hello everyone I'm Sara Downey and welcome to the community edition of five
questions this is the series that we launched within our Hospital within the
Michael Guerin hospital to give staff the chance to hear the answers to
questions from some of our experts about kovat 19 and it occurred to us that our
community is probably also interested in the answers to some important questions
from our experts and so this is our first community-based edition of five
questions and today it's my privilege to welcome dr. Jeff palace who is a medical
director of infection prevention in control at Michael Guerin hospital and
really the subject-matter expert in all things covered so welcome dr. palace
Thank You Sara so maybe we can start with can you
describe your role at Michael Guerin sure so I'm an infectious diseases
physician so my medical specialty is infectious diseases but I'm the medical
director of our infection prevention and control team and really the role of that
team is to make sure that we keep our patients and our staff safe from COBIT
19 and that involves many different things that we're doing at the hospital
to ensure that there is no transmission of CO good to patient to patient or
patients to staff saying can you briefly describe some of the major pieces of
work you've been leading within our organizations that can you give us a
sense of what it takes to keep us safe yeah no it's been a never-ending job I
would say starting in around January the 15th when this first came on to my radar
and we've been doing an extensive amount of work about reorganizing the way we
provide care to put systems in place to reduce the risk to everyone including
our patients and staff and that involves additional training additional personal
protective equipment and change in the way we do some things that may have been
considered safe in the past but in the new environment we don't feel are safe
to provide in an ongoing basis perfect thanks now another a series of questions
that I think are of great interest to the public in our community and first
let me say thank you so much to the community that lives around the
Michael Guerin Hospital we have appreciated that banging of the
pots and pans in the evening the mask sewing campaign has been phenomenal at
last count we had 17,000 masks that have been sewn and dropped off that we use on
a daily basis and the PPE he drive esra Mendeley and being prepared so we're
happy to get this back to you which is answers the questions my first question
is dr. palace should I get tested for code 19 so first thing I think is
important for people that appreciate us what are the symptoms of code 19 and the
virus and the infection present very much in the same way influenza or a cold
would present one of the challenges with this infection is the presentation can
be variable a difference in one group compared to another most commonly the
symptoms would include fever sore throat runny nose or stuffiness in the nose
cough particularly people who report a dry cough so not producing any phlegm
some people have gastrointestinal symptoms and a lot of people are
describing to me muscle aches and pains that you would normally get if you had
influenza with fever now in addition to the sentence one question people often
ask me as well when when should I actually go get tested there's lots of
increasing information about testing capacity in the province at present we
don't have the capacity for you to do testing in the home that might be
something we have eventually but we don't currently have that capacity in
Ontario and so we're asking people they need testing or or add the desire to be
tested to be assessed in the community Assessment Center now testing the same
as all resources it is a limited resource and so we've developed criteria
about who we should direct that limited resource towards and our focus in
testing at this times to test people who are at higher risk of complications
those people who are older with coexisting medical problems healthcare
workers who might be working at some of our community partner sites
and also individuals who are vulnerable and they live at some of those community
sites such as long-term care homes or retirement homes or other areas such as
shelters then the other question I commonly get when I talk to patients oh
when do I need to go to the hospital not so much for testing me when should I be
worried if I do have these symptoms of kovat most people can self-care at home
but the things that I always worry about are day five to fourteen of symptom
onset if people get problems with breathlessness and cough those two
things together that's when you need some assistance with hospital care
thanks for that next question is what's your advice for people living in
apartment buildings we know there's a lot in Easter Anto or in close quarters
with many family members under one roof how do we protect ourselves in those
situations yeah so me and my team we're calling all of the positive cases at MGH
and so I do get the opportunity to speak to my community and address some of
these questions and concerns and so what I've been teaching people first off is
that the way kovat is being transmitted for the most part has nothing to do with
inhaling droplets from someone else coughing or sneezing it's actually
touching a surface that's contaminated with those droplets from somebody
coughing or sneezing and then subsequently putting it up to your face
or your eyes and so when I try to teach everybody is every surface could
potentially be contaminated and that virus can be washed off your hands with
soap and water 20-second soap and water or if you have vocalized hand rub to use
that so you just need to remember every surface in a common space and they
potentially be contaminated and again it's the hand washing that's going to
keep your safe always clean hands up to your face now many people are asking me
well how long does it stay on surfaces that it can be variable based on the
type of surface but up to three days and again that's what's promoting
transmission in the community so if you do touch an elevator button for example
is your in your building you know just make sure that that hand now let's touch
something that other people have touched and as a result of that it needs to be
cleaned before you come up to your face eat something
your eye or rub your nose um a lot of people are concerned about the virus
being transmitted through the air and what I want to really sure reassure
people is that it's not being transmitted through the air in the
community in medical situations we do specific maneuvers to people there's a
chance it can be transmitted through the air but again this is being transmitted
through touch and so it's really that hand hygiene the cleaning of your hands
the considering of surfaces of being contaminated that is paramount to keep
yourself safe when you are outside of your own living space but what should I
do if someone in my house test positive for kovat and they're living with me how
do I protect myself from my children or my parents from them yeah to be honest
that's one of the other reasons why I'm calling everyone or my team is calling
everyone is because I you know everybody I speak to you if I can educate them
