From: Justin Maloney 
E.R. Doctor in Ottawa

I’m struck by how advisories about distancing and staying 2 metres from others don’t seem to be sticking to “us”. Experience elsewhere says we are on the front edge of a killing spree that will last a month or more. People will get this virus and some will die. Usually, that will be us. Different stats show us that anyone over 60 is at great risk from COVID 19. Kids do OK but carry the virus to spread it. Seniors die, despite best care, in 10-25% of cases. I didn’t make this shit up. Its real. It seems surreal to consider myself as a senior, that “at risk” person.

COVID 19 says stay at home, don’t invite family or friends for anything. Stay away from everyone. Ok, maybe not your main squeeze that wakes up beside you each day but anyone else. Don’t invite your son or daughter over. Don’t visit an elderly relative. Don’t go to a bar. Don’t share a cigarette, or a joint. Have a bathroom glass for each of you. Wipe all your surfaces (counters, taps, door knobs, remotes, cell phones, etc.) down with something like Lysol. Be frantic about it. Wash hands before meals and after.

You may feel you have your health now. When you don’t, when you have a cough or fever, pay attention to what I said above. Find a separate bedroom, bedding and bathroom. Your own clothes get hot water washed. Wait for it all to subside.

If you really have it you will know at day 7 – 10. That is when it gets awful. Keep a medical record or file nearby to help the poor ER doc figure out your past history. Have a will made out now and identify a POA before sudden things happen. If you get sick, think about how you or the POA would answer the “Goals of Care” questions that doctors will ask. (CPR?, ICU?, Ventilators?) We have no treatment for this killer other than social distancing and maintaining your best basic health..

We are only in the early stages of this. We see a few thousand cases this week but like other jurisdictions, we can expect perhaps a hundred thousand in coming weeks.

In Italy, without early social distancing, COVID 19 has exploded. Rationing has started. No one over 60 will be helped, not in hospital, no ICU/ventilator care. You may think of Italy as less capable and more resource challenged than us. Not at all. They have lots of beds/doctors etc. But they have lots of old people, just like you … OK, and me too.
Have virtual celebrations from your own place with others by video conferencing. All of our doctor/hospital meetings are via SKYPE, FaceTime or DUO etc. and now WhatsApp.

The thing is, despite a flood of public education, a lot of us still don’t see the risk of contracting COVID 19 as applying to us, us seniors that is. Get over it. You may die if you get this flu. Kids coming to visit will bring it into your space and leave it with you, even if they are not sick. Perhaps pets too by the way.

Some of you have returned from travel and are counting the days until quarantine is done and you can get on with your life. The problem is “your life” isn’t going to be any different than quarantine for the next while, perhaps months. Stay home. A birthday celebration should be about making sure there are future birthdays to celebrate.

At work this week I was involved with 6 COVID 19 suspects just in the areas we have for minor cases. The patient anxiety was high and it should have been. Don’t be a COVIDIOT! There was a lot to correct in their social patterns in the previous few days.

Need toilet paper? Just kidding. But really, there are some things you might need. Groceries, pharmacy, etc. but as this becomes even more alarming shopping online with delivery may make sense. Go out for walks but not for greetings and gatherings.

Take me seriously here. No invites for anything. Stay away!, Close your doors … drink if ya like, toast whatever, but use WhatsApp video to do it, I want food and Mount Gay rum and coke this summer, not some funeral with COVDID 19 egg salad sandwiches.

And perhaps don’t just stay away from each other, even your family and close friends, until it’s OK. Become champions for this message. You are with few exceptions (ahem !!) smart, respected voices who as seniors need to wake up others in the senior’s community.

Sincerely me, worried about you,
Justin Maloney, MD, FCFP, CCFP(EM), FRCP(C)
Associate Professor, Department of Emergency Medicine, University of Ottawa
Emergency Physician, The Ottawa Hospital
Medical Director Emeritus, Regional Paramedic Program For Eastern Ontario
The Ottawa Hospital, Ottawa, Ontario
 L