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Friday, June 14, 2024
Dr. Brown: Long-term care and Romeo

Dr. William Brown is a professor of neurology at McMaster University and co-founder of the Infohealth series held at the Niagara-on-the-Lake Public Library.  

Dr. William Brown
Special to The Lake Report

One of the toughest challenges we face with social distancing and face masks is that we can’t wrap our arms about those we care about when they’re lonely or otherwise in need.

I face that twice a week with my wife, at the long-term care facility where she lives these days. In warm clear days we practise our version of Romeo and Juliet: I outside the chain-link fence and she on the garden side – six feet from one another – and talk.

I must admit it’s really difficult some days because she doesn’t understand why we can’t come closer, hold hands and hug one another. That’s hard for her and hard for me. 

But however challenging the circumstances, the reasons for strict control are obvious. Long-term care facilities have had a terrible time with COVID-19. 

Infections and deaths, especially in Ontario and Quebec and every country struck by the virus, far exceed those in the rest of the population for several reasons.

Social distancing is all but impossible in the boxed-in space of most long-term care facilities, many of the residents are frail and the possibility of contact with this highly transmissible virus, whether by droplet, spray, aerosol or contact, is much higher, if only because so many staff come and go regularly. 

That last reason is why long-term care homes clamped down by regularly testing staff and anyone who might directly or indirectly carry the virus into the facility. Point-of-entry surveillance is so important because once in, the virus spreads quickly, overwhelming staff and other residents. 

Compared to other countries, Canada fared well after faltering early, chiefly related to those long-term care facilities. Since then, through far stricter controls and a combination of social distancing, wearing masks and good old-fashioned Canadian common sense about avoiding groups outside one’s “bubble” of family and close friends, Canada has done comparatively well. 

But we’re not off the hook. Countries like Australia and New Zealand had exemplary records, especially the latter. Even so, both experienced spikes related to careless close-contact social groups and sometimes, wilful behaviour on the part of individuals.

Some of the latter included persons who knew they were positive for the virus but went ahead anyway with their travel plans and joining social groups. The result in some instances was a spreading chain of infections – all of which was preventable with common sense and a sense of responsibility toward the welfare of others.

This pandemic will be with us until effective vaccines become widely available, likely sometime in the first quarter of 2021. Until then we can’t count on the “herd effect” because 90 percent or more of the population has no acquired natural immunity to the virus as yet.

That means social distancing, wearing masks and practising common sense when it comes to group events will be necessary for several months to come. That’s not good news. The alternative we’ve witnessed south of the border is far worse.

Let’s hope that effective vaccines become available earlier. And in the meantime we all miss closer contact with those we love. That’s tough. 


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