about how to prevent transmission to someone else in their home that's doing
good for a public and doing good for that individual and again when I talk to
people that's often one of the biggest concerns and I have noticed that many of
our community there are multi-generational families so there are
maybe older people in the home as well so generally what I'd recommend is that
if an individual is sick that they tried to self isolate as best as feasible
sometimes that's a challenge if the space isn't large enough and there's a
group of people living within a smaller space try to kind of separate yourself
from the rest of your family as much as possible again the rule of thumb is
within six feet so you should try to separate yourself within six feet um if
you have a mask you could wear the mask if you have a paper mask that's fine but
but a cloth mask it would be more than adequate and if you don't have a cloth
mask just something over your face like a scarf to prevent any coughing or
droplets from coughing to enter out into the environment the next thing I would
say is that those particularly vulnerable populations particularly
people have immune system problems or coexist in medical problems or older
that they need to be especially separated the other advice I give and
again this is something that I think needs to be amplified is that I usually
assign someone in the home who's healthy and
not sick to clean all those common touch surfaces
twice a day with something that kills the virus this virus isn't hard to kill
it's just the actual physical elbow grease required to take it off common
touch surfaces so envision yourself walking through your apartment and
anything you touch and any horizontal surface should be wiped down twice a day
if you don't have any license or antiviral wipes you can use bleach and
water you can use vinegar in water or even just soap and water a lot of
quickly remove the virus from those common touch surfaces and again I would
recommend doing that twice a day people have asked me about their their pets and
at this time we don't think Hobart is being transmitted from pets to humans
and so I don't think that's a big big concern and I think people should focus
more so on that physical distancing and cleaning the environment as I directed
I've talked about hands again every surface is potentially contaminated
never bring your hands to your face or your eyes without cleaning them
before doing so wash your hands and clean a lot that's what I've learned
from you and don't touch my face hard to do yeah what should I expect if I need
to bring my loved one to the hospital for care related to Cove in 19 what's
happening yeah so the thing I want to reassure the community is that you know
our teams have worked tirelessly to make sure that we can continue to provide you
the high-quality care that you come to expect from from Michael Guerin
there are cover changes in the way he may see care delivered probably one of
the things you'll notice is that we have put some restrictions on movement
throughout the hospital particularly in relationship to visitors visitors all
coming in through the coxal entrance and are screened by individuals to ensure
that they're not having symptoms we are restricting the number of visitors that
can come to see patients and we're doing that for the safety of the patients
themselves the other patients not the one being visited but also the staff to
ensure that we reduce the probability of CO vyd 19 being brought into the
healthcare institution because we are privileged to care for so many people
who are vulnerable and again the message I'd like to give to people is that you
know we're doing this because we want to keep your loved ones safe and I know
it's a challenging time and you want to be be with people when they're sick
we're trying to supplement connections by using virtual means to stay connected
as best we can but I want everyone to appreciate we're doing this because we
want to keep your loved ones healthy and safe the other thing I would reiterate
is that if you've been in contact with covitz
let's say your loved one is in hospital with Co but you yourself are contact if
you live in the same household and and we need to adhere to those
self-isolation requirements that Public Health is enforcing to ensure that we
don't then go out and spread it in the communities so if you are feeling sick
please try and connect with your with your loved one through virtual means and
please don't come to the hospital if you yourselfer suffer many symptoms of cope
with nineteen thanks so finally and it's a topic of great discussion lately is
when should I as a member of the public wear a mask and what kind of mask should
I wear sure so I you know I'd echo your comments at the start of this era is
that this has been a really hard time for everyone in health care and seeing
our community respond the way it did and produce masks when we ask them to you is
what keeps me going and the masks that that have asked you the community to
produce have been cloth masks and you'll notice that that is now being something
being recommended by but most North American governments that the community
should be masking whenever they're out in the community within six feet of each
other now ideally I'd like to save the medical grade masks for the medical
providers and the masks for the community in my mind the cloth masks are
adequate it's a few things people need to know about the mask and again it's
the same education I'm providing my own health care staff but when you have a
mask on you put it on and you you should try not to fuss with it that much once
you put it on leave it on and then take it off reach behind your ears pull it
off that way and then once it's then you need to clean it before you're
wearing it over and over again and again laundering it in regular soap and water
is is safe and will kill the virus many people ask me about gloves the great
thing is that we're covered in this amazing thing called skin which which
the virus can't penetrate you essentially have the most amazing glove
on your hand all the time which is skin and if you sanitize the hands and again
I know you're gonna get annoyed with me for saying this over and over again but
clean hands can't transmit virus we need to remember that's the best way to keep
yourself safe in the community so thank you very much dr. powers for
all that you're doing to keep our hospitals and our patients safe and also
our community safe by doing these kinds of public education sessions we really
appreciate it and thank you to our amazing community
for all that you're doing to support us through this difficult time we plead
with you to remember to practice physical distancing diligent
hand-washing you've heard dr. pol say why that's so important
limit your time outdoors in public spaces to essential visits only like
trips to the grocery store in the pharmacy we really hope that these kinds
of public health measures well made such that the burden of Cova 19 will not
overwhelm our health care system and we still have a number of weeks of this
kind of prudence that's that's absolutely necessary to keep us all safe
and minimize the impact that this virus can have and with that thank you
everyone stay safe and keep washing your hands have a good day