Your Decision: Relax at a busy park or let people work?
Vipan Nikore, MD, MBA
23 May 2020
I heard about the gathering at Trinity Bellwoods Park in Toronto today so I drove by, threw on a mask, and took this picture. Do you know how difficult it is to help design a plan to bring almost 100,000 employees back to work knowing our parks are packed like this just days after the slightest restrictions are lifted?
Between my clinical and leadership roles I've worked every day in 2020 since January 1st when I was on call at the hospital, 144 days straight, to do my best to fight COVID-19 – the biggest pandemic we have faced that has infected over 5 million people and killed almost 350,0000 people in less than 5 months. Many of my colleagues have done the same. We do this because we understand the seriousness of this disease and it is our responsibility to use our training to combat this. When we see people do their small part by distancing and using basic hygiene it is encouraging and makes the work feel that much more gratifying, but admittedly it's disheartening and discouraging to see what I saw today. I've seen many patients die alone from COVID-19 at one the highest volume COVID-19 hospitals in Canada, have quarantined thousands of employees, have sent heroic nurses and personal support workers into long term care homes through my company Homecare Hub, and have seen so many people lose their livelihoods without work. People are struggling and many of us are working hard to design a plan to bring people back to work safely. Yet too many people are ignoring the facts and still believe they are invincible and can defy the laws of science.
I do believe there is a way to bring people back to work safely. But we can only do so if people are compliant with basic behavioral rules, and understand that a small short term sacrifice will allow us to create safe plans so hard working people can get back to work. We want to start opening up our economy so people can get to work to feed their family, can get some fresh air and be outside, and have some level of normalcy - it is not so people can pack together densely like sardines as if we were not in the middle of a global pandemic that saw 106,000 people worldwide infected in a single day just 3 days ago (the highest number yet). When children begin to follow their parents rules, it allows parents to trust them with more responsibility. Similarly, when populations demonstrate compliance to basic rules, health authorities can develop trust to open up economies mindfully.
I’m one of the most social animals out there, I love the great weather and understand the need to interact more than anyone, but please have some self-discipline, use common sense, and do not ignore science. Yes it can be hard to socially distance, but what’s harder is losing someone you love. For those who believe their risk is low and that this is just a little flu, this is far from the truth (please read my Marshmallow Article to understand more about this virus). One of the best days in the hospital this year was when I discharged a 34 year old with ZERO medical conditions who was intubated on a breathing machine for two weeks, holding on to his life by a thread. He made it and is doing well, but not everyone in his shoes is so lucky. I’ve sent people home who are improving and look great, to have the disease come roaring back 48 hours later and end up on a ventilator. This is far from Ebola, but this is not just a little flu. Most of us doctors have been saying this, and we have no incentive to make this up and lie about such stories. And of course think about our seniors and those with chronic disease who are at high risk if they do get COVID-19. Unfortunately, contrary to what some people suggest, in our world there is no full proof way to create some magical wall between this virus and those who have chronic disease or elders. People don’t have to be scared to go out, but please wash your hands, stay in when sick, physical distance, don’t form large groups, and if there are too many people in an area, just go somewhere else. We need to decrease the number of cases and transmission between people. Every little bit counts. I’m simply asking everyone to follow the rules of public health and science.
I know it’s hard to conceptualize the dangers of something that you can’t see or feel. I am an internal medicine physician. I treat acute illnesses as well as chronic diseases such as hypertension (high blood pressure) and diabetes. These are some of the biggest killers and the reason they are is because people don’t “feel” them. A patient can sit with an elevated blood pressure of 165/95 and an elevated blood glucose for years but feel and see absolutely nothing. Suddenly without intervention the patient has lost kidney function and is on dialysis, has three heart vessels blocked, and an amputated leg. I see this almost every time I go into the hospital, and its saddening because these are usually completely preventable. Much of what I do is education to prevent these people from the long term consequences. COVID-19 presents a similar challenge, you can’t see or feel the disease so it’s so hard to understand the power of it – just like diabetes and hypertension.
I know the packing into the park was not a reflection of the majority of people in my great city, but rather a small minority. However, we need everyone in this together. We cannot stay in lockdown for over a year until a vaccine, and we will need to take some chances that will inherently increase our population risk. But let the risks that we take be controlled risks to get people to work and be healthy when the time is right (based on various factors related to case counts, testing, etc, a topic for another article), not risks like packing together to suntan on a beach or in a park.
Tomorrow is a new day. We will do better tomorrow everybody. Let’s stick together (figuratively, not literally) and fight this battle together.
Vipan Nikore, MD, MBA is the CEO and Cofounder of Homecare Hub, the Chief Medical Director of TD Bank, an internal medicine physician at the Cleveland Clinic and Trillium Health Partners, and an Assistant Professor at the University of Toronto Faculty of Medicine. His posts are personal views and do not necessarily reflect the opinions or positions of any organization he is affiliated with.