VANCOUVER — When the first COVID-19 cases trickled into Canada, little was known about the novel coronavirus. Almost one year later, experts have made major strides in cracking the virus's code and understanding its behaviour. Dr. Srinivas Murthy, who works in the intensive care unit at B.C. Children's Hospital in Vancouver, reviews some of the lessons learned.
1. It can spread through air. "I still remember the original conversations in January when we weren't really sure if it was sustained human-to-human transmission based on the first few cases in Wuhan," Murthy said. Since then, scientists have learned the virus can spread not only through droplets but also by air — important information for public health policy makers. Aerosol transmission means it may not be enough for two people to maintain a certain distance in the same room. It's important to ventilate the room, or avoid being in the same room entirely. "It's a combination of the two that's driving the pandemic."
2. Our health system has weak spots. "A pandemic stresses our health system and our population at its weak points, and we need to shore up those weak points," Murthy said. The COVID-19 pandemic has shown that some communities have less access to health care or are harder to reach through public health messaging. It has disproportionately affected vulnerable communities, including those living in long-term care facilities, Murthy said. While those groups may have baseline risks because of their co-morbidities, health outcomes could be improved, for example, through targeted messaging for particular cultural groups, Murthy said.
3. Children have better outcomes. Although there is some debate about the role children have played as spreaders of the novel coronavirus, a "saving grace" in the pandemic has been that they tend to have better outcomes when infected than adults. "If children were affected at a rate of severe disease that we're seeing with adults and the elderly, this would be a very different last 12 months," Murthy said.
4. The power of prevention. At the outset of the pandemic, much attention was paid to critical care capacity, like available beds and ventilators. As an ICU doctor himself, Murthy said he's glad that stage of care has been highlighted, however, it would be more effective to shift the focus onto prevention rather than treatment. That means focusing resources on measure that reduce the risk of transmission, contact tracing and vaccine development. "The overall goal in a pandemic should not be to rely on your intensive care unit to save you. Your goal in a pandemic should be not getting the disease," Murthy said. "We should be seen as the last line of defence."
5. There's a vaccine. "You can always generate a vaccine for anything but whether or not it's effective is the major question," Murthy said. Successful trials and the rollout of vaccines in Canada and across the world means there's light at the end of the tunnel. "That obviously is our pathway out of this. That's very cool, obviously, and the science and everything that led to where we are right now is awesome and cool to see happen."
This report by The Canadian Press was first published Dec. 21, 2020.
Amy Smart, The Canadian Press
