
  7. Denial
  8. Anger
  9. Bargaining
  10. Depression
  11. Acceptance
  12. Fortitude
  13. Adrenaline
  14. Euphoria
  15. The Afterglow

Substitute marathon, for COVID-19 pandemic and read the list again. If you’re like me, there’s a lot of recognition in those feelings. Did you notice something else? Numbers 7 to 12? These are the Kubler-Ross 5 stages of grief.

Enduring the COVID-19 pandemic is like running a marathon and it’s also like grieving. We are exhausted, but we are also experiencing loss, we are angry, doubtful, anxious, bored, depressed. We want out of this experience, but there is no off-ramp. There is only going through it. So how do we cope?

The key to enduring the pandemic, especially this 2nd wave is to recognize these feelings. They’re normal. It’s also absolutely essential to have fortitude. Muster strength from deep reserves. At the beginning, middle and end. Those us who are stronger, healthier, less at risk have an even greater responsibility to shoulder this responsibility. We need to follow the rules in order to support those who are more vulnerable (health care workers, seniors, those living or working in congregate settings, indigenous peoples etc.). We can’t stop being vigilant. We can’t cheat, we can’t avoid. We can only endure. Eventually, if we endure, if we do our best to take care of each other we will regain our energy (and our economy) and our freedom (to be with each other), and we’ll have the euphoria and afterglow that comes with making it through and a job well done.

At ArtMed, we have been and will continue to observe the lockdown. Because we are a medical clinic, and as such under Directive #2 (rather than the provincial framework), we could be open and operating with our regulated health professionals (doctors and nurses) but we have chosen not to be. In fact, we picked up the phone and talked to health inspectors at Public Health. Yes, technically we can be open. But they advised that we should only be open for ‘medically necessary’ procedures. We do have some of those and we are seeing those few patients.

But most of what we do in cosmetic medicine is elective and therefore not medically necessary. Nonetheless, some personal care establishments with nurses and many clinics are open and providing botox and fillers even in the hottest of hot spots. Is it illegal? It’a a grey zone like the lockdown itself. Is it the right thing to do? At ArtMed, we don’t think it is. And neither does Public Health. But Public Health has its hands full. Enforcing the medically necessary decision is not possible for them. We must choose do to the right thing. The spirit and intent of the lockdown is clear. This is a time to take care of others by staying home rather than taking care of business.

ArtMed will provide parking lot pickup for products on Wednesdays. If you’d like to order products, call or email the clinic and we’ll arrange contactless pickup. I will begin doing Instagram Live events once again on Fridays starting Jan. 15 at noon. All our media channels are open and we’re responding to inquiries daily. For myself, I’ll continue to work at the Ontario Virtual Care Clinic during the pandemic and especially during lockdown. If you don’t have access to a family doctor, the Ontario government provides virtual access which is covered by OHIP daily from 8am to midnight 7 days a week at seethedoctor.ca.

The safest thing to do at this time is stay home whenever possible. Work from home if you can. Go out shopping for food or medications strategically and infrequently. When you go outside to get exercise, maintain social distancing and wear a mask if your outdoor access is crowded in any way. Don’t go out in groups. Use parking lot pickup whenever you can and support local businesses. Stay in your own town or city. Avoid all discretionary travel. Be vigilant about testing. If you have COVID symptoms or a concern about a possible contact, get tested.

We’re only at mile 12 but the vaccine is coming! More on that in my next blog.

Stay safe.

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